Shaking Up States

Dr. Jeanette Benigas and cohost Preston Lewis, MS/SLP, are joined by Mikayla Treynor, MA/SLP, to discuss the vital work being done by Fix SLP’s state teams, from addressing Medicaid CCC requirements to educating legislators on the impact of outdated policies. The team emphasizes the importance of persistence, collaboration, and education in driving meaningful change at both state and national levels.

Looking ahead to 2025, Fix SLP has set ambitious goals to expand its efforts, target key states, and continue advocating for systemic reforms that empower clinicians. With updates on current projects and a call for volunteers to join the movement, this episode provides valuable insights and practical steps for those looking to make a difference in the field.

Whether you’re an experienced advocate or just starting to explore these issues, this episode offers a compelling look at how Fix SLP is reshaping the future of SLP, one state at a time.

Want to lead or join your state team? Email your name and state to [e-mail].

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Creators & Guests

Host

Jeanette Benigas, PhD/SLP

Host of Fix SLP

Host

Preston Lewis, MS/SLP

Co-host of Fix SLP

Guest

Mikayla Treynor, MA/SLP

Fix SLP - Regional Liaison

What is Fix SLP?

Fix SLP is grassroots advocacy firm here to challenge the status quo in speech-language pathology by driving real change—from insurance regulations to removing barriers to full autonomy like the CCC. This podcast is your space to learn, engage and take action in the field of SLP. We don’t wait for change, we make it. So let’s fix SLP!
Hosted by Jeanette Benigas, PhD, SLP

Jeanette Benigas 0:00
Hey, fixers. I'm Dr Jeanette Benigas, the owner of fix SLP, a grassroots advocacy firm here to challenge the status quo in speech language pathology by driving real change from insurance regulations to removing barriers that prevent full autonomy like the CCC, this podcast is your space to learn, engage and take action in the field of speech language pathology. We don't wait for change. We make it so let's fix SLP!

Preston Lewis 0:46
Happy New Year, fixers, we are back. It's 2025 and I don't know. I've been looking through the news, and I can't believe it. There are no headlines. There are no big tags on the screen. What the hell is going on? We have 1000s of SLPs out there right now which are not clinically competent, because they're either waiting toward january 31 to pay or they're like me, and they've said Sayonara, but I was expecting headlines Jeanette, Mikalya, are with me today, ladies, what the hell is going on? We've got clinically incompetent SLPs out there, according to ASHA.

Jeanette Benigas 1:28
Yep, I haven't paid I am the most incompetent person there is right now, leading this movement. I'm gonna have to but I haven't. Mikalya You and I have had some conversations, so we'll get to what we're talking about today, but Mikalya is on to help us discuss some of that. Mikalya, are you competent?

Mikayla Treynor 1:52
I am competent right now because I have a nationwide company that I work for that requires that you purchase the CCC by the end of the year. So that deadline is December 31 for me.

Jeanette Benigas 2:09
Well, thank God somebody is on this podcast who's competent, but you also didn't renew membership, and then we you and I decided that probably you should get it. So we were saying that Mikalya, we tried to be transparent. We were saying that Mikalya was going to drop her membership, but at very last minute, just a few days ago, you called and reinstated it didn't you?

Mikayla Treynor 2:35
I did. So originally, I did drop it, and then I got a phone call from Jeanette, who thought it might be a good idea to keep it for a bit longer based on the work situation that I'm currently in.

Jeanette Benigas 2:48
Yeah. So listen, guys, our effort here, you know, we had that petition for pricing transparency, but that was for the people who want to stay, or who are forced to stay, like Mikalya, who still has to pay for that. CCC, the ultimate goal here is to get autonomy for everyone. And while we are now going to be pursuing this legally with the lawyer that we've hired to represent Fix SLP, on behalf of interested parties, there are some other avenues we can take, and I have stumbled upon a potential class action possibility. I need to talk to our lawyer. But, uh, in order, just like the reason I have to keep the CCC and membership is, you know, to take legal action against Asha worth starting to suspect that in some states now, requiring the CCC without reimbursing is probably not legal. So this is very, very early days as we explore this, but we are going to hit this from every angle. And so we think in some states there is potential for class action against large employment companies, including Mikalya's. And so she is keeping the membership so she can file, if this is a thing, if this turns into a thing, she's gonna file on behalf of all of you. So that's all we can really say for now. But just know we are always looking for every angle, and people are always like, when's there's, when is there a class action? This actually could be one. So the next meeting just got a huge attorney Bill this morning. So Happy New Year. Yeah, we'll bundle it in there. Keep sending your money.

