California Licensed Speech-Language Pathologist SLP Bus. & Prof. Code § 2530 Attorney Fee Petition Mechanics: Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board License Verification at speechandhearing.ca.gov as Primary Welch Anchor (THE ONLY § 2530 SLP Page — DISTINCT FROM Audiologist § 2533.1, SLPA § 2536.1, and LCSW § 4996; ASHA Code of Ethics Advisory [PURE KETCHUM]; ASHA Scope of Practice in Speech-Language Pathology Advisory [PURE KETCHUM]; TWO PRIVATE STANDARDS ON ONE PAGE), CCP § 1021.5 Private Attorney General Mandatory Attorney Fees

Statutory Framework: Bus. & Prof. Code § 2530 and SLPAHADB SLP License — Scope of Practice, Unlicensed Practice Prohibition, ASHA Code of Ethics Advisory [PURE KETCHUM], ASHA Scope of Practice in SLP Advisory [PURE KETCHUM], and CCP § 1021.5 Mandatory Attorney Fees

California Bus. & Prof. Code § 2530 — within the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Act — requires that any person who practices speech-language pathology in California hold a valid SLP license issued by the Speech-Language Pathology and Audiology and Hearing Aid Dispensers Board (SLPAHADB). The Act defines the scope of speech-language pathology to encompass: evaluation and treatment of speech sound disorders including articulation disorders, phonological disorders, childhood apraxia of speech, and dysarthria; evaluation and treatment of language disorders including developmental language disorders, aphasia, right hemisphere communication disorders, and traumatic brain injury communication deficits; evaluation and treatment of swallowing disorders (dysphagia) in pediatric and adult populations including clinical swallowing evaluations, modified barium swallow (MBS) studies, fiberoptic endoscopic evaluation of swallowing (FEES), and dysphagia treatment; evaluation and treatment of voice and resonance disorders including vocal nodules, vocal cord paralysis, laryngeal cancer post-treatment rehabilitation, and velopharyngeal insufficiency; evaluation and treatment of fluency disorders including stuttering and cluttering; augmentative and alternative communication (AAC) assessment, prescription, and treatment including high-tech speech-generating devices, low-tech AAC systems, and feature matching for persons with autism spectrum disorder, cerebral palsy, ALS, and other complex communication needs; cognitive-communication disorders including memory and attention deficits; and social communication disorders. A California SLP license requires a master’s degree in speech-language pathology from a CAA-accredited program and passage of the Praxis examination in Speech-Language Pathology (ETS).

ASHA CODE OF ETHICS ADVISORY — THE ONLY PAGE IN THE FEE-PETITION-MECHANICS SERIES WITH AN ASHA CODE OF ETHICS ADVISORY — PURE KETCHUM: The American Speech-Language-Hearing Association (ASHA, founded 1925, Rockville MD) is the national professional, scientific, and credentialing association for audiologists, speech-language pathologists, and speech-language scientists with over 228,000 members and affiliates; ASHA promulgates the ASHA Code of Ethics (2023 edition), which establishes the professional obligations for all ASHA members and certificate holders and is widely adopted as the standard of care for licensed SLPs. Key ASHA Code of Ethics provisions relevant to California SLP fee petition practice include: (1) Principle I, Rule I-R — Competence in Service Delivery: the ASHA Code of Ethics requires that SLPs provide only services for which they have the necessary education, training, and supervised experience; in the context of dysphagia services, this requires documented clinical training in clinical swallowing evaluation, modified barium swallow studies, and FEES before independently delivering dysphagia evaluation services; an unlicensed person performing dysphagia assessment has no SLP degree, no ASHA CCC-SLP certification, and no documented training record demonstrating competency in any dysphagia evaluation method; (2) Principle I, Rule I-S — Referral for Unmet Needs: the ASHA Code requires that SLPs recognize the limits of their clinical competency and refer to other professionals when client needs exceed their skill set; an unlicensed practitioner has no professional framework within which to recognize clinical limits or make appropriate medical referrals, eliminating the safety valve that prevents harm escalation; (3) Principle II, Rule II-R — Prohibition on Facilitating Unlicensed Practice: the ASHA Code prohibits any ASHA member from supervising or directing unlicensed persons performing SLP services that require state licensure; (4) Principle IV, Rule IV-R — License Maintenance: the ASHA Code requires that each SLP hold the required state license and not misrepresent credentials to clients, payers, or employers. The ASHA Code creates no statutory fee-shifting; it is a PURE KETCHUM advisory.

