Speech-Language Pathologist and Audiologist Licensing Advisory Council Meeting October 28, 2011 Attendance Members Staff Absent Members

Transcription

1 Speech-Language Pathologist and Audiologist Licensing Advisory Council Meeting October 28, 2011 Attendance Members Staff Absent Members Mark DeRuiter, PhD, CCC-A/SLP Tom Hiendlmayr Sally Gorski, MA, CCC-SLP Jill Arvidson, MST, CCC-SLP Gloria Rudolph Josephine Helmbrecht, AuD Barbara Miller Justyn Pisa, AuD Catherine Dittberner Lloyd Melissa Ferrello, AuD Jerry Meinders, HID Katherine Driskell Lori Mayo Jason Schlotthauer I. Introductions Introductions were done by those in attendance. II. Review and Approve Minutes from April 15, 2011 The Minutes were approved as written. III. IV. Review/Adoption of Agenda The Agenda was adopted as written. Staff Reports A. Credentialing Report Rudolph presented the Credentialing Activity Report as of September 30, She stated the numbers of practitioners holding full licensure in speech-language pathology are 1,338, in audiology are 399, and dual licensure are two for a total of 1,739. The numbers of practitioners holding clinical fellowship or doctoral externship licenses in speech-language pathology are 111 and in audiology are 13 for a total of 124. The numbers of practitioners holding a 90-day temporary license in speech-language pathology are three and in audiology are six for a total of nine. There are 1,872 licensees in total. Rudolph stated that the next renewal is for licenses expiring January 31, 2012, and the renewal notices will be mailed in November Rudolph stated the notification regarding salutation and suffixes was sent to all audiologists, and she noted that notifications will be going out to speech-language pathologists. B. Investigations and Enforcement Report Hiendlmayr presented the Investigations and Enforcement Report for Audiologists for the first quarter of Fiscal Year He stated that there were nine intakes received. Of those 1

2 nine intakes, three were allegations, one was an application intake and five were inquiries for information. Two investigations were opened as the result of allegations. One investigation involves misrepresentation, and the other investigation involves failure to comply with requirements. No investigations were closed. No enforcement actions were opened or closed. Currently there are 20 investigations open involving 20 practitioners and eight enforcement actions open for a total 28 pending actions. Hiendlmayr presented the Investigations and Enforcement Report for Speech-Language Pathology for the first quarter of Fiscal Year Hiendlmayr stated that there were seven intakes. Of those seven intakes, six were application intakes and one was a query for information. One investigation was opened as the result of an application intake, and it involves discipline by another jurisdiction. No investigations were closed. No enforcement actions were opened or closed. Currently there are 20 investigations open involving 19 practitioners and seven enforcement actions open for a total of 27 pending actions. C. Budget and Expenditure Reports Hiendlmayr presented the Final Fourth Quarter Budget and Expenditure Report for Fiscal Year 2011 (FY11). He stated it was similar to the report mailed out in July. He noted this report is the final report for that quarter, and the only change is a $20 difference in the travel line item for Speech-Language Pathology. He pointed out that the indirect cost rate for Audiology appears at $7,644. That is not 24% of the direct cost, but the amount that was charged to the account. He stated it may be an accounting error. He has made two inquiries about it, and has not yet gotten an answer or explanation. Hiendlmayr believes that will be the amount that is sent to the Department of Finance as the closing amount on the books for FY11, but that there could be a further adjustment to the account in FY12. Hiendlmayr stated he would normally present a budget for the current fiscal year beginning July 1, However, the State has been converting its accounting software. Due to this change, Hiendlmayr does not have any information about appropriation amount, and there are not budget figures that can be entered or pulled from the system. Hiendlmayr presented the long range Expenditure and Projected Budget spreadsheets for Speech-Language Pathology and Audiology licensing systems. He noted that figures are updated for FY11, but the entries for FY12 and going forward were not updated. Hiendlmayr stated this sheet is usually the basis for a discussion about fee adjustments because it makes apparent what the accumulating ending balance is for the fiscal year and expense projections going forward. He stated that he did make a request for fee adjustments, but the Department denied it. He explained that there is a lot of uncertainty within the Department about exactly what budgets are and what resources the Department will have through the rest of the fiscal year because of the situation with the conversion of the accounting system as well as legislation that passed last year to consolidate information technology resources of the Department into the Office of Enterprise Technology. In addition, Hiendlmayr talked to several lobbyists about the next legislative session, and the prediction is that there could very well be supplemental appropriation legislation because of potential deficits in this fiscal year. He stated given all of the uncertainty about the fiscal status of government at this point, advice is to not make any 2

