The Petition Powerhouse: Fix SLP's Bold Push for ASHA Transparency

Dr. Jeanette Benigas and Preston Lewis, MS/SLP, discuss the recent petition submitted to ASHA, which aims to push for financial transparency and fair pricing of the Certificate of Clinical Competency (CCC). They share behind-the-scenes challenges in gathering thousands of signatures and highlight the growing impact of Fix SLP across the U.S. They also reflect on Fix SLP's first year of achievements and share goals for continued grassroots efforts in the coming year to further reforms in speech-language pathology.

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Creators & Guests

Host

Jeanette Benigas, PhD, SLP

Host of Fix SLP

Host

Preston Lewis, MA, SLP

Co-host of Fix SLP

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.

However, have you been? How was your summer?

Preston Lewis 0:45
It's been good, other than, you know, kind of miss having my new wife around. You know, job training is it's taken a while

Jeanette Benigas 0:54
this new way for your, your real new wife.

Preston Lewis 0:57
No, my, my lovely, hard working, brilliant new wife,

Jeanette Benigas 1:03
isn't that me?

Preston Lewis 1:06
Ah, you you never go, you never go away. Though. you're always there.

Jeanette Benigas 1:15
I'm always there.

Preston Lewis 1:16
Your 24 hours a day

Jeanette Benigas 1:18
like if I open this app will there be a message from Jeanette

Preston Lewis 1:22
it's the Jeanette 711

Jeanette Benigas 1:25
I mean, I've gotten better.

Preston Lewis 1:29
No, you're doing great. I've gotten better. I mean, I know how to draw boundaries when I need to.

Jeanette Benigas 1:33
The medication has helped a lot. My summer flew by. We took an unplanned hiatus. We just kind of decided we weren't doing this anymore. We disappeared from podcast land because it just got too hard. But I think, I think the break was good for us. I think a lot of our listeners were off work for the summer, because, you know, 50% or more of our listenership works in the schools, and so we saw a drop in numbers. As soon as you know, people started posting last day of school photos. We were like, Where did everybody go? So I think everybody's back to work, back into normal routine.

Preston Lewis 2:18
I think pretty common with a lot of the podcasts that I follow, or some of them are issue oriented, but, you know, they, a lot of them, take breaks in the summer. Yeah, I think that we all have different vacations, places we're going viewers, you know, listenership goes down. You know, frankly, we all needed to reset and reboot. Yeah, now, I was a newlywed. You were you never stopped. But the rest of us, whatever you do, sure. So Jeanette was here. I think she was recording some pods, but we'll never hear them, thank God. So we both had nice summers. Got a little bit of time away, and then when things start to gear back up, my God, we had a whole plan. I'm sitting there like maybe 10 days ago, and there's this huge group chat that is amongst you know, so the fixer team, and I get roasted quite often because I just have to put it on mute, and I go back and check it every few hours, and all of a sudden, it's like Jeanette is hitting the big red button saying, this is the thing. And this petition is put in front of me, which was, you know, putting forth large part due to a fixer that came forward to us with an idea, yeah. And then we kind of ran that idea through, you know, attorneys and everything, to put it forward, this petition to send to Asha. And it's like, wow, we are doing this. It has to be by this date. This is how many signatures we need. And we got busy very fast.

Jeanette Benigas 3:45
Yep, and I would, I would love to shout that fixer out, but that fixer has been behind the scenes since before you were even around super anonymous. Knows a lot about the SLP world, knows a lot about Asha, knows a lot about state issues, just knows a lot. And said, Hey, you should probably do this, because now that Ash is trying to change these bylaws, so for people who haven't followed, there's another movement that changed some bylaws, or is attempting to change the bylaws, which are good and, yeah, I think needed. And they're they're using a particular bylaw that says we can change the bylaws with 2% membership petition. And as a result of that effort, Asha is now trying to do away with that bylaw. They want to change it, and their response isn't great. We've gotten a lot of questions about that. I think the spirit of what they're trying to do is good. And you'll probably never hear me say what Ash is trying to do is good again. So everybody you know,

Preston Lewis 4:52
yeah, I look at it

Jeanette Benigas 4:54
What they're doing leaves it very open for interpretation on their end, which means. If somebody puts in a petition that they don't like, and let's be honest, it's always going to be a petition they don't like, because when people have to take this avenue, it's because we're not being heard. They want it to go to all membership, which is fine, but they have said that it will have to pass through the board for proper form and function, and they're not, they're not explaining what proper form and function is. And so what we've kind of seen with this other petition as we've watched, and we don't know what's going on behind the scenes, we only see what's coming out on that effort's end. But they're giving this group a hard time, and they, you know, they're sending it back for red lines, and you know, it's, it's kind of a lot when the bylaws just say, this is how you change it. This is what you do. We would have expected to see an immediate change, right? But Ash is giving them a hard time. And so if they're giving them that hard of a time, you know, history is kind of being written. If they get to choose what proper form and function is, they can choose proper form and function at any time. They can choose that requirement. So what does that mean? You know, they can add to it, make it harder, make it impossible to achieve. And so that's the concern. So anyway, this fixer reached out and gave us this idea, and we got with attorneys and and honestly, even sent us a little money to help support the effort, which really helped. So thank you. You know who you are. So, yeah, I you know this. This cost us way more. We thought it was going to cost, but it was very professionally done and submitted. And I can't imagine we're going to be contacted for redline edits. I think it's solid. We've We've followed the rules, we've made sure that we submitted it appropriately, even to the point where on the spreadsheet, and this was my fault. Maybe I could have checked it a little better, but, I mean, shoot, we were we hired a computer programmer at eight o'clock at night to help us get the signatures on the spreadsheet, because JotForm would not do it.

