TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING

BOARD OF AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY

Fast-Track Regulation

Title of Regulation: 18VAC30-21. Regulations Governing Audiology and Speech-Language Pathology (amending 18VAC30-21-40 through 18VAC30-21-80, 18VAC30-21-100, 18VAC30-21-110, 18VAC30-21-141; repealing 18VAC30-21-120, 18VAC30-21-150).

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

Public Hearing Information: No public hearing is currently scheduled.

Public Comment Deadline: January 29, 2025.

Effective Date: February 13, 2025.

Agency Contact: Kelli Moss, Executive Director, Board of Audiology and Speech-Language Pathology, 9960 Mayland Drive, Suite 300, Henrico, VA 23233, telephone (804) 597-4132, FAX (804) 939-5238, or email kelli.moss@dhp.virginia.gov.

Basis: Regulations of the Board of Audiology and Speech-Language Pathology are promulgated under the general authority of § 54.1-2400 of the Code of Virginia, which states that the general powers and duties of health regulatory boards shall be to promulgate regulations that are reasonable and necessary to effectively administer the regulatory system.

Purpose: The amendments delete duplicative language, combine provisions for clarity, and reduce requirements to obtain licensure in Virginia. The regulation has been determined by the General Assembly to be essential to protect the health, safety, or welfare of citizens.

Rationale for Using Fast-Track Rulemaking Process: The impetus for this action is Executive Order 19 (2022), the board's 2021 periodic review, and a petition for rulemaking received in late 2022; therefore, the action is expected to be noncontroversial.

Substance: The amendments (i) remove unclear or passive language, (ii) remove outdated provisions, (iii) remove provisions duplicative of statutory language, (iv) remove unnecessary or internally duplicative provisions, (v) combine listed requirements for audiology and speech-language pathology where possible, (vi) reduce requirements to obtain a license to practice by initial application and endorsement, and (vii) remove nonregulatory language from the chapter.

Issues: The primary advantages to the public are potential increase in licensees available to provide audiology or speech-language pathology services to the public. There are no disadvantages to the public. There are no primary advantages or disadvantages to the agency or the Commonwealth.

Department of Planning and Budget 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 and Executive Order 19. The analysis presented represents DPB's best estimate of the potential economic impacts as of the date of this analysis.¹

Summary of the Proposed Amendments to Regulation. The Board of Audiology and Speech-Language Pathology (board) proposes to lower the regulatory burden by expanding pathways and reducing the requirements involved in obtaining licensure in Virginia (i.e., initial and provisional licensure, and licensure by endorsement) as an audiologist or as a speech-language pathologist (SLP), while also clarifying the regulatory text.

Background. This action results from Executive Order 19, the board's 2021 periodic review, and partly from a petition for rulemaking received in late 2022.² The proposed changes would clarify the regulatory text by amending unclear or passive language, removing certain text (outdated provisions, provisions duplicative of statutory language, and unnecessary or internally duplicative provisions), combining listed requirements for audiology and speech-language pathology where possible, and removing non-regulatory language. The proposal would also expand the pathways and reduce the requirements involved in obtaining initial or provisional licensure as well as licensure by endorsement in Virginia as an audiologist or as a speech-language pathologist.

Estimated Benefits and Costs: One of the proposed changes would expand the pathways to initial licensure.³ The proposal would allow initial licensure to those who submit evidence of the following:

a. Documentation of graduation from a program accredited by the Council on Academic Accreditation of ASHA or an equivalent accrediting body recognized by the board;

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

c. Evidence of six months of practice pursuant to a provisional license as described in 18VAC30-21-70 and submission of recommendation for licensure from the applicant's supervisor during practice as a provisional licensee.

