Board of Examiners for Speech-Language Pathology and Audiology

​​ ​COVID-19


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Link to the Slides from the May 19th Presentation 

(These slides were not produced by BSPA)

May 15, 2020 Update

 ​The response to the COVID-19 outbreak is evolving rapidly, with mandatory measures and guidance being published daily at the local, state and national levels. We strongly encourage you to check our website and follow the resource links below frequently for updated information as things change.

Zoom Meeting for SLPs -  The Board is hosting a Zoom meeting for school-based SLPs at 9AM, Tuesday, May 19th:

Framework for serving students through Distance Learning for All

Presenter: AnaLia Oliva, MA CCC-SLP, NeuroEducator, Special Student Services Coordinator, Northwest Regional ESD

Co-Hosts: Janet Wagner, CCC-SLP, President, Oregon Speech-Language Hearing Association (OSHA); Wendy Gunter, CCC-SLP, OSHA State Advocacy Leader and ASHA Liaison; and Melissa Link Cole, CCC-SLP, OSHA School-based SLP representative.

This presentation will cover the experience of one education service district and how they are transitioning SLP services during the pandemic. It will include a discussion of telepractice as well as other modalities for the provision of services. This meeting is limited to 300 people and we hope to record and post it for all licensees. If you have questions, please send them in advance to: speechaud.board@state.or.us. Time permitting we will also take questions during the meeting. The best way to ask a question is to use the “raise hand" function on Zoom, or place your question in the chat function.

Time: May 19, 2020 09:00 AM Pacific Time (US and Canada) Join Zoom Meeting

https://us02web.zoom.us/j/84126353593?pwd=L0NDb0hOaVgxR3Z3TU5Tcy93eUxtdz09

Meeting ID: 841 2635 3593

Password: 0NTUGb

 

Informed consent: The Board has received multiple questions about how to obtain informed consent so that services may be provided by an speech-language pathology assistant (SLPA) and/ or provided through telecommunications technology.

Oregon statutes and rules require prior notification if services are being provided by a speech-language pathology assistant (SLPA): 

OAR 335-095-0050 (5)(a) Ensure that persons who receive services from a speech-language pathology assistant receive prior written notification that services are to be provided by a speech-language pathology assistant and that it is documented in the student/client/patient record;

Services provided via telecommunications technology, or “telepractice" is defined as:

OAR 335-005-0010(3) “Telepractice" is the application of telecommunications technology to delivery of professional services at a distance for assessment, intervention, and/or consultation. “Telepractice" means, but is not limited to, telehealth, telespeech, teleSLP, telehear, telerehab, teletherapy, teleswallow, teleaudiology when used separately or together.

(a) “Patient" or “client" means a consumer of telepractice services.

(b) “Telepractice service" means the application of telecommunication technology to deliver audiology and/or speech-language pathology services at a distance for assessment, intervention and/or consultation

Using telepractice as a treatment modality requires consent:

OAR 335-005-0016 (9) Prior to the initiation of telehealth services, a Licensee shall obtain the patient/client and if applicable, their parent or guardian's consent to receive the services via telepractice. The consent may be verbal, written, or recorded and must be documented in the patient/client's permanent record. The notification will include, but not be limited to, the right to refuse telepractice services, options for service delivery to the extent compliant with applicable Federal laws and regulations, and instructions on filing and resolving complaints.

If licensees use the rule language above in obtaining consent either in writing or orally, then licensees will meet the rule requirement.

The Board has been asked to provide a standardized form that would meet the requirements of the rule, but there are numerous drawbacks to that approach. Statutes and rules are subject to change. When the Board puts out a form, that form can be copied, circulated among licensees and the public, and used well into the future after the form becomes out of date. Each private practitioner or employer may have additional information they wish to include on a form, so there is not a one-size fits all solution. The Board's preference is to give practitioners full latitude to design their own form if they wish to use one. The Board is available to answer specific questions from licensees regarding legal compliance based on their individual circumstances. Generally, as long as licensees read the language above to the patient/student/client they can obtain oral consent. Whether obtained orally or in writing, consent should be noted in the patient/student/client official record.

RESOURCES/LINKS:

Oregon Board of Examiners COVID-19 Page

Oregon Speech-Language Pathology and Audiology Statutes

Oregon Speech-Language Pathology and Audiology Rules

Oregon Speech-Language Pathology and Audiology Professional and Ethical Standards Including Telepractice Definitions and Rules

Medicare questions: Medicare is now allowing speech-language pathologists and audiologists to bill for services provided through telepractice. Please see ASHA's website for more information.

