2023 -- S 0565

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LC002394

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- PROFESSIONAL LICENSING AND

REGULATION OF SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS

     

     Introduced By: Senators Gallo, Quezada, Pearson, Cano, Mack, and Zurier

     Date Introduced: March 07, 2023

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS"

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is hereby amended by adding thereto the following chapter:

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CHAPTER 48.2

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PROFESSIONAL LICENSING AND REGULATION OF SPEECH-LANGUAGE

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PATHOLOGISTS AND AUDIOLOGISTS

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     5-48.2-1. Purpose.

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     The purpose of this chapter is to establish and codify prevailing standards and procedures

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for licensing speech-language pathologists and audiologists in Rhode Island.

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     5-48.2-2. Incorporated materials.

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     This chapter hereby adopts and incorporates the American Speech-Language-Hearing

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Association’s "American Speech-Language-Hearing Association Code of Ethics" (2016) by

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reference, not including any further editions or amendments thereof and only to the extent that the

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provisions therein are not inconsistent with these regulations.

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     5-48.2-3. Definitions.

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     (a) As used in this chapter, the following words and terms shall have the following

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meanings, except where the context clearly indicates otherwise.

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     (1) "Accredited/approved" means that an institution/program holds regional accreditation

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from one of six (6) regional accrediting bodies: Middle States Association of Colleges and Schools,

 

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New England Association of Schools and Colleges, North Central Association of Colleges and

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Schools, Northwest Association of Schools and Colleges, Southern Association of Colleges and

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Schools, and Western Association of Schools and Colleges.

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     (2) "Act" means chapter 48 of title 5 entitled, "speech-language pathology and audiology,"

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as well as the provisions of this chapter, where the context so indicates.

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     (3) "Audiologist" means an individual who is licensed by the board to practice audiology

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either in person or via telepractice.

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     (4) "Audiology" means the audiologist applies the principles, methods, and procedures

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related to hearing and the disorders of the hearing and balance systems, to related language and

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speech disorders, and to aberrant behavior related to hearing loss. A hearing disorder is defined as

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altered sensitivity, acuity, function, processing, and/or damage to the integrity of the physiological

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auditory/vestibular systems, in individuals or groups of individuals who have or are suspected of

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having such disorders.

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     (5) "Audiology support personnel" shall operate under the title "audiometric aide" or

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"audiology assistant" and means an individual who meets minimum qualifications established by

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the board, which are less than those established by the act as necessary for licensing as an

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audiologist; does not act independently; is limited to hearing screening with pass/fail criteria, and

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works under the direction and supervision of an audiologist licensed under the act who has been

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actively working in the field for twenty-four (24) months after completion of the postgraduate

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professional experience and who accepts the responsibility for the acts and performances of the

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audiometric aide or audiology assistant while working under the act .

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     (6) "Board" means the state board of examiners for speech-language pathology and

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audiology established pursuant to § 5-48-2.

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     (7) "Clinical fellowship or traineeship" means the direct clinical work, consultation or other

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duties relevant to clinical speech-language pathology work with individuals presenting disorders in

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communication, for a cumulative or equivalent total of nine (9) months of full-time employment

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following completion of professional speech-language pathology education under supervision

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pursuant to § 5-48-7 and the provisions of this chapter.

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     (8) "Clinical fellow" means the person who is practicing speech-language pathology under

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the supervision of a licensed speech-language pathologist while completing the postgraduate

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professional experience as required by the act and who holds a current provisional license in

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accordance with the requirements described in this chapter.

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     (9) "Department" means the Rhode Island department of health.

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     (10) "Director" means the director of the Rhode Island department of health.

 

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     (11) "Graduate program" means a post-baccalaureate accredited program leading to a

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master’s or doctoral degree, including a professional doctoral degree, whether offered through an

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accredited graduate or professional school.

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     (12) "Newborn hearing screener" means an audiometric aide or audiology assistant

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working in a hospital-based newborn hearing screening program under the direction of the

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department of health newborn hearing screening program, or its appointee.

