December 17, 2024 • 25 mins
Discover the secrets behind efficient licensing and swift enforcement processes for speech-language pathologists in this week’s episode of Know Your Regulator! Learn how the Texas Department of Licensing and Regulation (TDLR) manages thousands of applications each year with remarkable speed and precision. Joined by Ron Foster, Director of Enforcement, and Katie Brice, Deputy Director of Licensing, you'll hear firsthand insights into the various types of licenses available and the benefits of applying online for a quicker turnaround. Learn how TDLR's strategic approach during peak times ensures applications are processed swiftly, often within just two weeks.
Explore the intricate world of enforcement as Ron sheds light on the types of complaints received, particularly those related to billing and ethical violations. Hear why timely responses to licensing board inquiries are crucial for quick resolutions. We also delve into the vast resources available on the TDLR website that empower licensees to remain compliant and excel in their practice. Ensure you have the knowledge and tools necessary for success in the field of speech-language pathology. Don't miss this episode filled with essential insights and expert guidance.
Get more information, details and resources on Know Your Regulator - https://www.belolaw.com/know-your-regulator
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
This podcast is for educational purposes only, does
not constitute legal advice anddoes not create an
attorney-client relationship.
If you need legal assistanceabout a legal problem, contact
an attorney.
Welcome back to another episodeof Know your Regulator, the
podcast that inspires you toengage.
I'm your host, simone Murphy,and co-hosting with me today is
(00:23):
Senior Associate LaJuana Acklin.
Hello, lj, hello, how are?
Speaker 2 (00:29):
you Good, I'm glad to be here.
Speaker 1 (00:30):
Good, we're glad to have you.
We've got another great episodelined up for our viewers.
We're going to be talking aboutlicensing and enforcement for
speech-language pathologists,and joining us for this exciting
discussion is Ron Foster,director of Enforcement, and
Katie Bryce, deputy Director ofLicensing.
Thank you, guys, both so muchfor being here.
(00:52):
I would like to start off atthe beginning of the process for
a licensee.
Katie, can you tell us about?
You know what you're seeing inthe licensing division.
How many applications are y'allgetting in?
You know a six to 12 monthtimeframe.
Speaker 3 (01:09):
Well, so I want to start with a little background,
because at TDLR we regulate sixdifferent license types under
the speech language pathologyand audiology program and those
include the speech languagepathologist, the SLP intern, the
SLP assistant, the audiologist,audiology intern and audiology
assistant licenses.
And so for this segment I'mjust going to discuss the
(01:32):
SLP-related licenses.
So for fiscal year 2024, wereceived a total of 13,185
applications.
That includes the initialapplications and renewals for
those three license types.
The SLP population is ourlargest population in this
(01:53):
program, so for them we had atotal of about 9,000, let's say
9,444 applications.
The SLP interns are a smallergroup.
They were at 1,013 applicationsand the SLP assistants were at
2,728 applications.
Speaker 1 (02:15):
Wow, so a good portion of those, like you said,
were speech languagepathologists.
And how many licenses weregranted to SLPs and their
interns and assistants at thattime?
Speaker 3 (02:28):
So during that same time period we issued 13,136
licenses.
So it's really just adifference of I want to say
about 50 between the numberwe've received, of applications
received, and the number oflicenses issued.
Speaker 1 (02:45):
Well, that's good.
That sounds like generally yourapplicants don't really have a
hard time obtaining a license.
Can you tell us maybe some of alittle bit of some of those
nuances that applicants couldexperience that may prolong this
process for them?
Speaker 3 (03:02):
At TDLR.
Even within this program, thereare varying levels of complexity
with the applications.
So, for example, if someoneholds their certificate of
clinical competence, which isissued by the American Speech
Language Hearing Association, wecall ASHA if they hold their
(03:23):
C's, it's a very straightforwardapplication process because we
waive things we waive like thepassing test score and proof of
their internship and things likethat, so that application is
really straightforward and easy.
For other licenses, like theSLP assistant license, it gets a
(03:44):
lot more complicated becausethere are a lot of additional
supporting documents that theyhave to also submit, like
supervision forms that arefilled out by them and their
supervisor.
All of the applications includehaving to submit a completion
of certificate, I mean, excuseme, a certificate of completion
of the jurisprudence exam, whichis a test covering the laws and
(04:07):
the rules for the program.
They also all require atranscript, which they can send
in an official transcript or itcan come electronically from the
university, and they all alsohave to pass fingerprint
background check.
And so you know there are justdifferent levels of complexity
within this program depending onwhat they're applying for.
Speaker 1 (04:30):
You know, I guess it would be fair to say my next
question was going to be howlong does this process take?
But it sounds like it'sdifferent, for you know, each
each license, that maybe thereare some of the same things that
you need to submit, but,depending on the license that
you're trying to obtain, oneprocess could take a little bit
longer than the other.
Speaker 3 (04:49):
Yeah, generally, if we receive a complete
application meaning it has allof the supporting documents, we
have the transcript and they'vedone the fingerprints it is
generally processed within twoweeks of us getting it.
