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SLP advocacy can't stop with data. If Medicare reimbursement fails to cover the cost of providing speech-language pathology services, patients and families ultimately feel the impact through longer waitlists, fewer providers, reduced insurance access, and practice closures.
In Part 2 of our SPEAK Project series, Jeanette Benigas, PhD/SLP, talks with pediatric occupational therapist and private practice owner Pam Marshall about mobilizing patients and families as part of a larger SLP reimbursement advocacy strategy.
After Kentucky therapy providers faced Medicaid reimbursement cuts, Pam helped create a system that made it easy for families to share their individual stories with lawmakers. Her practice generated more than 420 letters in roughly two weeks.
Jeanette and Pam discuss how SLPs and practice owners can turn patient experiences into meaningful advocacy, why individual stories matter to policymakers, how practices can make participation easier for families, and why protecting access to speech therapy will require more than SLPs advocating for themselves.
The economic data is only one piece of the SPEAK Project. Now we need data, dollars, connections, and people willing to SPEAK.
SLP advocacy can't stop with data. If Medicare reimbursement fails to cover the cost of providing speech-language pathology services, patients and families ultimately feel the impact through longer waitlists, fewer providers, reduced insurance access, and practice closures.
In Part 2 of our SPEAK Project series, Jeanette Benigas, PhD/SLP, talks with pediatric occupational therapist and private practice owner Pam Marshall about mobilizing patients and families as part of a larger SLP reimbursement advocacy strategy.
After Kentucky therapy providers faced Medicaid reimbursement cuts, Pam helped create a system that made it easy for families to share their individual stories with lawmakers. Her practice generated more than 420 letters in roughly two weeks.
Jeanette and Pam discuss how SLPs and practice owners can turn patient experiences into meaningful advocacy, why individual stories matter to policymakers, how practices can make participation easier for families, and why protecting access to speech therapy will require more than SLPs advocating for themselves.
The economic data is only one piece of the SPEAK Project. Now we need data, dollars, connections, and people willing to SPEAK.
Learn more, contribute data, and support the project at SPEAKPROJECT.NET.
Get caught up, wherever you stream podcasts!
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#118: It’s Time to SPEAK: Part 1 - Building the Data to Fight for SLP Reimbursement
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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 Jeanette Benigas, PhD, 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.
Hey, everybody. Welcome back. It's Jeanette. If you've been following what we're doing with the Speak Project, you know that one of our biggest priorities right now is collecting the economic data our profession has really historically been missing. But there's something that we've learned through our conversations with the federal health policy experts that we've been talking with.
Jeanette Benigas:This is really a multi step strategy, and the data is only one part of the strategy. When we talked to one of the firms in DC, they urged us to immediately start getting another layer of advocacy added into this, and that's getting members of Congress involved, specifically influential offices and members of committees like the House Ways and Means, the House Energy and Commerce, the Senate Finance, and giving them a reason to start asking CMS questions. So that can be letters, emails, phone calls, congressional pressure. And I think most importantly, this can't just be SLPs talking about what reimbursement cuts mean for the field. It has to become an access to care issue or a beneficiary issue.
Jeanette Benigas:And that's one of the things that one of the gentlemen said specifically: It isn't until beneficiaries are impacted that Washington, D. C. Wakes up. So, we need to help them understand what happens to patients and families when reimbursement is no longer going to cover the cost of providing services, what happens when practices stop accepting certain insurance plans or reduce staff, or have months long wait lists because SLPs decided to stop using their degree for the thing they were trained to do or when practices close altogether because they just can't sustain the financial cuts. So that's where today's guest comes in.
Jeanette Benigas:I have Pam Marshall with me today. Pam has already done something pretty remarkable in Kentucky. Kentucky was faced with Medicaid reimbursement cuts affecting occupational, physical, and speech therapy, and so she created a system that made it incredibly easy for families to tell their stories and to get those stories into the hands of lawmakers in Kentucky. Her practice alone generated more than four twenty letters in roughly two weeks. Mind blowing.
