Joint Sunset Committee .us



Joint Sunset Committee

Wednesday, February 18, 2009, 7:00 pm

House Chamber, Legislative Hall

Public Hearing Minutes

Board of Speech/Language Pathologists, Audiologists & Hearing Aid Dispensers

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JSC and Staff: Sen. David Sokola, Chair; Rep. John Kowalko, Vice-Chair; Sen. Brian Bushweller; Sen. Dorinda Connor; Rep. John Atkins; Rep. Bradford Bennett; Rep. Clifford Lee; Rep. Pamela Thornburg; Debbie Puzzo, JSC Executive Director; Judi Abbott, Legislative Council staff.

In attendance: James Collins, DPR; Kay Warren, DPR; Illene Courtright, President, Brd. Member; Mary Ann Connolly Gaskin, Secretary, Brd. Member; Tracy A. Bombara; Kathleen Vocek; Natalie Bentz; Michael Michelli, Brd. Member; Regina Bilton; Jacqueline Truluck; Dr. Jennifer Xenakes; Dr. Cynthia Parker, Brd. Member; Shawna Slaughter, Brd. Member; John Flaherty

_____________________________________________________________________________________

Agenda:

I. Overview of the Sunset Process (JSC Chair)

II. Opening Comments - Board of Speech/Language Pathologists, Audiologists & Hearing Aid Dispensers

( Question and Answer with JSC

( Public Comments (3 minutes per person)

III. Concluding remarks (JSC)

IV. Adjournment

Sen. Sokola called the meeting to order at 7:00 p.m.

I. Overview of the Sunset Process (JSC Chair)

Sen. Sokola welcomed everyone and thanked them for attending. Introduction of Committee members.

Sen. Sokola provided an overview of the JSC as well as the review process. The Board will have an opportunity to address the Committee and then the Committee members will ask questions. The Committee will meet with the Board at a later date to discuss suggested recommendations.

II. Opening Comments - Board of Speech/Language Pathologists, Audiologists & Hearing Aid Dispensers

Mr. Collins made the following statement:

Good Evening Senator Sokola, Representative Kowalko and members of the Joint Sunset Committee. Thank you for the opportunity to appear before you to discuss the review of the Delaware Board of Speech/Language Pathologists, Audiologists and Hearing Aid Dispensers. My name is James Collins (Director of the Division of Professional Regulation) and I am joined by Kay Warren (Deputy Director of the Division of Professional Regulation), Illene Courtright, Board President, Speech Pathologist; and Mary Ann Connolly Gaskin, Board Secretary, Audiologist. The other members of the Board Michael Michelli, Audiologist and Hearing Aid Dispenser; Regina Bilton, Speech Pathologist; Jennifer Xenakes, Educational Audiologist at Colonial; Cynthia Parker, Audiologist and Hearing Aid Dispenser; George Christensen [not present], Carol Guilbert [not present], and Dr. Marsha Britt [not present]).

The Board and the Division welcome the Joint Sunset Review process because we believe there are opportunities to increase public protection in this area [especially in the area of access to care]. It is our hope that such opportunities will result from this process.

I am pleased to provide an overview of the Board's activities, address major challenges identified in this Committee's Draft Report, and introduce the Board's suggestions:

Overview

( The Board currently licenses 451 speech pathologists, 68 audiologists and 92 hearing aid dispensers. Twenty-six of these licenses are temporary.

( From 2005 to 2007 there were eight complaints investigated. Four were forwarded to the AG's Office for prosecution (1 dismissed, 1 board imposed disciplinary action, 2 pending). The other four proved to be unfounded.

( The Board was previously reviewed by this committee in 1985 and 1993. The Board is in compliance with all of the committee's prior recommendations.

( During the 140th General Assembly SB 214 was enacted to implement the 1993 Joint Sunset Committee recommendations which added customary language regarding the Board's objectives; Board meetings, board member nonattendance provisions and bringing members under the provisions of the Public Integrity Act; rewriting powers and duties of the Board to include customary language concerning records, complaints, investigation of complaints; rewriting licensure qualifications to include all qualifications in one section of the code; adding language regarding impairment related to drugs, alcohol, felony or other criminal conviction for all applicants, including reciprocity applicants; rewriting reciprocity language requiring applicants to present proof of licensure in "good standing" in all states where the applicant is or has been licensed; rewriting language regarding issuance and renewal of licenses and completion of continuing education credits; rewriting the grounds for discipline and adding the ability to impose a monetary penalty not to exceed $500 for violations of the statute and rewriting and updating hearing procedures and investigation of complaints. Rules and regulations were promulgated in May 2001 to implement SB 214.

