Regulations vs. Best Practice: What School Professionals Need to Know

1. 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.Dccc-slp Colorado Dept. of education

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

3. 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

4. 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)

5. Have You Ever Heard. . . “But ASHA said we should use workload not caseload.” “That’s not how we did it in my last school.” “I heard that SLPs in another state don’t have to do things that way.”

6. 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?

7. Professionals must be aware of differences and follow state and local requirements to remain in compliance. When you’ve seen one state ~ you’ve seen one state

8. 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

9. Jurisdiction ju·ris·dic·tion/jo͝orisdikSHən/ Noun: The official power to make legal decisions and judgments. The extent of this power.

10. 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.

11. 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

12. 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 child’s educational performance” CFR§300.8(c)11 • States and LEAs may provide guidance or establish specific criteria • State interpretation of Language Impairment • Ohio • Colorado • Florida • Virginia • In your state?

13. 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: >100 • Pinellas Co: Cap ~ 45 • Colorado, Wisconsin, Utah: Local Control

14. 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.

15. 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

16. 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

17. 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

18. 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 Master’s Network Initiative in Education www.omnie.org

19. 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

20. 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

21. 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

22. www.seacdc.org

23. When Rules and Guidance Conflict

24. CaseloadAn Example of Conflict ASHA Document Recommends SLP Caseload At 45 States May Have A Higher Limit Or No Limit

25. Response to Intervention (RTI) or Multi Tiered System of Supports (MTSS) ASHA supports SLP involvement Each state determines the allowable level of participation

26. 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.

27. 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

28. 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.

29. 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)

30. Do You Know of a Conflict?

31. 3:1 Model Advocacy • Wisconsin didn’t allow minutes per month on IEPs which impacted the use of a 3:1 service delivery model • SEA and stakeholder group met to discuss options for documenting services on IEPs • Group drafted and SEA approved wording • Documentation of 3:1 service delivery permitted

32. 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

33. Advocacy

34. 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

35. Advocacy Resources • Places/documents to support your advocacy work: • SEA Rules/Regulations • SEA Technical Assistance Documents • Legal Opinions • ASHA Documents

36. The Change Process What’s Required?

38. Premise Change occurs when “top down” as well as “bottom up” efforts take place (Elmore, 2004; Fullan, 2005; Hall & Hord, 2010).

39. 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

40. Hall & Hord Change Principles • Change is a process, not an event CHANGE INVOLVES THE INDIVIDUAL THE SYSTEM

41. Change Organization Situational External Relatively quick Results-focused Marketplace/ Organization-driven Badly planned change = Painful or no transitions Individual Needs-driven Experiential Psychological Internal Process-based Gradual & slow Unmanaged transitions = No “real” change Transition Adapted from William Bridges & Associates.

42. It is important to understand the human side of change. (Bridges, 1980; 2001; 2003).

43. Hall & Hord Change Principles • There are significant differences in what is entailed in development and implementation of an innovation. • An organization does not change until the individuals within it change. • Innovations come in different sizes. • “Interventions” are the actions and events that are key to the success of the change process. • There will be no change in outcomes until new practices are implemented.

44. Hall & Hord Change Principles • Administrator leadership is essential to long-term change success. • Mandates can work. • The school is the primary unit of change. • Facilitating change is a “team” effort. • Appropriate interventions reduce resistance to change. • The context of the school influences the process of change.

46. For State Specific Information • State Education Agency • State Professional Association • State Licensing Board • www.seacdc.org • www.asha.org

47. Contact Information Marie C. Ireland, M.Ed. CCC-SLP Marie.ireland@doe.virginia.gov Shannon Hall-Mills, Ph.D. CCC-SLP Shannon.Hall-Mills@cci.fsu.edu Cindy Millikin, Ph.Dccc-slp Millikin_c@cde.state.co.us