Jeanette Benigas:So when I saw what Pam had built, I immediately thought, this is exactly the kind of grassroots infrastructure we've been talking about through FixSLP and now through the Speak Project. So today I want to talk with her about exactly how she did it, what she learned, and most importantly, what this could look like if SLP practices across the country mobilized the patients and families across the country who actually experience the reimbursement decisions. Pam, welcome to the podcast. So Pam, can you tell us a little bit about yourself before we get started with the questions?
Pam Marshall:Sure. So I am actually a pediatric occupational therapist of over thirty five years and started a private practice about fourteen I think we're in our fourteenth year. And as a pediatric therapist, started out in hospital hospital and then tried lots of different settings, but love private practice because of the relationships with families and the impact you can make in children's lives. So when I started this practice, just thought it would be kind of a tiny little thing, and then it grew, and we have a team of about 150, and we're in Kentucky, Central Kentucky, and I am a big advocate for what we do because it matters that children get services, And the only way to do that is to begin to advocate on behalf of them and all of us. So OTPT speech in pediatrics, we all work together.
Pam Marshall:So that's what I do. That's why I'm on a speech podcast today, because even though I'm an OT, I'm an advocate for speech, and I love how our speech language pathologists change and impact families' lives.
Jeanette Benigas:So you actually reached out to Emily and I, who are running the Speak- Speak Project, And I thought it would be good to have you on for this topic because we were moving towards this next anyway, so it was perfect timing. So, can you start by giving us the backstory? What was happening with Medicaid reimbursement in Kentucky that made you realize you couldn't just sit back and wait?
Pam Marshall:The backstory goes back even probably ten years ago. I started to get involved because with the expansion of Medicaid in 2014, nothing worked in our state. Meaning, you couldn't own a private practice and bill Medicaid prior to 2014. And then when they started enrolling speech language pathologists, OT, PT, and most of us who treat Medicaid are treating children, a lot anyway. And so you couldn't get a credentialed, get a prior authorization, provide the service, and get paid.
Pam Marshall:Like none of that worked. It's like the foot and the hand of Medicaid and the ear and the nose, none of it was connected to the same body. Like they didn't work. So it was really frustrating. So it was out of that desperation to wanting to be paid, wanting a business to actually work and help children that got me involved in advocacy and helped me bridge the gap between Medicaid and help them understand where the problems were.
Pam Marshall:And we do have managed care in our state, we have from the get go, and that was another whole confusing web of just things that didn't work and things that were hard. And so those MCOs have to follow Medicaid policy and rules and that sort of what got me involved in it. So our Medicaid fee schedules pretty low. And for a lot of years, we've been advocating for an increase to that fee schedule by rate studies by all the things you do in a state, working on that we do have lobbyists, we have an OT lobbyist, a speech lobbyist, a PT lobbyist, and there's very few of us that worked on it, very few. And then when the Medicare or CMS announced those cuts that were happening '22, '23, '24, '25, those years of cuts, I knew they were looming in ahead.
Pam Marshall:So I thought, well, if our state won't give us an increase, perhaps they'll agree to just hold our fee schedule, like just hold it where it's at, because the reg, the regulation says that we're to be paid 63.75% of Medicare. So whatever the Medicare rate is, we're reduced down. So that's pretty low and pretty tough. And to know that two-three percent cuts were coming every year for three-four years in a row was going to be very devastating for children. So I had the bright idea to ask them, Would you just hold this fee schedule?
Pam Marshall:And they did for several years. And that's why practitioners in the state didn't feel those cuts because we held that fee schedule. Well, we continue to work. There were really three of us mainly working on the advocacy and one other practice owner and I presented in February and gave all the facts and data you know why the why behind could you just at least look at these 10 codes we'd really like to ask for 10 codes and increase those if you can't do the whole fee schedule. So Medicaid actually agreed but when it came time and you know it goes back to understanding how government works so like on the federal level there's three branches of government there's legislators and that's Congress you know the House and the Senate Then there's the Executive Branch, which is the President and, you know, all the things that happen there.