Preston Lewis 7:14
I want to stop you just for a minute, because there are elements of this story. And when it started going. I thought, This is it. This is fixer. Season two has arrived, and it is a runaway beer cart careening down a hill. Will not be stopped, must not be stopped. And we get these forms in. And that jot form thing, I've got to tell this story. So Jeanette works out this arrangement where the petition is available through this signature company, jot form that we send out these emails to. Boom, we're going to do this. And we realized very quickly in the fine print that we can only get what was it? 500 500 signatures per per form or not, perform per account, per account, per account. And that was like, what? $65 a throw roughly, yeah, yeah. And so when we looked saying, Okay, well, can we up to the next level? How much was that next level? Was it eight grand? Started at eight grand, eight grand. So what are we going to do? We've We've launched this ship, we've put it out in the water. We heard eclipsed over 500 and now people are clicking and saying, it's not working. So Jeanette and the team scramble and come up with all of these different $65 accounts. And so every time we How many? 12? 12 accounts. And so every time one of them gets to about 450 it becomes like this babysitting job. You have to watch that account, because then we take those links and we switch it over to the new account. It just kind of like we're turning the page on a big roster. And it was hysterical. I mean, it'd be 1130 at night, and Jeanette is just flipping out saying we're at 484 I'm going to switch this thing over and, you know, we might be at 289 but we don't know where we're going to be at 6am in the morning. So it really became an all hands on deck effort, and that part was wild, and you guys picked up a fumble and advanced it down the field 30.

Jeanette Benigas 9:11
My gosh, what we did, what I mean that day. Thank God I do PRN and thank God I work for a company who is extremely patient with me. I'm a yes man for them, and I have been a yes man for 15 plus years, so they know if I say I'm going to do it, I'll get the job done. But I was committed to two nursing homes that day that were both an hour away from me, and there was also some other stuff going on as well. I was having a routine medical procedure two days later, and a bunch of stuff came up with them that really pushed me over the edge and made me start crying in the car, for real. But yeah, I mean, I sat here when I woke up and and got the notice that we weren't going to be able to have more signatures in like, 40 more submissions. And these things were coming in rapid fire. I freaked out. And as the day progressed, we figured it out. But, you know, I ended up not going to one of the buildings that I called them and said, Hey, some stuff has come up. Like, there's no way I'm going to make it to both buildings and be home in time to get my kids off the bus. I'll come see the patients on Saturday, and they were like, Okay, so, you know, I have that flexibility, thankfully. So people ask, like, how do you do it all? How? You know, if I was in academia and I had to teach class, that wouldn't have happened, right? Like, we would have just crashed and burned for the day. But, you know, I'm not in academia anymore, so I was able to kind of flex my schedule and do what I needed to do. But yeah, what we figured out was, if we just gave people one link to our website, very specifically, our blog. I pulled together a blog and that had links in it, and I had to change the links on the blog every time we flipped the form. So we gave all of our fixers one address, and then I was changing it behind the scenes. But what got complicated was, as people were signing the form, they were then copying and pasting the URL and sharing the form. And so we were getting hundreds of messages, hey, the form is full. It's met quota. And I'm like, that's because someone shared the form

Preston Lewis 11:20
and go to the link on the site. Yeah.

Jeanette Benigas 11:22
Yeah. So that was my fault. But, you know, I chose JotForm because, you know the change.org which is what a lot of people use, they solicit money from people, and with our initial petition that we had, that really ended up us not being able to use for anything. People were donating, thinking that the money was coming to us, and I didn't like that. And also, we weren't able to collect Asha membership numbers through change.org and I did not want to see receive 5000 plus emails for us having to match Asha numbers to signatures and figuring out how to present that. I wanted something clean. I wanted something protected, because, you know, you guys were giving us your action number and your signature, so I wanted to make sure it was in compliance with all regulations. And jot form seemed to be the best. But then at the end, as we tried to print this thing, we could either print out PDFs, which we thought would have the signatures. Well it did, but what it gave us was the full petition plus the signature. So it was three pages per signer. The the printing Bill was going to be over $1,000

Preston Lewis 12:35
yeah, sorry, 18,000 pages.

Jeanette Benigas 12:37
Yeah, yeah. And so the other option was to, like, export a spreadsheet, but it didn't put the signatures on the spreadsheet. It gave us unique URLs to every single, like, a PNG URL to every single signature. And I had some people unrelated to this movement check them, and they could not open them from their computer because they were my accounts. So that's why I ended up at eight o'clock at night finding a computer programmer who had availability right then to write program in Python to upload these signatures to the now, if you if you go to the fix SLP website. You'll see our new job listing for a fixer code programmer that's also an SLP, please apply. Shout out to Bobby from Ohio, speaking, saved us and I drove cash to him at 10 o'clock at night.

Unknown Speaker 13:36
So Thanks to Bobby. But what I ended up doing is the printing Bill was a little bit higher than expected, because some of the signature lines went into a new page. And so at the end of our petition, there's a solid 200 pages of almost blank cells because someone's signature had, like, leaked into a cell that wouldn't fit. And I could have deleted it, but I was like, No, I'm gonna leave it. I'm gonna leave everything. This shows the work of the signer. And so, yeah, we submitted over eight, I think it was total 890 pages to ask him. So yeah, that all costs money.

