DEPARTMENT OF HEALTH

(Board of Hearing and Speech)

[Filed December 18, 2024, 12:37 p.m.]

Preproposal statement of inquiry was filed as WSR 24-08-058.

Title of Rule and Other Identifying Information: Hearing and speech; implementing legislation, reducing licensure barriers for hearing and speech professions, and clarifying requirements for speech-language pathology assistant certification in chapter 246-828 WAC.

The board of hearing and speech (board) is proposing amendments to implement section 8 of 2SHB 1724 (chapter 425, Laws of 2023), codified as RCW 18.130.077, to reduce barriers to entering and remaining in the hearing and speech workforce and to shorten the credentialing process. The board is proposing revisions to WAC 246-828-020, 246-929-510, and creating new WAC 246-828-035 Licensure by endorsement. Additionally, the board is proposing amendments to WAC 246-828-617 to clarify the requirements for speech-language pathology assistant certification.

Hearing Location(s): On February 7, 2025, at 9:10 a.m., at Washington State Department of Health, Town Center 2, Room 166, 111 Israel Road S.E., Tumwater, WA 98501; or virtual via Microsoft Teams meeting. Join on your computer, mobile app, or room device. Copy this URL into your browser to join the meeting https://teams.microsoft.com/l/meetup-join/19%3ameeting_Yjc5OTNhNjgtZjI4Mi00NmEyLWJjZTMtMjlhYjA4OWE3ZjU3%40thread.v2/0?context=%7b%22Tid%22%3a%2211d0e217-264e-400a-8ba0-57dcc127d72d%22%2c%22Oid%22%3a%22ae44b66e-af0e-436f-a863-213f33d92a5c%22%7d; or download Teams https://www.microsoft.com/en-us/microsoft-teams/download-app, Meeting ID 286 553 793 714, Passcode kwdtpH; or call in (audio only) +1 564-999-2000, United States, Olympia, Phone Conference ID 819 266 217#. You may also submit comments in writing.

Date of Intended Adoption: February 7, 2025.

Submit Written Comments to: Kim-Boi Shadduck, Program Manager, Department of Health, P.O. Box 47852, Olympia, WA 98504-7852, email kimboi.shadduck@doh.wa.gov, https://fortress.wa.gov/doh/policyreview, beginning the date and time of this filing, by January 29, 2025, 11:59 p.m.

Assistance for Persons with Disabilities: Contact Kim-Boi Shadduck, program manager, phone 360-236-2912, TTY 711, email kimboi.shadduck@doh.wa.gov, by January 22, 2024.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The board is proposing revisions to existing rules and adding a new section of rule to waive education, training, experience, and examination requirements for applicants that qualify for licensure by endorsement to implement RCW 18.130.077. Specifically, the board is proposing to:

• Remove the jurisprudence examination requirement in WAC 246-828-020 for all hearing and speech professions licensed under chapter 246-828 WAC.

• Establish new WAC 246-828-035 to add an expedited pathway to Washington licensure for out-of-state speech and hearing professionals who have been credentialed in another state with substantially equivalent standards and a pathway to Washington licensure for speech and hearing professionals who have a national certification that is in good standing. In both cases applicants must also meet all of the requirements in RCW 18.130.077(3).

• Amend the continuing education (CE) requirements in WAC 246-828-510 to add the jurisprudence examination as free CE hour that must be completed within the first year of licensure, then once every three years.

The board is also proposing revisions to WAC 246-828-617 to address confusion about the education and experience needed to be certified as a speech-language pathology assistant.

Reasons Supporting Proposal: Under RCW 18.130.077, all disciplining authorities shall waive education, training, experience, and exam requirements for applicants who have been credentialed in another state or states with substantially equivalent standards for at least two years immediately preceding their application with no interruption in licensure for longer than 90 days. The statute also allows disciplining authorities to choose to waive education, training, experience, and exam requirements for applicants who have achieved the national credential for their profession.

The intent of the statute is to make disciplining authorities review and adjust licensure requirements to remove barriers to entering and remaining in the health care workforce and shorten the credentialing process.

The board is proposing to move the jurisprudence requirement from an initial licensure requirement to a CE. The jurisprudence exam is training that is Washington state specific. The board believes it is important that all speech and hearing credential holders new to the state are aware of Washington's laws and rules pertaining to their profession. While it may not be necessary to have the education prior to being licensed in Washington state, by having all providers take the jurisprudence examination within the first year of licensure, all providers will have knowledge of where to find laws and rules regarding their professions.