If it is a peak graduation timefrom May to maybe end of June
(05:13):
and then again at the end ofAugust when people are finishing
up summer school classes thosemay take a little bit longer
because that's just a huge peak,may take a little bit longer
because that's just a huge peaktime for this program.
Yeah, we will pull people infrom other teams to try to help
process those applicationsduring those peak times so that
it doesn't get too backlogged.
(05:34):
But generally within two weeks.
And if it's a renewal and theyapply online for the renewal,
those should renew within 48hours.
Apply online for the renewalthose should renew within 48
hours.
There are a few instances thatmight delay that, but generally,
you know it's a pretty quickturnaround.
Speaker 1 (05:51):
Can you walk us through just a typical
application for aspeech-language pathologist,
sure.
Speaker 3 (06:01):
Generally, we try to encourage everyone to apply
online.
Applying through a paperapplication just delays
everything because of mailrouting and the clearing of
checks and money orders, thingslike that.
So we encourage everyone to goonline.
They'll log on, create anaccount on our program I think
(06:22):
it's called Versa Online andthey will be able to provide
their contact information,answer some criminal history
questions.
There are some disciplinaryaction questions basically
wanting to know have you everheld a license in another state
or held a different type oflicense where there was a
disciplinary action taken?
(06:42):
So we have those types ofquestions and then they attach
all of the supporting documentsthat we need and can upload
those to the online applicationand then they'll submit it.
And once they submit it, wewill, you know, process it and
then we'll send them an emailwith their fingerprint
instructions, and so it's reallyimportant that they look for
(07:04):
their email with thoseinstructions to go get their
fingerprints done and then, oncethat's done and those are
cleared, then we are able toissue the license.
Speaker 1 (07:14):
Nice, awesome.
Some programs have like a gosh.
What is it called, like sort ofan eligibility or criminal?
I forgot the name of it.
Is this the criminal history?
Eligibility Criminal historyevaluation.
Yes, criminal historyevaluation Is that something
that you know prospective SLPscan use?
(07:38):
Is there something like thatfor them to use as well?
Speaker 3 (07:41):
Absolutely.
That's available on our webpageunder other forms.
There's a criminal historyevaluation form that you can
fill out and submit if you haveanything in your past that you
want to have reviewed before youapply.
Speaker 1 (07:57):
I know that that can when we're talking about
preparing and submitting all ofyour documentation and just
making sure that you fullyunderstand the application
process and that you'reproviding all of that
documentation, like you said, tocomplete your application,
because that I can imagine wouldif you guys are having to go
(08:19):
back and forth and requestingadditional documents that could
prolong you being able to begranted your license.
Speaker 3 (08:26):
Right, we always tell people to double-check their
forms, make sure everything issigned, because we get a lot of
forms that are filled out butthey're missing a signature or
some section is left blank orthe whole form is missing, and
so, yeah, just double-check andmake sure you have everything
(08:46):
complete, Okay.
Speaker 1 (08:48):
Absolutely, and is that a big issue that you're
seeing in the applicationdepartment?
Speaker 3 (08:54):
It is in this program just because of the number of
additional forms that arenecessary with the application,
because the assistant and theintern license types both
require supervision plans Inaddition to, like, verification
of training hours.
So there are a lot ofadditional forms, and so that is
(09:19):
one of the biggest issues.
And so another thing is justpeople not opening their emails
or mail that we send, because inthis program you know, if we
review the application andthey're missing something, we
will send them an email we callit a request for information
which outlines what they'remissing.
(09:40):
But if they don't ever open it,then they don't know that they
are still pending.
You know some documents.
That's another issue for peoplewho are renewing their license,
because in this program wecurrently have a continuing
education audit system and ifthey're flagged for audit they
are sent a notification.
But if they don't get thenotification or they don't open
(10:03):
it, then they don't know thatthey need to complete that
process upon renewing theirlicense.
Speaker 1 (10:10):
So well, that's really really good, Great
takeaway for our viewers Checkyour emails, their license so
Well, that's really really good.
A great takeaway for ourviewers Check your emails.
Speaker 3 (10:16):
Yes, yes, and update it when you move.
Yes.
Speaker 1 (10:19):
Yes.
Speaker 4 (10:20):
Yeah.
Speaker 1 (10:20):
Absolutely To your point.
Make sure that you have yourmost current contact information
up to date with your governingagency.
Speaker 3 (10:28):
Yes, we have a lot of students who apply as they're
about to graduate, and they willprovide a email address
associated with your universityand after a certain amount of
time, they no longer have accessto that and they forget to
update it, and so they quitreceiving information that they
need.
Speaker 1 (10:45):
That's a big one.
Yeah, the issues thatapplicants are facing in your
division.
Are these usually disclosed bythe applicant themselves?
Are they usually, you know,initiated by TDLR investigation?
Speaker 3 (11:02):
I don't have the statistics on the number who
self-disclose I would let Ronanswer that but I think
generally you know if we have anapplication that is flagged for
missing the fingerprints orthey check that yes, they've had
a disciplinary action taken inanother state or against another
(11:23):
license, we would refer thoseto our enforcement division.
