adding the customary language regarding the Board’s objectives;

adding customary language regarding Board meetings, nonattendance, and bringing members under the provisions of the Public Integrity Act;

rewriting powers and duties of the Board to include the customary language concerning records, complaints, investigation of complaints;

rewriting qualifications for licensure to include all qualifications in one section of the code; add customary language regarding impairment related to drugs, alcohol, felony or other criminal conviction for all applicants, including reciprocity applicants;

rewriting reciprocity language to require the applicant to present proof of licensure in ‘good standing’ in all states where he or she 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 including customary language; adding the ability to impose a monetary penalty not to exceed $500 for violations of the statute; rewriting and updating hearing procedures and investigation of complaints.

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 Rule and Regulation 11.0 (Crimes substantially related to the practice of speech/language pathology, audiology and hearing aid dispensing) effective 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 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 in its Rules and Regulations established the frequency of direct supervision during the training period. Rules and Regulation 3.3.1.3 Licensed audiologists only needed to pass the test to become licensed hearing aid dispensers.

In July 2006, SB 403 was enacted to allow Title 24 boards and commissions to waive convictions substantially related to the professions under certain conditions.

In June 2008, HB 36 was enacted to give all boards and commissions cease and desist authority to address unlicensed practice and to impose fines for those who violate cease and desist orders subject to hearing procedures. JSC Initial Questionnaire, pgs. 4-5

Proposed Legislation
The Board worked with its Deputy Attorney General to draft proposed legislation for the 144^th General Assembly, but held off introducing the bill due to the Board’s Joint Sunset Review. If the proposed legislation is adopted, the Board will need to promulgate rules and regulations to implement the legislation. JSC Initial Questionnaire, pg. 7 (Appendix B)

Speech/Language Pathologists and Audiologists
Speech/language pathologists assess, diagnose, treat, and help to prevent disorders related to speech, language, literacy, cognitive functioning, voice, swallowing, and fluency. In educational settings, speech/language pathologists collaborate with teachers, special educators, other educational personnel, and families to enhance educational outcomes for students with communication disabilities. In health care setting, speech/language pathologists work in conjunction with physicians, social workers, psychologists, nutritionists, and other therapy professionals to help individuals overcome the barriers posed by developmental or health conditions that impact communication. Final Report, Governor’s Task Force on Licensed Speech-Language Pathologists, pg. 1

Currently speech/language pathologists are assisted by speech pathology aides. Duties of the aide are prescribed by Regulation and include: assisting with testing or treatment, clerical support, client escort, preparation of therapeutic materials equipment maintenance and participation with research projects or in service training. All work must be performed under the direct supervision of a licensed speech/language pathologist. Board Rules and Regulations, Rule 6.3 This is not a licensed, permitted or certified position.

Speech/Language Pathology Assistants
Thirty four states currently regulate speech-language assistants, although the title and education requirements vary. Speech/Language Pathology Assistants would perform the following duties under the direct supervision of a speech/language pathologist: assist speech-language and hearing screenings (without interpretation), assist with informal documentation as directed by the speech-language pathologist, follow documented treatment plans or protocols developed by the supervising speech-language pathologist, document patient/client performance, assist the speech-language pathologist during assessment of patients/clients, assist with clerical duties such as preparing materials and scheduling activities as directed by the speech-language pathologist, perform checks and maintenance of equipment, support the supervising speech-language pathologist in research projects, in-service training, and public relations programs, and assist with departmental operations, collect data for monitoring quality improvement. http://www.asha.org/about/membership-certification/faq Speech/Language Pathology Assistants would not be used in place of licensed speech/language pathologist.

The Governor’s Task Force on Licensed Speech-Language Pathologists (discussed later in this Report) found that Delaware has a shortage of speech/language pathologists and Delaware’s licensure law preclude practice settings from employing any other providers of service such as speech-language pathology assistants. The Task Force recommended that in an attempt to address the personnel shortage the State explore the possibility of establishing an educational opportunity via collaboration among the University of Delaware, Delaware State University and Delaware Technical and Community College and thus licensing availability for speech-language pathology assistants. Final Report, Governor’s Task Force on Licensed Speech-Language Pathologists, pg. 13

The minutes from the October 8, 2008 Board meeting reflect that there was a discussion among the members regarding the use of Speech/Language Pathology Assistants. The following is an excerpt from those minutes:

A discussion took place regarding the use of SLP Aides or Assistants. The reasons provided for opposing the use of support staff, specifically SLPAs, are as follows: there are no programs in Delaware to train them, to much time would be spent supervising the SLPA, they would have no clinical training, and the quality of service would be compromised. The SLP members of the Board do not feel that Delaware Speech Language Pathologists are in favor of using SLPAs or assistants.

Audiologists
Practice of audiology includes the application of principles, methods and procedures of measurement, testing, evaluation, prediction, consultation, counseling, instruction, habilitation and rehabilitation related to hearing and disorders of hearing for the purpose of evaluating, identifying, preventing, ameliorating or modifying such disorders and conditions in individuals and/or groups. The terms "habilitation" and "rehabilitation" include, but are not limited to, hearing aid evaluation, recommendation, and fitting. 24 Del. C. § 3702(9) Audiologists frequently work with other medical specialists, speech-language pathologists, educators, engineers, scientists, and allied health professionals and technicians. www.asha.org/public/audiology

