thanks!

Yes and in a few days it will be posted to the COVID page on www.asha.org/certification

The information on this slide and more data from the survey will also be shared on the CFCC's COVID page in a few days

Thanks

Thanks, Todd

Thank you

Thanks so much for extending the accommodations deadline

Medicare still requires 100% spv for for telepractice, is that correct?

Courtney - here is ASHA advice on this topic - https://www.asha.org/Practice/reimbursement/medicare/Providing-Telehealth-Services-Under-Medicare-During-the-COVID-19-Pandemic/

what if the parent is present at the IEP meeting. could hours count them?

then

When students are supervised in an in-person clinic, with supervisor supervising 2 (or more) sessions, the supervisor may not be "in line of sight" with all sessions. The sessions may be occurring in different therapy rooms with the supervisor moving between observation rooms to observe. Today, you seem to be saying that the telepractice observations must be different, with "in line of sight" being a requirement rather than "immediately available", which could occur through email or text, with supervisor then returning immediately to the session where she was needed. Please explain.

I thought it was permissible for student clinicians to count their time that they were explaining diagnostic results for just the speech language portion during an IEP?

Or ICU rounds at the patient's bedside?

contact hrs.= contact with client or caregiver, so for IEP those are contact hrs.-explaining progress, goals, etc.

Agree with the need for clarification of "immediately available". Most clinical supervisors do not have 2 devices on which to log into to 2 separate Zoom meetings simultaneously. Your explanation here seems different that what was explained previously.

Just to clarify: During Telepractice with Telesupervision the client, the student, and the supervisor may all be in separate locations, correct?

Also requesting clarification on the IEP/IFSP meetings

With regard to the IEP meeting, rounds, etc. if the student is providing education or results to a client/patient, the time explaining the results or treatment plan, etc., to the caregiver may be counted. If the client/patient/family are not present, the time cannot be counted.

Has it ever been considered to reduce hour requirements for graduation and increase CFY requirements to off set this unprecendented time. Telepractice helps get the students hours but its not the same as in person. How are programs supposed to meet this need? Requiring a longer CFY would ensure that our students would be stronger professionals.

Your (CFCC) Standard VC needs clarification moving forward. It is respectfully contradictory. "The applicant must complete a minimum of 400 clock hours of supervised clinical experience in the practice of speech-language pathology. Twenty-five hours must be spent in guided clinical observation, and 375 hours must be spent in direct client/patient contact."

The CFCC did look at potentially modifying the CF experience but because of the autonomy a CF has it was determined to risk client/patient care

Supervised clinical experiences in the implementation standard references report writing.

Apologies if this was said, but is there consideration to allow more than 75 hours of simulation? Specifically, the use of highly skilled and trained SPs are quite different than software simulation without a live person

Just to clarify: "any combination" of supervision is acceptable - thus can client, student clinician be on site (face to face) and due to health needs the supervisor Telesupervision from off site location?

@Robert: YES. All parties may be in separate locations

Melanie - that is correct until 6/31/2021

Thank you

So, "in the line of sight" means 100% supervision, right?I'm not sure what the difference is.

If students are providing training, consultation, treatment planning in the context of an IEP meeting, whay does that not count? Please clarify.

@Melanie: That is correct.

Question: is in-person/face-to-face a preferred method of graduate student clinical experience over telepractice? In other words, if there is an option of in-person vs. telepractice, is one preferred?

If students are completing teletherapy in the on campus clinic using the clinic video/recording system while students are on a Zoom allows for line of sight---- even though you are not a participant in the telesession… correct?

@Renee: If the education is being given to the caregiver, the time spent educating the caregiver/family may count.

Did you say being available via phone does count as being 100% available or does not with telepractice?

Steven - if in-person practice or supervision is safely possible that would be great but not required at this time

thank you

100% Line of Sight allows a supervisor to have multiple telepractice sessions on screen at a time, but not necessarily focused on that session.

@gretchen - thank you.

What is a "standardized patient"?

@Elisa: Telesupervision needs to have a video component for ASHA certification purposes.

Will the CFCC be increasing the allowable hours obtained via clinical simulation, even short-term, to help alleviate the demand?

expand on immersive reality

Elisa - to add onto what Gretchen said that is also required by many regulators and reimbursors as well

@Christine: A standardized patient is an actor who has been trained to exhibit a specific disorder and can replicate that same disorder across multiple student clinicians.