3 adjustments and hold until a clearer picture emerges of the financial situation for all of the State s accounts. V. Old Business A. Audiology Assistants (ongoing discussion) Helmbrecht stated this is a project that Governmental Relations Committee in the Minnesota Academy of Audiology (MAA) is working on. They did a survey recently and found that about 73% of audiologists are using some form of support staff from clerical to other parts of their practice that they might delegate to someone, and there is not currently agreement about what that position might look like if audiologists were to sit down as a group and define it. At a minimum, MAA has decided to work collaboratively with the Department to figure out what things are that absolutely cannot be delegated in the audiology scope of practice, so that they can share that with their members. She stated they are not at a point where they are even thinking of introducing any kind of legislative initiative. Hiendlmayr inquired if the survey was to just members or all audiologists? Helmbrecht stated the survey was only sent to members of MAA, and about half of the audiologists in the state belong to MAA. Helmbrecht inquired if support staff currently cannot be called audiology assistant? Hiendlmayr stated that is correct because the title audiologist is restricted. Helmbrecht stated that audiology is not specifically in the list. Hiendlmayr responded that though correct, it was splitting hairs and would the interpretation allow businesses to have audiology in their title when there was not an audiologist on staff? Helmbrecht believes that some audiologists struggle when doing job descriptions and with what to call support staff, but it sounds like there could be some unintentional consequences of opening up audiology as an unprotected title. B. Dispenser Training and Education Workgroup Update Hiendlmayr stated there is a workgroup that the Department has convened made up of audiologists, hearing instrument dispensers, manufacture representatives, businesses, and consumers to take a look at what sorts of education and training opportunities and alternatives are available to address apparent deficiencies in the practical aspects of dispensing. The larger committee has not met recently. A subcommittee that is focused on finding educational programs that are available had recently met. The subcommittee is examining the extent to which the curriculum or the content matches up to or meets a set of standards that the larger committee had agreed upon and recommended as being a very detailed and adequate description of the knowledge areas and the skillsets that a person should have to safely and competently dispense hearing instruments. The subcommittee is also developing a survey of persons who have taken the hearing instrument dispenser examination who do not have audiology training to find out what they did to prepare for and take the examination. It is a very brief set of questions, and the Program is in the process of internally accessing the survey instrument they are required to use. Hiendlmayr stated during the recent meeting, they reviewed the survey questions and finalized them. The subcommittee also looked at three or four training programs, and they found them all wanting and/or expensive. C. Videostroboscopy & Nasopharyngoscopy Supervision Hiendlmayr presented the handout for the videostroboscopy and nasopharyngoscopy supervision update. He stated that CMS has rescinded the requirement that was put in 3

4 effect January 1, 2011 that required a physician to be in the room when these procedures were performed by a speech-language pathologist. VI. New Business A. Fee Adjustment Information and Proposed Legislation Hiendlmayr referred to the discussion of the fee adjustment information under Staff Reports, Budget and Expenditure Reports. Lloyd presented the proposed legislative item of changing the language to Minnesota Statutes, section , subdivision 3, regarding requirement to maintain current information. She stated the current language requires practitioners to update change of name, employment, or address within 30 days. She stated the other two occupational areas in the Program have statutory language that requires updates in business information. Lloyd explained that when there are changes in a practitioner s business, like a closure, the Program receives phone calls from consumers when they cannot reach the practitioner. Helmbrecht inquired if a similar change is being made to section 153? Lloyd responded that statutes 153 already require these proposed notifications, with the exception of address changes. Arvidson inquired if an address is a required field on the applications? Rudolph responded that it is. There was no objection to the proposed legislation. B. Mailing Lists Available from Credential Verification Website Hiendlmayr stated this topic is related to a concern that some practitioners had when their home address was available on the website when using the credential lookup feature a result of designating the home as the public address to be used to contact them. Because of that concern, the credential lookup now presents the search results without a street address. However, when a search is performed, there is still a link that says download, and clicking on that link enables an individual to download all address information into a spreadsheet, primarily for creating mailing lists. Hiendlmayr stated that certain information is always going to be considered public data, like a street address, concerning a licensee. Meinders inquired whether the public address could be a business address? Hiendlmayr responded that is an option. Helmbrecht stated it might be good to send out a reminder that practitioners have the option to choose their public address and that the public address is public and will remain public. Hiendlmayr stated that instruction is on the initial application and on the renewal application. Rudolph stated that currently practitioners can update or change their public address during a renewal or by sending her an . C. Proposed Schedule of 2012 Meetings Miller presented the proposed schedule for the 2012 meetings. There were no objections, and the schedule was accepted as proposed. D. Advisory Council Member Terms Miller stated that Jill Arvidson, Josephine Helmbrecht, Justyn Pisa, Jerry Meinders, and Lori Mayo have membership terms expiring January 2, She noted that there are still two vacancies. One vacant position is for an SLP employed by a school district and licensed by both the Board of Education and Minnesota Department of Health, and other 4

