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DEPARTMENT OF HEALTH
NOTICE OF PROPOSED RULEMAKING
The Director of the Department of Health, pursuant to the authority set forth in section 302(14) of the District of Columbia Health Occupations Revision Act of 1985 (Act), effective March 15, 1986 (D.C. Law 6-99; D.C. Official Code § 3-1203.02(14)), and Mayor’s Order 98-140, dated August 20, 1998, hereby gives notice of his intent to adopt the following amendments to Title 17, “Business, Occupations, and Professions,” of the District of Columbia Municipal Regulations (DCMR) in not less than thirty (30) days after the date of publication of this notice in the D.C. Register.
This rulemaking will establish licensure regulations for the profession of audiology, in conformity with the Audiology and Speech-Language Pathology Amendment Act of 2006, effective March 4, 2007 (D.C. Law 16-219; D.C. Official Code § 3-1202.18). That act requires licensure of audiologists and speech-language pathologists by the Board of Audiology and Speech-Language Pathology.
This notice of proposed rulemaking supersedes the notice of proposed rulemaking that was published in the D.C. Register on July 10, 2009, at 56 DCR 5600.
Title 17,”Business, Occupations, and Professions,” of the DCMR is amended by adding a new Chapter 78 to read as follows:
CHAPTER 78 AUDIOLOGY
7800 GENERAL PROVISIONS
7801 TERM OF LICENSE
7802 LICENSURE REQUIREMENTS
7803 SUPERVISED EXPERIENCE REQUIREMENTS
7804 WAIVER OF SUPERVISED EXPERIENCE REQUIREMENTS
7805 APPLICANTS EDUCATED IN FOREIGN COUNTRIES
7806 LICENSURE BY EXAMINATION
7807 LICENSURE BY ENDORSEMENT
7808 RESERVED
7809 RESERVED
7810 RESERVED
7811 PRACTICE OF AUDIOLOGY BY STUDENTS AND GRADUATES
7812 STANDARDS OF CONDUCT
7899 DEFINITIONS
7800 GENERAL PROVISIONS
7800.1 This chapter shall apply to applicants for and holders of a license to practice audiology.
7800.2 Chapters 40 (Health Occupations: General Rules) and 41 (Health Occupations: Administrative Procedures) of this title shall supplement this chapter.
7801 TERM OF LICENSE
7801.1 Subject to subsection 7801.2, a license issued pursuant to this chapter shall expire at midnight on December 31 of each even-numbered year.
7801.2 The Director may change the renewal system and the expiration dates of licenses issued pursuant to this chapter pursuant to subsection 4006.3.
7802 LICENSURE REQUIREMENTS
7802.1 Except as otherwise provided in this chapter, an applicant for a license to practice audiology shall furnish proof satisfactory to the Board that the applicant:
(a) Graduated with a Master’s degree or a Doctoral degree (Ph.D. or Au.D.) in audiology from a recognized educational institution whose audiology program is accredited by the Council on Academic Accreditation in Audiology and Speech Language Pathology, an accrediting body recognized by the United States Department of Education, or an equivalent accrediting body as determined by the Board;
(b) Passed a qualifying examination that meets the requirements set forth in section 7806; and
(c) Completed a period of supervised experience that meets the requirements set forth in section 7803.
7803 SUPERVISED EXPERIENCE REQUIREMENTS
7803.1 In order to satisfy the supervised experience requirement of subsection 7802.1(c) a person must meet one (1) of the following standards:
(a) The person shall have completed the equivalent of a clinical fellowship with a minimum of one thousand eight hundred twenty (1,820) hours of clinical practice under general supervision while a candidate for an Au.D. degree; or
(b) The person shall have graduated with a Master’s degree or Ph.D.
degree meeting the requirements set forth in subsection 7802.1(a)
before the start of the supervised experience; and
(c) The person shall have commenced a clinical fellowship, meeting the time period/works hours and supervised activities standards set forth in subsections 7803.2 and 7803.3, within two (2) years after the date of conferral of the Master’s or Ph.D. degree and shall have completed the clinical fellowship within three and a half (3½) years after the date of the conferral of the degree; provided, the Board may extend the period required for completion of the clinical fellowship for good cause shown.
7803.2 To meet the clinical fellowship time period and work hours requirement referenced in subsection 7803.1(b)(2), the applicant shall be employed, with or without direct compensation, as a professional in the field of audiology under general supervision for any of the following time periods and hours:
(a) Thirty (30) hours of work per week for a period of nine (9) months;
(b) Twenty-five (25) to twenty-nine (29) hours of work per week for a period of twelve (12) months;
(c) Twenty (20) to twenty-four (24) hours of work per week for a period of fifteen (15) months; or
(d) Fifteen (15) to nineteen (19) hours of work per week for a period of eighteen (18) months.
