Title of Regulation: 18VAC30-21. Regulations Governing Audiology and Speech-Language Pathology (amending 18VAC30-21-10 through 18VAC30-21-120, 18VAC30-21-160; adding 18VAC30-21-141).

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

Public Hearing Information: No public hearing is currently scheduled.

Public Comment Deadline: December 21, 2022.

Effective Date: January 5, 2023.

Agency Contact: Leslie L. Knachel, Executive Director, Board of Audiology and Speech-Language Pathology, 9960 Mayland Drive, Suite 300, Henrico, VA 23233, telephone (804) 597-4130, 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.

Purpose: A National Practitioner Data Bank (NPDB) report is being requested for all applicants for health profession licensure in order to be sure there are no indications that an applicant might present a risk to public health and safety and no grounds for denial of licensure.

Rationale for Using Fast-Track Rulemaking Process: This action is appropriate for the fast-track rulemaking process because it is primarily clarification of current requirements plus an additional pathway in audiology to facilitate licensure. It will not be controversial because the requirement for a report from NPDB is consistent with other professions licensed by boards of the Department of Health Professions, the cost is minimal, and there has never been a comment in opposition to such a requirement.

Substance: The board has completed a periodic review of regulations for 18VAC30-21 and is proposing amendments to (i) reorganize and clarify certain provisions for ease of understanding and compliance; (ii) eliminate unnecessary provisions such as posting of a license in every location; (iii) add a pathway for licensure in audiology based on an applicant's graduate degree and passage of the examination; and (iv) add a requirement for a report from NPDB for applicants for initial licensure and reactivation or reinstatement of a license that has been inactive or lapsed for five or more years.

Issues: The primary advantage to the public is greater clarity in the wording of the regulation for ease of compliance. There are no disadvantages. There are no advantages or disadvantages to the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

The Department of Planning and Budget (DPB) has analyzed the economic impact of this proposed regulation in accordance with § 2.2-4007.04 of the Code of Virginia (Code) and Executive Order 14 (as amended, July 16, 2018). The analysis presented represents DPB's best estimate of these economic impacts.¹

Summary of the Proposed Amendments to Regulation. The Board of Audiology and Speech-Language Pathology (Board) proposes to amend the regulation as follows: (i) eliminate the requirement to post a license in every location, (ii) require a report from the National Practitioner Data Bank for initial licensure and for reinstatement of licenses that have been lapsed for five or more years, (iii) add a pathway for licensure in audiology based on one's graduate degree and passing a qualifying examination conducted by an accredited body recognized by the Board, and (iv) make other clarifying changes to ensure understanding and compliance of the regulation.

Background. Pursuant to a periodic review of the regulation,² the Board proposes to make a number of changes that would clarify and update the requirements for initial licensure, license renewal and reinstatement, continuing education, recordkeeping, and unprofessional conduct. The most substantive changes are summarized as follows: In 18VAC30-21-20, Required licenses, the current requirement that a licensee shall "post his license in a place conspicuous to the public in each facility in which the licensee is employed" would be removed. The Department of Health Professions (DHP) reports that any verification as to whether a license is current must be done online and that a hard copy of the initial license is not informative as to its currency. Further, audiologists and speech language pathologists may work in multiple locations within the facilities that employ them, making it impractical to post a license in a "conspicuous place." Thus, this requirement would be removed. A more general requirement that "licensees shall provide a copy of their license upon request" would be maintained in this section.

In 18VAC30-21-50, Application requirements, applicants would be required to submit a current report from the U.S. Department of Health and Human Services National Practitioner Data Bank (NPDB).³ DHP reports that an NPDB report is being added to the requirements for all applicants for health profession licensure in order to be sure there are no indications that an applicant might present a risk to public health and safety and no grounds for denial of licensure. This requirement would also be added to 18VAC30-21-110, which contains requirements for reactivating an inactive license, and to 18VAC30-21-120, which contains requirements for reinstating a lapsed license.

In 18VAC30-21-110 and 18VAC30-21-120, the NPDB report would only be required for applicants whose licenses have been inactive or lapsed for five or more years.

