From Provisional to Permanent: Modernizing SLP Licensure & Mentorship in Virginia

Virginia is shaking up SLP licensure. Dr. Jeanette Benigas, SLP, talks with Ed Bice, M.Ed./SLP, acting president of the Speech-Hearing Association of Virginia, about their petition to eliminate provisional licenses and grant full licensure to new grads immediately upon graduation. They unpack the petition’s purpose, address mentorship versus supervision, explore impacts on The Audiology & Speech-Language Pathology Interstate Compact, and discuss how Virginia’s model could inspire other states to modernize their systems.

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Creators and Guests

Host

Jeanette Benigas, PhD/SLP

Host of Fix SLP

What is Fix SLP: Advocacy & Accountability in Speech-Language Pathology?

Fix SLP is an SLP Podcast by Dr. Jeanette Benigas about advocacy, autonomy, and reform in Speech-Language Pathology. This show exposes credentialing gatekeeping, dismantles CCC requirements, and helps SLPs advocate for change. Each episode equips SLPs with tools to reclaim their profession. Subscribe now and join the movement transforming speech-language pathology. Follow @fix.slp on Instagram and TikTok. Visit fixslp.com.

Jeanette Benigas 0:03
Welcome to the Fix SLP summer school series where we're schooling the system all summer long. If you're ready to challenge the status quo in speech language pathology, you're in the right place. Subscribe so you don't miss an episode, and if something fires you up, leave us a message on the minivan meltdown line at fix.slp.com, grab your favorite summer beverage and let's get to work. Hey everybody, welcome back. It's Jeanette Preston is not with us today. We are only a few days out from our Fix SLP, retreat, and I think he is fixered out, kind of like burnt out, but he's over the ladies of Fix SLP, I think he needs some time with his wife and his daughter and his life so he couldn't make it today. So it's just me, but I have Ed Bice. He's the acting president of the speech Hearing Association of Virginia, or shav. He is here to discuss some of these issues in Virginia, but he is not speaking on behalf of shav. These are all of his own opinions and thoughts and ideas, and we will have him back. I've been talking to Ed off and on about coming back, about student supervision issues that we'll we'll save for the fall, because that's better for the fall. He may do a state by state episode as well. So this isn't a state by state episode. This is very specifically focusing on the petitions that have come forward in Virginia, what some of the thoughts and ideas and opinions are and what they're looking at, hopefully doing moving forward, and really to give any state, any fixer who's listening some ideas of what might be possible in your state outside of what your license looks like right now. And we always have a lot of new listeners, even this last week, I've answered some very basic you just found Fix SLP questions. So as a reminder, the CCC is not a license to practice. It is a third party, proprietary product that you purchase. It is optional in many situations, but in practice, it's not always optional, and the state license is actually what you need to practice. The state license is regulatory. It controls what you can and cannot do in your state, and it is the consumer protection mechanism for consumers in the state, and that's always important to focus on, because it's really the board's job to protect consumers in the state, not necessarily the speech pathologist, although it's kind of all wrapped up In one but consumer protection is, is a main focus of boards, and so we always need to be thinking of that. So anyway, Ed, thanks for coming on and thanks for coming on like so last minute, because that's normally how we roll on this platform. Um, we do this in real life. So this is real life. This was happening right now and it was relevant. So thank you.

Ed Bice 3:01
Thank you for having me. Extemporaneous is kind of my style, too.

