(a) A licensed assistant in audiology (assistant) must be supervised by a licensed audiologist who has been approved by the department to serve as the assistant's supervisor (supervisor).
(b) A supervisor must agree to assume responsibility for all services provided by the assistant. The supervisor must comply with the requirements set out in the Act and §111.154.
(c) Supervisory Responsibility Statement Form. A Supervisory Responsibility Statement Form shall be submitted in a manner prescribed by the department by both the applicant and the proposed supervisor. The proposed supervisor must meet the requirements set out in the Act and §111.154.
  (1) Approval from the department shall be required prior to practice by the licensed assistant in audiology. The Supervisory Responsibility Statement for an Assistant in Audiology Form shall be submitted upon:
    (A) application for a license;
    (B) any changes in supervision; and
    (C) addition of other supervisors.
  (2) If more than one audiologist agrees to supervise the assistant, each proposed supervisor must submit a separate Supervisory Responsibility Statement Form in a manner prescribed by the department.
  (3) The assistant may not practice without an approved Supervisor Responsibility Statement Form. The supervisor may not allow an assistant to practice before a Supervisor Responsibility Statement Form is approved
  (4) The assistant shall only provide services for the caseload of the assistant's supervisors who have current Supervisor Responsibility Statement Forms on file with the department.
  (5) If the supervisor ceases supervision of the assistant, the supervisor shall notify the department, in a manner prescribed by the department, and shall inform the assistant to stop practicing immediately. The supervisor is responsible for the practice of the assistant until notification has been received by the department.
  (6) If the assistant's supervisor ceases supervision, the assistant shall stop practicing immediately. The assistant may not practice until a new Supervisor Responsibility Statement Form has been submitted to and approved by the department.
(d) A supervisor shall assign duties and provide appropriate supervision to the assistant.
(e) Client Contacts.
  (1) All diagnostic contacts shall be conducted by the supervisor.
  (2) Following the initial diagnostic contact, the supervisor shall determine whether the assistant has the competence to perform specific non-diagnostic and non-prohibited duties before delegating tasks as referenced in §111.92(c).
(f) Amount and Type of Supervision. Each supervisor must provide a minimum of ten (10) hours per week, or forty (40) hours per calendar month, of supervision to the assistant. This subsection applies whether the assistant is employed full-time or part-time.
  (1) At least one (1) hour per week, or four (4) hours per calendar month, must be direct supervision.
  (2) The remaining hours may be performed using indirect supervision.
  (3) If fewer than four (4) weeks are worked in a calendar month, then the number of hours of supervision provided will be based on the number of weeks worked. Ten (10) hours of supervision must be provided for each week worked, including one (1) hour of direct supervision.
  (4) Tele-supervision may be used for direct and indirect supervision.
  (5) When determining the amount and type of supervision, the supervisor must consider the skill and experience of the assistant as well as the services to be provided. The supervision hours established in this paragraph may be exceeded as determined by the supervisor.
(g) Delegating Clinical Tasks.
  (1) Although the supervisor may delegate specific clinical tasks to an assistant, the responsibility to the client for all services provided cannot be delegated.
  (2) The supervisor shall ensure that all services are documented and provided in compliance with the Act and this chapter.
  (3) The supervisor shall:
    (A) in writing, determine the skills and assigned tasks the assistant is able to carry out under §111.92. This document must be agreed upon by the assistant and the supervisor;
    (B) notify the client or client's legal guardian(s) that services will be provided by a licensed assistant; and
    (C) maintain responsibility for the services provided by the assistant.
(h) Records. The supervisor shall maintain the following records.
  (1) Supervisory records shall be maintained by the supervisor for a period of three years which verify regularly scheduled monitoring, assessment, and evaluation of the assistant's and client's performance. Such documentation may be requested by the department.
  (2) The supervisor shall keep job descriptions and performance records. Records shall be current and be made available upon request to the department.
(i) Supervision Audits. The department may audit a random sampling of assistants for compliance with this section and §111.154.
  (1) The department shall notify an assistant and the supervisor in a manner prescribed by the department that the assistant has been selected for an audit.
  (2) Upon receipt of an audit notification, the assistant and the supervisor, who agreed to accept responsibility for the services provided by the assistant, shall provide the requested proof of compliance to the department in a manner prescribed by the department.
  (3) The assistant and the supervisor shall comply with the department's request for documentation and information concerning compliance with the audit.
(j) Notwithstanding the supervision provisions in this section, the department may establish procedures, processes, and mechanisms for the monitoring and reporting of the supervision requirements.

Source Note: The provisions of this §111.91 adopted to be effective May 1, 2018, 43 TexReg 2544; amended to be effective December 30, 2021, 46 TexReg 9021