In 18VAC30-21-50, Application requirements, the regulation currently requires, "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." The proposed change would add "or has ever been held" so that an applicant who had been licensed in another jurisdiction would have to provide verification of that license even if it was no longer active.⁴ As with the NPDB report, this requirement would also be added to 18VAC30-21-110 and 18VAC30-21-120, specifically for applicants whose licenses have been inactive or lapsed for at least five year.

In 18VAC30-21-60, Qualifications for Initial Licensure, the proposed changes would list the requirements for audiologists separately from the requirements for speech pathologists, and add an option for audiology license applicants.

Specifically, audiologists can currently be licensed based on (i) a current and unrestricted Certificate of Clinical Competence issued by the American Speech-Language and Hearing Association (ASHA) or the American Board of Audiology (ABA) or other accrediting body recognized by the Board, and (ii) documentation of having passed a qualifying examination from an accrediting body recognized by the Board. The Board seeks to add a third option whereby an applicant for licensure in audiology who has graduated from an accredited audiology program and passed the national examination could be licensed prior to or without ASHA or ABA certification.⁵

Applicants for licensure in speech-language pathology would need a current and unrestricted Certificate of Clinical Competence issued by ASHA; DHP has clarified that this requirement is identical to current practice, since ASHA is the only accrediting body for speech-language pathology. The requirements for school speech-pathology licensure would remain the same.

In 18VAC30-21-80, Qualifications for Licensure by Endorsement, the Board proposes to expand the time period for qualifying for licensure by endorsement from within 12 months to within 24 months of graduation to allow more time for out-of-state applicants to become employed in Virginia. All other requirements would remain the same.

In 18VAC30-21-90, Continuing education requirements for renewal of an active license, the Board seeks to delete the allowance for a licensee to carry over up to ten contact hours of continuing education in excess of the number required for renewal. The Board reports that the current language about the carry-over is too confusing, and the current continuing education requirement of ten hours per year is not burdensome since they can be accrued in-service or online. This section would also be amended to delete the mandate for a periodic audit; this change is intended to give the Board some flexibility since it has not audited during the past two years during the pandemic.

Recordkeeping requirements that are currently part of 18VAC30-21-160, Unprofessional Conduct, would be moved to a new 18VAC30-21-141, Recordkeeping. The recordkeeping requirements would not be changed in any way. 18VAC30-21-50, 18VAC30-21-80, 18VAC30-21-110, and 18VAC30-21-120, which contain license application requirements, state that licenses may be denied to an applicant or licensee who has been determined to have committed and act in violation of 18VAC30-21-160. Thus, moving the recordkeeping requirements to a separate section preserves those requirements while ensuring that any violations cannot be treated as grounds for disciplinary action or license refusal in the same way that violating the other stipulations of 18VAC30-21-160 would warrant.

Estimated Benefits and Costs. The NPDB report requirement would create new costs for all new applicants, as well as those seeking to reinstate or activate a license after five years of letting it lapse or be inactive. DHP reports that it costs $4.00 for an applicant to request their NPDB report, which is unlikely to prevent anyone from seeking licensure, including reinstatement.⁶ Individuals who have been licensed in other U.S. jurisdictions may face new costs if they have to verify old licenses that are no longer active from multiple jurisdictions. However, requiring the NPDB report protects potential employers and clients of audiologists and speech-language pathologists by allowing greater transparency and oversight across jurisdictions regarding prior disciplinary actions.

The proposed amendment to allow audiologists who have graduated from an accredited program and passed the national examination to obtain licenses would benefit those individuals by saving them the monetary and time costs of pursuing further certification by ASHA or ABA. This change is expected to "expedite the license application process for a few individuals each year."⁷

The proposed amendments to the requirements for licensure by endorsement would benefit individuals who graduate from audiology or speech pathology programs in other states, obtain licenses there, and subsequently move to Virginia. These graduates would have an additional year to find jobs in Virginia and pursue licensure by endorsement, even though the other requirements (certification by ASHA or ABA, taking the national exam) would be the same as if they were applying for an initial license.

