L. B. E. S. P. A.
Louisiana Board of Examiners for Speech-Language Pathology and Audiology
Spring 2002Printed Newsletter Editor: Gay T. Vekovius / Online Newsletter Editor: Onesimus Internet Solutions, Inc.
The Louisiana Board of Examiners for Speech-Language Pathology and Audiology (LBESPA) is charged by law with public protection and standardization of the requirements for Speech-Language Pathology and Audiology licenses. The Board receives no funding from the state's general fund but operates solely on self-generated funds from license and renewal fees.
LBESPA's fees are used for a variety of activities; however, first and foremost is the license and renewal process. To accomplish this task, LBESPA maintains a full-time office, pays salaries for employees, and negotiates contracts for various professionals to provide needed services, such as legal, investigative, and financial, to name a few. The Board maintains a Video Library and sponsors an annual conference for the continuing education of licensees. In addition, Board members support the continuing education programs of two professional organizations, the Louisiana Speech-Language-Hearing Association (LSHA) and Speech-Language Pathologists in Public Schools Association (SPALS).
The Board maintains a website (www.lbespa.org) for public information and easy access to records and our staff. Currently the public can search our database of licensed practitioners to verify an individual's credentials or to find needed services in a specific area. LBESPA supports the continuing education of board members and staff and investigates between 15 and 30 complaints annually. While we share our licensees concern for the costs of licensing, we see the need for public protection and standardization of the requirements for licensure in the State of Louisiana
Legal and Ethical Issues in Supervision
In your current job, do your job duties include providing supervision? What are your responsibilities? Have you ever had an academic course or attended continuing education activities in supervision? How would you define your supervisory style? Does the process of supervision make you responsible for the action of others? Are you legally and ethically liable for the individuals you supervise?
Many professionals learn to supervise by being the recipient of supervision (Guest & Dooley, 1999; Newman, 2001; Rassi, 2002; Remley & Hendren, 1989). The assumption exists that being supervised teaches the skill of supervision. As a consumer, would you want a physician whose sole knowledge of medicine was obtained by going to the doctor?
Many practicing professionals consider supervision a duty, but may not understand the legal issues involved. Understanding the process of supervision enables navigation of the encompassing legal and ethical issues in supervision. Remley and Hendren (1989) state that it is important to realize the similarities that exist in ethical and legal issues. With all things, there are inherent risks especially when becoming responsible for the actions of others. Regardless of job or title, if you are supervising a student, colleague, or employee, you could be legally and ethically responsible for their actions.
There is potential for malpractice in the provision of supervision. Guest and Dooley (1999) stated a supervisor should be aware of the potential for malpractice. The authors outlined the "elements of malpractice as duty of care, standard of care, harm, and proximate cause" (p. 270). Although these are rather legal terms, further examination of each of these issues is relevant to speech-language pathology and audiology.
“Duty of care” implies that a contract exists (p. 271). The supervisor/supervisee relationship could be considered equivalent to the therapist/client relationship. For instance, the elements of trust and power are exhibited in both relationships.
Voluntary organizations (e.g., ASHA, LSHA, SPALS, or teacher unions) or state laws (e.g., LBESPA) establish “standards of care” through codes of ethics. Malpractice would consist of disregarding the “standard of care” in such a way that it would be evident to the consumer, or peer experts.
“Harm” can exist at a physical or subjective level. “Harm” could consist of overextension of the supervisee, and consequent injury. Guest and Dooley (1999) define consequent injury as "behavior from the supervisor that may cause the supervisee to lose income or be unable to obtain licensure" (p. 272). Subjective “harm” was defined as the frequently used terms "pain and suffering" (p. 272). Finally, if harm is established “proximate cause” could be proven.
