Scenario: The dually Registered Audiologist and Speech-Language Pathologist and the Office Assistant
You are a dually registered Audiologist and Speech-Language Pathologist and the owner/operator of a private practice. You have a part-time Office Assistant who provides administration for the office. The Office Assistant is also transitioning into occasionally providing services to your clients, as a communication health assistant (CHA). These services will include assisting with initial speech, language, and hearing screenings and portions of assessments, and providing some speech and language therapy, all under your delegation and supervision. Before delegating aspects of speech and hearing services to your CHA for any client, what is the process for obtaining consent from the client and the CHA for delivering those services?
For information about how the registrant in this scenario should proceed, read the Notice to the Professions containing the full scenario, and also read below.
Obtaining and documenting consent when working with CHAs
All RAUDs, RHIPs, and RSLPs have requirements for obtaining and documenting consent from clients before providing health services. Registrants who work with communication health assistants (CHAs) and delegate them to provide allowable aspects of speech and hearing health services to clients, have additional consent requirements.
As outlined in the Notice to the Professions on Communication Health Assistants (CHAs) titled Who are they and what registrants need to know about working with them, CHAs are non-registrants employed by a registrant or a registrant’s employer to support the registrant’s clinical practice of audiology, hearing instrument dispensing, or speech-language pathology. Delegation is a process where a registrant directs a qualified CHA to perform an allowable aspect of speech and hearing health services to specific clients, subject to meeting CSHBC requirements. Delegated services can involve some risk to clients and clinical decision-making.
A key part of the delegation process is obtaining informed consent from the client to the CHA’s involvement in providing care. The consent, which may be provided verbally and can be revoked by the client at any time, must be documented in the client record, in a written or electronically generated form.
Although a CHA may assist in the consenting process, it is the registered clinician (a RAUD, RHIP, and/or RSLP), who is ultimately responsible for obtaining and documenting consent.
Registrants must also obtain and document agreement to the delegation from the CHAs themselves before delegating aspects of speech and hearing health services.
“Obtaining and documenting consent are important professional responsibilities for registrants,” says Cathy Silversides, CSHBC’s Director, Quality Assurance & Professional Practice. “Failure to meet consent requirements when working with CHAs is a major issue that can lead to required remediation and referral to the Inquiry Committee.”
CSHBC Standards of Practice and related documents outline consent requirements for registrants working with CHAs. Registrants are expected to be familiar with these requirements. See the Key CSHBC resources section below for a list of important documents. Note that other resources not listed below are listed in the key documents and should also be reviewed by registrants.
Key CSHBC resources
Clinical Standards of Practice
- Client Consent (PDF)
- Communication Health Assistants (Delegation & Assignment) (PDF)
- Documentation & Records Management (PDF)
For more information
See the following Notices to the Professions:
- Communication Health Assistants (CHAs): Who are they and what registrants need to know about working with them
- Communication Health Assistant scenarios
If you have questions about how to adhere to practice standards and related documents on CHAs, consider requesting professional practice information from CSHBC Professional Practice Advisors. To request professional practice information, or to send general questions, contact CSHBC at [email protected].