Businesses and Other Entities Affected. DHP reports that there are currently 528 licensed audiologists, 4,272 licensed speech-language pathologists, and 318 school speech-language pathologists. However, most of the proposed amendments affect future applicants for licenses. Current license holders would only be affected if (a) they seek to re-activate an inactive license or reinstate a lapsed license after five or more years since they last had an active license, or (b) if they were carrying over up to ten hours of continuing education credits from the previous year and had to do more continuing education to make up the difference. Future applicants would face costs associated with the NPDB report; some of them would benefit from the new pathway to licensure for audiologists.

The Code of Virginia requires DPB to assess whether an adverse impact may result from the proposed regulation.⁸ An adverse impact is indicated if there is any increase in net cost or reduction in net revenue for any entity, even if the benefits exceed the costs for all entities combined. As noted above, the proposal to require NPDB reports from license applicants would create new costs for them. Thus, an adverse impact is indicated.

Small Businesses⁹ Affected.¹⁰ The proposed amendments do not appear to adversely affect small businesses. Some audiologists and speech-language pathologists may be employed by small businesses, or self-employed. However, the proposed amendments do not appear to create new costs for them. Thus, an adverse economic impact¹¹ on small businesses is not indicated.

Localities¹² Affected.¹³ The proposed amendments do not introduce costs for local governments. No locality would be disproportionately affected by the proposed changes. Consequently, an adverse economic impact¹⁴ is not indicated for any localities.

Projected Impact on Employment. The proposed amendments do not appear to affect total employment. Although new applicants for licenses would face new costs associated with requesting and submitting the NPDB report, these costs are expected to be modest relative to the other application fees and unlikely to affect the number of individuals seeking licensure as audiologists or speech pathologists in Virginia.

Effects on the Use and Value of Private Property. The proposed amendments would not affect the use or value of private property. The proposed amendments do not affect real estate development costs.

_______________________

¹Section 2.2-4007.04 of the Code of Virginia requires that such economic impact analyses determine the public benefits and costs of the proposed amendments. Further the analysis should include but not be limited to: (1) the projected number of businesses or other entities to whom the proposed regulatory action would apply, (2) the identity of any localities and types of businesses or other entities particularly affected, (3) the projected number of persons and employment positions to be affected, (4) the projected costs to affected businesses or entities to implement or comply with the regulation, and (5) the impact on the use and value of private property.

²See https://townhall.virginia.gov/L/ViewPReview.cfm?PRid=1956.

³See https://www.npdb.hrsa.gov/.

⁴This change is related to the NPDB report requirement in that the NPDB report includes any disciplinary actions that may have been taken in other states. Having applicants verify licenses/certifications held in other states provides a way for the Board to cross-reference the report.

⁵DHP states that both types of certification (ABA and ASHA) require practice experience. However, audiology students in an accredited program acquire supervised practical experience within their degree program, so they can be licensed based on their degree and passage of the examination. The certification indicating practical experience is not essential for those applicants. See page 8 of the Agency Background Document (ABD) at https://townhall.virginia.gov/l/GetFile.cfm?File=18\5876\9476\AgencyStatement_DHP_9476_v2.pdf.

⁶See ABD, page 5.

⁷See ABD, page 5.

⁸Pursuant to Code § 2.2-4007.04 D: In the event this economic impact analysis reveals that the proposed regulation would have an adverse economic impact on businesses or would impose a significant adverse economic impact on a locality, business, or entity particularly affected, the Department of Planning and Budget shall advise the Joint Commission on Administrative Rules, the House Committee on Appropriations, and the Senate Committee on Finance. Statute does not define "adverse impact," state whether only Virginia entities should be considered, nor indicate whether an adverse impact results from regulatory requirements mandated by legislation.

⁹Pursuant to § 2.2-4007.04, 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."

¹⁰If the proposed regulatory action may have an adverse effect on small businesses, § 2.2-4007.04 requires that such economic impact analyses include: (1) an identification and estimate of the number of small businesses subject to the proposed regulation, (2) the projected reporting, recordkeeping, and other administrative costs required for small businesses to comply with the proposed regulation, including the type of professional skills necessary for preparing required reports and other documents, (3) a statement of the probable effect of the proposed regulation on affected small businesses, and (4) a description of any less intrusive or less costly alternative methods of achieving the purpose of the proposed regulation. Additionally, pursuant to § 2.2-4007.1 of the Code of Virginia, if there is a finding that a proposed regulation may have an adverse impact on small business, the Joint Commission on Administrative Rules shall be notified.

