AB177 - Makes various changes relating to audiology, fitting and dispensing hearing aids and speech-language pathology. (BDR 54-199)

- 83rd Session (2025) Assembly Bill No. 177–Assemblymembers González; and Brown-May CHAPTER.......... AN ACT relating to professions; providing for the licensure of speech-language pathology assistants; authorizing certain persons to engage in the supervised practice of speech- language pathology; revising the scope of practice of audiologists, hearing aid specialists and speech-language pathologists; requiring certain persons to be licensed and regulated as audiologists or speech-language pathologists; increasing the maximum amount of certain fees; authorizing the Speech-Language Pathology, Audiology and Hearing Aid Dispensing Board to waive fees in certain circumstances; requiring that certain fees be discounted for certain persons affiliated with the military; revising the required qualifications for and processes for issuing certain licenses; eliminating the requirement for a licensed audiologist to obtain an endorsement before engaging in the practice of fitting and dispensing hearing aids; revising provisions relating to the sale of hearing aids; imposing certain requirements relating to the classification of persons who practice speech-language pathology in schools under a collective bargaining agreement; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law: (1) with certain exceptions, requires a person who engages in the practice of audiology, fitting and dispensing hearing aids or speech-language pathology to be licensed by the Speech-Language Pathology, Audiology and Hearing Aid Dispensing Board; and (2) prescribes the qualifications necessary to obtain such licenses. (NRS 637B.160, 637B.193-637B.204, 637B.290) Section 22 of this bill increases the maximum amount of certain fees relating to such licensure. Section 22 authorizes the Board to waive all or part of such fees in certain circumstances. Section 22 also requires the Board to collect not more than half of the fee that would otherwise be required for the initial licensure of an applicant who: (1) is an active member of the Armed Forces of the United States or a spouse of such a person; (2) a veteran or the surviving spouse of a veteran; or (3) a family member of a person killed in the line of duty in the Armed Forces of the United States under certain circumstances. Sections 27-29 of this bill authorize an applicant for certain types of licenses which require the applicant to hold a license in another state to satisfy this requirement by holding the required license in the District of Columbia or any state or territory of the United States. Section 30 of this bill revises the procedures for issuing an expedited license by endorsement to practice audiology or speech-language pathology. Existing law authorizes the Board to issue a provisional license to practice audiology or speech-language pathology to certain applicants affiliated with the military who are awaiting a decision by the Board on an application for an expedited license by endorsement. (NRS 637B.204) Section 39 of this bill repeals that authority, thereby making the – 2 – - 83rd Session (2025) procedures for issuing an expedited license by endorsement under section 30 applicable to all applicants for such a license. Sections 21 and 22 of this bill remove references to the repealed section. Section 16 of this bill expands the activities that constitute the practice of speech-language pathology to include the use of stroboscopy, in addition to nasal endoscopy, for evaluating and treating certain disorders. Section 16 also revises terminology used to refer to certain procedures that currently constitute the practice of speech-language pathology. Existing law authorizes a student who is pursuing a degree in speech-language pathology at certain institutions to engage in the unlicensed practice of speech- language pathology. (NRS 637B.080) Existing law authorizes the Board to issue a provisional license to engage in the practice of speech-language pathology to a person in the process of completing certain clinical fellowship requirements. (NRS 637B.201) Section 3 of this bill defines the term “speech-language pathology provisional licensee” to refer to the holder of such a provisional license. Section 26 of this bill makes a conforming change to appropriately substitute the term defined by section 3. Section 9 of this bill authorizes the Board to issue a license as a speech-language pathology assistant and prescribes the qualifications for such a license. Section 9 also requires the Board to adopt regulations governing the licensure and practice of speech-language pathology assistants. Section 10 of this bill authorizes a speech-language pathology assistant, a speech-language pathology provisional licensee or a speech-language pathology student to engage in the practice of speech-language pathology only under the supervision of a supervising speech-language pathologist. Section 18 of this bill makes a conforming change to reflect that a student engaged in the supervised practice of speech-language pathology is subject to regulation by the Board pursuant to section 10. Sections 35- 38 of this bill make conforming changes to clarify that a student who is engaging in the supervised practice of speech-language pathology pursuant to section 10 is not engaging in the unauthorized practice of speech-language pathology. Sections 2 and 4-7 of this bill define certain other terms relating to the supervised practice of speech-language pathology and section 12 of this bill establishes the applicability of those definitions. Existing law exempts from licensure and regulation by the Board a person who practices audiology or speech-language pathology within the scope of certain credentials issued by the Department of Education. (NRS 637B.080) Section 18 limits the applicability of this exemption to a person who holds a current endorsement that is issued by the Department on or before September 30, 2026. Section 9 provides that a person is qualified for licensure as a speech-language pathology assistant if the person: (1) holds an endorsement issued by the Department on or before September 30, 2026, which allows the person to teach pupils with speech and language impairments; and (2) actively practices speech- language pathology within the scope of that endorsement at the school or school district where the person is employed. Section 38.3 of this bill requires that a person who holds such an endorsement, is employed by a school district and is subject to a collective bargaining agreement be classified in the same manner for purposes of the agreement as a licensed speech-language pathologist. Sections 24, 25 and 28 of this bill revise the qualifications required to obtain a license as a hearing aid specialist, a license as an apprentice to engage in the practice of fitting and dispensing hearing aids or a provisional license to engage in the practice of fitting and dispensing hearing aids. Existing law authorizes the Board to grant an audiologist who wishes to engage in the practice of fitting and dispensing hearing aids an endorsement to engage in such practice as a dispensing audiologist. (NRS 637B.205) Section 14 of