10/8/2018 Eileen Crowe Director, State Association Relations ASHA - - PDF document

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10/8/2018 Eileen Crowe Director, State Association Relations ASHA - - PDF document

10/8/2018 Eileen Crowe Director, State Association Relations ASHA OSHA Conference October 13, 2018 Financial Relationship: ASHA employee Nonfinancial Relationship: None ASHA State Liaisons ASHAs History with Support Personnel


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Eileen Crowe Director, State Association Relations ASHA OSHA Conference October 13, 2018

Financial Relationship: ASHA employee Nonfinancial Relationship: None ASHA State Liaisons ASHA’s History with Support Personnel ASHA Scope of Practice, Education, and

Supervision of SLPAs

ASHA Practice Portal and Use of Support

Personnel

Reimbursement ASHA Networks and Nationwide Trends ASHA Web Resources and State Examples ASHA Affiliates Program Scenarios

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State Affairs Team Liaisons

Southern Region Shannon Morney Director, State Health Care and Education Affairs smorney@asha.org 301-296-5666 Northeastern Region Susan Adams Director, State Legislative & Regulatory Affairs sadams@asha.org 301-296-5665 Central Region Janet Deppe, Director, State Affairs jdeppe@asha.org 301-296-5668 Western Region Eileen Crowe, Director, State Association Relations ecrowe@asha.org 301-296-5667

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Six recommendations were approved by attendees and sent to ASHA’s BOD for consideration:

ASHA should develop a shared lexicon ASHA should develop and publish a framework

that articulates the range of acceptable practice across the different service provider levels

ASHA should consider developing a

comprehensive assessment consistent with its commitment to inclusion- A national examination represents one such option

ASHA should

  • Develop model state regulatory language for the

regulation of SLPAs

  • Develop principles and protocols of effective

supervision for both supervisors and those who require and benefit from supervision

  • Form a task force, in cooperation with the Council
  • f Academic Programs, to study the continuum of

academic preparation and determine how the continuum can best support SLPA and SLP preparation

www.asha.org/SLP/2011-SLP-Professional-

Summit/

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2017

  • June-CFCC presented recommendations to

ASHA’s Board

  • September-ASHA’s Financial Planning Board

approved funding

  • October-Board of Director’s approved

Status of ASHA Assistants Certification Program

via The Associates The Associates The Associates The Associates Center Center Center Center-

  • https://www.asha.org/associates/Assistants-

Certification-Program/

ASHA

ASHA ASHA ASHA Leader Live Leader Live Leader Live Leader Live blog post- https://blog.asha.org/2018/06/07/audiology- speech-language-pathology-assistants-begin- developing-new-certification-program/ regarding the job task analysis conducted at ASHA’s National Headquarters in June, 2018.

Send an email associates@asha.org

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www.asha.org/policy/SP2013-00337/

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The academic course of study must include or

be equivalent to

  • an associate's degree in a SLPA program or
  • a bachelor's degree in a speech-language

pathology or communication disorders program and

Successful completion of a minimum of 100

hours of supervised field work experience or its clinical experience equivalent and

Demonstration of competency in the skills

required of an SLPA

The SLPA should

The SLPA should The SLPA should The SLPA should NOT NOT NOT NOT engage in the following: engage in the following: engage in the following: engage in the following:

Representing themselves as an SLP; Performing standardized or nonstandardized diagnostic

tests, formal or informal evaluations, or swallowing screenings/checklists;

Performing procedures that require a high level of clinical

acumen and technical skill (e.g., vocal tract prosthesis shaping or fitting, vocal tract imaging and oral pharyngeal swallow therapy with bolus material);

Tabulating or interpreting results and observations of

feeding and swallowing evaluations performed by SLPs;

Participating in formal parent conferences, case

conferences, or any interdisciplinary team without the presence of the supervising SLP or other designated SLP;

Providing interpretative information to the

student/patient/client, family, or others regarding the patient/client status or service;

Writing, developing, or modifying a student's, patient's, or

client's treatment plan in any way;