School-based services questions: ODE is providing guidance, check out the ODE website COVID-19 page regularly for updates.

Oregon Health Authority's COVID -19 website and email updates—please use this website to track the latest Oregon guidance on how to deal with COVID-19. The site also has a place to sign up for email updates—sign up to get regular email updates from the OHA. The site also has all of the Governor's Executive Orders related to the virus.

American Speech-Language & Hearing Association (ASHA) COVID-19 Web Page

American Academy of Audiology COVID-19 Web Page

Centers for Disease Control (CDC) website—this website has information on what's happening in the U.S. with the virus, ways practitioners can take care of themselves, and recommended infection control procedures. There is also a place on the left hand side of the site to sign up for CDC email updates.

Oregon Governor Kate Brown's Office—there is a new web page on the Governor's site specifically addressing the Coronavirus 19.

Oregon Speech-Language & Hearing Association (OSHA) Website

Oregon Occupational Safety and Health (OSHA) COVID-19 Web Page

Oregon Unemployment information—the Employment Department has a specific website for COVID-19 business layoffs, closures and unemployment insurance benefits. Please use this resource for yourselves and your staff. https://www.oregon.gov/employ/Pages/COVID-19.aspx


April 6, 2020 Update

The response to the COVID-19 outbreak is evolving rapidly, with mandatory measures and guidance being published daily at the local, state and national levels. We strongly encourage you to check our website and follow the links below frequently for updated information as things change.

Medicare questions: The Board has been receiving a lot of questions about Federal changes to Medicare. ASHA is tracking that information.       

School-based services questions: The Board is working with the Department of Education (ODE) on guidance for providing speech-language and audiology services via telepractice. Check the Board's website and the ODE website COVID-19 page regularly for updates.

Audiologist, Otolaryngologist, and public member positions open: The Board is recruiting to fill one audiologist position, one otolaryngologist position, and one public member position on the Board. The term of office is three years, from July 1, 2020 through June 30, 2023. If you, or someone you know is interested, please fill out and send your application ASAP: https://www.oregon.gov/gov/admin/pages/how_to_apply.aspx. For more information, send an E-mail to Erin.Haag@state.or.us.

Resources:

Oregon Health Authority's COVID -19 website and email updates—please use this website to track the latest Oregon guidance on how to deal with COVID-19. The site also has a place to sign up for email updates—sign up to get regular email updates from the OHA. The site also has all of the Governor's Executive Orders related to the virus.

American Speech-Language & Hearing Association (ASHA) COVID-19 Web Page

American Academy of Audiology COVID-19 Web Page

Centers for Disease Control (CDC) website—this website has information on what's happening in the U.S. with the virus, ways practitioners can take care of themselves, and recommended infection control procedures. There is also a place on the left hand side of the site to sign up for CDC email updates.

Oregon Governor Kate Brown's Office—there is a new web page on the Governor's site specifically addressing the Coronavirus 19.

Oregon Speech-Language & Hearing Association (OSHA) Website

Oregon Occupational Safety and Health (OSHA) COVID-19 Web Page

Oregon Unemployment information—the Employment Department has a specific website for COVID-19 business layoffs, closures and unemployment insurance benefits. Please use this resource for yourselves and your staff. https://www.oregon.gov/employ/Pages/COVID-19.aspx


COVID-19 - March 25, 2020 Update
Do Clinics Have to Close Due to COVID-19? Where should I send PPE?
The response to the COVID-19 outbreak is evolving rapidly, with mandatory measures and guidance being published daily at the local, state and national levels. We strongly encourage you to check our website and follow the links below frequently for updated information as things change. On March 24th the Board issued a newsflash and later received questions about whether clinics should be closed. As such, we’re issuing additional guidance to licensees and the public who receive licensee services.

​On March 24, 2020, the Governor’s Office issued Executive Order 20-12 https://www.oregon.gov/gov/Documents/executive_orders/eo_20-12.pdf pertaining to the closure of certain business and social distancing in order to stem the spread of COVID-19. Speech-language and audiology clinics and practices, as health care facilities, are an allowable destination under 20-12 and not under a mandatory order to close. However as a provider, or a patient or student receiving services from an SLP or audiologist, it is critical that we all follow social distancing measures to the greatest extent possible to limit the spread of the virus and protect the most vulnerable populations. Overall, licensees should be sure to stay current on all requirements and recommendations for social distancing, cleaning and screening practices, and, as appropriate, make adjustments to patient care including the application of telepractice and rescheduling of all non-urgent care.