In order to avoid the legal and ethical liabilities of supervision, SLPs and audiologists are advised to:
 | seek training in supervision |
| refrain from supervision until educated |
| supervise only in the area of competence (Newman,2001) |
| develop contracts with supervisees outlining duties and responsibilities |
| practice risk management |
| evaluate performance of supervisees on an ongoing basis. |
As professionals, speech-language pathologists and audiologists must become aware and educated about the process of supervision. Through awareness and education, speech-language pathologists and audiologists can avoid legal and ethical liabilities.
References
Guest, C.L. & Dooley, K. (1999). Supervisor malpractice: Liability to the supervisee in clinical supervision. Counselor Education and Supervision, 38 (4), 269-276.
Newman, W.S. (2001). The ethical and legal aspects of clinical supervision. ASHA Special Interest Division 11, Administration and Supervision Newsletter, 11, (3), 18-22.
Rassi, J.A. (2002, February). Understanding supervision and making it effective. Paper presented at the Mid-South Conference on Communicative Disorders, Memphis, TN.
Remley, T. P & Hendren, G.R. (1989). Legal liability of supervisors. Rehabilitation Education, 3, 177-183. Kerri Phillips
Kerri Phillips, L-SLP
LBESPA Board Member
LBESPA Promulgates Rules Change
With the advent of universal hearing screening and the use of support personnel to perform the screenings has come the need to develop more definitive guidelines relative to the duties and supervision requirements for audiology aides. Medicaid recently expressed concern about reimbursement for hearing screenings that were being performed by individuals who were neither properly trained nor appropriately supervised. This issue, coupled with complaints that other audiology support personnel were performing tasks far beyond their scope of practice, led LBESPA to draft proposed rules changes that would ensure protection of the consumers of our services in all work settings.
The proposed changes re-define aides to include all individuals who perform tasks prescribed, directed, and supervised by speech-language pathologists and audiologists. The changes relate more specifically to audiology by establishing minimurn supervision requirements and by outlining the duties that aides can perform for audiologists who supervise these support personnel. Supervision requirements are consistent with those established by the Office of Public Health for the newborn hearing screening program and provide for periodic direct observation during the initial year of the aide's employment and for subsequent years. Duties allow for the performance of all hearing screening tests and for the administration of pure tone air conduction threshold tests without interpretation. Licensed speech-language pathologists and licensed audiologists will continue to be legally, ethically, and morally responsible for the services provided by aides working under their direction.
It is anticipated that the proposed changes will resolve some of the concerns related to individuals performing duties outside their scope of practice as well as address the reimbursement issues raised by Medicaid and other third party payers. A public hearing on the proposed changes is scheduled for Thursday, March 29, 2002, at 9:00 A.M. in the LBESPA Board office. The deadline for receipt of all written comments is 4:00 P.M. on Thursday, March 28, 2002.
The State of Louisiana has given the Department of Social Services (DSS) the authority to suspend licenses of parents who are delinquent in their child support payments. Driver's licenses, motor vehicle registrations, hunting and fishing, professional and occupational licenses can be suspended.
Speech pathology and audiology licenses are included among those in jeopardy. The Board has been notified by DSS that we must transmit the names and addresses of all the licensees four times a year. The first submission of licensed speech pathologists and audiologists was sent to DSS in January, 2002.
There are 45,000 to 50,000 child support collection cases that meet the criteria for license suspension. By the end of March or early April, the first licenses could be suspended. Certified letters of notification are being mailed by the Department of Social Services advising non-paying parents that their case is targeted for administrative license suspension.
Yvonne Fowler, Public Member of LBESPA, attended the 14th Annual Citizens Advocacy Conference in Philadelphia, PA - November 14-16, 2001. She found the session on “Capitalizing on Public Members to Enhance a Board’s Credibility and Accountability” most interesting. Topics discussed included: the number of public members on a licensing board, the acceptance of complaints by telephone, and posting a sign in licensees’ workplaces to inform consumers of contact information for reporting problems.
Ms. Fowler reports “Louisiana seems to rank very high where regulation of health care professions is concerned. LBESPA is a dedicated professional board and I am honored to be a part of this board.”
