The document discusses various ethics cases and guidelines related to the practice of speech-language pathology in Texas. It includes examples of ethical dilemmas around issues like appropriate supervision, scope of practice, cultural competence in assessment, and misrepresentation of credentials. The document also outlines sections of the Texas Administrative Code and ASHA's Code of Ethics that are relevant to evaluating the ethicality of practitioners' actions.
Why are we here? Not that we all aren’t concerned about ethical issues, but really we are here because of the new requirement for the Texas State Board of Examiners and to inform you of another requirement that goes into place January 1, 2010 (Juris Prudence Exam) Online, approx $30 for one hour training to be done one time only. Will count for 1 hr of ethics. http://www.dshs.state.tx.us/speech/default.shtm 2 Clock Hours – Ethics Continuing Education Requirement §741.162(c) Twenty clock hours (two CEUs) shall be required to renew a license issued for a two-year term. The holder of dual licenses, meaning both a speech-language pathology license and an audiology license, shall be required to earn 30 clock hours (three CEUs) to renew a license issued for a two-year term. Effective for renewals in May 2009 and after, a licensee must have had a minimum of two clock hours in ethics per renewal period. Extension of the Two Hour Ethics Requirement – at the February 27th board meeting the board members voted to extend the grace period for the ethics CEU requirement through December 31, 2009. Licensees who renew between May 2009 and December 2009 will have until December 31, 2009 to acquire the two clock hours in ethics for the previous renewal period, if they have not done so by the month of their renewal. These clock hours in ethics earned during the grace period will not count toward the ethics requirement for their next renewal in 2011. May 15, 2009 ESC Region XI 5/15/2009
ESC Region XI 5/15/2009 May 15, 2009
Governing bodies ESC Region XI May 15, 2009 5/15/2009
Have copy of SBOE SLP & Aud Board rules in your packet Beginning of Ethics section is 741.41 Prof responsibilities Bottom of Page 3 Divide this between the people at your table so that everyone is reviewing at least one section. Don’t read yet. ESC Region XI May 15, 2009 5/15/2009
On white sheet in your packet on the left titled Give One Get One Note a few things that you found interesting, surprising or something you didn’t know from your section under the Give one section -At your table share with your table mates one of the things you noted. Each person should share until all sections have been covered. ESC Region XI May 15, 2009 5/15/2009
READ ESC Region XI 5/15/2009 May 15, 2009
Did you see anything you had forgotten or were not familiar with? ESC Region XI May 15, 2009 5/15/2009
Disciplinary actions are taken by regulatory authorities (boards, committees, programs) in response to a violation of the law or rules. Different kinds of actions may be taken depending on the severity of the offense, the history of previous violations, efforts made to correct the violation, the harm to the victim(s), the likelihood of a repeat violation, and other matters related to each particular case. These actions are taken to protect and promote the health, safety, and welfare of the citizens of Texas. Final Disciplinary Actions - License Denial, Surrender, Revocation These actions will be permanently posted on this website . Further information, including a copy of the final order, is available upon written request from our office. Final Disciplinary Actions - All Other, including Probated Suspension, Reprimand, and Administrative Penalty These actions will be posted on this website for a total of seven (7) years, in accordance with our records retention schedule. The regulated individual may now be currently licensed, in good standing, and practicing without any restrictions. ESC Region XI May 15, 2009 5/15/2009
Complete the Matching Activity with your table group. ESC Region XI May 15, 2009 5/15/2009
ASHA Principles of Ethics (1 page) Complete ASHA code of ethics “Cultural Competency” ESC Region XI May 15, 2009 5/15/2009
Review ASHA’s 4 Principles of Ethics ESC Region XI May 15, 2009 5/15/2009
Review ESC Region XI 5/15/2009 May 15, 2009
Review ESC Region XI May 15, 2009 5/15/2009
Review ESC Region XI May 15, 2009 5/15/2009
ASHA has available on website several documents addressing specific ethics issues in more detail. Read page 2-3, “Discussion section”. At your table discuss implications for your job setting. You will be asked to share one with the large group. ESC Region XI May 15, 2009 5/15/2009