Speaker 1 (11:25):
And so it's too distinct.
You guys just handle theapplications and granting the
license.
Anything that has to do withdisciplinary action or
investigation then goes to Ron'sdivision, correct?
Okay, gotcha.
Well, before we switch over toenforcement, do you have any
advice for applicants who arepreparing to submit their
(11:47):
applications, Katie?
Speaker 3 (11:48):
My advice is really just to double check everything.
Try to attach everything thatthey can to the application when
they submit it, instead ofsending forms in one at a time.
You know, after they submit theapplication, that makes it much
harder for us to match it withthe application.
So try to have everything readywhen they're applying, upload
(12:12):
it, make sure it's all correctand then check their emails once
they submit it Nice.
Speaker 1 (12:17):
I think that's some great takeaways.
Definitely keep your ducks in arow and look out for
correspondence.
Speaker 2 (12:23):
Yeah, absolutely.
I think Katie's her commentsregarding self-disclosure is an
excellent segue to speak withRon about enforcement.
So, ron, I just want to startthere.
How many complaints do youreceive for speech and language
(12:44):
pathologists in the six to12-month period, and how many of
those complaints are connectedto self-disclosure for
applicants attempting to obtaintheir license.
Speaker 4 (12:57):
Thank you, luana.
Let me start off by giving aplug again for our website.
I want to make sure people knowto go to tdlrtexasgov to look
up all the licensing information.
There's another tab forcomplaints and enforcement.
So any of these statistics thatI'm throwing around you can go
and verify it.
We put that out there on ourwebsite for all of our programs.
(13:21):
So the self-disclosure piece ofit.
I actually don't have thatstatistic readily available,
luana, but what I can tell youis that in the last year we
received about 1,384 complaints.
But what I want you to know isthat that seems like a big
number but actually only 54consumer complaints were opened
(13:47):
and only eight departmentinitiated complaints based upon
those audits that Katiementioned are open.
So the other 1,322 are thereviews of applications that we
do for criminal history.
This is a very highly trainedand very educated group of
(14:09):
applicants.
That number represents a verysmall percentage.
I believe it's probably lessthan 5% of the number that Katie
mentioned that applied for alicense.
So I just want to throw outthere that out of those 1,322
cases that we reviewed that hada criminal history, we only
(14:30):
opened up nine cases againstapplicants in this program.
So this is a very highlytrained, highly educated and
non-criminal group of people.
Speaker 2 (14:42):
Oh, that's excellent.
That's what we like to hearfrom our speech language
pathologists.
So my next question is with thecases that are open, how many
cases are resolved?
How long does it take toresolve those cases?
Speaker 4 (14:57):
Yeah, you know, on general it takes about 171 days
to resolve cases.
My statistics show that weclose about 63 percent of the
cases within six months, whichis our kind of performance
measure that we have.
As you can imagine, some ofthese might involve
medical-related questions orissues and it takes a little bit
(15:21):
longer when you start gettingmedical records involved and you
need to review that type ofstandard of care type of thing.
So some of these can be closedreally quickly and other ones
they just take a little bitlonger.
Speaker 2 (15:35):
All right, and you already discussed with us in the
statistics what categoriesproduce the most complaints.
Just to tag along with that,what are the biggest issues
licensees face when it comesdown to the complaints that are
open due to the criminalbackground, criminal history?
Speaker 4 (15:55):
Thank you, luana.
Let me go into some of thosecomplaints because the criminal
history part of it is really sosmall.
I don't think we really need toworry too much about that.
The part that we see thebiggest complaints on from
consumers, which is the vastmajority of the cases.
It usually has to do withbilling for services not
provided People thinking theypaid for something and they
(16:18):
didn't get what they thoughtthey paid for.
The other thing we might get isrecords that are not matching.
That might come from our auditsthat we do or when we request
documents in an investigationwhere the records are not
matching up with what they tellus.
And you know there is a morebroad category of just ethical
(16:38):
type of violations that we seewhere we might be making some
kind of request from them andthey don't disclose protocols or
testing methods that are usedor they don't provide us the
supervisory documentation thatthey're supposed to for their
subordinates as part of theprocess.
Sometimes patients do getinjured.
(17:00):
You know their standard of careissues that come up.
So those are the type ofviolations that we tend to see
on the complaint side.
Speaker 2 (17:09):
Wow, that's very interesting, especially with the
billing for services not paidfor.
So in those types of cases, how, if you can put a percentage on
it, how many of those cases areactually like billing cases
versus ethical complaints?
Speaker 4 (17:29):
Let me see, I'm going to let me look at my statistics
, because that's a prettyspecific number.
I'm thinking maybe about athird of the cases.
About a third of the cases thatI see that come in are billing
related cases from consumers.
That's a pretty high percentageand overall a pretty low number
(17:53):
of complaints, though, for thewhole program.
Speaker 2 (17:55):
Okay, and since those cases are coming in from
consumers, is there anythingthat the licensing can do to
expedite the resolution process?