Jeanette Benigas 3:06
So Ed, do you want to give us a rundown of what's going on in the state

Ed Bice 3:11
Sure. So, we already are the second most lenient state in the country related to supervision requirement, North Dakota has none. The requirement to move from provisional to full license in Virginia is currently six months of supervision. So we're so we have already headed outside of this. You know of the normal nine months of supervision requirement as far as licensure is concerned. And so when the CMS changes came about, or the suggested CMS changes came about, we took a hard look at what we could do. We had 125 graduates in the state of Virginia who were potentially impacted by CMS decisions. And we talked about it actually. As an organization, I can say that shav, as an organization, actually discussed it, and we thought that the best course of action to protect both our consumers and our clinicians was to request a change in licensure, and that is to do away with provisional license. I spoke with the people in North Dakota. I spoke with people at the state association, I spoke with the licensing board. I asked them about what kind of issues they were encountering related to not having a supervision provision in their licensure, and we decided that it was really not a barrier, and that the best thing that we could do for our state was to petition the licensing board to do away with the provisional license, to be congruent with other allied health professionals and to protect our. Consumers so that they had access to care and that it wasn't prevented by Cs not being allowed to practice in certain settings because of limitations of supervision or lack of payment. And so that position petition actually the comment period, initial comment period ended yesterday, and the number of comments are quite positive. Typically, when the our licensing board has a comment period that gets three to five comments, this particular petition has many more than that.

Jeanette Benigas 5:37
I think last time I looked, it was 28 and it might be more I didn't look today, so

Ed Bice 5:44
So 400 times more, yeah, 400 times more than the typical comment. And we think that even though CMS has retracted their decision, we think this is the right trajectory for our state and and we plan to continue to go forward, you know, with the licensing board, to try to accomplish this task. So that's kind of we are.

Jeanette Benigas 6:14
And I guess I didn't realize until just now that the petition that was put forward by Melanie. We've talked about Melanie. We've, we've been in contact with Melanie.

Ed Bice 6:24
Yeah, Melanie is amazing. She is our she is VP of Government Affairs, and she was the one who filed the petition, and she has, she has worked with the Virginia legislature, and actually, in her first year in the role, got a piece of legislation passed through her advocacy so she she knows how to network, she knows how to get things done. She is very quiet in her approach, but she knows what she's doing and she knows how to accomplish what she needs to accomplish.

Jeanette Benigas 7:01
I didn't realize that it was through shove, or at least a result of the conversations shove was having on our team. We thought it was just some random, wonderful lady who put forward a petition that we really liked but but thought maybe needed some massaging. And you and I have talked before we hit record, and you'll share some things that I think is really in line with the ideas that we have, just a different approach. And I I loved it, and I've cut you off so you could just tell it while we were recording. But it's interesting, because the last petition that somebody put forth about dropping the CCC for initial licensure that also got a lot of comments. There were a lot of people commenting on that as well. So that's something else to say. Virginia was one of four states that required the CCC for initial licensure only. And not too long ago, a while back this year, it happened, they removed that requirement. So one down, three more to go!

Ed Bice 8:04
That came actually from a member of the House of Delegates, because Virginia is a Commonwealth that we have a house of delegates. So that actually came from, not from shop, but from someone else. But what it did was precipitate us as an organization to to to begin an annual award for a state legislator that we will give who advocates on behalf of our profession. So because we want to encourage those folks to continue to advocate for our profession in the state of Virginia. And so since someone went out of the box and just did it and took the initiative to do that, we want to reward members of our house of delegates who advocate on our behalf, and so we are establishing, this year, an annual award for a member of the House of Delegates.

Jeanette Benigas 8:55
That's amazing. More states need to do that. So you have this petition. Why don't you tell everybody exactly what the petition If passed? Because I'll be honest, when you first read it on the website, it doesn't exactly say what it is doing. It's very confusing. And so our first impression of it wasn't exactly what it was saying so