According to the executive order, businesses that have the technology and network ability to facilitate telework/work at home shall do so to the maximum extent possible. When telework/work at home options aren’t available, businesses must designate an employee to establish, implement, and enforce social distancing policies consistent with OHA guidance.
Where should I send my gloves, masks and other PPE?

Governor Brown issued Executive Order 20-10 on March 19, 2020. (https://www.oregon.gov/gov/Documents/executive_orders/eo_20-10.pdf) This order conserves personal protective equipment (PPE), postpones non-urgent health care procedures, and restricts visitation. “Procedures” and “non-urgent procedures” apply to speech-language and audiology care. The intent and purpose of this order is to conserve much needed PPE and to limit COVID-19 exposure for healthcare practitioners, patients, and the public.

Summary of EO 20-10:
• No later than March 23, 2020, all elective and non-urgent procedures within all healthcare settings (which includes speech-language and audiology clinics) that utilize PPE shall be cancelled or rescheduled no earlier than June 15, 2020.
• No later than March 27, 2020, any clinics with surplus PPE supplies shall notify the state’s PPE coordinator by calling (971) 900-9952 and arrange for delivery of those surplus supplies to the coordinator. This section does not specifically name speech-language and audiology clinics but it is the Board’s desire that licensee clinics participate in this provision. Also, the Board requests that all practitioners or clinics that have extra gloves include them in their surplus PPE delivery.

Resources:
Oregon Health Authority’s COVID -19 website and email updates—please use this website to track the latest Oregon guidance on how to deal with COVID-19. The site also has a place to sign up for email updates—sign up to get regular email updates from the OHA. The site also has all of the Governor’s Executive Orders related to the virus. https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Pages/emerging-respiratory-infections.aspx

Center for Disease Control (CDC) website—this website has information on what’s happening in the U.S. with the virus, ways practitioners can take care of themselves, and recommended infection control procedures. There is also a place on the left hand side of the site to sign up for CDC email updates.
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fsummary.html

Oregon Governor’s Office—there is a new web page on the Governor’s site specifically addressing the Coronavirus 19. Here’s a link to that page: ​https://www.oregon.gov/gov/Pages/coronavirus2020.aspx

Oregon Unemployment information—the Employment Department has a specific website for COVID-19 business layoffs, closures and unemployment insurance benefits. Please use this resource for yourselves and your staff. https://www.oregon.gov/employ/Pages/COVID-19.aspx​


March 24, 2020

Response to the COVID-19 Pandemic and Governor Brown's Executive Orders

​Erin K. Haag, Executive Director

 

STAY HOME – SAVE LIVES!

 

On March 23rd, Governor Brown issued Executive Order #20-12 calling on the public to stay home in order to save lives due to the coronavirus. A copy of the order may be found here: https://www.oregon.gov/gov/Documents/executive_orders/eo_20-12.pdf
On March 19th, the Governor issued Executive Order #20-10 which prohibits all elective and non-urgent procedures across all settings that use Personal Protective Equipment (PPE), effective March 23, 2020 through June 15, 2020. This order affects speech-language pathologists (SLPs), speech-language pathology assistants (SLPAs), clinical fellows (CFs) and audiologists. All licensees are urged to read and follow this order, found here:

https://www.oregon.gov/gov/Documents/executive_orders/eo_20-10.pdf
These new Executive Orders mean that most speech-language and audiology services will need to be provided via telepractice, rather than in-person/on-site, in order to maintain the required social distancing and to re-direct the PPE to hospitals.

 

Oregon's Telepractice rules can be found here: https://secure.sos.state.or.us/oard/viewSingleRule.action?ruleVrsnRsn=260113

Recordkeeping rules can be found here: https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=1406

 

Frequently asked questions about Telepractice:

Q. If I live in Oregon and hold an Oregon license, can I treat patients in Washington or other states via telepractice?

A. You must have the Oregon license and you may need a license in the state where the patient resides, so you will need to contact the other state regarding licensure and their rules.

Q. If I live outside of Oregon, can I treat Oregon patients via telepractice?

A. Yes, but you must hold the Oregon license. The Board is expediting licensing. Contact us for information.


Q. Are there additional requirements for conducting sessions via telepractice vs. on-site/in-person?

A. Yes, you must obtain prior authorization from the student/patient/client and document it in their record. In addition, you must determine and note in the record your professional judgement that the student/patient/client is suitable for this modality (according to ASHA, telepractice may not be appropriate for 5-15% of individuals). If the individual is not suitable for this modality, then it is the licensee's professional and ethical responsibility not to provide services via telepractice for that individual. In addition, the equipment used by both practitioner and student/patient/client must meet HIPAA/FERPA privacy standards.  Please note that telepractice services may not be delivered by telephone-only. Please see the link above and study all of the telepractice rules before beginning treatment using this method.


