Fix SLP

Guest hosts Mikayla Treynor, MA, CCC/SLP and Alexa Chapman MA, CCC/SLP join Dr. Jeanette Benigas to discuss their efforts at the state level to eliminate the CCC requirement to Medicaid billing. Find out why access to care is so important to them and what they have been doing about it.

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What is Fix SLP?

We are discussing the biggest challenges that are currently holding back the field of speech-language pathology. We present the issues with facts and invite you to be a part of joining our movement to make things better, one conversation at a time. Let's fix SLP!
Hosted by Jeanette Benigas, PhD, SLP

Jeanette Benigas 0:00
Hey fixers. I'm Dr. Jeanette Benigas, one of the cofounders of fix SLP. Our platform exists to discuss the biggest challenges that are currently holding back the field of speech language pathology. We present the issues with facts and invite you to be a part of joining this movement to make things better one conversation at a time. So let's fix SLP

Hey, everybody, welcome back to the fix SLP podcast. I have my first two co hosts, I guess, but really, I feel like I'm gonna be interviewing them. They were on the list, and then they both applied. I reached out to them. I said, Are you guys crazy? I was gonna ask you on anyway. So here we are. today. I have the Kayla Trainor and Alexa Chapman they are two of the three angry SLPs as ASHA has been referring to them as they are two of the three angry SLPs doing the work in Michigan to try it out on do the Medicaid CCC requirements. The third one we're going to call Moe. Moe is not on with us today. She has a level of fear about repercussions from her job for her involvement in all of this, I totally get that. I think there is a lot of fear surrounding Asha and the CCC and your employer's view of the CCC. So she's not on with us, but she's here in spirit. She's given her blessing and we're gonna call her mo because we definitely want her to have credit. So, Mikayla, tell us about yourself. Who are you? Where do you work? What do we need to know?

Mikayla Treynor 1:49
I'm Mikayla, I have been an SLP. Now for going on 10 years. I have my full time job in a pediatric outpatient clinic primarily treating autistic children. And then I own my own small private practice on the side. And I'm a workaholic and have two PRN jobs primarily in skilled nursing.

Jeanette Benigas 2:14
How about you Alexa, tell us about you. Hello.

Alexa Chapman 2:17
This is Alexa and I am primarily a school SLP in the northwest side of Michigan. So that is my primary position. I do PRN at a nursing home. So I started in the in the school educational setting. And I PRN on the side. But I started in Florida and then I moved back to Michigan to be with my family. So that's where I'm at right now.

Jeanette Benigas 2:45
And I am a teletherapy therapist in Michigan sometimes in the up is that what you refer to the Upper Peninsula as is that what we call it? Yes. All right. Sometimes in that sniff, we can't hold a Wi Fi signal. Sometimes I give therapy and then the Wi Fi goes out and we're just done for the day. Yeah, I do that occasionally. For a company I work for in Ohio that can't staff up there. The regional manager lives behind me and he every time he goes up to visit he takes his whole family because he says it's beautiful. He just doesn't understand why he can't stop it. Nobody wants to live there. Right? It's more of a vacation town.

Mikayla Treynor 3:29
The up is a different world. Totally different world.

Jeanette Benigas 3:34
Today, we're going to talk about Michigan. How did you guys all meet?

Mikayla Treynor 3:37
So we met basically from being voice dress SLPs through social media, and then eventually Pumble. So I met mo through a Facebook Michigan SLP group, we were trying to get in contact with Medicaid because Michigan is one of the 11 states that require CCC for billing Medicaid. And for the life of me, I could not find a good contact email. And then I noticed that she had posted something about being in contact with them. So I messaged her saying, what email did you use? What language should you use? How can we build off this so we started collaborating that way? Then both of us joined Pumble roo fix SLP. And Alexa reached out to me asking if I wanted to collaborate and see what else we can do. And Moe joined in as well. She said please include me. So the three of us had never met prior to all of this. And this brought us all together basically being kind of the squeaky wheel. We don't feel comfortable just sitting back and waiting and like oh, what's going to happen? We wanted to try to Make some sort of action, even if in the moment, we didn't exactly know what that action was.

Jeanette Benigas 5:06
But you came together? And what what did you guys do first, what, what was the crux of the issue here that you really wanted to address.

