.03 Licensure Requirements.
A. Limited Licensure.
(1) A person who has met all requirements for licensure except supervised post-graduate professional experience or examination, or both, may apply for limited licensure.
(2) An individual seeking limited licensure shall fulfill the following requirements:
(a) Hold a master's degree in speech-language pathology or a doctoral degree in audiology, or both, from an accredited educational institution having a graduate or doctoral program in either field;
(b) Have met the academic and practicum requirements for a Certificate of Clinical Competence of the American Speech-Language-Hearing Association or Board Certification in Audiology from the American Board of Audiology that were in effect at the time a master's degree in speech pathology or doctoral degree in either field was obtained; and
(c) Demonstrate oral English competency as follows:
(i) Completion of at least 60 credits from an undergraduate college or university where English was the language of instruction throughout the applicant's inclusive dates of attendance; or
(ii) Achievement of a minimum score of 105, with at least a 26 on Speaking and Listening, on the Test of English as a Foreign Language (TOEFL) within the 2 years preceding license application.
(3) Application.
(a) An individual applying for limited licensure shall submit a complete application.
(b) The Board shall determine whether an application is complete.
(c) A complete application shall include:
(i) The application fee;
(ii) All required documentation regarding supervision of the limited licensee; and
(iii) An official transcript from the accredited educational institution attended by the applicant.
(4) Upon approval of an application, the Board shall issue a document authorizing the applicant to practice in this State in accordance with Health Occupations Article, §2-306, Annotated Code of Maryland, and the regulations in this chapter.
B. Supervision of Professional Experience for Audiologists.
(1) Supervisory Plan for Audiologists.
(a) Each applicant shall submit to the Board for approval a description of the supervisory plan to be followed during the period of limited licensure.
(b) The plan shall show adequate supervision, in accordance with this chapter.
(c) The Board may accept completion of the clinical fellowship required for the American Speech-Language-Hearing Association Certificate of Clinical Competence or completion of the mentored practice required for American Board of Audiology Certification as meeting the requirements for supervised practice in this chapter.
(2) Unless an exception is approved by the Board for extenuating circumstances, an applicant shall begin the clinical training within 2 years after completion of the academic course work and academic clinical practicum requirements and shall complete the clinical training within 24 months.
(3) To complete a clinical training, the applicant shall be employed as a professional in the field of audiology under appropriate on-site direct supervision for not less than 9 months with a minimum of 36 hours of work per week. This requirement may also be met with part-time employment as follows:
(a) 14—16 hours a week for a period of 24 months;
(b) 17—20 hours a week for a period of 18 months;
(c) 21—24 hours a week for a period of 15 months;
(d) 25—35 hours a week for a period of 12 months.
(4) At least 80 percent of the applicant's employment during the clinical training shall be in direct client contact which includes:
(a) Assessment/diagnosis/evaluation;
(b) Screening, response to intervention (RTI), or observations of clients;
(c) Treatment, such as:
(i) Hearing device fitting;
(ii) Diagnostic assessment; and
(iii) Rehabilitation; and
(d) Activities related to client management including:
(i) Writing reports and notes;
(ii) Billing;
(iii) Making rounds; and
(iv) Attendance at an individualized education program (IEP), individualized family service plan (IFSP) meeting, or other meetings related to the management of a client’s diagnosis and treatment plan.
(5) An individual serving as a supervisor:
(a) Shall hold a valid license issued by the Board in audiology, or if the supervisor is employed by a facility whose employees qualify for an exemption from licensure the Certificate of Clinical Competence of the American Speech-Language-Hearing Association in audiology or Board Certification in Audiology from the American Board of Audiology;
(b) Shall have been in practice for a minimum of 3 years after completion of the clinical training;
(c) Shall supervise not more than three limited licensees at one time; and
(d) May not have been formally disciplined by the Board within the previous 5 years.
(6) An individual serving as a supervisor of a limited licensee is legally and ethically responsible for services provided or omitted by the limited licensee.