Establishing expedited pathways to Washington licensure for out-of-state professionals meets the intent of RCW 18.130.077 by reducing barriers for out-of-state health care professionals seeking certification in Washington, to expand the availability of qualified providers, and streamline the credentialing process.

The hearing and speech profession provides national credentialing opportunities. The board has determined that the following national certifications are substantially equivalent to meeting the requirements for Washington state licensure: The certificate of clinical competence from the American Speech-Language Hearing Association, board certification in audiology by the American Board of Audiology, or certification from the National Board for Certification in Hearing Instrument Sciences.

To ensure clear understanding of the education and experience requirements for certification as a speech-language pathology assistant, the board is proposing amendments.

Statutory Authority for Adoption: RCW 18.35.161; and 2SHB 1724 (chapter 425, Laws of 2023), codified as RCW 18.130.077.

Statute Being Implemented: RCW 18.130.077.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Board of hearing and speech, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Kim-Boi Shadduck, Program Manager, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-2912.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Kim-Boi Shadduck, Program Manager, Department of Health, P.O. Box 47852, Olympia, WA 98504-7852, phone 360-236-2912, TTY 711, email kimboi.shadduck@doh.wa.gov.

This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:

Is exempt under RCW 19.85.025(4).

Explanation of exemptions: The proposed amendments impact rules regulating individual professional licenses, not businesses.

Scope of exemption for rule proposal:

Sonja Bradford, Speech-Language Pathologist

Chair, Board of Hearing and Speech

AMENDATORY SECTION(Amending WSR 19-13-041, filed 6/12/19, effective 7/13/19)

WAC 246-828-020Examinations.

(1) A hearing aid specialist credential applicant is required to take the written International Licensing Exam developed by the International Hearing Society or other entity approved by the board. An applicant must obtain a passing score as recommended by the examination administrator and as approved by the board. An applicant may apply to take the written examination no more than ((ninety))90 days prior to the anticipated completion date of the educational program. The anticipated completion date must be verified by the educational program.

(2) A hearing aid specialist credential applicant((s)) who ((have))has completed a board-approved nine-month certificate program ((are))is required to take the practical examination approved by the board. The applicant((s)) must obtain a passing score as recommended by the examination administrator and as approved by the board.

(3) An audiology credential applicant((s are))is required to take the Praxis audiology exam ((or other entity approved by the board)). The applicant((s)) must obtain a passing score as recommended by the examination administrator ((and as approved by the board)).

(4) A speech-language pathologist credential applicant((s are))is required to take the Praxis speech-language pathology exam ((or other entity approved by the board)). The applicant((s)) must obtain a passing score as recommended by the examination administrator ((and as approved by the board.

(5) All credential applicants are required to take and pass a jurisprudence examination approved by the board. The passing score on the jurisprudence examination is one hundred percent)).

WAC 246-828-035Licensure by endorsement.

(1) An applicant that is currently licensed, and has been licensed for at least the immediately preceding two years in a state or jurisdiction with substantially equivalent standards to Washington, and meets all requirements in RCW 18.130.077 (1) and (3), qualifies for licensure by endorsement. The applicant shall submit to the department:

(a) An application on forms provided by the department;

(b) Proof of licensure history that demonstrates compliance with RCW 18.130.077; and

(2) An applicant qualifies for licensure by endorsement if they meet the requirements of RCW 18.130.077(3) and hold one of the following national certifications; the certificate of clinical competence (CCC) from the American Speech-Language Hearing Association (ASHA), board certification in audiology by the American Board of Audiology, or certification from the National Board for Certification in Hearing Instrument Sciences. The applicant shall submit to the department:

(a) An application on forms provided by the department;

(b) Proof of national certification;

(d) The appropriate licensing fees required under WAC 246-825-990(2).

(3) An applicant licensed in a state with substantially equivalent standards for less than two years:

(a) May obtain an initial license as provided in RCW 18.35.040.

(b) May obtain a temporary practice permit in WAC 246-828-305 or 246-828-315.

(4) An applicant licensed in a nonsubstantially equivalent state may obtain an initial license as provided in RCW 18.35.040.