5 vacant position is a physician certified by American Board of Otolaryngology, Head and Neck Surgery. Miller stated that she will be mailing renewal information in November. E. Online Hearing Aid Dispensing Helmbrecht stated in October there was a press release by UnitedHealth announcing that they were offering hearing aid coverage as part of their benefit package for the secondary insurance that Medicare beneficiaries receive. Based on MAA s initial investigation, it appears that UnitedHealth s model utilizes an online hearing test, and then people can order the hearing aids online. Helmbrecht stated there might be a mechanism for consumers to input test data from an audiologist into the system to recommend a hearing aid, and then the devices are sent to the consumer. Helmbrecht noted that this model exists already, but she believes that this is the first time this model has been linked to a prominent health care insurer. She believes a lot of national and state academies are working on position statements for this kind of model. Pisa stated in addition to the UnitedHealth case, MAA has also been getting complaints from members who are concerned about Best Buy s practice of selling what is called personal sound amplifiers (PSA) directly to consumers as well. The MAA complainants generally are saying that if it looks like a hearing aid and sounds like a hearing aid, then it is a hearing aid. The complainants want to know why they need a license or certification when someone down the street is bypassing all of that. Pisa stated right now that MAA is struggling with wording a good answer in response to those complainants, and he feels PSA concerns are part and parcel with this UnitedHealth model. Helmbrecht believes, but is not positive, that it is the same manufacturer that is making the devices for Best Buy and for UnitedHealth. Pisa stated the same device is being called hearing aids on one website and PSAs on another, which could be confusing for a consumer. Driskell inquired, as a consumer, if she could be hurt using one of these devices? Pisa responded that the output is around 110 db, and there is no output limitation on these devices. By definition, PSAs are supposed to be marketed to people with normal hearing. If a person with normal hearing is wearing something that can generate that output, it could be damaging. Meinders said it might an issue that the Attorney General might have to deal with because MDH s jurisdiction is over people that are licensed or certified. He inquired what MDH can do about this? Helmbrecht stated the recent MDH press release was good. Hiendlmayr responded that MDH has authority to regulate persons, and does not have the authority to regulate the devices, the manufacturers, or the businesses. MDH does have the authority to enforce federal regulations of hearing instrument dispensing, but that regulation has some challenges. There is a guideline from the FDA that makes a distinction between hearing aids and assisted listening devices: hearing aids are to address impaired hearing and assisted listening devices are to enhance a person s hearing in various environments. The FDA does require that a hearing aid be sold through a hearing professional and an evaluation be done to identify a number of different contra indications, and the professional is to make a referral if certain conditions exist. Also, every purchaser of a hearing instrument is to have a medical evaluation, but the purchaser may waive that requirement. Hiendlmayr stated that while MDH has the authority to enforce the federal regulation, their ability is limited by the fact that they only have the authority to regulate the person. He stated in view of the laws and regulations that MDH has, they decided the best approach is to inform consumers of their rights. Hiendlmayr thinks it is an educational challenge at this point, and in the current environment, does not 5

6 think it is going to be possible to change the statutes to get more regulation of business activity. Meinders inquired if it possible to get permission from MDH to take the press release and make copies of it? Hiendlmayr stated it is a press release, and so it can be freely duplicated and distributed. Lloyd noted it is on the MDH website under News Releases. Hiendlmayr thinks the selling of hearing instruments by a non-natural person is an issue for the FDA to respond to due to the changes in the marketing of these devices. For example, FDA has requirements that radiation equipment cannot be sold to anyone unless they are licensed in the jurisdiction in which they obtain it, but there is not a similar requirement for hearing aids. Pisa stated it is becoming such that those with licenses are penalized more than those without. Helmbrecht stated it sounds like the change might have to happen at the federal level. F. New Member Orientation Hiendlmayr stated this agenda item will be addressed at the end of the next meeting. Next Meeting January 27, :30 p.m. - 4:30 p.m. Snelling Office Park Minnesota Room 1645 Energy Park Drive Saint Paul, MN L:\HOP\CREDENTIAL\SLPA\ADV_COUN\MINUTES\2011\Oct 28.docx 6