Mikayla Treynor 5:17
So once we met on kind of Pumble, and we kind of went from there, we decided to get on a Zoom meeting and kind of go from there. So we all three of us got on a Zoom meeting together. And we talked about what really is kind of driving this issue and what we are really concerned with, so we started a Michigan petition. And we all got together, and we thought about what the biggest issue that we feel is going to be affecting our patients in Michigan. And we felt like it was the access to care, I think we can all see the writing on the wall, coming at the end of the year, with so many people being upset with what's kind of going on in our field right now. And there'll be dropping their CCC at the end of the year, which is going to cause a huge, you know, cascading effect in our state with access for patients, especially in rural areas who don't have a lot of patients to begin with, or sorry, a lot of therapists to begin with. And even in the metro Detroit area, I know that there's a huge waitlist, and Mikayla can talk a little bit about that in different areas. So we foresee that being a huge issue in our state, Medicaid clients as a whole, especially in the metro Detroit area where I'm at face, insanely long waitlist, not just for speech, but I just tried to refer a child for a psych eval. And the waitlist is literally years, we're looking at two to three years because they have two pediatric psychologists who accept Medicaid. So Alexa is right, our main standpoint on this is that we're trying to increase access to care. Because every client should have a right to choose who their therapist is. And regardless of the issues going on with the CCC, they can't choose me right now, if I don't have that certification that I'm paying for. And explaining that to a client, who doesn't understand anything going on with CCC. It's like, why why? Why can't you just take me, so it's a massive issue going on, we just want to increase access to care, we just want to do our jobs. We just want those clients who desperately need the care to not be waiting six plus months, going into years, just trying to get basic care and intervention.

Alexa Chapman 8:10
And yeah, just to add on to that at our last chair meeting, or our committee meeting, we talked about Flint, and everything that's going on with the Flint water crisis and how they've been trying to staff a speech therapist in that area. And they haven't really been able to find a lot of speech therapists specifically for that area. So that's also going to be a huge accessible issue in Flint as well.

Jeanette Benigas 8:39
So I'm just outside and I sort of know what's going on. But we have listeners all over the world. So why don't you just really briefly for listeners who don't understand what you were just talking about what is the Flint water crisis, and you know, just give like a one minute synopsis of what's going on.

Alexa Chapman 9:01
So Flint does not have clean water. Flint has not had clean water for years and years and years. There is a lead in their water and it is actively poisoning all of the people, all of the children, all of the everyone who lives there, they don't have clean water to shower with, to cook with to brush their teeth with to drink nothing. It is actively affecting the children that go to school there. There's a lot of programs in an educational setting right now that they've been supporting even the general education students in that area just because they've seen such a huge uptick in neurological issues as an effect from the lead in the water. So right now the people in Flint still to this day, do not have clean water to drink and it's actively poisoning them.

Jeanette Benigas 10:00
I can see how that adds to this Medicaid issue because Flint is it has a pretty high poverty rate to begin with. And so lots and lots of families are probably on Medicaid in that area.

Mikayla Treynor 10:17
Yeah, it becomes this vicious cycle in Flint, because not only is it affecting the current population, it's affecting the unborn babies. I know that I had covered out there at one point very briefly. And then the school SLPs were telling me that they were seeing increases in like Alexa said neurological deficits, even physical deformities in the problem is that, like Jeanette said, these families are facing such a high level of poverty that they truly can't afford to go out and buy bottled water, they can't afford the clean water. And well, families might be boiling their water, having to boil your water for years and years and years, is so taxing. I know when I have to do it for a day, if something happens, I'm like going crazy.

Alexa Chapman 11:17
So at one point, I lived towards that area a little bit. I lived in Durant, which is like 10 minutes away from Flint. And this was a couple years ago, but they're still being charged a water bill for this poisoned water, which I just think is horrible. Just an added tidbit there. And they still have they've been trying to find SLPs to work in Flint school system for years. Like they've been understaffed for years where they just don't have enough SLPs in that area. So I I continue to see this being a huge issue, if they are requiring the CCC continuously. Yeah.

Jeanette Benigas 11:58
Oh, boy. Okay, so you guys met you decided? We're going to take this on, walk us through the steps you took, what did you do?

