MSHA members in action.

Did you see the latest Law? ASHA’s blog on OTC Hearing Aids legislation

Be informed! Check out this ASHA blog! Now That President Trump Signed It Into Law

MSHA Monday: We’ll be posting a blog each Monday…stay tuned.

This summer, MSHA plans to post a blog every Monday. Our goal is to share and compile information that will be useful to your practice. If you’d like to guest blog on any therapy topic, let us know. Our schedule for June is June 5-Books for Therapy, June 12 Board Update, June 19-Sensory Boxes and June 26 Implementing AAC.

“If you know me, you know I love stories.  I read stories, I listen to podcasts that tell stories and I use stories in therapy to work on every aspect of language.  Each year I add to my list of stories that are good for developing specific skills.  While I have favorites for working on pronouns and past tense verbs, I thought I’d offer a list of books that I use most frequently for narrative and expository development.   I’m a big fan of the Story Grammar Marker. I use it to help me to focus on specific stages of narrative development. The icons really help build memory for the key story components and kids love to hold the actual story braid. If you aren’t familiar with this tool, check out this site. https://mindwingconcepts.com/ I’m a random abstract person, so these are in no particular order

  • Waiting is Not Easy by Mo Willems. Well, really anything by Mo Willems is great because the story elements of character and setting are so obvious that it is then easy to teach the temporal sequence and/or perspective taking. Elephant and Piggie have so many great adventures and their emotions are easy to read. I try to use at least one a month. If you haven’t discovered these books, do it. Right now.
  • High Wire Henry by Mary Calhoun.  Henry is another go to character for me and I use at least one of his stories each school year.  He typically has one problem in each book and this offers a great opportunity to teach the critical thinking triangle for the kick off, emotional response and plan that then leads him through the temporal sequence to a solution.  There is also opportunity for a two person perspective between Henry and The Man of the family.  Enjoy.
  • Titch by Pat Hutchins.  The original Titch is great for character and setting. Once again, the pictures support the elements of the story. The subsequent stories, Titch and Daisy, You’ll Soon Grow into them Titch and Tidy Titch,  offer a complete episode that is simple enough for  my kindergartens to retell.

 

  •  For those students who are into non fiction, these books by Gail Gibbons are perfect. They can be read and discussed in a twenty minute session and they offer great practice for expository structures. This one is good for a List as well as Problem/Solution.   There are also books about Hurricanes, Sea Turtles, The Moon, Frogs, From Seed to Plant and the Reason for Seasons.

 

  •  Finally, for the past three years, I’ve been using more classic comic books.  Calvin and Hobbes are great for teaching emotional vocabulary, critical thinking triangle and problem/solution.  After seeing the movie, Life Animated, I am even more committed to using a child’s interests to teach what he/she needs to learn.  I have one student with ASD who has taught me how to make this happen with this book in particular.

 

Our first Summer Blog  is from Rachel Stansberry. Rachel works as an SLP in rural schools in Central Montana. She is a past MSHA board member and a current member of the licensure board. If you have books you love, write them up. We’ll post your list along with this one. Email it to MSHA’s web manager,  Emily at emily.stafslien@lewistown.k12.mt.us 

 

January Webinar: School Aged Children who Stutter: Establishing Attainable Goals

MSHA hosted it’s first webinar of 2017 on Wednesday January 25 Rita Thurman, M.S., CCC-BCS-FD a Stuttering specialist who lives part time time in Bozeman packed a lot of great information into two hours. She did an excellent job of incorporating current research into goal selection. She also gave great examples of three main goals.

  1. The child should be an effective communicator.
  2. The child is comfortable with his/her present level of communication.
  3. The child effectively handles teasing and bullying.

The group discussed use of fluency shaping and stuttering modification as well of different approaches to breath work. We were fortunate to have Steven Moats from the University of Montana who is also a stuttering specialist in the group. Both he and Ms. Thurman shared examples of how they use Mindfulness in their sessions.

She share the following resources.

Stuttering Organizations and Resources

1.  National Stuttering Association www.WeStutter.org

2.  Specialty Board on Fluency Disorders  www:StutteringSpecialists.org

3.  The Stuttering Home Page www.stutteringhomepage.com

4.  Division 4 ASHA–Fluency and Fluency Disorders (Perspectives on Fluency and Fluency Ds)  http://www.asha.org/about/Membership-Certification/divs/div_4.htm

5.  StutterTalk: Podcasts on http://stuttertalk.com/

6.  DPI Module on Perry Flynn’s website:   http://csd.uncg.edu/wp-content/uploads/2012/12/Fluency_Document9.26.pdf

7.  Stuttering Therapy Resources, Inc  J. Scott Yaruss and Nine Reardon Reeves https://www.stutteringtherapyresources.com/

8.  International Stuttering Awareness Day:  October 2016

 

If you missed this webinar, stay tuned for the next one!  MSHA’s goal is to offer 6 this year.  MSHA CEUs are available for each session.

