Speech language pathologists.

Existing law, the Speech-Language Pathologists and Audiologists and Hearing Aid Dispensers Licensure Act, provides for the licensure and regulation of speech-language pathologists by the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board, and makes a violation of these provisions a crime. Existing law defines the practice of speech-language pathology to include the application of instrumental procedures for specified purposes relating to the development and disorders of speech, voice, language, or swallowing. Existing law specifies that instrumental procedures are the use of rigid and flexible endoscopes to observe specified areas of the throat for specified purposes, including collecting data. Existing law prohibits the construction of the provisions on the application of instrumental procedures as a diagnosis and imposes a requirement that any abnormalities be referred to a physician and surgeon. This bill would add to the above-specified provisions on instrumental procedures a statement that the passage of those instruments without the presence of a physician and surgeon is subject to the existing prohibition on construing those provisions as a diagnosis and the requirement to refer abnormalities to a physician and surgeon. Existing law prohibits a speech-language pathologist from performing a flexible fiber optic nasendoscopic procedure unless they have received verification from an otolaryngologist that, among other things, they have performed a minimum of 25 flexible fiber optic procedures. This bill would require the first 10 of those procedures to be supervised by a licensed physician and surgeon who performs nasal endoscopy as part of their practice and would require the subsequent 15 procedures to be supervised by either a licensed physician and surgeon who performs nasal endoscopy as part of their practice or another licensed speech-language pathologist that is verified as competent in performing flexible fiber optic transnasal endoscopic procedures. The bill would specify that the otolaryngologist shall verify that the 25 flexible fiber optic transnasal endoscopic procedures were supervised. Existing law authorizes a speech-language pathologist to pass a flexible fiber optic nasendoscopic instrument only under the direct authorization of an otolaryngologist and the supervision of a physician and surgeon. This bill would recast these provisions to, instead, authorize a speech-language pathologist to pass a flexible fiber optic transnasal endoscopic instrument only upon the orders of a licensed physician and surgeon, which the bill would deem to allow a speech-language pathologist to perform fiber optic transnasal endoscopic procedures at a location based on the patient's medical needs. The bill would require a speech-language pathologist performing flexible fiber optic transnasal endoscopic procedures on patients who have contraindications to the procedure, as specified, to consult and document clearance with the physician and surgeon that the licensed speech-language pathologist can safely perform the procedure. This bill would incorporate additional changes to Section 2530.2 of the Business and Professions Code proposed by AB 2686 to be operative only if this bill and AB 2686 are enacted and this bill is enacted last. By expanding the scope of a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.