# Health Occupations (GHO)

## Title 2. Audiologists, Hearing Aid Dispensers, Speech-language Pathologists, and Music Therapists

### Subtitle 1. Definitions and Policy

#### Section 2-101

(a) In this title the following words have the meanings indicated.

(b) "Audiologist" means an individual who practices audiology.

(b-1) "Audiology assistant" means an individual who:

  (1) Meets the minimum qualifications established under this subtitle and in regulations adopted by the Board;

  (2) Does not work independently; and

  (3) Works under the general supervision of an audiologist licensed under this title.

(c) "Board" means the State Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech-Language Pathologists, and Music Therapists.

(d) "Direct supervision" means on-site and personal oversight by an individual licensed under this title who assumes responsibility for another individual's conduct whether it is consistent or fails to be consistent with professional standards and the provisions of this title.

(d-1) "General supervision" means the supervision of a licensed audiology assistant by a licensed audiologist who may or may not be present when the licensed audiology assistant assists in the practice of audiology.

(e) "Hearing aid" means any FDA approved instrument or device that is designed for or represented as being capable of improving or correcting impaired human hearing.

(f) "Hearing aid dispenser" means an individual who practices hearing aid dispensing.

(g) "Hearing aid dispenser supervisor" means a licensed hearing aid dispenser or licensed audiologist who supervises a limited licensee who is studying hearing aid dispensing for the purpose of becoming eligible to sit for the licensure examination.

(h)

  (1) "Hearing aid dispensing" means performing, conducting, and interpreting hearing assessment procedures to determine the type and extent of hearing loss for the purpose of:

    (i) Fitting and ordering suitable hearing instruments, including prescription hearing aids;

    (ii) Selecting suitable hearing instruments;

    (iii) Programming a hearing aid by selecting and determining the frequency response, compression, output, gain, or other parameters of the hearing aid for initial wear by an  individual or any required alterations throughout the use of the hearing aid;

    (iv) Making ear molds or ear impressions; and

    (v) Providing appropriate counseling.

  (2) "Hearing aid dispensing" includes:

    (i) An act pertaining to the ordering, selling, renting, leasing, or delivering of a hearing instrument, including a prescription hearing aid; and

    (ii) Providing maintenance or repair services for a hearing aid.

(i) "Hearing aid establishment" means an establishment that offers, advertises, or performs hearing aid dispensing.

(j)

  (1) "License" means, unless the context requires otherwise, a license issued by the Board to practice audiology, hearing aid dispensing, or speech-language pathology, or to assist in the practice of speech-language pathology or audiology.

  (2) "License" includes, unless the context requires otherwise, a limited license.

(k) "Licensed audiologist" means, unless the context requires otherwise, an audiologist who is licensed by the Board to practice audiology.

(k-1) "Licensed audiology assistant" means, unless the context requires otherwise, an audiology assistant who is licensed by the Board to assist a licensed audiologist in the practice of audiology.

(l) "Licensed hearing aid dispenser" means, unless the context requires otherwise, a hearing aid dispenser who is licensed by the Board to practice hearing aid dispensing.

(m) "Licensed speech-language pathologist" means, unless the context requires otherwise, a speech-language pathologist who is licensed by the Board to practice speech-language pathology.

(n) "Licensed speech-language pathology assistant" means, unless the context requires otherwise, a speech-language pathology assistant who is licensed by the Board to assist a  licensed speech-language pathologist in the practice of speech-language pathology.

(o) "Limited license" means a license issued by the Board to practice audiology, hearing aid dispensing, or speech-language pathology, or to assist in the practice of speech-language pathology as limited by Sec.Sec. 2-310 through 2-310.3 of this title.

(p) "Oral competency" means the demonstration of general English-speaking proficiency by receiving a passing score on a standardized test that the Board has approved by regulation.

(q)

  (1) "Practice audiology" means to:

    (i) Evaluate, diagnose, manage, and treat auditory or vestibular conditions in the human ear;

    (ii) Prescribe, order, sell, dispense, or fit hearing aids to an individual for the correction or relief of a condition for which hearing aids are worn;

    (iii) Prescribe, order, sell, dispense, or externally fit a sound processor to an osseo-integrated device for the correction or relief of a condition for which osseo-integrated devices are worn; and

    (iv) Prescribe, order, sell, dispense, or externally fit a sound processor to a cochlear implant for the correction or relief of a condition for which cochlear implants are worn.

  (2) "Practice audiology" includes:

    (i) The conducting of health screenings;

    (ii) The removal of a foreign body from the external auditory canal that is not impacted to the point it requires anesthesia;

    (iii) The removal of cerumen from the external auditory canal that is not impacted to the point it requires anesthesia;

    (iv) The ordering of cultures and bloodwork testing as it relates to the auditory or vestibular conditions in the human ear;

    (v) The ordering and performing of in-office, nonradiographic scanning or imaging of the external auditory canal; and

    (vi) The ordering of radiographic imaging as it relates to the auditory or vestibular conditions in the human ear.

  (3) "Practice audiology" does not include:

    (i) Surgery using an instrument, including a laser, a scalpel, a needle, cautery, a cryoprobe, or a suture, in which human tissue is cut, burned, vaporized, removed, or otherwise permanently altered by mechanical means, laser, ionizing radiation, ultrasound, or other means;

    (ii) Osseo-integrated device surgery;

    (iii) Cochlear implant surgery; or

    (iv) The preparation, operation, or performance of radiographic imaging.

(r) "Practice speech-language pathology" means to apply the principles, methods, and procedures of measurement, prediction, evaluation, testing, counseling, consultation, and instruction that relate to the development and disorders of speech, voice, swallowing, and related language and hearing disorders, to prevent or modify the disorders or to assist individuals in cognition-language and communication skills.

(r-1) "Sound processor" means a nonsurgical, external unit that attaches to an internal osseo-integrated device or cochlear implant.

(s) "Speech-language pathologist" means an individual who practices speech-language pathology.

(t) "Speech-language pathology assistant" means an individual who:

  (1) Meets the minimum qualifications established by the Board that shall be less stringent than those established by this title to license speech-language pathologists;

  (2) Does not work independently; and

  (3) Works under the direct supervision of a speech-language pathologist licensed under this title.

(u) "Telehealth" means the use of telecommunications and information technologies for the exchange of information from one site to another for the provision of health care to an individual from a provider through hardwire or Internet connection.

#### Section 2-102

(a) This title applies to an individual who practices audiology, hearing aid dispensing, speech-language pathology, or music therapy, or assists in the practice of speech-language pathology or audiology in the State.

(b) This title does not:

  (1) Limit the right of an individual to practice a health occupation that the individual is authorized to practice under this article;

  (2) Prohibit an individual from practicing any other profession that the individual is authorized to practice under the laws of this State;

  (3) Limit the right of a physician who is authorized to practice medicine under the laws of the State to treat the human ear or fit hearing aids; or

  (4) Apply to the servicing, marketing, sale, dispensing, use, customer support, or distribution of over-the-counter hearing aids through in-person transactions, by mail, or online as authorized by federal law and regulations.

### Subtitle 2. State Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech-language Pathologists, and Music Therapists

#### Section 2-201

There is a State Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech-Language Pathologists, and Music Therapists in the Department.

#### Section 2-202

(a)

  (1) The Board consists of 15 members.

  (2) Of the 15 Board members:

    (i) 3 shall be licensed audiologists who have at least 5 years' paid work experience in audiology and are currently practicing audiology in the State;

    (ii) 3 shall be licensed speech-language pathologists who have at least 5 years' paid work experience in speech-language pathology and are currently practicing speech-language pathology in the State;

    (iii) 2 shall be physicians who shall be voting members of the Board, except on proposals that expand or restrict the practice of audiology as defined in Sec. 2-101(q) of this title or that expand or restrict the practice of speech-language pathology as defined in Sec. 2-101(r) of this title, and who:

      (1) Are licensed to practice medicine in the State;

      (2) Hold a certificate of qualification from the American Board of Otolaryngology; and

      (3) Are currently practicing in the State;

    (iv) 2 shall be consumer members, 1 of whom shall be a consumer of services provided by an individual licensed by the Board;

    (v) 3 shall be licensed hearing aid dispensers who have at least 5 years' paid work experience in dispensing hearing aids and are currently practicing hearing aid dispensing in the State; and

    (vi) 2 shall be licensed music therapists who have at least 5 years' paid work experience in music therapy and are currently practicing music therapy in the State.

  (3)

    (i) The Governor shall appoint the physician members, with the advice of the Secretary, from a list submitted to the Secretary and the Governor by the Maryland Society of Otolaryngology.

    (ii) There shall be at least 3 names on the list.

  (4)

    (i) The Governor shall appoint the speech-language pathologist members, with the advice of the Secretary, from a list submitted to the Secretary and the Governor by the Board.

    (ii) The number of names on the list shall be at least 3 times the number of vacancies.

    (iii) For each licensed speech-language pathologist vacancy, the Board shall notify all licensed speech-language pathologists in the State of the vacancy to solicit nominations to fill the vacancy.

  (5)

    (i) Subject to subparagraph (iii) of this paragraph, the Governor shall appoint the audiologist members, with the advice of the Secretary, from a list submitted to the Secretary and the Governor by the Maryland Academy of Audiology.

    (ii) The number of names on the list shall be at least 3 times the number of vacancies.

    (iii) For each audiologist vacancy, the Board shall notify all licensed audiologists in the State of the vacancy to solicit nominations to fill the vacancy.

  (6)

    (i) The Governor shall appoint the hearing aid dispenser members, with the advice of the Secretary, from a list submitted to the Secretary and the Governor by the Board.

    (ii) The number of names on the list shall be at least 3 times the number of vacancies.

    (iii) For each hearing aid dispenser vacancy, the Board shall notify all licensed hearing aid dispensers in the State of the vacancy to solicit nominations to fill the vacancy.

  (7)

    (i) The Governor shall appoint the consumer members with the advice of the Secretary and the advice and consent of the Senate.

    (ii) The Board and the Secretary may solicit applications for consumer member vacancies from the general public.

    (iii)

      (1) The Governor shall appoint the consumer member who is a consumer of services provided by an individual licensed by the Board from a list submitted by the Secretary.

      (2) An organization representing patients or family members of patients served by individuals licensed by the Board may submit recommendations for the consumer Board member appointed under this subparagraph to the Secretary.

      (3) The Board and the Secretary may notify organizations representing patients or family members of patients served by individuals licensed by the Board of a vacancy for the consumer member appointed under this subparagraph.

  (8)

    (i) The Governor shall appoint the music therapist members, with the advice of the Secretary, from a list submitted to the Secretary and the Governor by the Maryland Association for Music Therapy.

    (ii) The number of names on the list shall be at least 3 times the number of vacancies.

    (iii) On or before December 31, 2021, the music therapist members shall be board certified music therapists, as defined in Sec. 2-4A-01 of this title.

    (iv) On or after January 1, 2022, the music therapist members shall be licensed professional music therapists, as defined in Sec. 2-4A-01 of this title.

(b) Each member of the Board:

  (1) Shall be a resident of this State; but

  (2) May not be an employee of the Department.

(c) A consumer member of the Board:

  (1) Shall be a member of the general public;

  (2) May not be or ever have been an audiologist, hearing aid dispenser, speech-language pathologist, or speech-language pathology assistant, or in training to become an audiologist, hearing aid dispenser, speech-language pathologist, or speech-language pathology assistant;

  (3) May not have a household member who is an audiologist, hearing aid dispenser, or speech-language pathologist or in training to become an audiologist, hearing aid dispenser, or speech-language pathologist;

  (4) May not participate or ever have participated in a commercial or professional field related to audiology, hearing aid dispensing, or speech-language pathology;

  (5) May not have a household member who participates in a commercial or professional field related to audiology, hearing aid dispensing, or speech-language pathology; and

  (6) May not have had within 2 years before appointment a substantial financial interest in a person regulated by the Board.

(d) While a member of the Board, a consumer member may not have a substantial financial interest in a person regulated by the Board.

(e) Before taking office, each appointee to the Board shall take the oath required by Article I, Sec. 9 of the Maryland Constitution.

(f)

  (1) The term of a member is 4 years.

  (2) The terms of members are staggered as required by the terms provided for members of the Board on October 1, 1992.

  (3) At the end of a term, a member continues to serve until a successor is appointed and qualifies.

  (4) A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.

  (5) A member may not serve more than 2 consecutive full terms.

  (6) To the extent practicable, the Governor shall fill any vacancy on the Board within 60 days after the date of the vacancy.

(g)

  (1) The Governor may remove a member for incompetence or misconduct.

  (2) Upon the recommendation of the Secretary, the Governor may remove a member whom the Secretary finds to have been absent from 2 successive Board meetings without adequate reason.

(h) A member of the Board may not serve as an employee, an elected officer, or a director of a professional or trade association that has members who are under the authority of the Board.

#### Section 2-203

(a) From among its members, the Board annually shall elect a chairman.

(b) The Board shall determine:

  (1) The manner of election of officers; and

  (2) The duties of each officer.

#### Section 2-204

(a) A majority of the members currently serving on the Board, with at least 1 audiologist, hearing aid dispenser, speech-language pathologist, and music therapist regulated under the provisions of this title being present, is a quorum to do business.

(b) The Board shall meet at least once a year, at the times and places that it determines.

(c) In accordance with the budget of the Board, each member of the Board is entitled to:

  (1) Compensation, at a rate determined by the Board, for each day on which the member is engaged in the duties of the member's office; and

  (2) Reimbursement for expenses at a rate determined by the Board.

(d) The Board may employ a staff in accordance with the budget of the Board.

(e) The Board shall appoint an executive director who:

  (1) Shall serve at the pleasure of the Board;

  (2) Is the executive officer of the Board; and

  (3) Has the powers and duties assigned by the Board.