Preston Lewis 4:51
So regardless of any legal outcomes, though, you can imagine that if that was just a. Get filed. That the ripple that that would send across to many SLP employers to start taking that copy and pasted language out about that certificate of clinical competence, that would be one of those big tentacles. And Jeanette, you and I have had conversations about what it is that keeps this thing so ingrained, and it's not gold standard, you know, all that flowery BS really. What it is is that you've got supervision of students, and then a lot of employers that are still just copy and pasting those requirements. That is one thing that could be blown up by one single legal action.

Jeanette Benigas 5:36
Right. And I actually think if we can get this requirement lifted by employers faster that it will crumble the tower faster than us taking on Asha in the court system. So here's my call for all of you fixers listening, if you know an employment attorney or an attorney who does employment law in your state, who might be willing to have a 20 minute conversation with me off the books, not as representation and for free, that would be awesome, if I have to pay something. That's okay. That's why we have the sustaining partner money. But certainly there are SLPs out there who have partners or best friends or cousins or parents or somebody close who you could talk to to say, Hey, would you have a chat with this person? Please email me team at fix slp.com, this is another avenue that I think we can hit very hard. And I think in some states like California, is actually doable, so we're not stopping it's 2025, and we're gonna blow stuff up where no one gets hurt. It'll be a cool explosion.

Preston Lewis 7:03
California. Here I come.

Jeanette Benigas 7:05
Mmm-hmm. Do I need to move? There is the question,

Preston Lewis 7:09
California Dreaming?

Jeanette Benigas 7:10
Yeah, so Mikalya is holding on to that membership for now. We do have a topic that's going to go along with our content this week. It's state teams and state action, but there are a couple things that we want to talk about before we even get to that. So I'm just gonna play a minivan meltdown for a Preston because he loves these things he does again, doesn't love when you're melting down, but this is his baby, so I we got there's we guys. We get a good handful of these. But this one came in last night. It was short, sweet, so I was able to give it a quick listen, and I thought I'm gonna play this one in the morning. So here we go.

Minivan Meltdown 7:53
Oh, it's just a gripe. I wanted to suck it to Asha and wait till January 31 to pay well, found out one of my companies, I can't come back to work until that's paid up. Do they require OTS to be members of aota? No, do they require PTS to be members of their memberships? No, just us.

Preston Lewis 8:25
Let's find out who the employer is. My goodness, it might be, what do you want to bet that employer calls it a license too.

Jeanette Benigas 8:35
I. I would bet because then I would make some money, and that would be a creative way to pay the team.

Preston Lewis 8:43
You know, in the regular consumer market, this would be like if Mikalya had car insurance, and they called her and said, Mikalya, are you still a member of triple A? Because if you're not, we can't let you drive your car. I mean that that's the kind of bizarre things we're dealing with there, isn't it? Yeah, yeah. I Mikalya is just nodding like, Yeah, this is the world I live in.

Mikayla Treynor 9:07
I really wonder if it might be the same company that I work for, because I had this conversation about how technically we have through the end of January to renew without a late fee. And one of my higher ups in the company had said, well, the fear is, if you don't renew during the December period, then we can't bill for January. And there's a complete lack of understanding that this is not related to billing, especially now, because we've removed that here in Michigan. But having your CCC shouldn't dictate whether you're going to be reimbursed in that month.

Jeanette Benigas 9:52
I did not renew my state license until the final hour, and not because I. As being a jerk, really, just because it's a money thing, like a lot of you, you guys, I left my my full time productive income in January to grow my mobile fees business and to have more time to focus on Fix SLP, and or I left in February. I'm sorry to have you know my mom was sick, and so it was like, FMLA or move on. So a lot was happening, and my business income has not replaced my professor income yet. And so it what came down to a money thing. You know, it's Christmas time. I got little kids. I'm not working as much. I didn't get called for as many fees as I typically would in the month of December, and so I just waited. And it's interesting, because at 8am ish on the 31st I got messaged by both my both PRN companies. I work very regularly for a contract therapy company and a home health company. They both messaged me. One said, You are locked out of the system. Net Health has locked you out. You are not permitted to work again until you provide your state license. And I said, well, it doesn't expire until midnight tonight. And she said, I know she said, but this is how Net Health operates. So until you provide this to us, we can't unlock you. And my home health company doesn't use Net Health. But she just said, Hey, this is the last day you can work if you don't send your license. So I suspect those medical companies like yours, Mikalya, that are using Net Health have programmed in there to lock you out of the system until they input the data and probably action numbers are part of that data for your company.

