STATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY BOARD MEETING MINUTES Friday, September 24, 1999, 9:00 a.m. Sheraton Fiesta Beach Resort 310 South Padre Boulevard, Sailfish Room South Padre Island, Texas 78597 (512) 834-6627 The following members were present on Friday, September 24, 1999, for the board meeting: Jon K. Ashby, Ph.D. Elsa Cardenas-Hagan, M.A. Judith A. Chambers, M.Ed. George E. Cire, M.C.D. Harvey Komet, M.D. Deloris Marie Johnson, M.A. Teri Mata-Pistokache, Ph.D. Lee Reeves, D.V.M. R. Eric Reynolds, M.S. The following Department staff was in attendance: Dorothy Cawthon Marsha Lawson Debbie Peterson David Richards CALL TO ORDER: The meeting was called to order at 9:11 a.m. and guests were welcomed. MINUTES: Doctor Ashby asked that members review the minutes of the two Board meetings held on May 20 and 21, 1999. Doctor Reeves moved to adopt the minutes as written, Ms. Chambers seconded, and the motion carried. COMMITTEE REPORTS: COMPLAINTS: Ms. Cardenas-Hagan gave a report on the meeting held the previous day. The committee adopted the report of the meeting held May 20, 1999, closed three complaints because no violations were substantiated; closed two complaints with a cease/desist letter, recommended the Board request an Attorney General's Opinion concerning use of the "Au.D.?" recommended the Board issue four reprimands, and left one complaint pending the investigator's report. In addition, the committee agreed to the terms offered to a licensee at an informal settlement conference and recommended the Board accept the final order as amended relating to a probated suspension of another licensee. Doctor Mata-Pistokache moved to accept the report and the motion carried. SPEECH-LANGUAGE PATHOLOGY SCOPE OF PRACTICE: Ms. Johnson gave a report on the meeting held the previous day. The committee adopted the report of the meeting held May 20, 1999 and recommended that the Board accept the revised Guidelines for Caseload Limits and to notify licensees and the Texas Council of Administrators of Special Education of this decision. Ms. Johnson made a motion to accept the report and the motion carried. AUDIOLOGY SCOPE OF PRACTICE: Mr. Cire gave a report on the meeting held the previous day. The committee adopted the report of the meeting held May 20, 1999; defined appropriate training for an audiologist to provide vestibular and balance rehabilitation; and agreed that the list of continuing education courses a licensee submitted were sufficient training in order to provide this service. Mr. Reynolds made a motion to accept the report and the motion carried. DISCIPLINARY ACTION: A hearing was held on March 30, 1999 to consider the complaint filed against Ms. Eileen White. The hearing examiner's decision was that she be placed on probated suspension for one year for failure to maintain accurate records of services rendered. The allegation that she billed a client or third party for services not rendered was not substantiated. The Complaints Committee recommended that Ms. White be required to inform her employer of her probated suspension in addition to the conditions set out in the Final Order. Mr. Cire moved to adopt the draft Final Order as amended with the requirement that Ms. White inform her employer of her status, Ms. Cardenas-Hagan seconded, and the motion carried. REPORTS FROM ASSIGNED BOARD MEMBERS: FEES/BUDGET: After briefly discussing the National Council of State Boards of Examiners for Speech-Language Pathology and Audiology fall convention to be held October 21-23, 1999, in Wilmington, North Carolina, Ms. Johnson made a motion to approve travel expenditures for Doctor Gene Powers to attend as the Board's representative, Ms. Chambers seconded, and the motion carried. Ms. Debbie Peterson, Acting Director, Professional Licensing and Certification Division, Texas Department of Health (TDH), presented the Cost Allocation Report for expenditure through July 1999. She stated the Board's revenues were approximately $30,000.00 more than expenditures; the excess shall go into the General Revenue Fund. She did not recommend any fee changes at this time. One reason for the excess revenue was that the Board held only two meeting during the fiscal year 1999 when three or four meetings per year are usually held. Ms. Peterson stated that this month each program within the Division submitted a travel forecast for fiscal year 2000 and that expenditures for the upcoming year will be allocated based on the predictions. Doctor Ashby recognized Board staff for their services and recommended monetary rewards. DIVISION DIRECTOR'S REPORT: Ms. Peterson informed the Board of the changes occurring at the TDH, such as her