Pam Marshall:In the state, the Executive Branch would be the Governor and the Legislators, you know, would be called the General Assembly. And then judicial is pretty much similar for federal and state, and we didn't really have anything to do with judicial. The governor in our state runs all the cabinets, and the cabinet of Health and Family Services is where Medicaid sits under. So it's a pretty large expense for the state. We have about one in three people on Medicaid, so it is pretty significant in our state.
Pam Marshall:And so these two branches of government the legislation, the General Assembly, and the governor and executive branch they were kind of feuding and I don't get involved in politics because I want to help children I care about children and so I just thought this is really an issue where they need to sit down and solve the budget problem. Well, they didn't. So, you know, one side said we gave the governor enough money. And the governor said, No, they didn't. They didn't give me enough money.
Pam Marshall:So we're cutting Medicaid. And it just felt like a big show. And it just wasn't fair to put the families and the providers because all the providers, it was a straight 4% cut across the board, and no kind of hope in sight. I mean, there were major programs that were going to be threatened to close, and it just it just felt like a sock in the gut when we were promised an increase. And our fee schedule for 2026 actually didn't come out till May.
Pam Marshall:That's how long it took them to approve that fee schedule. And what they did is they actually, you know, CMS made increases to our profession this year, OTPT Speech, a little bit of increase. And what Kentucky decided to do was just apply it according to the reg. So where we hadn't had all those cuts, and then we had a gain, it came out to roughly about a 5% to seven percent cut. So that was a surprise.
Pam Marshall:We were supposed to get an increase, and we actually got a 5% to 7% cut. And then weeks later came out this surprise 4%, additional 4%. And so it was a big whammy and we were all going, What in the world? Especially me having put so much time in that advocacy. But I don't take no for an answer, so I was like, By golly, what are we going to do?
Pam Marshall:And I start studying, what have been the successes who's been successful? And looking outside of our profession, looking at other provider types who's been successful, and I started noticing a trend that it's engaging the families. It's engaging the people who get the services. Yeah. So that was my idea.
Pam Marshall:I thought we can do that. We can automate this. Can we can absolutely do that. So yeah, that's kind of what we started.
Jeanette Benigas:Yeah. And you were singing to our hearts because we already planned on having a Friends of SLP tab on our website, meaning families, colleagues, care partners, your brother or sister, or whoever, how can we get them involved not only to donate money to the Speak Project if they have it, but also through their action and connections. And so then you reached out and were like, duh, perfect. So we're on a limited time schedule. I have a bunch of questions that I'm going to kind of skip through, but you brought OT, PT, speech together.
Jeanette Benigas:Yes. And you created the Kentucky Therapy Advocacy Group. And can you just tell me what was the number one goal? What was the number one problem you were trying to solve as a group instead of just telling people to contact legislators?
Pam Marshall:We wanted to make it easy. We know a day in the life of a parent where a lot of us are parents and we know how hard it is even when your child doesn't have a major disability. But parents don't have time to write letters and do all these steps, and frankly they don't like form letters or the legislation, or government officials receiving letters don't want all the letters to look exactly the same because that's not meaningful. They feel like it's just a big show Yeah, or
Jeanette Benigas:and now with AI, it groups them into one. We were told that in one of our consults with a high powered firm in DC, they said every letter needs to be different.