Yvonne M. Fowler, Public Member
Appointed by Governor Foster October 17, 2001 to serve a 3 year term, expiring
August 15, 2004.
The following information is provided by Susan Lemonier, CCC-A/SLP and Dean Marie Lofaso, Claims Manager, with Slidell Ear, Nose and Throat Association. The Health Care Financing Administration (HCFA) issued a Medicare Program Memorandum (Transmittal B-01--34) clarifying that Medicare carriers may not automatically deny coverage of hearing tests because they result in a diagnosis of sensorineural hearing loss (CPT code 389.10).
If payment for audiological services has been denied in Louisiana Practices that provide for Medicare recipients, please contact Dr. Lynn Hickman at P.O. Box 83830, Baton Rouge, LA 70884-3830 (telephone number: 225-231-2114) to discuss procedures for payment.
Question: I was a practicing speech-language pathology assistant in a state where assistants were not required to be licensed. I worked in the schools and had a teaching certificate in that state. Although I have a bachelor's degree in speech-language pathology, I did not have any practicum experience other than my observation hours. I have been told that I will not be eligible for licensure in Louisiana. Is there any way the 100-hour practicum requirement can be waived?
Answer: The 100-hour practicum requirement is considered to be minimal and cannot be waived The standards for obtaining licensure as an assistant in Louisiana were based on much research, the input of practitioners, and careful consideration of the tasks that would be performed and the clients that would be served. In addition, LBESPA is bound to uphold Louisiana law and cannot deviate from the qualifications for licensure that have been enacted in law and adopted as rules under the legislative oversight process. Further, if seeking employment in a Louisiana school system, it would appear that the qualifications for an ancillary teaching certificate also would not be met, as specified on page 124 of Louisiana Bulletin 746, Louisiana Standards for State Certification of School Personnel ("An ancillary certificate for Speech/Language Pathology Assistant-Level 1, valid for three years and renewable, may be issued to an individual who has earned a baccalaureate degree in speech/language pathology from a regionally accredited institution and has completed at least 100 clock hours of supervised clinical practicum.")
Question: As the audiology supervisor of a hospital-based infant hearing screening program, I often train nurses as well as aides to perform the screenings. Am I legally and ethically responsible for the nurses even though they are regulated by their own licensure board?
Answer: Yes, anyone acting as an audiologist in charge of supervising newborn hearing screening must abide by the practice act and the Rules, Regulations and Procedures, including the Code of Ethics. The practice of audiology, the governance of which is specified in Act 892 of the 1995 Regular Session of the Louisiana Legislature, cannot be separated from the totality of the infant hearing screening program, including instances in which personnel other than those regulated by LBESPA are the individuals that actually carry out the screenings.
Open Book Exam on the Code of Ethics
Two years ago LBESPA copyrighted an open book exam on Act 892 (the practice act) and one on the Rules and Regulations. The exams have been used for educational purposes and as part of sanctions imposed on licensees who violate the licensing statute. Work has recently been completed on a two-part open book examination pertaining to the LBESPA Code of Ethics. Part I of the ethics exam pertains to the practices of both speech-language pathology and audiology and presents examples of situations or scenarios that violate the Code of Ethics. Licensees are asked to indicate which specific principle(s) have been violated. Part II requires a higher level of ethical decision-making by presenting detailed scenarios depicting possible violations of the Code of Ethics. The multiple-choice answer that represents the best ethical decision must then be selected. Part II of the exam has situations geared to the type of license held and contains a test specifically designed for speech-language pathologists, one for audiologists, and one for assistants. Plans are underway to submit Part I for copyrighting. Part II will not be copyrighted at this time as LBESPA plans to change and update the scenarios from time to time.
