Bill Text: CA SB1453 | 2021-2022 | Regular Session | Chaptered
Bill Title: Speech language pathologists.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Passed) 2022-09-19 - Chaptered by Secretary of State. Chapter 450, Statutes of 2022. [SB1453 Detail]
Download: California-2021-SB1453-Chaptered.html
Senate Bill
No. 1453
CHAPTER 450
An act to amend Section 2530.2 of the Business and Professions Code, relating to healing arts.
[
Approved by
Governor
September 19, 2022.
Filed with
Secretary of State
September 19, 2022.
]
LEGISLATIVE COUNSEL'S DIGEST
SB 1453, Ochoa Bogh.
Speech language pathologists.
Existing law, the Speech-Language Pathologists and Audiologists and Hearing Aid Dispensers Licensure Act, provides for the licensure and regulation of speech-language pathologists by the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board, and makes a violation of these provisions a crime. Existing law defines the practice of speech-language pathology to include the application of instrumental procedures for specified purposes relating to the development and disorders of speech, voice, language, or swallowing. Existing law specifies that instrumental procedures are the use of rigid and flexible endoscopes to observe specified areas of the throat for specified purposes, including collecting data. Existing law prohibits the construction of the provisions on the application of instrumental procedures as a diagnosis and imposes a requirement that any abnormalities be
referred to a physician and surgeon.
This bill would add to the above-specified provisions on instrumental procedures a statement that the passage of those instruments without the presence of a physician and surgeon is subject to the existing prohibition on construing those provisions as a diagnosis and the requirement to refer abnormalities to a physician and surgeon.
Existing law prohibits a speech-language pathologist from performing a flexible fiber optic nasendoscopic procedure unless they have received verification from an otolaryngologist that, among other things, they have performed a minimum of 25 flexible fiber optic procedures.
This bill would require the first 10 of those procedures to be supervised by a licensed physician and surgeon who performs nasal endoscopy as part of their practice and would require the subsequent 15 procedures to be supervised by either a
licensed physician and surgeon who performs nasal endoscopy as part of their practice or another licensed speech-language pathologist that is verified as competent in performing flexible fiber optic transnasal endoscopic procedures. The bill would specify that the otolaryngologist shall verify that the 25 flexible fiber optic transnasal endoscopic procedures were supervised.
Existing law authorizes a speech-language pathologist to pass a flexible fiber optic nasendoscopic instrument only under the direct authorization of an otolaryngologist and the supervision of a physician and surgeon.
This bill would recast these provisions to, instead, authorize a speech-language pathologist to pass a flexible fiber optic transnasal endoscopic instrument only upon the orders of a licensed physician and surgeon, which the bill would deem to allow a speech-language pathologist to perform fiber optic transnasal endoscopic procedures at a
location based on the patient’s medical needs. The bill would require a speech-language pathologist performing flexible fiber optic transnasal endoscopic procedures on patients who have contraindications to the procedure, as specified, to consult and document clearance with the physician and surgeon that the licensed speech-language pathologist can safely perform the procedure.
This bill would incorporate
additional changes to Section 2530.2 of the Business and Professions Code proposed by AB 2686 to be operative only if this bill and AB 2686 are enacted and this bill is enacted last.
By expanding the scope of a crime, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 2530.2 of the Business and Professions Code is amended to read:2530.2.
As used in this chapter, unless the context otherwise requires:(a) “Board” means the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board.
(b) “Person” means any individual, partnership, corporation, limited liability company, or other organization or combination thereof, except that only individuals can be licensed under this chapter.
(c) A “speech-language pathologist” is a person who practices speech-language pathology.
(d) The practice of speech-language pathology means all of the following:
(1) The application of principles, methods, instrumental procedures, and noninstrumental procedures for measurement, testing, screening, evaluation, identification, prediction, and counseling related to the development and disorders of speech, voice, language, or swallowing.
(2) The application of principles and methods for preventing, planning, directing, conducting, and supervising programs for habilitating, rehabilitating, ameliorating, managing, or modifying disorders of speech, voice, language, or swallowing in individuals or groups of individuals.
(3) Conducting hearing screenings.
(4) Performing suctioning in connection with the scope of practice
described in paragraphs (1) and (2), after compliance with a medical facility’s training protocols on suctioning procedures.
(e) (1) Instrumental procedures referred to in subdivision (d) are the use of rigid and flexible endoscopes to observe the pharyngeal and laryngeal areas of the throat in order to observe, collect data, and measure the parameters of communication and swallowing as well as to guide communication and swallowing assessment and therapy. Passage of these instruments without the presence of a physician and surgeon is subject to paragraph (2).