Ed Bice 9:24
and the reason it looks a little convoluted is because of the statute that we're asking to be removed or changed. And so yes, Melanie actually contacted our licensing board to say, how should this request be written, so that it be massaged in a way. There's a specific statute in the licensing law that we're asking to be changed, and that's why it's written in that way. But ultimately, what we're asking for is that new grads will not have a provisional license, but they will be giving further. Given full licensure upon graduation. Now, as you mentioned, Virginia is already a state that does not require the CCC and and that, I think that's an individual choice. I think again, I see some value for myself, particularly having the CCC, but I understand that everyone doesn't see that value. And so I am, you know, I'm liberal in all the areas of my thought, and I think that individual choice is paramount, yes, and so if you work in this state, and you get a full license upon graduation, and you choose to pursue the CCC, then we will, should, would support you in that and think that that's that, that's a you know, that's your personal choice, because you may not always want to work in Virginia. You may not always have an employer that doesn't require the CCC. So you have, there are lots of factors that you have to use to decide what you want to do with your career, but you should have that choice. And you know, and I can see a lot of school SOPs having no interest in in having a CCC so but that our end goal is to have new graduates receive full licensure without any provision, and that way, we're protected if in the future, if new issues come up, and pursuant to that, we as a state association are trying to prepare to help new grads. I listened to your podcast that you and Preston, where you talked about your conversation with Melanie, and so that was very interesting. And one of the things that that you talked about, I thought, fits so well with our plan, and that is to have a support system for early career professionals, and that's what we're calling our program, early career professional support system, where we actually have a new member on our board, that's a new position, who is developing this program, and because of the comprehensiveness of the program, it's going to take a while to develop, but what we want is a resource guide for it could go beyond early career professionals, but that's our target. So like a list of all the agencies in Virginia who, who can service our patients, are there support groups for Parkinson's, who is the Al ALS Association, and who are the contacts there? Who, where are physicians, Ents and gi physicians who will interface with us and who will work with us collaboratively, rather than being oppositional to us. What are the payment sources that are in our network, and how do we navigate those payer sources? You know, most clinicians graduating don't understand that hospitals are reimbursed by DRGs, and that skilled nursing facilities are reimbursed by how the MDS is code coded, and outpatient is part B or private insurance, and that it only pays 80% unless they have a co insurance. People don't understand all of this, and so when they start negotiating with people for pay raises or for entry level salaries. They need to understand how reimbursement works, so that they can talk about it from a point of knowledge. And so we want to compile this huge network, and in that also will be individuals in the state who are willing to provide mentorship in specific areas, like you would if I were a CF supervisor, I could never do schools right? I can't tell you one thing about speech sound disorders, other than he can't say that sound and that's as far as I can go. But, but I can provide mentorship in swallowing and swallowing disorders. And there are people in our state who are speech sound disorder specialists who can provide mentorship in that area. And even if you have a CF supervisor, they aren't going to be knowledgeable in every area that you will encounter in your CF but if you could talk to someone who understands motor speech disorders or who understands dementia care or who understands aphasia, then you would have a network of people who can help you at a high level to service your your patients better, rather than to have one resource who may have a very narrow view on what you should be doing. And so we will have a I will, I will say, I push back. We're not calling them experts, because experts has very specific definitions. And I you know, we're not vetting people to be an expert level, but we will have people who have a special interest in these areas that can provide you with help or support. And so that's kind of our vision in this state, is to provide people with a lot of support. Year, and we're even talking about resurrecting an old program of mentorship within the state association that's beyond a CF, and that may be, in the end, a part of this new early career professional program, but that's still being fleshed out. So we have lots of things going on in our state to try to help us, as Melanie would say, be the best state in the country for SLPs. So we want to be able to attract SLPs from all over the country, beating down the doors of Virginia to come here to practice.