1."employer demands," that is, demands and requests made by employers, supervisors, and directors that would cause our members—as their employees—to potentially violate the Code of Ethics as part of their employment. You can appreciate what a challenging situation this is for ASHA members. For example, if, on the one hand, the member does what is asked and it is unethical, then the member risks being sanctioned by ASHA's Board of Ethics and/or a state licensure board. On the other hand, if the member refuses to do what is demanded, he or she risks being disciplined (or terminated) by the employer. It is a classic dilemma. Fortunately, in my experience, in the majority of cases the employer does not appreciate that what he/she is demanding is problematic and the predicament can be cured by the clinician educating the employer, and advocating for best practices. Speech Assistants & Support Personnel: training, use, and supervision of support personnel and assistants. Dysphagia- evaluation & treatment of swallowing. When is it appropriate in school. Reimbursement: billing, coding Clinical Fellowships: Supervision Cultural Competence: provision of services to culturally and linguistically diverse populations. ESC Region XI May 15, 2009 5/15/2009
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ASHA Sanction(s): Penalties imposed by the Board of Ethics Reprimand: A formal rebuke or condemnation with limited disclosure Censure: A public Reprimand Suspension of Membership and/or Certification: A sanction that temporarily interrupts the Respondent's membership and/or certification in the Association for the period of time imposed. Suspension of Membership and/or Certification requires a majority vote of the Board of Ethics. The Respondent need not apply for reinstatement to regain membership and/or certification at the end of the suspension period. Revocation of Membership and/or Certification : A sanction that terminates the Respondent's membership and certification in the Association for the period of time specified. Revocation requires a two-thirds vote of those board members present and voting. The Respondent must apply for reinstatement to regain membership and/or certification. Withholding of Membership and/or Certification: This sanction, which applies only in situations in which the Respondent is in the certification or membership application process when a violation is found, prohibits future Association membership and/or certification for the period of time imposed. Withholding of Membership and/or Certification requires a majority vote of the Board of Ethics. When the sanction period of time has expired the Respondent is not required to apply to the Board of Ethics; application is made directly to the Association. ESC Region XI May 15, 2009 5/15/2009
Not required to be a member of TSHA to practice in Texas -Based upon ASHA Code of Ethics Procedures and sanctions are basically the same -Located on the TSHA website http://www.txsha.org/About_TSHA/code_of_ethics.asp -Interpreted, administered, and enforced by the Ethical Practice Committee (EPC) -Alleged violations are reviewed by the EPC resulting in a determination which can be appealed before a final decision is rendered ESC Region XI May 15, 2009 5/15/2009
REVIEW We feel like this at times. ESC Region XI 5/15/2009 May 15, 2009
Ask group to first rank the characters INDIVIDUALLY. Put signs around the room with the name of each character. Ask each person to stand by the name that represents the character they feel is MOST responsible for the death of the baroness. Large group discussion Return to tables. Ask table groups to try to come to consensus as to who they feel is the most responsible for the death of the baroness. No one right answer. Can be difficult to reach a consensus. Many ethics issues can be the same. The primary theme is to get participants to discuss personal responsibility but there are also issues related to relationships, business ethics, and personal values embedded within the story. Ethic/morals versus the Law -------------------------------------------------------------------------------------- Sample reasoning 1=Mad Man- With out him, there is definitely no murder. Whether he is insane or not doesn't affect responsibility, in my opinion, as then mentally insane people would bear no consequences. My professor actually said several states have adopted "Guilty, though insane" as opposed to "Innocent by means of insanity" in court cases. 2=Baroness- She, though reluctantly, attempted to pass the Mad Man despite his threats. She could have stayed across the bridge and accepted whatever punishment from the Baron, with it being, at worst, as bad as what the Mad Man would give her. 3=Lover- The morality of his affair aside, he lured and enticed her to leave the castle knowing she may be caught, yet denies her any form of help once that situation is realized. 