(2) Nothing in this subdivision shall be construed as a diagnosis. Any observation of an abnormality shall be referred to a physician and surgeon.
(f) A licensed speech-language pathologist shall not perform a flexible fiber optic transnasal endoscopic procedure unless they have received written verification from one otolaryngologist certified by the American Board of Otolaryngology that the speech-language pathologist has performed a minimum of 25 supervised flexible fiber optic transnasal endoscopic procedures and they are competent to perform these procedures. Of these 25 procedures, the first 10 procedures shall be supervised by a licensed physician and surgeon who performs nasal endoscopy as part of their practice and the subsequent 15 procedures shall be supervised by either a licensed physician and surgeon who performs nasal endoscopy as part of their practice or
by another licensed speech-language pathologist that is verified as competent in performing flexible fiber optic transnasal endoscopic procedures. The speech-language pathologist shall have this written verification on file and readily available for inspection upon request by the board. A speech-language pathologist with a verification on file shall pass a flexible fiber optic transnasal endoscopic instrument only upon the orders of a licensed physician and surgeon. The order by physician and surgeon is deemed to allow a speech-language pathologist with verification, in accordance with this paragraph, to perform fiber optic transnasal endoscopic procedures at a location based on the patient’s medical needs that complies with procedures specified in paragraph (1) of subdivision (g).
(g) (1) A licensed
speech-language pathologist shall only perform flexible endoscopic procedures described in subdivision (e) in the following settings that requires the facility to have protocols for emergency medical backup procedures, including a physician and surgeon or other appropriate medical professionals being readily available.
(A) A clinic, as defined in Section 1200 of the Health and Safety Code.
(B) A facility described in Chapter 2.5 (commencing with Section 1440) of Division 2 of the Health and Safety Code.
(C) A health facility, as defined in Section 1250 of the Health and Safety Code.
(D) A hospice facility licensed pursuant to Chapter 8.5 (commencing
with Section 1745) of Division 2 of the Health and Safety Code.
(E) A medical group practice, including a professional medical corporation, as defined in Section 2406, another form of corporation controlled by physicians and surgeons, a medical partnership, a medical foundation exempt from licensure, or another lawfully organized group of physicians and surgeons that provides health care services.
(2) A licensed speech-language pathologist performing flexible fiber optic transnasal endoscopic procedures on patients who have contraindications to the procedure
shall consult and document clearance with the physician and surgeon that the licensed speech-language pathologist can
safely perform the procedure. For purposes of this paragraph, contraindications for these procedures may include, but are not limited to, cases of bilateral obstruction of nasal passages, refractory epistaxis, cardiac disorder with acute risk of vasovagal episode and bradycardia, history of vasovagal episodes, facial trauma, recent trauma to the nasal cavity, or surrounding tissue and structures secondary to surgery or injury, severe bleeding disorders, severe movement disorders, severe agitation, and inability to cooperate with the
examination.
(h) “Speech-language pathology aide” means any person meeting the minimum requirements established by the board, who works directly under the supervision of a speech-language pathologist.
(i) (1) “Speech-language pathology assistant” means a person who meets the academic and supervised training requirements set forth by the board and who is approved by the board to assist in the provision of speech-language pathology under the direction and supervision of a speech-language pathologist who shall be responsible for the extent, kind, and quality of the services provided by the speech-language pathology assistant.
(2) The supervising speech-language pathologist employed or contracted
for by a public school may hold a valid and current license issued by the board, a valid, current, and professional clear clinical or rehabilitative services credential in language, speech, and hearing issued by the Commission on Teacher Credentialing, or other credential authorizing service in language, speech, and hearing issued by the Commission on Teacher Credentialing that is not issued on the basis of an emergency permit or waiver of requirements. For purposes of this paragraph, a “clear” credential is a credential that is not issued pursuant to a waiver or emergency permit and is as otherwise defined by the Commission on Teacher Credentialing. Nothing in this section referring to credentialed supervising speech-language pathologists expands existing exemptions from licensing pursuant to Section 2530.5.
(j) An “audiologist” is one
who practices audiology.
(k) “The practice of audiology” means the application of principles, methods, and procedures of measurement, testing, appraisal, prediction, consultation, counseling, and instruction related to auditory, vestibular, and related functions and the modification of communicative disorders involving speech, language, auditory behavior, or other aberrant behavior resulting from auditory dysfunction; and the planning, directing, conducting, supervising, or participating in programs of identification of auditory disorders, hearing conservation, cerumen removal, aural habilitation, and rehabilitation, including hearing aid recommendation and evaluation procedures, including, but not limited to, specifying amplification requirements and evaluation of the results thereof, auditory training, and speech reading, and the selling
of hearing aids.