Q. Can a speech-language pathology assistant (SLPA) provide services via telepractice?

A. Yes, as long as the SLP of record for the student/patient/client is the official supervisor of the SLPA, and has determined that the specific student/patient/client is suitable for telepractice services by that SLPA. That professional determination must be documented in the individual's record. All other requirements for SLPA supervision must be met. SLPA Rules are here: https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=1416

Q. Can a clinical fellow holding the Oregon Conditional Speech-Language Pathology license provide services via telepractice? In addition, can their supervising SLP provide that supervision via telepractice?

A. Clinical fellowships must meet standards of the American Speech-Language & Hearing Association (ASHA), which require clinical fellows to provide services on-site. They also require the SLP supervisor to supervise/rate the CF while physically on-site. However, due to COVID-19, ASHA is providing a temporary allowance in some of the standards related to telepractice and telesupervision from March 16 through April 30, 2020. (That date might be extended, check our websites on May 1). The details can be found here: https://www.asha.org/Certification/COVID-19-Use-of-Telepractice-and-Telesupervision/. Additional guidance can be found here: https://www.asha.org/Certification/COVID-19-Guidance-From-CFCC/. Please note that all other Oregon Board rules for supervising clinical fellows still apply. The rules are here: https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=1413

Q. Where can I learn more about best practices to ensure I have the appropriate knowledge and training to move to a telepractice service model?

A. ASHA has a special resource page:  https://www.asha.org/About/Coronavirus-Updates/. ​

In addition, the Board is working closely with the Oregon Speech-Language-Hearing Association (OSHA) to continue dissemination of telepractice resources. OSHA's Telepractice Advisory Committee held a livestream "Telepractice Q&A" last week. If you missed it, you can watch the recording of the livestream event on the OSHA YouTube page link: https://youtu.be/OwbrjgkHrDw 

Please contact the Board for any questions related to Oregon statutes and rules relating to telepractice. The OSHA Telepractice Advisory Committee is willing to answer additional questions regarding best practices in the use of telepractice as they arise. Here is the roster of the committee members and their specialty areas: 

Megann McGill, PhD, CCC-SLP is an Assistant Professor in the Department of Speech and Hearing Sciences at Portland State University. She specializes in clinical research of telepractice evaluation and treatment of fluency disorders, providing direct and indirect treatment to parents of young children who stutter, and supervising graduate student clinicians via telepractice. Email: Megann.McGill@pdx.edu 

Kira Wright, MS, CCC-SLP is Director of School-Based Services at The Hello Foundation. She is a telepractictioner with more than 10 years of experience serving rural Oregon and supervises SLP-Assistants. Kira is knowledgeable about how to implement telepractice in school settings with children individually and in groups.  Email: Kira.Wright@thehellofoundation.com

Jenny Peddicord, MA, CCC-SLP is Clinic Director at The Hello Clinic, a private practice in Portland, OR. She specializes in telepractice evaluation and treatment services for adults and children across the SLP scope of practice. Jenny is knowledgeable about insurance reimbursement and private practice considerations for telepractice. Email: jenny.peddicord@thehellofoundation.com 

Emily Quinn, PhD, CCC-SLP is an Assistant Professor in the Institute on Development and Disability at Oregon Health Sciences University. She conducts clinical research via telepractice for specialty populations such as young children with language disorders using a parent-coaching model of intervention. Email: QuinnEM@ohsu.edu 

Kate Morrell, MA, CCC-SLP is the Regional Manager at Providence Rehabilitation Services. She leads the telehealth research and clinical programs across Providence. Kate is knowledgeable about telepractice with medical populations and using telepractice to evaluation dysphagia. Email: Kate.Morrell@providence.org 

The Board is Open for Business

In an effort to help slow the spread of COVID-19 in Oregon and protect employees and the public, the Oregon Board of Examiners for Speech-Language Pathology and Audiology (BSPA/the Board) has changed the way it provides services at its main office in Portland as of March 10, 2020. Board staff are working remotely and can be reached by phone during regular business hours. Interactions between staff and the public will be by telephone or conference call appointment only. All licensing and other services are available through the Board's online licensing system. 

Email: speechaud.board@state.or.us