Jeanette Benigas 15:36
I'm moving to Virginia tomorrow. I want to be, I want to be a part of this. I want to, yeah, that's amazing. And like, disclosure, we haven't talked about this, but a lot of what you just said was what was in my public comment, which was, continue forward with the petition, maybe make some modifications, restructure that post graduate support. I specifically wrote, restructure the required post graduate support period to a mentored and I called it a mentored continuing education model. But you know, this was just a suggestion. Nothing has to happen. And I said, take it from six months to like that first year you are, what you say, a new professional I called it mpdh Because we love, like, letters and speech pathology, mentored professional development hours. And then I put a whole list of other things that it could be called, and didn't include what you guys called it was that early career support, which I love it's perfect. What a couple people have said was, well, if you said that it was supervised hours before, and now it's part of the license, what would stop payers from refusing first year professionals? And that's when I said, Well, you don't call it anything. You just make it the continuing education. But if in your model, even it's not even continuing education, it's just this, perhaps required. Maybe that's what you guys need to look at, required new graduate support, thing that anybody can participate in. But we now, I'm going to step to the side here for a second. I know Ed as a colleague. He's Preston loves to use the term ASHA fangirl, but Ed, I think, has fan girls and fanboys that he's kind of SLP royalty, if you will, in the dysphagia space, he's very, very, very smart when it comes to research and evidence and best practice, and he has a lot of knowledge to share, and he does that very openly online. He doesn't gate keep he's just so generous with his time and his knowledge, and he teaches at the academic level. Are you still teaching?

Ed Bice 18:04
I was teaching at the University of Maryland. I'm not going to be teaching there anymore, but I was just awarded a fellowship. Yes, and I'll be going, I'll be going and teaching in New Zealand in February.

Jeanette Benigas 18:17
That's what I was just gonna say. Ed just got an amazing fellowship!

Ed Bice 18:23
I am so honored that I was chosen to do this. Dr Huckabee, who started all of the dysphagia training in New Zealand, is going on sabbatical, and she specifically asked me herself if I would come and teach her dysphagia course. So I'm like, Yeah, I can't even, I mean, I pinch myself every day.

Jeanette Benigas 18:45
So Ed teaches. He's got this amazing fellowship, and so sort of like me, he sees this stuff from 1000 foot view. He sees it from the academic even though he's not a full time professor, he sees that. He sees the clinician aspect. He sees it all. And can...

Ed Bice 19:05
You may not know this about me, but I was the CEO of a therapy company as well, and I had almost 500 employees. I was in 37 states and so, so, yeah, I do. I do understand, from a macro view, that, you know, I haven't just worked in one facility for my four year career, I've been all over the country, and then, of course, I worked with another company where I traveled around the country, actually sitting with therapists as they treated their patients and coaching them in their facilities. Because I worked for a device company, and as they were using the device, I sat in their facility with them, interacting with patient, that clinicians and patients, and so I've literally met 1000s and 1000s of clinicians and interacted with 1000s of clinicians, and have lots of different viewpoints and lots of different perspectives, rather than just saying, Yeah, I know 10 SLPs, and we've worked together. Their whole career. No, it's not like that.

Jeanette Benigas 20:02
Right. You have this broad perspective. You see the issues. Now as it relates to medical, you know, our school, SLPs, our pediatric SLPs, they have some different issues, but the end of the day, there's a ton of issues that need to be addressed. The CMS, thing was more hospital, nursing home focus.

Ed Bice 20:23
and I did begin my career in the public schools as well.

Jeanette Benigas 20:26
Same I did too. Right! So Ed has got this whole view, and he's able to just meld it together into some really exceptional ideas. And when I found out that Ed was the acting president of shove, I was thrilled because I knew good things, but not that the people who were in Virginia weren't already killing it, but I knew, like, Ed's gonna help get stuff done. So anyway, back to my thoughts about this new early grad support kind of thing. So that's what I suggested. I and I suggested that maybe there is some. Now in the state of Virginia, you have your C, your CE requirements are pretty broad, but they do have to be approved by some type of provider or something like that. And so since this was the direction I was going, I just said, in order to check that box, I said, make it. Board approved. CE, that's what this is, that you don't have to have an organization like ASHA or something approving this, continuing ed, the board already approves it, because it's their first year CE program. And then I just said, give the mentees some hours for for partnering in this. I said, change the mentor structure, so maybe there's a primary mentor for accountability and paperwork, but there's multiple mentors allowed that have complementary skills. So there's a reduction of dependency on one person. Like you don't want that early professional depending on one person too much. It helps change that abuse of power that we hear about and we see like you can avoid the risk of one person really leaning into power that they shouldn't have. It broadens the new clinician's clinical judgment. The mentors can learn from that new grad who might be bringing information out of their program. It's really like a partnered thing. It's a partnered experience where it is true mentorship, not supervision, and that's what I was suggesting. And then I went on to give some interaction standards, like they should the mentor and the mentee should probably interact this minimal amount of time in the first month or the first three months, all the way up to a year, and then had some suggestions for safeguards and qualifications, but it's pretty reflective of what you just said. And so I love that we're are, we're connecting on that, because I think that's what's needed. We both know, yes, new grads are ready to do their job when they leave school. But it's not that they need supervise. It's just because we have this big nine, and students are prepared across the big nine, they anybody in a new job needs help, kind of getting up on their feet, but much more with SLP, because they've been prepared for the big nine, and now they're working in a school or a pediatric hospital or whatever. You need someone to come alongside you and help you really focus now on that, just that, right, right? So it's not supervision, it's it's that mentorship of getting up on your feet and really owning what you're doing now.