For clarification: Can a student independently acquire practicum hours outside of a course (ex. during Christmas break/during the summer) and they be counted toward practicum as long as a certified individual has validated them?

I appreciate that the CFCC is maintaining the standards that have been in place for so long. It has been extremely challenging to work along our PT program to see how they have been able to pivot - with greater success than tracking down minutes of direct contact. I recognize this opens a completely new discussion but hoping for a COVID-19 silver lining in our field as well. SLPs are consultants more and more in this field. Documentation is completed within sessions and if IPE is more and more they way we trend - learning from each other should be valued in more clear way.

It is conceivable that we will have a generation of SLPS that have never experienced an "on site" externship experience. How will we address this going forward as there are clearly knowledge and skills obtained from outside the University clinic environment. Students are also concerned that this will impact their employment as employers will expect them to have these experiences.

What is posted on the ASHA website regarding telesupervision requirement being "immediately available " and "similar to the 25% in-person" requirement is quite different from what you are saying today. Can we conclude that you are issuing new rules for telesupervision today, and that the website will be updated to reflect your new guidance?

@immersive reality: There are some programs that create virtual reality hospital rooms with avatars. CAPCSD has a great deal of information about this.

Wait did the last slide say that 100 hours can be accrued through clinical simulation?

75 hours

@peggy...I saw that too?

75 hours + 25 observation

25 through observation

25 can be guided observation and 75 during graduate program

Thanks Ellayne

@Peggy it said 25 for observation and 75 for grad total 100

Please clarify the 100% available requirement for telesupervision, as what's been shared here today is in conflict with what we've previously been told

I just want to be sure I heard correctly. Clinical educators do not need the 2 hours of CE until Jan 1, 2021?

In order to meet that 100% available requirement we have to have video view of the session?

25 guided observation hours can be earned through video recordings, and 75 clinical practicum can be earned through clinical simulation

For those of us with undergraduate clinics will students be allowed to use guided observations and virtual hours? or are the 75 hours only for graduate students?

@Stacie, that is correct.

Will these slides be shared with the group?

@Patrick: That is correct. 2 hours of CE in supervision do not need to be completed until 1/1/2021 for clinical educators.

@stacie......they said it will be on the website

Great!!! Look at PT!

If the supervisor requirement for 2 hours of CEU In supervision will not be extended, and it is so difficult to find sites (and supervisors)-- why can't ASHA continue to offer the hours for no charge? Supervisors are now required to pay for the ASHA courses in training for supervisors

There was a recent issue of Seminars in Speech and Language that covered some competency-based education issues. Full disclosure, I guest edited and wrote one of the articles. Just an SYI

FYI

YES! @Rosailie. I agree!

pretty sure audiology has a different model than SLP which includes competency based assessments

@Rosalie, they can email and receive it for free, but they SHOULD NOT have to.

@Rosailie, yes I agree! Just another hurdle

Yes @Rosailie !!

It is a real possibility that 1 or 2 cohorts of students will leave their graduate programs having less face-to-face practicum and direct client contact because of limitations of off campus sites. Students are concerned as well. What is ASHA collectively doing to help all of us trying to help students?

Can ASHA offer the Clinical Educator courses for free again? It is really a burden to find sites and now that ASHA has their course behind a paywall it is even more challenging

Kathleen - the CFCC does not mandate a time requirement but the CAA does have a 12 month requirement

@ Rosalie....I completely agree! I am told it is in the hands of the PD department and they are not interested in extending the "at no cost" model for the 9 building blocks

Even those who email aren't getting it for free

Are there any free courses that ASHA offers to meet the supervision requirement (2 hours of Professional Development).

No- I was told very clearly that the courses were free "long enough"

will this presentation be available for review?

The code 2020SIMCSD allows free access and CEUs for this course on SP.com- https://www.speechpathology.com/slp-ceus/course/integrating-simulation-in-csd-education-9191

sp.com has a code right now for a free course. They have multiple supervision options. code was 1FREECOURSE if it's still active @Rosalie

Rosalie - sorry you got that response. If you are affiliated with a CAPCSD member program they have several free courses that you access or be granted access to

On the ASHA website, if you go to subscribe for ASHA learning pass there is a yellow banner at the top of the page that allows you to complete the hardship access form which gives you access to the learning pass for a month for free and the Nine Building Blocks course is available on there!