Assisting with students, patients, or clients without

following the individualized treatment plan prepared by the certified SLP and/or without access to supervision;

Signing any formal documents (e.g., treatment plans,

reimbursement forms, or reports; the SLPA should should should should sign or initial informal treatment notes for review and co-sign with the supervising SLP as requested);

Selecting students, patients, or clients for service; Discharging a student, patient, or client from services;

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Making referrals for additional service; Disclosing clinical or confidential information

either orally or in writing to anyone other than the supervising SLP (the SLPA must comply with current HIPPA and FERPA guidelines) unless mandated by law;

Developing or determining the swallowing

strategies or precautions for patients, family, or staff;

Treating medically fragile

students/patients/clients independently; or

Designing or selecting augmentative and

alternative communication systems or devices.

Currently, ASHA suggests 30% weekly (at

least 20% direct) for the first 90 days

Direct supervision is defined as on-site, in-

view observation and guidance by a certified SLP while an assigned activity is performed by an SLPA

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Holds a CCC in SLP from ASHA and/or state

licensure

Have an active interest in the use of and

desire to use support personnel

Practiced SLP for at least 2 years following

ASHA certification

Have completed, or be currently enrolled in,

at least one course or workshop in supervision for at least 1 CEU Impact of Assistants or Aides on Workload or Caseload

Impact Impact Impact Impact Workload Workload Workload Workload Caseload Caseload Caseload Caseload Increased 46.3 26.7 Decreased 30.3 35.9 No Impact 19.8 33.4

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http://www.asha.org/academic/reports/

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www.asha.org/Practice-Portal/Professional-

Issues/Speech-Language-Pathology- Assistants/

  • www.asha.org/Practice-Portal/Professional-

Issues/Audiology-Assistants/

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The amount and type of supervision required

should be based on:

  • Skills and experience of the Audiology Assistant
  • The needs of the patient/client/student served
  • The service setting
  • The tasks assigned
  • Other factors

SLPAs are used in many states and in a variety

  • f settings including:
  • Schools
  • Hospitals
  • Private settings
  • Early intervention
  • Other
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Medicare policy currently does not recognize

SLPAs, regardless of the level of supervision and does not reimburse for SLPA services.

Private insurers may cover licensed or

registered SLPAs. One must query each payer to verify coverage.

Medicaid reimbursement for SLPA services

varies

www.asha.org/advocacy/state/ www.asha.org/advocacy/state/ www.asha.org/advocacy/state/ www.asha.org/advocacy/state/

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Oregon SEAL-Janet Wagner jwagnerslp@gmail.com ASHA Staff Liaison

  • Eileen Crowe
  • ecrowe@asha.org
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Oregon StAMP- Melissa Fryer

melfryer@gmail.com

ASHA staff liaison Sarah Warren

  • swarren@asha.org

Oregon STAR-Tina Haskins tvhask@icloud.com ASHA staff liaison

  • Laurie Alban Havens
  • lalbanhavens@asha.org
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School Support Personnel Trends Chart www.asha.org/advocacy/state/StateLicensureTrends Support Personnel Trends Chart-Outside of

School Settings

www.asha.org/advocacy/state/StateLicensureTrends

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  • Education
  • Supervision
  • Continuing Education
  • Title protection
  • http://www.asha.org/Advocacy/state/State-

Model-Bills-and-Mandates/

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Provide official transcripts showing 45 quarter hours

  • r 30 semester hours of SLP technical course work;

and Official transcripts showing 45 quarter hours or 30 semester hours of general education credit; and Written evidence of completion of clinical fieldwork that builds skills and competencies needed to practice as an SLPA

(a) Conduct speech and language screenings without

interpretation, utilizing screening protocols specified by the supervising SLP.

(b) Provide direct treatment assistance, excluding dysphagia (as

  • pposed to feeding for nutritional purposes), to patients/clients

identified by the supervising SLP by following written treatment plans or protocols developed by the supervising SLP.

(c) Document patient/client progress, without interpretation of

findings, toward meeting established objectives as stated in the treatment plan, and report this information to the supervising SLP.

