Eileen Crowe Director, State Association Relations ASHA OSHA - - PowerPoint PPT Presentation

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

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

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/

 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 e Associates sociates Center nter- https://www.asha.org/associates/Assistants- Certification-Program/

 ASHA

HA Lead ader r Live ve 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

 www.asha.org/policy/SP2013-00337/

 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

e SLPA shoul uld d NOT en engag age e in the e followin wing: g:

 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 shoul uld 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;

 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

 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 Workloa

• ad

Caseloa

• ad

Increased 46.3 26.7 Decreased 30.3 35.9 No Impact 19.8 33.4

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

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

Issues/Speech-Language-Pathology- Assistants/

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

Issues/Audiology-Assistants/

 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

 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 ww.asha .asha.o .org rg/advo /advocacy/state/ cacy/state/

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

• Eileen Crowe
• ecrowe@asha.org

 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

 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



Education



Supervision



Continuing Education



Title protection



http://www.asha.org/Advocacy/state/State- Model-Bills-and-Mandates/

 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.

 (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

 (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.

 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.

 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.

• 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

 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_

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

 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

 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/

 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.

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?