¹¹Adverse impact is indicated if there is any increase in net cost or reduction in net revenue for any entity, even if the benefits exceed the costs for all entities combined.

¹²"Locality" can refer to either local governments or the locations in the Commonwealth where the activities relevant to the regulatory change are most likely to occur.

¹³Section 2.2-4007.04 defines "particularly affected" as bearing disproportionate material impact.

¹⁴Adverse impact is indicated if there is any increase in net cost or reduction in net revenue for any entity, even if the benefits exceed the costs for all entities combined.

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) reorganize and clarify certain provisions for ease of understanding and compliance; (ii) eliminate unnecessary provisions such as posting of a license in every location; (iii) add a pathway for licensure in audiology based on an applicant's graduate degree and passage of the examination; and (iv) add a requirement for a report from the National Practitioner Data Bank for applicants for initial licensure and reactivation or reinstatement of a license that has been inactive or lapsed for five or more years.

18VAC30-21-10. Definitions.

A. The words and terms "audiologist," "board," "practice of audiology," "practice of speech-language pathology," "speech-language disorders," and "speech-language pathologist" when used in this chapter shall have the meanings ascribed to them in § 54.1-2600 of the Code of Virginia.

B. The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"ABA" means the American Board of Audiology.

"Active practice" means a minimum of 160 hours of professional practice as an audiologist or speech-language pathologist for each 12-month period immediately preceding application for licensure. Active practice may include supervisory, administrative, educational, research, or consultative activities or responsibilities for the delivery of such services.

"ASHA" means the American Speech-Language-Hearing Association.

"Client" means a patient or person receiving services in audiology or speech-language pathology.

"Contact hour" means 60 minutes of time spent in continuing learning activities.

"Limited cerumen management" means the identification and removal of cerumen from the cartilaginous outer one-third portion of the external auditory canal in accordance with minimum standards and procedures set forth in this chapter.

"School speech-language pathologist" means a person licensed pursuant to § 54.1-2603 of the Code of Virginia to provide speech-language pathology services solely in public school divisions.

"Supervision" means that the audiologist or speech-language pathologist is responsible for the entire service being rendered or activity being performed, is available for consultation, and is providing regular monitoring and documentation of clinical activities and competencies of the person being supervised.

18VAC30-21-20. Required licenses; posting of licenses.

A. There shall be separate licenses for the practices of audiology and speech-language pathology. It is prohibited for any person to practice as an audiologist or a speech-language pathologist unless the person has been issued the appropriate license.

B. A licensee shall post his license in a place conspicuous to the public in each facility in which the licensee is employed and holds himself out to practice. If it is not practical to post the license, the licensee shall provide a copy of his license upon request.

18VAC30-21-30. Records; accuracy of information.

A. All changes of name, address of record, or public address, if different from the address of record, shall be furnished to the board within 30 days after the change occurs.

B. A licensee who has changed his name shall submit as legal proof to the board a copy of the marriage certificate, a certificate of naturalization, or a court order evidencing the change. A duplicate license with the changed name shall be issued by the board upon receipt of such evidence and the required fee.

C. All notices required by law and by this chapter to be mailed by the board to any registrant or licensee shall be validly served when mailed to the latest address of record on file with the board.

18VAC30-21-40. Fees required.

A. The following fees shall be paid as applicable for licensure:

1. Application for audiology or speech-language pathology license	$135
2. Application for school speech-language pathology license	$70
3. Verification of licensure requests from other states	$20
4. Annual renewal of audiology or speech-language pathology license	$75
5. Late renewal of audiology or speech-language pathology license	$25
6. Annual renewal of school speech-language pathology license	$40
7. Late renewal of school speech-language pathology license	$15
8. Reinstatement of audiology or speech-language pathology license	$135
9. Reinstatement of school speech-language pathology license	$70
10. Duplicate wall certificate	$25
11. Duplicate license	$5
12. Handling fee for returned check or dishonored credit card or debit card	$50
13. Inactive license renewal for audiology or speech-language pathology	$40
14. Inactive license renewal for school speech-language pathology	$20
15. Application for provisional license	$50
16. Renewal of provisional license	$25

