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NEW JERSEY REGISTER
VOLUME 36, NUMBER 9
MONDAY, MAY 3, 2004
RULE PROPOSAL

LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY ADVISORY COMMITTEE
FIBER OPTIC ENDOSCOPIC EXAMINATION OF SWALLOWING (FEES)


Proposed New Rule: N.J.A.C. 13:44C-7.2A

Authorized By: Reni Erdos, Director, Division of Consumer Affairs.

Authority: N.J.S.A. 45:3B-24.
Calendar Reference: See Summary below for explanation of exception to calendar requirement.
Proposal Number: PRN 2004-165.

Submit written comments by July 2, 2004 to:

Renee Clark, Executive Director

Audiology and Speech-Language Pathology Advisory Committee

Division of Consumer Affairs

124 Halsey Street

PO Box 45002

Newark, NJ 07101

The agency proposal follows:

Summary

Pursuant to the rulemaking authority in N.J.S.A. 45:3-24, the Director of the Division of Consumer Affairs (the "Director") proposes new rule N.J.A.C. 13:44C-7.2A in order to allow licensed speech-language pathologists to perform Fiber Optic Endoscopic Examinations of Swallowing (FEES).

The New Jersey Speech-Language-Hearing Association has in the past requested that the Director allow licensed speech-language pathologists to perform FEES. The Director consulted with the Board of Medical Examiners to discuss this issue and it was determined that speech-language pathologists with proper training could perform FEES as long as a physician with training in the procedure was present. Based upon this determination, the Director proposes this new rule to permit speech-language pathologists to perform FEES.

Subsection (a) of the proposed new rule states that N.J.A.C. 13:44C-7.2A sets forth standards for the performance of FEES. The subsection also states that performing FEES is within the scope of practice of a licensed speech- language pathologist who meets the requirements of N.J.A.C. 13:44C-7.2A.

Subsection (b) sets forth the definition of "FEES." Subsection (c) restricts the performance of FEES to licensed speech-language pathologists who are certified in Basic Life Support and who have completed a 12-hour seminar in fiber optic endoscopy as a technique for investigating swallowing. The seminar must qualify for American Speech-Language-Hearing Association (ASHA) continuing education credit and shall include instruction in medical contraindications, possible adverse reactions to FEES, recognizing patient distress and appropriate actions to take if complications are encountered. The licensed speech-language pathologist is also required to observe 10 FEES procedures and perform 25 FEES procedures under the supervision of a speech pathologist who has met the requirements of the proposed new rule or a physician.

Subsection (d) limits the settings in which a licensed speech-language pathologist may perform FEES. Licensed speech-language pathologists may only perform the procedure in a healthcare facility licensed by the Department of Health and Senior Services or in the office of a physician who received training during residency in endoscopic examination.

Subsection (e) requires that FEES only be performed when a physician who received training in the procedure is present.

Subsection (f) requires that FEES be performed only upon the written request of a physician.

The Director has determined that the comment period for this proposal shall be 60 days; therefore, pursuant to N.J.A.C. 1:30-3.3(a)5, this proposal is excepted from the rulemaking calendar requirement.

Social Impact

The Director believes that the proposed new rule will have a positive impact upon patients and licensees. The new rule will allow licensed speech-language pathologists to perform FEES when they have the appropriate training and when a physician is present to provide care in case of an emergency. The rule provides protections for patients who undergo swallowing tests from licensees who have been trained to perform these tests.

Economic Impact

The Director does not believe that the proposed new rule will have an economic impact on the public. The proposed new rule may have an impact on licensees in that they will need to obtain specific training in order to perform FEES.

Federal Standards Statement

A Federal standards analysis is not required because there are no Federal standards or requirements applicable to the proposed new rule.

Jobs Impact

The Director does not believe that the proposed new rule will result in an increase or decrease of jobs in this State.

Agriculture Industry Impact

The Director does not believe that the proposed new rule will have any impact on the agriculture industry of this State.

Regulatory Flexibility Analysis

If, for the purposes of the Regulatory Flexibility Act, N.J.S.A. 52:14B-16 et seq., the approximately 4,400 licensed speech-language pathologists are deemed "small businesses," then the following analysis applies.

The Act requires the Director to set forth the reporting, recordkeeping and other compliance requirements of the proposed new rule including the kinds of professional services likely to be needed to comply with the requirements.

The costs imposed on small businesses by the proposed new rule are the same costs that are imposed on all businesses as outlined in the Economic Impact above.

The Director does not believe that licensees will need to employ any professional services to comply with the requirements of the proposed new rule.

The proposed new rule imposes compliance requirements but does not impose any recordkeeping or reporting requirements upon licensees. The proposed new rule requires that licensed speech-language pathologists who wish to perform FEES obtain specific training, observe 10 FEES procedures and perform 25 FEES procedures under the supervision of a speech-language pathologist who has met the requirements of the proposed new rule or a physician. The proposed new rule also requires that licensed speech-language pathologists only perform FEES in a healthcare facility licensed by the Department of Health and Senior Services or in the office of a physician who received training during residency in endoscopic examination. FEES can only be performed when a physician is present and upon the written request of a physician.

The Director believes that since the proposed new rule establishes a procedure within the scope of practice of licensed speech-language pathologists and protects the health, safety and welfare of patients, the rule should be applied uniformly to all licensees regardless of the size of the business.

Smart Growth Impact

The proposed new rule shall have no impact on the achievement of smart growth or the implementation of the State Development and Redevelopment Plan.

Full text of the proposed new rule follows:

<< NJ ADC 13:44C-7.2A >>

13:44C-7.2A Scope of practice: Fiber Optic Endoscopic Examination of Swallowing (FEES)

(a) The purpose of this section is to set forth standards for the performance of Fiber Optic Endoscopic Examination of Swallowing (FEES) by a licensed speech-language pathologist. FEES is within the scope of practice of a speech- language pathologist who meets the requirements of this section.

(b) The following words and terms, when used in this section, shall have the following meaning, unless the context clearly indicates otherwise:

"FEES" means a fiber optic endoscopic examination of swallowing.

(c) FEES shall only be performed by a licensed speech-language pathologist who is certified in Basic Life Support (BLS) and who has:

1. Completed a 12-hour seminar or workshop in fiber optic endoscopy as a technique for investigating swallowing which qualifies for American Speech- Language-Hearing Association (ASHA) continuing education credit and which includes instruction in:

i. Medical contraindications and possible adverse reactions to FEES, including the use of topical anesthesia to the nares; and

ii. Recognizing patient distress and appropriate actions to take if complications are encountered;

2. Observed 10 FEES procedures performed by either a speech pathologist who has met the requirements of this section or a physician, at a licensed healthcare facility that requires that healthcare professionals have privileges to perform the FEES procedure; and

3. Performed 25 FEES procedures under the supervision of a speech-language pathologist who has met the requirements of this section or a physician, at a licensed healthcare facility that requires a healthcare professional have privileges to perform the FEES procedure.

(d) A licensed speech-language pathologist shall only perform FEES in a healthcare facility licensed by the Department of Health and Senior Services or in the office of a physician who received training during residency in endoscopic examination.

(e) FEES shall only be performed when a physician who received training during residency in endoscopic examination is present.

(f) FEES shall only be performed upon the written request of a physician.

 

  

  

  

  

  

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