Mikayla Treynor 12:06
First, we've reached out to Michigan Medicaid, via email, repeatedly. And the response that we obtained was we are following the federal regulation. However, when I know I would respond, saying that there are free options in the federal regulations that we can choose from. But Michigan is saying, Nope, it's CCC that is required. I did not receive further responses back after that. I do know some others have received responses, basically saying, well, that's the way that we know the person is certified and they have their see us. So that's the one that we choose.

Jeanette Benigas 12:58
I'm confused. Why did they get to choose? Why are they special?

Alexa Chapman 13:04
It's a good question.

Mikayla Treynor 13:06
We've been asking ourselves this question for a while now.

Jeanette Benigas 13:11
Hmm. Okay. So then what did you do

Mikayla Treynor 13:14
we talk to our jobs, about what was going on the concerns. A few of us work for more nationwide companies that it's just very difficult to talk to you about at this point. I'm fortunate and my full time job, they were fully receptive. And they fully support me, which I'm extremely thankful for. But I do recognize that there is a level of fear, like our friend and advocate Mo is experiencing, because we need our jobs. We cannot go without work. We live on our own. We have families, we have bills, losing our livelihood is a very scary thought.

Jeanette Benigas 14:05
Well, thank you for being brave enough to take this on. I think that's huge. And it takes people willing to step forward and say, I'll do it to make big changes, like the change is scary. So I understand that fear every day I get it. So your jobs, your jobs supported ish, maybe not most. So who did you guys reach out to next? What was the next thing that you did?

Alexa Chapman 14:32
We decided to set up a petition. We got together and we looked at everything and we have I believe and Mikayla. Correct me if I'm wrong. We're right around 1200 signatures at this point we were sharing on social media we were sharing with our friends and family. We were posting on Facebook, Instagram, Twitter, everywhere we could go. I was buying donuts and I was going to local schools with My petition tape to the top, I was going to nursing homes in the area I was going into businesses and telling them who we were what we were all about how this affects people in our area, kids in the schools, our residents in the nursing homes and the hospitals across the board. It was very receptive, I went door to door in our neighborhood, or in my neighborhood. So we received really great feedback from families who receive speech therapy. So it was a, it was a kind of a cool thing to go out into our community.

Jeanette Benigas 15:34
But did you go to Flint, Michigan, because I feel like they all die.

Mikayla Treynor 15:40
I go to Flint, Michigan. And our petition, just to be clear is at a flat 1100 right now. So we would love for that to continue to grow. But we have it linked up at fix flp.com under quick links, you can go there and get your signature do they have to be SLPs only or can other people sign who have concerns about access to care. Anyone can sign the petition SLPs families, relatives, and anyone can sign it. Anyone who's a concerned citizen in Michigan, even outside of Michigan, we have some other outside of state people who have also signed,

Jeanette Benigas 16:23
I was gonna say I signed it because I'm licensed in Michigan, but I didn't have my husband sign it, should he be signing it or since he's not really involved in Michigan, should we?

Alexa Chapman 16:33
I think their limit here sign it because it's an access to care issue. And if you care about beach therapy, if you care about receiving that service, whether it affects Michigan, South Carolina, Florida, California, anyone I've signed some petitions outside of my state. And I think it's important if it's an issue that you care about, that you can support other states in that area.

Jeanette Benigas 16:57
Keep going keep walking me through.

Alexa Chapman 16:59
So after we did the petition, we we weren't sure if we needed to hit like a certain number in order to be taken seriously or not. So we reached out to a representative I reached out to my local representative, Representative Fox, I believe he's the 102nd district but don't quote me on that. I'd have to look it up. I gave him a call. I know him personally. He is in education. And he was also in the Commission on Aging locally in my area. He was my principal in middle school. He was a very nice guy. And so I reached out to him. I called his office in Lansing. I spoke to Secretary Payton. I kind of told him about our petition, and about our movement and what we were doing in our state and our concerns. And our feedback was taken very seriously. We were invited right after that to an advocacy day at our state capitol. So we were very excited I called Makayla and I called Mone. And I said we've been invited to Lansing. And so then our little movement kind of took us to the capitol and we were able to present at the Capitol. We also had another friend from Arkansas also join us. I don't know his names.