ASHA could incentivize supervisors with a free learning pass.

I thought the CAPCSD courses were offline right now

Other than clinical simulation, what additional opportunities are programs finding for clinical training in a medical site?

We are also having to delay student graduation dates. How are we accommodating for increased financial burden for students ?

None of the supervision courses are available via the 1FREECOURSE through sp.com

CAPCSD courses are offline until they get them up and running on a new delivery platform

Will ASHA provide programs recommendations for how many students can be enrolled in a single section of clinical practicum? (so the number of students a single clinical educator is responsible for can be managed) Teaching and counseling have recommendations from their accrediting bodies. With no recommendation, adminstrators see no reason why there is a need to cap sections of clinical practicums. This leads to clinical educator burn out and decreases the quality of the clinical education provided

I think ASHA needs to make a statement of positivity and encouragement that supervisors continue to take students during this tough time. Not all of them are.

How can we get access to this powerpoint?

In a previous update we were told being available by phone was enough

@stacie green...….yes, the CAPCSD courses are offline until...………..they wont commit to a date

I do not understand why Speech Pathology.com is capable of offering a free supervision course but ASHA is not willing to do this.

Where on the CFCC site can we find these slides?

Tina - this presentation will be available on www.asha.org.certification in a few days

Thank you, Todd.

ASHA is providing access to the Learning Pass for free for a month via the Hardship Access Form

CAPCSD supervision courses are free and are being reviewed now. We hope to have them available soon. I just sent my review in last night. We are working hard to get them up and running again soon.

And you mentioned breakout sessions are not permitted?

So the supervisor must have 2 or 3 computers?

https://apps.asha.org/eweb/OLSDynamicPage.aspx?webcode=olsASHALearningPass

With all due respect, the written instructions you have issued in the past have not included the "in line of sight" language that you are using today.

we use an iPad and a desktop with webcam

Agree that ASHA must support supervisors in attaining the supervision training. SLPs in the community and in schools are very hesitant to take students right now, and adding the supervision training requirement AND making them pay for it has disincentivized them.

Will graduate student still be required to have experience in multiple settings?

Given technological limitations i.e. computers... HOW IS THIS POSSIBLE

I was going to ask that @Erin

Zoom allows for those in breakout rooms to request that the host join instantaneously - it seems to me that would cover the 100% availability for video -

I would hope that ASHA could consider increasing the 75 hours of simulation when the experiences include live standardized patients. We have highly trained and skilled SPs that result in a very real experience for students. We use them for assessment and then continue on for treatment. In the situation where hours may be difficult to obtain, the SPs are a very good equivalent, and especially for low incidence disorders in the Big 9

@todd.....correct

Many students were never well-trained in telepractice before this pandemic. But they trained themselves, figured it out as a team of SLPs and moved forward. I believe our students have learned new skills we never even considered. It will be very unfortunate that they do not have many or any face to face clients, but i believe they too will figure it out…as long as they are competent with knowledge.

thank you Lisa Lenz- this is a huge issue

Having multiple sessions open makes HIPAA violations way too easy - making sure you know what’s muted and which videos are on/off. This is a concern.

What about face-to-face sessions-can a supervisor be 100% available by phone to a supervisee while providing 25% supervision?

Please clarify the position on breakout rooms?

we got our students licenses to help us log into 2 Zooms at once

will the courses on supervision continue to be free?

Please discuss how an educator could be on 2 zooms? Students often do not have the HIPAA compliant versions through the university, and the CI has to be the meeting organizer

Any suggested platforms that come to mind?

universities are experiencing extreme monetary shortages. chaining platforms not very easy.

Please clarify why breakout rooms are not ok

There is a zoom setting to allow multiple sessions at once.

@lori the ASHA courses on supervision are no longer being offered free of charge; in the past the CAPCSD required an access code offered by member programs but was free of charge

student clinicians are able to chat 100% of time with supervisors

Please clarify why students can’t receive hours for IFSPs and IEPs when the student is very involved?

We are using TEAMS for clinical supervision and it is HIPAA compliant and working well.

@Peggy--awesome! thanks

The same thing is true when you walk in different therapy rooms. You can't see everything at once. It's hard to see why we can't be flexible here.