Audiologists may be assisted by an Audiologist Aide who is certified by the Council of Accreditation of Occupational Hearing Conservationists, or its equivalent, with documentation. The supervising Delaware-licensed audiologist must annually register each Audiology Aide with the Board. Duties of the Audiology Aide include: air conduction pure tone assessment and data recording, hearing screenings, assisting with conditioning techniques, cursory otoscopy, basic hearing aid maintenance, routine instrument sterilization, biologic and electroacoustic assessment of the audiometer, clerical support, participation with the professional in research projects, in service training, or similar endeavors, and other duties as may be appropriately determined with training from and direct supervision of the Delaware licensed audiologist. The Audiology Aide may perform services only under the direct supervision of a licensed audiologist. Board Rules and Regulations, Rule 5.3

Hearing Aid Dispenser
A Hearing Aid Dispenser is a person licensed to dispense hearing aids pursuant to statute and who is engaged in the evaluation or measurement of the power or range of human hearing by means of an audiometer or any other means devised for the purpose of selecting, adapting and distributing or selling of hearing aids. Testing shall not include medical diagnosis or audiologic evaluation. Licensed hearing aid dispensers may provide instruction, orientation and counseling on the use and operation of a hearing aid; and they may use an otoscope or "ear light" to evaluate the feasibility and use of ear molds and ear mold impressions. 24 Del. C. § 3702(7)

Powers and Duties
The Board of Speech/Language Pathologists, Audiologists and Hearing Aid Dispensers has the authority to: 24 Del. C. § 3706

1) Formulate rules and regulations;

2) Designate the application form and process applications;

3) Designate the national, written, standardized examinations;

4) Evaluate the credentials of all persons to determine if qualified;

5) Grant licensees to and renew licenses of all persons who meet licensure qualifications;

6) Establish continuing education standards for license renewal by rule and regulation;

7) Evaluate certified records to determine whether applicants for licensure previously licensed, certified or registered in another jurisdiction meet reciprocity requirements;

8) Refer all complaints from licensees and the public to the Division of Professional Regulation.

9) Conduct hearings and issue orders in accordance with procedures established by statute.

10) Impose the appropriate sanction or penalty after time of appeal has lapsed.

11) Adopt and publish a code of ethics for each professional specialty and promulgate within 60 days of adoption.

12) Establish and publish standards for electronic equipment used for the purpose of measuring hearing, and require written proof of calibration for such equipment annually.

Additionally, statute provides that no member shall participate in any action of the Board involving directly or indirectly any person related in any way by blood or marriage to said member. JSC Initial Questionnaire, pgs. 5-6

Audits
The Board has never been audited by the State Auditor or another external organization. JSC Initial Questionnaire, pg. 8

Administrative Procedures Act
The Board is subject to the Administrative Procedures Act. Statute provides that the Board shall promulgate regulations specifically identifying those crimes which are substantially related to the practice of speech/language pathology, audiology and/or the dispensing of hearing aids. JSC Initial Questionnaire, pg. 6

The Board is assigned a Deputy Attorney General. A thorough review of the statute and the Board’s rules and regulations was completed in August 2007.

Freedom of Information Act
The Deputy Director of the Division of Professional Regulation, in coordination with the Division Director, and in accordance with the Department of State’s FOIA Policy, handles all FOIA requests.

Meeting agendas are posted in the customer service area of the Division of Professional Regulation a well as online of the Sate Calendar of Events. Meeting agendas are posted seven days prior to the meeting date in accordance with the Administrative Procedures Act. Agendas can be viewed online at the Division of Professional Regulation’s website at www.dpr.delaware.gov .

Meeting minutes are transcribed for each Board meeting and maintained electronically in the
Board’s office. Minutes are prepared for approval by the Board at the next regularly scheduled meeting. Approved minutes are posted on the online meeting calendar five business days after the meeting in accordance with the Freedom of Information Act. The public can download copies of the approved meeting minutes online or request a hard copy by contacting the Board office.

In accordance with the Delaware Freedom of Information Act, minutes of executive sessions are not public information. Other than executive sessions, all meetings are open to the public. In the last three years, the Board has had one executive session. This session was held on June 11, 2008 for the Board’s Deputy Attorney General to discuss preliminary hearing matters with the Board. JSC Initial Questionnaire, pgs. 7-8

Federal Laws, Interagency Agreements, Judicial Decisions, Memoranda of Understanding and Executive Orders
The Federal Food, Drug, and Cosmetic Act would be applicable to those dispensing hearing aids and the Attorney General’s Office could prosecute a claim under this federal provision. There have been no state or federal judicial decisions that have impacted the Board. There are no memorandums of understanding or interagency agreements. JSC Initial Questionnaire, pg. 8

Executive Order 84 - Task Force on Licensed Speech-Language Pathologists
In 2008, Executive Order 84 established the Task Force on Licensed Speech-Language Pathologists. The charge of the Task Force was to “examine the issues surrounding the shortage of licensed Speech-Language Pathologists in the state and to develop recommendations to address the shortage.” Final Report, Governor’s Task Force on Licensed Speech-Language Pathologists, pg. i

The Task Force’s Final Report included the following findings/recommendations: Final Report, Governor’s Task Force on Licensed Speech-Language Pathologists, pg. i-ii

Fact-finding revealed that the personnel shortage is not the result of a single factor, but rather of a convergence of factors that impacts the availability of qualified personnel and the ability to retain them in existing positions:

Delaware is one of only three states in the country without a graduate program in speech-language pathology. As the master's degree is a condition of licensure in the state, Delaware has no in-state "pipeline" for newly-minted graduates.

Although Delaware has an incentive program through the Higher Education Commission, it impacts a limited number of people, and currently there are no data regarding the success of this program in motivating graduates to return to the state to practice.