Pam Marshall:Yep, every letter needs to be different. So I came up with the idea of just asking questions, making it super easy, something I said to my team, it's gotta be something we can text to a parent and they all can voice text right they can do that on the fly they can do that pretty fast I know as a busy mom I raised five children I could do that so I thought if they could just voice text the answers, and we could create a form that converts it into a letter, and we knew we had to automate it because we thought well, if we're getting hundreds of these, how are we going to manually print and take these to Frankfurt and you know to our capital and and get them to where they need to go so we knew we had to automate it so by doing research and asking finding the county and the city of Which they live their zip code We could target which legislator was over their area or legislators, and then we knew the governor's office, you know, we could we could definitely send it there. And then we had a digital signature and an authorization, and the authorization was pretty much they said, I agree to let you take my answers, convert it to a letter, and put my name on it from me.
Pam Marshall:So every letter was unique. So we took those answers to the questions, converted it to a letter. We made a letter format, and you just plug in the answers in the letter. So the letter is similar, but it's definitely not they all look different, because it was their own story, their unique story and their unique answers. So that's what we did, and then automated, and I had people on my team that knew how to put the connectors in with AI, and knew how to take that form and automate it and get it sent to the right digital mailbox.
Pam Marshall:And since the parents were giving consent, it wasn't a HIPAA violation. It was there. Everybody freaks out about that. Well, what about HIPAA? And we do have HIPAA security in our processes, but it had to be sent to legislators.
Pam Marshall:The parent was agreeing to do that was giving their consent that was real important to to follow the rules.
Jeanette Benigas:What really caught my attention when you emailed was that your practice generated more than four twenty letters in about two weeks, which is amazing. We need to do that too. Now, people are thinking this September 14 deadline, that's more than two weeks out at the time that we're recording this. This is actually we're just recording two days before this drops. So, we still have more than two weeks, but there is going to take some back end organization, There's going to be some stuff to get this off the ground.
Jeanette Benigas:I don't know that I'm going to have the website ready when this drops because I'll be podcast editing. I'm wondering, you did this very succinctly within your practice and some other practices, but how much time did it take to do that many letters? How much time are we looking at? Because I can't do it, PhDSLP can't do it, our business owners listening are gonna have to help with this. And you know, as a business owner, you're stretched thin.
Jeanette Benigas:So how and they're already filling out a survey for us, This could take up to five hours. So how much time are they looking at needing to invest in this or having someone on their staff invest in this? Yeah.
Pam Marshall:Well, if you have the right process laid out for them, which I did and I shared with other practice owners, they were able to set it up in their system. Now, we're a Google company, not everybody is, some people use Microsoft, but either way you can set the same automation, the same steps up, and we just kind of laid it out what they needed to do step by step. And I mean I got feedback that people have never done anything like this were able to follow the steps and execute it and I'm also a big fan of we all have different gift sets I am not administrative at all So find people on your team where this would be real easy for them and they would find joy in it. That's what we talk a lot about at work. Where do you find your joy?
Pam Marshall:And I do not find joy. It sucks the life out of me to do administrative tasks, but other people find joy and are good at it. So those are the people you want executing it because they'll execute it pretty quickly. Does it cost time? It does, but they should be able to do it in a relatively short amount of time.
Pam Marshall:It's not like it takes a week or something of your time. It takes a few hours and you can have it done.
Jeanette Benigas:Here's the thing that's coming to mind as I think about that. It's going to cost time now, but if we are not successful with this, it's going to cost everyone money later. No one I keep saying no one's coming to save us at this point. We have to save ourselves. And this is the effort.
Jeanette Benigas:So, we keep saying data and dollars. Well, now we need letters to the government. Very specifically, the firm that we met with that we absolutely cannot afford to hire, but they gave us so much free time and free advice, and I will forever be grateful. One of them looked at us and said, immediately, right now, on top of this data, you have to start reaching out to government officials. Everybody needs to be reaching out.
Jeanette Benigas:They need to be making phone calls, letters, putting on pressure and supporting this cause. And that will go a long way. Even more so than some individual letters from SLPs who don't have data. They said that's going to make a difference. So putting on these pressures is a piece of this you said puzzle with people who have gifts, but a piece of this larger advocacy puzzle that we need all pieces to happen and connect and all wheels to be turning for our best chance of getting these rates up.