Jeanette Benigas 18:23
Yeah, well, we'll call him out. Preston. Hey, Preston, Preston has been doing some behind the scenes kind of work for us. He's very interested in governmental affairs. He's very articulate. He has he sometimes sees things differently than I see them which I very much appreciate his input. The present is great. If you ever reach out to fix us LP, I will often offer Preston up for to help if he's interested. But he Yeah, he has some good perspectives. And he really has the interest there. And kind of the knowledge and government to be effective. So and I wanted to go and I was so sad that I couldn't but my mom has been sick. But I was definitely planning to make the trip up there. It was going to be a really long day. So I'm if something like that happens again. Maybe we'll get it worked out. But yeah, I was so sad to not be present.

Alexa Chapman 19:18
So we had Preston join us and Mikayla and Moe joined us. So we weren't we all went up to the Capitol. And we were able to sit down with him and kind of talk about we made a face sheet. I had no idea what that was before this, but we created a document to kind of tell him what the issue is, who we've spoken to in Medicaid, what their response was to us and how this affects Michigan residents specifically, we told him about our petition, what we were at and how much support that we've been getting and also how this isn't just an isolated movement. It's happening across the US and this isn't just happening in Michigan. It's happening in multiple other states. And he was very receptive to listening to us and helping us after we had the meeting with him. The feedback was that he is getting together with some other representatives that he knows that he feels this would affect people in their districts as well. And they're going to come together as a group and meet with Michigan Medicaid to say, you know, what's going on here. My constituents are bringing this concern to the table, that this is the issue at hand, why are we not following the language of the law, he made a really good point that he feels that it's more so an application of law, not so much that we have to change the legislation itself. But we if we just follow what the law says that this really won't be an issue, it's more of an application. So that's kind of the gist of what happened at the Capitol.

Jeanette Benigas 20:59
And now I have goosebumps.

Mikayla Treynor 21:02
So did we

We have a meeting at the Capitol went extremely well, I think best case scenario, we gained support, our representative was like, let me talk to my fellow representatives. And you know, a lot of people have some level of speech therapy in their life. So Representative Fox has a daughter that went into speech, but ventured more into linguistics. So, you know, it's like he was familiar with the field as a whole. And I think that that can be said, for so many people, they have a child in speech, or Oh, my nephew went to speech, or I know someone who had a traumatic brain injury, and they needed to get speech after it affects so many people more than just SLPs. And I think it should be said, with as well as the meeting went at the Capitol, we had tried a couple of other avenues. First, we reached out to Misha, our state Ashot. And they were a little tight lipped with us, they promoted us becoming members, which we are considering doing, we would just like to know where they stand on some more detailed issues before we go and invest more money into an association that we feel may or may not have similar views as us or may or may not be open to us, we just want an open dialogue. And then we also had a meeting, I had reached out to a Lea that liaison for Ashok as well, as well, I first just reached out to the liaison. And I requested a meeting originally with myself and fix SLP. And that was not received super well. They just said, well, we want to be we're more than willing to meet with you is what I said.

Jeanette Benigas 23:05
Very scary. I mean, he you see me in my lecture right now. Very scary person. But I had every right to be at that meeting as a licensed practitioner in Michigan. And I feel like we could have pushed it. But I did . I did agree just you should do it. More might happen if I'm not present.

Mikayla Treynor 23:28
So I responded back, basically saying that, as paying members, I did not want to go into this meeting alone, I said that I had other women that were helping me and I included them on the email at that point. And they were receptive to holding the meeting. However, we then noticed that there was another name included on that email that responded back. And that was an ASHA representative for Medicaid. So we did have that meeting. And I think that that may have been what led to us being called the angry SLPs in Michigan, because I think we were pretty well prepared. I think that we had numbers, we knew what we were talking about. We had our emails and our contacts and all of our efforts. And I think that we were just hitting a wall. So at the end of that meeting, we thank them for their time, we do appreciate that they responded to us and that they were willing to meet with us, we do truly appreciate that rather than being dismissed because that had been so much of our experience, up to that point was being dismissed. So we appreciate that they met with us however, it just felt like we were coming to an impasse. So at that point, we thank them and said okay, we are going to continue our advocacy efforts in whatever way that we need to