 

 

January President’s Message: A call for State Clinical Achievement Award Nominations

Hello all.  Happy January!  I hope you are all warm and well.

It’s time again to make a call for nominations for the ASHA State Clinical Achievement Award and the Lewis DiCarlo Award. Last year, Catherine Off won the State Clinical Achievement award. In 2015,  Jenn Closson won. In 2014,  Diane Simpson received this award and from all the state winners she went on to win the Lewis DiCarlo Award.  Montana has been fortunate to put forth such excellent candidates!

If there is a clinician in your area who you think does outstanding work or has made significant contributions to the field of SLP or Audiology please send me an email with that person’s name and a brief description of his/her work.  I’d LOVE to see some rural nominees or heck, maybe even an audiologist (yes, I dream BIG).

You can find more information here.  These were the 2016 requirements, but it will give you the idea!

Ok, so let’s hear it.  We have many, many talented folks in our state.  Thanks for your participation.  Stay warm and safe, y’all.  See you soon.

 

Catherine

MSHA President

 

Catherine Drescher, Au.D.

Doctor of Audiology

Director of The Hearing Center

Rocky Mountain ENT

700 W. Kent

Missoula, MT 59801

2017 Legislature is now underway! Here’s a list of Bills MSHA is watching!

2017 Session of the Montana Legislature
Bill Summaries
Prepared for MSHA by Jessica Reynolds
Updated: 1/6/17

HB17/ LC0280
Title: Increase HCBS waiver slots and assisted living reimbursement rates
Sponsor: Ron Ehli (HD86)
Status: (H) Referred to Committee — (H) Human Services
Summary: Increase the number of residential slots available for home and community-based Medicaid services waiver by 200 over the next 2 years. It also increases the daily reimbursement rate over the same period.

HB31/ LC0297
Title: An act increasing the special education allowable cost payment; providing an appropriate; and providing an effective date.
Sponsor: Kathy Kelker (D) HD 47
Status: (H) Referred to Committee — (H) Education; Hearing on 1/9/17
Summary: Allocate money to OPI for increasing SpEd allowable cost payment; $587,620 in FY 2018 and $1,065,895 in FY 2019.

HB32/ LC0298
Title: Revise school funding related to special education
Sponsor: Kathy Kelker (D) HD 47
Status: (H) Referred to Committee — (H) Education; Hearing on 1/9/17
Summary: increase funding to special education cooperatives and joint boards for administration and travel and increasing overall special education allowable cost payment ($2,587,620 in FY 2018; $3,087,895 in FY2019).

HB33/ LC0299
Title: An act revising funding for special education; increasing and revising the distribution of the special education allowable cost payment; etc
Sponsor: Kathy Kelker (D) HD 47
Status: (H) Referred to Committee — (H) Education; Hearing on 1/9/17
Summary: increase funding to special education cooperatives and joint boards for administration and travel and increasing overall special education allowable cost payment ($2,000,000 in FY 2018 and FY2019).

HB36/ LC0279
Title: Fund Alzheimer’s related services provided by area agencies on aging
Sponsor: Gordon Pierson (D) HD 78
Status: (H) Referred to Committee — (H) Human Services
Summary: provide $1,500,000 to DPHHS to be used for care of patients with Alzheimer’s disease (e.g. respite care, in-home and community-based services, providing training for family members, etc.).

HB81/ LC0348
Title: Revise publication and distribution requirements for MAR and ARM
Sponsor: Willis Curdy (D) HD 98
Status: (H) Referred to Committee — (H) State Administration
Summary: the Secretary of State will electronically publish the ARM
HB141/ LC0392
Title: Provide licensing boards with active supervision in antitrust liability cases
Sponsor: Ryan Lynch (D) HD 76
Status: (H) Business and Labor; Hearing on 1/9/17, amendment proposed by MMA (Abby will elaborate)
Summary: provide active supervision to bring Montana state board in accordance with recent U.S. Supreme Court rulings

HB178/LC0161
Title: Provide ANB funding for 19 year olds
Sponsor: Mary Moe (SD12)
Status: (H) Referred to Committee — (H) Education
Summary: change admittance to school to 5 years of age on or before September 10th, A pupil who has not reached 20 years of age by September 10 of the school year, who has not graduated, and who is enrolled for the purpose of earning credits to meet the district’s graduation requirements for a high school diploma may be included in the ANB calculations

HB191/LC2267
Title: Provide inflationary increase for ANB funding
Sponsor: Seth Berglee (R) HD 58
Status: (H) Hearing — (H) Education; Hearing on 1/11/17
Summary: Provide inflationary adjustment for ANB funding (e.g. $300,000 per to $309,000 per year

