Training, Trends, Regulations,
and Support Personnel
Cheris Frailey, MA, CCC-SLP
Director, State Education and Legislative Advocacy
Disclosure
Cheris Frailey, Director, State Education and
Legislative Advocacy
• Financial: I am a paid employee of ASHA
• Non-Financial: I am an ASHA member. I support
ASHA’s Public Policy Agenda which includes the
advocacy initiatives that the association
supports.
Overview
• ASHA State Liaisons
• Definition of SLPAs and Support Personnel
• ASHA’ s History with Support Personnel
• Education, Regulation, Use and Supervision of
• ASHA’s Scope of Practice for SLPAs
• ASHA Documentation: State by State Trends
Overview
• Reimbursement
• State examples
• ASHA Affiliates Program
• ASHA Web Resources
• Scenarios
• Question and Answer
State Outreach
ASHA State Outreach Model
VT
Northeast Region – CT, DC, DE, MA, MD, ME, OH, NH, NJ, NY, PA, RI,
Susan Adams, JD, Director, State Legislative and Regulatory
sadams@asha.org , 800-498-2071, ext. 5665
Southern Region – AL, AR, FL, GA, KY, LA, MS, NC, SC, TN, VA, WV
Cheris Frailey, MA CCC-SLP, Director of State Education and
Legislative Advocacy
cfrailey@asha.org, 800-498-2071, ext. 5666
Central Region – IL, IN, IA, KS, MO, MI, MN, NE, ND, OK, SD, TX, WI
Janet Deppe, MS CCC-SLP, Director, State Advocacy
jdeppe@asha.org, 800-498-2071, ext. 5668
WY
Western Region – AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA
Eileen Crowe, Director, State Association Relations
ecrowe@asha.org, 800-498-2071, ext. 5667
Definitions
Definition of SLPAs
Speech-language pathology assistants are
support personnel who, following academic
and/or on-the-job training, perform tasks
prescribed, directed, and supervised by certified
speech-language pathologists.
Definition of Audiology
Assistants
An audiology assistant is a person who, after
appropriate training and demonstration of
competency, performs delegated tasks that are
prescribed, directed, and supervised by a
certified and/or licensed audiologist. When
hearing aid dealers are serving in the role of
assistant, their duties will always be clarified by
the supervising audiologist.
History
ASHA History with SLPAs
ASHA History with SLPAs
SLPAs
Education of SLPA
• State agencies regulating support personnel
• Training requirements
• ASHA’s recommendations
• Associate’s or bachelor’s degree
Training of SLPA
• Training varies
• Additional fieldwork beyond the degree
requirement
• On the job training post high school
• Unregulated
• No academic or training requirement
ASHA’s Scope of Practice for
SLPAs
• Qualifications of the SLPA
• BA degree in Communication Science
Disorders in an SLPA program or equivalent
course of study
• 100 hours of clinical practice within the
training program or supervised field work on
the job
• Adherence to SLPA responsibilities/policies
• Refrain from tasks that are the sole
responsibility of the SLP
ASHA’s Scope of Practice for
SLPAs
• Qualifications of the SLPA
• Adherence to state licensing and regulatory
rules governing the practice
• Completion of required CE and/or
professional development activities
• Guidance provided for allowable tasks,
ethical considerations and SLP supervisory
role
Recommended Tasks of SLPAs
• Assist with screenings
• Assist with informal documentation
• Follow documented treatment plans/protocols
• Document patient/client performance
• Report information to SLP
Recommended Tasks of SLPAs
• Assist the SLP during assessment of
patients/clients
• Assist with clerical duties
• Perform checks and maintenance of equipment
• Support the supervising SLP
Recommended Tasks of SLPAs
• Assist with departmental operations
• Collect data for monitoring quality
improvement
• Exhibit compliance
Use of SLPAs
• SLPAs are used in a variety of settings
• Schools
• Hospitals
• Private Settings
• Early Intervention
• Other
Supervision of SLPAs
• The amount and type of supervision required
should be based on
• Skills and experience of the SLPA
• The needs of patients/clients served
• The service setting
• The tasks assigned
• Other factors
Supervision of SLPAs
• ASHA suggests
• 30% weekly for first 90 workdays -At least 20%
direct
• 20% after initial work period -At least 10% direct
• 100% direct-medically fragile
• Direct supervision means
• On-site
• In-view observation
• Guidance by an SLP while an assigned activity is
performed by SLPA
Who can Supervise SLPAs?