Preston Lewis 14:14
Those 12 accounts. And to put it into, you know, a visual for the listeners. Imagine an Excel file with each of these 12 lists of 500 names on there, and all we have is a name and the ASHA number. So we had to confirm the memberships, and we had a list at the end of maybe what 250 that had to be cured and fixed. And we got a lot of great responses back on that, but it the one thing I actually liked about it, and it was Donkey work. I mean, this thing was just tedious, having to do this, and everybody helped out. But it probably, I mean, I think I could put in a good 10 hours on it myself. It was fascinating to me, though, to see the geographic reach of fixed SLP, all 50 states. We had people from Guam. We had one from the Saint Lucia, someone in Canada, in British Columbia. And that was really heartwarming to see that outreach from different corners, and also to see that very powerful nucleus of SLPs in the Ohio, Michigan area, Pennsylvania, it's it's there.

Jeanette Benigas 15:21
Um shout out to Mallory, who's in Taiwan, who was helping us check too. Mallory is a military wife, SLP, who maintains her C's because, you know, you know the story, why she's doing it. So she has asked to volunteer a couple times that I keep telling her we have a project, and the project changes or falls through or gets done before she responds. But this time, I was like, We really need you. And so Mallory was, you know, checking she was sleeping while we were awake, and she was awake while we were sleeping, and shout out to Teresa in Mississippi and Kristin in Pennsylvania, who also helped us check those signatures. I mean, it was truly a group effort.

Preston Lewis 16:01
So we had set a deadline of about September the 27th Yeah, you and I are recording this. It's September the 26th so we nailed that deadline long in advance. How many hours did it take to get to 6000?

Jeanette Benigas 16:15

Preston Lewis 16:16
it's really good

Jeanette Benigas 16:17
yeah. And we really only needed, like, 4750 or whatever the bylaw said 2% of the membership, which was not even 5000 I said, Let's go to 7000 but once we started seeing the effort it took to confirm and the the money it was costing us because we take using fearless fix our Money, sustaining partner money, we spend it with caution. Like, every time I spend it, I reach out to you guys and panic, like, Is this okay? So, you know, it's just, I didn't want to spend the extra money for another 500 signatures that real. We really didn't need it wasn't going to make a difference in the result. I think we proved our point. You know, we collected 6000 physical signatures. And actually a little over, because if you guys were submitting before 500 JotForm would still accept it. So like the first one, because we were collecting so rapidly, we got 512 signatures out of that one.

Preston Lewis 17:17
We did close the signature period. So I've already heard from half a dozen SLPs and said, Hey, I want to sign this thing. I can't now. We did close it because it had to be a finite amount in order to submit and transmit to Asha. But I think if we had kept that thing going Jeanette, my the end of October, we would have well eclipsed 10,000

Jeanette Benigas 17:36
Yeah, for sure, because I've gotten a lot of messages too. So printing was kind of expensive, we found a 20% off coupon to save some money. Thank you. Elizabeth, yeah, we've been scrappy. I called the lawyer to see the best way to go about this because we really wanted to make sure they got it before. Right now, they have a public comment period open on the change that they personally want to make to their bylaws, and they can do it without us. All they need is the two thirds majority board vote to change the bylaws, so they're probably going to do it, which is crappy, but you know, they've not. They've not had a thing to say about this bylaw until Asha member started exit, exercising their right to use it. And to me, that's an exertion of power and control, like power over people that I have a real problem with as well. You know, they don't like what they're doing, so fine, they're going to shut us down. But anyway, the 28th is when the public comment period closed, and the lawyer and I were pretty confident that they wouldn't have some secret meeting in the middle of the night to change the bylaw before that public comment period closed. And I think is that a Sunday? Yeah, that's that's a Sunday or Saturday. It's this coming Saturday as of this recording. And so we thought, man, if, if we wait until Monday, that could get dangerous. So we wanted to get it in before the public comment period closed, not after I went into ups. Shout out to Liam. Oh my gosh, I'm calling his manager today. He was the best. Liam was amazing. So Liam went through all of my options with me. We weighed stuff to see what we were looking at for shipping. He packaged it up beautifully, like, like he went above and beyond. I just can't. If I ever have to ship something from UPS again, I will drive an hour to go see Liam. Yeah, he's like, for 10 extra dollars, you could get it there at 1030 so I did overnight to get it there today. I shipped it yesterday.

Preston Lewis 19:34
The only thing I'm worried about, do you think anybody will be there? We're talking about the ASHA office.

Jeanette Benigas 19:40
something someone is always supposed to be there, and that was my concern, too. Two day shipping was going to be like 20 bucks. But are they there on a Friday? And do they leave early? We don't know. Nobody knows, but there is always supposed to be someone there during business hours, and so I paid more. Need to get it there today Thursday, to avoid tomorrow completely. And then for 10 extra dollars, I could guarantee delivery by 10:30am which as of this recording is in three minutes.

Preston Lewis 20:12
I know. Yes, I just looked at the clock. It's it's 1027 Eastern time. This thing has probably arrived. You should check your tracking, you know. So,

Jeanette Benigas 20:21
yeah, while we're recording, I'll check it.

Preston Lewis 20:22
Do you remember how many pounds that was?

