SPEECH-LANGUAGE PATHOLOGY SERVICES

Shannon Hall-Mills, Ph.D., CCC-SLP

BEESS Program Specialist2011 Schools & Medicaid Conference, TampaMay 5, 2011

ROLES & RESPONSIBILITIES OF SLPS

Recent guidance from the American Speech Language Hearing Association (ASHA; 2010): http://www.asha.org/SLP/schools/prof-consult/guidelines.htm Highlights key roles and responsibilities of the school-based SLP

Among the SLP’s range of responsibilities: Compliance –based duties, including Medicaid billing

Related Resources from ASHA: Medicaid Primer (in Special Interest Division newsletter) ASHA Schools Finance Committee Presentation (2010):

http://convention.asha.org/annual/2010/speaker_handouts.cfm(search for last name of speaker Deppe or Ireland)

ASHA WEB SITE RESOURCES

• Frequently Asked Questions…and Answers!!!• Info re: “under the direction/supervision of”

• Medicaid Billing Facts

• IDEA & Medicaid Side by Side

• Medicaid & 3rd Party Payments in Schools

• Flowchart of Medicaid Funds

ASHA School Funding Advocacy:http://www.asha.org/advocacy/schoolfundadv

SPEECH-LANGUAGE SERVICES & MEDICAID Chapter 4: Speech-language pathology services involve:

evaluation and treatment of speech and language disorders Services include evaluating and treating disorders of:

verbal and written language articulation, phonology voice fluency, mastication deglutition cognition communication (including the pragmatics of verbal communication) auditory or visual processing memory comprehension and interactive communication use of instrumentation, techniques, and strategies to remediate and

enhance the student’s communication needs, when appropriate. oral pharyngeal and laryngeal sensorimotor competencies

From School Match Handbook (January, 2005)

BEFORE IDEA 2004

Goals, Objectives, & Benchmarks: Prior to July 1, 2005, IDEA required that all annual IEP goals have measurable short term objectives or benchmarks.

Short-term objectives were defined as breaking "the skill described in the annual goal down into discrete components“,

Benchmarks were described as "the amount of progress the child is expected to make within specified segments of the year" (IDEA 1999 Regulations, Appendix A, Question 1).

IDEA 2004 The IEP must include the following elements for

all children. Present levels of performance, Measurable annual goals, including academic &

functional goalsmeasurable benchmarks or objectives for some

students*

Statement of needed special education & other services

300.320, CFR, Definition of individualized education program

Additional pieces for transition goals for older students (>age 16)

IDEA 2004

Beginning July 1, 2005 short-term objectives or benchmarks are required only on the IEPs of those students who are assessed (under No Child Left

Behind) using alternate standards rather than grade level standards.

For other IEPs, short-term objectives or benchmarks are no longer mandated.

However, there are compelling educational and legal reasons to continue to use them.

300.320, CFR, Definition of individualized education program

PURPOSES OF SHORT-TERM OBJECTIVES

Purpose of objectives and benchmarks is to assess progress.

Periodic Progress Reports are required: IEP must still reflect how progress will be assessed and

how often.

IDEA case decisions from recent years reflect the critical role of objectively measured progress in the education of children who have disabilities.

Medicaid requires objectives be in plans of care.

EVALUATIONS

WHAT MEDICAID REQUIRES WHAT SBE RULE 6A-6.0331, FAC, REQUIRES

Determine student’s level of functioning & competencies through professionally accepted techniques.

Use evaluation to develop baseline data to identify the need for early intervention & address the student’s functional abilities, capabilities, activities performance, deficits and limitations.

Students suspected of having a disability are subject to general education intervention procedures.

gather relevant functional, developmental, and academic information

decisions re: eligibility & educational program needs cannot rely solely on one measure

Instruments/measures used: variety of measures technically sound culturally & linguistically sensitive administered by appropriate personnel administered per intended purpose (reliability

& validity) tailored to assess specific areas of

educational need accurately reflect the student’s aptitude or

achievement level provide relevant information to determine

educational needs Cover all areas related to a suspected

disability sufficiently comprehensive to identify all ESE

needs (whether or not commonly linked to the disability category in which the student is classified)

SPEECH & LANGUAGE EVALUATION REQUIREMENTS PER SBE RULES

SBE Rules (Effective July 1, 2010) specify the minimum evaluation components required for speech and language evaluations SBE Rule 6A-6.03012, F.A.C., Exceptional Education

Eligibility for Students with Speech Impairments and Qualifications and Responsibilities for the Speech-Language Pathologists Providing Speech Services

SBE Rule 6A-6.030121, F.A.C., Exceptional Education Eligibility for Students with Language Impairments and Qualifications and Responsibilities for the Speech-Language Pathologists Providing Language Services

MINIMUM EVALUATION COMPONENTS (SI)

Speech Sound Disorders

(SSD)

Fluency Voice

Information gathered

Observation(s) (>2)

Oral mechanism exam

Other >1 Standardized,

NR measure for Artic/Phon

Assess 4 areas; Speech sample (300-500 words)

Medical report of laryngeal structure &

function

Eva

luat

ion

Com

pon

ent

Disorder Type

MINIMUM EVALUATION COMPONENTS (LI)

PK K-12

Information gathered

Observation(s)

Standardized, norm-referenced instrument(s)

Other N/A Data review of interventions &

student response

Grade Level

Eva

luat

ion

Com

pon

ent

CONTACT INFORMATION

Shannon Hall-Mills Phone: (850) 245-0478 Email: shannon.hall-mills@fldoe.org

Links: http://www.fldoe.org/ese/li.asp http://www.fldoe.org/ese/si.asp