( The Board promulgated rules and regulations in April 2003 to revise continuing education requirements.

( In June 2004 SB 229 was enacted which created a uniform approach throughout Title 24 requiring that the refusal, revocation or suspension of licenses for professions and occupations regulated under Title 24 be based upon conviction of crimes that are "substantially related" to the profession or occupation at issue, and not for crimes that are unrelated to the profession or occupation. The bill required the boards of affected professions and occupations to promulgate regulations that specifically identify the crimes that are "substantially related" to the profession or occupation within 180 days of the enactment of the bill. The Board promulgated final rules and regulations to implement SB 229 to identify crimes substantially related to the practice of speech-language pathology, audiology and hearing aid dispensing in February 1, 2005.

( In July 2005, SB 206 was enacted to give protection to active duty military, activated reservists or members of the National Guard from having their professional licenses expire during active military deployments.

( In February 2006, the Board promulgated a final rule and regulation to protect the public by ensuring that products and services for hearing aid dispensers are advertised so that the terms of the transaction are clear and understandable [i.e. the small print].

( In July 2006, SB 183 was enacted to require applicants for hearing aid dispenser to complete six months of training prior to taking the examination. The Board promulgated final rules and regulations to establish the frequency of direct supervision during the training period. Licensed audiologists only needed to pass the test to become licensed hearing aid dispensers. The Board clarified the required frequency for calibration of electronic equipment used to assess hearing and allow for attestation of such calibration during the renewal process.

( During the 1431d General Assembly, SB 403 was enacted in July 2006 to allow Title 24 boards and commissions to waive convictions substantially related to the professions under certain conditions.

( During the 144th General Assembly HB 36 was passed. The legislation provided all boards and commissions, within the Division of Professional Regulation, cease and desist authority to address unlicensed practice and to impose fines for those who violate cease and desist orders subject to hearing procedures. Prior to passage of this bill, unlicensed activity was under the jurisdiction of the Justice of the Peace Court.

Challenges

( The Board is aware of the access to care issue as it relates to speech-language pathologists. The Board believes that a solution to this issue is the use of Telepractice (aka. Teletherapy). [Currently, the boards statute prevents this type of practice.] This practice utilizes real-time interactive audio and visual telepractice technology to provide treatment interventions. This change will help speech-language pathologists spend more time in rendering care by more efficiently using their time and allow speech-language pathologists located outside of the State to obtain a license to practice, expanded the pool of available speech language pathologist professionals.

( The Board needs to bring the education requirements for audiologists in line with the national standard of educational requirements. Masters programs for audiology will be totally phased out in 2009. The Board will need to change its audiology educational requirements to a doctoral degree for new audiology applicants, which will encompass the current practicum and fellowship requirements. [Right now, you have a masters degree and then you have to go through a fellowship and so the educational requirements nationally have just encompassed both of those into a doctorate degree. For example the Board’s law currently says you have to have a masters degree and a fellowship. So if you came to us with a doctorate degree, arguably, we may not be able to license you. So that language needs to be changed.] This change will enable Delaware to be reciprocal with other states' requirements and allow portability of licensees.

( The Board proposed to create a single license for audiologists who also wish to dispense hearing aides. Audiology applicants receive instruction during their training making them competent to dispense hearing aides. A single license is common in other states.

With this single license, the licensure process for new and reciprocal audiology applicants would be streamlined to one application and one license instead of two [that are currently necessary].

( The Board is proposing to reconfigure the current composition of the board to more accurately represent the licensee population and the nature of the issues coming before them. This change would increase the number of speech-language pathologists from two to four; maintain the audiology members at two; decrease the number of hearing aid dispensers from two to one and reduce the public members from three to two.

( As is evidenced by this summary, the Draft Report prepared by this Committee comprehensively identifies the concerns and needs related to this Board [and its related professions]. The Division and the Board of Speech/Language Pathologists, Audiologists and Hearing Aid Dispensers welcome the opportunity to work with this Committee to address these issues. Thank you.

( Question and Answer with JSC

Pages 6 & 7 of the Draft Report.

There was a discussion about speech language pathology aids and speech language pathology assistants. Currently Delaware uses speech language pathology aids in a clerical position to assist a speech pathologist. Speech language pathology aids are not regulated.

34 states use speech language pathology assistants. Sometimes they are prohibited from working in a hospital setting, some work in school settings. The assistant needs to have a very specific set of coursework, practicum and supervision to practice.