ASHA SCOPE OF PRACTICE IN SPEECH-LANGUAGE PATHOLOGY ADVISORY — THE ONLY PAGE IN THE FEE-PETITION-MECHANICS SERIES WITH AN ASHA SCOPE OF PRACTICE IN SPEECH-LANGUAGE PATHOLOGY ADVISORY — PURE KETCHUM: The ASHA Scope of Practice in Speech-Language Pathology (2016 edition) is a private clinical policy document promulgated by ASHA that defines the full breadth of clinical services constituting the SLP scope of practice and the professional prerequisites for delivering services in each domain. Key ASHA Scope of Practice provisions relevant to California SLP fee petition practice include: (1) Swallowing and Swallowing Disorders Domain: the ASHA Scope of Practice establishes that dysphagia evaluation and treatment — including clinical swallowing evaluation (CSE), modified barium swallow (MBS), FEES, and all dysphagia treatment strategies — falls squarely within the SLP scope and requires a licensed SLP with documented competency in dysphagia assessment methods; the Scope of Practice explicitly states that dysphagia services require clinical training in both the anatomy and physiology of swallowing and the instrumented and non-instrumented assessment methods used to evaluate swallowing function; performing dysphagia assessment without this training creates the well-documented risk of misidentifying aspiration risk and issuing inappropriate diet texture recommendations that put the patient at risk for aspiration pneumonia; (2) Augmentative and Alternative Communication Domain: the ASHA Scope of Practice establishes that AAC evaluation, feature matching, device prescription, and implementation training falls within the SLP scope and requires a licensed SLP with documented competency in AAC assessment methods including the ASHA Functional Assessment of Communication Skills, the Communication Matrix, and the AAC feature matching process for high-tech speech-generating devices; selecting the wrong AAC device for a nonverbal child through an unlicensed evaluation delays communication development and may require complete reassessment; (3) Supervision of Speech-Language Pathology Assistants (SLPAs): the ASHA Scope of Practice establishes that SLPAs may only perform delegated treatment tasks under the direct or indirect supervision of a licensed SLP; SLPAs may not perform evaluations, develop treatment plans, or provide services in the absence of supervising licensed SLP oversight; an SLPA performing unsupervised evaluations is not only exceeding the SLPA scope but is effectively providing unlicensed SLP services that require a § 2530 SLP license. The ASHA Scope of Practice creates no statutory fee-shifting; it is a PURE KETCHUM advisory.

Three-Track Harm: LA County Unlicensed Dysphagia Assessment Aspiration Pneumonia ($285K), Orange County Unlicensed AAC Assessment Wrong Device 18-Month Communication Regression ($195K), and San Diego County Expired SLP License 22 Months Medi-Cal Billing ($95K)