Mikayla Treynor 11:52
I'm pretty sure it is, and at one point, I will have to pay more attention now, but I know at one point, like my Asha number followed by signature.

Jeanette Benigas 12:03
That's so dumb. So dumb.

Mikayla Treynor 12:05
It really is

Jeanette Benigas 12:07
So dumb.

Mikayla Treynor 12:08
Not even my state license.

Jeanette Benigas 12:09
Yeah. Let's keep this train moving. We got a really cute little review on Apple podcasts that I want to read. You guys are awesome with these five star rating and reviews. We so appreciate them. These don't help us chart, but what they do help us with is getting the word out that you guys, if you are on Facebook and you have been paying attention, there are so many people who still do not know about fix. SLP, it is wild. I think the last week or two, I have been tagged, either personally or by fix. SLP, multiple times. It's all I have been doing on socials, is educating and God bless those of you. I read one last night where you guys jumped in and you educated the heck out of these people. And I thought, You know what my work here is done. And actually, I don't even need to work here because y'all did it. And, man, you're awesome. So anyway, this one is from Lady board Jansen, and the heading is finally ash tool. It's like a play on actual advocacy, but she used the word Asha, or he used the word Asha in there. So here we go. December can be such a trying time, but this year, it's as if the holidays have been simmered, buttered and glazed, knowing each Monday there's a fresh, salty hour of ideas and intrigue to chew on. Never has the world of speech pathologists been so interesting through their investigations that produce impressive findings rivaling the work of Hard Boiled detectives and crime novels. These podcasters see through the smoke and mirrors and find the truth between the glossy embossed lines disclaimers. One, some listeners may experience lightheadedness or nausea after not only having your long held suspicions and grievances finally confirmed, but to also learn it's even worse than you thought. Two, due to the pod's tendency to elicit gasps, it's recommended to not engage in po intake while listening, and to instead satiate your hunger with the pods juicy food for thought, I love that if I knew who this person was, I would send this person a t shirt. Thank you for just making my day when I read that,

Preston Lewis 14:40
How much fun is it that we have disclaimers now?

Jeanette Benigas 14:42
I know! I love a good disclaimer in my life.

Preston Lewis 14:46
It is really remarkable. Jeanette and I have seen this before, and Mikalya has as well. And there's that moment where we'll have zoom calls or in person, and we explain all of this to SLPs, who have been. In practice for sometimes as much as a decade or longer, and all of the sudden, the, you know, switches get thrown, and their eyes get open, and it's like, wow, a fixer is just being born, and they've realized that I've been duped all these years, and it's a it's a remarkable thing to watch.

Mikayla Treynor 15:23
I love the way they worded all of that, but ultimately, I love the bottom line of like, look at all the things that we've been able to do within the past year. And there's only five of us, and I've seen multiple comments on social media about this as well how we're doing this truly based off donation. So it's super important when we have those sustaining partners, continuing on and donating every month to us, because we're truly putting that money where it needs to go to make real change in the field. So I think whoever wrote that, they said all that a lot better than I just did with a lot more flair. But I always think about that like, if we had the funds that ASHA has, can you only imagine maybe how different our field would be, or even a quarter sliver of what they have, we are truly like none of us are paid right now. We are just dedicated to making that change and doing it.

Preston Lewis 16:28
That's the fun thing is that we really have been trying to put forth that message. We've won some battles at some state levels in 2024 but it is exciting to think, like you said, Mikalya, what could be next, and Jeanette, and I sometimes feel like we're just beating a dead horse trying to put this message forward, but this week showed that there are still so many people out there that haven't gotten that message, and sometimes it just takes an SLP in their wallet to show up and say, What the heck is going on? And so we're going to keep putting that message forward, but we're also going to be going back to talking about states today, and I'm really excited because the state teams. And I know sometimes that can seem a bit, maybe a little intimidating. It's like, do I want to join a state team? So let's kind of get into that today. What are our state teams? For those that are maybe new to this concept.