@Thank you Robyn Wahl

turning your head and clicking into the session when requested is just as fast

Thanks Peggy Conner

How can you breakout your session in MS teams?

can you review the various examples of simulations again?

With Teams, when I open another meeting

Our supervisors used a different device/account and joined the breakout rooms on that device, to allow them to have line-of-sight

Respectfully, CFCC's Purview is quality assurance not consumer protection or quality control. Licensing boards address consumer protection. It's difficult and a bit offensive to hear that by making good faith efforts to think outside of the box to help students and provide a quality CF ready education, that CFCC won't yield because you presume we're not looking after consumers. I'm referring to Ms. Thorpe's comment. Have I misunderstood?

I think Deb mentioned several examples of acceptable types of simulations, but would like to hear them again

Respectfully, these regulations on Teletherapy/supervision should be re-looked at with respect to what is actially happening, what is functionally possible, and what is realistic. Also, what is simlliar to real-life (Ie: 25% means you don't have to be in line of sight the whole time.

Thank you @Gretchen for your responses.

Can Asha provide more telepractice technical training for member free?

Did I hear you say Any platform must be HIPAA compliant? Those standards have not been laxed?

Are we allowing up to 100 hours from simulation?

In Teams, when I connect to one meeting, the other one is on "pause" for me. I don't know if other people have different experiences

another strategy we use--Students can also be made "hosts" once the supervisor on the hipaa client has started a session, allowing the supervisor to launch another session on another device

Where will the answers be posted?

Again-- is there a reason why ASHA cannot offer free ceu hours for the supervisor requirement?

No up to 75 hours for clinical simulation

Why isn’t teletherapy being treated as any other typical service delivery model? We’ve been providing services via this model for years and 25% is the standard requirement for supervision. Can you explain more about why 100% line of sight is necessary?

Is the line of sight language going to be added to the current policies - or is just general guidance?

Will the CFCC/CAA make capping recommendations for admission of new students in university programs? Some distance ed programs are accepting over 150 students that will be having difficulty at some point being placed in the field.

Why not allow more than 75 hours (in CSD) via simulation?

For clarification: Can a student independently acquire practicum hours outside of a course (ex. during Christmas break/during the summer) and they be counted toward practicum as long as a certified individual has validated them?

where did 25% go????? please don’t treat tele practice like a bad thing here!

Keep in mind that budget cuts to programs prevent us from obtaining multiple monitors so we can line of sight for more than one room

Is there evidence suggesting a lag time between joining breakout rooms is less effective than other line of site/reorienting attention models of supervision?

25% is the MINIMUM ASHA has never said that 25% is the amount that is appropriate

I think the supervision is one of the main concerns, in terms of the 100% availability

This new definition of 100% available is extremely problematic. I don't know how that could be achieved using zoom, which is our only option right now.

Most payers require 100% already

It use to be that supervisor needed to be “on site” but this did not equal “line of sight.” Please clarify.

Seems like CFCC is really being guided by 3rd party payors rather than science or research on best practices.

Agreed @Christine Weill.

What if this is a donation based clinic in regards to on sight?

The standard has always been that the “appropriate amount” for a student …a beginning student will require more than 25% likely

CFCC should let programs determine what criteria are needed rather than prescribing 100%

Not all programs are beholden to 3rd party payors. Why hold ALL programs to this line of sight requirement when it doesn't apply to all?

Is there contact information somewhere for all the regional groups?

The CFCC isn't responsible for ensuring that clinical ed programs are in compliance with 3rd party payer regulations - that's differnt

We need to supervise the amount the client and student need not a minimum amount

Thank you

Thank you CFCC.

Many university clinics are free to the clients. We already adhere, if needed, to state requirements. But we do not need to adhere to third party payer requirements. Asking ALL of us to do this because some must is unfair, costly to strapped programs, and not a well-considered idea.

Thank you!

I want to thank you all for this presentation.

Thanks for taking time to meet wtih us

Thank you!

thank you!

Thank you!

Thank you

Thank you all for everything you’ve done!

Thank you!

Thank you

if we are all facing these problems and all have concerns, why can't changes occur to the 100%? It is rigid for now reason

Thank you!

Thank you all for this presentation, very helpful

Thanks