B. Fees shall be made payable to the Treasurer of Virginia and shall not be refunded once submitted.

C. The renewal fees due by December 31, 2018, shall be as follows:

	1. Annual renewal of audiology or speech-language pathology license	$55
	2. Annual renewal of school speech-language pathology license	$30

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 issued a provisional license pursuant to 18VAC30-21-70 A, 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 Verification of the status of the license or certification from each United States jurisdiction in which licensure or certification is held. or has ever been held; and

6. A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank.

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.

18VAC30-21-60. Qualifications for initial licensure.

A. The board may grant an initial license to an applicant for licensure in audiology or speech-language pathology who:

1. Holds a current and unrestricted Certificate of Clinical Competence issued by ASHA or;

2. Has passed the qualifying examination from an accrediting body recognized by the board. Holds a current and unrestricted certification issued by the American Board of Audiology ABA 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; and provides documentation of having passed the qualifying examination from an accrediting body recognized by the board; or

3. Provides documentation of (i) graduation from an audiology program accredited by the Council on Academic Accreditation of ASHA or an equivalent accrediting body as recognized by the board; and (ii) having passed the qualifying examination from an accrediting body recognized by the board.

B. The board may grant an initial license to an applicant for licensure in speech-language pathology who holds a current and unrestricted Certificate of Clinical Competence issued by ASHA.

C. The board may grant a license to an applicant as a school speech-language pathologist who holds a master's degree in speech-language-pathology.

C. Any individual who holds an active, renewable license issued by the Virginia Board of Education with a valid endorsement in speech-language pathology on June 30, 2014, shall be deemed qualified to obtain a school speech-language pathologist license from the board until July 1, 2016, or the date of expiration of such person's license issued by the Virginia Board of Education, whichever is later.

D. The board may refuse to issue a license to any applicant who has been determined to have committed an act in violation of 18VAC30-21-160.

18VAC30-21-70. Provisional licensure.

A. Provisional license to qualify for initial licensure. An applicant may be issued a provisional license in order to obtain clinical experience required for certification by ASHA, the American Board of Audiology ABA, or any other accrediting body recognized by the board. To obtain a provisional license in order to qualify for initial licensure, the applicant shall submit documentation that he has:

1. Passed the qualifying examination from an accrediting body recognized by the board; and

2. Either:

a. For provisional licensure in audiology, successfully completed all the didactic coursework required for the doctoral degree as documented by a college or university whose audiology program is accredited by the Council on Academic Accreditation of ASHA or an equivalent accrediting body as recognized by the board; or

b. For provisional licensure in speech-language pathology, successfully completed all the didactic coursework required for a graduate program in speech-language pathology as documented by a college or university whose program is accredited by the Council on Academic Accreditation of the American Speech-Language-Hearing Association ASHA or an equivalent accrediting body as recognized by the board.

B. Provisional license to qualify for endorsement or reentry into practice. An applicant may be issued a provisional license in order to qualify for licensure by endorsement pursuant to 18VAC30-21-80, reactivation of an inactive license pursuant to subsection C of 18VAC30-21-110, or reinstatement of a lapsed license pursuant to subsection B of 18VAC30-21-120.

C. All provisional licenses shall expire 18 months from the date of issuance and may be renewed for an additional six months by submission of a renewal form and payment of a renewal fee. Renewal of a provisional license beyond 24 months shall be for good cause shown as determined by a committee of the board.

D. The holder of a provisional license in audiology shall only practice under the supervision of a licensed audiologist, and the holder of a provisional license in speech-language pathology shall only practice under the supervision of a licensed speech-language pathologist. The provisional licensee shall be responsible and accountable for the safe performance of those direct client care tasks to which he has been assigned.

E. Licensed audiologists or speech-language pathologists providing supervision shall:

1. Notify the board electronically or in writing of the intent to provide supervision for a provisional licensee;

2. Have an active, current license and at least three years of active practice as an audiologist or speech-language pathologist prior to providing supervision;

3. 2. Document the frequency and nature of the supervision of provisional licensees;

4. 3. Be responsible and accountable for the assignment of clients and tasks based on their assessment and evaluation of the provisional licensee's knowledge and skills; and

5. 4. Monitor clinical performance and intervene if necessary for the safety and protection of the clients.