Pages 8 & 9 of the Draft Report.

The Board has never been audited by the State Auditor or another external organization, however, Mr. Collins stated that the Division handles all of the finances and administrative matters on behalf of all of the boards and commissions.

Sen. Sokola stated that Delaware is only one of 3 states in the country without a graduate program in speech-language pathology. There was a recommendation by the Speech/Language Pathologist Task Force to establish a graduate program at the University of Delaware.

Pages 10 & 11of the Draft Report.

Sen. Bushweller stated that the Report states that the Board’s primary objective is to protect the general public from unsafe practices and occupational practices which would reduce competition or fix the price of services rendered. The Senator asked for an example the type of things the Board does with regard to preventing practices that would reduce competition or fix the price of services rendered.

Ms. Gaskin replied that the objective is not to reduce competition, but rather to make sure that the public is getting the very best service.

There was a discussion about telepractice. Telepractice allows a practitioner from outside Delaware to treat a patient. Telepractice would increase competition as well as access to care in Delaware by increasing the pool of practitioners. A practitioner wanting to telepractice would be licensed to deliver services in Delaware. Currently the law prohibits telepractice or teletherapy in Delaware.

There was a discussion about the Board streamlining the renewal process by offering online renewals with the use of payment by credit card and the ability for licensees to attest to their continuing education online subject to post renewal audit. This procedure has been working well but there have been a few individuals that couldn’t produce the credentials. In that case, the individual is scheduled for a rule to show cause hearing. The Board has increased the percentage of new licensees that they audit will continue to keep it high until they are comfortable that they have compliance.

Pages 14 & 15 of the Draft Report.

There was a discussion about changing the composition of the 9 member Board to reflect the license population of which the majority of licenses are speech language pathologists. There are 451 speech pathologists, 68 audiologists, and 92 hearing aid dispensers, some of which are audiologists because they are required to get both licenses. The Board is proposing that the number of speech pathologists be increased from 2 to 4 members, keep the number of audiology members at 2 and decrease the number of hearing aid dispensers from 2 to 1and reduce the public members from 3 to 2.

Sen. Sokola stated that he has a problem with reducing the number of public members. He also likes to see a political balance as well as geographic balance on Boards. Typically most regulatory Boards have 1/3 public membership. Some Boards even include a member from the City of Wilmington. Mr. Collins suggested that perhaps the number of hearing aid dispensers could be decreased from 2 to 1 and add only one more speech pathologist. The number of public members would remain at 3.

Sen. Connor suggested that the statute be amended to provide that one of the public members be from each county. Mr. Collins suggested that the Governor be left with some discretion so as not to unnecessarily restrict the potential pool of qualified individuals.

Pages 16 & 17 of the Draft Report.

There was discussion about temporary licensure.

Pages 18 & 19 of the Draft Report.

There was a discussion about the fee schedule. Delaware's fees are generally lower than most states. Prior to the early 90’s fees were structured to where they believed the market would bear. In the early 90’s the Legislature established that the fees must reflect what it costs to run the various boards and commissions. As a result, some of the fees were lowered. Every 2 years the Department evaluates the cost to deliver the services for all boards and commissions and fees are based on that.

There was discussion about the proposal to change the licensure requirements for audiologists from a master’s degree to a doctoral degree. There would be a provision grandfathering those audiologists that are already licensed.

Pages 20 & 21 of the Draft Report.

Sen. Bushweller referenced the sentence on page 21 "Statute does not provide a specific exemption for physicians, except for the hearing screening issue." The Senator asked why there would be an exemption.

Mr. Collins replied that typically in most health care professions, the physicians are exempted because they are allowed to practice in any area where they are competent, so they generally get exempted in just about every health care law. The physician’s statute does not provide a scope of practice. Physicians are ethnically bound to practice in areas in which they are competent. In short it allows the ENT to practice speech pathology and audiology.

Sen. Bushweller stated that the topic of an exemption for physicians needs further discussion.

Sen. Sokola asked whether Delaware sets its own cut score or uses the national cut score with regard to the Praxis exam. The Praxis Exam for Speech/Language Pathologist and Audiology is a written, national exam developed by the American Speech-Language Hearing Association (ASHA). The test is offered 6-7 times a year.

Ms. Gaskin replied that individuals must achieve the national cut score in order to get what is called a Certificate of Clinical Competence which then allows them to get a permanent license in Delaware.

Pages 22 & 23 of the Draft Report.