Jeanette Benigas 25:00
Part of this issue here is not making the CCC go away. I continue to get questions about that. Why do we want it to go away? I worked hard for this. First of all, you worked hard for your state license. Right? That's it, you worked hard for your state license, you chose to purchase a certificate or you were coerced into purchasing a certificate. It doesn't the CCC does not need to go away. It needs to be truly optional. For those who wish to purchase it, and those who wish to not purchase it. And so the language that Asha continuously uses this is an optional product. And Michaela, when you presented this representative, and the lawyer that you met with at ASHA with that this is supposed to be optional. What What was the response? You told me? But what did they say to you?

Mikayla Treynor 25:58
Definitely. And I think that's where that angry SLP came into play was I had mentioned, you know, I'm speak out certified, I myofunctional, certified, Gestalt certified, you know, all of those certifications, I took the training, I did pay the one time fee, I pass the test, and I earned that certification. I do not have to pay for any of those sorts of certifications every single year, in the same way that I pay for Asha. So I brought into play, okay, here in Michigan, I can't treat Medicaid, I can't treat them. I can't bill for them, unless I have my C's. So how is this then a voluntary association? And that's where that impasse was coming in and was like, Well, I, I view it as voluntary. I view it as voluntary. There was even a comment made about my face, because I was smiling. Because I just I do I truly I don't feel like it is as someone who can't treat Medicaid and works in a clinic, with nearly all of my clients being Medicaid, I would not have my full time job if I didn't pay for this. So it became that level of an impasse. It was okay, you know, I view it as voluntary. I also brought up competency. I said, I've been in the field 10 years, I own my own private practice on the side. I have done this. I've been a director for six years I have taken on grad students and CF wise myself. Am I not considered competent in your eyes? If I don't pay for the certificate? And it was a very roundabout? Basically, I'm not going to answer that type of situation.

Jeanette Benigas 27:59
Right? Because the minute someone employed by ASHA says that it's not voluntary. They open themselves up to a lawsuit. And the minute they say that you are or are not competent. With or without the CCC, they open themselves up to a lawsuit. Or they say no, you don't have to have the CCC to prove competency then they aren't serving the interest of Asha. They're admitting that the CCC doesn't prove competency. And they're never going to do that. Because they work for Asha. So they can't admit that you're competent or not because they either open themselves up to a legal battle, or they throw their employer under the bus and lose their job. Right. So that's why you were getting those responses. But I think those last, that lack of response is the response. Right? And that's well, my view is it doesn't matter what your view is lawyer slash lobbyist. It doesn't matter what your view is, what matters are the facts on the paper. That day, you cannot work without your CCC, in this area with these people who have this type of insurance. You can't. It's not optional. Doesn't matter what your view is. That really gets me fired up. But Enough, enough of this, stop making things up and stick with the facts. That's it. That's all we need. That's where we start. Once we can lay the facts out on the table, then we can start fixing some of this and making it truly optional.

Mikayla Treynor 29:42
Like you view it as, like you said, having it be truly voluntary for me myself. I would absolutely love. If this was a one time certification. I would do it. I don't regret doing it. However, 10 years cin, as I'm paying 225. Now 250 Potentially plus for anything else that I may add on to that it's becoming glaringly obvious that this is not a certificate, you know, we can't call it that we are treating it as if it's a license to practice. And those fees are more than my state license. They are more than my business license. It just doesn't make sense. And I am all for paying for anything that you find value in in. It's not that I don't find value in my CCC, or ASHA. However, I feel as though I earned them. I feel as though I earned them 10 years ago. So I would like to have that just be the case. Have that be like any other certification that I have earned? I earned it once in now it's mine. I don't need to continue to pay every year for it.

Jeanette Benigas 31:00
Mikayla, was there a state license when you graduated?

Mikayla Treynor 31:04
So in Michigan, when it was presented to me, even in grad school, I went to grad school in Ohio. And it was very much presented it presented to us as if Asha was just something you did. I for WAY, WAY longer in my career that I can't care to say, I thought Asha was mandatory, like this is something I need to do. I didn't realize that there were SLPs, who were not paying for it, because it was presented to me as if you need to do this. So within my cf Why I had what was called my limited license, basically, meaning that I had a CF supervisor who was signing off on everything. At the end of my nine months. And after I paid the fees, I was able to apply to Michigan to get my full standard state license.