F. The identity of a provisional licensee shall be disclosed to the client prior to treatment and shall be made a part of the client's file.

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

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

1. 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 the applicant's supervisor. An applicant who graduated from an accredited program in audiology or speech-language pathology within 24 months immediately preceding application may be issued a license without evidence of active practice if the applicant holds a current and unrestricted Certificate of Clinical Competence in the area in which the applicant seeks licensure issued by ASHA or certification issued by ABA or any other accrediting body recognized by the board; and

2. One of the following:

a. Ten continuing education hours for each year in which the applicant has been licensed in the other jurisdiction, not to exceed 30 hours, or a and passage of the qualifying examination from the accrediting body recognized by the board;

b. A current and unrestricted Certificate of Clinical Competence in the area in which the applicant 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 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 the applicant's supervisor. An applicant who graduated from an accredited program in audiology or speech-language pathology within 12 months immediately preceding application may be issued a license without evidence of active practice if the applicant holds a current and unrestricted Certificate of Clinical Competence in the area in which the applicant seeks licensure issued by ASHA or certification issued by the American Board of Audiology or any other accrediting body recognized by the board.; or

c. A current and unrestricted certification issued by ABA and passage of the qualifying examination from the accrediting body recognized by the board.

B. The board may refuse to issue a license to any applicant who has been determined to have committed an act in violation of 18VAC30-21-160.

18VAC30-21-90. Renewal requirements.

A. A person who desires to renew his license shall, not later than December 31 of 2018 June 30 of each year, submit the renewal notice and applicable renewal fee. Beginning with calendar year 2020, the renewal of licensure deadline shall be June 30 of each year. For calendar year 2019, no renewal is required. A licensee who fails to renew his license by the expiration date shall have a lapsed license, and practice with a lapsed license may constitute grounds for disciplinary action by the board.

B. A person who fails to renew his license by the expiration date may renew at any time within one year of expiration by submission of a renewal notice, the renewal fee and late fee, and statement an attestation of compliance with continuing education requirements.

18VAC30-21-100. Continuing education requirements for renewal of an active license.

A. In order to renew an active license, a licensee shall complete at least 10 contact hours of continuing education prior to the renewal date each year. Up to 10 contact hours of continuing education in excess of the number required for renewal may be transferred or credited to the next renewal year. One hour of the 10 hours required for annual renewal may be satisfied through delivery of professional services, without compensation, to low-income individuals receiving health services through a local health department or a free clinic organized in whole or primarily for the delivery of those services. One hour of continuing education may be credited for three hours of providing such volunteer services, as documented by the health department or free clinic.

B. Continuing education shall be activities, programs, or courses related to audiology or speech-language pathology, depending on the license held, and offered or approved by one of the following accredited sponsors or organizations sanctioned by the profession:

1. The Speech-Language-Hearing Association of Virginia or a similar state speech-language-hearing association of another state;

2. The American Academy of Audiology;

3. The American Speech-Language-Hearing Association;

4. The Accreditation Council on Continuing Medical Education of the American Medical Association offering Category I continuing medical education;

5. Local, state, or federal government agencies;

6. Colleges and universities;

7. International Association of Continuing Education and Training; or

8. Health care organizations accredited by The Joint Commission or DNV GL Healthcare.

C. If the licensee is dually licensed by this board as an audiologist and speech-language pathologist, a total of no more than 15 hours of continuing education are required for renewal of both licenses with a minimum of 7.5 contact hours in each profession.

D. A licensee shall be exempt from the continuing education requirements for the first renewal following the date of initial licensure in Virginia under 18VAC30-21-60.

E. The licensee shall retain all continuing education documentation for a period of three years following the renewal of an active license. Documentation from the sponsor or organization shall include the title of the course, the name of the sponsoring organization, the date of the course, and the number of hours credited.

F. The board may grant an extension of the deadline for continuing education requirements, for up to one year, for good cause shown upon a written request from the licensee prior to the renewal date of each year.

