Policy Advisory

Policy Advisory Board Policies and Guidelines (Speech-Language Pathology and Audiology)

Date: 12/06/2017
Referenced Sources: Division of Professional Licensure's Office

Table of Contents

Speech-Language Pathologist Policy for the Administration of Barium During Radiographic Procedures

Policy No. 15-002

Speech-Language Pathologist Policy for the Administration of Barium During Radiographic Procedures

Speech-language pathologists provide evaluation and treatment services including radiographic procedures to evaluate an individual’s swallowing. Such procedures may require the administration of barium to the patient. Barium has been designated a medication. Therefore, the Board issues this Policy to clarify the scope of practice for the use, administration, storage and disposal of barium by speechlanguage pathologists. 

The Board interprets G.L. c. 112, §138 to allow licensed speech-language pathologists who are properly trained to administer barium when necessary for radiographic procedures and evaluations, under the general supervision of a physician, provided that there are protocols in place for emergency response. 

The following guidance has been adopted by the Board for speech-language pathologists when administering barium:

1. Before implementing the use of barium in his or her practice, the speech-language pathologist must review all available clinical information about the use, storage, administration and disposal of barium, as well as management of adverse reactions and follow-up care. This may include but is not limited to any relevant standards or studies issued by the American Speech-LanguageHearing Association (“ASHA”), and facility policies that govern all aspects of the use of barium. 

2. The speech-language pathologist must have an on-going relationship with a physician for referral and communication purposes.

3. The speech-language pathologist must comply with facility policies regarding the use, administration, storage and disposal of barium, which may include directives from the radiology and pharmacy departments.

4. The speech-language pathologist shall follow facility policy and procedure for the performance of radiographic studies, and shall not perform any functions assigned by the facility to another licensed medical professional, including but not limited to the operation of any radiographic equipment.

5. When participating in radiographic swallowing studies, the speech-language pathologist must have access to an appropriate medical professional with appropriate emergency response protocols in place to respond to an adverse reaction.

Policy on Speech-Language Pathologist and Audiologist Licensure Requirements

Policy No. 15-001

Policy on Speech-Language Pathologist and Audiologist Licensure Requirements

The Massachusetts Board of Registration of Speech-Language Pathology and Audiology (hereinafter, the “Board”) maintains licensure standards for speech-language pathologists and audiologists that are based, in part, upon standards created by recognized professional organizations. To reiterate the language in § 2.03 of the Board’s regulations, when “standards created by professional organizations are referenced, the Board does not require that licensees maintain membership in said organization.” In order to maintain high professional standards and ensure adequate preparation for applicants, the Board issues this policy in anticipation of a longer-term regulation change.

Applicants for licensure as speech-language pathologists on or after September 1, 2014 must meet the 2014 Standards for Certification of the American Speech-Language-Hearing Association (hereinafter, “ASHA”) or the then-current ASHA Standards for Certification in Speech-Language Pathology. For the 2014 Standards for Certification, the major differences between them and the prior standards are a greater emphasis on the study and mastery of biological science, the physical sciences, statistics, and the social/behavioral sciences. More information can be found on ASHA’s website: www.asha.org

Applicants for licensure as audiologists on or after September 1, 2014 must meet either the current ASHA Standards for Certification in Audiology or the current requirements for Board Certification in Audiology of the American Board of Audiology, other than any requirement of licensure for such certification. More information can be found on the American Board of Audiology’s website: www.boardofaudiology.com

Speech-Language Pathologist Policy for the Use of Topical Anesthesia

Policy No. 14-001

Speech-language pathologists provide evaluation and treatment services that may require the use of topical anesthetics to complete certain functional evaluation and/or treatment activities. For example, a patient may require the use of a topical anesthetic while undergoing a Fiberoptic Endoscopic Examination of Swallowing (FEES) procedure or Video Stroboscopy for the purpose of evaluating an individual’s voice or swallowing function.

The Massachusetts Board of Registration of Speech-Language Pathology and Audiology (hereinafter, the “Board”) interprets G.L. c. 112, § 138 to allow licensed speech-language pathologists who are specially trained to use topical anesthetics when necessary to complete such procedures and evaluations, pursuant to a physician’s order and under the general supervision of a physician, provided that there are protocols in place for emergency response. 

The following guidance has been adopted by the Board for speech-language pathologists when using topical anesthetics: 

1. The speech-language pathologist must check facility policies to ensure that he or she may apply a topical anesthetic in that facility.

2. The speech-language pathologist must undergo training in the use of topical anesthetics that includes information about negative reactions and follow-up care. It is required that such training be documented in the speech-language pathologist’s personnel file, be updated regularly, and be readily available to the Board upon request.

3. The speech-language pathologist must have an on-going relationship with a physician for information and referral purposes.

