Governor Approves Regulatory Suspensions to Facilitate Services to Speech-Language Pathologist and Audiologist Clients During the COVID-19 Pandemic

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Governor Approves Regulatory Suspensions to Facilitate Services to Speech-Language Pathologist and Audiologist Clients During the COVID-19 Pandemic

To help combat the spread of Coronavirus, TDLR requested and received authority from Governor Greg Abbott to suspend certain regulatory requirements, to the extent necessary, to allow licensees of the Speech-Language Pathologist and Audiologist program to provide more services to clients through telehealth and to ease other licensing restrictions.

These suspensions are in effect until terminated by the Office of the Governor or until the March 13, 2020 disaster declaration is lifted or expires. In accordance with Section 418.016 of the Texas Government Code, the Office of the Governor has granted TDLR’s request to suspend the following provisions:

Supervision:

Speech-Language Pathology (SLP) interns may now receive direct supervision through telehealth. The SLP internship is at least 36 weeks and 1,260 hours, divided into three (3) segments with no fewer than thirty-six (36) clock hours of supervisory activities to include:

  • six (6) hours of direct supervision per segment by the supervisor(s) of the intern's client contact in which the intern provides screening, evaluation, assessment, habilitation, and rehabilitation; and
  • six (6) hours of indirect supervision per segment with the supervisor(s) which may include correspondence, review of videos, evaluation of written reports, phone conferences with the intern, and evaluations by professional colleagues.

As a result of the suspension, all supervision hours—both direct and indirect—may be conducted through telehealth (suspension of 16 TAC §111.2(15), (23), and (25) and §111.213(c)).

Under a previous suspension granted by the Governor, SLP assistants may receive 100 percent of their monthly supervision through telehealth. Supervisors must provide a minimum of four hours of direct supervision each month and four hours of indirect supervision each month. Supervisors may use telehealth for both direct and indirect supervision (suspension of 16 TAC §111.51(g)(1) and (4); §111.2(14), (23), and (24); and §111.213(b)(1) and (2)).

Audiology assistants may now be supervised for all assigned tasks through telehealth (suspension of 16 TAC §111.2(14), (23), and (24); §111.91(f) and §111.216(b)).

Audiology interns are allowed to be supervised for all assigned tasks through telehealth (no suspension of the rules was required).

Practice:

For all licensees approved to provide telehealth services:

  • A smart phone, or any audio-visual, real-time, or two-way interactive communication system, qualifies as telecommunications technology and may now be used to provide telehealth services, as well as telehealth services related to fitting and dispensing hearing instruments (suspension of 16 TAC §§111.210(7)-(12), §111.213(d), §111.216(c), §§111.231(9)-(12) and §§111.232(b), (d) and (i)).
  • The same code of ethics and professional standards apply whether a client is seen via telehealth or an in-person visit as required under 16 TAC §111.212 and §111.215.

SLP interns:

  • SLP interns may now provide services to clients remotely using telehealth (suspension of 16 TAC §111.210(5)).

SLP Assistants:

  • SLP assistants may now provide services through telehealth, as directed by their supervisor, according to the SLP assistant practice and duties under 16 TAC §111.52 (suspension of §111.210(5)).

Audiologists and Audiology Interns:

  • Audiologists and audiology interns who fit and dispense hearing instruments through telehealth are no longer required to conduct an initial professional contact in person at the same physical location (suspension of 16 TAC §111.232(j)).

Services provided through telehealth must be performed with the same standard of care as in-person health care and within the licensee’s scope of practice and competence. The equipment used must be appropriate for the situation and properly working as required under 16 TAC §111.232(h) and (i).

Facilitators:

If a facilitator assists with the provision of telehealth services, no prior training is necessary if the provider determines that the facilitator has the competence needed to assist with the services given (suspension of 16 TAC §111.232(e) and (f)(1)).

Licensees who need additional information on billing policies relating to the provision of telehealth services during the COVID-19 pandemic should contact Texas Health and Human Services Medicaid or managed care organizations (MCOs), as policies are changing rapidly. It is critical to check with your payor before initiating a new type of service or service delivery model, such as telehealth.

Before providing telehealth services, licensees should verify the applicability of other requirements and obligations, such as HIPAA and other medical and personal privacy requirements.


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