Jeanette Benigas 20:25
I actually, you know what? I didn't his side of the scale wasn't working. So I actually don't know. But as we're talking, I have the receipts. I have multiple receipts. Like, I had to pay, I had to pay for printing, and then I had to like it was a it took over an hour. So I, I went to the town that I was working in, to the UPS there, and I dropped it off, worked with Liam on that first went in to tell them what we were doing, see what our options were. Because in the letter, the cover letter, I wanted to let them know that, yes, they were receiving an email, but also it was coming. We originally put certified mail, but I wanted to get the name of what we were using. So Liam got me all set up, and then I changed the cover letter in the car. Sent it off, sent it off to ups to print for us. And so he had it ready to go. When I got off work, it was all packaged up ready to go. So it was 10 pounds, 3.2 ounces. Okay, fillable. No, you do double sided printing. No, oh, okay. And I also included all of those cells that had, like, one scribble of the signature on it. So that was like, again, a solid 200 pages of like, all empty cells in one cell with a line. And I didn't realize that until after I had emailed it to UPS and it was already printing. And I was like, I could open these boxes and take these pages out, but you know what? That's part of their signature, and I don't want to give them any reason, yeah, to not accept this. We even had we, I don't know how any of us missed it. And even it was days that this petition was out before someone said, hey, there is an error in your red line. It it said certificate of clinical, I don't remember what, but it didn't say competence. It says so spell check had auto corrected it without with us missing it. And what we did was we also changed the cover letter to say we acknowledge this mistake. It does not change the intent of our of our petition. And again, the lawyer wrote this verbiage, but basically it doesn't change our intent. And initially we had gone and changed it back. And he said, you know, we will say, like, we've corrected it here, but then in the final hour, he said, I've been thinking about it. We're going to leave it with the mistake and point out to them that they have a bylaw in their own bylaws that said they can make clerical changes and like, you know, changes like that on their own, without an ASHA vote, without a public comment, without so we told them, we acknowledge there's this mistake. This is where it's at. We implore you to use bylaw with the number to make the spelling corrections. So that was in you know, we left those done stone unturned. So if they don't do this, it's not because of us, it's because of

Preston Lewis 23:26
so they're I'll ask the next question. I know a lot of people are wondering, what is this? What do you think or want to see here? Jeanette, I've got a few thoughts of my own, but I want to hear yours first.

Jeanette Benigas 23:37
So the intent of this was to force financial transparency, and the way that that will be forced is by charging fair market value for the CCC, which is a product. We are buying a product. It's like going to the store and buying a package of toilet paper, which fair market value is what these days, I have no idea. Let's call it $5 but they're charging, you know, target is instead charging you $500 and using that extra $495 to cover the cost of their paper towels or their target circle membership. That's what they're doing. They're, you know, they're, they're charging you as the target's charging a significant amount for the toilet paper, which everybody has to buy to then cover the cost of the target circle membership, which only moms like me use, who are crazy and get sucked into the $5 offers. So that's essentially what ASHA has done with the CCC. Per their tax forms, the CCC that certificate costs approximately 12 to $20 per certificate holder to maintain. Instead, they charge us 200 plus dollars at the same time for the membership, which is actually optional. They are currently charging, I think, $29 to maintain we all know that it takes more than $29 a person to run a membership program. It is why they don't have competition. No one can compete with them, which is an entirely separate issue that we have addressed over the last year privately. But you know that that's the problem. And so what we want, what the purpose of this was, was to force them to charge fair market value for the CCC, which we would expect to be because they're, you know, they're not going to go on the $12 end about $20 and charge membership fair market value, which should be somewhere around 200 and this is in line with physical therapy and occupational therapy. It's, it's interesting because they just came out with a statement on their website that says, you know, it's comparing membership and dues and how Asha is so reasonably priced to the occupational therapy and physical therapy associations, which their memberships are right around $200 fair market value, and they're saying, Oh, you're getting all this value. No, you what you're not you like you just made yourself look stupid because you're charging us $200 for a product, not a membership. That's the problem. And the thing is, for physical therapy and occupational therapy, just like for speech therapy, membership is optional. Membership's optional. And so why this is going to be a fight is if they actually do this. If they actually make the change without a fight, which they will not, they could, it could bankrupt them, because membership is optional. So if they flip these prices, and they charge around $200 for Asha membership and 20 for the CCC, which we all know is, quote, optional, right? Most of us have to keep it right now. People will drop membership. People will drop membership, and then they'll have, instead of approximately 200,000 people paying $250 a year, they're going to have 200,000 people paying $20 a year

Preston Lewis 27:21
they won't have that 99% you know, workforce capture rate that they brag about, or 98%you know, that's something they boast about in many of their board meetings. Yeah, I you know, that's the thing for a organization that loves committees. You know, where's the committee to really focus on, how do you modernize this and to where you're not doing a business model, which I learned the other day, a new term I knew, bait and switch, but that term lost leader, which is when you're using something else at a lower, artificially low price, and then you're, you know, but making up your cost of with another product, which in this case Is the CCC i i would love to see just a process that says we're going to change this. I, I'm not out to bankrupt anybody. Personally, sorry, bankrupt organization. I would like to see a pathway where maybe we gradually get there over the course of three years, maybe. But right now, there is no conversation, there is no committee that is made with actual working class SLPs or input. So I hope it sparks a conversation. But I like you, I remain dubious, because it's we get so lost in the weeds where it just becomes, how many barriers can we throw up to keep doing business as usual? And then, not only that, brag about business as usual, as if there's some kind of honor and dignity and having a loss leader business model, right?