Ed Bice 23:43
I love mentorship rather than supervision, because that's really what we want to do. We want to help these people replace us, right? I mean, that's our goal. I want someone to be able to replace me, and not that so I'm not needed anymore, and I will tell you that something that you will appreciate, because I know who you are as a person is I had this I talked to several people about a program like this, because if you're a student and you're in a nasty situation as an outplacement, you can go back to your university and get help. But if you're a CF and you find yourself in a really bad situation, there's really no one for you to go to for help. And so that was kind of what was the impetus of my vision for this program. And so when I came on the board at shop, what I didn't know was over here, they were working on creating this new position at the same time, and I already had an outline for the program that I wanted, and they were creating a new position. And so when, when I got on the board and we started talking, the synergy occurred, because it was like, this was something I dreamed of having in this state. And at the same time, while I wasn't on the board, the Virginia Board was working on this project as well. And so it became. Am even more invigorating and exciting to know that other people shared my vision and wanted to make this happen in this state.

Jeanette Benigas 25:06
It's amazing. I love, I just, I love that that's happening. And I think the one little piece of this that we may want to address then is that there were some comments very specifically, even from the the executive director of the interstate compact that if you pass this petition, you will no longer be compliant for the interstate compact, and there's a lot of issues there. And in fact, it's I will be sitting in a meeting for the interstate compact like I do regularly. This isn't anything special. I i i sit in these meetings with a few other SLPs just to monitor very for this very reason, what's going on. And so we kind of knew this was happening before you guys contacted them and and just last week, as I sat with the Fix SLP team, all the lights in my head were going off. I'm like, Oh, this is why all this is happening now. I now I've connected the dots. If this petition passes as it stands, would Virginia be able to still participate in the interstate compact as it's written? And I think that's still yet to be determined.

Ed Bice 26:16
It is yet to be determined based on my conversations or my email exchanges that that interstate compact has not solidified what the requirements will be as far as supervision. Again, as I say, it said in the beginning, we are already in Virginia at six months. And so if an if a nine month supervision period is required by the interstate compact, then we are already not. You're still out of compliance, right? We're already not in compliance with the interstate compact, right? But I hope that that the people on the board will not make it punitive, and will not and will consider that there are lots of ways to accomplish the same task and and not make this political, but make it for the benefit of of the SLPs, which is what it was intended to do. It was the interstate compact when it was initiated, was to allow movement of SLPs around the country. It wasn't a credentialing issue. It wasn't, you know, a political issue. And I hope that the people on the board of the interstate compact, and I've talked to our Virginia representatives already, will not try to make this punitive so that we all fit into the same into the same hole, yeah. And, you know, I have no control over that, and I have no ability to determine what they will do. I do know that there are some people in Virginia who would benefit from the interstate compact. We have naval bases out on the beach in Virginia, and so those people are mobile, and their families would benefit from from the ease of mobility. But again, that is not my issue. That's not what I'm you know, I'm not concerned about the interstate compact. I'm concerned about SOPs who work in the state of Virginia, and consumers who need speech services in the state of Virginia, that's my concern.