Jeanette Benigas 32:06
Michigan achieved the licensure for SLPs they became the 48th state to regulate speech language pathology, when it was signed on January 13 2009. So really, I guess, I guess we can look at it like this. I'll I'll I'll retract my earlier statement, where we have to change the language. There are some SLPs many SLPs practicing in Michigan who actually did work hard to earn their CCC because there was no state license. And you had to you had to have the CCC, that optional CCC, you had to have the CCC to practice. So I was in that situation. When I graduated from grad school in Michigan. There was no state license yet. It had not been signed into law. So yeah, some people in Michigan I could. So I could see this being McCaleb more of an issue, sort of like you have to where you did work hard to achieve it. I mean, even though there was a state license, you said 10 years? Oh, it was pretty well established by the time you're young. But you know, I I'm also young. I did I guess that was the thing you had to get. Even though I was paying attention to Ohio because I knew I wasn't practicing in Michigan. I was paying attention to the state requirements in Ohio as I went through school to make sure that I was meeting this Ohio licensure requirements. Since Michigan wasn't preparing me for that. But yeah, yeah, so that would be nice for people who actually did work hard to achieve their CCC that they can have that option as well a one and done. And Asha could do that. Asha could easily do that. They're not going to because that hits their wallet, they'd have to charge $12,000 Each for that one time payment, which no one's gonna pay.

Mikayla Treynor 34:01
No.

Alexa Chapman 34:02
So billing Medicaid also is split kind of down the middle in the state of Michigan, what I call them, they classify it as following like the educational route or the clinical route. So SLPs in the schools do not need to have their CCC in order to bill Medicaid because they follow and DHS which is the Michigan Department of Health and Human Services Guidelines. So all of these SLPs in the schools do not need their C's to bill Medicaid but all other settings in the state of Michigan hospital, skilled nursing private practice, if they're billing it outside of the school setting. They do require the C's because Michigan Medicaid follows 42 CR code. What are federal state guidelines, which are those three options available and they're only choosing the first option So that's kind of where we're at where? Oh, depending on your setting, if you're in the schools, do you need it? You know, if you're an outpatient do you need it? It's just it's kind of messy. And I was told that MD, MDHS change their rules and guidelines in 2010. So it's almost like they're following. All of a sudden, when we had a state licensing board, that was what they started to follow was state licensing boards, they relied on that for billing Medicaid, where all these other settings Michigan, Medicaid is following kind of these old guidelines where you know, we've always done it this way. We don't know any other way. This is how we've always done it. And they're kind of stuck in the mud, where they don't want to see any other options available.

Jeanette Benigas 35:47
That's exactly what happened. They are still practicing on old standards. Did you bring that up to the state representative that you met with? Did you point that out to him?

Alexa Chapman 35:57
We talked Yes, we did talk to him. Before we had the meeting. And we kind of brought that up a couple of times when we had the meeting with our state rep. So he he knows kind of what's going on, you know, obviously they don't want to drop the CCC requirements. That is a huge moneymaker for them. There's no and they don't even really want to acknowledge that either. When we brought it up in the meeting, have you thought about making it optional? Have you thought about changing these standards? The question was never really answered. It was a lot of kind of like dancing going around in circles. I don't even know if the question was really truly answered.

Mikayla Treynor 36:40
They would say we follow them federal guidelines. However, that's when I would receive no response when I would respond back and say, well, Michigan is one of only 11 states to require this. So if everybody is following the federal guidelines, wouldn't every state be in the exact same boat? However, that's where no response would come in? Yeah.

Jeanette Benigas 37:07
So what is up next, for the three of you, you've had this meeting, it sounds like it went really well. So now what?