(l) A “dispensing audiologist” is a person who is authorized to sell hearing aids pursuant to their audiology license.
(m) “Audiology aide” means any person meeting the minimum requirements established by the board. An audiology aid may not perform any function that constitutes the practice of audiology unless they are under the supervision of an audiologist. The board may by regulation exempt certain functions performed by an industrial audiology aide from supervision provided that their employer has established a set of procedures or protocols that the aide shall follow in performing these functions.
(n) “Medical board” means the Medical Board of California.
(o) A “hearing screening” performed by a speech-language pathologist means a binary puretone screening at a preset intensity level for the purpose of determining if the screened individuals are in need of further medical or audiological evaluation.
(p) “Cerumen removal” means the nonroutine removal of cerumen within the cartilaginous ear canal necessary for access in performance of audiological procedures that shall occur under physician and surgeon supervision. Cerumen removal, as provided by this section, shall only be performed by a licensed audiologist. Physician and surgeon supervision shall not be construed to require the physical presence of the physician, but shall include all of the following:
(1) Collaboration on the development of written standardized protocols.
The protocols shall include a requirement that the supervised audiologist immediately refer to an appropriate physician any trauma, including skin tears, bleeding, or other pathology of the ear discovered in the process of cerumen removal as defined in this subdivision.
(2) Approval by the supervising physician of the written standardized protocol.
(3) The supervising physician shall be within the general vicinity, as provided by the physician-audiologist protocol, of the supervised audiologist and available by telephone contact at the time of cerumen removal.
(4) A licensed physician and surgeon may not simultaneously supervise more than two audiologists for purposes of cerumen removal.
SEC. 1.5.
Section 2530.2 of the Business and Professions Code is amended to read:2530.2.
As used in this chapter, unless the context otherwise requires:(a) “Board” means the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board.
(b) “Person” means any individual, partnership, corporation, limited liability company, or other organization or combination thereof, except that only individuals can be licensed under this chapter.
(c) A “speech-language pathologist” is a person who practices speech-language pathology.
(d) The practice of speech-language pathology means all of the following:
(1) The
application of principles, methods, instrumental procedures, and noninstrumental procedures for measurement, testing, screening, evaluation, identification, prediction, and counseling related to the development and disorders of speech, voice, language, or swallowing.
(2) The application of principles and methods for preventing, planning, directing, conducting, and supervising programs for habilitating, rehabilitating, ameliorating, managing, or modifying disorders of speech, voice, language, or swallowing in individuals or groups of individuals.
(3) Conducting hearing screenings.
(4) Performing suctioning in connection with the scope of practice described in paragraphs (1) and (2), after compliance with a medical facility’s training protocols on suctioning procedures.
(e) (1) Instrumental procedures referred to in subdivision (d) are the use of rigid and flexible endoscopes to observe the pharyngeal and laryngeal areas of the throat in order to observe, collect data, and measure the parameters of communication and swallowing as well as to guide communication and swallowing assessment and therapy. Passage of these instruments without the presence of a physician and surgeon is subject to paragraph (2).
(2) Nothing in this subdivision shall be construed as a diagnosis. Any observation of an abnormality shall be referred to a physician and surgeon.
(f) A licensed speech-language pathologist shall not perform a flexible fiber optic
transnasal endoscopic procedure unless
they have received written verification from one otolaryngologist certified by the American Board of Otolaryngology that the speech-language pathologist has performed a minimum of 25 supervised
flexible fiber optic transnasal endoscopic procedures and they are competent to perform these procedures. Of these 25 procedures, the first 10 procedures shall be supervised by a licensed physician and surgeon who performs nasal endoscopy as part of their practice and the subsequent 15 procedures shall be supervised by either a licensed physician and surgeon who performs nasal endoscopy as part of their practice or by another licensed speech-language pathologist that is verified as competent in performing flexible
fiber optic transnasal endoscopic procedures. The speech-language pathologist shall have this written verification on file and readily available for inspection upon request by the board. A speech-language pathologist with a verification on file shall pass a flexible fiber optic transnasal endoscopic instrument only
upon the orders of a licensed physician and surgeon. The order by physician and surgeon is deemed to allow a speech-language pathologist with verification, in accordance with this paragraph, to perform fiber optic transnasal endoscopic procedures at a location based on the patient’s medical needs that complies with procedures specified in paragraph (1) of subdivision (g).
(g) (1) A licensed speech-language pathologist shall only perform flexible
endoscopic procedures described in subdivision (e) in the following settings that requires the facility to have protocols for emergency medical backup procedures, including a physician and surgeon or other appropriate medical professionals being readily available.
