BILL NUMBER: SB 1285 CHAPTERED 08/23/06 CHAPTER 153 FILED WITH SECRETARY OF STATE AUGUST 23, 2006 APPROVED BY GOVERNOR AUGUST 23, 2006 PASSED THE ASSEMBLY AUGUST 10, 2006 PASSED THE SENATE APRIL 27, 2006 AMENDED IN SENATE APRIL 17, 2006 AMENDED IN SENATE MARCH 20, 2006 INTRODUCED BY Senator Aanestad (Coauthor: Assembly Member Nakanishi) FEBRUARY 14, 2006 An act to amend Section 2530.2 of the Business and Professions Code, relating to speech-language pathology. LEGISLATIVE COUNSEL'S DIGEST SB 1285, Aanestad Speech-language pathology. Existing law, the Speech-Language Pathologists and Audiologists Licensure Act, licenses and regulates the practices of speech-language pathology and audiology by the Speech-Language Pathology and Audiology Board in the Department of Consumer Affairs. Existing law defines the practice of speech-language pathology for purposes of the act. This bill would include in that definition the performance of suctioning in connection with a speech-language pathologist's scope of practice, after compliance with a medical facility's training protocols. Existing law authorizes a speech-language pathologist to perform flexible endoscopic procedures, as specified, only in an acute care setting that has protocols for emergency medical backup procedures, as specified. This bill would instead authorize a speech-language pathologist to perform those procedures in any facility that has these protocols. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 2530.2 of the Business and Professions Code is amended to read: 2530.2. As used in this chapter, unless the context otherwise requires: (a) "Board" means the Speech-Language Pathology and Audiology Board or any successor. (b) "Person" means any individual, partnership, corporation, limited liability company, or other organization or combination thereof, except that only individuals can be licensed under this chapter. (c) A "speech-language pathologist" is a person who practices speech-language pathology. (d) The practice of speech-language pathology means all of the following: (1) The application of principles, methods, instrumental procedures, and noninstrumental procedures for measurement, testing, screening, evaluation, identification, prediction, and counseling related to the development and disorders of speech, voice, language, or swallowing. (2) The application of principles and methods for preventing, planning, directing, conducting, and supervising programs for habilitating, rehabilitating, ameliorating, managing, or modifying disorders of speech, voice, language, or swallowing in individuals or groups of individuals. (3) Conducting hearing screenings. (4) Performing suctioning in connection with the scope of practice described in paragraphs (1) and (2), after compliance with a medical facility's training protocols on suctioning procedures. (e) (1) Instrumental procedures referred to in subdivision (d) are the use of rigid and flexible endoscopes to observe the pharyngeal and laryngeal areas of the throat in order to observe, collect data, and measure the parameters of communication and swallowing as well as to guide communication and swallowing assessment and therapy. (2) Nothing in this subdivision shall be construed as a diagnosis. Any observation of an abnormality shall be referred to a physician and surgeon. (f) A licensed speech-language pathologist shall not perform a flexible fiberoptic nasendoscopic procedure unless he or she has received written verification from an otolaryngologist certified by the American Board of Otolaryngology that the speech-language pathologist has performed a minimum of 25 flexible fiberoptic nasendoscopic procedures and is competent to perform these procedures. The speech-language pathologist shall have this written verification on file and readily available for inspection upon request by the board. A speech-language pathologist shall pass a flexible fiberoptic nasendoscopic instrument only under the direct authorization of an otolaryngologist certified by the American Board of Otolaryngology and the supervision of a physician and surgeon. (g) A licensed speech-language pathologist shall only perform flexible endoscopic procedures described in subdivision (e) in a setting that requires the facility to have protocols for emergency medical backup procedures, including a physician and surgeon or other appropriate medical professionals being readily available. (h) "Speech-language pathology aide" means any person meeting the minimum requirements established by the board, who works directly under the supervision of a speech-language pathologist. (i) (1) "Speech-language pathology assistant" means a person who meets the academic and supervised training requirements set forth by the board and who is approved by the board to assist in the provision of speech-language pathology under the direction and supervision of a speech-language pathologist who shall be responsible for the extent, kind, and quality of the services provided by the speech-language pathology assistant. (2) The supervising speech-language pathologist employed or contracted for by a public school may hold a valid and current license issued by the board, a valid, current, and professional clear clinical or rehabilitative services credential in language, speech, and hearing issued by the Commission on Teacher Credentialing, or other credential authorizing service in language, speech, and hearing issued by the Commission on Teacher Credentialing that is not issued on the basis of an emergency permit or waiver of requirements. For purposes of this paragraph, a "clear" credential is a credential that is not issued pursuant to a waiver or emergency permit and is as otherwise defined by the Commission on Teacher Credentialing. Nothing in this section referring to credentialed supervising speech-language pathologists expands existing exemptions from licensing pursuant to Section 2530.5. (j) An "audiologist" is one who practices audiology. (k) "The practice of audiology" means the application of principles, methods, and procedures of measurement, testing, appraisal, prediction, consultation, counseling, instruction related to auditory, vestibular, and related functions and the modification of communicative disorders involving speech, language, auditory behavior or other aberrant behavior resulting from auditory dysfunction; and the planning, directing, conducting, supervising, or participating in programs of identification of auditory disorders, hearing conservation, cerumen removal, aural habilitation, and rehabilitation, including, hearing aid recommendation and evaluation procedures including, but not limited to, specifying amplification requirements and evaluation of the results thereof, auditory training, and speech reading. (l) "Audiology aide" means any person, meeting the minimum requirements established by the board, who works directly under the supervision of an audiologist. (m) "Medical board" means the Medical Board of California or a division of the board. (n) A "hearing screening" performed by a speech-language pathologist means a binary puretone screening at a preset intensity level for the purpose of determining if the screened individuals are in need of further medical or audiological evaluation. (o) "Cerumen removal" means the nonroutine removal of cerumen within the cartilaginous ear canal necessary for access in performance of audiological procedures that shall occur under physician and surgeon supervision. Cerumen removal, as provided by this section, shall only be performed by a licensed audiologist. Physician and surgeon supervision shall not be construed to require the physical presence of the physician, but shall include all of the following: (1) Collaboration on the development of written standardized protocols. The protocols shall include a requirement that the supervised audiologist immediately refer to an appropriate physician any trauma, including skin tears, bleeding, or other pathology of the ear discovered in the process of cerumen removal as defined in this subdivision. (2) Approval by the supervising physician of the written standardized protocol. (3) The supervising physician shall be within the general vicinity, as provided by the physician-audiologist protocol, of the supervised audiologist and available by telephone contact at the time of cerumen removal. (4) A licensed physician and surgeon may not simultaneously supervise more than two audiologists for purposes of cerumen removal.