Speaker 4 (18:06):
Yes, you know the most common issue that we have
is that people ignore ourattempts to contact them.
When we're reaching, we usuallywill try to call you.
We might send emails to youremail address of record that we
have and request information.
So the biggest challenge wehave is to get a response.
(18:26):
You know there can be complexissues at play with
investigations.
We are talking about medicalstuff, so you might have HIPAA
laws that come into play otherprivacy laws in Texas that might
apply.
So sometimes there has to beconversations about what
documents they can provide to us.
As the state regulator, we'reentitled to all of those
(18:50):
documents, even though theymight not understand that.
So I think the biggestchallenge is for us just to be
able to get them to give us thedocuments we need so that we can
verify whether or not thatallegation is true or not.
Speaker 2 (19:05):
And that leads me to my next question.
It sounds like not producingdocuments may slow down the
resolution of the case.
So what are some other factorsthat can either make a case move
faster or slower than average?
Speaker 4 (19:21):
Absolutely, you know.
So, as I mentioned, these casesmight involve a standard of
care and in in all of ourprograms, we do have expert
witnesses that we use on ourcases.
Some of them are in-houseexperts and some of them are
third-party experts, and so onoccasion Luana, when we have a
(19:43):
complicated case involvingstandard of care, we may need to
get an expert opinion.
It takes time to get thatopinion, get that report.
We may need then to have somekind of negotiated settlement
conversation with the personregarding the violations and the
evidence we have and theopinions that we have, and that
(20:05):
can slow down the process, and Iwill tell you that what really
slows down the process is if itends up going to litigation.
Right, if we go to a contestedcase, then you're talking about
something that, instead of beingresolved in a matter of weeks,
might take months.
Now.
Speaker 2 (20:25):
And you brought out some excellent information that
you know I can use in mypractice with defending my
clients.
So with that, with the standardof care case, how often does
law enforcement get involved andis law enforcement with those
cases?
Could they be a factor that maymake a case?
Speaker 4 (20:46):
resolve slower than average.
So I'm going to answer thesecond part of the question
first.
Yes, if law enforcement doesget involved it will slow down
cases.
We've had cases where there wasperhaps injury to a patient,
injury to a client which waspart of the allegation, and you
know, if that is serious enoughit could be a criminal act.
(21:09):
But that is very rare.
That's not happening a lot inthis type of program, right?
What you have, I think, mostlyis more of the paperwork billing
error type of violations withpeople honest mistake type of
things like that, I think, wherethey need to improve their
(21:29):
business practices a little bit.
You know not intentional doingsomething you know wrong type of
situation that would involvelaw enforcement.
This program has very littleinvolvement of law enforcement.
I would say that we have otherprograms that have a lot more
law enforcement involvement inthose cases have a lot more law
(21:52):
enforcement involvement in thosecases.
Speaker 2 (21:53):
Well, how do speech-language pathologists
proactively avoid complaints?
What can a speech-languagepathologist do so the Texas
Department of Licensing andRegulation is not sending a
notice to them regardingallegations of any misconduct.
Speaker 4 (22:10):
Well, I'm going to tell you, I'm going to give a
plug to our licensing divisionand our compliance division.
They are there to help peopleand you don't have to wait for
enforcement to get involved.
Right, you can reach out toTDLR that website, tdlrtexasgov.
There's a wealth of informationthere and you can call us.
(22:32):
You can call our customerservice line.
You can speak to someone in ourcompliance division.
They've got people there onstaff that are very
knowledgeable about this program.
They can answer questions aboutall sorts of things and help
you to stay out of the hot water.
Speaker 2 (22:49):
Absolutely, absolutely, as a lifelong water
run.
I really appreciate you comingand speaking with us today, so I
have one more question for you,and that is is there anything
unique about your divisioncompared with other divisions
within TDLR or any otherdepartments within the agency?
Speaker 4 (23:10):
I'm going to give a plug.
We do always need third partyexperts and we do pay for our
experts.
Just so everybody knows that,we do have contracts that we
sign, and if you want to go tothe TDLRTexasgov website and you
want to be an expert witnessfor the department on cases, we
(23:31):
will do a conflict of interestapplication and all kinds of
stuff.
But we really need the help ofour licensees and our experts
out there.
So I would urge folks that areinterested in this video and
this content to go to ourwebsite and see if maybe they
qualify as an expert on one ofour and we can use them on our
(23:54):
cases.
It doesn't hurt to have toomany experts.
Speaker 2 (23:58):
Oh, absolutely Well, Simone.
I think we've had a reallygreat conversation with both
Katie and Ron about speechlanguage pathologists and what
it takes to obtain a license andthen what it takes to maintain
the license, and I'm reallyappreciative of this.
Speaker 1 (24:18):
Yeah, no, definitely, and thanks for you know, kind
of highlighting some of thoseresources that you guys provide
as well, because that can be.
So I have had multiple calls.
I got a call this week ofsomeone looking for
interpretation of TDLRguidelines, and where did I
direct them?