Pam Marshall:I'm going to speak to all the SLPs listening. We need one of you in every state stepping up and taking the lead. I mean, it could be those of you who are already doing advocacy in your state, but you need to take the lead and make sure you get letters and do the same thing I did in Kentucky. Do that in your state and get people sending those letters to the legislators in your state because then that will feed in federally to what's happening. Yeah, and I think that's what it's going to take getting One person to own it in every state that we will make voices known I'm so missional like my heart What drives me?
Pam Marshall:I think what drives all of us I start crying when I talk about it, but every day to do the hard work is what a difference we make. I mean, what do parents say about your work? They say, My child said I love you for the first time, or said Mama for the first time, or could communicate their wants and needs through an AAC. You all make such an incredible difference, and this is your time to shine. Like this is time to get those parents talking, get them flooding Washington with the truth of this services matter they make a difference and they matter and We need collectively all those voices to be heard in from every state
Jeanette Benigas:and I want to add to that because we have a lot of pediatric private practice owners and SLPs listening and engaging in this movement. And my friends in the med SLP space are lagging behind. These are Medicare rates. These are Medicare rates that we're fighting for. You hear Pam saying 67% of the Medicare that's like $47 before any of the cuts she's talking about.
Jeanette Benigas:But these directly affect us. And your contract therapy company, your hospital, your nursing home, none of them are doing the work. They're just going to cut And your so, she said parents, but we need spouses and brothers and sisters and all of those people who come to visit your Part B patient who has had a stroke or had a this isn't dysphagia codes but had a swallowing problem. We need them too just as much as we need the pediatric people. Because if all of the pediatric people are making the case in Washington, D.
Jeanette Benigas:C. And with government, that's where the focus is going to be. We need our med SLPs stepping up into this. It's going to take all of us. Private practice owners can't save our Part B med SLPs.
Jeanette Benigas:Keep saying it. Have to save ourselves. That's so important, Pam. And what we're going to do is we will have the resources. We're going to work with you.
Jeanette Benigas:Hopefully, we haven't asked you that. But hopefully, we can have a quick phone call or a meeting so you can kind of give us some of that advice. You've already given us some in an email. But then that will be available on our website under the Private Practice Toolkit. That's where everybody can go to look.
Jeanette Benigas:And then we'll have some more information for parents and families and people who love SLPs under that tab. So please be contacting us if you're interested. Pam said one person in every state. The other thing I might challenge is if you own a large practice, and it doesn't even necessarily need to be a SLP for this, I don't think. But if she said gifts, who has the gifts?
Jeanette Benigas:If you have someone with this gift in your large practice, and you can afford to throw them some extra money and pay them to do some of this work, that would be even better. But we're all volunteering. So no one's getting paid. Even our website that was built by a volunteer. So we need volunteers.
Jeanette Benigas:But if you could help it along in your state, we need this.
Pam Marshall:And it all costs us something, right? It costs us time and if you're an owner and you're off the movement of your practice and you're on this advocacy thing, it costs something. It has a cost to it, but I've always found that the advocacy efforts do come back around and have a return. It does have a return. It's just there's so few people willing to do it.
Pam Marshall:One, maybe they're confused, they don't know how or two, they just think, I can't really make a difference. Or three, they just don't want to, they're just focused on their little bubble and trying to get through their pain points and problems. We all have problems every day, every day in what we do. It is not easy getting up and delivering therapy every day. It's hard.
Pam Marshall:It's hard work, and there's roadblocks, and I'm a believer that together we can get over those brick walls together. And that's what this is. It's a big brick wall. We've got to figure out how to get over, smash it down. And I say we need to win on behalf of the kids and the adults and the people that we serve.
Pam Marshall:We need to win for on behalf of them because we know our profession makes a difference.