#### Section 2-205

In addition to the powers and duties set forth elsewhere in this title, the Board has the following powers and duties:

(1) To adopt rules and regulations to carry out the provisions of this title;

(2) To adopt and publish codes of ethics for the practices of audiology, hearing aid dispensing, and speech-language pathology, and the assistance in the practice of speech-language pathology and audiology;

(3) To adopt an official seal;

(4) To hold hearings and keep records and minutes necessary for the orderly conduct of business;

(5) To issue a list annually of the names of all individuals licensed by the Board;

(6) To send any notice that the Board is required to give to a licensee under this title to the last known address given to the Board by the licensee;

(7) To adopt regulations governing the use of telehealth communications by audiologists, hearing aid dispensers, and speech-language pathologists; and

(8) To adopt regulations governing the licensing of audiology assistants and assistance in the practice of audiology.

#### Section 2-205.1

(a) While investigating an allegation against a licensee under this title, the Board may require the licensee to submit to an appropriate examination by a health care provider designated by the Board if the Board has reason to believe that the licensee may cause harm to a person affected by the licensee's practice of audiology, hearing aid dispensing, speech-language pathology, or music therapy, or assistance in the practice of speech-language pathology or audiology.

(b) In return for the privilege given to a licensee to practice audiology, hearing aid dispensing, speech-language pathology, or music therapy, or assist in the practice of speech-language pathology or audiology in the State, the licensee is deemed to have:

  (1) Consented to submit to an examination under this section, if requested by the Board in writing; and

  (2) Waived any claim of privilege as to the testimony or reports of a health care provider who examines the licensee.

(c) The failure or refusal of the licensee to submit to an examination required under subsection (b) of this section is prima facie evidence of the licensee's inability to practice audiology, hearing aid dispensing, speech-language pathology, or music therapy, or assist in the practice of speech-language pathology or audiology competently, unless the Board finds that the failure or refusal was beyond the control of the licensee.

(d) The Board shall pay the cost of any examination made under this section.

#### Section 2-206

(a) There is a State Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech-Language Pathologists, and Music Therapists Fund.

(b)

  (1) The Board may set reasonable fees for the issuance and renewal of licenses and its other services.

  (2) The fees charged shall be set so as to produce funds to approximate the cost of maintaining the Board.

  (3) Funds to cover the compensation and expenses of the Board members shall be generated by fees set under this section.

(c) In accordance with the budget of the Board, the Board may pay expenses incurred in carrying out the provisions of this title.

(d)

  (1) The Board shall pay all funds collected under this title to the Comptroller of the State.

  (2) The Comptroller shall distribute the fees to the State Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech-Language Pathologists, and Music Therapists Fund.

(e)

  (1) The Fund shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by the provisions of this article.

  (2) The Fund is a continuing, nonlapsing fund, not subject to Sec. 7-302 of the State Finance and Procurement Article.

  (3) Any unspent portions of the Fund may not be transferred or revert to the General Fund of the State, but shall remain in the Fund to be used for the purposes specified in this article.

  (4) No other State money may be used to support the Fund.

(f)

  (1) A designee of the Board shall administer the Fund.

  (2) Moneys in the Fund may be expended only for any lawful purpose authorized under the provisions of this article.

(g) The Legislative Auditor shall audit the accounts and transactions of the Fund as provided in Sec. 2-1220 of the State Government Article.

#### Section 2-207

A person shall have immunity from the liability described under Sec. 5-703 of the Courts and Judicial Proceedings Article for giving information to the Board or otherwise participating in its activities.

### Subtitle 3

#### Section 2-301

(a)

  (1) Except as otherwise provided in this title, an individual shall be licensed by the Board before the individual may practice audiology, hearing aid dispensing, speech-language pathology, or music therapy, or assist in the practice of speech-language pathology or audiology in this State.

  (2) On or after October 1, 2007, an individual hired by a Maryland local public school system, State-approved nonpublic school for handicapped children, or chartered educational institution of the State to practice speech-language pathology or assist in the practice of speech-language pathology, shall be licensed by the Board.

(b)

  (1) This section does not apply:

    (i) To an individual employed by any agency of the federal government performing the duties of that employment;

    (ii) To an individual continuously employed to practice audiology since June 30, 1988, by a county public school system, a State-approved nonpublic school for handicapped children, a chartered institution of the State, or the State Department of Education while performing the duties of that employment;

    (iii) To an individual employed by a Maryland local public school system, State-approved nonpublic school for handicapped children, or chartered educational institution of the State or the State Department of Education to practice speech-language pathology continuously since on or before September 30, 2007, while performing the duties of that employment;

    (iv) To a student or trainee in audiology or speech-language pathology while pursuing a supervised course of study at an accredited university or college or a recognized training center while the student is obtaining clinical practicum hours;

    (v) To a volunteer while working in free speech and hearing screening programs;

    (vi) To an individual licensed to practice audiology or speech-language pathology in another state or a foreign country while the individual:

      (1) Provides a clinical demonstration at a training or an educational event in the State; or

      (2) Receives clinical training at a training or an educational event in the State; or

    (vii) To an individual authorized to practice audiology, hearing aid dispensing, speech-language pathology, or music therapy, or to assist in the practice of speech-language pathology or audiology in the State under Sec. 10-14A-03 of the State Government Article.

  (2) The Board may allow an audiologist, hearing aid dispenser, speech-language pathologist, music therapist, speech-language pathology assistant, or audiology assistant licensed in another state to practice audiology, hearing aid dispensing, speech-language pathology, or music therapy, or assist in the practice of speech-language pathology or audiology in this State without a license if the applicant has:

    (i) Been granted preliminary approval by the Board to practice; and

    (ii) A completed application for a license pending before the Board.

#### Section 2-302

(a) To qualify for a license to practice audiology, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant shall be of good moral character.

(c) The applicant shall:

  (1) On or before September 30, 2007:

    (i) Hold a master's or doctoral degree in audiology from an accredited educational institution which incorporates the academic course work and the minimum hours of supervised clinical training required by the regulations adopted by the Board; and

    (ii) Have completed the period of supervised postgraduate professional practice in audiology as specified by the regulations adopted by the Board;

  (2) On or after October 1, 2007, hold a doctoral degree in audiology from an accredited educational institution which incorporates the academic course work and the minimum hours of supervised clinical training required by the regulations adopted by the Board; or

  (3) Qualify for a license under Sec. 2-305 of this subtitle.

(d) Except as otherwise provided in this title, the applicant shall:

  (1) Pass an examination in audiology required by the regulations adopted by the Board; and

  (2) Complete training consistent with the standards established by:

    (i) The Accreditation Commission for Audiology Education; or

    (ii) The Counsel of Academic Accreditation.

(e) The applicant shall demonstrate oral competency.

(f) The applicant shall submit to a criminal history records check in accordance with Sec. 2-303.1 of this subtitle.

#### Section 2-302.1

(a) To qualify for an initial license to practice hearing aid dispensing, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant shall be of good moral character.

(c) The applicant shall:

  (1) Be a graduate of an accredited 2-year postsecondary program with a diploma or degree; and

  (2) Prior to taking the State licensing examination, provide proof of successful completion of the International Hearing Society Curriculum entitled "Distance Learning For Professionals in Hearing Health Sciences" or an equivalent course approved by the Board.

(d)

  (1) Except as otherwise provided in this subtitle, the applicant shall pass an examination given by the Board under this subtitle.

  (2) Except for an applicant who holds a valid license to provide hearing aid dispenser services in another state, the applicant shall obtain 6 months' training under the supervision of a licensed hearing aid dispenser or licensed audiologist prior to taking the examination given by the Board.

(e) The applicant shall demonstrate oral competency.

(f) The applicant shall submit to a criminal history records check in accordance with Sec. 2-303.1 of this subtitle.

#### Section 2-302.2

(a) To qualify for a license to practice speech-language pathology, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant shall be of good moral character.

(c) The applicant shall:

  (1) Hold a master's degree in the area of speech-language pathology from an educational institution which incorporates the academic course work and the minimum hours of supervised training required by the regulations adopted by the Board;

  (2) Have completed the period of supervised postgraduate professional practice in speech-language pathology as specified by the regulations adopted by the Board;

  (3) Except as otherwise provided in this title, pass an examination in speech-language pathology as required by regulations adopted by the Board;

  (4) Demonstrate oral competency; and

  (5) Submit to a criminal history records check in accordance with Sec. 2-303.1 of this subtitle.

#### Section 2-302.3

(a) To qualify for a license to assist in the practice of speech-language pathology, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant shall:

  (1) Be of good moral character;

  (2) Hold a baccalaureate degree in speech-language pathology or communication sciences and disorders from an accredited institution or other degree as provided for in regulations adopted by the Board;

  (3) Have successfully completed the clinical observation hours and supervised clinical assisting experience hours required by the regulations adopted by the Board;

  (4) After a period of supervised practice by a licensed speech-language pathologist, have successfully completed a competency skills checklist as provided for in regulations adopted by the Board;

  (5) Demonstrate oral competency; and

  (6) Submit to a criminal history records check in accordance with Sec. 2-303.1 of this subtitle.

(c) The Board may waive any of the qualifications required under this section as provided for in regulations adopted by the Board.

#### Section 2-303

To apply for a license, an applicant shall:

(1) Submit an application to the Board on the form that the Board requires;

(2) Pay to the Board the application fee set by the Board; and

(3) Submit satisfactory evidence of having completed a State and national criminal history records check in accordance with Sec. 2-303.1 of this subtitle.

#### Section 2-303.1

(a) In this section, "Central Repository" means the Criminal Justice Information System Central Repository of the Department of Public Safety and Correctional Services.

(b) As part of an application to the Central Repository for a State and national criminal history records check, an applicant shall submit to the Central Repository:

  (1) One complete set of legible fingerprints taken in a manner approved by the Director of the Central Repository and the Director of the Federal Bureau of Investigation;

  (2) The fee authorized under Sec. 10-221(b)(7) of the Criminal Procedure Article for access to State criminal history records; and

  (3) The processing fee required by the Federal Bureau of Investigation for a national criminal history records check.

(c) In accordance with Sec.Sec. 10-201 through 10-229 of the Criminal Procedure Article, the Central Repository shall forward to the Board and the applicant the criminal history record information of the applicant.

(d) If criminal history record information is reported to the Central Repository after the date of the initial criminal history records check, the Central Repository shall provide to the Board a revised printed statement of the individual's State criminal history record.

(e) Information obtained from the Central Repository under this section:

  (1) Is confidential;

  (2) May not be redisseminated; and

  (3) May be used only for the licensing purpose authorized by this title.

(f) The subject of a criminal history records check under this section may contest the contents of the printed statement issued by the Central Repository as provided in Sec. 10-223 of the Criminal Procedure Article.

#### Section 2-304

(a) An applicant who otherwise qualifies for a license is entitled to be examined as provided in this section.

(b)

  (1) For the examination of applicants for a license to practice audiology or speech-language pathology, the Board may adopt appropriate examinations given by a professional body in the field of audiology or the field of speech-language pathology.

  (2) An examination shall be in writing and consist of tests that require an applicant to demonstrate the minimum knowledge of services and subject matter related to the practice of audiology or speech-language pathology that will enable the applicant to practice audiology or speech-language pathology effectively.

  (3) The Board may supplement any written examination given under this section with an oral examination.

(c) The Board shall notify each qualified applicant of the time and place of examination.

(d) The Board:

  (1) Shall determine the subjects, scope, form, and passing scores for examinations given under this subtitle; or

  (2) May adopt an examination given by a national body.

(e) The Board may not limit the number of times an applicant may take an examination required under this subtitle.

(f)

  (1) An applicant who otherwise qualifies for a license to practice hearing aid dispensing is entitled to be examined as provided in this subsection.

  (2) The examination shall consist of a written part and a practical part as required by regulations by the Board.

#### Section 2-305

(a) The Board, in its discretion, may waive any of the qualifications required for a license to practice audiology under this title for an individual who:

  (1) Is of good moral character;

  (2) Pays the application fee required by the Board under Sec. 2-303 of this subtitle; and

  (3)

    (i) Holds or has held a national certification in audiology from an organization if the organization is recognized by the Board and the qualifications for certification meet the practice requirements established by the regulations adopted by the Board;

    (ii) Holds a current license to practice audiology in another state if the Board determines that the state has requirements for licensure that are at least equivalent to the requirements of this State and meet the practice requirements established under regulations adopted by the Board; or

    (iii) Holds a current license to practice audiology in this or another state or practices audiology under the authority and supervision of an agency of the federal government or a board, agency, or department of this State or another state if:

      (1) The individual holds a master's degree in audiology from an accredited educational program;

      (2) The Board determines that the requirements for practice are at least equivalent to the requirements of this Board; and

      (3) The individual meets other requirements established by regulations adopted by the Board that may not include a requirement for a doctoral degree in audiology.

(b) The Board, in its discretion, may waive any of the qualifications required for a license to practice speech-language pathology or to assist in the practice of speech-language pathology under this title for an individual who:

  (1) Is of good moral character;

  (2) Pays the application fee required by the Board under Sec. 2-303 of this subtitle; and

  (3)

    (i) Holds or has held a national certification in speech-language pathology or as an assistant of speech-language pathology from an organization if the organization is recognized by the Board and the qualifications for certification meet the practice requirements established by the regulations adopted by the Board; or

    (ii) Holds a current license to practice speech-language pathology or to assist in the practice of speech-language pathology in another state that the Board determines has requirements for licensure and practice that are at least equivalent to the requirements established under regulations adopted by the Board.

(c) The Board may waive any examination requirement of this subtitle for an applicant for a license to practice audiology or speech-language pathology who:

  (1) Pays the application fee required by the Board under Sec. 2-303 of this subtitle; and

  (2) Provides adequate evidence that the applicant:

    (i) Meets the qualifications otherwise required by this title; and

    (ii) Became licensed in the other state after meeting, in that or any other state, requirements that are at least equivalent to the licensing requirements of this State.

(d)

  (1) The Board shall waive the examination requirements of this subtitle for an applicant for a license to practice hearing aid dispensing who is licensed to practice hearing aid dispensing in another state.

  (2) The Board may grant a waiver under this subsection only if the applicant:

    (i) Pays the application fee required under Sec. 2-303 of this subtitle; and

    (ii) Provides adequate evidence that the applicant:

      (1) Meets the qualifications otherwise required by this title;

      (2) Became licensed in the other state after meeting, in that or any other state, requirements that are at least equivalent to the licensing requirements of this State; and

      (3) Meets the practice requirements established by the regulations adopted by the Board.

