Effective 1/3/05 Flexible Endoscopic Evaluation of Swallowing (FEES) is within the Scope of Practice for Speech-Language Pathologists. The full text of the adoption follows. All SLPs are urged to read and abide by these regulations.

N.J.A.C. 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.

In responding to public comments Reni Erdos, Director of the Division of Consumer Affairs provided the following comments and clarifications:

• pic examinations be present. The Director understands that most, if not all, physicians receive such training during residency. The Director does not believe that this requirement will be unduly restrictive as physicians would meet the requirements of this rule and believe that the rule will allow for this procedure to be performed in nursing homes.”

• Regarding the issue of whether a physician must be present in the exam room, the Director stated that “N.J.A.C. 13:44C-7.2A(e) requires that FEES only be performed when a physician is present. As the rule does not specifically require the presence of the physician in the examination room, it is not necessary for the physician to be in the room…provided the physician is in sufficient proximity to respond to any emergency that arises during the procedure.”

• The Director further commented that “the rule does not require that a speech-language pathologist verify that a physician had training in endoscopic examination during residency. As long as the speech-language pathologist inquires and the physician represents that he or she had such training, the speech-language pathologist may perform a FEES procedure.”