Qualifications Needed to Provide SLP Services in Health Care

Certificate of Clinical Competence
A qualified speech-language pathologist holds a Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association, which requires: 1) a Master's degree from an accredited graduate program; 2) a passing score on the national PRAXIS exam; and 3) completion of a nine-month Clinical Fellowship under the supervision of a certified SLP. 

State Licensure
Most states license speech-language pathologists. Requirements for licensure tend to be comparable, but may not be equivalent, to the qualifications for the Certificate of Clinical Competence. SLPs licensed in other states must apply for licensure in the state in which they are practicing; holding the Certificate of Clinical Competence tends to facilitate more rapid processing of applications for licensure.  

Clinical Fellows
In some states, individuals who have completed their Master's degree and passed the PRAXIS exam may meet state requirements to be licensed on a provisional basis and may be hired to work in health care settings as Clinical Fellows with the required supervision. 

Students pursuing their Master's degree in speech-language pathology are placed in external practicum settings as part of their graduate program requirements. This is an invaluable opportunity to introduce students to the caseloads and procedures typically associated with health care settings, and to potentially recruit students for positions as Clinical Fellows following graduation. Students may not bill or treat patients independently of the supervising SLP. 


In addition to meeting the basic requirements of certification and licensure, many health care facilities verify competencies of SLPs in selected areas of practice and procedures. Documentation of competency in the high volume or high risk activities of the professional in a specific setting is required by accrediting bodies such as the Joint Commission on Accreditation of Health Care Organizations (JCAHO). SLPs who have not achieved competency in specific treatment areas (e.g., swallowing disorders, laryngectomy rehabilitation, trach/vent management) or procedures (e.g., performing and interpreting videofluoroscopic studies of swallowing) may need to complete a combination of reading professional literature, continuing professional education, observation, mentoring, and supervised practice before being deemed competent to practice independently in these areas.

If you recruit SLPs from other settings, offering professional development programs will help new staff achieve a higher degree of competence and compliance with practice patterns in the setting and ultimately, a higher level of satisfaction in their employment.

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