4=Baron- His rules struck great fear in her, but rules without fear are not very good rules (more so with important rules). He may have just threatened and not actually punished her. Either way, she would have visited her lover none the less and the Mad Man would still be there. But would she just not cross? Probably. 5=Friend- The responsibility of a friend comes into question here. Should a friend always bail another friend out, regardless of the circumstances? I feel that the Baroness' life truly wasn't in danger at the time she talked to the friend, as she could choose to still not cross the bridge. Also, if the friend is reoved from the situation, the Baroness still dies, so the friend couldn't be too responsible for it. 6=Boatman- He was only doing his job. She was not in mortal danger, and to break such a rule every time some one claimed they desperately needed to get across would ruin his business. ESC Region XI May 15, 2009 5/15/2009
At your table you each have a case study. Pink paper Each table will only have 1 student. Take a few moments to read the case study. Then at your table please discuss the ethical dilemma and if appropriate which SBOE rules and/or ASHA rules are being violated. Be prepared to report back your finding to the large group. Each table also has a one page pink document with all 6 case studies on it. This is so you can follow along when we report back as a large group. ESC Region XI May 15, 2009 5/15/2009
Texas Administrative Code §741.41 Professional Responsibilities of License Holders (a) A licensee shall: (1) engage in only those aspects of the profession that are within the scope of the licensee's competence considering level of education, training, and experience; (b) A licensee shall not: (13) misrepresent his or her training or competence; ASHA Code of Ethics Principle of Ethics II: Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence. (B). Individuals shall engage in only those aspects of the professions that are within the scope of their competence, considering their level of education, training, and experience. ESC Region XI May 15, 2009 5/15/2009
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Texas Administrative Code §741.44 (b) A supervisor of an intern or assistant shall: (3) provide appropriate supervision after the board office approves the supervisory arrangement; (d) A licensed intern or assistant shall abide by the decisions made by the supervisor relating to the intern's or assistant's scope of practice. In the event the supervisor requests that the intern or assistant violate this chapter, the Act, or any other law, the intern or assistant shall refuse to do so and immediately notify the board office and any other appropriate authority. §741.41 Professional Responsibilities of License Holders (a) A licensee shall: (1) engage in only those aspects of the profession that are within the scope of the licensee's competence considering level of education, training, and experience; (b) A licensee shall not: (4) delegate any service requiring professional competence of a licensee or registrant to anyone not licensed or registered for the performance of that service; ASHA Code of Ethics Principle of Ethics II: Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence. (B). Individuals shall engage in only those aspects of the professions that are within the scope of their competence, considering their level of education, training, and experience. ESC Region XI May 15, 2009 5/15/2009
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Texas Administrative Code §741.41 Professional Responsibilities of License Holders (b) A licensee shall not: (13) misrepresent his or her training or competence; §741.64 Requirements for an Assistant in Speech-Language Pathology License (Page 9) (l) In any professional context the licensee must indicate the licensee status as a speech-language pathology assistant. ASHA Code of Ethics Principle of Ethics I Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or participants in research and scholarly activities and shall treat animals involved in research in a humane manner. (D). Individuals shall not misrepresent the credentials of assistants, technicians, or support personnel and shall inform those they serve professionally of the name and professional credentials of persons providing services. ESC Region XI May 15, 2009 5/15/2009
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Texas Administrative Code §741.41 Professional Responsibilities of License Holders (a) A licensee shall: (4) seek appropriate medical consultation whenever indicated; (b) A licensee shall not: (1) engage in the medical treatment of speech-language and hearing disorders; (5) provide services if the services cannot be provided with reasonable skill or safety to the client; ASHA Code of Ethics ESC Region XI May 15, 2009 5/15/2009