Jeanette Benigas 17:24
So our state teams are groups of volunteers, and I'm not even going to say SLPs, because in one state, we actually have a special educator who is an administrator in her school district and who's very well connected with other school districts. So we will take any able bodied person who believes in this movement and wants to help. So they are made up of volunteers who have emailed us to let us know that they are interested. Some states meet monthly. Some states communicate exclusively by text and only meet when needed. Others do a lot of work through active emails. We don't really stipulate how the work gets done. We just hope that it's getting done. But these volunteers are tasked with making changes in their states. We have some initial suggestions. For example, states that have Medicaid requirements still that number one thing, if we're going to support you, that's what we're going to support you in doing. We know, caseload caps, contract therapy, companies, reimbursement rates, all of those things need addressed at the state level, and there will be a time for that when fix SLP has been around for a couple years, or maybe even less, depending on how fast this thing continues to move, we will take these things on at a much larger level and at the state levels, but right now, we're trying to get autonomy, and so things like Medicaid is where we're focusing, or every state seems to have little glitchy different issues, so they're doing the work of calling their state licensing boards, contacting state representatives, every state again, doing something different. So everybody just takes a little piece. I'll make that phone call, I'll write this letter, I'll do that. And they're, they're all working towards making some type of positive change in their states. So that's really in a nutshell what our state teams are there are 10 launched now. We have about 10 on deck that I met with maybe in November. It got hard to really manage all of that through the holidays. So we'll be talking about what's coming in terms of those teams, and hopefully they're all listening. I might shoot them all emails so they can hear me talking. So. So if you're listening, and I fell off the face of the planet, I'm sorry. We're coming back and we're coming back strong, but yeah, our hope by the end of the year, we haven't set a goal, which I probably will with the person who's going to be helping me manage this, but I don't know is, is 30 teams launched by the end of the year? Does that seem like a lofty goal? Should we go bigger? Do we want to go like 40 at all 50 states? In DC, I don't know. What should our goal be?

Preston Lewis 20:30
Not stopping till I get to Guam.

Jeanette Benigas 20:32
Okay, that's our goal, for sure. This is smart goal, measurable.

Preston Lewis 20:36
Yes. Don't forget, the territories. We actually did have signatures on our petition derived from Guam,

Jeanette Benigas 20:42
We have a sustaining partner who's not in the US. So that's what our state teams are. We try to make them manageable for people, because we're all busy, we are very protective of our state team members, so we had some issues, if you have followed along. We had pumble, which was kind of a communication app for people in states to be communicating, and we had some issues where people were taking screenshots and sharing them to social media, and our fixers in that particular state were kind of being attacked on social media, and that's just not acceptable. So while you can attack me or Preston, or any of us who have put ourselves out there and are forward facing, go for it, but I am not okay with you attacking my team volunteers, that's just where I'm going to personally draw the line, if people are taking their time to try to make things better in their state, they don't need to be attacked on social media. So that is why you don't see their names or their faces out there. There may come a time when perhaps there needs to be a letter writing campaign like there was in Michigan, and at that time, those state volunteers will decide who's comfortable leading that effort as a more publicly facing effort. But for now, we keep the names and identification of our state team members very private, very confidential. There aren't notes taken in these meetings that are distributed, they are not recorded. You have to be at the meetings or in the communications to know what's going on, and you have to be actively participating. So we do not allow people to sign up for these teams and sit through two meetings where they haven't volunteered to do anything. If you are not working and helping you are removed from the team. And that's not to be punitive. It is really just to protect our volunteers, because we know, one, Asha wants to know what's going on for sure. And two, there are people with not good intentions who want to know what's happening. So we're not going to let non active people just sit and observe. So far, that's been working. We haven't seen any issues publicly on social media. You know, though we're pretty serious about protecting our volunteers, we have a new volunteer who's going to be helping us with emails. When you sign up. She is going to be contacting you, getting you plugged in, giving you the information you need. And she is going to be leading or the touch point person for all of the West Coast teams I am going to be doing the East Coast teams. This is going to cut my load in half. I do a lot for Fix SLP, and I have just not been able to manage all of this. If it was a paid, full time job, I could do it, but at this point, I am tapped out. I have no spoons left. So she's gonna come on, she's gonna take half of the work from me, and that should make it more manageable. And then hopefully another really strong leader or two comes out of this that can jump in and maybe do Central Time, like maybe we have someone in every time zone. But for now, there are going to be two of us. We have invested in some software that will help us track projects. The teams will have access to them. We will have access to them, and it will help everybody stay on the same page with the work that's being done. So we can have some level of accountability. And so I don't have 75 pages of little notes all over my table or 15 files in my computer that I need to go find, it'll all be in one place. So that's what we're moving to for the new year. If you have messaged us, giving your name in your state, or asking questions about your state, or even following up on a project that I said, Hey, let me know how this is going. And you've not heard from me. This is why we had the holidays. We all have families and jobs and stuff. And so while she and I really thought. I organized some systems. I haven't responded to those emails. What I have done is forwarded them to states at fix slp.com, which is our new email, and I would expect in the next month, you will be hearing from either her or I and getting plugged in or getting the information you need. So please sit tight. We're not ignoring you. We're just trying to get some good systems in place for the new year. We asked Mikalya to come on today, because Mikalya is actually the team leader of some state teams that are doing some good work, and because all of these teams operate a little differently, I thought it might be interesting to hear from her about how her teams have been working, what they've been doing, and if we have time, I can share about one as well. But Mikalya, do you want to tell us about some of your teams?

