Colorado § 12-305-111.5 - Direction and supervision of speech-language pathology assistants by speech-language pathologists - definitions.

§ 12-305-111.5. Direction and supervision of speech-language pathology assistants by speech-language pathologists - definitions.

(1) As used in this section, unless the context otherwise requires:

(a) "Direct supervision" means in-view observation and guidance by a supervising speech-language pathologist while the speech-language pathology assistant is performing a clinical activity. "Direct supervision" may include the supervising speech-language pathologist communicating with the speech-language pathology assistant via telecommunication technology during the speech-language pathology assistant's provision of clinical services.

(b) "Indirect supervision" means supervision during which a speech-language pathologist is not required to be physically present or available via telecommunication technology while the speech-language pathology assistant is providing services. "Indirect supervision" may include:

(I) Reviewing demonstration videos;

(II) Reviewing patient files;

(III) Reviewing and evaluating audio or video recorded sessions; or

(IV) Conducting supervisory conferences either in person or via telephone or in live, secure virtual meetings.

(2) A speech-language pathology assistant shall practice speech-language pathology only under the direction and supervision of a speech-language pathologist.

(3) A supervising speech-language pathologist is responsible for the direction and supervision of a speech-language pathology assistant's practice of speech-language pathology. The level of supervision must be based on the needs, competencies, skills, expectations, philosophies, and experience of the speech-language pathology assistant and the supervisor; the needs of the patient served; the service setting; the tasks assigned; and any other relevant factors. The supervising speech-language pathologist is responsible for designing and implementing a written supervisory plan to outline the practices of the supervising speech-language pathologist and to document progress. A supervisor shall not assign tasks to a speech-language pathology assistant that are beyond the level of competence of the speech-language pathology assistant or that are beyond the scope of a speech-language pathology assistant's practice. The care of the patient remains the supervising speech-language pathologist's responsibility.

(4) A supervising speech-language pathologist shall determine the appropriate number of speech-language pathology assistants whose practice may be supervised, with a number for supervision of no more than three speech-language pathology assistants per speech-language pathologist. The factors to consider in determining supervision ratios include caseload characteristics, the speech-language pathology assistant's experience, and the speech-language pathologist's experience and workload.

(5) Before a speech-language pathology assistant begins to provide independent support to a patient, the supervising speech-language pathologist shall initiate first contact with the patient and prepare a plan of care for the patient. After the establishment of the supervisory relationship, minimum ongoing supervision must include documentation of direct supervision provided by the supervisor for each patient at least every thirty to sixty days, depending on the frequency of the sessions and setting, and the supervisor shall review patient data. The supervisor shall adjust the amount of supervision based on the speech-language pathology assistant's competencies and skill level in treating patients who have a variety of communication disorders. The supervising speech-language pathologist shall accurately document and regularly record all supervisory activities, for both direct and indirect supervision. For medically fragile patients who are acutely ill and in an unstable health condition, the supervisor shall provide one hundred percent direct supervision of the speech-language pathology assistant, which may be through synchronous or live telesupervision.

(6) A supervisor shall provide feedback regarding the quality of a speech-language pathology assistant's performance of assigned tasks. Information obtained during direct supervision may include data relative to the reliability between the speech-language pathology assistant and the supervisor on correct or incorrect recording of target behavior, accuracy in implementing assigned treatment procedures and in recording data, and the ability to interact effectively with the patient during the presentation and implementation of assigned procedures and activities.

(7) A speech-language pathology assistant shall not perform tasks when a supervisor cannot be reached by personal contact, via phone, or by other immediate electronic means. If for some reason a supervisor becomes unable to continue supervision, the speech-language pathology assistant shall not perform speech-language pathology tasks until another qualified supervisor is available to supervise.

Source: L. 2025: Entire section added, (HB 25-1075), ch. 163, p. 660, § 6, effective August 6.