Jeanette Benigas 28:48
And, you know, it's not like this was our first option, like this was the last resort, and, and we're not out to bankrupt Asha. Asha does do good things. Yes, you know they it. They're just so lost in the value of the CCC, which is their money maker, they're so lost in making that money that they've lost their way, which is that last leader that you just said. But we started one year ago with this is not a new topic for us. One year ago, we started talking about the inflated price of the CCC and the deflated price of membership, and how they're using the CCC to subsidize membership. One year ago, we had a call to action with our little tiny following shout out to everybody who's been with us since the beginning, and we said, write letters to the board. And we had a board member reach out to us, who appeared to be on board from the beginning, and suggested like, if you want change, this is the way to do it. So we followed the suggestion of the board member, we did exactly what that board member said for us to do, and we did a call to action. Send your own personal letter to the board. If you look back, we posted some people's letters, and those letters were in prior to the date that they needed to be in by to be reviewed by board members prior to meeting, and they ignored us. They flat out ignored us when those minutes came out, they addressed letters to the board for what 10 minutes they didn't talk about it. And so we we were ignored. Our efforts were ignored. And I think our submit this, and this is what gets me really excited. Our submission was like 217 but I think from what we could count, if people let us know that they sent in letters. It was, well, no, that's a lie. I think it was somewhere around 150 from what we could tell. But then we heard from people after so I think it was right around 200 yesterday, I submitted 6000 signatures. So that's how much growth we've seen in a year. And it's exciting to me that people appreciate, appreciate what we're doing, and can take the time to get engaged, but that's how we started. So this wasn't new. This wasn't we're going to punch you in the face where it hurts. We tried to follow what they told us to do, and they did nothing, and we've continued to post about it. You know, they're watching our account. They're watching our account. They I, I wouldn't be surprised if they had someone in that office assigned to fix SLP, to look and review at every single thing we say in post be and we see that, because when we do good things, they are either trying to get out ahead of us, or they're coming in right behind us, to try to show their value as it relates to what we're doing. So when we changed credentialing in Arkansas and in North Carolina, when those efforts were made to change Medicaid credentialing, and we succeeded, you saw a very public push from Asha as it relates to those two states with what they were doing to make things better. And really it was a load of baloney, you know, like, what exactly did they do? No one knows, still to this day, where we had some measurable outcomes, where there are people now in both states getting credentialed to bill Medicaid without the CCC. You know, we have measurable, significant outcomes. So when we say we had a win, it's an actual win that speech pathologists can lean into and know, we did the work and yeah, so I lost my train of thought. But

Preston Lewis 32:40
I think there's a third party in all this too, that I want to bring up that's kind of the silent partner, and that is the the state associations, because in it, we heard a lot about that through this signature process. And let's face it, there is only a certain amount of resources, money that SLPs are carrying around that they're able to put toward advocacy, toward organizations. And our state organizations are in dire need of additional members, and they have lobbyists that are on the ground in state legislatures in many of these states that you know they're paying with what little money they have to deal with Medicaid reimbursements in those actual state legislatures, if you have a national organization that is boasting that it's, you know, sucking up 98 99% of the workforce's, you know, resources into selling a product which actually cost 12 to $20 and they're charging $225 for it, then those are resources that are being robbed from a potential use within these state organizations. So I think they're watching closely. Many of them have been on the pod. We want them to come on the pod to talk about their issues, because some of them are doing just incredible things. So it's, it's not that we're just saying, you know, as you go kick rocks and go into the shadows. It's saying, perhaps this big Leviathan, sort of national organization that's trying to be all these things, is not quite succeeding in its mission, and perhaps can modernize itself to where it's more nimble to its tasks without overshadowing everybody, losing the autonomy and sort of the Go get them, kind of spirit of the SLPs that you and I have met. And then also just kind of telling the state organization, sorry, we took all the money.

Jeanette Benigas 34:28
Yeah. And that's, that's to me, the third partner, I We remain steadfast in reporting or not reporting, in supporting these state organizations. And it's, it hurts my heart a little bit. I know we came out of the gate hard we, you know? We dug in with Big Daddy Asha, you know? But it's the shock value, right? Like we are good people, doing good work and making the changes that clinicians want to see. And yet the majority of these state organizations refuse to talk to us or write us nasty emails. We've received a few of those, and have this like private agreement not to engage with us. And we know that that agreement exists. We have moles everywhere. There was a meeting with ASHA, where the presidents, you know, Asha, helped the presidents come up with verbiage on how they were going to respond to people inquiring about the CCC. Asha told these presidents, if you're contacted about the requirement of the CCC, forward those emails to us, and we will respond for you. And you know there was this gentleman's agreement that they weren't going to engage with us, which thankfully, some state associations have ignored. And so even though we're almost like the I don't want to this isn't a woe is me, but it's almost like the abused kid, or, you know, where these state associations don't want to talk to us, and yet we still love them and and support them. So we're still doing that. We would still love for state organizations to come on and tell tell our listeners what they're doing. And I that very last that form 12 on the petition I was verifying in lifetime, because we knew that we had to be ready to go as soon as we shut down. The amount of signers from Ohio was significant. And I know you said when you were confirming the amount of signers from Ohio was significant, and I was hoping I could run statistics. There is no way for me to know how many Ohio signers we had, unless I go back through all 600 and

Preston Lewis 36:58
I think I was the only one. There was somebody else team that was marking them, I was putting state abbreviations next to Yeah, and maybe ones that I did Ohio led the way. And, you know, California and Texas are going to have a lot because their population, but Ohio definitely, per capita just punched a big time above its

