Marie C. Ireland, M.Ed. CCC-SLP

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Regulations vs. Best Practice What School
Professionals Need to Know

• Marie C. Ireland, M.Ed. CCC-SLP
• Virginia Dept. of Education
• Shannon Hall-Mills, Ph.D. CCC-SLP
• Florida State University
• Cindy Millikin, Ph.D ccc-slp
• Colorado Dept. of education

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Disclaimer

• The presenters have no relevant financial or
  nonfinancial relationship(s) within the products
  or services described, reviewed, evaluated or
  compared in this presentation.

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State Education Agencies Communication
Disabilities Council (SEACDC)

• Consultants working to support speech-language
  and hearing professionals in schools since 1939
• Members from across the USA
• Share information and network to improve services
• Collaborates with ASHA to address needs in school
  settings
• Website provides links to regulations and
  guidance

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State Education Agencies (SEA)

• Promulgate state regulations
• Interpret federal regulations
• Manage and distribute funds
• Adjudicate complaints and resolve disputes
• Monitor Local Education Agencies (LEAs) for
  compliance
• Provide technical assistance to LEAs
• Publish guidance and best practices
• 34 C.F.R. 300.149-154(2006)

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Have You Ever Heard. . .

• But ASHA said we should use workload not
  caseload.
• Thats not how we did it in my last school.
• I heard that SLPs in another state dont have to
  do things that way.

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Examples of Differences

• What is the maximum caseload permitted?
• What is the criteria for eligibility for SLI?
• What is the maximum group size for a Medicaid
  billable treatment session?
• If parents do not give consent for an IEP change
  what happens next?

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When youve seen one state youve seen one
state

• Professionals must be aware of differences and
  follow state and local requirements to remain in
  compliance.

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Following the Law and the Rules

• May be set at the federal, state or local level
• Statute
• Must be followed
• Can be changed following a legislative process
• Regulations/Rules
• Must be followed
• Can be changed following a strict administrative
  process

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Jurisdiction

• jurisdiction /jo?oris dikSH?n/
• Noun The official power to make legal decisions
  and judgments.
• The extent of this power.

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Federal and State Statutes, Regulations/Rules

• Statutes are passed by the government
• Regulations/Rules may be promulgated by the
  federal or state agencies.
• Changes to state law or regulation must follow an
  approved process.

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Interpretive Authority

• Once a law or regulations is written, governments
  have interpretive authority when regulations are
  open for interpretation.
• Interpretations cannot conflict with the law or
  regulation
• Interpretations may be written as
• Regulations
• Procedures
• Guidance

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An Example of Interpretive Authority

• Speech or Language Impairment means a
  communication disorder, such as stuttering,
  impaired articulation, a language impairment, or
  a voice impairment, that adversely affects a
  childs educational performance
  CFR300.8(c)11

• States and LEAs may provide guidance or establish
  specific criteria
• State interpretation of Language Impairment
• Ohio
• Colorado
• Florida
• Virginia
• In your state?

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Another Example of Interpretive Authority

• SLP caseload are not addressed in federal
  regulation.
• Some states may limit caseloads for SLPs by
  regulation while others may not.

• Examples from states
• Ohio 80
• Virginia 68
• South Carolina 60
• Oklahoma Based on IEP Services
• Florida Local Control
• Hernando Co gt100
• Pinellas Co Cap 45
• Colorado, Wisconsin, Utah Local Control

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Other Types of Rules to Follow

• Policies
• May be written to explain processes as long as
  they do not conflict with regulations of a higher
  entity (federal, state, or local)
• Must be followed to remain in compliance
• Procedures
• May be written to explain processes as long as
  they do not conflict with regulations of a higher
  entity (federal, state, or local)
• May not result in a compliance violation but may
  result in disciplinary action if not followed.

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Example of Local Policy or Procedure

• Records retention
• Special Education forms or software
• Procedures of updating staff on regulation
  changes
• Medicaid billing procedure
• Student assistance or intervention team procedure

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Best Practices and Professional Guidance

• Best Practices and Guidance can be issued by
• School Districts
• State Education Agencies
• ASHA or State Associations
• University Programs
• Any group or author
• Does not replace regulations, policy or procedure
• May be consulted to answer complaints or issues
• May be used to advocate for change
• Not binding but does carry weight

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Commonly Heard Areas of Concern

• Best Practices General
• Evaluation, eligibility and related services
• Specific disorders or treatments
• Licensure
• SLPAs
• Supervision
• Medicaid
• Intervention for children without disabilities
  RtI

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Guidance and Resource Links

• General SLP Best Practice and Guidance
• Visit www.seacdc.org for links to
• Speech Language Pathology Services in Schools
  Guidelines for Best Practice (Virginia)
• Speech Language Pathology Guidance (West
  Virginia)
• Guidelines for Speech-Language Pathology Services
  in Schools (North Carolina)
• Talking EBP (Virginia)
• ASHA Roles and Responsibilities
• Other links
• Ohio Masters Network Initiative in Education
  www.omnie.org

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Guidance and Resource Links

• Evaluation, Eligibility, and Related Services
• Visit www.seacdc.org for links to
• SLI Assessment and Criteria (Wisconsin)
• Guidance on Evaluation and Eligibility for the
  Special Education Process (Virginia)
• Specific Disorders /Treatment
• Visit www.seacdc.org for links to
• Role of SLP in Reading (Florida)
• Assessment and Eligibility (Wisconsin)
• CEC Evidence-Based Practice

