Dynamic Documentation: Supervising SLPAs

Jennie Price M.S. CCC-SLPIMESD, Director, Regional Program and Related Services

BSPA Vice ChairAshley Northam M.S. CCC-SLP

Chemeketa Community College, Director SLPA ProgramPast Chair, BSPA

Tennis Anyone??• Rules are nonnegotiable• Scoring criteria, changing of the

court after every odd game, alternation of players between serves are constant.

• If you don’t know the rules, you can’t play the game without stacking up a lot of penalties.

• Played single or double• Just like SLP’s have a set of rules

when playing “solo” they have one when they play a doubles match.

• Stay in the game by following the rules.

Solo vs. Doubles

• Independent• Call the shots• Get tired faster• Responsible for the

score

• You don’t have to cover the whole court

• Game is defined when both partners stay in their respective boundaries

• With time/trust you will learn to play the doubles game more effectively.

• All players must know the rules, learn the boundaries, and respect the game.

Licensure in the State of Oregon

• TSPC- Teacher Standards and Practice Commission. Regulatory body that primarily accredits teacher training programs, but also historically issues licenses to other professionals such as SLPs.

• BSPA- Oregon Board of Examiners for Speech Pathology and Audiology

OSHA, ASHA, BSPA …What is the difference?

• OSHA- Oregon Speech-Language Hearing Association.

• Professional Association: CEUs, advocacy, no regulatory authority.

• Membership composed of SLPs, SLPAs, Audiologists, Educators of the Deaf and HOH as well as others

OSHA, ASHA, BSPA …What is the difference?

• ASHA:• Accreditation of SPHR programs• CFY/CCC - * this is not a license! This is a

certification. A person must possess a state mandated license to practice as an SLP.

• Advocacy• CEU opportunities• Standards, positions, leadership

BSPA Mission

• The Board of Examiners for Speech-Language Pathology & Audiology seeks to protect the public by licensing and regulating the performance of SLPs, SLPAs, and audiologists.

• The Board does not represent the profession, but we are in partnership with our professional members to achieve our mission

• Board composed of 2 Speech-Language Pathologists, 2 Audiologists, 2 Public Members, 1 Otolaryngologist (ENT) doctor

• Incoming complaints are investigated by an investigated in conjunction with the board members who have practice or have professional knowledge pertaining to the practice area.

BSPA Board

BSPA MissionRegulatory Authority is necessary to:1. Safeguard the public health, safety and welfare;2. Protect the public from being misled by

incompetent, unscrupulous and unauthorized persons;

3. Protect the public from unprofessional conduct by licensees; and

4. Help ensure the availability of the highest possible quality SLP and audiology services to Oregonians with communication disabilities.

Putting it in the net(Compliance/Disciplinary Issues)

• BSPA receives complaints from the public or other professional members

• Professional Competence; Professional Conduct; Ethics/Misrepresentation; Practice w/o License; Inappropriate Supervision of SLPAs

BSPA

• Statute: ORS Chapter 681

• OARs ( Oregon Administrative Rules)• Chapter 335

BSPA

• Divisions- rule sections pertaining to general topic areas

• Division 1: Procedural Rules• Division 5: Professional and Ethical Standards• Division 10: Recordkeeping• Division 40: Disciplinary Actions• Division 60: Licensing • Division 70: Professional Development• Division 80: Conditional Licenses• Division 95: Speech-Language Pathology Assistants

BSPA

• A conditional license for SLPs is meant to be used during the 9 month CFY experience. After which, an individual applies for a standard license.

• Standard licenses are issues on an biannual schedule- every 2 years on even-numbered years.

• Licensees are subject to CEU requirements. 30 hours are required with each biannual renewal.

Staying Within The Boundaries(Scope of Practice)

In order to practice in the state of Oregon, a person performing the functions and duties of an SLPA must be licensed by the Oregon Board of Examiners for Speech Pathology and Audiology (BSPA)

DeterminationSLPA Coursework – Chemeketa Comm Coll.

SLP 180: Survey of Speech and Hearing Disorders SLP 181: Phonetics SLP 182: Intervention Strategies for SLPAs SLP 183: Intro to Language Development SLP 184: Language Therapy SLP 185: Anatomy and Physiology of Sp/Hearing SLP 186: Speech Intervention SLP 187: Clinical Documentation and Materials

Mgmt

DeterminationSLPA Coursework – Chemeketa Comm Coll.

SLP 188: Low Incidence Populations SLP 189: SLPA Practicum I SLP 190: SLPA Practicum II SLP 191: Ethics/ Legal Considerations in SLP SLP 192: Adult Language Disorders SLP 193: AAC SLP 194: Language, Cultures and Society

ADVANTAGE(SLPA Licensure Requirements)

• An applicant must submit:• 45 credits of general education academic

coursework, all course marks must be a “C” or better

• 45 credits of speech pathology technical coursework, all course marks must be a “C” or better

• 100 hours of clinical interaction experience

Practicum Requirements Student SLPA is placed under the direct

supervision of an SLP who holds a current BSPA or TSPC license

SLP Supervisor must have a minimum of 2 years of professional experience before supervising an SLPA or student.

A minimum of 100 clinical interaction hours are needed between 2 terms

Practicum Requirements Supervision is 100% direct- SLP must be on-site and

within sight and/or sound during practicum Hours are collected during “clinical interaction

activities” = Hands On Therapy Activities Student SLPA can work independent of SLP- can be

running separate treatment groups or working nearby Student to gain gradual independence through SLP

modeling working towards running their own treatment groups within practicum time frame including materials prep and taking data.