• LOS ANGELES COUNTY SKILLED NURSING FACILITY EMPLOYING UNLICENSED PERSON TO PERFORM DYSPHAGIA ASSESSMENTS — SLPAHADB LICENSE VERIFICATION AT SPEECHANDHEARING.CA.GOV CONFIRMED NO SLP LICENSE ON RECORD — ASHA CODE PRINCIPLE I-R COMPETENCE REQUIREMENT VIOLATED — CLINICAL SWALLOWING EVALUATION NOT COMPLETED — DIET TEXTURE RECOMMENDATIONS ISSUED WITHOUT DYSPHAGIA STUDY — RESIDENT ASPIRATING ON PUREE DIET — ASPIRATION PNEUMONIA — 18-DAY ACUTE HOSPITALIZATION — CRITICAL ILLNESS WITH SEPTIC SHOCK — FAMILY WRONGFUL DISCHARGE LAWSUIT — $285,000 TOTAL INCLUDING HOSPITALIZATION AND SETTLEMENT. A Los Angeles County skilled nursing facility employed an unlicensed individual holding only a bachelor’s degree in communication disorders to perform dysphagia assessments and issue diet texture recommendations for residents in the SNF memory care unit; an SLPAHADB license verification search at speechandhearing.ca.gov confirmed that the individual held no SLP license in any status and had never completed a master’s degree program in speech-language pathology or passed the Praxis SLP examination. The unlicensed individual performed a bedside “swallowing screen” on an 82-year-old resident with dementia presenting with coughing and wet-vocal quality during meals; without completing a standardized clinical swallowing evaluation protocol, a modified barium swallow study referral, or a FEES referral as required by ASHA Scope of Practice for residents presenting with dysphagia red flag signs, the unlicensed individual issued a diet texture recommendation of IDDSI Level 4 Puree and IDDSI Level 2 Mildly Thick liquids; a licensed SLP retained for the fee petition reviewed the bedside screen documentation and determined that the unlicensed individual had failed to complete any standardized CSE instrument, had not assessed laryngeal elevation, had not assessed voluntary cough strength, and had not identified the presence of a wet-gurgling vocal quality post-swallow — all of which the ASHA Scope of Practice requires before issuing a diet texture recommendation. The resident continued aspirating on the puree-texture diet due to an underlying pharyngeal dysphagia pattern that the IDDSI Level 4 recommendation did not address; the resident developed aspiration pneumonia confirmed by chest X-ray at day 7, was hospitalized for 18 days including 4 days in the intensive care unit with septic shock, and required a percutaneous endoscopic gastrostomy (PEG) tube for nutritional support during recovery. Combined acute hospitalization costs and family settlement totaled $285,000.
• ORANGE COUNTY DEVELOPMENTAL DISABILITY CENTER EMPLOYING UNLICENSED PERSON TO PERFORM AAC EVALUATIONS WITHOUT SLPAHADB SLP LICENSE — SLPAHADB CONFIRMED NO SLP LICENSE — ASHA SCOPE OF PRACTICE AAC DOMAIN VIOLATED — WRONG AAC DEVICE SELECTED FOR NONVERBAL CHILD WITH AUTISM SPECTRUM DISORDER DURING FEATURE MATCHING PROCESS — DEVICE RETURNED UNUSED AFTER 8 MONTHS — COMMUNICATION REGRESSION — 18 ADDITIONAL MONTHS OF COMMUNICATION DELAY — PRIVATE SLP AAC ASSESSMENT AND CORRECTED DEVICE PROCUREMENT REQUIRED — $195,000 COMBINED REMEDIATION AND DEVELOPMENTAL DAMAGE AWARD. An Orange County developmental disability center employed an unlicensed individual holding a registered behavior technician (RBT) credential to perform AAC evaluations and device recommendations for children with autism spectrum disorder who were nonverbal or minimally verbal; SLPAHADB license verification at speechandhearing.ca.gov confirmed that the individual held no SLP license in any status and held only an RBT credential, which does not authorize AAC evaluation or device prescription in any California setting. The unlicensed individual performed an “AAC assessment” on a 6-year-old nonverbal child with autism spectrum disorder and moderate intellectual disability using an informal language sample and brief symbol recognition activity; the unlicensed individual did not administer any standardized AAC assessment instrument (Communication Matrix, ASHA FACS, or equivalent), did not perform feature matching comparing the child’s motor, cognitive, language, and communication profile against available high-tech AAC device options, and did not conduct a trial period with multiple device options as required by the ASHA Scope of Practice AAC domain before recommending a specific speech-generating device. The device recommended based on the unlicensed assessment was a high-cost symbol-based device requiring fine motor precision that exceeded the child’s current motor capacity; after 8 months of failed implementation in which the child could not reliably activate the device and showed increased behavioral escalation and communication frustration, the family returned the device unused. A licensed SLP with AAC specialization retained for the fee petition performed a proper AAC evaluation including the Communication Matrix assessment and a motor-access feature matching process and recommended a different device with eye-gaze access; the appropriate device was implemented successfully within 60 days of the licensed assessment. The 18-month communication development delay, behavioral escalation, and costs of the failed device procurement, private licensed SLP assessment, and corrected device totaled $195,000.
• SAN DIEGO COUNTY OUTPATIENT SPEECH THERAPY CLINIC LICENSED SLP CONTINUED TREATING PATIENTS AND BILLING MEDI-CAL AND TRICARE WITH SLP LICENSE EXPIRED 22 CONTINUOUS MONTHS — SLPAHADB COMPLIANCE INSPECTION TRIGGERED BY MEDI-CAL FRAUD UNIT BILLING AUDIT — ADMINISTRATIVE CITATION — CIVIL PENALTY — $95,000. A San Diego County outpatient speech therapy clinic continued providing speech therapy services to adults recovering from stroke, traumatic brain injury, and head and neck cancer and billing Medi-Cal and TRICARE after the treating SLP’s SLPAHADB license had lapsed into expired status 22 continuous months before an SLPAHADB compliance inspection; the inspection, triggered by a Medi-Cal Fraud Unit billing audit referral following a routine provider credentialing re-verification review, confirmed the expired license status through the speechandhearing.ca.gov license verification database and documented that during the 22-month expired-license period the SLP had continued treating patients, documenting services under the SLP’s SLPAHADB license number, and submitting claims to Medi-Cal (procedure code 92507 treatment of speech, language, voice, communication, and/or auditory processing disorder; individual) and TRICARE, both of which required an active state SLP license as a condition of provider enrollment and reimbursement. The SLPAHADB issued an administrative citation requiring immediate cessation of clinical practice pending license reinstatement, imposed mandatory continuing education in California speech-language pathology law and ethics and scope of practice, assessed $95,000 in civil penalties, and referred the expired-license Medi-Cal billing to the California Department of Health Care Services Medi-Cal Fraud and Elder Abuse Unit for review of reimbursement received during the 22-month lapse period.