  (3) The Board may grant a waiver under this subsection if an applicant holds current national board certification as a hearing instrument specialist and meets the practice requirements established by regulations adopted by the Board.

#### Section 2-306

(a) Subject to subsection (b) of this section, the Board shall issue a license to any applicant who:

  (1) Meets the requirements of this title;

  (2) Pays the license fee set by the Board; and

  (3) Submits to the Board satisfactory evidence of having completed a State and national criminal history records check in accordance with Sec. 2-303.1 of this subtitle.

(b)

  (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with Sec. 2-303.1 of this subtitle, in determining whether to grant a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Any other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

  (2) The Board may not issue a license if the criminal history record information required under Sec. 2-303.1 of this subtitle has not been received.

#### Section 2-307

A license to practice audiology authorizes the licensee to practice audiology while the license is effective.

#### Section 2-307.1

A license to practice hearing aid dispensing authorizes the licensee to practice hearing aid dispensing while the license is effective.

#### Section 2-307.2

A license to practice speech-language pathology authorizes the licensee to practice speech-language pathology while the license is effective.

#### Section 2-307.3

A license to assist in the practice of speech-language pathology authorizes the licensee to assist a speech-language pathologist in the practice of speech-language pathology while the license is effective.

#### Section 2-307.4

(a) A licensee shall identify and represent themselves to the public by:

  (1) The profession for which the licensee holds a license;

  (2) The degree earned to obtain the license; and

  (3) The name on the license.

(b) A licensee shall include the licensee's license number on work-related documentation, including:

  (1) Written client reports; and

  (2) If applicable, audiograms.

#### Section 2-308

(a) Except as provided for a limited license in Sec.Sec. 2-310 through 2-310.3 of this subtitle, a license expires on the date set by the Board, unless the license is renewed for an additional term as provided in this section.

(b) At least 2 months before the license expires, the Board shall contact the licensee by electronic means or first-class mail at the last known electronic or physical address provided by the licensee and advise the licensee of:

  (1) The date on which the current license expires;

  (2) The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and

  (3) The amount of the renewal fee.

(c) Before the license expires, the licensee periodically may renew it for an additional term, if the licensee:

  (1) Otherwise is entitled to be licensed;

  (2) Pays to the Board a renewal fee set by the Board; and

  (3) Submits to the Board:

    (i) A renewal application on the form that the Board requires;

    (ii) Evidence of compliance with any continuing education requirement set under this section for license renewal;

    (iii) Evidence that each audiometer in use has been calibrated within 12 months before the date the license is renewed; and

    (iv) Satisfactory evidence of having completed a State and national criminal history records check in accordance with Sec. 2-303.1 of this subtitle.

(d) In addition to any other qualifications and requirements established by the Board, the Board, by rule or regulation, shall establish continuing education requirements as a condition to the renewal of licenses under this section.

(e) Subject to subsection (g) of this section, the Board shall renew the license of each licensee who meets the requirements of this section.

(f) A licensee has a grace period of 30 days after a license expires in which to renew it retroactively, if the licensee:

  (1) Otherwise is entitled to have the license renewed; and

  (2) Pays to the Board the renewal fee and any late fee set by the Board.

(g)

  (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with Sec. 2-303.1 of this subtitle, in determining whether to grant a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Any other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

  (2) The Board may not renew a license if the criminal history record information required under Sec. 2-303.1 of this subtitle has not been received.

  (3) Unless otherwise required, a renewal applicant who previously has completed the criminal history records check as required for the Board's application process does not have to submit to a subsequent criminal history records check for license renewal.

#### Section 2-308.1

(a)

  (1) The Board shall place a licensee on inactive status if the licensee submits to the Board:

    (i) An application for inactive status on the form required by the Board; and

    (ii) The inactive status fee set by the Board.

  (2) The Board may not place a licensee on inactive status for more than 2 years, beginning on the date the Board grants the application for inactive status.

(b) A licensee may renew the inactive status for not more than two consecutive additional terms.

(c) The Board shall provide a licensee who has complied with the requirements of subsection (a) of this section with written notification of:

  (1) The date that the licensee's inactive status becomes effective;

  (2) The date that the licensee's inactive status period expires; and

  (3) The consequences of not reactivating the license or, if the inactive status may be renewed, renewing the inactive status before the inactive status period expires.

(d) A licensee on inactive status under subsection (a) of this section may not practice audiology, hearing aid dispensing, or speech-language pathology or assist in the practice of speech-language pathology while the license is on inactive status.

(e) A licensee on inactive status under subsection (a) of this section may reactivate the license at any time during the inactive status period if the licensee:

  (1) Pays to the Board the reactivation fee set by the Board; and

  (2) Complies with any other requirements set by the Board.

(f) If a licensee fails to renew the inactive status under subsection (b) of this section or reactivate the license under subsection (e) of this section, the license shall be placed on nonrenewed status.

(g) A licensee whose license has been placed on nonrenewed status under subsection (f) of this section may apply to the Board to reinstate the license if the licensee:

  (1) Meets the requirements of Sec. 2-305 of this subtitle; or

  (2) Meets:

    (i) The current requirements for obtaining a new license under this subtitle; and

    (ii) The continuing education requirements established by the regulations of the Board.

#### Section 2-309

(a) If a licensee fails for any reason to renew a license by the end of the 30-day grace period, the Board shall reinstate the license if the licensee:

  (1) Applies to the Board for reinstatement of the license within 5 years after the license expires;

  (2) Meets the renewal requirements of Sec. 2-308 of this subtitle; and

  (3) Pays to the Board the renewal fee and the reinstatement fee set by the Board.

(b) The Board may not reinstate the license of an audiologist, hearing aid dispenser, speech-language pathologist, or speech-language pathology assistant who fails to apply for reinstatement of the license within 5 years after the license expires, unless the audiologist, hearing aid dispenser, speech-language pathologist, or speech-language pathology assistant:

  (1) Meets the requirements of Sec. 2-305 of this subtitle; or

  (2) Meets the current requirements for obtaining a new license under this title including continuing education requirements established by the rules and regulations of the Board.

#### Section 2-310

(a) Subject to the provisions of this section, the Board shall issue a limited license to practice audiology to an applicant who:

  (1) Except for the examination or supervised clinical training, meets the license requirements under Sec. 2-302 of this subtitle;

  (2) Demonstrates to the satisfaction of the Board that for the term of the limited license the applicant will practice audiology only under the supervision of an individual described under subsection (b)(2) of this section;

  (3) Submits an application to the Board on the form that the Board requires; and

  (4) Pays to the Board the application fee set by the Board.

(b)

  (1) The purpose of a limited license is to permit an individual to practice audiology while completing the licensing requirements of this title.

  (2) While it is effective, a limited license authorizes the licensee to practice audiology under the supervision of:

    (i) A fully licensed audiologist; or

    (ii) If the individual is employed in a setting in which licensure is not required as provided under Sec. 2-301(b)(1)(i) of this subtitle, an individual who holds national certification in audiology from a professional organization acceptable to the Board as provided in the regulations adopted by the Board.

(c) A limited license expires on the first anniversary of its effective date.

(d) The Board may renew the limited license once for an additional 1-year term, if the holder:

  (1) Otherwise meets the requirements of this section;

  (2) Submits a renewal application to the Board on the form that the Board requires; and

  (3) Pays to the Board a limited license renewal fee set by the Board.

(e) If a limited licensee fails to receive a full license within 2 years after the initial limited license was issued, the individual may not apply for another limited license.

#### Section 2-310.1

(a) Subject to the provisions of this section, the Board shall issue a limited license to practice hearing aid dispensing to an individual who is waiting to take a licensing examination under this subtitle.

(b) The Board may issue a limited license to practice hearing aid dispensing only to an individual who:

  (1) Except for completing the requirements under Sec. 2-302.1(c) of this subtitle, otherwise qualifies for a license;

  (2) Submits to the Board an application on the form that the Board provides;

  (3) Satisfies the Board that the individual will practice hearing aid dispensing only within the scope allowed under subsection (c) of this section; and

  (4) Pays to the Board the application fee set by the Board.

(c) While a limited license to practice hearing aid dispensing is in effect, it authorizes the holder to practice hearing aid dispensing only while being trained under the supervision of a licensed hearing aid dispenser or a licensed audiologist.

(d) A limited license to practice hearing aid dispensing expires on the first anniversary of its effective date.

(e) Subject to the provisions of this subsection, the Board may renew once for an additional 1-year term the limited license to practice hearing aid dispensing to an individual who:

  (1)

    (i) Takes but fails to pass the examination; or

    (ii) Does not take the examination for a reason that the Board finds adequate to excuse the failure to take the examination;

  (2) Submits to the Board a renewal application on the form that the Board provides; and

  (3) Pays to the Board the renewal fee set by the Board.

(f) The total amount of time during which an individual may practice hearing aid dispensing under a limited license or licenses may not be more than 2 years.

(g) If a limited licensee fails to receive a full license within 2 years after the initial limited license was issued, the individual shall wait a minimum of 1 year before the individual may apply for another license.

#### Section 2-310.2

(a) Subject to the provisions of this section, the Board shall issue a limited license to practice speech-language pathology to an applicant who:

  (1) Except for the examination and supervised postgraduate professional practice in speech-language pathology, meets the license requirements under Sec. 2-302.2 of this subtitle;

  (2) Demonstrates to the satisfaction of the Board that for the term of the limited license the applicant will practice only under the supervision of an individual described under subsection (b)(2) of this section;

  (3) Submits an application to the Board on the form that the Board requires; and

  (4) Pays to the Board the application fee set by the Board.

(b)

  (1) The purpose of a limited license to practice speech-language pathology is to permit an individual to practice speech-language pathology while completing the licensing requirements of this title.

  (2) While it is effective, a limited license to practice speech-language pathology authorizes the licensee to practice speech-language pathology under the supervision of:

    (i) A fully licensed speech-language pathologist; or

    (ii) If the individual is employed in a setting in which licensure is not required as provided under Sec. 2-301(b)(1)(i) of this subtitle, an individual who holds national certification in speech-language pathology from a professional organization acceptable to the Board as provided for in the regulations adopted by the Board.

(c) A limited license to practice speech-language pathology expires on the first anniversary of its effective date.

(d) The Board may renew the limited license to practice speech-language pathology once for an additional 1-year term, if the holder:

  (1) Otherwise meets the requirements of this section;

  (2) Submits a renewal application to the Board on the form that the Board requires; and

  (3) Pays to the Board a limited license renewal fee set by the Board.

(e) If a limited licensee fails to receive a full license within 2 years after the date the initial limited license was issued, the individual shall wait a minimum of 1 year before the individual may apply for another license.

#### Section 2-310.3

(a) Subject to the provisions of this section, the Board shall issue a limited license to assist in the practice of speech-language pathology to an applicant who:

  (1) Except for the clinical observation hours and supervised clinical assisting experience hours requirement, meets the license requirements under Sec. 2-302.3 of this subtitle;

  (2) Demonstrates to the satisfaction of the Board that for the term of the limited license the applicant will practice only under the supervision of an individual described under subsection (b)(2) of this section;

  (3) Submits an application to the Board on the form that the Board requires; and

  (4) Pays to the Board an application fee set by the Board.

(b)

  (1) The purpose of a limited license to assist in the practice of speech-language pathology is to permit an individual to practice as a speech-language pathology assistant while completing the licensing requirements of this title.

  (2) While it is effective, a limited license to assist in the practice of speech-language pathology authorizes the licensee to assist in the practice of speech-language pathology under the direct supervision of:

    (i) A fully licensed speech-language pathologist; or

    (ii) If the individual is employed in a setting in which licensure is not required as provided under Sec. 2-301(b)(1)(i) of this subtitle, an individual who holds national certification in speech-language pathology from a professional organization as provided for in  the regulations adopted by the Board.

(c) A limited license to assist in the practice of speech-language pathology expires on the first anniversary of its effective date.

(d) The Board may renew a limited license to assist in the practice of speech-language pathology once for an additional 1-year term, if the holder:

  (1) Otherwise meets the requirements of this section;

  (2) Submits a renewal application to the Board on the form that the Board requires; and

  (3) Pays to the Board a limited license renewal fee set by the Board.

(e) If a limited licensee fails to receive a full license within 2 years, the individual shall wait a minimum of 1 year before the individual may apply for another license.

#### Section 2-311

(a) Each licensee shall display the license conspicuously in the office or place of employment of the licensee.

(b)

  (1) The Board shall maintain an electronic list of each individual licensed by the Board.

  (2) An individual may contact the Board to verify an individual's license.

(c) If a licensee has more than one place of business, the licensee shall notify the Board of the address the Board may use to send notices and other correspondence.

(d) A licensee shall notify the Board in writing of a change of mailing address, e-mail address, or phone number within 30 days after the change.

#### Section 2-312

(a)

  (1) The Board shall investigate any alleged violation of this title.

  (2) The Board may issue subpoenas, administer oaths, and examine witnesses.

(b) The Board may issue a cease and desist order or obtain injunctive relief for a violation of any provision of Sec. 2-314 of this subtitle or Sec.Sec. 2-401 through 2-402.3 of this title.

(c)

  (1) An action may be maintained in the name of the State or the Board to enjoin:

    (i) Conduct that is a ground for disciplinary action under Sec. 2-314 of this subtitle;

    (ii) The unauthorized practice of audiology, hearing aid dispensing, or speech-language pathology; or

    (iii) Aiding and abetting in the unauthorized practice of audiology, hearing aid dispensing, or speech-language pathology.

  (2) An action under this subsection may be brought by:

    (i) The Board, in its own name;

    (ii) The Attorney General, in the name of the State; or

    (iii) A State's Attorney, in the name of the State.

  (3) An action under this subsection shall be brought in the county where the defendant:

    (i) Resides; or

    (ii) Engages in the act sought to be enjoined.

  (4) Proof of actual damages or that any person is likely to sustain any damage if an injunction is not granted is not required for an action under this subsection.

  (5) An action under this subsection is in addition to and not instead of disciplinary action under Sec. 2-314 of this subtitle or criminal prosecution for the unauthorized practice of audiology, hearing aid dispensing, or speech-language pathology under Sec.Sec. 2-401 through 2-402.3 of this title.