(A) A clinic, as defined in Section 1200 of the Health and Safety Code.
(B) A facility described in Chapter 2.5 (commencing with Section 1440) of Division 2 of the Health and Safety Code.
(C) A health facility, as defined in Section 1250 of the Health and Safety Code.
(D) A hospice facility licensed pursuant to Chapter 8.5 (commencing with Section 1745) of Division 2 of the Health and Safety Code.
(E) A medical group practice, including a professional medical corporation, as defined in Section 2406, another form of corporation controlled by physicians and surgeons, a medical partnership, a medical foundation exempt from licensure, or another lawfully organized group of physicians and surgeons that provides health care services.
(2) A licensed speech-language pathologist performing flexible fiber optic transnasal endoscopic procedures on patients who have contraindications to the procedure shall consult and document clearance with the physician and surgeon that the licensed speech-language pathologist can safely perform the procedure. For purposes of this paragraph, contraindications
for these procedures may include, but are not limited to, cases of bilateral obstruction of nasal passages, refractory epistaxis, cardiac disorder with acute risk of vasovagal episode and bradycardia, history of vasovagal episodes, facial trauma, recent trauma to the nasal cavity, or surrounding tissue and structures secondary to surgery or injury, severe bleeding disorders, severe movement disorders, severe agitation, and inability to cooperate with the examination.
(h) “Speech-language pathology aide” means any person meeting the minimum requirements established by the board, who works directly under the supervision of a speech-language pathologist.
(i) (1) “Speech-language pathology assistant” means a person who meets the academic and supervised training requirements set forth by the board and who is approved by the board to assist
in the provision of speech-language pathology under the direction and supervision of a speech-language pathologist who shall be responsible for the extent, kind, and quality of the services provided by the speech-language pathology assistant.
(2) The supervising speech-language pathologist employed or contracted for by a public school may hold a valid and current license issued by the board, a valid, current, and professional clear clinical or rehabilitative services credential in language, speech, and hearing issued by the Commission on Teacher Credentialing, or other credential authorizing service in language, speech, and hearing issued by the Commission on Teacher Credentialing that is not issued on the basis of an emergency permit or waiver of requirements. For purposes of this paragraph, a “clear” credential is a credential that is not issued pursuant to a waiver or emergency permit and is as otherwise defined by the Commission on Teacher
Credentialing. Nothing in this section referring to credentialed supervising speech-language pathologists expands existing exemptions from licensing pursuant to Section 2530.5.
(j) An “audiologist” is one who practices audiology.
(k) “The practice of audiology” means the application of principles, methods, and procedures of measurement, testing, appraisal, prediction, consultation, counseling, and instruction related to auditory, vestibular, and related functions and the modification of communicative disorders involving speech, language, auditory behavior, or other aberrant behavior resulting from auditory dysfunction; and the planning, directing, conducting, supervising, or participating in programs of identification of auditory disorders, hearing conservation, cerumen removal, aural habilitation, and rehabilitation, including hearing aid recommendation and evaluation procedures,
including, but not limited to, specifying amplification requirements and evaluation of the results thereof, auditory training, and speech reading, and the selling of hearing aids.
(l) A “dispensing audiologist” is a person who is authorized to sell hearing aids pursuant to their audiology license.
(m) “Audiology aide” means any person meeting the minimum requirements established by the board who works directly under the supervision of an audiologist. The board may by regulation exempt certain functions performed by an industrial audiology aide from supervision provided that their employer has established a set of procedures or protocols that the aide shall follow in performing these functions.
(n) “Medical board” means the Medical Board of California.
(o) A “hearing screening” performed by a speech-language pathologist means a binary puretone screening at a preset intensity level for the purpose of determining if the screened individuals are
in need of further medical or audiological evaluation.
(p) “Cerumen removal” means the nonroutine removal of cerumen within the cartilaginous ear canal necessary for access in performance of audiological procedures that shall occur under physician and surgeon supervision. Cerumen removal, as provided by this section, shall only be performed by a licensed audiologist. Physician and surgeon supervision shall not be construed to require the physical presence of the physician, but shall include all of the following:
(1) Collaboration on the development of written standardized protocols. The protocols shall include a requirement that the supervised audiologist immediately refer to an appropriate physician any trauma, including skin tears, bleeding, or other pathology of the ear discovered in the process of cerumen removal as defined in this subdivision.
(2) Approval by the supervising physician of the written standardized protocol.
(3) The supervising physician shall be within the general vicinity, as provided by the physician-audiologist protocol, of the supervised audiologist and available by telephone contact at the time of cerumen removal.
(4) A licensed physician and surgeon may not simultaneously supervise more than two audiologists for purposes of cerumen removal.