Mikayla Treynor 25:51
Sure. So right now, my main main teams that I have are Colorado and Oregon, and I was going through some things this past fall. So Jeanette took one of the teams from me, so I know she's probably going to reach out and get that organized in the future. But my two teams have been really, really out there doing it. And we initially met, and we were meeting like once every three weeks, and I kind of did some background work for these teams, and I'm like, okay, Asha language is all wrapped up in your licensure and applications, and there's just a misunderstanding. And this creates a gray area when they're talking about completing your supervision period, and they're using terms like CF, y clinical fellowship, that's creating confusion, and it's making these new grads think that they don't have a choice and they have to proceed forward with getting their CCC. So that's a big goal of both of my teams right now is getting that clarified, where it's not related to Asha and it's just related to getting licensed in the field, so making things a little bit more broad and not using specific terminology from a nonprofit organization. So doing that, Oh, I see Jeanette has a finger.

Jeanette Benigas 27:22
Yeah, I'm going to jump in here too. I want to clarify, because I see this question asked of us quite a bit on socials when we talk about this stuff, we are not encouraging states to remove the nine month period following graduation, just so we're clear on that. What we are asking of states is to not name it the certified fellowship, because many states have their own version, and they call it something else, like the professional experience or the post graduate experience. There's different names. We don't care what it's named. We just don't want it to be named the certified fellowship year, because that is an ASHA branded term. And we also don't want it to be required that people go through the formal certified fellowship year. If a state wants that experience, and they should, they need to name it something else and outline what they want. And we are encouraging, like in the state of California, like in the state of Ohio, that they increase the supervision requirements to make it a little bit harder than the CFY, and here's why. One, so there's even more reason for Asha to be saying you're going above and beyond by getting the CCC, nope, these states have harder requirements, so stop saying it. And two, because we know that there is a supervision crisis, and while this doesn't address the issue of the abuse that we know happens, what it does address is the lack of supervision that happens during this time period, and it's an easy thing. It doesn't cost legislators any money to do this, and it is addressing a problem that can increase the care that we're providing to consumers in the state. So it's a very low hanging fruit for states to address, and it's easy. So I did want to make sure that we clarified that we are not encouraging states to do away with the nine month period. We actually are encouraging they keep it and make it a little harder,

Mikayla Treynor 29:42
Right. Yes, we definitely think it's necessary. It's super important, especially when you're fresh out of school, to hopefully have a supervisor that you can go to and you feel comfortable with. So we don't want to do away with that. We just want the language cleared up. So. So that's been a huge part of what my state teams have been working on. And then there's another component, which, of course, many, many states are working on, is that employer education piece, which I know Elizabeth is really handling, and she's talked about that a little bit before, and she's absolutely killing it with all the work that she's putting in there. So that is something that my state teams are also working on. And over time, we have kind of spread out our meetings with me a little bit. They've gained some independence. So at first we were meeting like every three weeks, and now we meet every four to six weeks, kind of depending on issues that are going on. And of course, you know, as they are doing their own research, and they are calling their state boards, and they are reaching out to state representatives, they are uncovering other things, so they text me in the meantime, and we kind of brainstorm if it's a big enough issue, then I send it to the group, the fix SLP group here, and we collaborate, and I take that back to the state team, so we can kind of come up with a game plan. The ultimate goal is that these state teams will become more and more independent, because what we're realizing is so much of this truly falls on the education piece. Many people who are writing those regulations for licensure at the state level, they don't really understand they're often not SLPs themselves. So they see someone out there has labeled CCC as the gold standard, and they're like, Oh yeah, let's do that. So so much of this comes down to education. And as I know, Preston spoke about in the last episode, my ordeal with Blue Cross, Blue Shield and calling around, calling around, calling around, I tell my state teams, this is not a one and done. You're in it for the long haul. It's a long game we're playing here. You're likely going to call and you're not going to get through to the right person, so you're going to have to call again. You know it, it's a thing. I mean, I worked on Blue Cross, Blue Shield for months, and then finally, when I got through to the right person, it was quick. It was a quick change, but we just don't have those contacts right now to know exactly who to reach out to, so it takes a level of dedication. And all of my state team members are working full time themselves. They have families. They have their own lives. Multiple of them are business owners themselves. So, you know, it takes a level of dedication, but they're out there doing it, and it really only takes two to three people. Ideally, I would like my state teams to have, like four, but using Michigan, where I'm from, as an example, we started with three of us, Alexa and myself, and we lovingly have referred to her in the past. A long, long time ago on the podcast, is Moe. Then Moe feared some potential repercussions with her job, and kind of backed out, which is okay, so Alexa and I kind of picked up the steam there, and we, we did the work. We met with state reps. We have a bill that's being proposed, so you don't need a massive team to get things done. I know Jeanette had asked, like, what's a realistic number for state teams this next year? We only need like, two or three of you in every state that are like, Okay, I'm going to do this. I'm going to take a little time after work, a few nights a week. I'm going to call on my lunch break, a couple state reps. We just need a couple of you from every state who really want to make the change, and you can do it. Michigan is a great example of that.