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Texas Administrative Code §741.44 Requirements, Duties, and Responsibilities of Supervisors pg 9 (b) A supervisor of an intern or assistant shall: (3) provide appropriate supervision after the board office approves the supervisory arrangement; (4) supervise no more than a total of four interns and/or assistants. An exception may be made allowing supervision of more than four individuals if the supervisor submits documentation demonstrating their ability to manage the entire caseload. The board's designee will determine if an exception is granted (d) A licensed intern or assistant shall abide by the decisions made by the supervisor relating to the intern's or assistant's scope of practice. In the event the supervisor requests that the intern or assistant violate this chapter, the Act, or any other law, the intern or assistant shall refuse to do so and immediately notify the board office and any other appropriate authority. (g) A licensed speech-language pathologist shall assign duties and provide appropriate supervision to the assistant. (1) Initial diagnostic contacts shall be conducted by the supervising speech-language pathologist. (4) The supervising speech-language pathologist shall provide a minimum of two hours per week of supervision, at least one hour of which is face-to-face supervision where the speech-language pathology assistant is providing the therapy. This applies whether the assistant's practice is full or part-time. (7) (B) An assistant may not conduct an evaluation which includes diagnostic testing and observation, test interpretation, diagnosis, decision making, statement of severity or implication, case selection or case load decisions. §741.41 Professional Responsibilities of License Holders (a) A licensee shall: (1) engage in only those aspects of the profession that are within the scope of the licensee's competence considering level of education, training, and experience; (b) A licensee shall not: (4) delegate any service requiring professional competence of a licensee or registrant to anyone not licensed or registered for the performance of that service; ASHA Code of Ethics Principle of Ethics II: Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence. (B). Individuals shall engage in only those aspects of the professions that are within the scope of their competence, considering their level of education, training, and experience. ESC Region XI May 15, 2009 5/15/2009
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* Discussion Point- Can you report a standard score for this student? Texas Administrative Code ASHA Code of Ethics Principle of Ethics IV Individuals shall honor their responsibilities to the professions and their relationships with colleagues, students, and members of allied professions. Individuals shall uphold the dignity and autonomy of the professions, maintain harmonious interprofessional and intraprofessional relationships, and accept the professions' self-imposed standards. G. Individuals shall not provide professional services without exercising independent professional judgment, regardless of referral source or prescription. American Speech-Language-Hearing Association. (2005). Cultural Competence [Issues in Ethics]. Available from www.asha.org/policy. Federal Register Vol. 71 No. 156 August 14, 2006/ Rules and Regulations § 300.304 Evaluation procedures. (c) Other evaluation procedures. Each public agency must ensure that— (1) Assessments and other evaluation materials used to assess a child under this part— (i) Are selected and administered so as not to be discriminatory on a racial or cultural basis; (ii) Are provided and administered in the child’s native language or other mode of communication and in the form most likely to yield accurate information on what the child knows and can do academically, developmentally, and functionally, unless it is clearly not feasible to so provide or administer; (iii) Are used for the purposes for which the assessments or measures are valid and reliable; (iv) Are administered by trained and knowledgeable personnel; and (v) Are administered in accordance with any instructions provided by the producer of the assessments. § 300.306 Determination of eligibility. (b) Special rule for eligibility determination. A child must not be determined to be a child with a disability under this part— (1) If the determinant factor for that determination is— (iii) Limited English proficiency; ESC Region XI May 15, 2009 5/15/2009
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ESC Region XI May 15, 2009 5/15/2009
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Attachments: SBOE TAC Chapter 741 Give one Get one SBOE Types of Disciplinary Actions Matching activity ASHA Code of Ethics- Principles Summary ASHA Code of Ethics Document ASHA Cultural Competence TSHA Code of Ethics The Drawbridge Exercise Case Studies ESC Region XI May 15, 2009 5/15/2009