A number of factors impact the recruitment of qualified personnel to Delaware positions and the retention of those individuals in existing positions. Among these are compensation issues, workplace conditions—including caseload size— and geography. Delaware lacks a coordinated approach to recruitment and retention.

The licensure law restricts the practice of speech-language pathology in Delaware to certified SLPs, precluding practice settings from employing any other providers of service such as speech-language pathology assistants.

The Task Force endorses a multidimensional solution for a multidimensional problem. The following recommendations reflect the Task Force's commitment to ensure that Delawareans with communication disabilities should receive high-quality speech- language pathology services of adequate frequency and intensity to meet their needs.

Establish a graduate program in speech-language pathology at the University of Delaware.

Establish consolidated recruitment mechanisms.

Establish a mechanism for offering sign-on bonuses for public school positions that incorporates retention incentives (e.g., a payback clause if the individual leaves the position prior to completing the required tenure or the payout of the bonus in installments over multiple years).

Develop materials to attract qualified clinicians to Delaware.

Implement programs designed to attract individuals to careers in communication sciences and disorders.

Analyze the utilization and impact of existing higher education financial incentives to determine whether they are achieving their intended objective.

Examine the ramifications associated with permitting speech-language pathology assistants to practice in Delaware.

Explore the viability of establishing a continuum of professional development opportunities via collaboration among the University of Delaware, Delaware State University, and Delaware Technical and Community College.

Reconvene the Task Force in two years to evaluate progress toward accomplishment of the aforementioned objectives.

Performance
Mission
The Board’s mission is to protect the public and to maintain minimum standards of practitioner competency and certain standards in the delivery of services to the public. However, as mentioned throughout this Draft Report, the Board’s statute does not align with the educational requirements of new students graduating from audiology programs.

The mission of the Division of Professional Regulation is to ensure the protection of the public's health, safety and economic well-being through administrative and investigative services to Governor-appointed boards/commissions JSC Initial Questionnaire, pg. 15

Objectives
The Board’s primary objective is to protect the general public from unsafe practices and from occupational practices which would reduce competition or fix the price of services rendered.

The secondary objectives of the Board are to maintain minimum standards of practitioner competency and to maintain certain standards in the delivery of services to the public. In meeting its objectives, the Board develops standards assuring professional competence, monitors complaints brought against practitioners regulated by the Board, adjudicates at formal hearings, promulgate rules and regulations; and imposes sanctions when necessary against licensed practitioners. JSC Initial Questionnaire, pg. 15

Accomplishments
The Board listed the following as its most significant accomplishments: JSC Initial Questionnaire, pgs. 13-14

The Board implemented the 1993 Joint Sunset Committee Recommendations (Senate Bill 214).

The Board promulgated final rules and regulations in May 2001to implement Senate Bill 214.

The Board adopted the Voluntary Treatment Option Program for Chemically Dependent or Impaired professionals under the board’s regulatory authority. The rule and regulation was adopted in 2001.

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

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. (February 2005)

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. (February 2006) Rule and Regulation 9.3.1.8

The Board initiated SB 183 during the during the 143^rd General Assembly 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 requiring hearing aid dispenser candidates to obtain temporary licensure while completing a six-month training period under the direct supervision of a licensed hearing aid dispenser. The extent of the direct supervision is also delineated. The Board developed a Hearing Aid Training Plan. The Board clarified the required frequency for calibration of electronic equipment used to assess hearing and allow for attestation of such calibration during the license renewal process.(December 2007 )

The Board developed a strategic plan with the goals and objectives to improve communication with licensees, change Board member representation to accurately reflect licensee population and accommodate changes in Audiology education and the profession.

The Board streamlined the renewal process by offering online renewal with the use of payment by credit card and the ability of licensees to attest to their continuing education online subject to post renewal audit.

The Board updated the Division of Professional Regulation’s website to make it more user-friendly for the public to access licensee and disciplinary information and for applicants and licensees to access licensure requirements, laws and rules and regulations.

The Board coordinated with the Department of Education to create a link on their website (Delaware Educator Data System) to the Division of Professional Regulation to communicate to school administrators and speech/language pathologists about licensure and renewal requirements.

The Board drafted a bill during the 144^th General Assembly to increase the educational requirements for audiologists from a master’s degree and completion of a supervised clinical practicum and a supervised clinical fellowship to a doctoral degree. The Board also proposed to change the representation on the Board to more accurately reflect the licensee population. Appendix B

Challenges
The Board is currently challenged by the following: JSC Initial Questionnaire, pg. 14

Moving Delaware in line with the national standard of educational requirements for audiologists. Masters programs for audiology will be phased out by 2009, and as such there will be no more master degree program graduates. The Board will need to change its audiology licensure requirements to a doctoral degree for new audiology applicants, which will encompass the current practicum and fellowship requirements. This change will enable Delaware to be reciprocal with other states’ requirements and allow portability of licensees.

Responding to the Task Force’s recommendations in response to Executive Order Eighty Four created to study licensed speech/language pathologists and examine issues surrounding the shortage of licensed speech/language pathologists in the State of Delaware. A Final Report was issued on June 24, 2008. One of the recommendations was to examine the ramifications associated with permitting speech-language pathology assistants to practice in Delaware.

Looking at emerging issues in the professions such as teletherapy.

Opportunities for Improvement
The Board indicated that the following as areas for improvement: JSC Initial Questionnaire, pg. 14

Ensure that Delaware’s minimum standards of practitioner competency and the delivery of speech/language pathology, audiology and hearing aid dispensing services are in line with those nationally to ensure the highest level of public protection.