According to the board, each of the current pathways requires that the applicant hold a Certificate of Clinical Competency (CCC) issued by ASHA. The board has determined that this approach is overly burdensome because it imposes a burden on those licensees who wish to obtain an initial license in Virginia (e.g., a military spouse) but who have had a break in their practice for various reasons such as pregnancy, sickness, family leave, etc. The board states that such an individual has to regain current and unrestricted CCC status, often at a significant cost, in order to then obtain initial licensure in the Commonwealth. For example, for an applicant to access and provide their CCC, they must maintain a current membership with ASHA by paying renewal fees for annual dues and certification fees. The total cost for initial membership and certification fees currently ranges between $256 and $511.⁴ The renewal dues or fees for 2025 range between $71 and $250.⁵ Additionally, otherwise qualified applicants may be unable to access their test scores from more than 10 years ago if they do not maintain a membership with ASHA, as the testing administrator destroys the related documentation. As is, the current regulations do not provide a pathway for experienced applicants to obtain a license if they qualify to apply only by examination and cannot access their scores through ASHA. Moreover, there may be delays depending on how quickly ASHA receives and processes the application or fees and provides the certification information to the board. The proposal would allow for an additional pathway to initial licensure that does not require a CCC, thereby eliminating the fees that may be charged by ASHA as well as the potential delays. The second substantive proposed change would amend the requirements for provisional licensure. A provisional license is issued to allow a practitioner who does not meet the requirements of the initial license; this allows them to practice until they fully meet the requirements. For example, if a practitioner has a deficiency in one or more required areas for full licensure, a provisional license allows practice while the applicant is addressing the deficiency. Currently, a provisional license is issued only to allow the applicant to obtain a CCC because that is the only avenue to full licensure. Since there would be a new pathway for initial licensure as discussed above, the language would be amended to include the new pathway as well. In essence, the proposed language would broaden the language that currently restricts the pathway only to those applicants who can obtain current and unrestricted CCC status by accommodating the new pathway. A third change would extend the duration of a provisional license from 18 months to 24 months, extend the ability to renew a provisional license for a period of 12 months instead of the existing six months, and allow the possibility of renewing a provisional license after 36 months rather than 24 months. These extensions of time are intended to reduce the burden of completing practice requirements in order to obtain a full license. The fourth substantive change is related to licensure by endorsement and would repeal the 10 hours of continuing education required for each year in which the applicant has been licensed in another jurisdiction, not to exceed 30 hours. The board does not believe the continuing education requirement is necessary for an individual holding a license in another state because most states require continuing education. Moreover, the board believes that applicants are likely to have taken continuing education, although it does not have any data on this topic. The board states that, generally, other states maintain their own renewal requirements and it does not need to perform additional checks on such requirements. This change is expected to provide some administrative cost savings to the board as well as the applicant in terms of time that would have been expended on demonstrating compliance with the current continuing education requirement.

Businesses and Other Entities Affected. This regulation applies to audiologists and SLPs licensed in Virginia. As of March 2024, there were 601 audiologists, 362 school SLPs, and 5,318 SLPs. However, the substantive proposed changes primarily apply to initial and provisional licensure and licensure by endorsement. The board estimates that approximately 10% to 20% of future applicants for initial licensure in Virginia may qualify for licensure under the proposed new pathway to initial licensure. In fiscal year 2024, there were 987 initial licenses issued. Thus, annually, approximately 99 to 198 initial licensees may benefit from that change. The number of provisional licenses issued in 2023 was 223, but the number of licenses issued by endorsement is not available. No licensure applicant appears to be disproportionally affected. The Code of Virginia requires DPB to assess whether an adverse impact may result from the proposed regulation.⁶ An adverse impact is indicated if there is any increase in net cost or reduction in net benefit for any entity, even if the benefits exceed the costs for all entities combined.⁷ The proposal would primarily expand the pathways and reduce the requirements for licensure and reduce burdens. Thus, no adverse impact is indicated.

Small Businesses⁸ Affected.⁹ The proposed amendments do not appear to adversely affect small businesses directly as they apply to individual practitioner licenses.

Localities¹⁰ Affected.¹¹ The proposed amendments do not introduce costs on localities.

Projected Impact on Employment. The proposed amendments would expand the pathways to licensure and reduce the requirements and burdens on audiologists and SLPs. Thus, a positive impact on the supply of such practitioners in Virginia may be expected.

Effects on the Use and Value of Private Property. With an increase in the supply of audiologists and SLPs, firms that employ audiologists or SLPs may find it easier and less costly to hire and employ such practitioners. This could moderately increase their value. No impact on real estate development costs is expected.

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¹ Section 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.

² https://townhall.virginia.gov/L/ViewPetition.cfm?petitionId=379.