HJ1/ LC0301
Title: Request study of funding for education programs for special needs students
Sponsor: Kathy Kelker (D) HD 47
Status: (H) Referred to Committee — (H) Education
Summary: establish an interim committee to study best practices, funding, etc for special needs, gifted and talented children, and at-risk students in Montana

LC0013
Title: Repeal Montana Health and Economic Livelihood Partnership Act
Sponsor: Bob Keenan (SD5)
Status: Draft on hold
Summary: Not available

LC0024-0025
Title: Generally revise healthcare laws
Sponsor: Edward Buttrey (SD11)
Status: Drafts on hold
Summary: Not available

LC0058
Title: Generally revise insurance laws
Sponsor: Cary Smith (SD27)
Status: Draft on hold
Summary: Not available

LC0080-LC0083
Title: Generally revise insurance laws
Sponsor: Mary Caferro (SD41)
Status: Draft on hold
Summary: Not available

LC0147
Title: Revise insurance laws
Sponsor: Jim Keane (HD73)
Status: Draft on hold
Summary: Not available

LC0163
Title: Increase K-12 BASE aid
Sponsor: Jill Cohenour (SD42)
Status: Draft ready for delivery
Summary: Increase overall ANB in Montana (e.g. from $300,000 per year to $309,000 per year)

LC0164
Title: Allow ANB funding for students with disabilities up to age 22
Sponsor: Moffie Funk (D) HD 82
Status: Draft ready for delivery
Summary: decrease school admittance age to 5 on or before September 10th, allow students with disabilities on special education services and who have not yet graduated to be included in ANB calculations up to age 22

LC0165
Title: Increase funding for special education cooperatives
Sponsor: Moffie Funk (HD82)
Status: Draft ready for delivery
Summary: increase proportion of special education funds to special education cooperatives and joint boards for administration and travel, increase funding by $2,000,000 for special education in FY2018 and FY2019

LC0166
Title: Inflationary increase for special education allowable cost of payment
Sponsor: Moffie Funk (HD82)
Status: Draft ready for delivery
Summary: include special education allowable cost payment in overall education inflationary increases

LC0251
Title: Generally revise laws regarding disabilities
Sponsor: Mary Caferro (SD41)
Status: Draft on hold
Summary: Not available

LC0253
Title: Generally revise healthy Montana kid laws
Sponsor: Mary Caferro (SD41)
Status: Draft to requester for review
Summary: Not available

LC0256
Title: Provide for licensing of board certified behavior analysts
Sponsor: Mary Caferro (SD41)
Status: Draft to requester for review
Summary: Not available

LC0529-LC0532
Title: Generally revise insurance laws
Sponsor: Mary Caferro (D) SD 41
Status: Drafts on hold
Summary: Not available

LC0584
Title: Interim study resolution on developmental disabilities
Sponsor: Mary Caferro (D) SD 41
Status: Draft request received
Summary: Not available

LC0596
Title: Generally revise insurance laws
Sponsor: Pat Connell (R) SD 43
Status: Draft request received
Summary: Not available

LC0665
Title: Generally revise medicaid laws
Sponsor: Nancy Ballance (R) HD 87
Status: Draft on hold
Summary: Not available

LC0687
Title: Generally revise insurance laws
Sponsor: Mary Caferro (D) SD 41
Status: Draft on hold
Summary: Not available

LC0794-0795
Title: Revise insurance laws
Sponsor: Steve Fitzpatrick (R) SD 10
Status: Draft on hold
Summary: Not available

LC0822
Title: Change the opt-in for TBI to an opt-out on vehicle registration forms
Sponsor: Bradley Hamlett (D) HD 23
Status: Draft ready for delivery
Summary: changes use of TBI revenues to be used for education and support recovery of individuals with TBI; changes the $1 donation to this fund given during vehicle registration to an opt-out

LC0860-0863
Title: Generally revise insurance laws
Sponsor: Gordon Vance (R) SD 34
Status: Drafts on hold
Summary: Not available
LC0913
Title: Provide for early edge
Sponsor: Ryan Lynch (D) HD 76
Status: Draft request received
Summary: Not available

LC0943
Title: Provide for Head Start funding
Sponsor: Edith (Edie) McClafferty (D) SD 38
Status: Draft on hold
Summary: Not available

LC0961
Title: Generally revise K-12 funding
Sponsor: Dave Fern (D) HD 5
Status: Draft on hold
Summary: Not available

LC1055
Title: Generally revise insurance laws
Sponsor: Ellie Hill Smith (D) HD 90
Status: Draft on hold
Summary: Not available

LC1078
Title: Provide legislative intent for Medicaid waiver for DD services
Sponsor: Mary Caferro (D) SD 41
Status: Draft request received
Summary: Not available

LC1079
Title: Fund direct care worker wage increases in developmental disability services
Sponsor: Mary Caferro (D) SD 41
Status: Draft request received
Summary: Not available