The TDLR website, you know.
(24:39):
So there is information that'sout there that's helpful to
licensees.
Again, thank you, ron and Katie, for joining us this afternoon.
We really appreciate you guystaking the time out of your day
to be transparent andinformative and educate our
license holders, because that'swhat this is really all about is
just making sure that theselicense holders are equipped to
(25:01):
go out into the world andpractice while maintaining
compliance.
Thank you, simone.
Speaker 4 (25:07):
I really appreciate the opportunity to share our
perspective with you.
Know your Regulator the podcastthat inspires you to engage.
This podcast is for educational purposes only, does
not constitute legal advice anddoes not create an
attorney-client relationship.
If you need legal assistanceabout a legal problem, contact
an attorney.
Welcome back to another episodeof Know your Regulator, the
podcast that inspires you toengage.
I'm your host, simone Murphy,and co-hosting with me today is
(00:23):
Senior Associate LaJuana Acklin.
Hello, lj, hello, how are?
Speaker 2 (00:29):
you Good, I'm glad to be here.
Speaker 1 (00:30):
Good, we're glad to have you.
We've got another great episodelined up for our viewers.
We're going to be talking aboutlicensing and enforcement for
speech-language pathologists,and joining us for this exciting
discussion is Ron Foster,director of Enforcement, and
Katie Bryce, deputy Director ofLicensing.
Thank you, guys, both so muchfor being here.
(00:52):
I would like to start off atthe beginning of the process for
a licensee.
Katie, can you tell us about?
You know what you're seeing inthe licensing division.
How many applications are y'allgetting in?
You know a six to 12 monthtimeframe.
Speaker 3 (01:09):
Well, so I want to start with a little background,
because at TDLR we regulate sixdifferent license types under
the speech language pathologyand audiology program and those
include the speech languagepathologist, the SLP intern, the
SLP assistant, the audiologist,audiology intern and audiology
assistant licenses.
And so for this segment I'mjust going to discuss the
(01:32):
SLP-related licenses.
So for fiscal year 2024, wereceived a total of 13,185
applications.
That includes the initialapplications and renewals for
those three license types.
The SLP population is ourlargest population in this
(01:53):
program, so for them we had atotal of about 9,000, let's say
9,444 applications.
The SLP interns are a smallergroup.
They were at 1,013 applicationsand the SLP assistants were at
2,728 applications.
Speaker 1 (02:15):
Wow, so a good portion of those, like you said,
were speech languagepathologists.
And how many licenses weregranted to SLPs and their
interns and assistants at thattime?
Speaker 3 (02:28):
So during that same time period we issued 13,136
licenses.
So it's really just adifference of I want to say
about 50 between the numberwe've received, of applications
received, and the number oflicenses issued.
Speaker 1 (02:45):
Well, that's good.
That sounds like generally yourapplicants don't really have a
hard time obtaining a license.
Can you tell us maybe some of alittle bit of some of those
nuances that applicants couldexperience that may prolong this
process for them?
Speaker 3 (03:02):
At TDLR.
Even within this program, thereare varying levels of complexity
with the applications.
So, for example, if someoneholds their certificate of
clinical competence, which isissued by the American Speech
Language Hearing Association, wecall ASHA if they hold their
(03:23):
C's, it's a very straightforwardapplication process because we
waive things we waive like thepassing test score and proof of
their internship and things likethat, so that application is
really straightforward and easy.
For other licenses, like theSLP assistant license, it gets a
(03:44):
lot more complicated becausethere are a lot of additional
supporting documents that theyhave to also submit, like
supervision forms that arefilled out by them and their
supervisor.
All of the applications includehaving to submit a completion
of certificate, I mean, excuseme, a certificate of completion
of the jurisprudence exam, whichis a test covering the laws and
(04:07):
the rules for the program.
They also all require atranscript, which they can send
in an official transcript or itcan come electronically from the
university, and they all alsohave to pass fingerprint
background check.
And so you know there are justdifferent levels of complexity
within this program depending onwhat they're applying for.
Speaker 1 (04:30):
You know, I guess it would be fair to say my next
question was going to be howlong does this process take?
But it sounds like it'sdifferent, for you know, each
each license, that maybe thereare some of the same things that
you need to submit, but,depending on the license that
you're trying to obtain, oneprocess could take a little bit
longer than the other.
Speaker 3 (04:49):
Yeah, generally, if we receive a complete
application meaning it has allof the supporting documents, we
have the transcript and they'vedone the fingerprints it is
generally processed within twoweeks of us getting it.
If it is a peak graduation timefrom May to maybe end of June
(05:13):
and then again at the end ofAugust when people are finishing
up summer school classes thosemay take a little bit longer
because that's just a huge peak,may take a little bit longer
because that's just a huge peaktime for this program.
Yeah, we will pull people infrom other teams to try to help
process those applicationsduring those peak times so that
it doesn't get too backlogged.
(05:34):
But generally within two weeks.
And if it's a renewal and theyapply online for the renewal,
those should renew within 48hours.
Apply online for the renewalthose should renew within 48
hours.