appointment as Acting Division Director and Doctor Jim Zukowski's appointment as Acting Bureau Chief, but stated she did not believe the changes would effect the Board's staff. These changes are the result of a regulatory study mandated by the Sunset Commission. In addition the Legislature directed the Health and Human Services Commission to conduct a study to determine if all health-related regulatory boards and committees should be co-located within the Health Professions Council, in a new agency, or remain where they currently are. She also stated that disciplinary actions for the Division are being submitted to the Healthcare Integrity Protection Data Bank, each board's or committee's website is being revised to include disciplinary actions, all hearing shall be conducted by the State Office of Administrative Hearings (SOAH), and that legislation was passed to grant subpoena authority to those boards or committees that do not have that authority. PRESIDING OFFICER'S REPORT: Doctor Ashby welcomed David Richards as the Board's new attorney and expressed appreciation to Board members and Board staff during his tenure on this Board. His term expired August 31, 1999. EXECUTIVE SECRETARY'S REPORT: Ms. Cawthon presented a chart showing the number of new applications received and licenses issued during the past year. She stated that within a two week period in August over 170 new applications were received. This was mainly a result of the graduates of the long distance learning program at the Texas Woman's University who were beginning an internship in the public schools. Other items discussed were the total number of licensees, new travel limitations, the Board's Internet home page, the number of hits on the Internet site, the Call for Papers submitted to the Texas Speech-Language- Hearing Association, request from Lieutenant Governor Rick Perry to be kept abreast of activities and developments of the Board, and contract procedures as amended during the last legislative session. PUBLIC COMMENTS: Ms. Deborah Sears, representing the Texas Speech-Language-Hearing Association, stated that they shall proceed with a task force on caseloads and would appreciate the Board's input. The Board had asked that TSHA include sessions dealing with supervision of assistants and Ms. Sears stated that some session were planned for next year's convention but it was very difficult to obtain qualified presenters. Ms. Cardenas-Hagan suggested that Doctor Sue Dowling be contacted. OTHER BUSINESS/ITEMS FOR FUTURE CONSIDERATION: The Board shall consider the draft proposed rule changes that will be prepared by Board staff. ELECTION OF OFFICERS: Ms. Johnson nominated Ms. Chambers as secretary/treasurer and asked that she be elected by acclimation, Doctor Mata-Pistokache seconded, and the motion carried. Mr. Reynolds nominated Mr. Cire as assistant presiding officer and asked that he be elected by acclimation, Ms. Chambers seconded, and the motion carried. Doctor Reeves nominated Ms. Cardenas- Hagan as presiding officer and asked that she be elected by acclimation, Mr. Cire seconded, and the motion carried. NEXT MEETING DATE: Ms. Chambers made a motion that the next meeting be held March 2-3, 2000 in the Dallas-Fort Worth area, Ms. Cardenas-Hagan seconded, and the motion carried. After further consideration of the time span between this meeting and the next, Ms. Chambers made a motion to change the date to January 27-28, 2000, Ms. Cardenas-Hagan seconded, and the motion carried. ADJOURNMENT: Doctor Reeves moved to adjourn the meeting at 10:20 a.m., Mr. Cire seconded, and the motion carried. Jon K. Ashby, Ph.D., Presiding Officer Deloris Johnson, Secretary-Treasurer Dorothy Cawthon, Executive Secretary STATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY COMPLAINTS COMMITTEE REPORT Thursday, September 23, 1999, 8:00 a.m. Sheraton Fiesta Beach Resort 310 South Padre Boulevard, Sailfish Room South Padre Island, Texas 78597 (512) 834-6627 The meeting was called to order at 8:20 a.m. with Committee members Teri Mata-Pistokache, Elsa Cardenas-Hagan, Judith A. Chambers, and George Cire and Department staff Dorothy Cawthon, Marsha Lawson and David Richards present. Doctor Mata-Pistokache asked that Ms. Cardenas- Hagan conduct the meeting. The Committee reviewed the report of the meeting held May 20, 1999. Ms. Chambers moved that the report be adopted as written and the motion carried. The Committee discussed the following complaints with action taken as stated. 