#### Section 2-313

(a) Unless the Board agrees to accept the surrender of a license or a limited license, a licensee or limited licensee may not surrender the license or limited license nor may the license lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee.

(b) The Board may set conditions on its agreement with a licensee or limited licensee under investigation or against whom charges are pending to accept surrender of the license.

#### Section 2-314

Subject to the hearing provisions of Sec. 2-315 of this subtitle, the Board may deny a license or limited license to any applicant, reprimand any licensee or holder of a limited license, place any licensee or holder of a limited license on probation, or suspend or revoke a license or limited license if the applicant, licensee, or holder:

(1) Fraudulently or deceptively obtains or attempts to obtain a license or limited license for the applicant, licensee, or holder or for another;

(2) Fraudulently or deceptively uses a license or limited license;

(3) Commits fraud or deceit in the practice of audiology, hearing aid dispensing, or speech-language pathology, or assistance of the practice of speech-language pathology or audiology;

(4) Is convicted of or pleads guilty or nolo contendere to a felony or to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside;

(5) Obtains a fee through fraud or misrepresentation;

(6) Directly or indirectly employs any unlicensed person or any person whose license or limited license has been suspended;

(7) Uses or promotes or causes the use of any misleading, deceiving, improbable, or untruthful advertising matter, promotional literature, testimonial, guarantee, warranty, label, brand, insignia, or other representation;

(8) In the practice of audiology, hearing aid dispensing, or speech-language pathology, or assistance of the practice of speech-language pathology or audiology:

  (i) Falsely represents the use or availability of services or advice of a physician; or

  (ii) Misrepresents the applicant, licensee, or holder by using the word "doctor" or any similar word, abbreviation, or symbol if the use is not accurate;

(9) Permits another person to use the license of the licensee or limited license of the holder;

(10) Commits any act of unprofessional conduct in the practice of audiology, hearing aid dispensing, or speech-language pathology, or the assistance of the practice of speech-language pathology or audiology;

(11) Violates any lawful order given or regulation adopted by the Board;

(12) Violates any provision of this title;

(13) Provides professional services while:

  (i) Under the influence of alcohol; or

  (ii) Using any narcotic or controlled dangerous substance, as defined in Sec. 5-101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication;

(14) Is disciplined by a licensing or disciplinary authority of any other state or country or convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs, for an act that would be grounds for disciplinary action under the Board's disciplinary statutes;

(15) Practices audiology, hearing aid dispensing, or speech-language pathology, or assists in the practice of speech-language pathology or audiology with an unauthorized person or supervises or aids an unauthorized person in the practice of audiology, hearing aid dispensing, or speech-language pathology, or assistance of the practice of speech-language pathology or audiology;

(16) Knowingly makes or files a false report or record in the practice of audiology, hearing aid dispensing, or speech-language pathology, or assistance in the practice of speech-language pathology or audiology;

(17) Knowingly fails to file or record any report as required by law, willfully impedes or obstructs the filing or recording of the report, or induces another to fail to file or record the report;

(18) Submits a false statement to collect a fee;

(19) Is professionally, physically, or mentally incompetent;

(20) Promotes the sale of devices, appliances, or goods to a patient so as to exploit the patient for financial gain;

(21) Behaves immorally in the practice of audiology, hearing aid dispensing, or speech-language pathology, or assistance of the practice of speech-language pathology or audiology;

(22) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;

(23) Pays or agrees to pay any sum to any person for bringing or referring a patient;

(24) Fails to submit to a criminal history records check in accordance with Sec. 2-303.1 of this subtitle; or

(25) Supervises or aids an unauthorized individual in the assistance of audiology.

#### Section 2-314.1

(a) In this section, "medical examination" means a physical examination of the ear of an individual by an otolaryngologist, otologist, or other physician.

(b)

  (1) Before an audiologist or a hearing aid dispenser sells a hearing aid to an individual, the audiologist or hearing aid dispenser shall determine whether the individual has had a medical examination within the 6 months before the hearing aid service is to be provided.

  (2) Unless an audiologist or a hearing aid dispenser determines that an individual has had a medical examination within the period set under paragraph (1) of this subsection, the audiologist or hearing aid dispenser:

    (i) Shall give the individual a written recommendation that the individual obtain a medical examination; and

    (ii) Except as provided in subsection (c) of this section, may not sell a hearing aid to the individual until the individual provides to the audiologist or the hearing aid dispenser satisfactory written evidence that the individual has had a medical examination within the 6 months before the hearing aid is provided.

(c)

  (1) An audiologist or a hearing aid dispenser may sell a hearing aid to an individual without complying with the requirements of subsection (b)(2)(ii) of this section only if the services are:

    (i) Limited to replacement of a hearing aid; or

    (ii) Provided to an individual who:

      (1) Is at least 18 years old; and

      (2) Before a hearing aid is provided, signs a written waiver of the medical examination that otherwise is required under subsection (b)(2)(ii) of this section.

  (2) Each audiologist or hearing aid dispenser shall keep a copy of each signed waiver.

#### Section 2-314.2

While practicing audiology or hearing aid dispensing, an audiologist or a hearing aid dispenser may not:

(1) Advertise a particular model, type, or kind of hearing aid for sale while intending:

  (i)

    (1) Not to allow an individual who responds to the advertisement to buy the hearing aid advertised; or

    (2) To dissuade an individual who responds to the advertisement from buying the hearing aid advertised; and

  (ii) To obtain for a prospective buyer a model, type, or kind of hearing aid that differs from that advertised; or

(2) Falsely represent the use or availability of services or advice of a physician for providing hearing aid services.

#### Section 2-314.3

While practicing hearing aid dispensing, a hearing aid dispenser may not misrepresent the place of business of the person by use of the word "clinic" or any similar word, abbreviation, or symbol to indicate falsely that a medical service is provided at that place.

#### Section 2-314.4

A person may not practice hearing aid dispensing under a false name.

#### Section 2-314.5

While practicing audiology or hearing aid dispensing, an audiologist or a hearing aid dispenser may not directly or indirectly give or offer to give anything of value to another person who provides professional services to clients, if the thing of value is given to induce the person receiving the thing of value to:

(1) Buy a product or service from the person giving the thing of value;

(2) Refrain from buying a product or service of a competitor of the person giving the thing of value; or

(3) Influence another to:

  (i) Buy a product or service from the person giving the thing of value; or

  (ii) Refrain from buying a product or service of a competitor of the person giving the thing of value.

#### Section 2-314.6

(a) Subject to subsection (b) of this section, a person may not sell or attempt to sell a hearing aid to any person by door-to-door solicitation.

(b) Subsection (a) of this section does not apply to a solicitation that is made:

  (1) At the request of the solicited individual; or

  (2) In response to an inquiry from the solicited individual.

#### Section 2-314.7

While practicing audiology or hearing aid dispensing, a person may not engage in an unfair or deceptive trade practice, as defined in Sec. 13-301 of the Commercial Law Article.

#### Section 2-314.8

Each time an audiologist or a hearing aid dispenser sells a hearing aid to an individual, the audiologist or the hearing aid dispenser shall give the individual a receipt that includes:

(1) The name and address of the regular place of business of the audiologist or the hearing aid dispenser;

(2) The license number of the audiologist or the hearing aid dispenser;

(3) The make, model, and serial number of the hearing aid provided;

(4) If the hearing aid is used or reconditioned, a statement that indicates that the hearing aid is used or reconditioned;

(5) The amount charged for the hearing aid;

(6) The total refundable amount of the hearing aid if it is returned within 30 days as provided in the Hearing Aid Sales Act, Title 14, Subtitle 25 of the Commercial Law Article; and

(7) The signature of the audiologist or the hearing aid dispenser.

#### Section 2-314.9

(a) If after a hearing under Sec. 2-315 of this subtitle, the Board finds that there are grounds under Sec. 2-314 of this subtitle to suspend or revoke a license or to reprimand a licensee or place a licensee on probation, the Board may impose a penalty not exceeding $5,000 in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.

(b) The Board shall adopt regulations to set standards for the imposition of penalties under this section.

(c) The Board shall pay any penalty collected under this section into the General Fund of the State.

#### Section 2-315

(a) Except as otherwise provided in the Administrative Procedure Act, before the Board takes any action under Sec. 2-314 of this subtitle or denies a license or a limited license for any other reason, it shall give the individual against whom the action is contemplated an opportunity for a hearing before the Board.

(b) The Board shall give notice and hold the hearing in accordance with the Administrative Procedure Act.

(c) Any notice given under this section shall be sent by first-class mail to the last known address given to the Board by the individual.

(d) If after due notice the individual against whom the action is contemplated fails or refuses to appear, nevertheless the Board may hear and determine the matter.

(e) Over the signature of an officer or the administrator of the Board, the Board may issue a subpoena or administer an oath in connection with an investigation, hearing, or proceeding by the Board.

(f) If, after a hearing, a licensee is found in violation of this title, the licensee shall pay costs of the hearing as specified in regulations adopted by the Board.

#### Section 2-316

(a) Except as provided in this section for an action under Sec. 2-314 of this subtitle, any person aggrieved by a final decision of the Board in a contested case, as defined in the Administrative Procedure Act, may petition for judicial review as allowed by the Administrative Procedure Act.

(b) Any person aggrieved by a final decision of the Board under Sec. 2-314 of this subtitle may not appeal to the Secretary but may take a direct judicial appeal as provided in the Administrative Procedure Act.

(c) An order of the Board may not be stayed pending review.

#### Section 2-317

(a) If the license of an audiologist, hearing aid dispenser, speech-language pathologist, or speech-language pathology assistant is suspended or revoked under Sec. 2-314 of this subtitle, and it is not reinstated by the Board within 5 years, the Board may not reinstate it.

(b) If a license may not be reinstated under subsection (a) of this section, an audiologist, hearing aid dispenser, speech-language pathologist, or speech-language pathology assistant may apply for a new license by meeting the current licensing requirements for obtaining a new license under this title and any additional requirements determined by the Board.

#### Section 2-318

(a) In this section, "rehabilitation committee" means a committee that:

  (1) Is defined in subsection (b) of this section; and

  (2) Performs any of the functions listed in subsection (d) of this section.

(b) For purposes of this section, a rehabilitation committee is a committee of the Board or a committee of a professional association approved by the Board that:

  (1) Is recognized by the Board; and

  (2) Includes but is not limited to audiologists, hearing aid dispensers, speech-language pathologists, and speech-language pathology assistants.

(c) A rehabilitation committee of the Board or recognized by the Board may function:

  (1) Solely for the Board; or

  (2) Jointly with a rehabilitation committee representing another board or boards.

(d) For purposes of this section, a rehabilitation committee evaluates and provides assistance to any audiologist, hearing aid dispenser, speech-language pathologist, or speech-language pathology assistant, and any other individual regulated by the Board, in need of treatment and rehabilitation for alcoholism, drug abuse, chemical dependency, or other physical, emotional, or mental condition.

(e)

  (1) Except as otherwise provided in this subsection, the proceedings, records, and files of the rehabilitation committee are not discoverable and are not admissible in evidence in any civil action arising out of matters that are being or have been reviewed and evaluated by the rehabilitation committee.

  (2) Paragraph (1) of this subsection does not apply to any record or document that is considered by the rehabilitation committee and that otherwise would be subject to discovery or introduction into evidence in a civil action.

  (3) For purposes of this subsection, civil action does not include a proceeding before the Board or judicial review of a proceeding before the Board.

(f) A person who acts in good faith and within the scope of jurisdiction of the rehabilitation committee is not civilly liable for any action as a member of the rehabilitation committee or for giving information to, participating in, or contributing to the function of the rehabilitation committee.

#### Section 2-319

(a)

  (1) A licensed speech-language pathologist may delegate duties to an assistant within the scope of practice and supervision guidelines in the regulations adopted under paragraph (2) of this subsection.

(2) The Board shall adopt regulations to establish qualifications and scope of practice for the position of a speech-language pathology assistant and the requirements for the supervision of a speech-language pathology assistant by a supervisor of a speech-language pathology assistant.

(b)

  (1) A licensed audiologist may delegate duties to an assistant within the scope of practice and supervision guidelines in the regulations adopted under paragraph (2) of this subsection.

  (2) The Board shall adopt regulations to establish qualifications and scope of practice for the position of an audiology assistant and the requirements for the supervision of an audiology assistant by a supervisor of an audiology assistant.

### Subtitle 3A. Licensing of Audiology Assistants

#### Section 2-3A-01

The Audiology and Speech-Language Pathology Interstate Compact is enacted into law and entered into with all other states legally joining in it in the form substantially as it appears in this section as follows: 

SECTION 1. PURPOSE 

The purpose of this Compact is to facilitate interstate practice of audiology and speech-language pathology with the goal of improving public access to audiology and speech-language pathology services. The practice of audiology and speech-language pathology occurs in the state where the patient is located at the time of the patient encounter. The Compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure. This Compact is designed to achieve the following objectives: 

(1) Increase public access to audiology and speech-language pathology services by providing for the mutual recognition of other member state licenses;

(2) Enhance the ability of states to protect the public's health and safety;

(3) Encourage the cooperation of member states in regulating multistate audiology and speech-language pathology practice;

(4) Support spouses of relocating active duty military personnel;

(5) Enhance the exchange of licensure, investigative, and disciplinary information among member states;

(6) Allow a remote state to hold a provider of services with a Compact privilege in that state accountable to the practice standards of that state; and

(7) Allow for the use of telehealth technology to facilitate increased access to audiology and speech-language pathology services.

SECTION 2. DEFINITIONS 

As used in this Compact, and except as otherwise provided, the following definitions shall apply: 

(a) "Active duty military" means full-time duty status in the active uniformed service of the United States, including members of the National Guard and Reserve on active duty orders in accordance with 10 U.S.C. Sec.Sec. 1209 and 1211.

(b) "Adverse action" means any administrative, civil, equitable, or criminal action authorized by a state's laws that is imposed by a licensing board or other authority against an audiologist or a speech-language pathologist, including actions against an individual's license or privilege to practice such as revocation, suspension, probation, monitoring of the licensee, or restriction on the licensee's practice.

(c) "Alternative program" means a nondisciplinary monitoring process approved by an audiology or speech-language pathology licensing board to address impaired practitioners.