LC1096
Title: Revise developmental disability laws
Sponsor: Ryan Lynch (D) HD 76
Status: Draft request received
Summary: Not available

LC1104
Title: Provide for pre-kindergarten education
Sponsor: Ryan Lynch (D) HD 76
Status: Draft on hold
Summary: Not available

LC1280
Title: Revise insurance laws
Sponsor: Steve Fitzpatrick (R) SD 10
Status: Draft on hold
Summary: Not available

LC1336
Title: Interim study on healthcare and health insurance costs
Sponsor: Andrea Olsen (D) HD 100
Status: Draft on hold
Summary: Not available

LC1343
Title: Generally revise healthcare law
Sponsor: Andrea Olsen (D) HD 100
Status: Draft on hold
Summary: Not available

LC1346 & LC1348
Title: Generally revise insurance laws
Sponsor: Andrea Olsen (D) HD 100
Status: Drafts on hold
Summary: Not available

LC1368
Title: Generally revise K-12 education funding
Sponsor: Fred Anderson (R) HD 20
Status: Draft on hold
Summary: Not available

LC1464
Title: Provide reimbursement parity for healthcare providers
Sponsor: Vince Ricci (R) HD 55
Status: Draft request received
Summary: Not available

LC1467
Title: Reform Medicaid
Sponsor: Vince Ricci (R) HD 55
Status: Draft request received
Summary: Not available

LC1483
Title: Generally revise healthcare laws
Sponsor: Frank Garner (R) HD 7
Status: Draft request received
Summary: Not available

LC1502
Title: Generally revise occupational license laws
Sponsor: Frank Garner (R) HD 7
Status: Draft request received
Summary: Not available

LC1515
Title: Revise laws related to access for persons with disabilities
Sponsor: Denley M Loge (R) HD 14
Status: Draft request received
Summary: Not available

LC1552
Title: Revise insurance laws
Sponsor: JP Pomnichowski (D) SD 33
Status: Draft on hold
Summary: Not available

LC1609
Title: Generally revise laws related to Medicaid
Sponsor: Andrea Olsen (D) HD 100
Status: Draft request received
Summary: Not available

LC1615-1616
Title: Generally revise insurance laws
Sponsor: Keith Regier (R) SD 3
Status: Drafts on hold
Summary: Not available

LC1620
Title: Generally revising laws related to EPSDT benefit
Sponsor: Mary Caferro (D) SD 41
Status: Draft request received
Summary: Not available

LC1670-1672
Title: Generally revise insurance laws
Sponsor: Matt Regier (R) HD 4
Status: Drafts on hold
Summary: Not available

LC1732-1733
Title: Generally revise laws on occupations and professions
Sponsor: Casey Knudsen (R) HD 33
Status: Draft requests received
Summary: Not available

LC1738
Title: Pilot project on supported employment, training for workers with disabilities
Sponsor: Casey Schreiner (D) HD 26
Status: Draft on hold
Summary: Not available

LC1743
Title: Generally revise Medicaid laws
Sponsor: Casey Schreiner (D) HD 26
Status: Draft request received
Summary: Not available

LC1768 & LC1776
Title: Generally revise HELP act
Sponsor: Tom Burnett (R) HD 67
Status: 1768: Draft to requester for review; 1776: Draft request received
Summary:

LC1786
Title: Generally revise health care
Sponsor: Geraldine Custer (R) HD 39
Status: Draft request received
Summary: Not available

LC1856
Title: Generally revise health care laws
Sponsor: Tom Woods (D) HD 62
Status: Draft request received
Summary: Not available

LC1936
Title: Revise insurance laws
Sponsor: Jim Keane (D) HD 73
Status: Draft request received
Summary: Not available

LC1962
Title: Generally revise Medicaid laws
Sponsor: Frederick (Eric) Moore (R) SD 19
Status: Draft on hold
Summary: Not available

LC1966
Title: Generally revise laws concerning Medicaid expansion
Sponsor: Frederick (Eric) Moore (R) SD 19
Status: Draft on hold
Summary: Not available

LC1974
Title: Generally revise education laws regarding pre-kindergarten
Sponsor: Frederick (Eric) Moore (R) SD 19
Status: Draft request received
Summary: Not available

LC1992
Title: Revise funding for students with disabilities
Sponsor: Jim Hamilton (D) HD 61
Status: Draft on hold
Summary: Not available

LC2025
Title: Revise laws related to professions and occupations
Sponsor: Derek Skees (R) HD 11
Status: Draft request received
Summary: Not available

LC2046
Title: Generally revise insurance laws
Sponsor: Jennifer Eck (D) HD 79
Status: Draft on hold
Summary: Not available

LC2081
Title: Revise laws related to requirements for teachers of deaf students
Sponsor: Jean Price (D) HD 24
Status: Draft request received
Summary: Not available

LC2085
Title: Generally revise insurance laws
Sponsor: Terry Gauthier (R) SD 40
Status: Draft request received
Summary: Not available