99-SA-0010, 99-SA-0011 and 99-SA-0015: A licensed assistant filed the first two complaints concerning supervision of her practice. During the investigation of these two complaints, it was determined that the complainant also violated Board rules by practicing without appropriate supervision and a complaint #99-SA-0015 was filed. The investigative report substantiated the violation in complaint 99-SA-0010. The respondent did not provide appropriate supervision to the complainant. In addition, the respondent submitted a falsified document to the investigator. Mr. Cire moved to recommend the Board issue a letter of reprimand and that a copy of the reprimand be mailed to the respondent's employer and the motion carried. No violation was substantiated against the respondent in complaint 99-SA-0011 and the complaint was closed. The investigative report substantiated the violation in complaint 99-SA-0015. The respondent practiced without appropriate supervision. Doctor Mata-Pistokache moved to recommend the Board issue a letter of reprimand and the motion carried. 99-SA-0012 and 99-SA-0019: Both of these complaints were filed against the same audiologist. The investigative report revealed that the respondent did not possess a doctoral degree from an accredited college or university. The respondent stated she earned the Au.D. as an entitlement from the Audiology Foundation of America. Ms. Chambers moved that a cease/desist letter be issued because use of the Au.D. was misleading to consumers and to recommend the Board seek an Attorney General's Opinion and the motion carried with Mr. Cire abstaining. The complaint was closed. State Board of Examiners for Speech- Language Pathology and Audiology Complaints Committee Report Page 2 - September 23, 1999 99-SA-0013 and 99-SA-0014: Both of these complaints were filed against the same licensed assistant. The investigative report substantiated the violations that the respondent attended several Admission, Review and Dismissals (ARD's) without the supervisor being present; made a diagnostic statement concerning the decrease in services to a client; and signed as a member of the ARD committee under "speech pathologist". Ms. Chambers moved to recommend to the Board that a letter of reprimand be issued and the motion carried. 99-SA-0016: The investigative report did not substantiate a violation of the law or Board rules. It appeared that the respondent's husband provided the service. The husband is licensed by the State Committee of Examiners in the Fitting and Dispensing of Hearing Instruments; therefore, the complaint and investigative report were forwarded to them. The complaint was closed. 99-SA-0017: The investigative report did not substantiate a violation of the law or Board rules. The complainant was advised to contact an attorney if she wished to pursue recovery of monetary losses. The complaint was closed. 99-SA-0018: The complaint was left pending the investigative report. The committee discussed the informal settlement conference held with the respondent of complaint 98-SA-0014 and her attorney. Mr. Cire made a motion to accept the probationary terms agreed upon at the conference and the motion carried. The committee discussed the draft final order for probated suspension of the respondent of complaint 98-SA-0001. Ms. Chambers made a motion to recommend to the Board that the draft order be amended to require the respondent to notify her employer and the motion carried. Mr. Cire made a motion to adjourn at 9:30 a.m. and the motion carried. This report shall be presented to the full board at the meeting scheduled for the following day. Elsa Cardenas-Hagan, M.A. Committee Acting Presiding Officer STATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY SPEECH-LANGUAGE PATHOLOGY SCOPE OF PRACTICE COMMITTEE MEETING REPORT Thursday, September 23, 1999, 9:00 a.m. Sheraton Fiesta Beach Resort 310 South Padre Boulevard, Sailfish Room South Padre Island, Texas 78597 (512) 834-6627 The meeting was called to order at 9:45 a.m. with Committee members Deloris M. Johnson, Elsa Cardenas-Hagan, Teri Mata-Pistokache, and Lee Reeves; Board member Jon K. Ashby; and Department staff Dorothy Cawthon, Marsha Lawson, and David Richards present. The Committee reviewed the report of the meeting held May 20, 1999. Ms. Cardenas-Hagan moved that the report be adopted as written and the motion carried. The Committee discussed the comments received relating to the draft guidelines for caseload limits. It was agreed that the guidelines not be adopted as Board rules. Members of the Texas Speech- Language-Hearing Association were present and invited Committee members to participate in a task force to address this issue. Doctor Ashby stated that this issue has been unresolved for too long and he believed that a decision should be reached today. Because most of the comments received were in favor of a specific number