Jeanette Benigas:Yeah. And there's another plan too. If we don't win, rates don't go up, they don't do anything. One of the firms that we met with actually gave us another step that we can take. And so that will be even more important, that these letters, this contact can keep going in beyond this September 14 period.
Jeanette Benigas:I would say maybe even until the final ruling at the beginning of November, because they're still working on that. And so, with the pressure coming in, we can carry this out beyond the September 14 deadline because Emily and I know what the next step is and we're not going to talk about that publicly yet because there's a lot of moving parts here. But when it's time, if we have to, we have a very specific strategy open to us that is actually pretty easy with maybe a lawyer to help us with it a little bit, but we're going need those letters ongoing. So when you say when, we're still trying to be realistic. We might do all this work and still not get there, but we have another road to stop this.
Jeanette Benigas:These letters that people were sending, what did you ask families to talk about specifically?
Pam Marshall:I'll review the questions that we asked. So, and remember, we put it in a form that we could text this link, they could click on the link, and we used JotForm. Everybody has different forms that they use, but we just happen to use JotForm and we're able to automate it from JotForm. And we asked the question, What is at stake for your family? They knew it was in regards to the Medicaid cuts.
Pam Marshall:Were able to explain it. Number two was tell your child's story and number three was what would the cuts mean to you? They said things like, well if my therapy place closes, we're going to be devastated. My child's been making so progress. And if people have to leave their job to go get a higher paying job or whatever, they put answers like that.
Pam Marshall:And what is your message to leaders? And so they just wrote a message like, please don't cut this. This is a much needed service, that sort of thing. And then number five is what would this cost you? And they were really able to express how many families don't have the extra income to pay for this out of pocket that they need Medicaid to cover it or insurance to cover it.
Pam Marshall:And they also, if this place that I go to closes, I won't be able to get the help that I need for my child, and kind of explained that a little bit. And then they did an electronic signature dated, authorized, that authorization just said I authorize for Marshall Pediatric Therapy to send this story, my story, in a letter format to both the governor and the Kentucky legislators on my behalf. And so that's really all it was to it. And then we had that convert on the back end we linked to our Google Drive, which has a BAA is HIPAA compliant, converted it to the letter. And then we were able to automate it based on because we asked identifying information in the beginning for name, city, zip code, that kind of thing so we could know which legislators to send it to and be able to automate it.
Jeanette Benigas:Did you see evidence of legislators noticing the volume of all of this?
Pam Marshall:We did, but unfortunately this situation was a little different in what we're facing right now with ninety two thousand five hundred seven. The reason it was a little different is because I think of the political show that was involved between these two feuding branches of government. But it definitely impacted. There was a lot of news stories. One thing I would do different is I would really have that because I was into news interviews but I would have the news focus on the actual stories from the families.
Pam Marshall:They were focused on some of the stories because there were some families that were a part of a center for adults and teens with disabilities that was being threatened to close. And that specialty clinic provides a lot of medical services to the community and to those families. So there was a lot of exposure to that. But this particular thing, I would do that a little different, you know, talking about what this means. The other thing I had wanted to do, but there just wasn't time.
Pam Marshall:In our situation, since it was Medicaid and it was all providers, I wanted to link more with other providers. And that's different in this situation with 92,507, we wouldn't be linking, other than OT and PT should be helping this effort.
Jeanette Benigas:Yeah. I actually just had the idea too. It probably doesn't even need to be an SLP or an OT or a business owner who's helping us in each state. If you have a practice with a go get them dad or a go get them mom who they left their job to stay at home with their kids for a while and they have time, because this stuff doesn't have to be done during business hours, they could do it in the middle of the night when their kids are sleeping. Think about recruiting maybe families to directly help in getting some of these letters out too if you're listening.
Jeanette Benigas:Or if you're a family or a loved one or a friend of an SLP listening, I've had plenty of outside colleagues say, If I can help, let me know. We just need people who are dedicated to helping get this forward to volunteer in every state to do this. So that's a side note.