LC2089
Title: Generally revise telemedicine laws
Sponsor: Kirk Wagoner (R) HD 75
Status: Draft taken off hold
Summary: Not avilable

LC2181
Title: Generally revise school funding
Sponsor: Vince Ricci (R) HD 55
Status: Draft request received
Summary: Not available

LC2231
Title: Reduce medical/dental deductibility threshold to 5% of adjusted gross income
Sponsor: Brad Tschida (R) HD 97
Status: Draft to requester for review
Summary: Not available

LC2249
Title: Provide for limited speech-language pathologist or audiologist license
Sponsor: Donald W Jones (R) HD 46
Status: Draft request received
Summary: Provide the Aud-SLP licensing board the authority to issue temporary licenses to clinical fellows

LC2270
Title: Revise insurance laws
Sponsor: Steve Fitzpatrick (R) SD 10
Status: Draft request received
Summary: Not available

LC2294
Title: Revise laws related to education funding
Sponsor: Edith (Edie) McClafferty (D) SD 38
Status: Draft request received
Summary: Not available

LC2318
Title: Joint resolution regarding social security and medicare
Sponsor: Edith (Edie) McClafferty (D) SD 38
Status: Draft request received
Summary: Not available

LC2338
Title: Generally revise insurance laws
Sponsor: Forrest Mandeville (R) HD 57
Status: Draft on hold
Summary: Not available

LC2358
Title: Generally revising insurance laws
Sponsor: Jonathan Windy Boy (D) HD 32
Status: Draft on hold
Summary: Not available

Speech Aide Registrations Due October 31

This is the month when SLPs and Audiologists are required to register their aides by October 31. The Executive Officer for the Board of Speech Language Pathologists and Audiologists sent an email with the updated registration form. If you did not receive this form or if you have questions on submitting this form, you can contact Licensing Unit A at 406-444-6880 or UnitA@mt.gov You can download the form from the board’s website at www.slpaud.mt.gov.
Here is the link to the MCA that lists this requirement
http://leg.mt.gov/bills/mca/37/15/37-15-313.htm
The form is much easier to complete, but if you are not familiar with the rules and regulations for types of aides, supervisor responsibility, allowable function and determining the amount of supervision for your aide, check out the statutes and rules which can be found here:
http://www.mtrules.org/gateway/ChapterHome.asp?Chapter=24%2E222
http://www.mtrules.org/gateway/RuleNo.asp?RN=24%2E222%2E301

Perhaps the most frequently asked question is what level is my aide? Even if someone is a great person, has a degree in a related field, the law reads as follows:

“Speech-language pathology aides or assistants shall be classified in one of the following categories:
(a) “aide or assistant I” means a person who holds an undergraduate degree in communication sciences and disorders, or its equivalent, and is currently enrolled in an accredited graduate program for the purpose of completing licensure requirements;
(b) “aide or assistant II” means a person who holds an undergraduate degree in communication sciences and disorders, or its equivalent, but is not currently enrolled in an accredited graduate program; and
(c) “aide or assistant III” means a person who holds no undergraduate degree in communication sciences and disorders or its equivalent.
(6) “Supervision” means on-site observation and guidance by the supervising licensed speech-language pathologist or audiologist while a clinical activity is performed by the speech-language pathology or audiology aide or assistant. On-site supervision performed by the licensee may include but is not limited to the following:
(a) observation of a portion of the screening or treatment procedures performed by the aide or assistant;
(b) coaching the aide or assistant; and
(c) modeling for the aide or assistant.”

The other frequently asked question is “How much do I need to supervise my aide”
Here is the information from 24.222.702
SCHEDULE OF SUPERVISION – CONTENTS
(1) For monitoring purposes, the supervisor must complete an aide registration form supplied by the board, including a schedule of supervision. The board or board designee shall review and approve all schedules of supervision.
(2) Speech-language pathology aides or assistants shall be supervised in accordance with their level of aide classification under the following schedule:
(a) aide or assistant I shall be supervised on-site a minimum of ten percent of total client contact time. At the discretion of the supervising speech-language pathologist, the on-site supervision requirement may be reduced to two percent after the first year of supervision.
(i) If diagnostic evaluations are being performed, the aide or assistant I shall be supervised on-site a minimum of 30 percent of the total diagnostic process.
(b) aide or assistant II shall be supervised on-site ten percent of client contact time; and
(c) aide or assistant III shall be supervised on-site 20 percent of client contact time.
(3) Audiology aides or assistants shall be supervised in accordance with the following schedule:
(a) audiology aides or assistants shall be supervised under a proposed plan to be submitted by the supervisor with the aide application that includes a minimum of ten percent of client contact time; and
(b) industrial audiology aides or assistants shall be supervised under (3)(a), but may be authorized to conduct pure tone air conduction threshold audiograms when performing outside the physical presence of a supervisor.
(4) The schedule of supervision must be signed by the proposed supervisor and by a responsible representative of the employing agency and submitted to the board on or before October 31. Aides employed after October 31 shall work no more than 30 calendar days without registering with the board.