7803.3 To meet the clinical fellowship supervised activities requirement referenced in subsection 7803.1(b)(2):
(a) At least eighty percent (80%) of the supervisee’s supervised experience shall be in direct client contact, which includes the following:
(1) Assessment, diagnosis, evaluation, and treatment;
(2) Screening;
(3) Habilitation and rehabilitation; and
(4) Activities related to case management.
(b) The remaining percentage of the supervisee’s supervised experience shall be comprised of supervised activities such as writing, research, or planning.
(c) The activities during the supervised experience shall consist of the following:
(1) Conducting evaluations and treatment procedures;
(2) Interpreting test results;
(3) Determining case selections;
(4) Designing treatment programs;
(5) Collecting data and documenting performance;
(6) Maintaining clinical records;
(7) Providing written or oral reports (progress notes, diagnostic reports) regarding patients’ or clients’ statuses;
(8) Making referrals; and
(9) Participating in case conferences.
7803.4 An individual serving as a supervisor for the supervised experience requirement shall:
(a) Hold either a District of Columbia license in audiology, a license issued by another jurisdiction with requirements substantially similar to the licensure requirements in the District, or, for states that do not require licensure, a Certificate of Clinical Competence from the American Speech-Language Hearing Association in audiology or a board certification from the American Board of Audiology;
(b) Have been in practice for a minimum of two (2) years after his or her licensure or certification;
(c) Not supervise more than three (3) individuals at one (1) time;
(d) Not have been disciplined by a board within the previous five (5) years; and
(e) Provide a minimum of thirty-six (36) hours of supervisory activities during the supervised experience, including a minimum of two (2) hours of monitoring activities each month.
7803.5 An individual serving as a supervisor in the District shall be legally responsible for services provided by the supervisee.
7803.6 An applicant shall demonstrate that he or she has met the requirements of subsections 7803.2-7803.3 by submitting with his or her application a signed statement from each supervisor who supervised the applicant during the required period of experience. Each statement shall set forth the following:
(a) The number of hours per week of the applicant’s practice of audiology;
(b) The number of hours of general supervision of the applicant;
(c) The specific nature of, and responsibilities included in, the applicant’s practice;
(d) A rating of the applicant’s performance;
(e) The location at which, and period(s) of time during which, the supervision took place; and
(f) The license number and jurisdiction in which the supervisor was licensed during the supervised period or proof that the supervisor has a Certificate of Clinical Competence from the American Speech-Language Hearing Association or board certification from the American Board of Audiology if the supervised experience took place in a state that does not require licensure of audiologists.
7803.7 The Board may accept successful completion of the clinical fellowship required for the American Speech-Language-Hearing Association Certificate of Clinical Competence or American Board of Audiology certification as meeting the requirements for supervised experience.
7804 WAIVER OF SUPERVISED EXPERIENCE REQUIREMENTS
7804.1 The Board may waive the supervised experience requirements for an applicant who:
(a) Provides proof that he or she has been employed in the practice of audiology for at least ten (10) of the fifteen (15) years immediately preceding the effective date of this chapter;
(b) Meets all other applicable requirements of this chapter; and
(c) Applies within six (6) months of the effective date of these regulations.
7805 APPLICANTS EDUCATED IN FOREIGN COUNTRIES
7805.1 The Board may grant a license to practice audiology to an applicant who completed an educational program in a college or university in a foreign country which was not accredited in accordance with section 7802 if the applicant:
(a) Meets all requirements of this chapter except for subsection 7802.1(a); and
(b) Demonstrates to the satisfaction of the board that the applicant’s education and training are substantially equivalent to the requirements of this chapter and the Act by submitting the documentation required by subsection 7805.2 of this section and, if applicable, by submitting to an interview pursuant to subsection 7805.3.
7805.2 An applicant under this section shall, in lieu of meeting the requirements of subsection 7802.1(a), submit one (1) of the following:
(a) Proof satisfactory to the Board that the applicant has received a Master’s degree or higher from a foreign institution which was accredited, at the time the degree was conferred, by an accrediting body recognized by the national government of the country in which the institution is located; or
(b) A certification from a private education evaluation service approved by the Board that the applicant’s foreign education is substantially equivalent to the education provided in an audiology program accredited by the Council on Academic Accreditation in Audiology and Speech Language Pathology or an accrediting body recognized by the United States Department of Education or the Board.
7805.3 The Board may interview an applicant under this section to determine whether the applicant’s education or training meets the requirements of the Act and this chapter.
7805.4 If a document required by this chapter is in a language other than English, an applicant shall arrange for its translation into English by a translation service acceptable to the Board and shall submit a translation signed by the translator attesting to its accuracy.
7806 LICENSE BY EXAMINATION
7806.1 To qualify for a license by examination, an applicant for a license to practice audiology shall submit proof of having obtained a score of at least six hundred (600) on the National Examination in Audiology (PRAXIS II: Subject Assessment in Audiology), and shall meet one (1) of the following requirements:
(a) The score was obtained within the five (5) years before the date of the application for licensure; or
(b) The score was obtained more than five (5) years before the date of the application for licensure;
(c) The applicant submits proof that he or she has practiced audiology for at least three (3) years of the five (5) years before the date of the application for licensure; and
(d) The applicant submits proof that he or she is certified by the American Speech-Language-Hearing Association or the American Board of Audiology or proof that the applicant obtained a score of at least six hundred (600) on the National Examination in Audiology.