Examine the feasibility of regulating speech/language assistants.

Change the composition of the Board to accurately reflect the licensee population and improve the availability of finding members to serve.

Internal Performance Measures
The Board does not have an internal process to evaluate its performance. However, the Division of Professional Regulation conducts formal and informal performance reviews of staff providing support to the Board. Additionally, the Division develops performance measures through the strategic planning process to evaluate and monitor the progress and performance of the administrative and investigative support provided to the boards and commissions. JSC Initial Questionnaire, pg. 16

Coordination of Services with other Agencies
The Division coordinates with the Department of Justice, Office of the Attorney General for legal representation and the Department of Education. JSC Initial Questionnaire, pg. 15

Customer Satisfaction
The Board indicated that its primary customers are: JSC Initial Questionnaire, pgs. 14-15

Speech/language pathology applicants and licensees

Audiology applicants and licensees

Hearing Aid Dispenser applicants and licensees

The public

American Speech/Language and Hearing Association (ASHA)

International Hearing Society

American Academy of Audiology

The Division of Professional Regulation evaluates customer satisfaction through a variety of ways:
Walk-in customers to the Division complete a customer satisfaction log to evaluate the level of service that they receive by staff.

New licensees, licensees who renew online, complainants and respondents involved in the complaint process and Board members are asked to complete an online survey to rate the level of satisfaction with the Division’s services.

The initial customer survey results gave the Division an overall customer satisfaction rating of 4.50 out of 5.0. Customer satisfaction data is used to identify areas of improvement.

Organization
Policymaking Structure
The Board is composed of 9 members who are appointed by the Governor. The members include 3 public members, 2 licensed speech/language pathologists, 2 audiologists and 2 hearing aid dispensers. Senate confirmation is not required. The Board President and Secretary are elected by the Board and serve for 1 year, and cannot succeed himself or herself for more than 2 consecutive terms. Statute provides that “each term of office shall expire on the date specified in the appointment; however, the Board member shall remain eligible to participate in Board proceedings unless or until replaced by the Governor.”

Members serve three year terms and must be residents of Delaware. A member or any member appointed to fill a vacancy may “succeed himself or herself for 1 additional term.” Statute provides: “A person who has never served on the Board may be appointed to the Board for 2 consecutive terms; but no such person shall thereafter be eligible for 2 consecutive appointments. No person who has been twice appointed to the Board or who has served on the Board for 6 years within any 9-year period shall again be appointed to the Board until an interim period of at least 1 term has expired since such person last served.” 24 Del. C. § 3703

BOARD MEMBER	APPOINTMENT EXPIRATION	TERM
Illene Courtright, President Speech/Language Pathologist New Castle County	7/30/10	2nd
Mary Ann Connolly Gaskin, Secretary Audiologist Sussex County	3/23/09	1st
Michael A. Michelli Audiologist New Castle County	7/24/10	2nd
Regina A. Bilton Speech/Language Pathologist New Castle County	11/07/10	2nd
George A. Christensen Public Member Kent County	2/26/11	2nd
Jennifer Xenakes Hearing Aid Dispenser New Castle County	03/23/09	1st
Carol A. Guilbert Public Member Sussex County	11/07/10	2nd
Cynthia Parker Hearing Aid Dispenser Sussex County	1/3/09	2nd
Maisha Britt Public Member Kent County	4/18/11	1st

The Governor’s Office recently filled the vacant hearing aid dispenser member in October 2008, which was vacant since September 2007. The Governor’s Office has found it difficult to fill this professional member designation due to the limited number of licensed hearing aid dispensers. Also, there is currently a hearing aid dispenser member who is “holding over” until a replacement can be found (term expired 1/3/09). Proposed Changes to Draft JSC Report for Board of Speech/Language Pathologists, Audiologists,
and Hearing Aid Dispensers, pg. 2

The Board is proposing to change the composition of the nine-member Board to more accurately reflect the licensee population of which the majority of licensees are speech/language pathologists. The Board is suggesting an increase in the number of speech/pathology members from two to four; maintaining the audiology members at two; decreasing the number of hearing aid dispensers from two to one and reducing the public members from three to two. JSC Initial Questionnaire, pg. 6

One point to consider regarding the Board’s suggested change to the Board composition would be to consider increasing the number of speech/language pathologists to 3 not 4, as suggested by the Board and reduce the number of hearing aid dispensers to one. Therefore the number of speech/language pathologists and the number of public members would be an odd number.

Board Member Training and Compensation
Pursuant to statute, the Division provides an orientation and annual training for Board members. This training outlines the legal responsibilities of Board members to protect the health, safety and welfare of the general public. Attendance at this training is mandatory. Members are also provided with a resource manual. JSC Initial Questionnaire, pg. 19

As is standard practice with other Boards, members are compensated for Board meeting attendance at a rate of $50 per meeting, but not more than $500 in any calendar year. Members are also reimbursed for mileage at the State’s reimbursement rate. JSC Initial Questionnaire, pg 19

Removal of a Board Member
Board members can be suspended or removed from a Board by the Governor for misfeasance, nonfeasance, malfeasance, misconduct, incompetency or neglect of duty. Neglect of duty is defined as absences without adequate reason for 3 consecutive meetings or when a member fails to attend at least half of all regular business meetings during any calendar year. JSC Initial Questionnaire, pg. 19 When a Board member’s attendance becomes a concern, the Director of the Division of Professional Regulation sends a letter to the member. To date, no Board members have been removed under these provisions.

