Title of Regulation: 18VAC30-21. Regulations Governing Audiology and Speech-Language Pathology (amending 18VAC30-21-50, 18VAC30-21-80).

Statutory Authority: § 54.1-2400 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: September 5, 2018.

Effective Date: September 20, 2018.

Agency Contact: Leslie L. Knachel, Executive Director, Board of Audiology and Speech-Language Pathology, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4630, FAX (804) 527-4471, or email audbd@dhp.virginia.gov.

Basis: Regulations are promulgated under the general authority of § 54.1-2400 of the Code of Virginia, which provides the Board of Audiology and Speech-Language Pathology the authority to promulgate regulations to administer the regulatory system, and §§ 54.1-2603 and 54.1-2604 of the Code of Virginia, which provide the board authority to regulate licensing of audiologists and speech-language pathologists.

Purpose: The purpose of the amended regulation is to clarify that licensure by endorsement is intended for applicants who have already been licensed in another state so that the board is assured of current competency and has information about whether disciplinary action has been imposed by the other state. Evidence of competency (continuing education hours and active practice or practice with a provisional license) is necessary to ensure that the licensee can practice audiology or speech-language pathology in a manner to protect the health and welfare of the licensee's clients or patients. Licensure by examination is intended for recent graduates whose competency has been demonstrated by passage of the licensure examination and attainment of the certification of competency.

Rationale for Using Fast-Track Rulemaking Process: The amendments clarify the intent of the regulations for licensure by endorsement. In the case of the application amendment in 18VAC30-21-50, the result will be a reduced fee for applicants who have had a provisional license and are applying for full licensure.

Substance: The amendments clarify that an audiologist or speech-language pathologist who has been licensed in another state must apply for licensure by endorsement and that the license in the other state must either be current and unrestricted or if lapsed, eligible for reinstatement. Another amendment allows an applicant who has already received a provisional license to pay only the difference between the provisional licensure fee and the application licensure fee when he applies for full licensure.

Issues: The advantage to the public is more assurance that a licensee coming from another state has current competency as evidenced by hours of continuing education and that the licensee has either been actively practicing in the other state or will practice in Virginia on a provisional license before full licensure is granted. There are no disadvantages to the public. There are no advantages or disadvantages to the agency or the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Audiology and Speech-Language Pathology (Board) proposes to: 1) credit the provisional licensure fee paid when charging the application licensure fee, and 2) clarify that an audiologist or speech-language pathologist who has been licensed in another state must apply for licensure by endorsement.

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact.

Fees: The regulation provides that applicants may be issued a provisional license in order to obtain clinical experience that is required in order to obtain initial full licensure. A provisional license may also be issued to applicants who are seeking: 1) licensure by endorsement and have not actively practiced for at least one of the past three years, 2) reactivation of an inactive license, or 3) reinstatement of a lapsed license. Under the current regulation, an individual with a provisional license who is applying for full licensure pays the full license fee.

	Full License	Provisional License	Difference
Audiology	$135	$50	$85
Speech-language Pathology	$135	$50	$85
School Speech-language Pathology	$70	$50	$20

The Board proposes only to charge such applicants the difference between the provisional license fee and the full licensure fee. In other words, all applicants for full licensure who have a provisional license would have their fee reduced by $50. This is, of course, beneficial for these applicants.

Licensure by Endorsement: The current regulation states that individuals who have been licensed in another United States jurisdiction in audiology or speech-language pathology and seek licensure in Virginia may apply for licensure by endorsement in Virginia, provided that they: 1) meet specified continuing education hours, 2) meet specified clinical competence certification, 3) have passed a qualifying examination from an accrediting body recognized by the Board, 4) have no disciplinary action that is pending or unresolved, and 5) either have had active practice in another United States jurisdiction for at least one of the past three years or practice for six months with a Virginia provisional license. The Board proposes to change the "may" to "shall," in order to make clear that applicants for Virginia licensure who have been licensed in other United States jurisdictions are to apply for licensure by endorsement rather than the process intended for those who have never been licensed. According to the Department of Health Professions, applicants who have been licensed out-of-state and have expressed interest in Virginia licensure have in practice been told to apply for licensure by endorsement.

Allowing individuals who have been licensed in another United States jurisdiction to apply for licensure through the route intended for those who have never been licensed would potentially enable those with unresolved disciplinary actions to become licensed in Virginia without the Board's knowledge of past problematic practice. Thus, the proposal to make clear that applicants for Virginia licensure who have been licensed in other United States jurisdictions are to apply for licensure by endorsement would be beneficial in that it reduces the likelihood that incompetent or unethical practitioners may become licensed in Virginia.