At this time, Montana doesn’t recognize Speech-Language Pathology Assistants, so if an individual who has completed an SLPA program would still need to be registered according the the categories listed above.

MSHA is committed to supporting professionals who supervise aides and we are here to help you with this process. We are also looking toward establishing training for SLP Assistants. If you would like to be a part of this process, let us know!

Telepractice Law and Rules

Telepractice LawMontana in June
MSHA is committed to supporting telepractice by providing training and information to practitioners and consumers.  Practitioners should be familiar with both the law and the rules prior to initiating services via telepractice.

The complete law can be found by searching the Montana Code Annotated

37-15-102 (relevent portions)

(5) “Facilitator” means a trained individual who is physically present with the patient and facilitates telepractice at the direction of an audiologist or speech-language pathologist. A facilitator may be but is not limited to an audiology or speech-language pathology aide or assistant.

(6) “Patient” means a consumer of services from an audiologist or speech-language pathologist, including a consumer of those services provided through telepractice.

(11) “Telepractice” means the practice of audiology or speech-language pathology by an audiologist or speech-language pathologist at a distance through any means, method, device, or instrumentality for the purposes of assessment, intervention, and consultation.

37-15-314. Telepractice — authorization — licensure. (1) An audiologist or speech-language pathologist who is licensed under and meets the requirements of this chapter may engage in telepractice in Montana without obtaining a separate or additional license from the board.
(2) Except as provided in 37-15-103, an audiologist or speech-language pathologist who is not a resident of Montana and who is not licensed under this chapter may not provide services to patients in Montana through telepractice without first obtaining a license from the board in accordance with this part.
(3) An audiology aide or assistant or a speech-language pathology aide or assistant may not engage in telepractice. This section does not prohibit an audiology aide or assistant or a speech-language pathology aide or assistant from serving as a facilitator.

37-15-315. Scope of telepractice — requirements. (1) The quality of services provided through telepractice must be equivalent to the quality of audiology or speech-language pathology services that are provided in person and must conform to all existing state, federal, and institutional professional standards, policies, and requirements for audiologists and speech-language pathologists.
(2) Technology used to provide telepractice, including but not limited to equipment, connectivity, software, hardware, and network compatibility, must be appropriate for the service being delivered and must address the unique needs of each patient. Audio and video quality utilized in telepractice must be sufficient to deliver services that are equivalent to services that are provided in person. A person providing telepractice services is responsible for calibrating clinical instruments in accordance with standard operating procedures and the manufacturer’s specifications.
(3) A person providing telepractice services shall comply with all state and federal laws, rules, and regulations governing the maintenance of patient records, including maintaining patient confidentiality and protecting sensitive patient data.
(4) A person providing telepractice services shall conduct an initial assessment of each patient’s candidacy for telepractice, including the patient’s behavioral, physical, and cognitive abilities to participate in services provided through telepractice. Telepractice may not be provided only through written correspondence.
(5) At a minimum, a person providing telepractice services shall provide a notice of telepractice services to each patient and, if applicable, the patient’s guardian, caregiver, or multidisciplinary team. The notification must provide that a patient has the right to refuse telepractice services and has options for service delivery and must include instructions on filing and resolving complaints.

The Rules can be found by searching the rules
http://www.mtrules.org/gateway/showNoticeFile.asp?TID=5731

Rule I definitions

(1) “Asynchronous” means a method of exchanging information that does not require the patient and the provider to be available at the same time. Examples of such communication, also known as “store-and-forward” transmission, include e-mails, faxes, recorded video clips, audio files and virtual technologies and e-learning programs.

(2) “Synchronous” means interactive transmission of data occurring bi-directionally in real time and requiring the patient and the provider be available at the same time.

Rule II provision of telepractice serives

(1) The provision of speech-language pathology or audiology services in this state through telepractice, regardless of the physical location of the speech-language pathologist or audiologist, constitutes the practice of speech-language pathology or audiology and is subject to state licensure requirements and regulation by the board.

Rule III limits on telepractice

(1) No person licensed as a speech-language pathologist or audiologist in another state may engage in the practice of speech-language pathology or audiology in Montana, including telepractice services, unless a license to practice has been issued in Montana.

(2) A person located outside this state who provides speech-language pathology or audiology telepractice services to any patient in Montana shall be appropriately licensed in the jurisdiction in which the person providing telepractice services is located.

(3) All telepractitioners must abide by any statute or rule of this state governing the maintenance of patient records and patient confidentiality, regardless of the state where the records are maintained.