Meetings
Statute mandates that the Board hold regularly scheduled business meetings at least once in each quarter of a calendar year and at such times as the President deems necessary or at the request of a majority of the Board members. 24 Del. C. §3704 A review of the meeting minutes of the past three years indicate that the Board met its statutory requirement for holding meetings. Meetings were well attended by members and the DAG.

A majority of the members shall constitute a quorum for the purpose of transacting business, and no disciplinary action shall be taken without the affirmative vote of at least 5 members. 24 Del. C. §3704

Staff
Prior to November 2007, one administrative staff person (merit system employee) was assigned to provide all services to the Board, other than investigations. Subsequently, a Service Team of 5 members (all merit system employees) provide administrative support to the Board. This support includes credentialing, licensee and board liaison services. The Division has an Investigative Unit that assigns investigators to assist the Board in handling complaints filed against licensees. The Service Team also provides administrative services to eleven other professional boards and commissions and the Investigative Unit handles complaints for all professional boards and commissions. JSC Initial Questionnaire, pg. 19

Staff is hired through the State of Delaware Merit System competitive hiring process, which is coordinated through the Department of State’s Human Resources Office and the Office of Management and Budget, Human Resources Office. Specifically, there is statewide recruitment, the Office of Management and Budget evaluates applicants to determine if they meet minimum qualifications, prepares the certification list of eligible persons and interviews are conducted by the Division of Professional Regulation. JSC Initial Questionnaire, pgs. 20-21

Staff Responsibilities
The Commission provided the following chart regarding staff responsibilities: JSC Initial Questionnaire, pg. 21

Credentialing Services Administrative Specialist II)	Board Liaison Services (2) Administrative Specialist II	Licensee Services Administrative Specialist II
Review applications Complete licensing system checklist and coordinate with board services Issue licenses Respond to customer inquiries-Level 2 Issue temporary permits Coordinate testing and applicant results Website updates Maintain licensing database.	Attend/schedule/notice meetings & hearings Prepare board agenda and minutes Process board member payments Monitor formal complaints (from DAG) Manage all board correspondence Website updates Conduct research/ legislative initiatives. Respond to customer inquiries – Level 2 Maintain licensing database.	Issue licenses and temporary permits Complete license verifications Review paper renewals Release renewal holds Respond to customer inquiries – Level 2 Update website Maintain licensing database

Based on the new Service Team structure, the above reflects the tasks that each staff member performs in each work category for twelve professions. Each profession within the service team was assigned an overall workload rating. Based on the workload rating of the Board of Speech/Language Pathologists, Audiologists and Hearing Aid Dispensers, 8-10% of each staff’s time is spent providing the above administrative activities to the Board. JSC Initial Questionnaire, pg. 21

Training
Both the Department of State Human Resources Office and the Division of Professional Regulation conduct orientations with all new employees. Training opportunities for staff are available through in-house training, offerings by the Office of Management & Budget, Human Resources Management, national conferences and committees, education reimbursement for higher education as well as participation in the State’s Supervisory Development and Career Enrichment Programs. JSC Initial Questionnaire, pg. 21

Licensing
The Board issues licenses for speech/language pathologists, audiologists and hearing aid dispensers. Permanent licenses are valid for two years. The biennial renewal period begins August 1^st through July 31^st in odd years. A person may be licensed in more than 1 specialty as long as the person meets the requirements of each specialty.

The minutes from October 8, 2008 Board meeting reflect that there has been some discussion among the Board members regarding the possibility of issuing a combined license for audiologists who also dispense hearing aids.

Temporary Licensure
Temporary licenses are valid for one year, but can be renewed for an additional 1 year in extenuating circumstances as determined by the Board. 24 Del. C. § 3713

The Board indicated that §3713(b), which addresses the issuance of a temporary license, should state that an audiologist does not need to be supervised during the period of temporary licensure. JSC Initial Questionnaire, pg. 6

License Renewal
Licenses expire biennially and may be renewed with the payment of the fee and evidence of continuing education courses. Applicants must complete 20 hours of continuing education every two years, as set out in Rules and Regulations. If an individual is renewing a triple license, he/she must complete 30 hours of continuing education that includes 10 hours of continuing education in each specialty.

A licensee may apply to the Board for inactive status for up to five years. The license may be reactivated upon application and proof of continuing education completed within 24 months and payment of the fee. 24 Del. C. § 3712(d)

Fees
The following fees are in effect for FY’09:

License Type	Fee
Audiologist	$97
Hearing Aid Dispenser	$97
Speech/Language Pathologist	$97
Temporary (All Types)	$65

Reciprocity
With regard to reciprocity, the Board is empowered to license an applicant who:
1) is currently licensed, and in good standing, in another state, the District of Columbia or territory of the United States whose standards for licensure are substantially similar to Delaware’s standards; and
2) holds a current certificate of clinical competence from the American Speech/Language and Hearing Association in the area in which the applicant is applying for licensure; and
3) meets the conditions for licensure set forth in statute pertaining to administrative penalties, drug and alcohol impairment and criminal history. 24 Del. C. § 3710

For Speech and Audiology, the following states have similar standards equivalent to Delaware: Alaska, Arkansas, Connecticut, Hawaii, Kansas, Louisiana, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, New Hampshire, New Mexico, North Dakota, Ohio, Pennsylvania, Rhode Island, Texas, Virginia, Wisconsin and Wyoming.

For Hearing Aid Dispensers, the State of Maryland has been determined substantially similar to Delaware. Delaware receives very few reciprocity applications, as such the Board reviews them on a case by case basis.