Sen. Bushweller referenced the very last sentence on page 23 that read "One complaint was forwarded to the Attorney Generals Office and the Board imposed disciplinary action (2 fines of $500 and a written reprimand)." The Senator asked about the violation.

Ms. Parker replied that the violation was in connection with the size of type used in an offer regarding hearing aids.

Pages 24, 25 & 26 of the Draft Report.

Sen. Sokola asked whether all licensing fees are considered special funds. Mr. Collins replied that pursuant to Title 29 all fees are deposited into a special fund account and not general funds.

Pages 28, 29 & 30 of the Draft Report.

Sen. Sokola asked the Board to review the Points for Consideration and to let the Committee know if any are problematic.

( Public Comments

Ms. Bombara stated:

My name is Tracy Bombara, and I am a speech language pathologist. I'm employed by the Lake Forest School District and I'm also a member of the Delaware Speech and Hearing Assoc, Executive Council. I am here to provide some public comment on some of the issues that are in front of the Sunset Review committee. I would like to publicly state that I am in support of reconfiguring the licensure board to allow for more representation for speech language pathologists because we do make up the majority of persons who participate in the licensing process. Ms. Bombara continues with her statement as read below:

❖ I agree with changing the licensure law to support the AuD level of service provision to improve services to consumers.

❖ I agree with re-configuring the Speech Pathology-Audiology licensure board to increase speech pathologist representation on the board as speech-language pathologists comprise the majority of persons represented by the board.

❖ I have a few comments on SLPAs in Delaware:

o I am in support of providing a means of increasing access to services for consumers with regard to speech-language pathology in Delaware. [We certainly are dealing with a shortage of providers in the state right now.] I do feel that it must be done in a manner that continues to allow highly qualified persons to provide services that are equally high in quality to consumers. Any steps that are taken to increase service providers in Delaware should maintain a standard of high quality that the licensure board has guaranteed consumers for the past several years.

o I would like to suggest that any guidelines or qualifications that are established for an assistant level position be done so in cooperation with members of the Delaware Speech-Language and Hearing Association (DSHA) who have researched SLPA qualifications and responsibilities as part of service on the Governor’s Task Force on the Speech Pathology Shortage or through the DSHA Executive Council. Having served on both committees, I feel it is important to have knowledgeable voices involved when setting public policy and law. Having reviewed the qualifications for SLPAs on 3 different occasions in the past 10 years, I would like to state that the conclusion drawn each time is that SLPAs do not dramatically increase the number of persons served as the master’s level SLPs are effectively removed from service provision due to evaluation and supervision responsibilities.

o I also have concerns regarding the fact that there is a shortage of master’s level SLPs in Delaware. Adding a level of service provider that requires intensive supervision from master’s level SLPs when there aren’t currently enough in the state to meet current demands will spread thinner the capabilities of the master’s level SLPs who are practicing in the state.

o Since there is no national certification or registration process through the American Speech-Language Hearing Association (ASHA), I am concerned that any level of speech pathology assistant added to the current licensure guidelines for speech pathology practice in Delaware would mean that the assistant would actually be providing services under the master’s level SLP’s actual certification and state license. Because there is no recognized training program for SLPAs in the state, I feel that protection for supervising master’s level SLPs should be provided in any legislation that adds an SLPA level.

o The final concern that I would like to share is whether the addition of a “sub” level of speech pathology service providers may lead to possible procedural safeguard issues and/or due process cases. Because accredited or certified training programs for SLPAs do not currently exist in the state, the licensure board may be stipulating qualifications for a pool of service providers that is currently undefined [and untested].

So I would also like to ask that we take great care when we establish such a level of service provision in the state to make sure that the consumer rights are protected.]. I am hopeful that establishing a master’s level program in the state would take precedence or at least be considered of equal importance with establishing a assistant training program. Thank you.

Ms. Vocek made the following statement:

Thank you. Good evening, Members of the Committee. My name is Kathleen Vocek. I'm a speech language pathologist and I'm a resident of Newark, Delaware.

Thank you for this opportunity to speak to you on behalf of individuals who experience communication challenges as well as the professionals who provide services to those who may not easily be able to express themselves.

I am an ASHA Certified Speech Language Pathologist and have been a Delaware Licensed Speech Language Pathologist since 1982. In the past twenty-seven years I have worked in traditional public schools, in a public charter school, and provided home health services. I am a member of the Delaware Speech Hearing Language Association and have been a member of its Executive Council for more than twenty years. During that time, I have had the opportunity to participate in several Ad Hoc committees including the 1991, the 1997, and the 2006 committees discussing and drafting proposals regarding the use of speech aides and Speech Language Pathology Assistants in Delaware.

