Legislative Update:

 

New Mexico State Law Regarding SLP Caseloads in the Schools

New Mexico Administrative Code 6.30.2.10.g “Class loads”

Title 6   PRIMARY AND SECONDARY EDUCATION
Chapter 30EDUCATIONAL STANDARDS – GENERAL REQUIREMENTS
Part 2STANDARD FOR EXCELLENCE
2.10PROCECURAL REQUIREMENTS
2.10.g  CLASS LOADS

(2)   Student/staff ratios in gifted and special education

(a)     The student/staff caseload shall not exceed 35:1 for a special education teacher and 60:1 for a speech-language pathologist for special education services or speech-only services, in which properly licensed special education teachers or speech-language pathologists travel from class to class or school to school, providing services to students with disabilities whose individualized education programs (IEPs) require a minimal amount of special education.  (A minimal amount of special education services shall not exceed 10 per cent of the school day/week.)

(b)     The student/staff caseload shall not exceed 24:1 for a special education teacher and 35:1 for a speech-language pathologist for special education services or speech-only services which properly-licensed special education teachers or speech-language pathologists provide to students with disabilities who’s IEPs require a moderate amount of special education. (A moderate amount of special education services shall be less than 50 per cent of the school day.)

The best site for information about services in the public schools is the New Mexico State Public Education Department the link is:

http://www.ped.state.nm.us/SEB/law/index.html

Research Survey Regarding Behavioral Strategies Used by Educational Assistants

Marc Schroeder, a graduate student in the Communication Disorders Program at Eastern New Mexico University, is conducting research to find out if there a need for specialized training in behavior management for the educational professional. He is particularly interested in what behavior strategies educational professionals use, where they learned these strategies, and how effective these strategies are in practice. Information collected from this research will be used to advance clinical knowledge on behavioral techniques and necessary training required for educational professionals.

If you choose to participate, you will be asked to participate in either or both of the following:

1. To answer questions in an online survey format. No identifying information will be collected in this survey (including your IP address). The survey will be approximately 10-15 minutes in length and can be completed at any time for your convenience.

2. To answer questions in an interview format. If you agree to participate in this aspect of the research, you will be asked to provide contact information to the researcher and to sign a consent form. The researcher will contact you to conduct an interview. All information collected from interviews will be held in confidence and your name will not be associated with your responses (you will be assigned an identification number). All data collected will be stored in password protected digital files at all times.

Your decision to participate in this research is completely voluntary and your consent or declination will not affect your relationship with ENMU or your employer in any way (grades, job status, access to services, etc.). You also have the right to withdraw from the study at any time without penalty by simply exiting the survey or declining to answer any question. Please rest assured that all information disclosed will be held under the strictest confidence and will not be made available under any circumstances to another person without your express written permission. Should this research be published for scientific purposes at a later date, your identity will remain confidential.

Questions regarding this research study are welcomed and encouraged. Please address them to this researcher, Marc Schroeder, marc.schroeder@enmu.edu or 505-720-6395. Questions may also be addressed to my project supervisor, Dr. Suzanne House Swift, CCC-SLP at the ENMU Speech and Hearing Rehabilitation Outreach Center, Station #3, Lea Hall, Room #225, Portales, NM 88130 (575) 562-2724; suzanne.swift@enmu.edu.

Participants who elect to complete the survey online will not be asked to sign a consent form and no identifying information will be collected from them. Please access the on-line survey via the following link:

https://www.surveymonkey.com/r/2HPYTKT

If you are interested in participating in the interview, please contact Marc Schroder directly at marc.shroeder@enmu.edu and he will guide you from there.

Guidelines for the US Department of Education for Evaluation and Appropriate Treatment for ASD Students

U.S. Education Department Says ABA Is Not the Only Treatment for Children With ASD. CMS Agrees.Here is what you can do to advocate for speech-language pathology treatment.

Background. The United States Department of Education (USDOE) issued a guidance letter clarifying the roles of providers and the importance of coordinated delivery of services for children with autism spectrum disorder (ASD). The letter noted that school and early intervention programs should not rely on a single treatment method for children with ASD, such as ABA, and should include speech-language pathologists and other professionals in all decisions regarding evaluation and treatment. This follows extensive advocacy efforts from ASHA on behalf of members and state leaders concerned about the lack of consistent procedures pursuant to IDEA in the assessment and treatment of children with ASD.

There is a similar trend in health care to utilize only ABA specialists to provide care for children with ASD. Singling out ABA services in legislation, such as in mandates and payer policies, as the only treatment for individuals with developmental disabilities, including those with ASD, does not provide the full complement of appropriate treatments, and limits consumer choice. Legislators, payers, and policy makers at local, state, and federal levels should work to ensure that all therapies, not just ABA services, are included for coverage. CMS issued guidance on this topic in July 2014 stating, “While much of the current national discussion focuses on one particular treatment modality called Applied Behavioral Analysis (ABA), there are other recognized and emerging treatment modalities for children with ASD.” Clearly, CMS supports the full complement of services for individuals with autism, as does the U.S. Department of Education.