The Board has indicated that the reciprocity provision in §3710(a) needs to be amended to clarify that an applicant would need to meet the requirements in both (a)(1) and (a)(2). JSC Initial Questionnaire, pg. 6

Licensure for Speech/Language Pathologists and Audiologists
There are currently 422 active licensed speech/language pathologists and 18 with a temporary license. There are currently 63 active licensed audiologists.

Applicants applying for licensure as a speech/language pathologist or audiologist must meet the national requirements for certification of clinical competence issued by the American Speech/Language and Hearing Association (ASHA). These requirements include: 24 Del. C. § 3708

a. Possession of a master's degree or its equivalent from an accredited college or university, with major emphasis in speech/language pathology, audiology, communication disorders or speech/language and hearing science.
b. Complete a supervised clinical practicum of 375 hours. (prescribed in Regulation)
c. Completion of 9-months' full-time or 18-months' part-time supervised Clinical Fellowship year, begun after fulfilling academic and clinical practicum requirements.
d. Successful completion of a national examination in the area of applicant's specialty prepared by a national testing service and approved by the Division.

There are also other conditions for licensure regarding conduct, drug and alcohol impairment, criminal conviction or charges and intentionally providing fraudulent information. JSC Initial Questionnaire, pgs. 24-25

Currently statute requires a degree with “major emphasis” in speech/language pathology, communication disorders or speech/language and hearing science. 24 Del. C. § 3708(a)(1) AHSA specifies a minimum of 75 hours in a course of study addressing knowledge and skills pertinent to the field of speech/language pathology. The Board has suggested that this provision be addressed in rules and regulation issues as opposed to statutory language.

The Board’s Deputy Attorney General did a comparison of the current ASHA standards with those specified in the Board’s Rules and Regulations, and some revisions are necessary. For example, statute references a clinical practicum in accordance with Board Rules. 24 Del. C. § 3708(a)(1)b Rule 2.2.1 mentions 375 clock hours. ASHA now requires 400 clock hours. The Board has suggested that these provisions remain as rules and regulation issues, as opposed to statutory language.

The Board is proposing that the licensure requirements for audiologists be changed from a master’s degree and completion of a supervised clinical practicum and supervised clinical fellowship to completion of a doctoral degree. The purpose of this change is that educational institutions are no longer offering master’s degree programs in audiology. The doctoral programs encompass the practicum and fellowship requirements. JSC Initial Questionnaire, pg. 6 The Board is proposing that these changes become effective two years after the date of enactment or through August 31, 2011 which is the end of the licensure renewal period. Proposed Changes to Draft JSC Report for Board of Speech/Language Pathologists, Audiologists,
and Hearing Aid Dispensers, pg. 2

Examination
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 and is administered by Education Testing Services (ETS). Delaware testing sites are located in Dover, Georgetown and Newark. The exams are scored by ETS and the scores are sent to the Division of Professional Regulation within 4 weeks of the exam date. JSC Initial Questionnaire, pg. 31

Data for licensure as a Speech/Language Pathologist: JSC Initial Questionnaire, pg. 30

	# of License Applications Received	# of Licenses Issued	# of License Applications Rejected (Denied)	# of Licenses Suspended	# of Licenses Revoked
Calendar Year 2007	51	55-permanent 13-temp.	0	0	0
Calendar Year 2006	51	46-permanent 20-temp.	0	0	0
Calendar Year 2005	40	38-permanent 12-temp.	0	0	0

	# of License Applications Received	# of Licenses Issued	# of License Applications Rejected (Denied)	# of Licenses Suspended	# of Licenses Revoked
Calendar Year 2007	12	9-permanent 1-temp	0	0	0
Calendar Year 2006	3	5-permanent 0-temp	0	0	0
Calendar Year 2005	5	5-permanent 1-temp	0	0	0

b. Provide proof of successful completion of a national examination prepared by a national testing service and approved by the Division. The applicant shall complete 6 months of training prior to taking the examination. The Board in its rules and regulations shall establish the frequency of direct supervision during the training period. (Direct supervision means direct, on-site observations of the applicant by the supervisor. Applicants shall be under direct supervision for 100% of the time during the first 2 months, 50% of the time during the subsequent 2 months and 25% of the time during the final 2months of the training period. Rules and Regulation 3.1.2.2)

c. Provide notarized signature of Delaware-licensed hearing aid dispenser sponsor providing direct supervision and training of applicant.

d. Paragraphs (a) and (c) above do not apply to applicants who are licensed audiologists.

There are also other conditions for licensure regarding conduct, drug and alcohol impairment, criminal conviction or charges and intentionally providing fraudulent information

The statutory requirements 24 Del. C § 3708(a)(2) for a hearing aid dispenser need to clarify that an audiologist applicant does not need to meet the six months’ training requirement. JSC Initial Questionnaire, pg. 6

Examination
The exam for Hearing Aid Dispensers is a written, national exam developed by the International Institute for Hearing Instrument Studies. The test is offered 4 times a year and is administered by Prometric. Delaware testing sites are located in Dover and Newark. The exams are scored by Protmetric and the scores are sent to the Division of Professional Regulation within 10 days of the exam date JSC Initial Questionnaire, pg. 31

Data for licensure as a hearing aid dispenser: JSC Initial Questionnaire, pgs. 30-31

	# of License Applications Received	# of Licenses Issued	# of License Applications Rejected (Denied)	# of Licenses Suspended	# of Licenses Revoked
Calendar Year 2007	10	8-permanent 5-temp	0	0	0
Calendar Year 2006	7	6-permanent 9-temp	1	0	0
Calendar Year 2005	4	7-permanent 5-temp	0	0	0

	Calendar Year 2005	Calendar Year 2006	Calendar Year 2007
Total Number of Complaints Received by the Board of Speech/Language Pathologists, Audiologists, and Hearing Aid Dispensers	1	4 (1 not accepted)	4
Total Number of Complaints Investigated	1 (closed after investigation)	3 (2 closed after investigation)	4 (1 closed after investigation)
Total Number of Complaints found to be Valid	0	1	3
Total Number of Complaints Forwarded to the Attorney General’s Office	0	1	3 1 -Dismissed by AG’s Office 2- Pending by AG’s Office
Total Number of Complaints Resulting in Disciplinary Action	0	1 (2 fines of $500 and letter of reprimand)	0

· Procuring a license or attempting to procure a license by fraud or intentional misrepresentation.