There are a few instances thatmight delay that, but generally,
you know it's a pretty quickturnaround.
Speaker 1 (05:51):
Can you walk us through just a typical
application for aspeech-language pathologist,
sure.
Speaker 3 (06:01):
Generally, we try to encourage everyone to apply
online.
Applying through a paperapplication just delays
everything because of mailrouting and the clearing of
checks and money orders, thingslike that.
So we encourage everyone to goonline.
They'll log on, create anaccount on our program I think
(06:22):
it's called Versa Online andthey will be able to provide
their contact information,answer some criminal history
questions.
There are some disciplinaryaction questions basically
wanting to know have you everheld a license in another state
or held a different type oflicense where there was a
disciplinary action taken?
(06:42):
So we have those types ofquestions and then they attach
all of the supporting documentsthat we need and can upload
those to the online applicationand then they'll submit it.
And once they submit it, wewill, you know, process it and
then we'll send them an emailwith their fingerprint
instructions, and so it's reallyimportant that they look for
(07:04):
their email with thoseinstructions to go get their
fingerprints done and then, oncethat's done and those are
cleared, then we are able toissue the license.
Speaker 1 (07:14):
Nice, awesome.
Some programs have like a gosh.
What is it called, like sort ofan eligibility or criminal?
I forgot the name of it.
Is this the criminal history?
Eligibility Criminal historyevaluation.
Yes, criminal historyevaluation Is that something
that you know prospective SLPscan use?
(07:38):
Is there something like thatfor them to use as well?
Speaker 3 (07:41):
Absolutely.
That's available on our webpageunder other forms.
There's a criminal historyevaluation form that you can
fill out and submit if you haveanything in your past that you
want to have reviewed before youapply.
Speaker 1 (07:57):
I know that that can when we're talking about
preparing and submitting all ofyour documentation and just
making sure that you fullyunderstand the application
process and that you'reproviding all of that
documentation, like you said, tocomplete your application,
because that I can imagine wouldif you guys are having to go
(08:19):
back and forth and requestingadditional documents that could
prolong you being able to begranted your license.
Speaker 3 (08:26):
Right, we always tell people to double-check their
forms, make sure everything issigned, because we get a lot of
forms that are filled out butthey're missing a signature or
some section is left blank orthe whole form is missing, and
so, yeah, just double-check andmake sure you have everything
(08:46):
complete, Okay.
Speaker 1 (08:48):
Absolutely, and is that a big issue that you're
seeing in the applicationdepartment?
Speaker 3 (08:54):
It is in this program just because of the number of
additional forms that arenecessary with the application,
because the assistant and theintern license types both
require supervision plans Inaddition to, like, verification
of training hours.
So there are a lot ofadditional forms, and so that is
(09:19):
one of the biggest issues.
And so another thing is justpeople not opening their emails
or mail that we send, because inthis program you know, if we
review the application andthey're missing something, we
will send them an email we callit a request for information
which outlines what they'remissing.
(09:40):
But if they don't ever open it,then they don't know that they
are still pending.
You know some documents.
That's another issue for peoplewho are renewing their license,
because in this program wecurrently have a continuing
education audit system and ifthey're flagged for audit they
are sent a notification.
But if they don't get thenotification or they don't open
(10:03):
it, then they don't know thatthey need to complete that
process upon renewing theirlicense.
Speaker 1 (10:10):
So well, that's really really good, Great
takeaway for our viewers Checkyour emails, their license so
Well, that's really really good.
A great takeaway for ourviewers Check your emails.
Speaker 3 (10:16):
Yes, yes, and update it when you move.
Yes.
Speaker 1 (10:19):
Yes.
Speaker 4 (10:20):
Yeah.
Speaker 1 (10:20):
Absolutely To your point.
Make sure that you have yourmost current contact information
up to date with your governingagency.
Speaker 3 (10:28):
Yes, we have a lot of students who apply as they're
about to graduate, and they willprovide a email address
associated with your universityand after a certain amount of
time, they no longer have accessto that and they forget to
update it, and so they quitreceiving information that they
need.
Speaker 1 (10:45):
That's a big one.
Yeah, the issues thatapplicants are facing in your
division.
Are these usually disclosed bythe applicant themselves?
Are they usually, you know,initiated by TDLR investigation?
Speaker 3 (11:02):
I don't have the statistics on the number who
self-disclose I would let Ronanswer that but I think
generally you know if we have anapplication that is flagged for
missing the fingerprints orthey check that yes, they've had
a disciplinary action taken inanother state or against another
(11:23):
license, we would refer thoseto our enforcement division.
Speaker 1 (11:25):
And so it's too distinct.
You guys just handle theapplications and granting the
license.
Anything that has to do withdisciplinary action or
investigation then goes to Ron'sdivision, correct?
Okay, gotcha.
Well, before we switch over toenforcement, do you have any
advice for applicants who arepreparing to submit their
(11:47):
applications, Katie?
Speaker 3 (11:48):
My advice is really just to double check everything.