4. The speech-language pathologist must inform the patient of the need for the use of a topical anesthetic, and of the right to have a physician (instead of the speech-language pathologist) administer the topical anesthetic. Informed consent forms required by the facility must be signed by the patient.

5. The speech-language pathologist must have access to an appropriate medical professional and/or facility, with appropriate emergency response protocols in place, in the event that an adverse reaction occurs.

6. Speech-language pathologists should review relevant scope of practice documents, position statements, and related ethics issues prior to implementing the use of topical anesthetics in their practice.

Providing Speech-Language Pathology and Audiology Services by Electronic Means

Policy No. 2019-001

The Board of Registration for Speech-Language Pathology and Audiology (“Board”) issues this policy on providing speech-language pathology and audiology services by electronic means, which the Board refers to as “telepractice” as defined in this Policy.

Telepractice is a permitted mode of practice in Massachusetts subject to the terms of this Policy. 

 

Licensure

 

  1. All persons who provide telepractice services to clients who reside or are located in Massachusetts must be licensed by the Board. 
  2. Massachusetts-licensed Speech-Language Pathologists and Audiologists must comply with statutes, regulations and policies of the state or country where the client is located and with applicable Massachusetts statutes, regulations and policies to the extent they do not conflict with the applicable law of the state or country where the client is located. 

 

Standards

 

  1. A telepractitioner must be competent in the type of services provided and in the methodology and equipment used to provide the service. 
  2. The scope, nature and quality of telepractice services must be equivalent to the quality of services delivered face-to-face and in-person. 
  3. Before providing telepractice services, a speech-language pathologist or audiologist must obtain ten (10) hours of training in telepractice in classroom courses or via distance learning.  Training must include equipment and technology, clinical practice via telepractice, security and encryption of data, and compliance with Health Insurance Portability and Accountability Act (HIPAA) and Family Educational Rights and Privacy Act (FERPA). Telepractitioners must maintain documentation of their training for inspection by the Board upon request. 
  4. A telepractitioner may begin a client relationship via telepractice following an in-person evaluation of the prospective client by a licensed speech-language pathologist or audiologist to assess the client’s need for services and candidacy for telepractice, including behavioral, physical and cognitive abilities to participate in telepractice services. 
  5. Prior to initiating telepractice services, a telepractitioner must:
    1. Document whether the client has the necessary knowledge and skills to benefit from the type of telepractice provided by the licensee;
    2. Obtain informed consent of the client to use a private environment with a secure connection;
    3. Assess the equipment and environment to be used by the client for the telepractice services, or ensure that such an assessment has been performed;
    4. Provide orientation and training to the client in the use of telepractice equipment and the telepractice protocol at an appropriate level for the client;
    5. Provide orientation and training to a facilitator, if needed for the client, in the use of telepractice equipment and the telepractice protocol;
    6. Give the client written notification of telepractice services, including notification of:
      1. The limitations of using technology in providing telepractice;
      2. The potential risks to the confidentiality of information due to technology used in telepractice;
      3. How communications can be directed to a specific licensee;
      4. Options for service delivery by telepractice and in person;
      5. The client’s right to refuse or discontinue telepractice services;
      6. Instructions on filing and resolving complaints; and
    7. Obtain the signature of the client or the parent or guardian of a minor client on this written document, and maintain this document in the clinical record.

 

  1. The office or off-site location from which telepractice services are being transmitted should be controlled and managed for security and confidentiality of client information in compliance with HIPAA and FERPA guidelines and all other applicable state and federal laws.
  2. Telepractitioners must know and comply with existing law, rules and regulations regarding security, privacy protections, reimbursement for services, licensure, liability and malpractice.
  3. In addition to the above requirements, licensees must address the particular impact of telepractice on every aspect of providing speech-language pathology services or audiology services, by taking action including but not limited to:

 

  1. Maintaining appropriate documentation of all services provided to the client;
  2. Taking into account cultural and linguistic variables that affect the assessment and treatment of individuals receiving services via telepractice;
  3. Evaluating the effectiveness of services provided by telepractice and measuring their outcomes;
  4. Ensuring the confidentiality and privacy of patients and their transmissions, and complying with all Massachusetts, HIPAA and FERPA requirements and any other applicable state and federal requirements regarding patient records and confidentiality of patient information; and
  5. Collaborating with physicians for timely referral and follow-up services as necessary.

 

  1. Continuing Education
    As a matter of professional responsibility, those providing telepractice services must obtain a minimum of two (2) hours of continuing education in telepractice as part of the 20 hours of continuing education required by the Board’s regulations (260 CMR 7.02) during every licensure renewal period.

Downloads for Board Policies and Guidelines (Speech-Language Pathology and Audiology)

Referenced Sources:
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