Has illegally, incompetently or negligently practiced speech/language pathology, audiology or hearing aid dispensing.

Has engaged in an act of consumer fraud or deception; engaged in the restraint of competition; or participated in price-fixing activities.

Has excessively used or abused drugs either in the past 2 years or currently.

· Has been convicted of a crime that is substantially related to the practice of speech/language pathology, audiology and/or the dispensing of hearing aids

· Has a physical condition such that the performance of speech/language pathology, audiology or dispensing of hearing aids is or may be injurious or prejudicial to the public.

The practitioner's license has been suspended or revoked, or other disciplinary action has been taken in another jurisdiction; provided, however, the Board has determined that the facts found in the other jurisdiction constitute 1 or more of the grounds defined in Delaware statute.

· Failure to notify the Board that the practitioner's license had been suspended or revoked, or other disciplinary action had been taken in another jurisdiction

Disciplinary Action by the Board
After the Board hears evidence and deliberates in public hearing, they can impose the following sanctions: 24 Del. C. §3716

Issue a letter of reprimand

Censure a practitioner.

Place a practitioner on probationary status, and require the practitioner to:

Report regularly to the Board upon the matters that are the basis of the probation.

Limit all practice and professional activities to those areas prescribed by the Board.

Suspend any practitioner's license.

Revoke any practitioner's license.

Impose a monetary penalty not to exceed $500 for each violation.

The Board may withdraw or reduce conditions of probation when it finds that the deficiencies that required such action have been remedied.

Where a license has been suspended due to a disability of the licensee, the Board may reinstate such license if, after a hearing, the Board is satisfied that the licensee is able to practice with reasonable skill and safety.

As a condition to the reinstatement of a suspended license, or removal from probationary status, the Board may impose such disciplinary or corrective measures as are authorized by statute.

Disciplinary Action by the Justice of the Peace Court
Currently statute authorizes the Justice of the Peace Court to have jurisdiction over unlicensed practice by a person not currently licensed as a speech/language pathologist, audiologist or dispenser of hearing aids. 24 Del. C. § 3720 HB 36 in the 144^th General Assembly provided Boards with the cease and desist authority with regard to the unauthorized practice of the regulated profession, as well as authorizing the Board to establish and impose administrative fines against a person who violates such cease and desist orders.

Reinstatement of a suspended license; removal from probationary status; replacement of license. 24 Del. C. § 3718
As a condition to reinstatement of a suspended license, or removal from probationary status, the Board may reinstate such license if, after a hearing, the Board is satisfied that the licensee has taken the prescribed corrective actions and otherwise satisfied all of the conditions of the suspension and/or the probation.

When a license or registration has been suspended due to the licensee's inability to practice, the Board may reinstate such license if after a hearing, the Board is satisfied that the licensee is again able to perform the essential functions of a speech pathologist, audiologist or hearing aid dispenser, with or without reasonable accommodations, and that there is no longer a significant risk of substantial harm to the health and safety of the individual or others.

Applicants for reinstatement must pay the appropriate fees and submit the documentation required by the Board as evidence that all the conditions of a suspension and/or probation have been met. Proof that the applicant has met the continuing education requirements may also be required, as appropriate.

A new license to replace any license lost, destroyed or mutilated may be issued subject to the rules of the Board. A charge set by the Division shall be made for such issuance.

Public Information
The Board has a web presence on the Division of Professional Regulation’s website at www.dpr.delaware.gov . This site provides laws, rules and regulations, frequency asked questions, licensure and renewal requirements. The public can search for licensees at a “Verify License Online” link to determine the licensure status and whether the licensee has public disciplinary action. Information is available to the public about the complaint process and a complaint form can be downloaded.

Rule and regulation changes and hearings are noticed in the media and through the Register of Regulation pursuant to the Administrative Procedures Act. The Board stated it held numerous workshops to discuss proposed changes to its statute and rules and regulations. Board meeting agendas and minutes are available online. JSC Initial Questionnaire, pg. 16

Below is a chart showing groups that are affected by the Board’s actions or groups that represent others served by or affected by the Board.

Group or Association Name/Contact Person	Phone Number/ Internet Address
Delaware Speech-Language-Hearing Association (DSHA) Shelly Davidson, President	dsha@dsha.org
Hearing Loss Association of Delaware (HLADE) Linda Heller, State Coordinator,	(302) 292-3066 hlade@comcast.net or www.hlade.org

Below is a chart showing national organizations or other government entities that serve as an information clearinghouse or regularly interact with the Board.