Pam Marshall:And I can piggyback off that. One of the things we can all recognize is parents of children with autism have really made their voices known, and it's been effective. There's been a lot of services and a lot of things expanded and policy changed and policy written because those families have been loud and have voiced it for that help and they've been organized. So that's an example where yes, we can we can definitely better if you have a parent who might be a lawyer or a parent who has some understanding, but really any parent could be an advocate for this.
Jeanette Benigas:It's all about connection. Emily and I have a webinar tonight where we're going to talk about how need your connections to make this happen. In So, this effort specifically, when we met with the firm who really talked all of this through, they mentioned some legislators very specifically to focus on. They said, Get a few legislators from the House Ways and Means Committee, the House Commerce Committee, and the Senate Finance Committees to really focus. And so I'm also wondering, as Emily and I and maybe you a little bit sit down and think through the details of this, perhaps we're not reaching out to governors or state legislators.
Jeanette Benigas:Maybe that's where we're going to end up focusing these letters to And so then, yes, we still need people from every state to help, but it's going to be a lot less state specific and a lot more, we're going to pound the heck out of these 15 people to get behind this, that might be more effective.
Pam Marshall:We do need people in every state because I think that says something when you have, you know, responses coming from every state to that finance committee, Senate Finance Committee, or whatever the other two committees are. I think that speaks loudly.
Jeanette Benigas:Yes, I just meant we don't need a volunteer in every state to True. Get these Yeah. But yes, we still need every state, just like we need every state to get data into our survey, because we can't call this a nationwide survey if Alaska I keep saying it, I'm looking at you if Alaska or Washington, D. C. Or Hawaii is missing.
Jeanette Benigas:We need everybody. So everybody, don't assume someone else is going to do it. If we have a state missing from this, it is no longer nationwide.
Pam Marshall:And I want to challenge everybody just to commit to a yes. Everyone that's listening, say YES to be a part of this. It will make a difference. Just say YES now. Just choose it no matter what part you have in it.
Pam Marshall:Say YES to Advocate.
Jeanette Benigas:There's nothing more for me to say. We're done here. No. It was so good. But we do have to wrap up in a few minutes because you have a heart out.
Jeanette Benigas:Piggybacking off of that, just say yes. For the SLP listening who thinks, I'm just one clinician, Congress isn't going to care what I have to say, or I'm just one mom, the House Ways and Means Committee doesn't care, what would you tell them after watching hundreds of families participate in this Kentucky effort?
Pam Marshall:I would say no, not one single person can make a difference. But many single people together, many people together, we can make a difference together. That's the truth. So if you're feeling like, Ugh, I'm not really going to participate, or maybe I don't bill insurance and I'm just taking private pay and I'm not really invested in this, think about all the children you've turned down because they needed to go to a facility Medicaid or needed to go to a facility that had their insurance. Think about you know children, you know the impact, just be a part of it because it impacts children.
Pam Marshall:That's why I do what I do. It's not my only because I run a private practice, it's because I see the child who's in Rural Kentucky that has no service and needs that service, and we can't get it when the rates are so low. There's no one willing to go and provide that service. So it's on behalf of all patients, clients, children, adults that you serve. It's on behalf of all of them.
Jeanette Benigas:Yep. And so for the private practice owner listening who has families who would absolutely speak up if they understood what was happening, but hasn't involved families before, maybe they're nervous or they don't think it's professional, what would you tell the owner?
Pam Marshall:I would say your families matter to you, right? I would ask them that question. And if they say yes, say, Well, their stories are really needed. Can you help their stories be known? Will you get on board and help their stories be heard?
Pam Marshall:And that's what we need because think there's so many families who've been impacted by excellent quality speech language pathology services. And I just I could go on and on about that absolutely whether it's school based or outpatient or hospital or sniff or it doesn't matter what setting there's been families impacted by the good work
Jeanette Benigas:And if you could put one message directly in front of the people making reimbursement decisions, what would you want them to understand about what happens to patients when reimbursement no longer supports the actual cost of delivering care?