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     (13) "Person" means an individual, partnership organization or corporation, except that

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only individuals can be licensed under this chapter.

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     (14) "The practice of audiology" means an audiologist rendering or offering to render any

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service in audiology either in person or via telepractice as defined in § 5-48-1 and in this section.

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     (15) "The practice of speech-language pathology" means rendering or offering to render

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any service in speech-language pathology either in person or via telepractice as defined in this

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section.

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     (16) "Regionally accredited" means the official guarantee that a college or university or

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other educational institution is in conformity with the standards of education prescribed by a

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regional accrediting commission recognized by the United States Secretary of Education.

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     (17) "School hearing screener" means an audiometric aide or audiology assistant working

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in a school-based hearing screening program under the direction of the Rhode Island department

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of elementary and secondary education or its appointee.

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     (18) "Speech-language pathologist" means an individual who is licensed by the board to

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practice speech-language pathology either in person or via telepractice.

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     (19) " Speech-language pathology" means the activities defined in § 5-48-1 and in this

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section.

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     (20) "Speech-language pathology assistant (SLPA) support personnel" means an individual

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who meets minimum qualifications established by the board, which are less than those established

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by the act as necessary for licensing as a speech-language pathologist; does not act independently;

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and works under the direction and supervision of a speech-language pathologist licensed under the

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act who has been actively working in the field for twenty-four (24) months after completion of the

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postgraduate professional experience and who accepts the responsibility for the acts and

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performances of the speech language speech-language pathology assistant while working under

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this chapter.

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     (21) "Telepractice" means the use of telecommunication technology to deliver speech-

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language pathology and audiology services remotely. Other terms such as teleaudiology, telespeech

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and speech teletherapy are also used in addition to telepractice. Use of telepractice should be of

 

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equal quality to services provided in person and consistent with adherence to ASHA’s Code of

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Ethics (ASHA, 2016a), Scope of Practice in Audiology (ASHA, 2018), Scope of Practice in

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Speech-Language Pathology (ASHA, 2016b), and Assistants Code of Conduct (ASHA, 2020)

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     5-48.2-4. License requirements.

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     (a) No person shall practice as, advertise as, or use the title of speech-language pathologist

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or audiologist unless licensed in accordance with the provisions of the act and this section. The

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provisions of the act and this section shall not apply to individuals specifically exempt from the

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provisions thereof by § 5-48-10.

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     (b) A provisional license for the clinical fellow as defined in this chapter shall be required

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in speech-language pathology for that period of postgraduate professional experience as required

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in §§ 5-48-7 and 5-48.2-5. A provisional license shall authorize an individual to practice speech-

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language pathology solely in connection with the completion of the supervised postgraduate

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professional experience.

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     (c) Any person residing in and/or licensed in another state who provides telepractice

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services in the area of speech-language pathology and audiology within the State of Rhode Island

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regardless of their legal residence must be licensed in the state in accordance with the provisions

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of the act and this chapter. The provisions of the act and this chapter shall not apply to individuals

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specifically exempt from the provisions thereof by § 5-48-10.

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     5-48.2-5. Qualifications for licensure.

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     (a) Audiologists.

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     (1) In addition to the requirements set forth in § 5-48-7.2, persons seeking initial licensure

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as an audiologist providing in-person or telepractice services shall meet the following requirements:

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     (i) Submit an official transcript indicating possession of an earned doctorate degree in

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audiology from a regionally accredited educational institution or other national accrediting

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organization as may be approved by the board;

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     (ii) Pass a national examination in audiology approved by the board;

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     (iii) Present evidence of practicum experience that is equivalent to a minimum of twelve

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(12) months of full-time, supervised experience, that may be completed as part of the graduate

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degree, as delineated in this chapter;

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     (iv) Applicants with a master’s degree holding licensure from another state must present

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verification of a Certificate of Clinical Competence from the American Speech-Language-Hearing

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Association (ASHA) or other national accrediting association as may be approved by the board.

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     (b) Qualifications for audiologists licensed in alternate jurisdictions.