	Source(s) of Funds	Amount
FY’09 (budgeted)*	Special Funds
FY’08 (actual)	Special Funds	$25,995.00
FY’07 (actual)	Special Funds	$28,793.00

Fiscal Year	Source(s)	Amount $$
FY’09 (budgeted*)	Special Fund
FY’08 (actual)	Special Fund	$ 30,926
FY’07 (actual)	Special Fund	$ 31,600

WHEREAS, speech/language pathologists in Delaware must be regulated by the state and possess a valid professional license in order to protect the safety and well being and provide high quality services for Delaware citizens; and

WHEREAS, in order to be a licensed speech/language pathologists in Delaware, a person must have earned a Master’s degree or its equivalent from an accredited college or university; and

WHEREAS, such Master’s degree is required to entail a major emphasis in speech language pathology, audiology, communication disorder or speech/language and hearing science; and

WHEREAS, there is no college or university in Delaware that currently offers a Master’s degree with an emphasis in the applicable subjects in order for a person to become a licensed speech/language pathologist in our state; and

WHEREAS, potential licensed speech/language pathologists from Delaware must complete their educational requirements in other states, often finding competitive jobs in our surrounding states and not returning to Delaware to provide such critical services; and

WHEREAS, the demand for licensed speech/language pathologists in Delaware has continued to increase and the demand for licensed speech/language pathologists in Delaware is not being met; and

WHEREAS, the public school system in Delaware, which is vital to the educational development of our children, is currently facing a severe shortage of licensed speech/language pathologists, and there is a need to confront this shortage and develop strategies to address this demand for critical services in our state.

NOW THEREFORE, I, RUTH ANN MINNER, by virtue of the authority vested in me as Governor of the State of Delaware, do hereby declare and order the following:1. A Task Force is created to examine issues surrounding the shortage of licensed speech/language pathologists in the State of Delaware and develop recommendations to address that shortage.

2. The members of the Task Force shall consist of the following:

a. two members of the Delaware House of Representatives appointed by the Governor, one to be appointed from each Caucus;

b. two members of the Delaware Senate appointed by the Governor, one to be appointed from each Caucus;

c. the Secretary of Education for the State of Delaware or her designee;

d. one representative from the Early Childhood and Exceptional Children’s WINK Group in the Department of Education;

e. one representative from the Delaware Department of Health and Social Services;

f. one representative from Easter Seals, appointed by the Easter Seals;

g. one representative from A.I. Dupont Hospital for Children, appointed by the Hospital;

h. the Provost of the University of Delaware or his designee;

i. one representative from the Education Department of Delaware State University;

j. the State Speech/Language Pathologist;

k. one member of the business community appointed by the Delaware State Chamber of Commerce;

l. one representative of the Delaware Speech and Hearing Association’s Executive Council, appointed by the Council;

m. one member of the Governor’s Advisory Council for Exceptional Citizens, appointed by the Council;

n. the Director of Family and Workplace Connection or her designee; and o. one parent of a child in Delaware with developmental and learning needs appointed by the Governor.

All members shall serve during the pleasure of the person or authority appointing them.

3. The Chairperson of the Task Force shall be appointed from among its members by the Governor and serve at the pleasure of the Governor.

4. The Task Force shall develop recommendations for improving the shortage of licensed speech/language pathologists in Delaware, including the identification of revenue sources for the implementation of an accredited Master’s program at a college and/or university in Delaware.

5. The Task Force shall submit its findings to the Speaker of the House of Representatives, the President Pro Tempore of the Senate and the Governor by June 15, 2006.

Approved: April 13, 2006

Executive Order Number Ninety-One Amending Executive Order Number 84

WHEREAS, by Executive Order Number 84, adopted April 13, 2006, I created a Task Force to examine issues surrounding a shortage of licensed speech/language pathologists in the State of Delaware; and

WHEREAS, the Task Force has commenced its work as contemplated by Executive Order No. 84, but needs additional time to gather facts and obtain the advice and input of national experts on the issues relating the shortage of licensed speech/language pathologists; and

WHEREAS, it is appropriate to extend the deadline for the Task Force to complete its work and render its findings as contemplated by Executive Order No. 84,

NOW THEREFORE, I, RUTH ANN MINNER, by virtue of the authority vested in me as Governor of the State of Delaware, do hereby order and declare as follows:

1. Executive Order No. 84, dated April 13, 2006 is amended by striking Paragraph 5 of the Order in its entirety and replacing it with the following:“5. The Task Force shall submit its findings to the Speaker of the House of Representatives, the President Pro Tempore of the Senate, and the Governor by March 1, 2007.”

2. Except as otherwise provided herein, the provisions of Executive Order No. 84 shall remain effective in their entirety.

Approved and adopted: November 6, 2006

Representative Gregory F. Lavelle (R-Sharpley)

Senator Steven H. Amick (R-Glasgow)

Senator David P. Sokola (D-Newark)

Dr. Martha Brooks, Delaware Department of Education

Dr. Martha Toomey, Delaware Department of Education, Early Childhood and Exceptional Children’s Group

Roseanne Griff-Cabelli, Delaware Birth-to-Three Early Intervention Program, Delaware Department of Health and Social Services

Verna Hensley, Easter Seals

Kim Pierson, A.I. Dupont Hospital for Children

Dr. Timothy Barnekov, University of Delaware

Dr. Abdul-Aziz Diop, Delaware State University

Dr. Beth Mineo, University of Delaware

Samtra Devard, parent of child with developmental and learning needs

Wendy Strauss, Governor’s Advisory Council for Exceptional Citizens

Tracy Bombara, Delaware Speech-Language-Hearing Association

Janet Cates, Delaware Speech-Language-Hearing Association

Jill Nigro, Delaware Speech-Language-Hearing Association

Evelyn Keating, The Family and Workplace Connection