Doing Your Clinical Fellowship in a Different State

Plenty of new graduates take their first job somewhere other than the state where they trained. Others stay home but accept a teletherapy fellowship serving students or patients in another state. Either way, the licensing question is the same: the fellowship is regulated by the state where your clients are, not the state where you studied or live.

Which state's rules govern your fellowship?

The state where the services are delivered. Texas puts it plainly for telehealth: if the clients receiving the services are located in Texas, the provider must hold an appropriate Texas license. That includes the intern license a clinical fellow needs. A fellow who lives in Oklahoma and treats Texas students online needs the Texas credential.

The ASLP Compact does not change this. The Commission says practice through the compact requires a license to practice independently, and a clinical fellow is not eligible. See who the compact does not cover.

Can your supervisor be licensed in a different state?

For your state hours, usually not. The rules we checked:

• Texas: only hours earned under a Texas-licensed supervisor approved by TDLR count toward the internship.
• Illinois: experience obtained in Illinois must be done on an Illinois temporary license and supervised by an SLP licensed by IDFPR.
• Connecticut: the supervised professional experience must be under a Connecticut-licensed SLP and approved by the Department of Public Health before it counts.
• New York: supervision must be provided where you work by a New York licensee, but experience gained in another state, or in an exempt setting such as a school, may be supervised by someone holding the ASHA CCC.

ASHA adds its own layer: your mentor must hold a current CCC-SLP for the whole fellowship, with at least 9 months of full-time experience after earning it and 2 hours of supervision training. A supervisor who satisfies the state but not ASHA, or ASHA but not the state, leaves you with hours that count for only one of the two.

Do you need the credential before your first day?

In several states, yes. Texas says the internship cannot begin until the intern license has been issued and you are listed on your supervisor's license. Ohio says a conditional license applicant may not begin employment until the license is issued. Florida requires board certification before the professional experience starts. Illinois requires the temporary license first.

Connecticut adds a sequencing trap: the department will not approve a supervision plan until it has your application and proof that you finished your education, either the transcript or a program director's letter. Apply as soon as you accept the job, not when you arrive.

How do out-of-state fellowship hours get verified later?

If you finish the fellowship in one state and want your first full license in another, the second board will want proof that the supervision was legitimate where it happened. Texas spells out what it accepts for an internship completed out of state: a copy of the supervisor's valid license in that state, or, if that state did not require licensure, a letter from ASHA confirming the supervisor held the CCC at the time.

New York accepts experience completed outside the state as long as the supervisor was ASHA certified, and the supervisor sends the completion form directly. If you hold the CCC, New York will also take a verification statement sent by ASHA. Keep a copy of your mentor's license number and CCC number from the first week. See license verifications for SLPs and audiologists.

Does a teletherapy fellowship work across state lines?

It can, but it carries two extra checks. First, you need the fellowship credential of each state where your clients are located, and your supervisor needs whatever that state requires of a supervisor. Second, ASHA's fellowship guide calls for 6 hours of on-site, in-person direct supervision per segment. A fellow and mentor considering telesupervision are told to submit a written request to the Council for Clinical Certification and have it approved before the fellowship starts.

If you split your caseload between two states, you are running two state clocks, two supervisor approvals and possibly two jurisprudence exams. For telehealth platform questions such as confirming where a client is sitting, see our sister site's note on patient location verification, and see teletherapy for SLPs across state lines.

What about a school-based fellowship?

Schools add the education department's credential. In New York, a speech-language pathologist employed by a school provides services under a teaching certificate (Teacher of Students with Speech and Language Disabilities) rather than the license, according to the State Education Department's credential table, while a contractor serving schools needs both. Other states require the state license and an education credential. Check both before you sign a school contract in a new state; see school SLP credentials.

Why is a different state's clock a bigger risk?

Because you will not know its quirks. Illinois, Indiana and Ohio cap the fellowship credential at 18 months against ASHA's 48. Indiana does not count weeks under 15 hours and discards the hours if you run past 18 months. Connecticut counts 30 hours a week as full time and requires 1,080 hours, not ASHA's 1,260. A fellow who moves mid-year can also end up with two partial fellowships that each need their own state paperwork. Our overview of fellowship credentials by state lists the clocks we have checked.

How can we help with an out-of-state fellowship?

Our Clinical Fellowship and Provisional License service is $349 per state. We identify the right credential in the state where your clients are, check your supervisor against that state's rules and ASHA's, prepare the application and plan, and set reminders for the state's deadlines. You and your supervisor sign everything. State, fingerprint and exam fees are separate. Start with the state license index.