(7) Change in Supervisor or Place of Professional Employment.
(a) During the period of limited licensure, if an individual changes supervisor, or place of professional employment, or both, the individual shall submit a revised supervisory plan to the Board for Board approval.
(b) The Board shall approve the new supervisor or the new setting before the individual may begin to practice under the new supervisor or in the new setting.
(8) A supervisor shall notify the Board within 5 days if the supervisor withdraws from supervising a limited licensee.
C. Supervision of Clinical Fellowship for Speech Pathologists.
(1) Supervisory Plan for Speech Pathologists.
(a) An applicant shall submit to the Board for approval a description of the supervisory plan to be followed during the period of limited licensure.
(b) The plan shall show adequate supervision, in accordance with this chapter.
(c) The Board may accept completion of the clinical fellowship required for the American Speech-Language-Hearing Association Certificate of Clinical Competence as meeting the requirements for supervised practice in this chapter.
(2) Unless an exception is approved by the Board for extenuating circumstances, an applicant shall:
(a) Begin the clinical fellowship within 2 years after completion of the academic course work and clinical practicum requirements; and
(b) Complete the clinical fellowship within 24 months.
(3) To complete a clinical fellowship, the applicant shall be employed as a professional in the field of speech-language pathology under appropriate supervision for not less than 9 months with a minimum of 30 hours of work per week. This requirement may also be met with part-time employment as follows:
(a) 15—19 hours a week for a period of 18 months;
(b) 20—24 hours a week for a period of 15 months; or
(c) 25—29 hours a week for a period of 12 months.
(4) At least 80 percent of the applicant's employment during the clinical fellowship shall be in direct client contact, which includes:
(a) Assessment/diagnosis/evaluation;
(b) Screening, response to intervention (RTI), or observations of clients;
(c) Treatment, such as:
(i) Diagnostic assessment; and
(ii) Rehabilitation; and
(d) Activities related to client management, including:
(i) Writing reports and notes;
(ii) Billing;
(iii) Making rounds; and
(iv) Attendance at an individualized education program (IEP), individualized family service plan (IFSP) meeting, or other meetings related to the management of a client’s diagnosis and treatment plan.
(5) An individual serving as a supervisor:
(a) Shall hold a valid license issued by the Board in speech pathology, or if the supervisor is employed by a facility whose employees qualify for an exemption from licensure the Certificate of Clinical Competence of the American Speech-Language-Hearing Association in speech pathology;
(b) Shall have been in practice for a minimum of 2 years after completion of the clinical fellowship;
(c) May not supervise more than three limited licensees at one time;
(d) May not have been formally disciplined by the Board within the previous 5 years; and
(e) Shall provide a minimum of 4 hours per month for at least 9 months of supervisory activities during the clinical fellowship to include a minimum of 2 hours of other monitoring activities each month.
(6) An individual serving as a supervisor of a limited licensee is legally and ethically responsible for services provided or omitted by the limited licensee.
(7) Change in Supervisor or Place of Professional Employment.
(a) During the period of limited licensure, if an individual changes supervisor, or place of professional employment, or both, the individual shall submit a revised supervisory plan to the Board for Board approval.
(b) The Board shall approve the new supervisor or the new setting before the individual may begin to practice under the new supervisor or in the new setting.
(8) A supervisor shall notify the Board within 5 days if the supervisor withdraws from supervising a limited licensee.
D. Full Licensure.
(1) Licensure Requirements for Audiologists.
(a) An individual may apply for full licensure if the individual fulfills all of the following requirements:
(i) The individual holds a current unsuspended and unrevoked certificate of licensure to practice audiology from another state or jurisdiction which was obtained by meeting requirements that are at least equivalent to the requirements of §D(2) of this regulation;
(ii) The individual has completed the academic requirements, the supervised on-site direct clinical experience, the examination requirements as set forth in §D(2) of this regulation, and submits evidence of the successful completion of the clinical training.