(d) Assist the SLP in collecting and tallying of data for

assessment purposes, without interpretation.

(e) Act as second-language interpreters during

assessments.

(f) Assist the SLP with informal documentation

during an intervention session (collecting and tallying data as directed by the SLP), prepare materials, and assist with other clerical duties as specified by the supervising SLP.

(g) Schedule activities and prepare charts,

records, graphs, or other displays of data.

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(h) Perform checks and maintenance of

equipment.

(i) Participate with the SLP in research

projects, in-service training, and public relations programs.

(j) Initial each clinical entry and sign each

page of records.

(a) May not conduct swallowing screening,

assessment, and intervention protocols, including modified barium swallow studies.

(b) May not administer standardized or non-

standardized diagnostic tests, formal or informal evaluations, or interpret test results.

(c) May not participate in parent conferences,

case conferences, Individualized Education Plan (IEP) meetings, Individualized Family Services Plan (IFSP) meetings or any interdisciplinary team without the presence of the supervising SLP.

(d) May not write, develop, or modify a

patient/client's treatment plan in any way.

(e) May not provide intervention for

patients/clients without following the treatment plan prepared by the supervising SLP.

(f) May not sign any formal documents

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(g) May not select patients/clients for

services.

(h) May not discharge patients/clients from

services.

(i) May not disclose clinical or confidential

information either orally or in writing to anyone not designated by the SLP.

(j) May not make referral for additional

service.

Active, valid license from the Board of

Examiners for Speech-Language Pathology and Audiology or

Is exempt from licensure under Oregon law

and holds a an active, valid basic or standard teaching license with an endorsement in speech impaired or an initial or continuing teaching license with an endorsement in communication disorders issued by the Teacher Standards and Practices Commission

First 90 days of employment, a minimum of

30% of all the time an assistant is providing client interaction must be supervised.

After the first 90 calendar days of

employment, a minimum of 20 % of hours spent in clinical interaction must be directly

  • supervised. A minimum of 10% hours spent

in clinical interaction must be directly supervised.

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If the supervising SLP is on extended leave,

an interim supervising SLP who meets the requirements of Oregon law must be assigned.

The caseload of the supervising SLP must

allow for administration, including SLPA supervision, evaluation of clients, and meeting times.

The supervising SLP may not supervise more

than the equivalent of two full-time SLPAs.

The supervising SLP must co-sign each page

  • f records.

Supervision of the SLPA must be documented.

In remote geographic areas of the state, or in other

situations with severe shortages of licensed personnel, where direct supervision requirements can’t be met by an on-site SLP, educational facilities may apply for a 1 year exemption from certain requirements for supervision of certified SLPAs.

This exemption allows educational facilities to use

the review and evaluation of audio or video-taped records or live audio or video conferencing of clinical interactions, or a combination of these, to provide a portion of the required direct supervision hours, up to a maximum of 75% of the required direct supervision hours.

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Limited term certificates may be issued to

SLPAs whose application for a regular license is submitted after May 1st of each odd- numbered year.

Limited term certificates expire at the same

time as regular licenses, Jan. 30th of even- numbered years.

Provisional SLPA Certificates are temporary

license certificates issued by the licensure board to SLPA applicants who have completed academic requirements required by law and are actively engaged in completing their clinical fieldwork hours outside of an academic program.

A holder of a Provisional SLPA Certificate

must clearly identify themselves as a “provisional speech-language pathology assistant”, and may not hold a job title of or be employed as a “speech-language pathology assistant”. The provisional certificate holder may be employed in a unlicensed position such as educational assistant, may be paid a stipend, or may be uncompensated.

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  • https://secure.sos.state.or.us/oard/displayChapter

Rules.action?selectedChapter=7

Be active in your state association https://www.oregonspeechandhearing.org/ http://www.txsha.org/page/slp-assistants-

guide

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Roles/Responsibilities of SLPAs Roles/Responsibilities of Supervisors Clinical Considerations Therapy Planning Speech Sound Disorders Language Disorders Disorders Related to Cultural Linguistic

Diversity

Fluency Disorders

An SLPA must be licensed by the Board An SLPA must hold an associate’s degree from an

accredited institution

Continuing education requirements that apply to

SLPs also apply to SLPAs

The Board considers the following before granting

a license:

  • Academic training and clinical experience,
  • The specific duties and responsibilities assigned,
  • The amount and nature of available supervision,

and

  • The number of other persons assigned to the

supervisor.