Jeanette Benigas 28:26
Yeah, and it should be, I mean, because Virginia has to do what Virginia needs to do. So I have been highly complimentary of the Compact committees. So far. I've seen all the little committees that meet. I've because they have a bunch of different committees that are all on different meeting schedules. So I've been in general meetings, I've been in finance meetings. I've been so I kind of know the names and the faces now, and it's not made up of all SLPs, there's lawyers, so there are a lot of people making these decisions, and I think they truly do a really good job of staying neutral and keeping the purpose of the compact in mind. So I am very hopeful that they will do the right thing here, which is focus on allowing the states to make their own decisions. If you want to hear my thoughts and comments about this nine month, 1260 hours that they're looking at which directly reflects the CF. You can go back to our bonus episode that is probably out just before this one, and you can hear what I have to say about that. That's not the topic of this, but I will, I will speak up. There are others that have already filed some complaints and letters about what's happening with that, but the goal is to protect the state's ability to make their own decisions and and if that's the thing, then okay, you have to have a supervised year. Well, then, you know, make it your new professional year, and that's what you report, and then you are still in compliance. I really do, like the executive director of the compass, she is typically in all of the meetings. I know exactly. I see your face in my head. I know exactly who she is. I've never spoken with her, but she does a good job of keeping them on track and advising you can do this, you can't do that. I think it was a little trigger happy there saying you're not going to be in compliance, because they are very much thinking inside the box when there are all of these other ways to think outside of the box and still be in compliance, still let the folks of Virginia participate. And that's the other thing, even if you guys decide to go forward with this petition, people can still participate in the nine month CF and then those SLPs are still in compliance. It doesn't mean the entire state of Virginia is up. You can't do it. It just means there's a whole report I know way more than I ever need to know about this compact. They have built this entire system on the back end with counseling and OT all three compacts are sharing the cost of this thing for reporting and payment and all. So the states are going to feed the names of their clinicians into this system. Just don't feed the people who haven't gone through the nine month CF.

Ed Bice 31:31
Right. It doesn't have to be all or nothing, yeah, yeah. Again, right. I just, and I think

Jeanette Benigas 31:38
Leave it up to the Virginia Board on how they're going to report the people who have and have not. That's for you guys to figure out. But I mean, come on, like that was that was a little trigger happy, and I was really surprised to see it from her.

Ed Bice 31:49
I don't know them at all, but yeah, again, I think that we need as a profession, as a society, as a to respect individual choice, and that's just what it boils down to. And we don't need to have a knee jerk reaction or do all or nothing. And, and I will say that that was what was brought back to me, was that we as shav were having a knee jerk reaction. That's what I was told. And, and actually, no, it's not a knee jerk reaction. It's actually a thoughtful process that we've been through and that we still support, regardless of what CMS has done, but it probably was the trigger for us to make this request, but it was not the sole purpose of us making history.

Jeanette Benigas 32:42
When CMS did that, I said to our team, what they have done, whether they keep it or they roll it back, or whatever they do, what they have done has really propelled our mission to help states figure some of this stuff out, and that's what we're starting to see, you know, with Virginia, with this other state where there's a senator who's contacted us, there's another state with a center senator who we've been on the line with, but nothing has started yet. It's exciting to see now people thinking about these issues, because then the last issue that I want to bring up with you is the issue of TRICARE and the Medicare administrator contractor who credentials SLPs for the state of Virginia that even though CMS rolled this back, TRICARE has not been credentialing new graduates for many years. And you guys, you said this to me before I knew this, but you said this to me before we recording, there's a lot of military families in Virginia. So if you're not aware of what TRICARE is, TRICARE is the insurance policy that active military have, that families, I think even retired military, you know, if you've been in the military or served in some capacity, or are currently serving, you can have TRICARE. And so that's a problem, because it's not just a Virginia issue. We have service, men and women, current and former all over the United States. That's an access to care issue for our military, for those who need to be treated, who you know, if you're in a rural area, and the local hospital system only has a new grad in their post supervision period. That new grad can't bill or get credentialed. So it's it's a real issue, and yes, it is not the general public like obviously, CMS impacted a much larger pool of people for access to care. But that doesn't mean that these people don't matter, and we still need to have these conversations.