Staying Within The Boundaries(Scope of Practice)

Provide Direct Treatment to students in various settings under the supervising SLP

Take Data Do Screenings (w/o interpretation) Design materials for treatment Prepare lesson plan activities following the

treatment plan (IEP) and with supervision Act as interpreters during assessments

What can an SLPA do?(game momentum)

• Assist with speech-language and hearing screenings (without interpretation)

• Follow documented treatment plans (IEP) or protocols by supervising SLP

• Tallying data for the SLP• Assist the SLP during assessment of clients• Assist with informal documentation as

directed by the SLP

What can an SLPA do?

• Assist with clerical duties (schedules)• Perform checks and maintenance of

equipment (AAC, etc)• Support supervising SLP with in-service

trainings• Collect data for quality improvement

What SLPA’s can not do(Fault)

• Perform standardized diagnostic tests, formal or informal evaluations, or interpret test results

• Screen or diagnose clients for feeding evaluations

What SLPA’s can not do(Fault)

• Provide client or family counseling• Write, develop, or modify a client’s

individualized treatment plan in any way.• Sign any formal documents• Select clients for services• Discharge clients from services• Disclose clinical or confidential information

What SLPA’s can not do(Double Fault)

• Make referrals for additional services• Represent him/herself as an SLP• Participate in parent conferences, case

conferences, or any interdisciplinary team conferences without the presence of the supervising SLP.

Scope of Practice for EA/IA Non-instructional activities such as materials

preparation Clerical duties such as scheduling

appointments, meetings May not perform screenings or perform

treatment activities ( maintenance and carry over practice is OK)

May not collect data for the SLP

Scope of Practice for EA/IA Non-instructional activities such as materials

preparation Clerical duties such as scheduling

appointments, meetings May not perform screenings or perform

treatment activities ( maintenance and carry over practice is OK)

May not collect data for the SLP

“Ace” your Supervision Supervising SLP is required to provide a portion

of DIRECT and INDIRECT supervision to the SLPA DIRECT: On Site, within sight and/or sound or

via live videoconference while SLPA performs clinical interaction (treatment)

INDIRECT: Activities other than direct supervision/ observation- lesson planning, consultation, record review, data review. May be done via email or phone if appropriate

“Ace” your Supervision For the first 90 days of employment with a

given employer, 30% of the time the SLPA is providing clinical interaction must be supervised ( 20% of that in Direct Supervision, 10% Indirect Supervision)

Subsequently, an SLPA must be supervised a total of 20% of the time spent providing clinical interaction. ( 10% of that time is Direct Supervision, 10% Indirect)

• SLPA spends a total of 5 hours per day in clinical interaction with students

(5 hours per day) x (5 days per week) =25 hours per week on average

25 hours per week x 4 weeks in a month = 100 hours per month on average

Direct supervision = 10 hours per monthIndirect supervision = 10 hours per month

• Speech Language Pathologist licensed by Teacher Standards and Practices Commission

(TSPC) may supervise Speech Language Pathology Assistants (ORS 681.360),

• TSPC licensed SLP’s must follow Board rules when supervising SLPAs.

• OAR 335-095-0040 (2)(a) states that“The supervising speech-language pathologist must have at least two years of professional speech-language pathology experience. The

clinical post-graduate fellowship year may be counted as one year of professional experience.”

Game time

Get in the zone

• True or False?

• SLPA’s can independently conduct speech-language pathology evaluations?

FALSE

• OAR 335-095-006 (a)

• However; they can conduct speech and language screenings without interpretation, utilizing screening protocols specified by the supervising SLP.

True or False?

• Dysphagia management (swallowing) is not one of the authorized tasks for SLPA’s?

True

• The SLPA may not conduct swallowing screening, assessment, and intervention

protocols, including modified barium swallow

True or False?

• SLPA’s can provide treatment without direct observation by a licensed SLP?

False

• OAR: 335-095-0050 (e)

• The SLP’s caseload consists of ALL students including those seen by the SLPA. The SLPA service model should not be designed so that certain students are only seen by the SLPA and others are seen on a regular basis by the SLP.

True or False?

• SLPAs can tally scores on standardized and criterion-referenced tests as long as they do not interpret the data.

TRUE

• OAR 335-095-0060 (d)

• Assist the speech-language pathologist in collecting and tallying of data for assessment purposes, without interpretations.

True or False?

• Can and should SLPA’s go to IEP meetings and sign the IEP?

Both!

• The OARs outline the SLPA scope of practice and OAR 335-095-0060 (2) (c) states that an SLPA “May not participate in parent conferences, case conferences, or any interdisciplinary team without the presence of the supervising SLP”.

• If an SLPA who regularly sees a student attends an IEP meeting to help provide some additional perspective for the parents, that is an option, but legal and professional role in the meeting is held by the SLP.

• However the SLPA can not sign formal documents!!

Avoid the “Serve”

http://www.oregon.gov/BSPA/forms.shtml

Be a Smart Playerhttp://www.oregon.gov/BSPA/forms.shtml

Don’t stand in no mans land!

Play tennis and make a racquet!

Remember…

When in doubt, call it out!• Oregon Board of Examiners for Speech Pathology and Audiology for

OARS• http://www.oregon.gov/BSPA/index.shtml

• ASHA Code of Ethics:• http://www.asha.org/Practice/ethics/NewEthicsCode2010

• Chemeketa Community College SLPA Program• http://speechpathology.chemeketa.edu