this bill – 3 – - 83rd Session (2025) includes within the practice of audiology certain activities that substantially overlap with the practice of fitting and dispensing hearing aids, including ordering the use of hearing aids. Section 15 of this bill expands the activities that constitute the practice of fitting and dispensing hearing aids to include ordering the use of hearing aids. Accordingly, section 39 repeals the separate endorsement for dispensing audiologists and sections 17, 19, 20, 22, 23, 25, 27 and 31-33 of this bill make conforming changes to eliminate references to such endorsements and to dispensing audiologists. Federal law requires the United States Food and Drug Administration to regulate over-the-counter hearing aids. (FDA Reauthorization Act of 2017 Pub. L. No. 115-52, § 709, 131 Stat. 1005, 1065–67) Federal law and regulations prohibit state or local governments from requiring the order, involvement or intervention of a licensed person for a consumer to access an over-the-counter hearing aid. (Pub. L. No. 115-52, § 709; 21 C.F.R. § 800.30) Sections 13 and 34 of this bill prohibit the Board from regulating or restricting the provision of over-the-counter hearing aids unless a licensee violates federal law applicable to such devices. Section 34 also updates certain references to related federal regulations. In 2022, the federal Food and Drug Administration repealed a regulation that prohibited the sale of a hearing aid unless: (1) the person dispensing the hearing aid has received a written statement or waiver stating that the patient’s hearing loss has been medically evaluated and the patient may be considered a candidate for a hearing aid; or (2) the patient waives the medical evaluation in writing. (87 FR 50755) Section 32 removes conforming requirements from Nevada law governing the sale of hearing aids by catalog, mail or the Internet, thereby authorizing such sales without such a statement or waiver. EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Chapter 637B of NRS is hereby amended by adding thereto the provisions set forth as sections 2 to 11, inclusive, of this act. Sec. 2. “Speech-language pathology assistant” means a person licensed pursuant to section 9 of this act to engage in the practice of speech-language pathology under the supervision of a supervising speech-language pathologist. Sec. 3. “Speech-language pathology provisional licensee” means any person who holds a provisional license issued pursuant to NRS 637B.201 to engage in the practice of speech-language pathology while completing the clinical fellowship requirements for obtaining a Certificate of Clinical Competence in Speech- Language Pathology issued by the American Speech-Language- Hearing Association. Sec. 4. “Speech-language pathology student” means an unlicensed student who engages in the practice of – 4 – - 83rd Session (2025) speech-language pathology under the supervision of a supervising speech-language pathologist pursuant to section 10 of this act. Sec. 5. “Supervising speech-language pathologist” means a speech-language pathologist who supervises a speech-language pathology assistant, speech-language pathology provisional licensee or speech-language pathology student. Sec. 6. “Supervision” means the provision of direction and the evaluation of the tasks assigned by a supervising speech- language pathologist to a speech-language pathology assistant, speech-language pathology provisional licensee or speech- language pathology student. The term includes, without limitation, direct supervision, indirect supervision and telesupervision. Sec. 7. “Telesupervision” means the real-time, distance observation by a supervising speech-language pathologist of services delivered by a speech-language pathology assistant, speech-language pathology provisional licensee or speech- language pathology student, with feedback or assistance provided by the supervising speech-language pathologist as needed. The term may include, without limitation, the utilization of technology which allows a supervising speech-language pathologist to view and communicate with the client and speech-language pathology assistant, speech-language pathology provisional licensee or speech-language pathology student in real time through virtual telecommunication software, webcam, telephone or other similar devices and services to provide immediate feedback. Sec. 8. (Deleted by amendment.) Sec. 9. 1. An applicant for a license to engage in the practice of speech-language pathology as a speech-language pathology assistant must hold: (a) A bachelor’s degree or master’s degree in speech-language pathology or communication sciences and disorders awarded by: (1) An educational institution that is accredited by an accrediting agency recognized by the United States Department of Education; or (2) A foreign school which is accredited by an accrediting agency approved by the Board and which provides an educational program that is substantially equivalent to the educational program provided by an institution described in subparagraph (1); or (b) A current endorsement issued on or before September 30, 2026, by the Department of Education pursuant to NRS 391.019 and any regulations adopted pursuant thereto which allows a person to teach pupils who have speech and language – 5 – - 83rd Session (2025) impairments and actively engage in the practice of speech- language pathology within the scope of that endorsement at the school or school district where the applicant is employed. 2. The Board shall adopt regulations regarding speech- language pathology assistants, including, without limitation: (a) The licensing of speech-language pathology assistants; (b) The educational and training requirements for speech- language pathology assistants, in addition to the requirements prescribed by subsection 1; and (c) The practice of speech-language pathology by speech- language pathology assistants. Sec. 10. 1. A speech-language pathology assistant, speech- language pathology provisional licensee or speech-language pathology student may engage in the practice of speech-language pathology only under the supervision of a supervising speech- language pathologist and in accordance with the provisions of this chapter and any regulations adopted pursuant thereto. 2. A speech-language pathology student who engages in the practice of speech-language pathology must be enrolled in a program to obtain a bachelor’s degree or master’s degree in the field of speech-language pathology or communication sciences and disorders at an educational institution that is accredited by a nationally recognized agency under the United States Department of Education. 3. The Board shall adopt regulations regarding the supervision of speech-language pathology assistants, speech- language pathology provisional licensees and speech-language pathology students. Sec. 11. (Deleted by amendment.) Sec. 12. NRS 637B.020 is hereby amended to read as follows: 637B.020 As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 637B.025 to 637B.075, inclusive, and sections 2 to 8, inclusive, of this act have the meanings ascribed to them in those sections. Sec. 13. NRS 637B.044 is he [Text truncated for display. 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