The SLPA must practice in a geographic setting

which permits on site, direct supervision

The SLPA must be supervised by an SLP who has

been licensed for two years

The SLPA license is granted for one year A licensed SLP may not supervise more than two

assistants at one time

Supervision and scope of duties follow ASHA

guidelines

http://www.oar.state.ok.us/oar/codedoc02.nsf/f

rmMain?OpenFrameSet&Frame=Main&Src=_75tn m2shfcdnm8pb4dthj0chedppmcbq8dtmmak31ct ijujrgcln50ob7ckj42tbkdt374obdcli00_

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SLPAs must

  • Hold an associate’s degree in speech-language

pathology assisting or bachelor’s degree with major emphasis in speech-language pathology or communication disorders from an accredited institution

  • Complete 100 hours of clinical training as an

SLPA either during academic preparation or during their first employment

  • The supervising SLP
  • Is responsible for the extent, kind, and quality of service

provided by the assistant, consistent with the licensure board's designated standards and requirements;

  • Shall ensure that persons receiving services from an

assistant receive prior written notification that services are to be provided, in whole or in part, by an SLPA; and

  • May not supervise more than three SLPAs at one time.
  • http://sdlegislature.gov/Statutes/Codified_Laws/DisplaySta

tute.aspx?Type=Statute&Statute=36-37-18

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Potential applicants will be required to obtain the

signature of their ASHA certified supervisors in

  • rder to become ASHA Associates

If applicants are not employed, they will have to

  • btain the signature of their program director (or

training program instructor) certifying that they are qualified to provide services under the direction of a CCC-SLP or CCC-A

Applicants will have to agree to follow all ASHA

policies related to responsibilities and supervision of support personnel

Applicants will have to pay annual fees to

maintain their affiliation

Applicants will also have to be qualified to

practice in their state and follow the state licensure rules (if any) that are applicable to them

Networking opportunities with other assistants Affinity benefits Consultation provided by ASHA's professional

practices staff

Listing and search capabilities on ASHA's online

Member and Affiliate Directory

Opportunity to participate in advocacy efforts Opportunity to participate in mentoring

programs

Reduced registration fees for education programs

and products

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Online Career Center Subscription to The ASHA Leader and access

to The ASHA Leader Online

Access to four online scholarly journals Subscription to Associate e-newsletter Associate e-Group (listserv/forum/social

network)

Professional Development Hours for

Associates

For more information about ASHA’s

Associate’s program go to:

  • www.asha.org/Members/Associate-Affiliation/
  • associates@asha.org

Speech-Language Pathology Assistant Scope of Practice

www.asha.org/policy/SP2013-00337/

ASHA Associates Program: ASHA SLP Professional

Summit Report www.asha.org/uploadedFiles/2011-SLP-Summit- Report.pdf

Support Personnel Requirements State-by-State

www.asha.org/advocacy/state/

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Technical Training Programs for SLPAs

http://www.asha.org/associates/SLPA- Technical-Training-Programs/

What are the implications for each scenario? What resources would you use to support

your concerns? You work in Oregon. Your administrator has asked you to supervise an additional full-time SLPA who will be in a facility on the other side

  • f the state that you have limited access to.

You already supervise two.

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You are an SLPA with a provisional certificate. You been offered the opportunity to complete your clinical fieldwork requirements in a remote area that you’re told would have limited SLP supervision available for you. You’ve been an SLPA for 15 years in a local

  • school. You’ve been responsible for planning,

materials, data collection, input for goals and

  • bjectives according to student’s strengths

and weaknesses, progress reports, attending annual meetings, etc. How much supervision, particularly direct, is required for you based on your experience?