Rule IV delivery of telepractice serices

(1) Telepractice services may be delivered in a variety of ways, including:
(a) Asynchronous transmission:
(i) store-and-forward model/electronic transmission of stored clinical data from one location to another usually by the Internet via e-mail or fax; and
(ii) video and audio transmission through regular mail service delivery and express delivery services; and
(b) Synchronous transmission:
(i) clinician interactive model is a real time interaction between provider and patient that may occur via audio or audio/video transmission over telecommunication links such as telephone, Internet, or other methods for distance communication, including:
(A) videoconferencing;
(B) remote control software applications;
(C) computer applications;
(D) e-mail correspondence, including attachments; or
(E) self-monitoring/testing model, which refers to the patient who receives the services and provides data to the provider without a facilitator present at the site of the patient.
(2) Live versus stored data refers to the actual data transmitted during the telepractice. Live, real time, and stored clinical data may be included during the telepractice.

Rule V quality of telepractice services

(1) Elements of quality assurance include the competency of licensees, selection of patients, appropriateness of technology to the service being delivered, identification of appropriate outcome measures, collection of data, and satisfaction of the patient, caregiver, and provider.
(2) Telepractice services must conform to professional standards, including all appropriate and applicable codes of ethics.
(3) Licensees shall not engage in false, misleading, or deceptive advertising of telepractice services.
(4) Telepractice services may not be provided solely by correspondence, e.g., mail, e-mail, and faxes, although such may be adjuncts to telepractice.
(5) Licensees shall engage in only those aspects of the professions that are within the scope of their competence, considering their level of education, training, and experience.
(6) Telepractice services must be in compliance with safety and infection control policies and procedures.

Rule VI establishing the practitioner-patient relationship

(1) A practitioner-patient relationship may commence via telepractice following a practitioner’s in-person evaluation of the prospective patient to assess the patient’s:
(a) need for services; and
(b) candidacy for telepractice, including behavioral, physical, and cognitive abilities to participate in telepractice services. Telepractice services may be provided by the patient’s evaluator or another qualified speech-language pathologist or audiologist by the board.

(2) Prior to initiating services, a speech-language pathologist or audiologist shall:
(a) make reasonable attempts to verify the identity of the patient;
(b) obtain alternative means of contacting the patient other than electronically;
(c) provide to the patient alternative means of contacting the licensee other than electronically;
(d) document whether the patient has the necessary knowledge and skills to benefit from the type of telepractice provided by the licensee;
(e) determine the availability of a facilitator, if needed, with the necessary level of training to assist at the patient’s location;
(f) provide orientation and training to the patient in the use of telepractice equipment and the telepractice protocol at an appropriate level for the patient; and
(g) inform the patient in writing of the following:
(i) the limitations of using technology in the provision of telepractice;
(ii) the potential risks to the confidentiality of information due to technology used in telepractice;
(iii) the potential risks of disruption in the use of telepractice;
(iv) when and how the licensee will respond to routine electronic messages;
(v) in what circumstances the licensee will use alternative communications for emergency purposes;
(vi) who else may have access to patient communications with the licensee;
(vii) how communications can be directed to a specific licensee;
(viii) how the licensee stores electronic communications from the patient; and
(ix) that the licensee may elect to discontinue the provision of telepractice services.

(3) The written document required by (2)(g) shall be signed by both the licensee and the patient and maintained in the clinical record. If the patient is a minor, the document shall be signed by the patient’s parent or guardian.

Rule VII competence-practice limits-maintenance and retention of records

(1) A licensee using telepractice to deliver services shall:
(a) complete four hours of board-approved telepractice training prior to engaging in telepractice in Montana;
(b) limit telepractice services to the licensee’s scope of practice;
(c) maintain continuing competency or associate with a group who has experience in telepractice delivery of care;
(d) use methods for protecting health information that include authentication and encryption technology;
(e) limit access to protected health information to only those necessary for the provision of services or those required by law; and
(f) ensure that confidential communications obtained and stored electronically cannot be recovered and accessed by unauthorized persons when the licensee disposes of electronic equipment and data.

(2) A speech-language pathology or audiology aide or assistant may function as a facilitator, but may not provide telepractice services.

Finding rules and Regulations for license, supervision of aides and telepractice

Hell MSHA

At our January web meeting, we offered information on how to navigate the Montana Rules and Regulations.

Are you looking for Information on how to apply for a license?  This address should take you to the page you need to get started. Click on the License Information tab and select what type you need.

bsd.dli.mt.gov/license/bsd_boards/slp_board/board_page.asp

One of the unique requirements in Montana is
“Passage of the Board of Speech-Language and Audiology Montana Jurisprudence exam with a score of 95% or higher”

This should take you to the license application and the exam is at the end.

http://bsd.dli.mt.gov/license/bsd_boards/slp_board/pdf/slp_app.pdf

The answers for this exam can be found by going to this page

http://www.mtrules.org/

and then searching for the rule.

Once you are licensed, it is helpful to have these links.