• ASHA suggests
• SLP certified by ASHA
• Licensed by the state
• Practicing for at least 2 years following ASHA
certification
• ASHA recommends
• One pre-service course or CEU in supervision
Audiology Assistants
Qualifications of Audiology
Assistants
• Communication/interpersonal skills
• Basic understanding of the needs of the population
being served
• Meet training requirements
• Have competency-based skills for specific assigned
tasks
• Possess additional qualifications established by the
supervising audiologist
• Additional requirements established by the facility
of employment
Supervision of 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
• Supervisor must possess a valid state license
• CCC from ASHA is recommended
Reimbursement
Medicare Reimbursement
• Medicare policy currently does not recognize
SLPAs, regardless of the level of supervision
• Medicare does not reimburse for SLPA service
• Private insurers may cover licensed or
registered SLPAs
• Query each payer to verify coverage
Medicaid Reimbursement
• Medicaid reimbursement for SLPA services
varies
• 10 states allow it in their state plan
• Some allow for SLPA billing in education
settings
• No pattern in the states
• Oklahoma Example
Resources and Trends
Support Personnel Use
21,262 in use
ASHA’s Documentation on
Support Personnel
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State-by-state requirements for SLPAs
ASHA Practice Portal
Model Language
Support Personnel -SLPA trends
State-by-State Requirements
State-by-State Requirements
Practice Portal on SLP Assistants
• Key issues covered on the Practice Portal
• Education
• Supervising
• Ethical Obligations
• Reimbursement for Services Provided by SLPAs
• State and Federal Regulations
• Affiliation with ASHA
• Frequently Asked Questions
• Definitions
http://www.asha.org/Practice-Portal/ProfessionalIssues/Speech-Language-Pathology-Assistants/
Practice Portal on SLP Assistants
Practice Portal Audiology
Assistants
• Key Issues
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Education and Training
Supervision
Ethical Obligations for Audiology Assistants and their supervisors
Reimbursement for Services Provided by Audiology Assistants
State and Federal Regulations
Affiliation with ASHA
Definitions
www.asha.org/Practice-Portal/Professional-Issues/AudiologyAssistants/
Practice Portal Audiology
Assistants
Model Language for SLPAs
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Education
Supervision
Continuing Education
Title protection
http://www.asha.org/advocacy/state/State-Model-Billsand-Mandates/
Model Language for SLPAs
Support Personnel Trends
Support Personnel Trends
Support Personnel Trends
• Education Setting
• Laws
• Terms
• Degree Requirements
• Continuing Education
• Supervision Requirements
• Titles
Support Personnel Trends
• Healthcare
• Laws and Regulations
• Degree Requirements
• Continuing Education
• Supervision Requirements
2014 School Conference
• How has the number of SLPAs in our LEA/district changed in
the last calendar year?
State Examples
South Dakota SLPA
Requirements
• SLPA
• AA or BA
• Clinical Practicum – 100 hrs.
• Official Transcript
• No disciplinary action
• Pay the fees
South Dakota SLPA
Requirements
• Supervision
• SLP is responsible for the service provided
• Written notification that services are to be provided
by an SLPA
• Supervise no more than 3 SLPAs
• Three years of experience
Texas SLPA Requirements
• SLPA
• BA
• 24 semester hours in speech-language pathology
• 25 hours of clinical observation
• 25 hours of clinical assisting experience
Texas SLPA Requirements
• SLPA
• Shall perform duties within their scope of practice
• May NOT represent the SLP or attend staff and IEP
meetings without permission of the SLP except under
certain circumstances
• 20 hours of CEUs every 2 years
Texas SLPA Requirements
• Supervision
• Max of four interns and/or assistants
• Practiced for at least two years
• Supervise at least two hours per week
• Supervise at least one hour of which is face-face
Oklahoma SLPA Requirements
• SLPA
• Licensed by the board
• Associate’s degree
• Must practice in a geographic setting which permits
on site direct supervision
• SLPA license is granted for one year
• Continuing Education requirements that apply to
SLPs also apply to SLPAs
Oklahoma SLPA Requirements
• 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
• The number of other persons assigned to the
supervision
Oklahoma SLPA Requirements
• Supervision
• No more than two
• Supervision and scope of duties follow ASHA
guidelines
South Carolina
South Carolina Support
Personnel
• School Setting Requirements• Not regulated in South Carolina schools
• Statutory and Regulatory Requirements
• Bachelor's degree in speech-language pathology
• Core curriculum of 36 semester hours
• 100 clock hours of clinical practicum
• Supervisory Agreement Approved by the Board
• No speech-language pathology assistant may begin
working in direct contact with clients without the
Board of Examiner's written approval of a
supervisory agreement and on-the-job training plan
South Carolina SLPA
Requirements
• Supervision
• A licensee may supervise no more than two full time or three
part-time assistants.