Jeanette Benigas 37:14
and you know what? Maybe if anyone wants to volunteer to look into what states are, it would be a re verification process. We don't have the manpower to do that again, but hey, if I could get 12 to 24 of you, I'm putting the call out there right now. If you would like to go through our petition to pull the States, I would love to see where people were signing from. Let's do that. Let's let's do like, a cool heat map too. Yeah, yeah. Let's take a look at these petitions. But what I did do was I reached out to my state organization, and I said, Hey, Ohio is engaged. You've got a ton of people signing our petition, and you don't have a ton of people on membership, and I want to support you. And what this tells me is, Ohio SLPs are engaged. They are paying attention. They want to see change in this field. And what's crazy to me is that the CCC is not required in Ohio at all. It is not written the words American Speech Language Pathology, certificate of clinical competency, Asha, CF, clinical fellow, any of the abbreviations, none of those are in our regulations to practice. None of those are in our regulations for billing anything. It's not required for an AAC device in this in this state, I just ordered one, and I did not provide my Asha number. It is not required. The only thing you need it for right now is student supervision, which I'm hoping we take on this year. The only thing holding Ohio SLPs back is employers. And so I said that. I said, we need to get creative about getting giving people options in this state. So I know her. And I said, I know you and I both know the challenge of student supervision. I would love to have a conversation about how we can get creative to support the state organization, and I've not yet heard back, yeah, which is makes me sad, because clearly we want change. You know, we're engaged here and and so I'd love to get those numbers from other states too, so we can provide them to the state organizations. Hey, this is the percentage of signers from your state. We just want you to know that your state is engaged. Your SLPs want change. And maybe if we could find a creative way to come at this together, we have the voice you. You look at state association posts, they get 10 likes. They get 20 likes. What kind they're not hitting the algorithm. If we could post for you, if we could help push things out for you, what would happen?

Preston Lewis 39:52
And you're engaging those SLPs, and there's, there's nothing wrong with, you know, those that are just not engaged and they're just doing their thing Day in and day out, they're too busy to think about all these issues. Hey, we get it. We all have lives. But of these now 6000 plus signatures on this petition, and of the core nucleus of fixers that communicate with us regularly, these are people who really want to dive in, not just on the ASHA CCC issue, but also on reimbursements, on quality of workforce, on, you know, some of the rehab companies that are squeezing us on productivity, these are people that really want to engage. And here's an active arm in order to do this.

Jeanette Benigas 40:33
And I think with a year in I mean, if you look at the post I made last night, cheers to one year of fix. SLP, look at the list of the things that we have accomplished with a small team of volunteers with on a shoestring budget. It's wild to me, what we have accomplished. And so now we have a track record and and within the next two weeks, things are changing in Michigan, and our track record is going to be even stronger. And we did that with two people leading the way in Michigan, two people, two dedicated people. We just need dedicated people to make these changes that aren't sitting waiting for us to tell them what to do. We did it with two people. We have draft legislation that'll that'll go through, hopefully after the election cycles over, it won't even be needed by the time it goes through. But we're going to do it anyway, just to put protections in for Michigan clinicians. And we've done the work, yeah, and we've done the work, um, but you know, to just to show what we can do on very little money, with very few volunteers. To me, it's because, like, when you look at ASHA and people are like, what does Asha do for us? It's because there's so many levels of bureaucracy, and when the focus is on income and money, it's hard to get things done. I feel like we've done more than ASHA has in some of these states in a year, than they've done in years. And so if these state organizations would just look at at what we can accomplish, man, if we had access to their lobbyist, what else could we do? And that would be the thing my I know we talked about what we want to see for the future. We now have 10 state teams. If we can get the kind of leaders on those teams that we had in Michigan, and we can make more changes, I keep saying, this is a long, a long game. We're not going anywhere. My plan is to pull those leaders into a national team that takes on Medicare and Medicaid to get the verbiage changed, and that was probably going to take lobbyists, and if we had some lobbyists from some of these states helping us, it would sure save us a lot of money, because if we don't, we're going to be fundraising, and we're going to need money from our fixers, because lobbyists are not cheap. But that's where we need to head. If we want true autonomy, if we want true choice, we need to eliminate the confusion in all of these regulations. That's the key for true autonomy and choice. And once we have that autonomy and choice, then at the state level, we can start pounding regulation. Nationally. We can start pounding these staffing companies and these contract therapy companies who kind of force us into tough choices, where are we going to commit fraud today or not? Like, I joke with some of my friends, sometimes I'll send a text. I'm like, I'm on my way to this building, and they know what company that is. And like, you know, I'm prepared to commit fraud today, and it's a joke. But with every joke, there's a level of truth, right, like and so there's no accountability for these companies. That's where we're headed, at least. And I say that now, but if you would have told me a year ago we were headed where we were headed, I wouldn't have believed you. But those are the things that Asha is not doing for us, that we want, that we're confident we can make happen because there's five of us on this team. Now, if some of these state teams produce the kind of leaders that we have on this team, there is no stopping us.

Preston Lewis 44:12
Can I brag on we got some great teams, but Jeanette benigas on one of those teams in particular?

Jeanette Benigas 44:17
Yep

Preston Lewis 44:18
Colorado. I mean, these people are bringing it. Wow. This is a team.

Jeanette Benigas 44:26
What are they doing? So let me preface that by saying I cannot be all places at once. I have liaisons in every state and and I'm only notified if there is a problem or a question or something we need to brainstorm on people are doing the thing without me. What are they doing? Tell us.

Preston Lewis 44:44
I'm gonna have to defer that answer to, I think it's Elizabeth. It might be Michaela, but it came up on one of our calls the other day, and, you know, it was a lengthy call. I'm sitting there keeping notes and trying to, you know, do all the things here in my house, and all of a sudden I start hearing Colorado.. Colorado. So I'm going to let one of our fellow fixers talk about that, but I wanted to just kind of put that out there, because if, if you're on that Colorado team, you are making some noise. So I just wanted to kind of put that little, little plug in there.

Jeanette Benigas 45:13
I love that, and see that's what we need. I don't need to have my hand in everything. I'm not here to micromanage you. You know what our goals are. What does the state want? We're not here to tell the states. I have tried to attend every single launch meeting, to introduce myself, to say I'm accessible. This is how you get a hold of me, like certainly communicate with your liaison, but if there's a problem or something you need, or you just want to chat, this is how you get with me and and from now on, you won't see me again. You won't hear from me again, because you guys are going to kill it, and you've got your liaison. And here's what we think the problems are and where you should start, but ultimately it's your state and your state team. And so we're here to support you and fund you if you need some money, and work with us, partner with us, and that's what we're trying to do. And so I'm glad to hear that there's stuff going on that I don't know about, because that's exactly what I want to see.