RULES FOR AIDES

http://www.mtrules.org/notice/result.asp

TELEPRACTICE RULES

http://www.mtrules.org/notice/result.asp

Good luck and contact MSHA if you need help with this process!

 

Rachel Stansberry

MSHA End of the Year Summary

Hello MSHA,

As we come to the end of 2015, I thought I’d share the highlights of our year by sharing our goals and progress. At our first meeting January, we established the following goals. Following each, I’ve summarized our progress.

  1. Maintain the high quality of Fall Convention and MSHA sponsored activities.  Our fall convention was a success and we were also cosponsors of many CEU activities including the Ritecare Spring Conference with Sarah Ward.
  2. Maintain Membership at 200 and increase active members.  We actually hit 300! We have 96 students, 164 SLPs, 24 Audiologists, 7 dual and 9 speech aides.  Don’t forget to renew for 2016 if you haven’t already! We have members active on several issues including telepractice, convention planning, scholarship and licensure issues.
  3. Maintain Involvement at the National Level  We received two grants from ASHA, our president-elect attended CSAP, our SEAL attended the schools conference.  We nominated two members for national awards.
  4. Be active and involved in the legislature with issues that effect members.  We successfully passed a bill to allow billing for E and M codes and we were actively involved in several other bills including one that allows for speech therapy coverage for individuals with Down’s Syndrome.  We recently appeared at the Economic Affairs Interim Committee meeting to express our concern about license fees.
  5. Be active and involved with all our members including our students. We awarded two MSHA scholarships, we answered questions from members, provided monthly training on telepractice and addressed concerns about licensure fees.  We launched our new website. We published out newsletter, the Communicator. We sent monthly emails and kept our facebook page active with monthly themes.  We added a pinterest account. We had excellent student participation at convention for the poster session.
  6. Improve communication and involvement with the licensure board.  We spent the year working to get a complete licensure board and we are now respectively requesting  this new board to address our concerns about license fees.

We are proud of our members and our accomplishments. For 2016, we plan to survey members and continue to build groups to address our interests and concerns. We plan to offer monthly web meetings to address these concerns and we are encouraging and supporting groups to gather. We are working to provide fall convention offerings that will attract school based and medical based SLPs, audiologists and students.  We welcome your input!

Happy New Year!

Rachel Stansberry,  2015 MSHA President.

 

Convention Highlights-Social Communication Development

The Montana Speech-language Hearing Association hosted Maryellen Moreau at their annual convention this year. Mrs. Moreau is known for her work developing the Story Grammar Marker. She has since expanded her company, Mindwing Concepts to include excellent tools for students to build narrative, thinking social communication and comprehension skills. Check out all they do at Mindwingconcepts.com
Her presentation focused on social communication development through narrative based intervention. Story based intervention was cited as one of the eleven established treatments for Autism.: The only non-behavioral intervention cited.  (National standards Project, Evidence Based Practice and Autism in the schools).
Those of us who know and use the Story Grammar Marker know this tool to be an amazing support for students in their efforts to learn how to put together a personal narrative, story retell or for understanding expository text.  In this presentation, she highlighted books and ways that focus us toward the specific needs of students with social communication challenges.
The key points she made included these:
  • The importance of fully describing and discussing the setting in a story to help children recognize and truly understand all that is expected and unexpected within a given context. The kick off in story is what then separates the expected from the unexpected.
  • The importance of narrating the same story from the view point of more than one character. This is a great way to work on perspective taking and help students understand that two different characters can have a different emotional reaction and plan in response to the same situation.
  • The importance of teaching the thinking verbs as well as the verbs that tell how something is expressed (she called these the linguistic verbs).
  • It’s often the illustrations that provide much of this information and we can use these as a teaching tool.
The Paper Bag Princess Robert Munch-Great for illustrations for body language/emotional language. Text is good for emotional verbs/thinking verbs
Clifford’s Pals  Norman Birdwell – and all the Clifford books are good for  seeing a kick off, showing cause and effect from more than one perspective.
Knuffle Bunny   Mo Willems -wonderful for two person perspective (All of Mo Willems books are good for this).
Calvin Can’t Fly  -Nice to show a social situation as well as problem solving.
Are you Ready to Play Outside-Mo Wilhelms- Five stars to show emotional language, two perspectives, problem solving and how one being can be working toward a solution while the other is caught in the problem.
She also read a passage from  this adult bookRain, Reign  by Ann Martin.  It is the story of a girl with ASD and the way she thinks. The passage provided a great example of how an individuals compulsions or obsessions can interfere with his/her ability to process what is going on in any given moment.  Just as the book The Curious Incident of the Dog in the Night had a great example of how something as random as seeing a certain color car can cause someone to have a bad day, this book showed how preoccupation with something like homophones can take over all thinking.
This was a great workshop and I personally left with many ideas and new ways to use books to build social communication skills.
-Rachel