Ed Bice 34:45
You talked about us having another discussion about supervision, but I will just say here is that is that supervision is not, supervision is not supervision, or mentorship is not. Mentorship is not mentorship, and. That's why we see on social media all these early career professionals coming on and saying, I have this patient who's NPO and blah blah. And the first question I always ask is, where's your CF supervisor?

Jeanette Benigas 35:11
"I've never met her." "She's never been here in person." "He doesn't talk to me."

Ed Bice 35:17
"We're supposed to have a call tomorrow." "She doesn't return my phone calls." "She doesn't return my emails." "She doesn't..." and so a lot of it is paperwork compliance, and it really has nothing to do with supervision or mentorship. It's someone filling out paperwork, and if ASHA took a survey of CFs, they would learn that information. I will say I had an amazing CF I worked with 12 other SLPs at a nonprofit Speech and Hearing Center, and so I had 12 mentors. I mean, there was one that was assigned to be my specific ASHA mentor, but if I had a question about something, I could go to a person who understood that area of practice very well. What I'm finding now is that that's not the case for many people who are experiencing the CF and and the only thing that I will say is I think that ashes should take initiative and reevaluate what that is and what it looks like, and and the supervision requirements and their mentorship requirements there, and actually have something in place that will support that new career Professional so that they're getting the help that they need. Yeah, I understand the concept, but it's not working. And so we just need to reevaluate it. If it were working, we wouldn't, as Shaw would be doing all of this work to support new career professionals, but we know it's not working, yeah, and so I hope that in all of this that it will encourage our national organization to re evaluate how they're proposing and how they're monitoring what's happening during that time, because I think mentorship and supervision is extremely valuable in that early career professional time period, but we need to make sure that it's actually happening and that there is a quality component.

Jeanette Benigas 37:04
Yes, we like to use the word modernize the profession. ASHA needs to modernize what they're doing, because what they're doing was created for decades ago, and that's not the situation we're living in now. We've pointed out before that that system that was set up was when we didn't have a big nine, what we had like a big four or something, right? And there weren't productivity standards, there weren't caseloads in schools of 120 kids. There weren't slpas to supervise that that system worked when it was set up, and it has never been touched again, and it just, it's not that it's not needed. It's just it has to be modernized. And that's often what we say, is there's a place for ASHA, there is a place for a national membership organization standing up and helping their professionals right, and helping with consumer protections as well, and all of those things, but they don't like to change, and that's what that's where the one of the barriers are is they just need to make some changes. And listen to the people who are shouting it from the rooftops, and it would solve a lot of their problems.

Ed Bice 38:17
Yeah, just adapt to the times. You know, when I was a new career professional, my productivity was like 70%.

Jeanette Benigas 38:23
Yeah. Same. Mine was 75.

Ed Bice 38:27
Yeah. And now people are at 90 and 95 and when I was a new career professional, people would make allowances if you were a CF supervisor. They would give you time. They would say, "oh, we're going to decrease your productivity requirement because you're a supervisor."

Jeanette Benigas 38:43
Right.