The Board also proposes to add that the out-of-state license must be current and unrestricted, or if lapsed is eligible for reinstatement. This further helps reduce the likelihood that incompetent or unethical practitioners may become licensed in Virginia.

Businesses and Entities Affected. The proposed amendments directly affect individuals applying for licensure as an audiologist, a speech-language pathologist, or as a school speech-language pathologist, and indirectly firms and schools that employ them. In the year 2017, there were 30 new licenses issued for audiologists, 381 for speech language pathologists, and 35 for school speech-language pathologists.¹

Localities Particularly Affected. The proposed amendments do not disproportionately affect particular localities.

Projected Impact on Employment. The proposed amendments do not significantly affect total employment.

Effects on the Use and Value of Private Property. The proposed amendments do not significantly affect the use and value of private property.

Real Estate Development Costs. The proposed amendments do not affect real estate development costs.

Small Businesses:

Definition. Pursuant to § 2.2-4007.04 of the Code of Virginia, small business is defined as "a business entity, including its affiliates, that (i) is independently owned and operated and (ii) employs fewer than 500 full-time employees or has gross annual sales of less than $6 million."

Costs and Other Effects. The proposed amendments do not affect significantly costs for small businesses.

Alternative Method that Minimizes Adverse Impact. The proposed amendments do not adversely affect small businesses.

Adverse Impacts:

Businesses. The proposed amendments do not adversely affect businesses.

Localities. The proposed amendments do not adversely affect localities.

Other Entities. The proposed amendments do not adversely affect other entities.

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¹Source: Department of Health Professions.

Agency's Response to Economic Impact Analysis: The Board of Audiology and Speech-Language Pathology concurs with the economic impact analysis of the Department of Planning and Budget.

Summary:

The amendments (i) clarify that an audiologist or speech-language pathologist who has been licensed in another state must apply for licensure by endorsement and that the license in any other state must either be current and unrestricted or if lapsed, eligible for reinstatement and (ii) allow an applicant who has already received a provisional license to pay only the difference between the provisional licensure fee and the application licensure fee.

Part II
Requirements for Licensure

18VAC30-21-50. Application requirements.

A. A person seeking a provisional license or licensure as an audiologist, a speech-language pathologist, or a school speech-language pathologist shall submit:

1. A completed and signed application;

2. The applicable fee prescribed in 18VAC30-21-40, or in the case of an application for licensure as an audiologist, a speech-language pathologist, or a school speech-language pathologist following issuance of a provisional license, the difference between the provisional licensure fee and the application licensure fee;

3. Documentation as required by the board to determine if the applicant has met the qualifications for licensure;

4. An attestation that the applicant has read, understands, and will comply with the statutes and regulations governing the practice of audiology or speech-language pathology; and

5. If licensed or certified in another United States jurisdiction, verification of the status of the license or certification from each jurisdiction in which licensure or certification is held.

B. An incomplete application package shall be retained by the board for a period of one year from the date the application is received by the board. If an application is not completed within the year, an applicant shall reapply and pay a new application fee.

18VAC30-21-80. Qualifications for licensure by endorsement.

An applicant for licensure in audiology or speech-language pathology who has been licensed in another United States jurisdiction may shall apply for licensure in Virginia in accordance with application requirements in 18VAC30-21-50 and submission of documentation of:

1. Ten continuing education hours for each year in which he has been licensed in the other jurisdiction, not to exceed 30 hours, or a current and unrestricted Certificate of Clinical Competence in the area in which he seeks licensure issued by ASHA or certification issued by the American Board of Audiology or any other accrediting body recognized by the board. Verification of currency shall be in the form of a certified letter from a recognized accrediting body issued within six months prior to filing an application for licensure;

2. Passage of the qualifying examination from an accrediting body recognized by the board;

3. Current status of licensure in another any other United States jurisdiction showing that the license is current and unrestricted or if lapsed, is eligible for reinstatement and that no disciplinary action is pending or unresolved. The board may deny a request for licensure to any applicant who has been determined to have committed an act in violation of 18VAC30-21-160; and

4. Evidence of active practice in another United States jurisdiction for at least one of the past three years or practice for six months with a provisional license in accordance with 18VAC30-21-70 and by providing evidence of a recommendation for licensure by his supervisor.