• Following on-the-job training,
• At least 15% (6 hours per 40 hour week) of documented direct,
visual supervision of client contact
• 5% indirect supervision is also required (2 hours per 40 hour
week) and must include review of written records
• Quarterly performance reviews are also required
• Clients must be informed in writing when an assistant is
providing direct services.
• Assistants must be clearly identified by a name tag
South Carolina SLPA
Requirements
• Continuing Education
• Speech-language pathology assistants must
complete 8 hours of continuing education per
license renewal period (biennial)
South Carolina Audiology
Assistants
• School Setting Requirements
• Audiology support personnel are not
regulated in school settings
• Statutory and Regulatory Requirements
• Audiology support personnel are not
regulated by statute
South Carolina State Resource
Page
South Carolina Resources
• Laws and Regulations:
http://www.llr.state.sc.us/pol/speech/index.asp?file=la
ws.htm
ASHA Associates Program
“Associates” are speech-language pathology
assistants who are eligible to join ASHA under a
new affiliation category.
Requirements for Joining as an
Associate
• Potential applicants will be required to:
• Obtain the signature of their ASHA certified
supervisors
• If applicants are not employed:
• Obtain the signature of their program director or
instructor
• Applicants will have to agree to follow all ASHA
policies
Requirements for Joining as an
Associate
• Agree to practice only under the supervision of ASHACertified SLPs
• Annual Fee
• Meet qualifications in state and follow state licensure
rules
Benefits for Associates
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Networking opportunities
Affinity benefits
Consultation
ASHA's online Member and Affiliate Directory
Advocacy efforts
Benefits for Associates
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Mentoring programs
Reduced registration fees
Online Career Center
Subscription to The ASHA Leader
Benefits for Associates
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Four online scholarly journals
Associate e-newsletter
Associate e-Group
Professional Development Hours
ASHA Associates
• For more information about ASHA’s associates program
go to: www.asha.org/associates/default/
• For other questions contact Steve Ritch, Manager of
Association Program, Membership Recruitment and
Retention at SRitch@asha.org.
ASHA Associate Center
ASHA Resources
• ASHA Practice Portal for SLPAs
http://www.asha.org/Practice-Portal/ProfessionalIssues/Speech-Language-Pathology-Assistants/
• ASHA Associates Program
www.asha.org/associates/default/
• ASHA SLP Professional Summit recommendations
www.asha.org/uploadedFiles/2011-SLP-SummitReport.pdf#search=%22SLP%22
• SLPA requirements state-by-state
www.asha.org/advocacy/state/
ASHA Resources
• Speech-Language Pathology Assistant Scope of Practice
http://www.asha.org/policy/SP2013-00337/
• SLPA State Trends: Support Personnel Requirements in
School Settings
http://www.asha.org/uploadedFiles/Support-PersonnelRequirements-School-Settings.pdf
• SLPA State Trends: Support Personnel in Other Settings
http://www.asha.org/uploadedFiles/Support-PersonnelExcluding-School-Settings.pdf
ASHA Networks
ASHA Network Leaders
STARs- State Advocates for Reimbursement
• South Carolina
Andrea Lary, therapyc@atmc.net
• ASHA Staff Liaison
Laurie Alban Havens, Director, Private Health Plans &
Medicaid Advocacy
lalbanhavens@asha.org
ASHA Network Leaders
SMACs – State Medicare Administrative Contractor
Network
• South Carolina
Regina Lemmon, lemmonly@gmail.com
• ASHA Staff Liaison
Lisa Satterfield, lsatterfield@asha.org
ASHA Network Leaders
SEALs- State Education Advocacy Leaders
• South Carolina
Gabi Hilliard, GabiHilliard@anderson5.net
• ASHA Staff Liaison
Eileen Crowe, Director State Association Relations
ecrowe@asha.org
SLPA Scenarios
1. What are the implications for each
scenario?
2. What resources would you use to
support your concerns?
Scenario #1
SLP Perspective
Your administrator has asked you to supervise an
additional full-time SLPA who will be in a facility on the
other side of the state that you have limited access to.
You already supervise two full time SLPAs.
What should you do?
Scenario #2
SLP Perspective
You are an SLP supervising an SLPA that you
would like to utilize to assist with a hearing
screening. ASHA states that SLPAs can assist
with speech-language and hearing screenings
(without interpretation).
Does this mean that the SLPA can help me
conduct the screenings? Can the SLPA
complete the screening and give it to me for
interpretation?
Scenario #3
SLPA Perspective
You’ve been an SLPA for 15 years in a local
school. You’ve been responsible for planning, materials,
data collection, input for goals & objectives 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?
Questions:
Cheris Frailey, Director State Education and Legislative
Advocacy
cfrailey@asha.org or 800-498-2071, ext. 5666
ASHA Associates Program: associates@asha.org