Jeanette Benigas 34:12
That's exactly it. And just to remember the why of this, because sometimes it's easy to forget in the thick of it why we're doing this. And the reason is, the why is for autonomy for this field, so you don't have to purchase the CCC next year at this time, so your colleagues don't have to do it. And we're not saying that the CCC should go away. Some people think it should. Some people think it shouldn't. We're not here to debate that the purpose is choice. If you don't want it, you shouldn't have to have it. You should be able to do your job with the state license that you worked hard to earn. And so that's the reason we do this. We're doing this for choice, and it's easy to forget that. And you're doing this for your colleagues, but also you're doing it for yourself. And so I said this all of last year when we thought about Asha raising rates throughout the year, I said, Hey, Asha gave us a warning. What have you done to have choice? They gave us an eight month warning, or whatever. Five months left, what have you done? And so now the clock is ticking again. You have a year to do something, and we can't do it for you, because we're not in your state. We can help, but we can't do it. And so what are you doing? How are you going to get involved? So one year from now, you have the choice.

Preston Lewis 35:40
That help part, just to let some folks know that are considering being part of a state team, is that when we talk about reaching out to a state legislator or trying to get in touch with maybe a private insurer, we will help you on what to say. If you're not certain, if you know what to say and you've got a good message, then take that and run with it. But sometimes it's difficult to say, Well, I've never called a state rep before. What do I say? That's where our team and some of us can jump in and give you some templates, or have a conversation with the team and show you how to approach it, who to approach in the state. So we're here for you, but it's difficult, time wise, for us to engage in 50 different states and keep that fire churning. And it helps too, folks, because if I contact a state legislator, and we had some luck in Michigan, because I had a great team there, but if I contact a state legislator in Iowa, then the likelihood that they're going to want to talk to an arkansan is low, even though I can speak for fix. SLP, to some extent, you are the ones that their constituents. You are the customers within that state. You're the employers of a company sometimes. So you having a stake in that is going to be able to move this process forward. But we will help you with what the message is and how to attenuate it.

Mikayla Treynor 37:04
And I know that I said that this is like a long haul, long term game, and it really is, however, Jeanette said something that made me think of how quickly Alexa, Moe and I kind of all got together and got the ball rolling, and ASHA, I remember ASHA had announced their dues increase. And I think it was like February 7, if I can remember. And I am pretty sure it was within like under three to five days that the three of us just saw each other on social media, like being like, we got to do something, so we scheduled a Zoom meeting, and by March 1, we had had a meeting with ASHA, and then by March 19, we were at the state capitol, meeting with a state representative to write our bill proposal. So, you know, we were dedicated, and we were meeting once a week. We were talking through text almost daily about like, oh, I reached out here. I reached out here. But if you get lucky and you have a connection, or you just get that opportunity where you talk to the right person to get the ball rolling might not actually take all that long.