It is becoming more common for states to require applicants for a speech-language pathology or audiology license to complete an examination on the enabling statute that governs the practice in that state. While LBESPA has no plans to incorporate an exam as part of the application process, the Board will continue to employ the copyrighted exams to educate its licensees. It should be noted that Louisiana is the only state thus far to have obtained a copyright on exams specific to speech-language pathology and audiology licensing.
| Glenn M. Waguespack, L-AUD, Chair |
| Kerrilyn Phillips, L-SLP, Vice-Chair |
| Annie Mouton, L-SLP, Secretary/Treasurer |
| Melinda Peat, L-AUD, Board Member |
| Theresa H. Rodgers, L-SLP, Board Member |
| Yvonne Fowler, Public Member |
| Lawrence Braud, M.D., Medical Advisor |
CONTACT LBESPA
LBESPA
18550 Highland Road, Suite B
Baton Rouge, LA 70809
(225) 756-3480 Telephone
(225) 756-3472 Fax
Email: aud-slp@lbespa.org
Website: www.lbespa.org
Staff:
|
Suzanne Pevey, Administrator |
|
Judy Graham, Administrative Assistant |
|
Deborah Pratt, Clerical Assistant |
|
Terry Martin, Clerical Assistant |
|
Newsletter Editor: Gay T. Vekovius |
Adkins, Melissa
Almond, Lisa
Ard, Becky
Bailey, Angela
Banwell, Carly
Barranco, Melanie
Bauer, Casey
Bauer, Courtney
Beazley, Sharon
Beck, Bridget
Bell, T. Michelle
Bourne, Karen
Branch, Linda
Brewer, Tammy
Bridges, Latonia
Broussard, Alison
Broussard, S.
Brown, Alona
Brown, Joseph
Buckley, Aimee
Carbajal, Patricia
Chustz, Jerica
Clement, Kristy
Colomb, Ayanna
Coney, Megan
Coplin, Brian
Crawford, Kristie
Crifasi, Tracey
Cruz-Mitchell, A.
Damon, Leslie
Davis, Kimberly
Davis, Tracy
Dixon, Rosailyn
Domengeaux, J.
Drost, Theresa
Estes, Sarah
Fletcher, Ashley
Flurry, Brandy
Foret, Audra
Free, Malee
Fruge, Paula
Gallman, D.
Garcia, Stacey
Giannobile, C.
Gill, Jessica
Green, Rita
Greene, Madelyn
Griffith, Carol
Grissom, Tara
Guillotte, K.
Hardy, Kaarina
Hartenstein, Aimee
Hasbargen, Brandi
Hayes, Jennifer
Hudson, Darcy
James, Tara
Johnson, April
Johnson, G.
Keesler, Anne M.
Kern, Rochelle
Korfhage, Lea
Korowin, Michael
Lanier-Nabors, J.
Lavergne, Simone
Leblanc, Elena
Lopez, Adam
Lormand, Hallie
Marble, Amy
Marks, Lisa
Matherne, Ellen
Matherne, Renee
Mathews, E.
Matte, Amanda
McNeal, Jennifer
Mixon, Kimberly
Moore, Bridgette
Morgan, Shannon
Morris, Kara
Musfeldt, Robin
Myers, Julie
Navalance, M.
Norvell, Leanne
Ogle, Cherie
Parche’, Shelly
Parkman, Laura
Patten, Anne
Rodgers, Linda
Prat, Anne
Prejean, Aimee
Perich, Audrey
Prakoura, Elena
Prestridge, Karla
Ricaud, Andre
Ricks, Dorothy
Rogers, Rebecca
Rose, Kelly
Sellers-Leaumont, R.
Seneca, April
Simon, Kaci
Rouillier, Leslie
Solomon, Bianca
Rugeley, Sara
Seiler, Karen
Solomon, Denise
Stewart, Gretchen
Stoot, Carol
Talmore, Nichelei
Thibodeaux, M.
Thomas, Tara Jane
Thompson, S.
Tinnerello, Tonya
Toma, Reem
Trahan, Elizabeth
Trahan, Tanya
Tran, Thuy
Tuminaro, Tammra
Van Wagener, E.
Varnado, Chantelle
Vignes, Leah
Whitson, Kerri
Winfrey, Michelle
Young, Carmen
Zahn,Ashley