(d) "Audiologist" means an individual who is licensed by a state to practice audiology.

(e) "Audiology" means the care and services provided by a licensed audiologist as set forth in the member state's statutes and rules.

(f) "Audiology and Speech-Language Pathology Compact Commission" or "Commission" means the national administrative body established under Section 8 whose membership consists of all states that have enacted the Compact.

(g) "Audiology or speech-language pathology licensing board", "audiology licensing board", "speech-language pathology licensing board", or "licensing board" means the agency of a state that is responsible for the licensing and regulation of audiologists or speech-language pathologists.

(h) "Compact privilege" means the authorization granted by a remote state to allow a licensee from another member state to practice as an audiologist or a speech-language pathologist in the remote state under its laws and rules. The practice of audiology or speech-language pathology occurs in the member state where the patient is located at the time of the patient encounter.

(i) "Current significant investigative information" means investigative information that a licensing board, after an inquiry or investigation that includes notification and an opportunity for the audiologist or speech-language pathologist to respond, if required by state law, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction.

(j) "Data system" means a repository of information about licensees established under Section 9, including, but not limited to, continuing education, examination, licensure, investigative, Compact privilege, and adverse action.

(k) "Encumbered license" means a license in which an adverse action restricts the practice of audiology or speech-language pathology by the licensee and said adverse action has been reported to the National Practitioners Data Bank.

(l) "Executive Committee" means a group of directors elected or appointed to act on behalf of, and within the powers granted to them by, the Commission.

(m) "Home state" means the member state that is the licensee's primary state of residence.

(n) "Impaired practitioner" means an individual whose professional practice is adversely affected by substance abuse, addiction, or other health-related conditions.

(o) "Licensee" means an individual who currently holds an authorization from a state licensing board to practice as an audiologist or a speech-language pathologist.

(p) "Member state" means a state that has enacted the Compact.

(q) "Privilege to practice" means a legal authorization authorizing the practice of audiology or speech-language pathology in a remote state.

(r) "Remote state" means a member state other than the home state where a licensee is exercising or seeking to exercise the Compact privilege.

(s) "Rule" means a regulation, principle, or directive adopted by the Commission that has the force of law.

(t) "Single-state license" means an audiology or speech-language pathology license issued by a member state that authorizes practice only within the issuing state and does not include a privilege to practice in any other member state.

(u) "Speech-language pathologist" means an individual who is licensed by a state to practice speech-language pathology.

(v) "Speech-language pathology" means the care and services provided by a licensed speech-language pathologist as set forth in the member state's statutes and rules.

(w) "State" means any state, commonwealth, district, or territory of the United States of America that regulates the practice of audiology and speech-language pathology.

(x) "State practice laws" means the laws, rules, and regulations of a member state that govern the practice of audiology or speech-language pathology, define the scope of audiology or speech-language pathology practice, and create the methods and grounds for imposing discipline.

(y) "Telehealth" means the application of telecommunication, audio-visual, or other information technologies that meets the applicable standard of care to deliver audiology or speech-language pathology services or information at a distance for assessment, intervention, or consultation.

SECTION 3. STATE PARTICIPATION IN THE COMPACT 

(a) A license issued to an audiologist or a speech-language pathologist by a home state to a resident in that state shall be recognized by each member state as authorizing an audiologist or a speech-language pathologist to practice audiology or speech-language pathology, under a privilege to practice, in each member state where the licensee obtains such a privilege.

(b)

  (1) A state must implement or use procedures for considering the criminal history records of applicants for initial privilege to practice. These procedures shall include the submission of fingerprints or other biometric-based information by applicants for the purpose of obtaining an applicant's criminal history record information from the Federal Bureau of Investigation and the agency responsible for retaining that state's criminal records.

  (2) A member state must fully implement a criminal background check requirement, within a time frame established by rule, by receiving the results of the Federal Bureau of Investigation record search on criminal background checks and use the results in making licensure decisions.

  (3) Communication between a member state and the Commission, and among member states regarding the verification of eligibility for licensure through the Compact may not include any information received from the Federal Bureau of Investigation relating to a federal criminal records check performed by a member state under Public Law 92-544.

(c) On application for a privilege to practice, the licensing board in the issuing remote state shall ascertain, through the data system, whether the applicant has ever held, or is the holder of, a license issued by any other state, whether there are any encumbrances on any license or privilege to practice held by the applicant, and whether any adverse action has been taken against any license or privilege to practice held by the applicant.

(d) Each member state shall require an applicant to obtain or retain a license in the home state and meet the home state's qualifications for licensure or renewal of licensure, as well as all other applicable state laws.

(e) An audiologist must:

  (1) Meet one of the following educational requirements:

    (i) On or before December 31, 2007, have graduated with a master's degree or doctorate in audiology, or equivalent degree regardless of degree name, from a program that is accredited by an accrediting agency recognized by the Council for Higher Education Accreditation, or its successor, or by the United States Department of Education and operated by a college or university accredited by a regional or national accrediting organization recognized by a state licensing board;

    (ii) On or after January 1, 2008, have graduated with a doctoral degree in audiology, or equivalent degree, regardless of degree name, from a program that is accredited by an accrediting agency recognized by the Council for Higher Education Accreditation, or its successor, or by the United States Department of Education and operated by a college or university accredited by a regional or national accrediting organization recognized by a state licensing board; or

    (iii) Have graduated from an audiology program that is housed in an institution of higher education outside the United States:

      (1) For which the program and institution have been approved by the authorized accrediting body in the applicable country; and

      (2) Whose degree program has been verified by an independent credentials review agency to be comparable to a state licensing board-approved program;

  (2) Have completed a supervised clinical practicum experience from an accredited educational institution or its cooperating programs as required by the Commission;

  (3) Have successfully passed a national examination approved by the Commission;

  (4) Hold an active, unencumbered license;

  (5) Have not been convicted or found guilty of, and have not entered into an agreed disposition regarding, a felony related to the practice of audiology, under applicable state or federal criminal law; and

  (6) Have a valid United States Social Security or National Practitioner Identification number.

(f) A speech-language pathologist must:

  (1) Meet one of the following educational requirements:

    (i) Have graduated with a master's degree from a speech-language pathology program that is accredited by an organization recognized by the United States Department of Education and operated by a college or university accredited by a regional or national accrediting organization recognized by a licensing board; or

    (ii) Have graduated from a speech-language pathology program that is housed in an institution of higher education outside the United States:

      (1) For which the program and institution have been approved by the authorized accrediting body in the applicable country; and

      (2) Whose degree program has been verified by an independent credentials review agency to be comparable to a state licensing board-approved program;

  (2) Have completed a supervised clinical practicum experience from an educational institution or its cooperating programs as required by the Commission;

  (3) Have completed a supervised postgraduate professional experience as required by the Commission;

  (4) Have successfully passed a national examination approved by the Commission;

  (5) Hold an active, unencumbered license;

  (6) Have not been convicted or found guilty of, and have not entered into an agreed disposition regarding, a felony related to the practice of speech-language pathology, under applicable state or federal criminal law; and

  (7) Have a valid United States Social Security or National Practitioner Identification number.

(g) The privilege to practice is derived from the home state license.

(h) An audiologist or a speech-language pathologist practicing in a member state must comply with the state practice laws of the state in which the patient is located at the time service is provided. The practice of audiology and speech-language pathology shall include all audiology and speech-language pathology practice as defined by the state practice laws of the member state in which the patient is located. The practice of audiology and speech-language pathology in a member state under a privilege to practice shall subject an audiologist or a speech-language pathologist to the jurisdiction of the licensing board, the courts, and the laws of the member state in which the patient is located at the time service is provided.

(i) Individuals not residing in a member state shall continue to be able to apply for a member state's single-state license as provided under the laws of each member state. However, the single-state license granted to these individuals may not be recognized as granting the privilege to practice audiology or speech-language pathology in any other member state. Nothing in this Compact shall affect the requirements established by a member state for the issuance of a single-state license.

(j) Member states may charge a fee for granting a Compact privilege.

(k) Member states must comply with the bylaws and rules and regulations of the Commission.

SECTION 4. COMPACT PRIVILEGE 

(a) To exercise the Compact privilege under the terms and provisions of the Compact, the audiologist or speech-language pathologist shall:

  (1) Hold an active license in the home state;

  (2) Have no encumbrance on any state license;

  (3) Be eligible for a Compact privilege in any member state in accordance with Section 3;

  (4) Have not had any adverse action against any license or Compact privilege within the previous 2 years from date of application;

  (5) Notify the Commission that the licensee is seeking the Compact privilege within a remote state;

  (6) Pay any applicable fees, including any state fee, for the Compact privilege; and

  (7) Report to the Commission adverse action taken by any nonmember state within 30 days from the date the adverse action is taken.

(b) For the purposes of the Compact privilege, an audiologist or a speech-language pathologist may hold only one home state license at a time.

(c) Except as provided in Section 6, if an audiologist or a speech-language pathologist changes primary state of residence by moving between two member states, the audiologist or speech-language pathologist must apply for licensure in the new home state, and the license issued by the prior home state shall be deactivated in accordance with applicable rules adopted by the Commission.

(d) The audiologist or speech-language pathologist may apply for licensure in advance of a change in primary state of residence.

(e) A license may not be issued by the new home state until the audiologist or speech-language pathologist provides satisfactory evidence of a change in primary state of residence to the new home state and satisfies all applicable requirements to obtain a license from the new home state.

(f) If an audiologist or a speech-language pathologist changes primary state of residence by moving from a member state to a nonmember state, the license issued by the prior home state shall convert to a single-state license, valid only in the former home state, and the Compact privilege in any member state is deactivated in accordance with rules adopted by the Commission.

(g) The Compact privilege is valid until the expiration date of the home state license. The licensee must comply with the requirements of subsection (a) of this section to maintain the Compact privilege in the remote state.

(h) A licensee providing audiology or speech-language pathology services in a remote state under the Compact privilege shall function within the laws and regulations of the remote state.

(i) A licensee providing audiology or speech-language pathology services in a remote state is subject to the regulatory authority of that state. A remote state may, in accordance with due process and the laws of that state, remove a licensee's Compact privilege in the remote state for a specific period of time, impose fines, or take any other necessary actions to protect the health and safety of its citizens.

(j) If a home state license is encumbered, the licensee shall lose the Compact privilege in any remote state until the following occur:

  (1) The home state license is no longer encumbered; and

  (2) 2 years have elapsed from the date of the adverse action.

(k) Once an encumbered license in the home state is restored to good standing, the licensee must meet the requirements of subsection (a) of this section to obtain a Compact privilege in any remote state.

(l) Once the requirements of subsection (j) of this section have been met, the licensee must meet the requirements in subsection (a) of this section to obtain a Compact privilege in a remote state.

SECTION 5. COMPACT PRIVILEGE TO PRACTICE TELEHEALTH 

(a) Member states shall recognize the right of an audiologist or a speech-language pathologist, licensed by a home state in accordance with Section 3 and under rules promulgated by the Commission, to practice audiology or speech-language pathology in any member state via telehealth under a privilege to practice as provided in the Compact and rules promulgated by the Commission.

(b) A licensee providing audiology or speech-language pathology services in a remote state under the Compact privilege shall function within the laws and regulations of the remote state.

SECTION 6. ACTIVE DUTY MILITARY PERSONNEL OR THEIR SPOUSES 

Active duty military personnel, or their spouses, shall designate a home state where the individual has a current license in good standing. The individual may retain the home state designation during the period the service member is on active duty. Subsequent to designating a home state, the individual shall change the home state of the individual only through application for licensure in the new state. 

SECTION 7. ADVERSE ACTIONS 

(a)

  (1) In addition to the other powers conferred by state law, a remote state shall have the authority, in accordance with existing state due process law, to:

    (i) Take adverse action against an audiologist's or a speech-language pathologist's privilege to practice within that member state; and

    (ii) Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses as well as the production of evidence.

  (2) Subpoenas issued by a licensing board in a member state for the attendance and testimony of witnesses or the production of evidence from another member state shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state in which the witnesses or evidence are located.

  (3) Only the home state shall have the power to take adverse action against an audiologist's or a speech-language pathologist's license issued by the home state.

(b) For purposes of taking adverse action, the home state shall give the same priority and effect to reported conduct received from a member state as it would if the conduct had occurred within the home state. In so doing, the home state shall apply its own state laws to determine appropriate action.

(c) The home state shall complete any pending investigations of an audiologist or a speech-language pathologist who changes primary state of residence during the course of the investigations. The home state shall also have the authority to take appropriate action and shall promptly report the conclusions of the investigations to the administrator of the data system. The administrator of the data system shall promptly notify the new home state of any adverse actions.

(d) If otherwise authorized by state law, the member state may recover from the affected audiologist or speech-language pathologist the costs of investigations and disposition of cases resulting from any adverse action taken against that audiologist or speech-language pathologist.

(e) The member state may take adverse action based on the factual findings of the remote state, provided that the member state follows its own procedures for taking the adverse action.

(f)

  (1) In addition to the authority granted to a member state by its respective audiology or speech-language pathology practice act or other applicable state law, any member state may participate with other member states in joint investigations of licensees.

  (2) Member states shall share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.

(g) If adverse action is taken by the home state against an audiologist's or a speech-language pathologist's license, the audiologist's or speech-language pathologist's privilege to practice in all other member states shall be deactivated until all encumbrances have been removed from the state license. All home state disciplinary orders that impose adverse action against an audiologist's or a speech-language pathologist's license shall include a statement that the audiologist's or speech-language pathologist's privilege to practice is deactivated in all member states during the pendency of the order.

(h) If a member state takes adverse action against a licensee, it shall promptly notify the administrator of the data system. The administrator of the data system shall promptly notify the home state, and any remote state in which the licensee has a privilege to practice, of any adverse actions by the home state or remote states.

(i) Nothing in this Compact shall override a member state's decision that participation in an alternative program may be used in lieu of adverse action.

SECTION 8. ESTABLISHMENT OF THE AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY COMPACT COMMISSION 

(a)

  (1) The Compact member states hereby create and establish a joint public agency known as the Audiology and Speech-Language Pathology Compact Commission.

  (2) The Commission is an instrumentality of the Compact states.