Jeanette Benigas 38:30
That kind of reminds me of the work that we did with Blue Cross, Blue Shield Medicare in Michigan. It was months and months and months of phone calls and being blocked on email, and once we found the the path, it was undone in like, a week, right? I mean, we, we, you, not we, you did the thing that got the ball rolling, and they called you rather aggressively to to fix the issue, because a complaint had been filed. You filed a complaint. And I want to point out you actually filed a complaint with CMS, which is the Center for Medicare and Medicaid, right? And we are still being told by well meaning clinicians that Medicare requires the CCC. They do not there is an or in that language. And the way that we undid Blue Cross, Blue Shield, Michigan Medicare requirement was by filing a complaint with Medicare, and Medicare came down on them, and they called us to see exactly what we wanted fixed, and we told them, and they did it. And so if Medicare required the CCC, that would not have happened. So now we actually have this proof of concept where we reach out to Medicare and said, Hey, you don't require this. But. Blue Cross, Blue Shield is asking it for it for credentialing, and it got fixed really fast. So I don't know how long we're gonna have to keep educating on this. I hope someday it comes to an end. But to reinforce it one more time, Medicare does not require the CCC for billing. It is a federal policy. There are still two managed healthcare plans for Medicare who are requiring it for credentialing. And Mikalya is about to gear up. She just moved she's getting settled into her new place, and then she's going to work with those state teams on getting that undone, because now that we know the process and the procedure, we got it done in Michigan, it will happen just as fast in those other states. We just need the stakeholders to do it.

Mikayla Treynor 40:51
I always tell my state teams that when we're making these phone calls, we want to say that we want to collaborate. Jeanette had mentioned like I had been blocked before, Alexa had been blocked as well, through people pretty high up in Blue Cross, Blue Shield. And I mean, we weren't like hounding either. I'd send an email, hear nothing get left on red and send another one a week later, nothing. Wait another week. I was truly like trying to play the long game here, and we were just saying we'd love to collaborate about this. This is a barrier to access to care for speech therapy. We wanted to be as collaborative as we could be, and I promote that in the state teams, because that's true. We want to provide education. We want to collaborate. However, I filed that CMS complaint because there was a lack of collaboration. I was being blocked. I was being left on red I was just circling the drain for many, many months. And I decided, you know, okay, this is wrong, and nobody is willing to collaborate with me. So this is the next step. And then, Yep, I got multiple phone calls, a voicemail I want to say, maybe two weeks after I filed the complaint from Blue Cross, and it was the appropriate person who I needed to speak to. And it got done.

Preston Lewis 42:22
You know, it. But speaking of being aggressive, that was the thing is that I like to joke around that Mikalya waited in the elevator, you know, with a baseball bat, but really, Mikalya couldn't have been more kind. It was just a matter of persistence. It's a matter of saying, I recognize that there is a corporate world out here that there are bureaucracies, but I have to get before the decision maker, because I have a very simple issue. I have facts, I have, you know, language that is in existence where this has been misused, and we just want someone to look at it with a logical set of eyes and make a decision. And it was, it was impressive, but wow, did it take a lot of persistence that that group text thread of ours, there were just days where I thought Mikalya was literally waiting in the parking lot on people at Blue Cross and Blue Shield. I know you weren't, but you were being very persistent, and it paid off, because, like you said, once you got before the right person, it was like waving a magic wand. You had met the fairy godmother,

Mikayla Treynor 43:23
Right. Maybe I thought about waiting in the parking lot of time or two, but I didn't actually go that far. But yes, it just takes dedication. You just have to be persistent. It was definitely frustrating at times, because I definitely felt as though I was circling the drain, like, Okay, I heard this before. Okay, here we go again. I'm being left on red. Nobody wants to hear me out. And I was feeling it was because nobody wants to do the the dirty work, the tedious work of going back and like changing the language of things. I think precedent. Mentioned that earlier. You know, it's extra work. We've just always done it this way, and that's the easier way right now, but it doesn't mean that that's the right way. So that's why our state teams are so crucial. And it really does only take a couple of you, a couple of you that are dedicated and willing to put in some extra hours outside of your full time job and family life, which I know is a lot to ask, but it's really making a difference. I mean, look at all the things that we've done in the past year. It's really impressive, and it really humbles me when I think of all the things that we've done, just us, just us and our state teams.

Preston Lewis 44:42
So we now have a new state teams. Email address, right? Jeanette?