Try to attach everything thatthey can to the application when
they submit it, instead ofsending forms in one at a time.
You know, after they submit theapplication, that makes it much
harder for us to match it withthe application.
So try to have everything readywhen they're applying, upload
(12:12):
it, make sure it's all correctand then check their emails once
they submit it Nice.
Speaker 1 (12:17):
I think that's some great takeaways.
Definitely keep your ducks in arow and look out for
correspondence.
Speaker 2 (12:23):
Yeah, absolutely.
I think Katie's her commentsregarding self-disclosure is an
excellent segue to speak withRon about enforcement.
So, ron, I just want to startthere.
How many complaints do youreceive for speech and language
(12:44):
pathologists in the six to12-month period, and how many of
those complaints are connectedto self-disclosure for
applicants attempting to obtaintheir license.
Speaker 4 (12:57):
Thank you, luana.
Let me start off by giving aplug again for our website.
I want to make sure people knowto go to tdlrtexasgov to look
up all the licensing information.
There's another tab forcomplaints and enforcement.
So any of these statistics thatI'm throwing around you can go
and verify it.
We put that out there on ourwebsite for all of our programs.
(13:21):
So the self-disclosure piece ofit.
I actually don't have thatstatistic readily available,
luana, but what I can tell youis that in the last year we
received about 1,384 complaints.
But what I want you to know isthat that seems like a big
number but actually only 54consumer complaints were opened
(13:47):
and only eight departmentinitiated complaints based upon
those audits that Katiementioned are open.
So the other 1,322 are thereviews of applications that we
do for criminal history.
This is a very highly trainedand very educated group of
(14:09):
applicants.
That number represents a verysmall percentage.
I believe it's probably lessthan 5% of the number that Katie
mentioned that applied for alicense.
So I just want to throw outthere that out of those 1,322
cases that we reviewed that hada criminal history, we only
(14:30):
opened up nine cases againstapplicants in this program.
So this is a very highlytrained, highly educated and
non-criminal group of people.
Speaker 2 (14:42):
Oh, that's excellent.
That's what we like to hearfrom our speech language
pathologists.
So my next question is with thecases that are open, how many
cases are resolved?
How long does it take toresolve those cases?
Speaker 4 (14:57):
Yeah, you know, on general it takes about 171 days
to resolve cases.
My statistics show that weclose about 63 percent of the
cases within six months, whichis our kind of performance
measure that we have.
As you can imagine, some ofthese might involve
medical-related questions orissues and it takes a little bit
(15:21):
longer when you start gettingmedical records involved and you
need to review that type ofstandard of care type of thing.
So some of these can be closedreally quickly and other ones
they just take a little bitlonger.
Speaker 2 (15:35):
All right, and you already discussed with us in the
statistics what categoriesproduce the most complaints.
Just to tag along with that,what are the biggest issues
licensees face when it comesdown to the complaints that are
open due to the criminalbackground, criminal history?
Speaker 4 (15:55):
Thank you, luana.
Let me go into some of thosecomplaints because the criminal
history part of it is really sosmall.
I don't think we really need toworry too much about that.
The part that we see thebiggest complaints on from
consumers, which is the vastmajority of the cases.
It usually has to do withbilling for services not
provided People thinking theypaid for something and they
(16:18):
didn't get what they thoughtthey paid for.
The other thing we might get isrecords that are not matching.
That might come from our auditsthat we do or when we request
documents in an investigationwhere the records are not
matching up with what they tellus.
And you know there is a morebroad category of just ethical
(16:38):
type of violations that we seewhere we might be making some
kind of request from them andthey don't disclose protocols or
testing methods that are usedor they don't provide us the
supervisory documentation thatthey're supposed to for their
subordinates as part of theprocess.
Sometimes patients do getinjured.
(17:00):
You know their standard of careissues that come up.
So those are the type ofviolations that we tend to see
on the complaint side.
Speaker 2 (17:09):
Wow, that's very interesting, especially with the
billing for services not paidfor.
So in those types of cases, how, if you can put a percentage on
it, how many of those cases areactually like billing cases
versus ethical complaints?
Speaker 4 (17:29):
Let me see, I'm going to let me look at my statistics
, because that's a prettyspecific number.
I'm thinking maybe about athird of the cases.
About a third of the cases thatI see that come in are billing
related cases from consumers.
That's a pretty high percentageand overall a pretty low number
(17:53):
of complaints, though, for thewhole program.
Speaker 2 (17:55):
Okay, and since those cases are coming in from
consumers, is there anythingthat the licensing can do to
expedite the resolution process?
Speaker 4 (18:06):
Yes, you know the most common issue that we have
is that people ignore ourattempts to contact them.
When we're reaching, we usuallywill try to call you.
We might send emails to youremail address of record that we
have and request information.
So the biggest challenge wehave is to get a response.
(18:26):
You know there can be complexissues at play with
investigations.
We are talking about medicalstuff, so you might have HIPAA
laws that come into play otherprivacy laws in Texas that might
apply.
So sometimes there has to beconversations about what
documents they can provide to us.