Preston Lewis 46:05
I want to set one more qualitative goal as we start season two. I want next year, this time, not to have this happen. And you get these calls, I've gotten these emails and texts. I want to see where this does I want to go a whole six months, maybe a year, where I don't get one of those emails that says I'm afraid to sign this petition because I think that I'll lose my job if Asha puts it out there, if I'm found out, and that level of just Orwellian fear, it's there for a reason, and that is just shameful, and I want that to go away, because it just breaks my heart that there are clinicians that are that afraid that if they just speak out, speak their mind, that somehow, you know they're going to get ethics violations or they're going to get their license ripped away from which it's not a bloody license. But it you get those calls, Jeanette, I hear them. It's so sad.

Jeanette Benigas 47:01
Yeah, I even got a message from someone, a very concerned, well meaning fixer. And I, I don't judge it. I love it, but, you know, this week has been a lot. I two nights ago, I literally got three hours of sleep in an effort to get this petition in. And so I did some lives while I was driving to work, and someone messaged and said, hey, you know, in a lot of states that what you did was illegal, and you don't want to give Asha a reason to, like, submit a a police report, but that's the level of fear that fixers get, and I hate it

Preston Lewis 47:39
While you get ready to queue this up. I want to say, in the spirit of trying to be accountable to feedback, we had had an idea that we bandied abound last year, we were going to call it clinical war stories. So we have a toll free number that we encourage people to call. They get about 90 seconds to you can tell us something that a good story that happened in your clinical practice, a tough story, a challenge that you're facing at work, a challenge that you're facing with a bureaucracy or Asha itself. It's, you know, it's a line that's there. We had a someone on social media say, you know, you might want to not say war stories and, you know, okay, we've been we, you know, toss that around as a topic, and I think we came up with something that's really nice. So for our inaugural season two episode, we present meltdown in the minivan line. So that's what we're going to call this section for now, we'll continue to post that number. We had, I think, a few submissions, and we've got one this week, and I think we're gonna let everybody hear it.

Minivan Meltdown 48:49
Hello. My name is John hehim pronouns, and I would like to give you a story about my initial experience as a speech language pathologist. I started my CF in a outpatient clinic, and I went through three different CF supervisors. The first two were, number one, extremely new. They didn't really know what was going on. And then number two, they weren't entirely going by the book of what you should do as a CF mentor, and that was really concerning to me. Luckily, my third mentor, who I did know about this situation, basically said, Why don't you switch and I'll be your mentor Now, granted, this was a whole different job as well, because the outpatient clinic also had me go to a school district, which was ridiculous, especially as a CF. And this woman really, really, really helped me the CF mentor. But you know, just to think about how tough that was as somebody first starting out with. Really concerning. And now that I know, you know, almost 10 years into the field, you know, a lot of the stuff that I saw then shouldn't have gone down. Thank you so much. That's one of my recordings.

Jeanette Benigas 50:15
I don't think that story's uncommon. No, my very first, CF, that I supervised, I was the third.

Preston Lewis 50:22
yeah, that's that tells one of those stories that that tells one of those stories that we want to hear. You know, it's, it's out there. They're definitely, you know, I'm glad that you guys are looking at supervision as, you know, an ongoing issue, and how to broaden that and make it more effective and nimble. And yeah, I feel for it, because, like you said, we hear that all the time,

Jeanette Benigas 50:48
and that's that's something that, as we build these state teams, that these state teams can take on. Ohio has stricter supervision policies than that of the CCC, and that's something that these state teams can be looking at. Is we know that these issues exist for CFS, the mentorship situation is a mess, and a lot of it is modeled after what's required for the C the CF, which, by the way, if you don't understand that the clinical fellowship is required to purchase the CCC, you do not have to do the technical clinical fellowship if you are not going to purchase the CCC. And hopefully someday that will be a thing. But right now we we kind of on the we sort of recommend that you do it train and get the C's at least once, until we have all of this mess cleaned up and you have a safer place to practice without the C's. But every state, I think, except for one, and I don't have that state on the top of my head, has their own version of the CF in a good chunk of states, it's called something different, like the professional experience year or something like that. Some states still call it the CF. And then, actually, there are a few that do require the physical CF. They don't care if you purchase the CS at the end, but they want you to go through that process. So yes, states can be making their requirements more rigorous so these things don't happen. They could be outlining the expectations of a mentor, and again, mentor, not supervisor. You're out of school, you're not you have a degree, you're not being supervised anymore. This is a mentor, mentee relationship, and unfortunately, in a lot of situations, the clinician, excuse me, the practicing clinician, the mentor, almost acts like a boss, and they're not

Preston Lewis 53:02
In some cases, it is your boss. It wasn't mine,

Jeanette Benigas 53:04
yes, could also be your boss. Your mentor is not there to tell you what to do. Your mentor is supposed to be there to help you learn and grow. And so if you're not receiving that kind of experience, if you were a CF in your mentorship now, and that is not what is happening for you. Get out. Go find a new mentor. You have a right to choose your mentor. It your your job doesn't get to dictate that. Go find a new one. You can do that. Just make sure, if you're purchasing the CCC, that that mentor signs off on everything that is needed for whatever segment they were mentoring you in, and then check your state paperwork as well and get those signatures, because tracking that person down at the end, especially if there's hurt feelings, is going to be really difficult. I know in my situation where I was the third mentor, there were some state violations that happened, and both the second CF mentor and my CF had some flaps on the hand. The mentor was never allowed to mentor again in the state. And then my CF had to do some extra CEUs that year as her quote punishment, and that was because as as a professional, it's your job to fill out paperwork, and the paperwork wasn't done, and you know, it was a mess. So take a responsibility, get the paperwork signed and move on. Go get a new mentor. You're not stuck with that person for nine months.