Mikayla Treynor 37:14
We are attending a meeting coming up at the end of April, with Michigan Medicaid, and we are hoping to gain more supporters who will also be attending with us. And we are going to attend that meeting. As from my understanding, I don't think there will be much collaboration going on because they had a submit questions ahead of time. So our plan is right now to see how that meeting goes. Based upon what happens there. We will continue our advocacy, we are still doing advocacy, even between now. And that meeting, we are spreading the word. Alexa, Moe and myself meet almost weekly via zoom, figuring out different avenues. So even if we don't exactly know, this is what we're doing next. And then after this, we're gonna do this. We just find a way. And I think that that's how we started. And I think that other states can do the same thing. You don't necessarily need to know like, I need to do this. And then this and then this, you just have to be uncomfortable enough with sitting back and doing nothing to find other SLPs that are a little more boisterous to gain support. I'm very fortunate that I have Moe and Alexa, because it would be challenging to do by myself. However, I do think it's possible even if you're in another state, and you're like, oh, everybody's really tight lipped, but I want change, you can do it. And you can always reach out to any of us. We love bouncing ideas off from other SLPs. I think that that has been one of the major perks that has come from all of this is we've met Preston in Arkansas, we have met Briana, in Ohio, we have met multiple SLPs that we never would have met had we not started to speak out.

Alexa Chapman 39:16
There's also movement happening in the house in the state of Michigan too. After this meeting with Representative Fox, we know that he's meeting with another group of reps to kind of bring this to the next level. We have a call out to someone who is higher up in legislation as well. So there's movement happening and there's also chatter not just in our states, in our state, but other states as well.

Jeanette Benigas 39:44
It's exciting. It's an exciting time we are planting the seeds for what our profession is going to look like 10 years from now. And advocacy work is exhausting. And it like gritty and there's highs and there's lows And it's like, I don't know. It's, it's hard. Like Michaela said, it's hard to do it alone. This is why I need a fix SLP podcast co host because it's hard to do it this stuff is hard to do alone. So thank you for. Again, I've already said thank you. But thank you to the three of you for leading this and and really making a difference not only for SLPs. But for the families who need the service and and their families. And though the you know this, this is a trickle down effect that will leave a legacy if it has changed for a long time. And it's so important. What can people do if they want to join you or support you? What can they do to to be a part of it?

Mikayla Treynor 40:47
Sign our petition! So you can go to Fix SLP and sign there. You can also follow I'm spamming my own social media, my science and their families are super understanding of me spamming my social media all the time. Sandy speaks therapy on Instagram or Facebook, I also just posted a link there. We are now selling the shirts that we wore to the state capitol and all of those proceeds are going to continue to help us like Alexa said go buy doughnuts, go stop in sniffs schools, spread the word. All of that is just going to put back in to advocacy.

Jeanette Benigas 41:34
Mikayla didn't you tell me that your Sandy speaks therapy is named after your late mother?

Mikayla Treynor 41:41
It is yes, my mother died in 2018 from a very rare form of cancer. And I am super fortunate. Another reason why I'm not fully ready to leave my full time job is because they have been so supportive. The one of the CEOs was amazing. When I went to her regarding, I want to open my own private practice, I'll sign any noncompete you want me to please don't fire me. And she said to me, you should absolutely open your own thing. And she said, You don't have to sign a thing. We can all help. And that has stuck with me. And she is someone that I I look up to. Because that is what it's supposed to be about. This is all supposed to be about care. It's not supposed to be about, oh, you need this to build this or it is supposed to be about helping our clients.

Jeanette Benigas 42:42
Yeah. And I just wanted to say What a legacy for your mom say I'm sparing my social media. But this is deeper. I mean, I'm someone that you know, my private practice to my my late father is all tied up in that but um, your mom's probably so proud and like what a what a cool thing to be doing with her name on it that just, you know, she lives on. So I just wanted to recognize that because having a deceased parent from a pretty, I'm assuming if it was a rare cancer, pretty dramatic kind of illness like that, you know, it's important to keep our parents alive and their their memories and their legacies alive. So I know she's probably so proud. So...

Mikayla Treynor 43:23
Thank you, I appreciate that.

Jeanette Benigas 43:27
We will have y'all back for updates when we have them. Hopefully we'll have Preston on in the future because he's, he's, you know, he's in not just Michigan, but he's helping elsewhere too. So, hopefully we hear from him in a couple episodes. And I'll just tell everybody, thanks for fixing it. Bye, everybody.