G. The board may grant an exemption for all or part of the requirements for circumstances beyond the control of the licensee, such as temporary disability, mandatory military service, or officially declared disasters.

H. The board shall may periodically conduct an audit for compliance with continuing education requirements. Licensees selected for an audit conducted by the board shall complete the Continuing Education Form and provide all supporting documentation within 30 days of receiving notification of the audit.

I. Failure to comply with these requirements may subject the licensee to disciplinary action by the board.

18VAC30-21-110. Inactive licensure; reactivation for audiologists, speech-language pathologists, or school speech-language pathologists.

A. An audiologist, speech-language pathologist, or school speech-language pathologist who holds a current, unrestricted license in Virginia may, upon a request on the renewal application and submission of the required fee, be issued an inactive license. The holder of an inactive license shall not be required to maintain continuing education requirements and shall not be entitled to perform any act requiring a license to practice audiology or speech-language pathology in Virginia.

B. A licensee whose license has been inactive and who requests reactivation of an active license shall file an application, pay the difference between the inactive and active renewal fees for the current year, and provide documentation of current ASHA:

1. Current certification issued by ASHA or ABA; or

of having completed 2. Completion of 10 continuing education hours equal to the requirement for the number of years in which the license has been inactive, not to exceed 30 contact hours.

C. A licensee who does not reactivate within five years shall meet the requirements of subsection B of this section and shall either provide:

1. Meet the requirements for initial licensure as prescribed by 18VAC30-21-60 or A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank;

2. Provide documentation of a current license in another jurisdiction in the United States and evidence active Verification of the status of any license or certification from each United States jurisdiction in which licensure or certification is held or has ever been held; and

3. Evidence of either:

a. Active practice for at least one of the past three years, or

practice b. Practice in accordance with 18VAC30-21-70 with a provisional license for six months and submit a recommendation for licensure from his one's supervisor.

D. If the licensee holds licensure in any other state or jurisdiction, he shall provide evidence that no disciplinary action is pending or unresolved. The board may deny a request for reactivation to any licensee who has been determined to have committed an act in violation of 18VAC30-21-160.

18VAC30-21-120. Reinstatement of a lapsed license for audiologists, speech-language pathologists, or school speech-language pathologists.

A. A person may renew a lapsed license within one year of expiration by following the requirements for late renewal in subsection B of 18VAC30-21-90.

B. When a license has not been renewed within one year of the expiration date, a person may apply to reinstate his license by submission of a reinstatement application, payment of the reinstatement fee, and submission of documentation of a either:

1. A current Certificate of Clinical Competence issued by ASHA or certification issued by the American Board of Audiology ABA or any other accrediting body recognized by the board; or at

2. At least 10 continuing education hours for each year the license has been lapsed, not to exceed 30 contact hours, obtained during the time the license in Virginia was lapsed.

B. C. A licensee who does not reinstate within five years shall meet the requirements of subsection A B of this section and shall either provide:

1. Reinstate by meeting the requirements for initial licensure as prescribed by 18VAC30-21-60 A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank (NPDB); or

2. Provide documentation of a current license in another United States jurisdiction and evidence of active Verification of the status of any license or certification from each United States jurisdiction in which licensure or certification is or has ever been held; and

3. Evidence of either:

a. Active practice for at least one of the past three years; or

practice b. Practice in accordance with 18VAC30-21-70 with a provisional license for six months and submit a recommendation for licensure from his one's supervisor.

C. If the licensee holds licensure in any other state or jurisdiction, he shall provide evidence that no disciplinary action is pending or unresolved. D. The board may deny a request for reinstatement to any licensee who has been determined to have committed an act in violation of 18VAC30-21-160.

18VAC30-21-141. Recordkeeping.

A licensee shall:

1. Comply with provisions of § 32.1-127.1:03 of the Code of Virginia related to the confidentiality and disclosure of client records or related to provision of client records to another practitioner or to the client or the client's personal representative.