³ Relatedly, this change stems from a petition for rulemaking received by the board in late 2022, which requested that the board provide alternative pathways to licensure outside the Certificate of Clinical Competency requirement..

⁴ https://www.asha.org/certification/slpcertification/.

⁵ https://www.asha.org/renew/.

⁶ Pursuant to § 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.

⁷ 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. As a result, DPB has adopted a definition of adverse impact that assesses changes in net costs and benefits for each affected Virginia entity that directly results from discretionary changes to the regulation.

⁸ Pursuant 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."

⁹ If 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.

¹⁰ "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.

¹¹ Section 2.2-4007.04 defines "particularly affected" as bearing disproportionate material impact.

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

Summary:

Pursuant to Executive Order 19 (2022), as a result of a periodic review, and in response to a petition for rulemaking, the amendments (i) remove unclear or passive language, outdated provisions, nonregulatory language, and provisions duplicative of statutory language; (ii) combine listed requirements for audiology and speech-language pathology where possible; (iii) reduce requirements to obtain a license to practice by initial application and endorsement; and (vii) extend by six months the effectiveness of a provisional license.

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 nonrefundable.

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 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. 3. 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. 4. 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. Holds a current and unrestricted certification issued by the ABA or any other accrediting body recognized by the board 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. Submits evidence of the following:

a. Documentation of graduation from a program accredited by the Council on Academic Accreditation of ASHA or an equivalent accrediting body recognized by the board;

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

c. Evidence of six months of practice pursuant to a provisional license as described in 18VAC30-21-70 and submission of recommendation for licensure from the applicant's supervisor during practice as a provisional licensee.

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. B. 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.

D. C. 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, ABA, or any other accrediting body recognized by the board. To obtain a provisional license in order to qualify for initial licensure, the for initial licensure in Virginia. The applicant shall submit documentation that he the applicant 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, submission of documentation of graduation or evidence that the applicant 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 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 24 months from the date of issuance and may be renewed for an additional six 12 months by submission of a renewal form and payment of a renewal fee. Renewal of a provisional license beyond 24 36 months shall be for good cause shown.

D. C. 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 the provisional licensee has been assigned.

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

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

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

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

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

F. E. 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 may apply for licensure in Virginia in accordance with application requirements in 18VAC30-21-50 and shall submit documentation of current active and unrestricted licensure in another United States jurisdiction and either:

1. Evidence of one year of active practice in another United States jurisdiction for at least one of over 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, 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

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

2. Evidence of six months of practice pursuant to a provisional license as described in 18VAC30-21-70 and submission of recommendation for licensure from the applicant's supervisor during practice as a provisional licensee.

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.

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

A. In order to renew an active license, a licensee shall complete at least 10 hours of continuing education prior to the renewal date each 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 a board-recognized, accredited sponsors sponsor or organizations sanctioned by the profession: organization.

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 the 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 may periodically conduct an audit for compliance with continuing education requirements. Licensees selected for an audit conducted by the board shall 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 and reinstatement 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 or has lapsed and who requests reactivation or reinstatement of an active license shall file an application, pay the prescribed fee, which, for reactivation of an inactive license, shall be the difference between the inactive and active renewal fees for the current year, and provide documentation of:

1. Either:

a. Current certification issued by ASHA or ABA; or

2. b. 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 provide: 1.; and

2. A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank; 2. 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 b. Practice in accordance with 18VAC30-21-70 with a provisional license for six months and a recommendation for licensure from one's supervisor.

D. C. 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. (Repealed.)

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 reinstatement application, payment of the reinstatement fee, and submission of documentation of either:

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

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.

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

1. A current report from the U.S. Department of Health and Human Services National Practitioner Data Bank (NPDB);

2. 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

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

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

a. 1. 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. 2. 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) a. 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 of age or becomes emancipated, whichever is longer; or

(2) b. 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.

18VAC30-21-150. Prohibited conduct. (Repealed.)

A. No person, unless otherwise licensed to do so, shall prepare, order, dispense, alter, or repair hearing aids or parts of or attachments to hearing aids for consideration. However, audiologists licensed under this chapter may make earmold impressions and prepare and alter earmolds for clinical use and research.

B. No person licensed as a school speech-language pathologist shall conduct the practice of speech-language pathology outside of the public school setting.