As the state regulator, we'reentitled to all of those
(18:50):
documents, even though theymight not understand that.
So I think the biggestchallenge is for us just to be
able to get them to give us thedocuments we need so that we can
verify whether or not thatallegation is true or not.
Speaker 2 (19:05):
And that leads me to my next question.
It sounds like not producingdocuments may slow down the
resolution of the case.
So what are some other factorsthat can either make a case move
faster or slower than average?
Speaker 4 (19:21):
Absolutely, you know.
So, as I mentioned, these casesmight involve a standard of
care and in in all of ourprograms, we do have expert
witnesses that we use on ourcases.
Some of them are in-houseexperts and some of them are
third-party experts, and so onoccasion Luana, when we have a
(19:43):
complicated case involvingstandard of care, we may need to
get an expert opinion.
It takes time to get thatopinion, get that report.
We may need then to have somekind of negotiated settlement
conversation with the personregarding the violations and the
evidence we have and theopinions that we have, and that
(20:05):
can slow down the process, and Iwill tell you that what really
slows down the process is if itends up going to litigation.
Right, if we go to a contestedcase, then you're talking about
something that, instead of beingresolved in a matter of weeks,
might take months.
Now.
Speaker 2 (20:25):
And you brought out some excellent information that
you know I can use in mypractice with defending my
clients.
So with that, with the standardof care case, how often does
law enforcement get involved andis law enforcement with those
cases?
Could they be a factor that maymake a case?
Speaker 4 (20:46):
resolve slower than average.
So I'm going to answer thesecond part of the question
first.
Yes, if law enforcement doesget involved it will slow down
cases.
We've had cases where there wasperhaps injury to a patient,
injury to a client which waspart of the allegation, and you
know, if that is serious enoughit could be a criminal act.
(21:09):
But that is very rare.
That's not happening a lot inthis type of program, right?
What you have, I think, mostlyis more of the paperwork billing
error type of violations withpeople honest mistake type of
things like that, I think, wherethey need to improve their
(21:29):
business practices a little bit.
You know not intentional doingsomething you know wrong type of
situation that would involvelaw enforcement.
This program has very littleinvolvement of law enforcement.
I would say that we have otherprograms that have a lot more
law enforcement involvement inthose cases have a lot more law
(21:52):
enforcement involvement in thosecases.
Speaker 2 (21:53):
Well, how do speech-language pathologists
proactively avoid complaints?
What can a speech-languagepathologist do so the Texas
Department of Licensing andRegulation is not sending a
notice to them regardingallegations of any misconduct.
Speaker 4 (22:10):
Well, I'm going to tell you, I'm going to give a
plug to our licensing divisionand our compliance division.
They are there to help peopleand you don't have to wait for
enforcement to get involved.
Right, you can reach out toTDLR that website, tdlrtexasgov.
There's a wealth of informationthere and you can call us.
(22:32):
You can call our customerservice line.
You can speak to someone in ourcompliance division.
They've got people there onstaff that are very
knowledgeable about this program.
They can answer questions aboutall sorts of things and help
you to stay out of the hot water.
Speaker 2 (22:49):
Absolutely, absolutely, as a lifelong water
run.
I really appreciate you comingand speaking with us today, so I
have one more question for you,and that is is there anything
unique about your divisioncompared with other divisions
within TDLR or any otherdepartments within the agency?
Speaker 4 (23:10):
I'm going to give a plug.
We do always need third partyexperts and we do pay for our
experts.
Just so everybody knows that,we do have contracts that we
sign, and if you want to go tothe TDLRTexasgov website and you
want to be an expert witnessfor the department on cases, we
(23:31):
will do a conflict of interestapplication and all kinds of
stuff.
But we really need the help ofour licensees and our experts
out there.
So I would urge folks that areinterested in this video and
this content to go to ourwebsite and see if maybe they
qualify as an expert on one ofour and we can use them on our
(23:54):
cases.
It doesn't hurt to have toomany experts.
Speaker 2 (23:58):
Oh, absolutely Well, Simone.
I think we've had a reallygreat conversation with both
Katie and Ron about speechlanguage pathologists and what
it takes to obtain a license andthen what it takes to maintain
the license, and I'm reallyappreciative of this.
Speaker 1 (24:18):
Yeah, no, definitely, and thanks for you know, kind
of highlighting some of thoseresources that you guys provide
as well, because that can be.
So I have had multiple calls.
I got a call this week ofsomeone looking for
interpretation of TDLRguidelines, and where did I
direct them?
The TDLR website, you know.
(24:39):
So there is information that'sout there that's helpful to
licensees.
Again, thank you, ron and Katie, for joining us this afternoon.
We really appreciate you guystaking the time out of your day
to be transparent andinformative and educate our
license holders, because that'swhat this is really all about is
just making sure that theselicense holders are equipped to
(25:01):
go out into the world andpractice while maintaining
compliance.
Thank you, simone.
Speaker 4 (25:07):
I really appreciate the opportunity to share our
perspective with you.
Know your Regulator the podcastthat inspires you to engage.
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