limit, Ms. Cardenas-Hagan and Doctor Mata-Pistokache will revise the draft to include a limit of 60. Ms. Cardenas-Hagan moved to recommend to the Board that the revised guidelines be mailed to all licensed speech-language pathologists and to the Texas Council of Administrators of Special Education and the motion carried. The guidelines shall also be published in the Board's newsletter. The Committee did not address the number of assistants and interns a licensed speech-language pathologist may supervise. Doctor Reeves moved that the meeting be adjourned at 10:35 a.m. and the motion carried. This information will be presented to the full board at the meeting scheduled for the following day. Deloris M. Johnson, M.A. Committee Presiding Officer STATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY AUDIOLOGY SCOPE OF PRACTICE COMMITTEE MEETING REPORT Thursday, September 23, 1999, 10:00 a.m. Sheraton Fiesta Beach Resort 310 South Padre Boulevard, Sailfish Room South Padre Island, Texas 78597 (512) 834-6627 The meeting was called to order at 10:37 a.m. with Committee members George E. Cire, Jon K. Ashby, Harvey Komet, M.D., and R. Eric Reynolds and Department staff Dorothy Cawthon, Marsha Lawson, and David Richards present. The Committee reviewed the report of the meeting held May 20, 1999. Mr. Reynolds moved that the report be adopted as written and the motion carried. The Committee discussed the level of training or competency an audiologist must possess in order to provide vestibular and balance rehabilitation. It was agreed that a licensee should maintain documentation verifying appropriate training. A licensee shall be required to provide this documentation if a complaint were filed relating to this issue. Appropriate training was defined as continuing education hours earned through an accredited college or university, approved by an American Speech-Language-Hearing Association sponsor, the American Academy of Audiology, or the American Medical Association. The Committee asked that this information be made available on the Internet and in the Board's newsletter. Also discussed was the documentation provided by a licensee who provides this service. It was agreed that the continuing education courses listed provided sufficient training. In addition, the business now has an otologist on staff and plans to have a physical therapist on staff soon. Mr. Cire shall inform the licensee of the Committee's decision. Mr. Todd Porter, an audiologist representing Audiology Practices, Inc., was present and provided additional information on this subject. He also stated he would assist the Board should further study be needed. Doctor Ashby made a motion to adjourn at 11:35 a.m. and the motion carried. This information will be presented to the full board at the next scheduled meeting. George E. Cire, M.C.D. Committee Presiding Officer STATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY AD HOC COMMITTEES FOR AGENCY RULE REVIEW REPORT Thursday, September 23, 1999, 11:00 a.m. Resumed on Friday, September 24, 1999 Sheraton Fiesta Beach Resort 310 South Padre Boulevard, Sailfish Room South Padre Island, Texas 78597 (512) 834-6627 Members present included Jon K. Ashby, Elsa Cardenas-Hagan, Judith A. Chambers, George E. Cire, Harvey Komet, M.D., Deloris Marie Johnson, Teri Mata-Pistokache, Lee Reeves, D.V.M., and R. Eric Reynolds. Department staff present were Dorothy Cawthon, Marsha Lawson, Debbie Peterson, and David Richards. The purpose of this rule review, as required by Government Code, Sec. 2001.039, was to delete those rules for which the reasons for adoption no longer exists, readopt those rules for which the reasons for adoption still exist and which continue to effectively and efficiently serve those reasons and to revise those rules for which the reasons for adoption still exist but which can be amended to better serve those reasons. In addition to this review, other previously suggested amendments to rules were considered. Prior to this meeting, Board members had been assigned to review specific subchapters of the rules, 22 T.A.C., Chapter 741. In addition, the executive secretary reviewed the rules and prepared a draft with changes to each subchapter. Each assigned group considered the recommended changes except for the Complaints Committee's review of Subchapter M. It was determined that the executive secretary and legal counsel should review the changes to Subchapter M at a later date and prepare a draft of proposed rules for the Board's consideration. The office staff shall prepare all proposed changes in Texas Register format for the Board's review at the next scheduled meeting. Jon K. Ashby, Ph.D., Presiding Officer