Distinct From Audiologist (Bus. & Prof. Code § 2533.1), SLPA (Bus. & Prof. Code § 2536.1), and Licensed Clinical Social Worker LCSW (Bus. & Prof. Code § 4996)

• DISTINCT FROM Audiologist (Bus. & Prof. Code § 2533.1 — SLPAHADB Audiology License) — The audiologist license authorizes audiology services including audiological evaluation, hearing aid dispensing, cochlear implant mapping, and auditory processing disorder assessment; the audiology scope does not include speech-language pathology scope and does not satisfy the SLPAHADB SLP licensure requirement for SLP services: California audiologists are licensed by the SLPAHADB under the same licensing board as SLPs but hold a separate audiology license under Bus. & Prof. Code § 2533.1; an audiologist performing speech-language pathology services (dysphagia evaluation, aphasia treatment, AAC assessment) without an SLPAHADB SLP license is engaged in unlicensed speech-language pathology practice under § 2530 regardless of the audiology license; a § 2530 fee petition must confirm through speechandhearing.ca.gov that the respondent holds no SLP license in any status, independent of whether the respondent holds an audiology or any other health care license.
• DISTINCT FROM Speech-Language Pathology Assistant SLPA (Bus. & Prof. Code § 2536.1 — SLPAHADB SLPA Registration) — The SLPA registration authorizes performance of delegated treatment tasks under the supervision of a licensed SLP; the SLPA scope explicitly does not authorize evaluations, diagnosis, or independent treatment plan development: California SLPAs are registered by the SLPAHADB under Bus. & Prof. Code § 2536.1 and may only perform speech-language pathology treatment tasks that have been specifically delegated by and are supervised by a licensed SLP; an SLPA who performs a dysphagia evaluation, an AAC assessment, or any evaluation function independently — without real-time or close supervision by an SLPAHADB-licensed SLP who has designed the assessment protocol — is performing unlicensed speech-language pathology practice under § 2530 regardless of the SLPA registration; a § 2530 fee petition against a person performing unlicensed evaluations must confirm through speechandhearing.ca.gov that the respondent holds no SLP license in addition to confirming any SLPA registration status.
• DISTINCT FROM Licensed Clinical Social Worker LCSW (Bus. & Prof. Code § 4996 — Board of Behavioral Sciences BBS LCSW License) — The LCSW license authorizes clinical social work services including psychotherapy, counseling, and social rehabilitation; the LCSW scope does not include speech-language pathology scope and does not satisfy the SLPAHADB SLP licensure requirement for SLP services: California LCSWs are licensed by the Board of Behavioral Sciences (BBS), a separate DCA licensing board from SLPAHADB; while communication support may be a component of some LCSW interventions, a person holding only an LCSW license who performs dysphagia assessments, AAC evaluations, aphasia treatment, or any clinical SLP service requiring SLP licensure is engaged in unlicensed speech-language pathology practice under § 2530 regardless of the LCSW license; a § 2530 fee petition must confirm through speechandhearing.ca.gov that the respondent holds no SLP license, independent of any other professional licensure.

Billing Gaps 1–3 Summary (13.25 hrs/yr = $3,975–$6,625/yr)

Frequently Asked Questions