Ed Bice 38:43
And so none of those things are happening now. And so here's what I will say, we as a profession cannot change corporate greed, and a lot of those things are because of capitalism and the way that our healthcare system is structured. We can't change that, but what we can change is this side, which is our national organization to meet the demands of the current healthcare system, right? And I will say there is a great new documentary series out on Prime Yes, called No Country for Old people, and it's an expose on the healthcare industry as it stands. And I think because I worked in it, I was like, oh, yeah, I know that. I've seen that. I've seen that happen. I've seen people die because people didn't let their oxygen tanks run out and didn't fill them. I've seen people die because the nurse was documenting that she was giving them their medication that would help with their transplant, not rejecting their transplant. She was documenting that she did it when indeed the medication wasn't even in the facility. I've seen things, I mean, and I'm not making this up. These are actual things that I have witnessed in my career. And for people who want to understand how healthcare works in this country. We watch that documentary series. It's three it's three episodes. They're $1.99 or a piece or something like that. It will help you understand what we're dealing with and when we're you understand that that's what we're dealing with. You understand we can't work within the system to change we have to create a parallel system that will support our clinicians who are working in that system.

Jeanette Benigas 40:25
Right. Well, said Ed. Love that. That might be a good place to wrap, because you just, like, said that so beautifully. Do you... do you have anything else that you want to say or talk about?

Ed Bice 40:37
I appreciate you talking to me today. I hope that that this has been very positive, that we're not bashing people, and we're not saying that people are doing things wrong. We're just saying, you know, let's elevate what we're doing and do and do it better.

Jeanette Benigas 40:50
Yeah, protecting a system that isn't working isn't a good path forward, open conversation, safe conversations like this, where we may you and I don't always have the same opinions, and that's okay. We can still be friends. I love that. It's so important. And one of the very early things that I always said before Fix SLP even started, it was when I started this med SLP advocacy page on Instagram, was that states need to better communicate. And while presidents of state organizations maybe do have some avenues for that, that's one person from each state talking, what about the rest of the clinicians and people who want to be involved in improving the situations in their state? I didn't know any of this about Virginia until you and I just started talking, and that's, that's what's important is like taking what you guys are doing, connecting you with, you know, I told you at the beginning, when, before we were recording this senator from this other state that they're trying to do almost what you guys are trying to do. Why are we recreating the wheel in two different states when you guys could come together with amazing ideas and then have something even better than what you just put forward, right? And who's doing that? Connecting nobody. That's the core of what's happening here is one, let's get our autonomy back. And two, within that autonomy and making the choices that we want to make for ourselves as clinicians, bringing clinicians together to share good ideas, mentorship, growth, licensure, all of these things, to make these changes in their states on their own, because they have the power to do it. They don't have to rely on a big organization or a state organization or or someone to tell them what step one. Step two, it's we have the power to make this profession whatever we want it to be. We just have to lean into that power and go do it. And so connecting all of you is is a goal for Fix SLP is Ed. You better believe I'm going to be asking you for this outline so we can share it with other people. It's not ours, but like, let's get it out there and help other states, because our profession, our national organization, sure as heck isn't going to share your model. So where can we share? You know what I mean? That's just, it's what I would love to do. That's great. And I love your passion. If people want to either join your state association or contact you guys about this issue. Who's the best person to contact you, Melanie, somebody else?

Ed Bice 43:28
Me or Melanie, email me because I know my email is [e-mail] and then I'll forward them to her.

Jeanette Benigas 43:40
I bet you there's a decent amount of people in Virginia that didn't know this was going on. So hopefully you guys get some some good support.

Ed Bice 43:48
I sure hope so. I sure hope so.

Jeanette Benigas 43:50
We're certainly going to be watching and supporting and helping to push out information too, because our Fearless Fixers all over the country are watching and paying attention and supporting some of this stuff, so it's great to see. So this isn't in our summer school series, but this wasn't a planned thing. So Ed again, thanks for this last minute thing, and everybody, thanks for fixing it. We'll see you next time!

Jeanette Benigas 44:13
Thanks for listening to the Fix SLP podcast. If this episode help you feel more informed or empowered, take a second to leave a five star rating and review. It helps more SLPs find us. Fix SLP runs on $5 sustaining partnership donations that small monthly support pays for everything behind the scenes, including our website, legal fees and advocacy work. Want to be a part of it. Join us at fixslp.com enjoy the sunshine. Stay scrappy and we'll see you next time you.

Transcribed by https://otter.ai