Preston Lewis 54:42
Great advice. Well, I think season two is off to a very fine start.

Jeanette Benigas 54:46
I think so too. We are going to try to follow some sort of a format here, and I don't know how long we've been running

Preston Lewis 54:54
an ongoing goal.

I told Preston we talked about trying to keep it under an hour. And. He's like, we'll record for a half hour. And I said, That's too restrictive for me. I don't I need freedom, but we are going to try to keep it under an hour. We're going to have a little bit of a format, and because we now have a content calendar, we can also talk about what's coming next. This is celebration week. We're going to do some giveaways. We're going to give away some T shirts. We're going to announce our new tagline. Yeah, we're just going to have fun. We're going to try to raise awareness about what we've done this year. We're going to have a lot of shareable posts, or by a lot, maybe two. Yeah, we hope you get involved. We want to see you celebrating with us and sharing what your vision is for the future, for this next year too. For us, we hear everything you're saying, and even if we're not acting on it right now, a lot of the times we're adding it into the plan. We can't do everything at once. We can't do everything with five of us, and we can't do everything without money. So that's the other thing. We do have a sustaining Partnership Program. We don't have a Patreon as part of this podcast. We have a subscription that you can do where all we're asking is for $5 a month. You can certainly give more if you want to. Most people give it $5 a month. We have a couple 10s, couple 20s, I don't think we have anything above that. We take that donation very seriously, and for full transparency, we do not take money from it to pay ourselves. The service that we're using takes a cut, and I'm going to have to pay taxes on it. So if you're giving us $5 a month by the end, I after taxes, are we even seeing $3 a month? So we're doing a lot with a little, and we really appreciate it. There is not a way. I've been asked in the past, how many sustaining partners are there? There is not a way for me to know that the service that we're using is a rolling subscription plan, and I can't look at how many people are currently subscribed. It acts like an E commerce site, so every time it builds that monthly subscription, it looks like somebody purchased something off of our site. And after nearly nine months of doing this, between t shirt purchases and it also mix in with email subscriptions, and we have about 3000 subscribers. So yeah, I'd have to go through 3000 plus names to see who has purchased something and who has subscribed, and flesh that out. I don't know. I suspect it's maybe at $5 a month. As I look at what comes in on the statements, somewhere around 200 subscribers give or take. There's always people unsubscribing and subscribing. It's enough to keep our back end going with a little bit left over every month, and we swirl that away for things like what you saw this week. So if you'd like to be a sustaining partner, we would love for you to walk beside us and do that you just head to fix slp.com, there is a tile on our homepage. Oh, another big plan for this year. These state teams are working on state specific employer education materials. We will brand those out. You probably will not see those until the new year. It's a lot of work. It's an enormous project. But also for that, I need a place for those things to live in a professional way that has a very good user experience. So if you come to our website, there needs to be an easy way for you to access those materials without having to click out to a Google form and copy and paste or what have you. So the long term plan is to get a real website. Real websites cost money. I spent a couple weeks prior to this petition soliciting quotes. We have to meet as a team and see what we're willing to spend. But now we're a little behind, because this week cost us more money than we had planned. So that's coming. That's a big way that your sustaining partnership money will be used in the coming months, is getting a real website. Because the website we use now again, is E commerce, off of Shopify. It says if we're selling something, but we've done a dang good job of making it look like a real website. That's not what it's meant for. So the back end is very, very difficult to set up, and we just need to move on, especially if we're going to have hundreds of materials available for you. It's something we promised as part of the sustaining Partnership Program, and it's coming. It's just a big job. And now that we know how many files we're going to house. We need a real website to do that. So if you made it this far, thanks for listening to that little spiel. Fix. Slp.com, we're just going to skip it today. We want to read podcast reviews. We didn't get any this summer because we weren't around. So please like and subscribe to our podcast wherever you're listening. Please leave us a kind review you might get it read here. On the podcast. Yeah, we're excited to jump in. And I think that's it. Anything else? Preston?

no, I'm looking forward. We'll have Michigan news next week as well. I'm excited about that.

Jeanette Benigas 1:00:09
Yeah, all right, guys, well, that's it. Thanks for fixing it.

Um, I yeah, I missed you.

Preston Lewis 1:00:25
Well, I've missed you as well. And you know, it was a spooky thing last night when you said, you know, just think a year ago, he was single, and now he's got five wives. And I was like, Oh my gosh.

Jeanette Benigas 1:00:40
I mean, come on now. That's cute.

Preston Lewis 1:00:43
It is. You all look fantastic.

Jeanette Benigas 1:00:45
That cheers to one year in our PJs with do you see us throwing that confetti?

Preston Lewis 1:00:51
Oh, yeah.

Jeanette Benigas 1:00:52
Confetti was all over that Airbnb for a solid 24 hours. You know what you can't see behind that second E is champagne glass with champagne in it that says Preston on it.

Preston Lewis 1:01:05
Oh, who drank from that one?

Jeanette Benigas 1:01:09
We all did.

Preston Lewis 1:01:10
Who?

Jeanette Benigas 1:01:14
We all did. I think by the end, we were just all drinking whatever drinke we could find

Preston Lewis 1:01:19
Wonderful.

Transcribed by https://otter.ai