  (3) Venue is proper and judicial proceedings by or against the Commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the Commission is located. The Commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings.

  (4) Nothing in this Compact shall be construed to be a waiver of sovereign immunity.

(b)

  (1) Each member state shall have two delegates selected by the licensing board of that member state. The delegates shall be current members of the licensing board. One shall be an audiologist and one shall be a speech-language pathologist.

  (2) An additional five delegates, who are either public members or board administrators from state licensing boards, shall be chosen by the Executive Committee from a pool of nominees provided by the Commission at large.

  (3) Any delegate may be removed or suspended from office as provided by the law of the state from which the delegate is appointed.

  (4) The member state board shall fill any vacancy occurring on the Commission within 90 days.

  (5) Each delegate shall be entitled to one vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the Commission.

  (6) A delegate shall vote in person or by other means as provided in the bylaws. The bylaws may provide for the participation of the delegates in meetings by telephone or other means of communication.

  (7) The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.

(c) The Commission shall have the following powers and duties:

  (1) Establish the fiscal year of the Commission;

  (2) Establish bylaws;

  (3) Establish a Code of Ethics;

  (4) Maintain its financial records in accordance with the bylaws;

  (5) Meet and take actions as are consistent with the provisions of this Compact and the bylaws;

  (6) Promulgate uniform rules to facilitate and coordinate implementation and administration of this Compact that shall have the force and effect of law and shall be binding in all member states to the extent and manner provided for in this Compact;

  (7) Bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any state audiology or speech-language pathology licensing board to sue or be sued under applicable law shall not be affected;

  (8) Purchase and maintain insurance and bonds;

  (9) Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a member state;

  (10) Hire employees, elect or appoint officers, fix compensation, define duties, grant individuals appropriate authority to carry out the purposes of the Compact, and establish the Commission's personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters;

  (11) Accept any and all appropriate donations and grants of money, equipment, supplies, materials, and services, and receive, utilize, and dispose of the same, provided that at all times the Commission shall avoid any appearance of impropriety or conflict of interest;

  (12) Lease, purchase, accept appropriate gifts or donations of, or otherwise own, hold, improve, or use any property, real, personal, or mixed, provided that at all times the Commission shall avoid any appearance of impropriety;

  (13) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed;

  (14) Establish a budget and make expenditures;

  (15) Borrow money;

  (16) Appoint committees, including standing committees composed of members and other interested persons as may be designated in this Compact and the bylaws;

  (17) Provide and receive information from, and cooperate with, law enforcement agencies;

  (18) Establish and elect an Executive Committee; and

  (19) Perform other functions as may be necessary or appropriate to achieve the purposes of this Compact consistent with state regulation of audiology and speech-language pathology licensure and practice.

(d) The Commission has no authority to change or modify the laws of the member states which define the practice of audiology or speech-language pathology in the respective states.

(e)

  (1) The Executive Committee shall have the power to act on behalf of the Commission, within the powers of the Commission, according to the terms of this Compact.

  (2) The Executive Committee shall be composed of the following members:

    (i) Seven voting members who are elected by the Commission from the current membership of the Commission;

    (ii) Two ex officio members, consisting of one nonvoting member from a recognized national audiology professional association and one nonvoting member from a recognized national speech-language pathology association; and

    (iii) One ex officio, nonvoting member from the recognized membership organization of the audiology or speech-language pathology licensing boards.

  (3) The ex officio members shall be selected by their respective organizations.

(f)

  (1) The Commission may remove any member of the Executive Committee as provided in the bylaws.

  (2) The Executive Committee shall meet at least annually.

  (3) The Executive Committee shall have the following duties and responsibilities:

    (i) Recommend to the entire Commission changes to the rules or bylaws, changes to this Compact legislation, fees paid by Compact member states, such as annual dues, and any Commission Compact fee charged to licensees for the Compact privilege;

    (ii) Ensure Compact administration services are appropriately provided, contractual or otherwise;

    (iii) Prepare and recommend the budget;

    (iv) Maintain financial records on behalf of the Commission;

    (v) Monitor Compact compliance of member states and provide compliance reports to the Commission;

    (vi) Establish additional committees as necessary; and

    (vii) Other duties as provided in rules or bylaws.

  (4) All meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the rulemaking provisions in Section 10.

  (5) The Commission, the Executive Committee, or other committees of the Commission may convene in a closed, nonpublic meeting if the Commission or Executive Committee or other committees of the Commission must discuss:

    (i) Noncompliance of a member state with its obligations under the Compact;

    (ii) The employment, compensation, discipline or other matters, practices or procedures related to specific employees, or other matters related to the Commission's internal personnel practices and procedures;

    (iii) Current, threatened, or reasonably anticipated litigation;

    (iv) Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate;

    (v) Accusing any person of a crime or formally censuring any person;

    (vi) Disclosure of trade secrets or commercial or financial information that is privileged or confidential;

    (vii) Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;

    (viii) Disclosure of investigative records compiled for law enforcement purposes;

    (ix) Disclosure of information related to any investigative reports prepared by or on behalf of or for use of the Commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to the Compact; or

    (x) Matters specifically exempted from disclosure by federal or member state statute.

  (6) If a meeting, or portion of a meeting, is closed in accordance with this provision, the Commission's legal counsel or designee shall certify that the meeting may be closed and shall reference each relevant exempting provision.

  (7) The Commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, and the reasons therefore, including a description of the views expressed. All documents considered in connection with an action shall be identified in minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the Commission or order of a court of competent jurisdiction. All minutes and documents of meetings other than a closed meeting shall be made available to members of the public upon request at the requesting person's expense.

  (8)

    (i) The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.

    (ii) The Commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services.

    (iii) The Commission may levy on and collect an annual assessment from each member state or impose fees on other parties to cover the cost of the operations and activities of the Commission and its staff, which must be in a total amount sufficient to cover its annual budget as approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated based on a formula to be determined by the Commission, which shall promulgate a rule binding on all member states.

  (9) The Commission may not incur obligations of any kind prior to securing the funds adequate to meet the same, nor shall the Commission pledge the credit of any of the member states, except by and with the authority of the member state.

  (10) The Commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the Commission shall be subject to the audit and accounting procedures established under its bylaws. However, all receipts and disbursements of funds handled by the Commission shall be audited yearly by a certified or licensed public accountant, and the report of the audit shall be included in and become part of the annual report of the Commission.

(g)

  (1) The members, officers, executive director, employees, and representatives of the Commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error, or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities, provided that nothing in this paragraph shall be construed to protect any person from suit or liability for any damage, loss, injury, or liability caused by the intentional or willful or wanton misconduct of that person.

  (2) The Commission shall defend any member, officer, executive director, employee, or representative of the Commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of Commission employment, duties, or responsibilities, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities, provided that nothing herein shall be construed to prohibit that person from retaining his or her own counsel, and provided further, that the actual or alleged act, error, or omission did not result from that person's intentional or willful or wanton misconduct.

  (3) The Commission shall indemnify and hold harmless any member, officer, executive director, employee, or representative of the Commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error, or omission that occurred within the scope of Commission employment, duties, or responsibilities, or that person had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from the intentional or willful or wanton misconduct of that person.

  SECTION 9. DATA SYSTEM 

(a) The Commission shall provide for the development, maintenance, and utilization of a coordinated database and reporting system containing licensure, adverse action, and investigative information on all licensed individuals in member states.

(b) Notwithstanding any other provision of state law to the contrary, a member state shall submit a uniform data set to the data system on all individuals to whom this Compact is applicable as required by the rules of the Commission, including:

  (1) Identifying information;

  (2) Licensure data;

  (3) Adverse actions against a license or Compact privilege;

  (4) Nonconfidential information related to alternative program participation;

  (5) Any denial of application for licensure, and the reason for the denial; and

  (6) Other information that may facilitate the administration of this Compact, as determined by the rules of the Commission.

(c) Investigative information pertaining to a licensee in any member state may be available only to other member states.

(d) The Commission shall promptly notify all member states of any adverse action taken against a licensee or an individual applying for a license. Adverse action information pertaining to a licensee in any member state shall be available to any other member state.

(e) Member states contributing information to the data system may designate information that may not be shared with the public without the express permission of the contributing state.

(f) Any information submitted to the data system that is subsequently required to be expunged by the laws of the member state contributing the information shall be removed from the data system.

SECTION 10. RULEMAKING 

(a) The Commission shall exercise its rulemaking powers in accordance with the criteria set forth in this section and the rules adopted thereunder. Rules and amendments shall become binding as of the date specified in each rule or amendment.

(b) If a majority of the legislatures of the member states rejects a rule, by enactment of a statute or resolution in the same manner used to adopt the Compact within 4 years after the date of adoption of the rule, the rule shall have no further force and effect in any member state.

(c) Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.

(d) Prior to promulgation and adoption of a final rule or rules by the Commission, and at least 30 days in advance of the meeting at which the rule shall be considered and voted on, the Commission shall file a Notice of Proposed Rulemaking:

  (1) On the website of the Commission or other publicly accessible platform; and

  (2) On the website of each member state audiology or speech-language pathology licensing board or other publicly accessible platform or the publication in which each state would otherwise publish proposed rules.

(e) The Notice of Proposed Rulemaking shall include:

  (1) The proposed time, date, and location of the meeting during which the rule shall be considered and voted on;

  (2) The text of the proposed rule or amendment and the reason for the proposed rule;

  (3) A request for comments on the proposed rule from any interested person; and

  (4) The manner in which interested persons may submit notice to the Commission of their intention to attend the public hearing and any written comments.

(f) Prior to the adoption of a proposed rule, the Commission shall allow persons to submit written data, facts, opinions, and arguments, which shall be made available to the public.

(g) The Commission shall grant an opportunity for a public hearing before it adopts a rule or amendment if a hearing is requested by:

  (1) At least 25 persons;

  (2) A state or federal governmental subdivision or agency; or

  (3) An association having at least 25 members.

(h)

  (1) If a hearing is held on the proposed rule or amendment, the Commission shall publish the place, time, and date of the scheduled public hearing. If the hearing is held via electronic means, the Commission shall publish the mechanism for accessing the electronic hearing.

  (2) All persons wishing to be heard at the hearing shall notify the executive director of the Commission or other designated member in writing of their desire to appear and testify at the hearing not less than 5 business days before the scheduled date of the hearing.

  (3) Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing.

  (4) All hearings shall be recorded. A copy of the recording shall be made available to any person on request and at the requesting person's expense.

  (5) Nothing in this subsection shall be construed as requiring a separate hearing on each rule. Rules may be grouped for the convenience of the Commission at hearings required by this subsection.

(i) Following the scheduled hearing date, or by the close of business on the scheduled hearing date if the hearing was not held, the Commission shall consider all written and oral comments received.

(j) If no written notice of intent to attend the public hearing by interested parties is received, the Commission may proceed with promulgation of the proposed rule without a public hearing.

(k) The Commission shall, by majority vote of all members, take final action on the proposed rule and shall determine the effective date of the rule, if any, based on the rulemaking record and the full text of the rule.

(l) On determination that an emergency exists, the Commission may consider and adopt an emergency rule without prior notice, opportunity for comment, or hearing, provided that the usual rulemaking procedures provided in the Compact and in this section shall be retroactively applied to the rule as soon as reasonably possible, in no event later than 90 days after the effective date of the rule. For the purposes of this provision, an emergency rule is one that must be adopted immediately in order to:

  (1) Meet an imminent threat to public health, safety, or welfare;

  (2) Prevent a loss of Commission or member state funds; or

  (3) Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule.

(m) The Commission or an authorized committee of the Commission may direct revisions to a previously adopted rule or amendment for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors. Public notice of any revisions shall be posted on the website of the Commission. The revision shall be subject to challenge by any person for a period of 30 days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made in writing and delivered to the chair of the Commission prior to the end of the notice period. If no challenge is made, the revision shall take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the Commission.

SECTION 11. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT 

(a)

  (1) On request by a member state, the Commission shall attempt to resolve disputes related to the Compact that arise among member states and between member and nonmember states.

  (2) The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate.

(b)

  (1) The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this Compact.

  (2) By majority vote, the Commission may initiate legal action in the United States District Court for the District of Columbia or the federal district where the Commission has its principal offices against a member state in default to enforce compliance with the provisions of the Compact and its promulgated rules and bylaws. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of litigation, including reasonable attorney's fees.

  (3) The remedies herein shall not be the exclusive remedies of the Commission. The Commission may pursue any other remedies available under federal or state law.

  SECTION 12. DATE OF IMPLEMENTATION OF THE AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY INTERSTATE COMPACT AND ASSOCIATED RULES, WITHDRAWAL, AND AMENDMENT 

(a) The Compact shall come into effect on the date on which the Compact statute is enacted into law in the 10th member state. The provisions, which become effective at that time, shall be limited to the powers granted to the Commission relating to assembly and the promulgation of rules. Thereafter, the Commission shall meet and exercise rulemaking powers necessary to the implementation and administration of the Compact.

(b) Any state that joins the Compact subsequent to the initial adoption of the rules by the Commission shall be subject to the rules as they exist on the date on which the Compact becomes law in that state. Any rule that has been previously adopted by the Commission shall have the full force and effect of law on the day the Compact becomes law in that state.

(c)

  (1) Any member state may withdraw from this Compact by enacting a statute repealing the same.

  (2) A member state's withdrawal shall not take effect until 6 months after enactment of the repealing statute.

  (3) Withdrawal shall not affect the continuing requirement of the withdrawing state's audiology or speech-language pathology licensing board to comply with the investigative and adverse action reporting requirements of this act prior to the effective date of withdrawal.

(d) Nothing contained in this Compact shall be construed to invalidate or prevent any audiology or speech-language pathology licensure agreement or other cooperative arrangement between a member state and a nonmember state that does not conflict with the provisions of this Compact.

(e) This Compact may be amended by the member states. No amendment to this Compact shall become effective and binding on any member state until it is enacted into the laws of all member states.