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     (1) Persons licensed as an audiologist in alternate jurisdictions on or before January 1,

 

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2008, shall meet the requirements of Rhode Island that were in effect at the time of initial licensure

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in the alternate jurisdiction.

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     (c) Speech-language pathologists.

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     (1) In addition to the requirements set forth in § 5-48-7, an applicant seeking licensure to

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practice as a speech-language pathologist who provides in person or telepractice services in Rhode

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Island must:

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     (i) Have attained a master's degree or a doctoral degree or equivalent in speech-language

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pathology from an accredited educational institution accredited by the Council on Academic

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Accreditation (CAA) of the American Speech-Language-Hearing Association (ASHA) or other

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national accrediting association as may be approved by the board. The degree shall consist of course

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work in accordance with the current minimum requirements for the Certificate of Clinical

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Competence issued by the American Speech-Language-Hearing Association (ASHA) or other

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national accrediting association as may be approved by the board.

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     (d) Qualifications for a provisional license for speech-language pathologists.

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     (1) To be eligible for provisional licensure by the department, the speech-language

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pathologist must submit an application with the required application fee and be in compliance with

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the requirements of this chapter and § 5-48-7.1.

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     5-48.2-6. Issuance and renewal of license and fee.

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     (a) The department shall issue a license as an audiologist or speech-language pathologist,

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or renewal thereof, for a period of two (2) years. The license, unless sooner suspended or revoked,

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shall expire on the first day of July, two (2) years following its issuance, and may be renewed

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biennially (in even years); provided the applicant meets the requirements of this chapter and the

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statutory provisions of the act. The licensee must maintain their certificate of clinical competence

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in their practicing area (speech-language pathology or audiology) in order to renew their license.

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     (b) A license may be renewed by submission of the renewal application and renewal fee as

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set forth in the fee structure for licensing, laboratory and administrative services provided by the

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department of health in their regulations payable before July 1 of even years (biennially).

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     (c) A provisional license may be renewed annually from the date of issue, if the post-

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graduate professional experience has exceeded one year, by submission of the renewal application

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and renewal fee as set forth in the fee structure for licensing, laboratory and administrative services

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provided by the department of health. A provisional license shall not exceed thirty-six (36) months

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past the initiation of the professional experience and will expire ninety (90) days after the end of

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the postgraduate professional experience.

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     (d) Any licensee who allows his or her license to lapse by failing to renew it on or before

 

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the thirtieth day of June of even years (biennially), may have the license renewed by submitting to

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the department an application and renewal fee plus an additional late fee as set forth in the fee

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structure for licensing, laboratory and administrative services provided by the department of health.

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     (1) Any person who allows his or her license to lapse longer than two (2) consecutive

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licensing periods may be reinstated by the department, upon the filing of:

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     (i) A reinstatement application for licensure;

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     (ii) Payment of the current licensure renewal fee plus an additional late fee as set forth in

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the fee structure for licensing, laboratory and administrative services provided by the department

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of health; and

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     (iii) Documentation of completion of CEUs as required in this chapter taken during the

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previous two (2) years.

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     (e) Inactive status.

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     (1) An individual licensed as a speech-language pathologist and/or audiologist in Rhode

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Island, not in the active practice of speech-language pathology or audiology within Rhode Island

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during any year, may upon request to the department, have his or her name transferred to an inactive

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status and shall not be required to register biennially or pay any fee as long as he or she remains

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inactive.

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     (2) Inactive status may be maintained for no longer than two (2) consecutive licensing

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periods, after which period licensure will be terminated and a reinstatement application submitted

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to the department will be required to resume practice.

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     (3) Any individual whose name has been transferred to an inactive status may be restored

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to active status within two (2) licensing periods to practice speech-language pathology or audiology

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without a penalty fee, upon the filing of:

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     (i) An application for licensure renewal with a licensure renewal fee as set forth in the fee

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structure for licensing, laboratory and administrative services provided by the department of health;

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and

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     (ii) Such other information as may be requested by the board.

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     5-48.2-7. Denial, suspension and revocation of license.