Jeanette Benigas 44:47
Yes. It is the word states plural, nice and easy [e-mail], and you. I recognize that we all have different skill sets and different personalities and different things that we bring to the table, and not everyone is built to be a state team volunteer in the way that Mikalya just described. There is a place in this puzzle for all of us. You do not have to be the one attacking Blue Cross Blue Shield to make a difference. So I don't want people to think that you need to be a carbon copy of Mikalya or a carbon copy of Jeanette or a carbon copy of Preston to be a viable part of this movement. If you have a willing heart. That is all we need. I see a lot too well. I don't know what I'm doing. I don't know about advocacy. Neither do we. We are learning as we are going and so now we are 15 months ahead of you, and we've learned a few lessons along the way, and we can share those lessons. So we're This isn't now we know we're not going to start here. We're going to start here on the map of things to do, and we're going to say this, not this. And you know what? We're going to do that in your state, and we're going to learn new lessons that we will take to the state after that and the state after that. So we do this in real life. We figure it out together, and that is what a grassroots movement is. It spreads like wildfire, and so we need a willing heart. So if you're interested in volunteering for your state team, you can message your name and your state to states at fix slp.com, and sometime in the next month, someone will be in touch with you, either to get you on a list, to plug you in, or to update you with what is going on. Our big goal as the team, as our core team, me. Alexa Preston, Elizabeth, did I miss somebody? Mikalya, who's on here. Our goal is this year to knock out those Medicaid states. Mikalya and Alexa doesn't know this, so hey, Alexa, this is what you're going to do this year. Mikalya and Alexa are really going to help with those Medicaid state teams, because they've been through the process. We can get some of this replicated. Preston is going to be used in a way where we have to really deal with legislators directly. Nevada, we're looking at you. Preston is really helping out a lot. We've kind of paused that as well as we got to the holidays. But as legislative sessions move forward, or, you know, there's, there are going to be states where we need state legislator involvement. That's where Preston dips his toe. He will hop around, not actually leading any teams, but helping in that capacity, because that's where he shines. Hawaii, we're looking at you and your continuing education. And North Dakota, we're looking at you and your nine month experience. These are the things this year that we really need to fix in the next 12 months. So that is our agenda that we want to hit hard. We are coming after those states. We are going to be aggressively pursuing volunteers in those states, all of the other states, you're not chopped liver. We just need you to really step up and do the work with us just walking beside you, because our efforts have to go to those states where the CCC is a requirement for Medicaid billing, or where there's some kind of problematic issue that actually does make the CCC the higher standard. So with that, send some emails. We will be in touch. We need you this year. We need you also. The Education Team is creating materials that will be a part of our new website that will launch in the fall. Our vision is to have a PowerPoint, a letter template of one sheet, fact sheet for every state, for every setting. So we need people pulling those things together. I do not have volunteers for every state and every setting. So we still need you if you think that you can use a Canva template or a PowerPoint template, and fill in information please again, email states at fix slp.com Give us your name, your state, and very specifically, tell us you're interested in the state education part of it. So that's I think we'll wrap that right there. I have a pro liability update that I wanted to share. I did a live last week. I'm not going to rehash all of that. If you're interested, you can I think I did it maybe on the 23rd or the 24th it was in the last week of December. I did a live where I talked about malpractice. Insurance for people who are dropping membership. Pro liability will not insure non ASHA members. So the question has been, what do I do? Well, I told you, in that live, I was 99.999% sure that you would be fine that I was waiting on some communication from Proliability, that communication has come so I we are going to probably put this out today, the day that we're recording. So you may have already seen this in our content, but we do reach people differently. So I just want to update and say I received a letter signed by Stephen Miller, who is the Senior Vice President of amber Amba pro liability. And in the letter, he stated, If you cancel your Asha membership after you have an active policy in place, we will not cancel the policy mid term. The policy will remain active until the expiration date. So if you are someone holding out till the end of the year, and you have pro liability malpractice insurance and you're planning on dropping your Asha membership, if you are in the window where you can renew, do it now. Do it before you drop your membership. That will bridge you as we work on a partnership with another insurance company that is going to insure our fixers, a company that believes in what we do, who offers comparable rates that you can later change to. We will walk you through that process when we get there, but I at least wanted to share that in writing. I have that you will not lose your coverage if you have an active policy and you drop your membership, Preston, anything else before we head out?

Preston Lewis 52:03
I'm excited 2025 and that goal of going after those Medicaid issues within the states that is critical. It's one that we have shown we can deliver on, and I'm looking forward to being part of it and trying to highlight who's on the health and policy committees in each of those states and trying to attenuate that message. And I have a feeling we will slay at least three more states this year.

Jeanette Benigas 52:30
Oh, Preston, that's small potatoes. It's gonna be more than three. Come on. I think in measurable goals, yeah, West Virginia, Kansas, New Mexico, Hawaii, Nevada, we are coming for you. So sign up before I have to chase you down. We want to see emails. And um, we will see you guys next week. Thanks for fixing it!

Preston Lewis 52:57
Are you ready?

Jeanette Benigas 52:58
Preston is... he's hot this morning.

Preston Lewis 53:01
Well, you said you needed to get going, trying to be the timekeeper. The keeper of Jeanette is what you are, right? Well, count me down in 3-2-1.

Transcribed by https://otter.ai