While this direct guidance is important for ASHA members and consumers, it is only helpful if all of us endeavor to get the “word out” to decision makers at the state level, in school districts, Part C early intervention programs, Medicaid programs, legislatures, and health plans. So please review the letter and share it with decision makers in your work setting.

Actions to Take

In Schools and Early Intervention…

  • Offer in-service training to staff; include how SLPs evaluate and treat children with ASD
  • Suggest to your supervisor ways that SLPs and ABA service providers can collaborate on treatment
  • Communicate with Part C Coordinators and lead agencies about the CMS policy and the USDOE letter

In the Community…

  • Speak with parent groups and local community disability organizations about the importance of a comprehensive evaluation and treatment program (IFSP/IEP), what services speech-language pathology services provide to children with ASD, and how services can be coordinated to provide maximum benefit for children
  • Communicate with pediatricians and primary care physicians about the role SLPs play in treating individuals with ASD, and how USDOE and CMS guidance supports that role

In health and private settings…

  • Communicate with local Medicaid and department of health representatives about the CMS policy and USDOE letter
  • Communicate with health plan representatives and regulators about how the CMS policy and USDOE letter can and should influence payer policies

State legislators and regulators…

  • Meet with legislators to discuss how the CMS policy and USDOE letter can influence state and payer policies
  • Communicate with state insurance regulators about ACA Marketplace exchange plans that require habilitation services, such as speech-language treatment, and how individuals with ASD, who make up a subset of the population with developmental disabilities, may need habilitative services, as well as behavioral treatments, such as ABA

Talking Points

  • SLPs are uniquely qualified to provide assessment and treatment of communication disorders for children with ASD, including social communication disorders
  • Under IDEA Part B, a Free and Appropriate Public Education (FAPE) must be available to all students with disabilities under the law; allowing ABA therapists to dictate services is a violation of the law
  • IDEA requires that decisions about services must be made by a full complement of appropriate qualified providers following a comprehensive evaluation
  • IDEA’s IEP and IFSP processes are designed to ensure that an appropriate program is developed to meet the unique individual needs of a child with a disability, and that services are identified based on the unique needs of the child by a team
  • An ABA therapist may serve on the team, but is not the sole decision maker and cannot restrict access to services by other team members, such as SLPs
  • No one treatment (including ABA) is appropriate for all individuals with ASD or other developmental disabilities

Regarding Medicaid coverage, CMS recognizes that there are other treatments for children with ASD besides ABA, and that CMS, too, supports the full complement of appropriate services.

The following is a Press Release regarding the above information:

ASHA Press release on Dept of Ed Guidance for Children with ASD

2017 Essential Health Benefit Plan Regarding Insurance Coverage

ASHA President, Judith Page, provides commentary and information to the New Mexico Superintendent of Insurance, John Franchini, regarding the 2017 Essential Health Benefit Plan. This plan affects speech-language and audiology insurance benefits for consumers nationwide. Access the following link for specifics:

ASHANewMexicoStateLetter

 State Medicare Administrative Contractor (SMAC) Network

The mission of the State Medicare Administrative Contractor (SMAC) Network is to enhance and perpetuate the advocacy, leadership, and communication of NMSHA members to influence administrative and public policy decisions that impact Medicare coverage and reimbursement of audiology and speech-language pathology services.

SMAC Network participants are appointed by the state speech-language-hearing associations. SMAC representatives serve as a resource to fellow audiologists and speech-language pathologists regarding compliance with local and national Medicare coverage and payment policies. Andrea Fisher is the New Mexico state representative for SMAC.  Send her an e-mail with your questions or concerns.

New Mexico State Administrative Contractor (SMAC)
Julie Barrego
julie.a.borrego@gmail.com

Additional Resources

  • Find your local Medicare administrative contractors [PDF] on the CMS Web site.
  • See other resources such as the Medicare Fee Schedule, CCI edits, and Medicare coding rules under the Medicare Billing & Reimbursement section of ASHA’s website.
  • Ask general reimbursement questions by contacting reimbursement@asha.org.

See more at: http://www.asha.org/Practice/reimbursement/medicare/SMAC/#sthash.nlGEgeHV.dpuf

State Advocates for Reimbursement (STARs)

A State-Based Reimbursement Network

The State Advocates for Reimbursement (STARs) are ASHA-member audiologists and speech-language pathologists who advocate in their states for improved health care coverage and reasonable reimbursement. Their targets are key decision-makers in private corporations, public agencies, and the local legislature. Examples are health care insurance executives, benefits administrators, state insurance department officials, and state congress members. STARs create advocacy strategies and share skills with the state speech-language-hearing associations that appoint them.

The New Mexico STAR representative is Michael Kaplan. Communicate reimbursement questions or concerns to Michael at the following email address:

New Mexico State Advocates for Reimbursement (STAR)
Michael Kaplan
stachemannm@aol.com

Additional information can be found at:

http://www.asha.org/practice/reimbursement/privateplans/reimbursement_network/#sthash.4LAOqcEQ.dpuf

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