(b) The supervised post-graduate professional practice shall have been supervised by an individual who, at the time of supervision, held a valid audiology license issued by the Board, or if the supervisor is employed by a facility whose employees qualify for an exemption from licensure the Certificate of Clinical Competence of the American Speech-Language-Hearing Association or Board Certification in Audiology from the American Board of Audiology.
(c) The supervisor's license or certificate shall be in audiology.
(d) The applicant shall demonstrate oral English competency as follows:
(i) Completion of at least 60 credits from an undergraduate college or university where English was the language of instruction throughout the applicant's inclusive dates of attendance; or
(ii) Achievement of a minimum score of 105, with at least a 26 on Speaking and Listening, on the Test of English as a Foreign Language (TOEFL) within the 2 years preceding license application.
(2) Examination Requirements for Audiologists.
(a) An applicant shall have obtained a passing score on the National Examination in Audiology.
(b) If a passing score on the National Examination in Audiology was not obtained within the 5 years before applying for licensure, the applicant shall fulfill one or more of the following requirements as approved by the Board:
(i) Provide evidence that the applicant has practiced in audiology for 3 of the 5 years before applying for licensure;
(ii) Complete a period of supervised practice equivalent to that required of a limited licensee; or
(iii) Hold a current license in another state and submit proof of continuing education as stated in Regulation .06 of this chapter for the time period not practicing.
(3) A first time licensee, who has not held a full license in this State or another state for 1 full year, shall submit verification from the academic institution conferring the individual's degree attesting to the following:
(a) The academic course work completed by the individual applying for a license is consistent with the standards established by the Accreditation Commission for Audiology Education (ACAE) or the Council for Academic Accreditation (CAA); and
(b) The individual applying for licensure has completed 1,000 actual patient contact hours while working under direct on-site supervision.
(4) Licensure Requirements for Speech-Language Pathologists.
(a) An individual may apply for full licensure if the individual fulfills any of the following requirements:
(i) The individual holds a valid Certificate of Clinical Competence in speech-language pathology from the American Speech-Language-Hearing Association and meets the academic, practicum, examination, and supervised professional practice requirements of this chapter and the requirements of §D(5) of this regulation;
(ii) The individual holds a current unsuspended and unrevoked certificate of licensure to practice speech-language pathology from another state or jurisdiction which was obtained by meeting requirements that are at least equivalent to the requirements of this State and that meet the requirements of §D(5) of this regulation; or
(iii) The individual has completed the academic requirements, the supervised direct clinical experience, the examination requirements as set forth in §D(5) of this regulation, and submits evidence of the successful completion of the clinical fellowship.
(b) The supervised post-graduate professional practice shall have been supervised by an individual who, at the time of supervision, held a valid speech-language pathology license issued by the Board, or if the supervisor is employed by a facility whose employees qualify for an exemption from licensure, the Certificate of Clinical Competence of the American Speech-Language-Hearing Association.
(c) The supervisor's license or certificate shall be in the area of speech pathology.
(d) The applicant shall demonstrate oral English competency as follows:
(i) Completion of at least 60 credits from an undergraduate college or university where English was the language of instruction throughout the applicant's inclusive dates of attendance; or
(ii) Achievement of a minimum score of 105, with at least a 26 on Speaking and Listening, the Test of English as a Foreign Language (TOEFL) within the 2 years preceding license application.
(5) Examination Requirements for Speech-Language Pathologists.
(a) An applicant shall have obtained a passing score on the National Examination in Speech-Language Pathology.
(b) If a passing score on the National Examination in Speech-Language Pathology was not obtained within the 5 years before applying for licensure, the applicant shall fulfill one or more of the following requirements as approved by the Board:
(i) Provide evidence that the applicant has practiced in speech-language pathology for 3 of the 5 years before applying for licensure;
(ii) Complete a period of supervised practice equivalent to that required of a limited license; or
(iii) Hold a current speech-language pathologist license in another state and submit proof of continuing education as stated in Regulation .06 of this chapter for the time period not practicing.