Pam Marshall:Well, I'd love to say two things because they're related. And the first thing is the clinicians are all master level clinicians with high school loans and rates. Those individuals, how are they employed if the reimbursement rates are so low, they cannot pay them adequate wages to do the service that they do. That's the first thing. Consider the whole picture, you have to back up and look at the whole picture.
Pam Marshall:And many people don't look at that picture. They don't understand how much it costs to pay a decent salary. I'm aghast at when even people in our own state advertise the average starting salary for an SLP being $85,000 I just go, Where? How? Because that isn't possible with the reimbursement.
Pam Marshall:And two, it is the impact. You need to take time to understand the impact that Speech Language Pathology has on individuals lives. You know you think about people from all different circumstances whether they've had an unexpected injury or illness Whether they have a child who has autism or a child who has developmental disability or even a child that has a severe stutter you think about those kinds of patients you think about a an elderly person who recently had a stroke who can no longer speak communicate swallow eat. You have to know the stories. You have to listen to the stories and how this impacts people in everyday life.
Pam Marshall:And they're your constituents, and they need to be heard.
Jeanette Benigas:Yeah, that's a great place to wrap up. Right on time. Pam, I want to thank you for joining us today. I really appreciate it. Hopefully, we'll be in touch in the next couple days if Emily and I have questions, and hopefully we talk again soon.
Pam Marshall:Thank you for having me and all the speechies listening. You keep doing the good work you're doing.
Jeanette Benigas:Thanks, Pam. I had so many more questions for Pam, but we were on a time crunch, and it's been a crazy day. So, I'm glad that we were able to squeeze in what we got in, but you can see exactly why I wanted her here to talk with all of us today. We need to be able to walk into these conversations with credible numbers, showing what it actually costs to provide speech language pathology services. But a spreadsheet can't tell a policymaker what happens when a child sits on a waitlist for six months, or an elderly adult doesn't get services because there isn't anyone to provide them.
Jeanette Benigas:It can't explain what happens when the only practice within driving distance of a family stops accepting their insurance. And it doesn't show what happens when a practice owner simply cannot afford to hire another SLP, even when people are begging for services. This is where the people who love us and the people who we serve come in. The Speak Project is currently working on the data side of this, but this is all happening at once. All the cogs and wheels are turning.
Jeanette Benigas:And as we move into the next phase of this advocacy effort, you're going to hear a lot more about getting parents and families and care partners and loved ones involved. We do need them to donate. We need their connections. But we also need them to participate in the government outreach portion of this advocacy effort. Because collecting the data isn't the finish line.
Jeanette Benigas:Collecting the data is just the first part of this. There is a lot more ahead because next we'll be talking about how SLPs who don't own practices can comment, too. Because collecting the data isn't the finish line. It's what gives us something powerful enough to take to the people who have the power to make the change. So please head to speakproject.net, give generously.
Jeanette Benigas:We cannot hire our consultant or our lawyer officially until there's money in the account. Unfortunately, I'm just not willing to sign personally for such a big expense. So once we have the data and the numbers, we have to have someone help us with the rest of this. If you're a private practice owner, download the spreadsheet, get that going. It does take time.
Jeanette Benigas:Do not wait until the end of this to get started. Get it in now. Our CPA is actively working through the submissions so we can accept more if everyone waits until the end. In the week that he has to analyze the data, he won't be able to get them all in. You will receive an email from him on September 10 with the results so you can use those in your own comments.
Jeanette Benigas:And SLPs, please continue to stay involved too. We'll be coming to you next with how to draft your comment to CMS, so stay tuned for that. And as always, everybody, thanks for fixing it. Thanks for listening to the Fix SLP podcast, the podcast shaking up the field of speech language pathology. Don't forget to check out our social media or fixslp.com for our latest promo codes for continuing education, therapy materials, merch, and more.
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