SECTION 13. CONSTRUCTION AND SEVERABILITY 

This Compact shall be liberally construed so as to effectuate the purposes thereof. The provisions of this Compact shall be severable and if any phrase, clause, sentence, or provision of this Compact is declared to be contrary to the constitution of any member state or of the United States or the applicability thereof to any government, agency, person, or circumstance is held invalid, the validity of the remainder of this Compact and the applicability thereof to any government, agency, person, or circumstance shall not be affected thereby. If this Compact shall be held contrary to the constitution of any member state, the Compact shall remain in full force and effect as to the remaining member states and in full force and effect as to the member state affected as to all severable matters. 

SECTION 14. BINDING EFFECT OF COMPACT AND OTHER LAWS 

(a) Nothing herein prevents the enforcement of any other law of a member state that is not inconsistent with the Compact.

(b) All laws in a member state in conflict with the Compact are superseded to the extent of the conflict.

(c) All lawful actions of the Commission, including all rules and bylaws promulgated by the Commission, are binding on the member states.

(d) All agreements between the Commission and the member states are binding in accordance with their terms.

(e) In the event any provision of the Compact exceeds the constitutional limits imposed on the legislature of any member state, the provision shall be ineffective to the extent of the conflict with the constitutional provision in question in that member state.

### Subtitle 3B

#### Section 2-3B-01

(a) Except as otherwise provided in this title or Sec.Sec. 10-14A-03 and 10-14B-03 of the State Government Article, an individual shall be licensed by the Board before the individual may assist a licensed audiologist in the practice of audiology in this State.

(b) The Board may allow an audiology assistant licensed in another state to assist in the practice of audiology in this State without a license if the audiology assistant has a completed application for a license pending before the Board.

#### Section 2-3B-02

(a) To qualify for a license to assist in the practice of audiology, an applicant must be an individual who meets the requirements of this section.

(b) The applicant must:

  (1) Be of good moral character;

  (2) Hold a high school diploma or equivalent degree;

  (3) Demonstrate oral competency;

  (4) Submit to a criminal history records check in accordance with Sec. 2-303.1 of this title;

  (5) Submit an application to the Board on the form that the Board requires; and

  (6) Pay to the Board the application fee set by the Board.

(c) The Board may waive any of the requirements under this section as provided for in regulations adopted by the Board.

#### Section 2-3B-03

(a) The Board shall issue a license to any applicant who meets the requirements of this subtitle and any regulations adopted by the Board to carry out this subtitle.

(b) The Board may not adopt regulations to establish qualifications of applicants that are more stringent than the qualifications established under this title for applicants for a license to practice audiology.

#### Section 2-3B-04

A license to assist in the practice of audiology authorizes the licensed individual to assist a licensed audiologist in the practice of audiology while the license is effective.

#### Section 2-3B-05

The Board shall determine through regulations the term of a license and any renewal or reinstatement requirements.

#### Section 2-3B-06

(a) A licensed audiology assistant shall assist the practice of audiology under the general supervision of a licensed audiologist.

(b) A licensed audiologist may provide general supervision for not more than two licensed audiology assistants at any time.

#### Section 2-3B-07

A licensed audiology assistant or an applicant to be a licensed audiology assistant shall be subject to the provisions in Sec.Sec. 2-314.1, 2-314.2, 2-314.5, 2-314.7, 2-314.8, and 2-317 of this title in the same manner as those provisions apply to applicants for a license to practice audiology and licensed audiologists. 

### Subtitle 4

#### Section 2-401

(a) Except as otherwise provided in this title, a person may not practice, attempt to practice, or offer to practice audiology, hearing aid dispensing, or speech-language pathology, or assist in the practice of speech-language pathology or audiology in this State unless licensed by the Board to practice audiology, hearing aid dispensing, or speech-language pathology, or assist in the practice of speech-language pathology or audiology.

(b) A person may not use or attempt to use a license or a limited license that has been purchased, fraudulently obtained, counterfeited, or materially altered.

#### Section 2-402

(a) Unless authorized to practice audiology under this title or unless otherwise provided for in this article, a person may not represent to the public by title, by description of services, methods, or procedures, or otherwise that the person:

  (1) Is authorized to practice audiology in this State; or

  (2) Evaluates, examines, directs, instructs, or counsels individuals suffering from disorders or conditions that affect hearing and balance or assists those individuals in the perception of sound.

(b) Unless authorized to practice audiology under this title or unless otherwise provided for in this article, a person may not use, with the intent to represent that the person practices audiology, words or terms, including:

  (1) "Audiological";

  (2) "Audiologist";

  (3) "Audiology";

  (4) "Aural rehabilitation";

  (5) "Hearing clinic";

  (6) "Hearing clinician";

  (7) "Hearing rehabilitation"; or

  (8) "Hearing specialist".

(c) While performing the duties of that employment, an individual employed by any agency of the federal government may use any of the titles listed in subsection (b) of this section.

#### Section 2-402.1

Unless authorized under this title to practice hearing aid dispensing or unless otherwise provided for in this article, a person may not represent to the public, by use of a title, including "licensed hearing aid dispenser", by description of services, methods, or procedures, or otherwise, that the person is authorized to practice hearing aid dispensing in the State.

#### Section 2-402.2

(a) Subject to subsection (d) of this section, unless authorized to practice speech-language pathology under this title or unless otherwise provided for under this article, a person may not represent to the public by title, by description of services, methods, or procedures, or otherwise that the person:

  (1) Is authorized to practice speech-language pathology in this State; or

  (2) Evaluates, examines, instructs, or counsels individuals suffering from disorders or conditions that affect speech, language, communication, and swallowing.

(b) Subject to subsection (d) of this section, unless authorized to practice speech-language pathology under this title or unless otherwise provided for under this article, a person may not use any word or term connoting professional proficiency in speech-language pathology, including but not limited to:

  (1) "Communication disorders";

  (2) "Communicologist";

  (3) "Dysphagist";

  (4) "Language pathologist";

  (5) "Logopedist";

  (6) "Speech and language clinician";

  (7) "Speech and language therapist";

  (8) "Speech clinic";

  (9) "Speech clinician";

  (10) "Speech correction";

  (11) "Speech correctionist";

  (12) "Speech pathology";

  (13) "Speech-language pathology";

  (14) "Speech therapist";

  (15) "Speech therapy"; or

  (16) "Swallowing therapist".

(c) While performing the duties of that employment, an individual employed by any agency of the federal government may use any of the titles listed in subsection (b) of this section.

(d)

  (1) Except as provided in paragraph (2) of this subsection, an individual licensed under Subtitle 4A of this title to engage in the practice of music therapy may not represent to the public that the individual is authorized to treat a communication disorder.

  (2) This section may not be construed to prohibit an individual licensed under Subtitle 4A of this title to engage in the practice of music therapy from representing to the public that the individual may work with a client who has a communication disorder and address communication skills.

#### Section 2-402.3

(a) Unless authorized to practice as a speech-language pathology assistant under this title or unless otherwise provided for under this article, a person may not represent to the public, by title, description of services, methods, or procedures, or otherwise, that the person:

  (1) Is authorized to practice as a speech-language pathology assistant in the State; or

  (2) Assists in the practice of speech-language pathology.

(b) Unless authorized to practice as a speech-language pathology assistant under this title or unless otherwise provided for under this article, a person may not use any word or term connoting professional proficiency  in assisting the practice of speech-language pathology, including:

  (1) "Communication assistant";

  (2) "Speech assistant";

  (3) "Speech-language assistant";

  (4) "Speech-language teacher"; or

  (5) "Speech teacher".

#### Section 2-402.4

(a) Unless authorized to practice as an audiology assistant under this title or unless otherwise provided for under this article, a person may not represent to the public, by title, description of services, methods, or procedures, or otherwise, that the person:

  (1) Is authorized to practice as an audiology assistant in the State; or

  (2) Assists in the practice of audiology.

(b) Unless authorized to practice as an audiology assistant under this title or unless otherwise provided for under this article, a person may not use any word or term connoting professional proficiency in assisting the practice of audiology, including:

  (1) "Audiology assistant";

  (2) "Audiologist assistant";

  (3) "Audiometry assistant";

  (4) "Audiometrist assistant";

  (5) "Audiological assistant";

  (6) "Hearing aid technician"; or

  (7) "Cochlear implant technician".

#### Section 2-403

A person may not knowingly make a false, material statement in an application for a license or a limited license or for renewal of a license or a limited license.

#### Section 2-404

A person may not materially alter a license or a limited license with fraudulent intent.

#### Section 2-405

A person may not transfer or offer to transfer a license or a limited license for consideration.

#### Section 2-406

While providing hearing aid services as an audiologist, an audiology assistant, or a hearing aid dispenser, a person may not:

(1) Engage in an unfair or deceptive trade practice, as defined in Sec. 13-301 of the Commercial Law Article; or

(2) Violate any provision of Title 14, Subtitle 25 of the Commercial Law Article.

#### Section 2-408

A person who violates any provision of this title is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 3 years or both.

### Subtitle 4A. Music Therapists

#### Section 2-4A-01

(a) In this subtitle the following words have the meanings indicated.

(b) "Board certified music therapist" means an individual who:

  (1) Has completed the education and clinical training requirements established by the American Music Therapy Association; and

  (2) Holds current board certification from the Certification Board for Music Therapists.

(c) "Individualized music therapy treatment plan" means a music therapy treatment plan for a client that identifies the goals, objectives, and potential strategies for the music therapy services appropriate for the client using music therapy interventions, including:

  (1) Music improvisation;

  (2) Receptive music listening;

  (3) Songwriting;

  (4) Lyric discussion;

  (5) Music and imagery;

  (6) Music performance;

  (7) Learning through music; and

  (8) Movement to music.

(d)

  (1) "License" means a license issued by the Board to engage in the practice of music therapy.

  (2) "License" includes, unless the context requires otherwise, a limited license.

(e) "Licensed professional music therapist" or "licensee" means an individual who is licensed by the Board to engage in the practice of music therapy.

(f) "Limited license" means a license issued by the Board to practice music therapy as limited by Sec. 2-4A-11.1 of this subtitle.

(g)

  (1) "Practice of music therapy" means the clinical and evidence-based use of music therapy interventions to accomplish individualized goals for individuals of all ages and ability levels within a therapeutic relationship.

  (2) "Practice of music therapy" includes:

    (i) Accepting referrals for music therapy services from:

      (1) Medical, developmental, mental health, or education professionals;

      (2) Family members;

      (3) Clients;

      (4) Caregivers; or

      (5) Others involved with the provision of and authorized to provide client services;

    (ii) Collaborating with a client's treatment team to review the client's diagnosis, treatment needs, and treatment plan before providing music therapy services to a client for an identified clinical or developmental need;

    (iii) Collaborating with a client's treatment team during the provision of music therapy services to the client, including collaborating with and discussing the music therapy treatment plan with the audiologist or speech-language pathologist of a client with a communication disorder so that a music therapist may work with the client and address communication skills;

    (iv) Conducting a music therapy assessment of a client to collect systematic, comprehensive, and accurate information necessary to determine the appropriate type of music therapy services to provide for the client;

    (v) Developing an individualized music therapy treatment plan for a client that is based on the music therapy assessment;

    (vi) Implementing an individualized music therapy treatment plan that:

      (1) Is consistent with any other developmental, rehabilitative, habilitative, medical, mental health, preventive, or wellness care or educational services being provided to a client; and

      (2) Does not replace the services provided by an audiologist or a speech-language pathologist;

    (vii) Evaluating a client's response to music therapy and the individualized music therapy treatment plan, documenting change and progress, and suggesting modifications, as appropriate;

    (viii) Developing a plan for determining when the provision of music therapy services is no longer needed in collaboration with a client, the client's physician or another provider of health care or education for the client, an appropriate member of the client's family, and any other appropriate individual on whom the client relies for support;

    (ix) Minimizing any barriers to ensure that a client receives music therapy services in the least restrictive environment;

    (x) Collaborating with and educating a client, the family or caregiver of the client, or any other appropriate individual about the needs of the client that are being addressed in music therapy and the manner in which the music therapy addresses those needs; and

    (xi) Using appropriate knowledge and skills, including research, reasoning, and problem-solving skills, to inform practice and determine appropriate actions in the context of each specific clinical setting.

  (3) "Practice of music therapy" does not include the screening, diagnosis, or assessment of any physical, mental, or communication disorder.

#### Section 2-4A-02

This subtitle does not prohibit or restrict the practice, services, or activities of:

(1) An individual licensed, certified, or regulated under the laws of the State in another profession or occupation or personnel supervised by a licensed professional in the State performing work including the use of music incidental to the practice of the individual's licensed, certified, or regulated profession or occupation, if the individual does not represent that the individual is a licensed music therapist;

(2) Any individual whose training and national certification attest to the individual's preparation and ability to practice the certified profession or occupation of the individual, if the individual does not represent that the individual is a licensed music therapist;

(3) Any practice of music therapy as an integral part of a program of study for students enrolled in an accredited music therapy program, if the student does not represent that the student is a licensed music therapist; or

(4) Any individual who engages in the practice of music therapy under the supervision of a licensed music therapist, if the individual does not represent that the individual is a licensed music therapist.

#### Section 2-4A-03

The Board:

(1) Shall adopt regulations for the licensure and practice of music therapy;

(2) Shall adopt a code of ethics for the practice of music therapy; and

(3) May facilitate the statewide dissemination of music therapy information to music therapists, the American Music Therapy Association or any successor organization, and the Certification Board for Music Therapists or any successor organization.

#### Section 2-4A-04

(a)

  (1) The Board shall set reasonable fees for the issuance and renewal of licenses and the other services the Board provides to music therapists.

  (2) The fees charged shall be set so as to produce funds to approximate the cost of maintaining the licensure program and the other services provided to music therapists.

(b)

  (1) The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller.

  (2) The Comptroller shall distribute all fees to the Board.

(c) The fees shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board under this subtitle.

#### Section 2-4A-05

Except as otherwise provided in this subtitle, beginning January 1, 2022, an individual shall be licensed by the Board before the individual may engage in the practice of music therapy in the State.

#### Section 2-4A-06

(a) To qualify for a license, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant shall:

  (1) Be of good moral character; and

  (2) Be at least 18 years old.