AMENDATORY SECTION(Amending WSR 24-01-120, filed 12/19/23, effective 1/19/24)

WAC 246-828-510Continuing education.

The purpose of continuing education is to ensure the highest quality professional care. The objectives are to improve and increase the ability of the hearing aid specialist, audiologist, speech-language pathologist, and speech-language pathology assistant to deliver the highest possible quality professional care and keep the professional abreast of current developments.

Continuing education consists of educational activities designed to review existing concepts and techniques and to convey information and knowledge about advances in hearing instrument fitting and dispensing, audiology, and speech-language pathology fields as applied to the work setting. Continuing education requirements include:

(1) ((Continuing education requirement.))A credential holder must take and pass the jurisprudence examination approved by the board within the first year of licensure. The jurisprudence examination requirement counts as one hour of continuing education.

(2) A credential holder must complete a minimum of 30 hours of continuing education every three years.

(a) At least one hour of the continuing education must be on infection control.

(b) One hour of continuing education must be the successful completion of the jurisprudence examination approved by the board.

(c) Multicultural education aimed at removing barriers to access to care may count for up to five hours of continuing education.

(((c)))(d) At least 25 hours of continuing education must be related to profession specific skills and competencies.

(((i)))(e) At least two hours of continuing education must be on health equity training, as specified in WAC 246-12-800 through 246-12-830. (((ii))) This training must be completed by the end of the second full continuing education reporting period after January 1, 2024, or the second full continuing education reporting period after initial licensure, whichever is later.

(((2)))(3) Continuing education is defined as any of the following activities:

(a) Courses, seminars, workshops and postgraduate programs offered by accredited educational institutions. These educational activities must be recorded on an official transcript or by documentation stating the number of continuing education hours completed.

(b) Courses, seminars and workshops offering continuing clock or continuing educational units offered by profession-related organizations or industries. These activities will be accepted with documentation of the number of continuing education hours completed.

(c) Attendance at a continuing education program having a featured speaker(s) or panel, which has been provided by, sponsored by, or endorsed by a profession-related organization or industry. This activity will be accepted with documentation of the number of continuing education hours completed.

(d) Participation as a speaker or panel member in a continuing education program which has been provided by, sponsored by, or endorsed by a profession-related organization or industry. A maximum of eight hours, including preparation time, may be applied to the total three-year requirement.

(e) Completion of a written, video, internet, or audio continuing education program which has been provided by, sponsored by, or endorsed by a profession-related organization or industry. Only programs in which proof of completion is provided or with tests that are not self-graded will be accepted.

(((3)))(4) The board may grant an exception for continuing education requirements under certain circumstances including, but not limited to, severe illness. The credential holder must submit a written request for exception to the board for review. The board will approve or deny the request.

(((4)))(5) A credential holder may be randomly audited for continuing education compliance as specified in ((chapter 246-12 WAC, Part 7))WAC 246-12-170 through 246-12-240.

AMENDATORY SECTION(Amending WSR 15-14-092, filed 6/29/15, effective 7/1/15)

WAC 246-828-617Requirements for speech-language pathology assistant certification.

An applicant for certification as a speech-language pathology assistant must have one of the following minimum qualifications:

(1) An associate of arts or sciences degree, or a certificate of proficiency((, with transcripts showing forty-five quarter hours or thirty semester hours of speech-language pathology course work and transcripts showing)).

(a) Transcripts must show:

(i) Coursework that culminates in a speech-language pathology assistant certification program; and

(ii) Forty-five quarter hours or ((thirty))30 semester hours of general education credit from a board-approved institution of higher education as defined in WAC 246-828-025 (1)(b).

(b) Transcripts must reflect, or applicant must demonstrate, ((one hundred))100 hours of supervised patient/client/student work experience completed within a one-year time frame, or clinical experience practicum, with at least ((fifty))50 of those hours under direct supervision; or

(2) A bachelor of arts or bachelor of sciences degree with transcripts from a speech, language, and hearing program from a board-approved institution of higher education as defined in WAC 246-828-025 (1)(b). Transcripts must reflect, or applicant must demonstrate, ((one hundred))100 hours of supervised patient/client/student work experience completed within a one-year time frame, or clinical experience practicum, with at least ((fifty))50 of those hours under direct supervision.