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     (a) The board is authorized to suspend or revoke any license to practice speech-language

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pathology and/or audiology upon finding by the board that the person is guilty of conduct as set

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forth in § 5-48-11, and in addition:

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     (1) Violating any provision of the act, any lawful order given, or rule or regulation adopted

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by the board or departure from or failure to conform to the current standards of acceptable

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prevailing practice and code of ethics of speech-language pathology or audiology as adopted by the

 

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board and as contained in the "American Speech-Language-Hearing Association Code of Ethics"

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as incorporated in this chapter. The board need not establish actual injury to clients in order to

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adjudge a speech-language pathologist or audiologist of the above named conduct.

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     (2) The procedure for denial, revocation or suspension shall be as that set forth § 5-48-13.

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     5-48.2-8. Support personnel.

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     (a) A speech-language pathology assistant (SLPA) for speech-language pathologists shall

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meet the following requirements:

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     (1) Hold a bachelor's degree from an accredited college or university and have successfully

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completed no less than eighteen (18) hours of graduate credit in the areas of speech-language

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pathology to include the following:

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     (i) Normal processes in speech, language and hearing three (3) hours;

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     (ii) Disorders of speech, language and hearing nine (9) hours;

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     (iii) Equipment, materials, procedures and data collection used in assessment and/or

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management of speech, language and hearing disorders six (6) hours; and

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     (iv) Completion of twenty-five percent (25%) of those practicum hours required for

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professional personnel by the American Speech-Language-Hearing Association.

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     (2) A speech-language pathology assistant (SLPA) shall be registered at the department

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and be required to re-register every two (2) years.

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     (b) Support personnel for audiologists (audiometric aide) or audiology assistants must meet

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the following requirements:

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     (1) Hold a high school diploma;

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     (2) Receive intensive on-the-job training in accordance with the American Speech-

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Language-Hearing Association (ASHA) or American Academy of Audiology (AAA) guidelines

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for support personnel by the supervising licensed audiologist prior to providing services. Any

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subsequent supervising licensed audiologist may require retraining of an audiometric aide or

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audiology assistants under his/her supervision.

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     (3) Audiometric aides or audiology assistants shall be registered at the department and be

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required to re-register every two (2) years.

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     5-48.2-9. Supervision and responsibility.

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     (a) A supervising professional must be a speech-language pathologist or audiologist who

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is licensed under the act and this chapter, has attained and maintained their certificate of clinical

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competency and who has been actively working in the field for twenty-four (24) months after

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completion of the postgraduate professional experience, and must be responsible for the acts and

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performances, patient screening, and specific tasks assigned by the licensee to the speech-language

 

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pathology assistant (SLPA)/audiometric aide or audiology assistant.

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     (1) A licensee who supervises support personnel must:

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     (i) Utilize the services of only those who meet the minimum requirements enumerated

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under this chapter;

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     (ii) Ensure that the support personnel are assigned only those duties and responsibilities for

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which the person has been specifically trained and which the assistant is qualified to perform;

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     (iii) Ensure that persons who will be receiving services from support personnel, or the

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person's legal representative, are informed that services are being rendered by support personnel;

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     (iv) Provide supervision of the support personnel (other than newborn hearing screeners

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and school hearing screeners); and

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     (v) Complete of a minimum of two (2) hours of professional development in clinical

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instruction/supervision.

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     (b) A speech-language pathologist supervisor may only supervise one full-time equivalent

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speech-language pathology assistant (SLPA) support personnel and an audiologist supervisor may

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only supervise three (3) full-time equivalent audiometric aides or audiology assistants unless

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otherwise approved by the board.

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     (c) Observations of support audiometric aides must be completed and documented as to

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date, amount of time, and accuracy and efficacy of service according to the following: Direct on-

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site observations of the first ten (10) hours of direct client contact; and five percent (5%) of all

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clinical sessions after the first ten (10) hours for every forty (40) consecutive hours worked; and

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Indirect supervision (e.g. home, interactive television, audio/video review or patient record review)

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of five percent (5%) of each forty (40) consecutive hours worked.

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     5-48.2-10. Supervision of the support personnel -- newborn hearing screeners and

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school hearing screeners.