7807 LICENSURE BY ENDORSEMENT
7807.1 The Board may issue a license by endorsement to an audiologist who has a valid, unrestricted license in good standing from another jurisdiction of the United States with standards which are, as determined by the Board, substantially equivalent to the District of Columbia standards for licensure.
7808 RESERVED
7809 RESERVED
7810 RESERVED
7811 PRACTICE OF AUDIOLOGY BY GRADUATE STUDENTS
7811.1 A graduate student in audiology may practice audiology in the District if:
(a) The practice is part of an audiology educational program; and
(b) The graduate student practices only under the direct supervision of an audiologist licensed in the District of Columbia.
7811.2 This section shall not apply to an Au.D. student who is completing his or her one thousand eight hundred twenty (1,820) hours of supervised experience.
7811.3 A graduate student practicing audiology pursuant to this section shall identify himself or herself as a graduate student practicing under supervision at all times when practicing audiology.
7811.4 An individual serving as a supervisor for a graduate student in the District:
(a) Shall hold a valid District of Columbia license in audiology: and
(b) May not have been disciplined by a board within the previous five (5) years.
7811.5 Both the supervisor and the graduate student shall sign reports with their full name and credentials.
7811.6 A student may sign only with the highest degree earned.
7811.7 The title or designation of “graduate student” shall be placed after the student’s name in the report.
7811.8 If electronic records only accept one (1) signature, the supervisor shall sign the electronic record.
7811.9 A supervisor shall not supervise more than two (2) full-time students per day in off-site placements from a university.
78l1.10 A supervisor shall be personally responsible for each patient the student evaluates and treats during the period of supervision and shall be subject to disciplinary action for any violation of the Act or this chapter by the student.
7812 STANDARDS OF CONDUCT
7812.1 A licensee or graduate student practicing audiology shall adhere to the standards set forth in either the then-current Code of Ethics of the American Speech-Language-Hearing Association or the then-current Code of Ethics for the American Academy of Audiology.
7899 DEFINITIONS
7899.1 The definitions in section 4099 of this title are incorporated by reference into and are applicable to this chapter.
7899.2 As used in this chapter, the following terms shall have the meanings ascribed:
Applicant – a person applying for a license to practice audiology under this chapter.
Au.D. – Doctor of Audiology.
Board – the Board of Audiology and Speech-Language Pathology, established by section 841 of the Audiology and Speech-Language Pathology Amendment Act of 2006, effective March 6, 2007 (D.C. Law 16-219; D.C. Official Code § 3-1208.41).
Direct supervision – supervision in which the supervisor is immediately available on the premises to the supervisee and within vocal communication of the supervisee either directly or by a communication device.
General supervision – supervision in which the supervisor is available to the supervisee, either in person or by a communications device.
Good cause – serious illness of the applicant, the death or serious illness of a member of the applicant’s immediate family, or other cause sufficient to the Board.
Ph.D. – Doctor of Philosophy in Audiology.
Practice of audiology – means the planning, directing, supervising, and conducting of habilitative or rehabilitative counseling programs for individuals or groups of individuals who have, or are suspected of having, disorders of hearing; any service in audiology, including prevention, identification, evaluation, consultation, habilitation or rehabilitation, instruction, or research; participating in hearing conservation or hearing aid and assistive listening device evaluation, selection, preparation, dispensing, and orientation; fabricating ear molds; providing auditory training and speech reading; or administering tests of vestibular function and tests for tinnitus. The practice of audiology includes speech and language screening limited to a pass-or-fail determination for the purpose of identification of individuals with disorders of communication. The practice of audiology does not include the practice of medicine or osteopathic medicine, or the performance of a task in the normal practice of medicine or osteopathic medicine by a person to whom the task is delegated by a licensed physician.
Supervised experience – the clinical fellowship year required for applicants for licensure with a Master’s degree or Ph.D. degree, or the period of supervised practice during an Au.D. program.
Supervisor – an audiologist who is qualified under subsection 7803.7 and who is providing general supervision to an individual completing the supervised experience requirements in section 7803, or an audiologist qualified under subsection 7812.9 who is providing direct supervision to a graduate student under section 7812.
Supervisee – an individual who is completing the supervised experience requirements.
All persons desiring to comment on the subject matter of this proposed rulemaking should file comments, in writing, no later than thirty (30) days after the date of publication of this notice in the D.C. Register. Comments should be sent to the Department of Health, Office of the General Counsel, 899 North Capitol Street, N.E., 4th Floor, Washington, D.C. 20002. Copies of the proposed rule may be obtained from the Department at the same address during the hours of 9:00 a.m. and 5:00 p.m., Monday through Friday, excluding holidays.