It is the issue of credentialing individuals practicing as Speech Language Pathologists and the issue of Speech Language Pathology Assistants on which I wish to speak on this evening. It is critical that the highest standards for licensure as a Speech Language Pathologist remain in place. Should the State of Delaware authorize Speech Language Pathology Assistants, it is critical that those individuals are highly trained and well supervised by licensed Speech Language Pathologists. The residents of Delaware deserve nothing less than the best.

The individuals we treat are just that, individuals with complex and distinctive needs. Our clients present with neurological, physical, and educational issues which impact the communication process. We provide professional services from cradle to grave. The decisions we make as we provide services impact the quality of life and in some cases, may extend life.

Speech language therapy is dynamic. It requires ongoing evaluation and decision-making. The individuals making these critical decisions must have extensive knowledge and training not only in articulation, language, fluency, and voice disorders but also dysphasia, aphasia, neurological disorders, cognitive issues, augmentative communication, hearing, cochlear implants, neonatal needs, early intervention, gerontology, and the list of clinical skills goes on. One must not only know when and how to treat but also when not to treat and when to make a referral.

It is critical that the Master’s Degree be maintained as the minimum standard for licensure in [speech language pathology] in Delaware. Individuals who have completed only a Bachelor’s Degree do not have the classroom training or supervised clinical experience to address these diverse treatment needs. In fact, it is reasonable to think that they have not had coursework in many of these topics and may not have any clinical experience. The residents of Delaware deserve to be treated by trained professionals who have knowledge and experience. [Consideration of lowering that standard as one way to address the shortage is not in the best interest of the residents of Delaware.] Reducing the standards is not the solution to the shortage of Speech Language Pathologists in Delaware.

If you ask practicing Speech Language Pathologists their opinion on the use of Speech Language Pathology Assistants in providing professional services, I believe you will find them conflicted on the issue. We recognize that many individuals are in need of speech language services and that we often wish that there were more hours in the week allowing us to provide more services to individuals in need of our specialized professional skills and to provide more training and education to families, educators, and caregivers. As an association, DSHA has addressed the issue of aides and assistants three times in the past eighteen years. Each time, the greatest concern is the clients that we serve. How do we ensure that the individuals who “assist” are properly trained before they are working with the clients? How do we ensure that the interventions that are to be carried out by an assistant reflect best practices? How do we ensure that the residents of Delaware are receiving the best services available?

The answer to this has always been to establish high entry standards and to provide ongoing supervision for these assistants. Time does not permit me to detail how this can be accomplished if Delaware chooses to move in this direction. As a professional association, DSHA has developed a draft proposal that the DSHA membership has reviewed and given tentative approval to. I am sure that this document can be made available for your review should you wish to pursue the issue of Speech Language Pathology Assistants. Thank you for your time this evening.

Sen. Sokola asked Mr. Collins to provide the Committee with information about the number of complaints, actions, and other issues that states that regulate Speech Language Pathology Assistants are facing.

Ms. Bentz made the following comments:

Good evening. My name is Natalie Bentz. I am a speech-language pathologist currently working for Smyrna School District. In light of recent comments, I would like to share my opinion about speech pathology assistants and their impact on our field. I previously worked for 7 years in Texas in a district that set stringent requirements for the hiring of speech language pathology assistants. The district was required to have documented their attempts to find qualified masters level speech pathologists for the position before they could hire an SLPA. The primary physician that most speech language pathology assistants occupied in my former district were those where the position was bilingual. This was a win-win situation for my district, as a number of bilingual children qualifying as speech impaired were increasing yearly and there were very few bilingual certified SLPs. I am concerned that there are no national standards for speech language pathology assistants. If Delaware were to allow speech language pathology assistants to practice, I would recommend that Delaware's currently practicing SLPs be involved in setting the requirements and standards for our state. While speech language pathology assistants may help in reducing our case loads, they may not necessarily maintain the quality of services our students/clients receive without proper knowledge and background communication development and disorders. In order to provide speech language pathology assistants with enough training, a bachelors level degree in specific courses in language acquisition and development should be required. If speech language pathology assistants are allowed to practice in Delaware, they must be properly supervised by certified SLPs. Those of us working in Delaware are already overloaded with our case loads, adding more paperwork and supervision as well as planning for both the speech language pathology assistants case loads as well as own is a tremendous amount of work to require. Proper supervision will turn most SLPs working with the speech language pathology assistants and supervisors who no longer have direct contact with all the students who we serve. Some speech pathologists may choose not to work with speech language pathology assistants due to the extra expectations and responsibilities unless they are properly evaluated. Due to the lack of graduate program within our state, I do not perceive the number of speech language pathologists growing in the near future. However, I do see the growth in the number of students with communication needs. Therefore something must be done. But I don't feel the addition of speech language pathology assistants is the answer to solving Delaware's shortage of speech language pathologists, I do feel that with proper consideration of standards set by practicing SLPs and appropriate supervision expectations, we can make this work to help alleviate our work loads. Thank you.