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     (a) Hospital-based newborn hearing screeners and school-based hearing screeners shall be

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trained by a licensed audiologist working in the newborn hearing or school screening program

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according to training guidelines established by the programs.

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     (b) Supervision shall include a method of evaluation and documenting the competency of

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each screener upon completion of the initial training and at least annually thereafter by a licensed

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audiologist working in the newborn hearing or school screening program.

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     (c) Observations of a speech-language pathology assistant (SLPA) pathology support

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personnel must be completed and documented as to date, amount of time, and accuracy and efficacy

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of service according to the following:

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     (1) Direct on-site observations of the first ten (10) hours of direct client contact; and ten

 

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percent (10%) of clinical sessions after the first ten (10) hours of each forty (40) consecutive hours

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worked; and

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     (2) Indirect supervision (e.g. phone, interactive television, audio/video review) of ten

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percent (10%) of each forty (40) consecutive hours worked.

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     (d) Supervisors must observe all provisions of the ASHA policy regarding support

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personnel unless a specific policy is addressed in this chapter, including, but not limited to, that the

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licensee must maintain records which document the frequency and type of supervision of support

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personnel, such records to be available for audit upon request by the board.

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     5-48.2-11. Continuing education requirements.

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     (a) On or before the thirtieth day of June of even years, every person licensed to practice

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speech-language pathology and/or audiology within Rhode Island shall complete not less than

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twenty (20) clock hours of continuing education within the preceding two (2) years and be able to

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present satisfactory evidence of completion to the department.

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     (1) Course descriptions, proof of attendance, or other documentation of completion shall

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be retained by the licensee for a minimum of four (4) years and is subject to random audit by the

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department.

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     (2) Activities approved by the board for continuing education credit are those sponsored

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by the American Speech-Language Hearing Association (ASHA), the American Academy of

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Audiology (AAA), a state department of education, other International Association for Continuing

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Education and Training (IACET)-authorized providers, and/or continuing medical education units

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(CMEs) from the Accreditation Council for Continuing Medical Education (ACCME). Approved

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activities may include conferences, seminars, self-study programs, courses, or workshops

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sponsored by the organizations noted above, or course work from an accredited institution.

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     (b) Those persons holding licensure in both speech-language pathology and audiology must

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have completed and have evidence of completion of not less than thirty (30) clock hours of

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continuing education within the preceding two (2) years.

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     (c) Continuing education hours may not be carried over from one renewal period to the

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next.

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     (d) Continuing education hours must be in accordance with the American-Speech-

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Language-Hearing Association's requirements including at least two (2) hours in cultural

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competency, cultural humility, culturally responsive practice or diversity, equity, and inclusion

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(DEI) and at least one hour in the area of ethics.

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     (1) If the licensee is acting as a clinical supervisor a minimum of two (2) hours of

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professional development in clinical instruction/supervision is required.

 

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     (e) Speech-language pathologists or audiologists initially licensed by examination after the

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July 1 renewal date shall be exempt from the continuing education requirements stated in this

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section until the date of the next renewal cycle (i.e., June 30 of the second year following its

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issuance).

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     (f) The board, at its discretion, may extend, reduce, or waive for a person the requirement

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for continuing education for hardship or other extenuating circumstances as the board deems

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appropriate.

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     5-48.2-12. Rules governing the dispensing and/or selling of hearing aids.

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     An audiologist who engages in the dispensing and/or selling of hearing aids shall comply

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with any and all federal and state laws and regulations governing the sale of hearing aids.

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     5-48.2-13. Rules governing practices and procedures.

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     All hearings and reviews required under the provisions of the act shall be held in

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accordance with the provisions of the rules and regulations regarding practices and procedures

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before the department of health.

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     SECTION 2. This act shall take effect upon passage.

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LC002394

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- PROFESSIONAL LICENSING AND

REGULATION OF SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS

***

1

     This act would establish prevailing standards and procedures for licensing speech-language

2

pathologists and audiologists in Rhode Island.

3

     This act would take effect upon passage.

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LC002394

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