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Guidance and Resource Links

• SLPAs and Technicians
• Visit www.seacdc.org for links to
• SLPA Guidance (Colorado)
• SLP Associates Certification (Florida)
• SLP Paraprofessional Standards (North Dakota)
• SLP Technicians (Utah)
• SLPA Resources from ASHA
• Medicaid
• Visit www.seacdc.org for links to
• Overview of Medicaid in Schools
• LEA Use of Medicaid Funds

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More Guidance and Resources

• Licensure
• Visit www.asha.org or your state licensure
  agencies web page
• Intervention for Children without Disabilities
• Pre-referral Intervention
• Response to Intervention (RtI) also known as
  Multi-Tiered System of Support (MTSS)
• Supervision
• Visit www.asha.org for resources
• ASHA SIG 11 Administration and Supervision

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www.seacdc.org
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When Rules and Guidance Conflict
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CaseloadAn Example of Conflict

• ASHA Document Recommends SLP Caseload At 45
• States May Have A Higher Limit Or No Limit

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Response to Intervention (RTI) or Multi Tiered
System of Supports (MTSS)

• ASHA supports SLP involvement
• Each state determines the allowable level of
  participation

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When Conflicts Occur

• At times, best practice may conflict with
  regulatory and procedural requirements.
• Professionals must follow the regulations and
  policies to remain in compliance.
• Professionals should investigate the issues
• Professionals may need to advocate for change in
  their state or locality using best practice
  information.

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Conflicts Occur Because. . .

• Misinterpretation and/or miscommunication
• Information shared may be either misinterpreted
  or mis-communicated causing perceived or real
  conflicts.
• Local requirement surpasses or conflicts with
  state requirements
• Guidance that includes specific examples (such as
  cut scores or tests used) are interpreted as
  rules

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Conflicts Occur Because . . .

• Some states may be required to implement
  regulations because of federal oversight
• State example
• Stakeholders and advocacy groups may have
  differing viewpoints on possible changes to law
  or regulation
• Virginia requires parental consent for any
  changes to an IEP. Parents may view this as a
  right. LEAs may be required to implement
  something that is not required at their expense.

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Conflicts Occur Because . . .

• Professional practice changes can happen quickly
• Research on sensitivity and specificity of tests
  reveals very few are appropriate for
  identification (Spaulding, 2006). Many states
  have guidance or regulations that refer to a test
  score for eligibility determinations in direct
  conflict with this finding.
• Law and regulation changes take time and
  resources
• IDEA was reauthorized Dec. 3, 2004 with rules and
  regulations published on Aug. 14, 2006. States
  regulations must follow state process which may
  extend the timelines (ex. Virginia 2010)

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Do You Know of a Conflict?
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31 Model Advocacy

• Wisconsin didnt allow minutes per month on IEPs
  which impacted the use of a 31 service delivery
  model
• SEA and stakeholder group met to discuss options
  for documenting services on IEPs
• Group drafted and SEA approved wording
• Documentation of 31 service delivery permitted

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Eligibility Advocacy

• Florida and Virginia regulations did not address
  dialect or CLD as a rule out for eligibility
• SEA gathered stakeholder input and developed
  draft language to address dialect and CLD
• Language was added to draft regulations and
  followed state process for comment and final
  approval

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Advocacy
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Advocating for Change

• Identify the issue
• Identify who has jurisdiction (federal, state, or
  local)
• Determine if compliance is required
• Determine timeline for possible change
• Identify stakeholders for collaboration
• Draft information and gather supporting evidence
• Work for change

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Advocacy Resources

• Places/documents to support your advocacy work
• SEA Rules/Regulations
• SEA Technical Assistance Documents
• Legal Opinions
• ASHA Documents

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The Change Process

• Whats Required?

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Premise

• Change occurs when top down as well as bottom
  up efforts take place (Elmore, 2004 Fullan,
  2005 Hall Hord, 2010).

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A Two-Pronged Approach

• A BOTTOM UP APPROACH
• to work at the grassroots level to cultivate
  their leadership
• A TOP DOWN APPROACH
• employ these leaders to influence policy makers
  to make the legislative and administrative
  changes necessary to move your state forward

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Hall Hord Change Principles

• Change is a process, not an event

CHANGE INVOLVES
THE INDIVIDUAL
THE SYSTEM
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• It is important to understand the human side of
  change.
• (Bridges, 1980 2001 2003).

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Hall Hord Change Principles

1. There are significant differences in what is
   entailed in development and implementation of an
   innovation.
2. An organization does not change until the
   individuals within it change.
3. Innovations come in different sizes.
4. Interventions are the actions and events that
   are key to the success of the change process.
5. There will be no change in outcomes until new
   practices are implemented.

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Hall Hord Change Principles

1. Administrator leadership is essential to
   long-term change success.
2. Mandates can work.
3. The school is the primary unit of change.
4. Facilitating change is a team effort.
5. Appropriate interventions reduce resistance to
   change.
6. The context of the school influences the process
   of change.

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For State Specific Information

• State Education Agency
• State Professional Association
• State Licensing Board
• www.seacdc.org
• www.asha.org

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Contact Information

• Marie C. Ireland, M.Ed. CCC-SLP
• Marie.ireland_at_doe.virginia.gov
• Shannon Hall-Mills, Ph.D. CCC-SLP
• Shannon.Hall-Mills_at_cci.fsu.edu
• Cindy Millikin, Ph.D ccc-slp
• Millikin_c_at_cde.state.co.us