2. Properly manage and keep timely, accurate, legible, and complete client records, to include the following:

a. For licensees who are employed by a health care institution, school system, or other entity, in which the individual practitioner does not own or maintain the practitioner's own records, failure to maintain client records in accordance with the policies and procedures of the employing entity; or

b. For licensees who are self-employed or employed by an entity in which the individual practitioner does own and is responsible for client records, failure to maintain a client record for a minimum of six years following the last client encounter with the following exceptions:

(1) For records of a minor child, the minimum time is six years from the last client encounter or until the child reaches the age of 18 years or becomes emancipated, whichever is longer; or

(2) Records that have previously been transferred to another practitioner or health care provider or provided to the client or the client's personal representative as documented in a record or database maintained for a minimum of six years.

3. Comply with requirements of § 54.1-2405 of the Code of Virginia for notification and transfer of patient records in conjunction with closure, sale, or relocation of one's practice.

18VAC30-21-160. Unprofessional conduct.

The board may refuse to issue a license to any applicant, suspend a license for a stated period of time or indefinitely, reprimand a licensee or place his license on probation with such terms and conditions and for such time as it may designate, impose a monetary penalty, or revoke a license for any of the following:

1. Guarantee of the results of any speech, voice, language, or hearing consultative or therapeutic procedure or exploitation of clients by accepting them for treatment when benefit cannot reasonably be expected to occur or by continuing treatment unnecessarily;

2. Diagnosis or treatment of speech, voice, language, and hearing disorders solely by written correspondence, provided this shall not preclude:

a. Follow-up by written correspondence or electronic communication concerning individuals previously seen; or

b. Providing clients with general information of an educational nature;

3. Failure to comply with provisions of § 32.1-127.1:03 of the Code of Virginia related to the confidentiality and disclosure of client records or related to provision of client records to another practitioner or to the client or his personal representative;

4. Failure to properly manage and keep timely, accurate, legible, and complete client records, to include the following:

a. For licensees who are employed by a health care institution, school system, or other entity, in which the individual practitioner does not own or maintain his own records, failure to maintain client records in accordance with the policies and procedures of the employing entity; or

b. For licensees who are self-employed or employed by an entity in which the individual practitioner does own and is responsible for client records, failure to maintain a client record for a minimum of six years following the last client encounter with the following exceptions:

(1) For records of a minor child, the minimum time is six years from the last client encounter or until the child reaches the age of 18 or becomes emancipated, whichever is longer; or

(2) Records that have previously been transferred to another practitioner or health care provider or provided to the client or his personal representative as documented in a record or database maintained for a minimum of six years;

5. Engaging or attempting to engage in a relationship with a client that constitutes a professional boundary violation in which the practitioner uses his professional position to take advantage of the vulnerability of a client or a client's family, including but not limited to sexual misconduct with a client or a member of the client's family or other conduct that results or could result in personal gain at the expense of the client;

6. 5. Incompetence or negligence in the practice of the profession;

7. 6. Failure to comply with applicable state and federal statutes or regulations specifying the consultations and examinations required prior to the fitting of a new or replacement prosthetic aid for any communicatively impaired person;

8. 7. Failure to refer a client to an appropriate health care practitioner when there is evidence of an impairment for which assessment, evaluation, care, or treatment might be necessary;

9. 8. Failure to supervise persons who assist in the practice of audiology or speech-language pathology as well as failure to disclose the use and identity of unlicensed assistants;

10. 9. Conviction of a felony or a misdemeanor involving moral turpitude;

11. 10. Violating or cooperating with others in violating any of the provisions of Chapters Chapter 1 (§ 54.1-100 et seq.), 24 (§ 54.1-2400 et seq.), or 26 (§ 54.1-2600 et seq.) of Title 54 of the Code of Virginia or the regulations of the board;

12. 11. Publishing or causing to be published in any manner an advertisement relating to his professional practice that is false, deceptive, or misleading;

13. 12. Inability to practice with skill and safety;

14. 13. Fraud, deceit, or misrepresentation in provision of documentation or information to the board or in the practice of audiology or speech-language pathology;

15. 14. Aiding and abetting unlicensed activity; or

16. 15. Revocation, suspension, restriction, or any other discipline of a license or certificate to practice or surrender of license or certificate while an investigation or administrative proceedings are pending in another regulatory agency in Virginia or another jurisdiction.