(c) The applicant shall:

  (1)

    (i) Be a board certified music therapist; and

    (ii) Provide proof:

      (1)

        (A) Of passing the examination for board certification offered by the Certification Board for Music Therapists or any successor organization; or

      (B) Of being transitioned into board certification; and

      (2) That the applicant is currently a board certified music therapist;

  (2) Hold a bachelor's degree or higher in music therapy, or its equivalent, including clinical training, from an educational program that is:

    (i) Approved by the American Music Therapy Association or any successor organization; and

    (ii) Within an accredited college or university;

  (3) Be in good standing based on a review of the applicant's music therapy licensure, certification, or registration history in other jurisdictions, including a review of any disciplinary actions in the practice of music therapy; and

  (4) Meet any other requirements established by the Board.

#### Section 2-4A-07

To apply for a license, an applicant shall:

(1) Submit an application to the Board on the form that the Board requires;

(2) Pay to the Board the application fee set by the Board; and

(3) Submit to a criminal history records check in accordance with Sec. 2-303.1 of this title.

#### Section 2-4A-08

(a) The Board shall issue a license to any applicant who:

  (1) Meets the requirements of this subtitle; or

  (2)

    (i) Meets the requirements of Sec. 2-4A-07 of this subtitle; and

    (ii) Provides evidence satisfactory to the Board that the applicant is licensed and in good standing as a music therapist in another jurisdiction where the qualifications required are equal to or greater than those required in this subtitle.

(b) The Board shall include on each license that the Board issues:

  (1) The full name of the licensed music therapist;

  (2) The dates of issuance and expiration; and

  (3) A license number.

(c)

  (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with Sec. 2-303.1 of this title, in determining whether to grant a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The circumstances surrounding the crime;

    (iii) The length of time that has passed since the crime;

    (iv) Subsequent work history;

    (v) Employment and character references; and

    (vi) Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

  (2) The Board may not issue a license if the criminal history record information required under Sec. 2-303.1 of this title has not been received.

#### Section 2-4A-09

A music therapist license authorizes the licensee to engage in the practice of music therapy while the license is effective.

#### Section 2-4A-10

(a)

  (1) A license expires on a date set by the Board unless the license is renewed for an additional term as provided in this section.

  (2) A license may not be renewed for a term longer than 2 years.

(b) At least 1 month before a license expires, the Board shall send to the licensee, by first-class mail or e-mail to the last known address of the licensee, a renewal notice that states:

  (1) The date on which the current license expires;

  (2) The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and

  (3) The amount of the renewal fee.

(c) Before a license expires, the licensee periodically may renew the license for an additional term if the licensee:

  (1) Otherwise is entitled to be licensed;

  (2) Pays to the Board a renewal fee set by the Board; and

  (3) Submits to the Board:

    (i) A renewal application on the form that the Board requires; and

    (ii) Satisfactory evidence of compliance with any continuing education requirements established by the Board under subsection (d) of this section.

(d)

  (1) The Board shall establish continuing education requirements as a condition of the renewal of licenses under this section.

  (2) The continuing education requirements shall include proof of completion of at least 40 hours of continuing education in a program approved by the Certification Board of Music Therapists or any successor organization.

(e) The Board shall renew the license of each licensee who meets the requirements of this section.

#### Section 2-4A-11

(a)

  (1) The Board shall place a licensee on inactive status if the licensee submits to the Board:

    (i) An application for inactive status on the form that the Board requires; and

    (ii) The inactive status fee set by the Board.

  (2)

    (i) The Board shall license an individual on inactive status who applies for a license if the individual:

      (1) Meets the renewal requirements of Sec. 2-4A-10 of this subtitle; and

      (2) Meets any continuing education requirements established by the Board.

    (ii) The Board may not require payment of a late fee by an individual as a condition to licensing under this paragraph.

(b) The Board shall reinstate the license of an individual who has not been put on inactive status and who has failed to renew the license for any reason if the individual:

  (1) Meets the renewal requirements of Sec. 2-4A-10 of this subtitle;

  (2) Pays to the Board a reinstatement fee set by the Board; and

  (3) Applies to the Board for reinstatement of the license within 5 years after the license expires.

(c)

  (1) The Board may not reinstate the license of an individual who fails to apply for reinstatement of the license within 5 years after the license expires.

  (2) Notwithstanding paragraph (1) of this subsection, an individual may become licensed by meeting the requirements of Sec. 2-4A-06 of this subtitle for obtaining a new license.

#### Section 2-4A-11.1

(a) Subject to the provisions of this section, the Board shall issue a limited license to practice music therapy to an applicant who:

  (1) Except for the examination, meets the license requirements under Sec. 2-4A-06 of this subtitle;

  (2) Demonstrates to the satisfaction of the Board that for the term of the limited license the applicant will practice music therapy only under the supervision of an individual described under subsection (b)(2) of this section;

  (3) Submits an application to the Board on the form that the Board requires; and

  (4) Pays the Board the application fee set by the Board.

(b)

  (1) The purpose of a limited license is to permit an individual to practice music therapy while completing the licensing requirements of this subtitle.

  (2) While it is effective, a limited license authorizes the licensee to practice music therapy under the supervision of a fully licensed music therapist.

(c) A limited license expires on the first anniversary of its effective date.

(d) The Board may renew the limited license once for an additional 1-year term, if the holder:

  (1) Otherwise meets the requirements of this section;

  (2) Submits a renewal application to the Board on the form that the Board requires; and

  (3) Pays to the Board a limited license renewal fee set by the Board.

(e) If the holder of a limited license fails to receive a full license within 2 years after the initial limited license was issued, the individual shall wait a minimum of 1 year before applying for another limited license.

#### Section 2-4A-12

(a) A licensee shall notify the Board in writing of a change in name or address within 60 days after the change occurs.

(b) A licensee who fails to comply with subsection (a) of this section is subject to an administrative penalty of $100.

(c) The Board shall pay any penalty collected under this section to the General Fund of the State.

#### Section 2-4A-13

Unless the Board accepts the surrender of a license, the license may not lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee. 

#### Section 2-4A-14

Subject to the hearing provisions of Sec. 2-4A-16 of this subtitle, the Board, on the affirmative vote of a majority of its members then serving, may deny a license to an applicant, reprimand a licensee, place a licensee on probation, or suspend or revoke the license of a licensee if the applicant or licensee:

(1) Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or licensee or for another;

(2) Fraudulently or deceptively uses a license;

(3) Is convicted of or pleads guilty or nolo contendere to a felony or a crime involving moral turpitude, whether or not an appeal or other proceeding is pending to have the conviction or plea set aside;

(4) Aids or abets an unauthorized person in practicing music therapy or self-representing as a music therapist;

(5) Practices music therapy fraudulently or deceitfully;

(6) Violates the code of ethics adopted by the Board under Sec. 2-4A-03(2) of this subtitle;

(7) Willfully fails to file or record any report as required under law, willfully impedes or obstructs the filing or recording of a report, or induces another to fail to file or record a report;

(8) Submits a false statement to collect a fee;

(9) Willfully makes or files a false report or record in the practice of music therapy;

(10) Is disciplined by a licensing or disciplinary authority of any state or country, convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the United States Department of Veterans Affairs for an act that would be grounds for disciplinary action under this section;

(11) Violates any provision of this subtitle or any regulation adopted by the Board;

(12) Uses or promotes or causes the use or promotion of any misleading, deceiving, or untruthful advertising matter, promotional literature, or testimonial;

(13) Is professionally, physically, or mentally incompetent;

(14) Promotes the sale of devices, appliances, or goods to a patient so as to exploit the patient for financial gain;

(15) Behaves immorally in the practice of music therapy;

(16) Commits an act of unprofessional conduct in the practice of music therapy;

(17) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;

(18) Fails to cooperate with a lawful investigation conducted by the Board;

(19) Commits an act that is inconsistent with generally accepted professional standards in the practice of music therapy;

(20) Fails to submit to a criminal history records check in accordance with Sec. 2-303.1 of this title;

(21) Habitually is intoxicated;

(22) Provides professional services while under the influence of alcohol or while using any narcotic or controlled dangerous substance, as defined in Sec. 5-101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication;

(23) Knowingly fails to report suspected child abuse in violation of Sec. 5-704 of the Family Law Article;

(24) In the practice of music therapy:

  (i) Falsely represents the use or availability of services or advice of a physician; or

  (ii) Misrepresents the applicant, licensee, or holder by using the word "doctor" or any similar word, abbreviation, or symbol if the use is not accurate; or

(25) Practices music therapy with an unauthorized person or supervises or aids an unauthorized person in the practice of music therapy.

#### Section 2-4A-15

(a) If, after a hearing under Sec. 2-4A-16 of this subtitle, the Board finds that there are grounds under Sec. 2-4A-14 of this subtitle to suspend or revoke a license or to reprimand a licensee, the Board may impose a monetary penalty not exceeding $5,000:

  (1) Instead of suspending the license; or

  (2) In addition to suspending or revoking the license.

(b) The Board shall adopt regulations to set standards for the imposition of monetary penalties under this section.

(c) The Board shall pay any penalty collected under this section into the General Fund of the State.

#### Section 2-4A-16

(a) Except as otherwise provided in the Administrative Procedure Act, before the Board takes any action under Sec. 2-4A-14 of this subtitle, it shall give the individual against whom the action is contemplated an opportunity for a hearing before the Board.

(b) The Board shall give notice and hold the hearing in accordance with the Administrative Procedure Act.

(c) The individual may be represented at the hearing by counsel.

(d)

  (1) Over the signature of an officer or the administrator of the Board, the Board may issue subpoenas and administer oaths in connection with any investigation under this subtitle and any hearings or proceedings before the Board.

  (2) The Board shall issue subpoenas on behalf of the individual if the individual:

    (i) Requests that the Board do so; and

    (ii) States under oath that the testimony or evidence sought is necessary to the individual's defense.

  (3) If, without lawful excuse, an individual disobeys a subpoena from the Board or an order by the Board to take an oath, testify, or answer a question, a court of competent jurisdiction may compel, on petition of the Board, compliance with the subpoena.

(e) If, after due notice, the individual against whom the action is contemplated fails or refuses to appear, the Board nevertheless may hear and determine the matter.

(f) The hearing of charges may not be stayed or challenged by any procedural defect alleged to have occurred before the filing of charges.

#### Section 2-4A-17

(a) Except as provided in this section for an action under Sec. 2-4A-14 of this subtitle, a person aggrieved by a final decision of the Board in a contested case, as defined in the Administrative Procedure Act, may petition for judicial review as allowed by the Administrative Procedure Act.

(b) A person aggrieved by a final decision of the Board under Sec. 2-4A-14 of this subtitle may not appeal to the Secretary but may take a direct judicial appeal as provided by the Administrative Procedure Act.

(c) A decision of the Board to deny a license, enforce a suspension of a license for more than 1 year, or revoke a license may not be stayed pending judicial review.

#### Section 2-4A-18

For reasons the Board considers sufficient, and on the affirmative vote of a majority of its members then serving, the Board may:

(1) Reinstate a license that has been revoked;

(2) Reduce the period of a suspension; or

(3) Withdraw a reprimand.

#### Section 2-4A-19

The Board may issue a cease and desist order for a violation of this subtitle.

#### Section 2-4A-20

(a) An action may be maintained in the name of the State or the Board to enjoin:

  (1) The unauthorized practice of music therapy; or

  (2) Conduct that is a ground for disciplinary action under Sec. 2-4A-14 of this subtitle.

(b) An action under this section may be brought by:

  (1) The Board, in its own name;

  (2) The Attorney General, in the name of the State; or

  (3) A State's Attorney, in the name of the State.

(c) An action under this section shall be brought in the county where the defendant:

  (1) Resides; or

  (2) Engages in the acts sought to be enjoined.

(d) Proof of actual damage or that any person will sustain any damage if an injunction is not granted is not required for an action under this section.

(e) An action under this section is in addition to and not instead of criminal prosecution for the unauthorized practice of music therapy under Sec. 2-4A-22 of this subtitle or disciplinary action under Sec. 2-4A-14 of this subtitle.

#### Section 2-4A-21

(a) In this section, "music therapist rehabilitation committee" means a committee of the Board that:

  (1) Is recognized by the Board;

  (2) Includes music therapists; and

  (3) Evaluates and provides assistance to any music therapist in need of treatment and rehabilitation for alcoholism, drug abuse, chemical dependency, or other physical, emotional, or mental condition.

(b) The music therapist rehabilitation committee may function:

  (1) Solely for the Board; or

  (2) Jointly with a rehabilitation committee representing another board or boards.

(c)

  (1) Except as otherwise provided in this subsection, the proceedings, records, and files of the music therapist rehabilitation committee are not discoverable and are not admissible in evidence in any civil action arising out of the matters that are being or have been reviewed and evaluated by the music therapist rehabilitation committee.

  (2) Paragraph (1) of this subsection does not apply to any record or document that is considered by the music therapist rehabilitation committee and that otherwise would be subject to discovery or introduction into evidence in a civil action.

  (3) For purposes of this subsection, civil action does not include a proceeding before the Board or judicial review of a proceeding before the Board.

(d) An individual who acts in good faith and within the scope of jurisdiction of the music therapist rehabilitation committee is not civilly liable for any action as a member of the music therapist rehabilitation committee or for giving information to, participating in, or contributing to the function of the music therapist rehabilitation committee.

#### Section 2-4A-22

(a) Except as otherwise provided in this subtitle, an individual may not practice, attempt to practice, or offer to practice music therapy in the State unless licensed by the Board.

(b) Each violation of this section is a separate offense.

#### Section 2-4A-23

Unless authorized to practice music therapy under this subtitle, an individual may not:

(1) Represent to the public that the individual is a licensed music therapist; or

(2) Use any title, abbreviation, sign, card, or other representation that the individual is a licensed music therapist.

#### Section 2-4A-24

An individual who violates any provision of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 1 year or both.

#### Section 2-4A-25

This subtitle may be cited as the Maryland Music Therapists Act.

### Subtitle 5

#### Section 2-501

This title may be cited as the "Maryland Audiology, Hearing Aid Dispensing, Speech-Language Pathology, and Music Therapy Act". 

#### Section 2-502

Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act, this title and all rules and regulations adopted under this title shall terminate and be of no effect after July 1, 2031.

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Md. Code Ann., Health Occ. (as displayed at mgaleg.maryland.gov, October 16, 2026)