9. SLP Eligibility Management: Planning

In an older post, “Reducing Speech Therapy Workload,”an outline of attack points concerning workload reduction were listed. It’s a starting point.

“Throughout our posts we have been evolving an approach to managing SLP workloads. Workload in the U. S. has been the Number 1 professional issue for more than a decade. Some SLPs report high stress leading to early retirement or career change. Here are the elements of a comprehensive workload reduction plan:

 

A. TRADITIONAL

 

1. Lobbying by speech and language professional groups for state reductions in caseload size (cf. 6. SLP Dismissal / Exits).

 

2. Lobbying by speech and language professional groups for local (LEA) reductions in workload as determined through workload analysis.

 

B. ELIGIBILITY REDUCTION

 

1. Reduce the number of children enrolled in special education.

 

2. Use least restrictive environment to move pupils toward dismissal.

 

3. Dismiss children who no longer belong in special education.

 

C. CASELOAD MANAGEMENT

 

1. Adopt a caseload management approach to service delivery providing flexibility to move children quickly toward dismissal.
( 12. SLP Dismissal / Exits)

 

2. Participate in evidence-based educational programs to prevent special education placements.”

 

Comment

 

Dismissal approaches hold great potential but require original thinking and invention.  The “flexibility” point is an evolved change in your role self-concept and role applications.  Become more of a case  manager rather than a straight service provider is the subtle part of SEM thinking.  It’s taking control and organizing for a purpose.

  

 

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Comments

  • Heather Heaman  On July 26, 2011 at 3:16 pm

    The Interprofessional Caseload Management Tool will be released this fall (funded by Health Canada). This may be helpful in determining an appropriate workload and advocating to funders for the same.

    The website describes the caseload management tool as:

    The Interprofessional Caseload Management Tool is intended to be an evidence-based tool or structured set of factors and considerations that will be designed to assist individual professionals, organizations and policy makers in determining effective caseload/workload management for occupational therapy , physiotherapy and speech-language pathology services in Canada. This work will integrate an understanding of the competencies of the three professions into a caseload/workload management planning tool which is intended to facilitate the effective and efficient matching of human resources to a wide variety of client populations and service delivery models.

    http://www.caot.ca/default.asp?pageid=2331

    • schoolspeechpathology  On July 26, 2011 at 6:33 pm

      It is good to see a proactive approach taken. The American response has been toward techniques
      and protecting employment, rather than working within education to enhance SLP’s status and
      demonstrate leadership. A caseload management system implies flexible planning and activity
      to meet the needs of patients. Here, we also want to protect FAPE. These lines struck us as important:
      “With global budgets steadily diminishing, little consideration is given to patient and population health needs in workforce planning for these professions. The status quo or existing numbers of funded positions are frequently used as the gold standard despite reports of therapists facing increased numbers of patients with complex health issues. This situation is leading to therapist recruitment and retention issues and patients experiencing lengthy wait times and unmet health needs.

  • Yoda  On September 10, 2011 at 12:55 am

    With regard to the following from above:

    “Dismissal approaches hold great potential but require original thinking and invention. The “flexibility” point is an evolved change in your role self-concept and role applications. Become more of a case manager rather than a straight service provider is the subtle part of SEM thinking. It’s taking control and organizing for a purpose,”

    I can understand it in spirit. I am hoping that the author of it, by saying “become more of a case manager” wasn’t actually advocating SLP’s being case managers in schools. The reason I say this is from personal experience as an SLP in NM. In some states (NM included), when the ONLY special education service that a student receives is speech/language intervention, typically the duties of case management fall to the SLP. The amount of work inherent in being a case manager in the public schools of NM is very significant, and sadly, is one of the big contributing factors to SLP burnout in schools, i.e., since the SLP with a lot of case management ends up spending a lot of time doing clerical and administrative work. In particular, case management by SLP’s in NM schools is large at the elementary levels.

    • schoolspeechpathology  On September 10, 2011 at 10:26 am

      Thank you for your report from New Mexico. One can do as much direct service as necessary but it can be done within a broader perspective of looking at the entire caseload to find ways of exiting children who should not be in special education, and ways of reaching IEP goals without direct service. If you exit one child ethically, it is one child who does not take up time. Some children can generalize articulation training through prompts from parents and teachers. Some can go to Tier 3 of RTI and avoid placement. Some can be treated through early reading intervention. SLPs are de facto managers now. Case management is an approach and not a duty. Be safe from wild fires. JMP

    • schoolspeechpathology  On September 10, 2011 at 10:26 am

      Thank you for your report from New Mexico. One can do as much direct service as necessary but it can be done within a broader perspective of looking at the entire caseload to find ways of exiting children who should not be in special education, and ways of reaching IEP goals without direct service. If you exit one child ethically, it is one child who does not take up time. Some children can generalize articulation training through prompts from parents and teachers. Some can go to Tier 3 of RTI and avoid placement. Some can be treated through early reading intervention. SLPs are de facto managers now. Case management is an approach and not a duty. Be safe from wild fires. JMP

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