Ms. Truluck made the following statement:

My name is Jacqueline Truluck. I am a speech language pathologist and I am actually the president of the Delaware Speech and Hearing Association. I started in January of 2009. I am new to the course, and I do feel that many of the comments of my colleagues obviously have been well thought out and well supported. Many are speech language pathologists who are not here this evening. I currently work for the Delaware Early Childhood Center which and even more specifically Early Choices which is a program that is an agency that is in each of our counties. I've worked in Sussex County as well as in New Castle county in the past 10 years I've been through pre-school programming, early intervention, as well as I've worked in a hospital setting and a nursing home setting. I've had a range of experience and I feel that from the speech language assistant, there have been many issues brought up this evening that are concerning. What I want to talk a little bit about is the telepractice because I feel that although I personally have not had experience with this, not anybody who has been in Delaware has since it is not legal, do feel that we do need to keep up with the times that are in front of us. I think that you can get your degree on line these days, you can take an anatomy class and learn lots of information through new technology and I think that it is certainly a mode that we should be ready go with in order to keep up as well as in order to address the shortage. And it is addressing the shortage in a way that we are maintaining the standards that we know already exist within speech language pathologists. That is what I think everyone is saying here. As long as that person who is performing telepractice is going through the same process and that administrators and people in charge of who are hiring that sort of contracted work and that sort of service are understanding which sometimes there is a little bit of a problem with that, but to make sure that they understand the same policies and procedures are going to occur when telepractice is occurring. When that is going to happen, there are going to be business license… but Delaware I think we can go back to the same procedures and the same committee and the same board that we are utilizing to make sure that all of us here are doing the best we can. I think we can insure that. There certainly are certain areas where telepractice is probably not maybe the best opportunity, probably not the best way. The American Speech and Hearing Association has certainly put out technical reports and while I feel very confident that as a speech language pathologist and with my peers, that we as a profession will be prepared, if that is something we feel is something that is appropriate for our clients, for our families, and for the people we are working with. I think that anybody who is ready to go for it will get themselves trained, will get the CEU's in order to deliver that service the best way possible. I think that is just a really good stepping ground to address the shortage without jumping into a whole new venture, a venture that some of us are very scared of and are very concerned that administrators and people who are paying salaries will view as just such a potential thing that they are not going to have the foresight to understand what is going to come down the pike. This has been a board that has only addressed 8 complaints in 2 years. I'm very concerned that you will be spending a lot of your time dealing with complaints that are going to – potentially between parents, administrators, SLPs, - you are going to have potentially more people on staff to deal with the issues that could potentially come up from SLPAs. So I think really to be in support of telepractice, I think it is an exciting thing that will get us all up with the times as well as something that will ensure that our professionalism is still being carried out – that speech language pathologists is going to be present, is going to be administering the service and is going to be responsible for everything that is happening and going on. There is not going to be a middle man. Thank you.

Sen. Sokola stated that the most common complaint he hears is that there are not enough speech/language pathologists in Delaware.

III. Concluding remarks (JSC)

Ms. Puzzo stated that comments made at this public hearing, as well as the Points for Consideration will be listed as possible JSC Recommendations. The possible recommendation will be shared with the Board, the Director and the Committee members prior to the next JSC meeting.

Sen. Sokola thanked the members of the Committee for their attention and for their attendance. The record regarding Speech/Language Pathologists, Audiologists and Hearing Aid Dispensers will be kept open for a few weeks.

Rep. Kowalko stated that this Committee performs some very useful functions and at times there may be some contentious moments with regard to some of the entities the Committee reviews. The Representative requested that Committee members reserve judgment and try not to discuss the issues in public until the Committee makes its final recommendations.

IV. Adjournment

The meeting was adjourned at 8:30 p.m.

dap/March 16, 2009

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