COVID-19: ASHA Schools Virtual Town Hall

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COVID-19: ASHA Schools Virtual Town Hall

JEFF REGAN: Good evening everyone and welcome to the COVID-19 ASHA Schools Virtual Town Hall My name is Jeff Regan I am ASHA’s Director of Government Affairs and Public Policy, and I will be serving as the moderator of tonight’s event It’s a privilege to be with all of you this evening The ASHA Audiology Practices and SLP School Services Teams developed this town hall for educational audiologists and school based speech-language pathologists who serve preschool through 12th grade students Simply put, the pandemic of COVID-19 has had sweeping and disruptive impacts on our professional and personal lives The impact of the pandemic has been especially severe on our schools and on our ability both to educate and provide critical services to our nation’s children Over the past month, my ASHA colleagues and I have heard from thousands of you across the country during this uncertain and stressful time The concerns, challenges, opportunities, and successes you shared with us have been essential in the development of effective resources and guidance on a number of critical topics, as well as effectively advocating on your behalf We know this time has been incredibly difficult Most of you are navigating virtual distance learning platforms and a confusing array of licensure and privacy laws in order to continue services Many of you are receiving adequate support from your local education agency, many of you are not And some of you have endured job losses Your continued commitment to your students and colleagues during this turbulent time has been nothing short of inspiring Please know that ASHA is here for you throughout this pandemic and beyond It is an honor to work for you, to partner with you, and to fight for the support you need Tonight we will discuss a number of important topics related to the pandemic, including emotional, physical, mental wellbeing, service delivery, assessment, documentation, employment difficulties, and key ethical considerations These topics have been identified as most critical to educational audiologists and school based SLP’s through our ongoing engagement and partnership with you As we cover each topic this evening, I invite you to submit questions for the panelists While we will be unable to answer every question posted, we will do our best to address themes or topics of particular importance to you I am pleased to be joined by a distinguished panel this evening And I would like to recognize each panelist to introduce herself I first recognize Donna Euben Donna DONNA EUBEN: Hi, I’m Donna Euben, Director of Ethics at ASHA Thank you for joining us this evening JEFF REGAN: Thank you Donna Donna Smiley? DONNA SMILEY: Yes, I’m Donna Smiley I am an audiologist in Arkansas and I work for Arkansas children’s Hospital But I coordinate a group of school-based audiologists, and we provide contract school based audiology in Arkansas JEFF REGAN: Great, thank you Donna Julie? JULIE MALONE: Hi, my name’s Julie Malone; I’m an SLP, preschool through 6th grade currently I’m also Vice President of the Teacher’s Association for my district in San Diego I’m part of the Special Interest Group 16 Coordinating Committee, as well as a School Finance Committee member JEFF REGAN: Great, thank you Julie Michele? MICHELE HOPKINS Hi, I’m Dr. Hopkins I am the Assistant Director for Related Services and Special Programs for Alexandria City Public Schools And I oversee a group of speech-language pathologists, occupational therapists, physical therapists, and adaptive PE health and vision JEFF REGAN: Thank you Dr. Hopkins And finally Tracy TRACY SIPPL: Hello and welcome My name’s Tracy Sippl, I’m a speech-language pathologist and tele-therapist I’ve worked in schools, serving students from Pre-K through 12th grade, and, um… worked in the schools for over 24 years, and then now have been providing telepractice services over the past 7 years JEFF REGAN: Great, thank you Tracy And thank you all for being with us tonight Before we move to the specific topics of tonight’s town hall, I would like to take a few moments and share with you some additional information about ASHA’s role as your partner curing this pandemic

We have seen the following question asked in many venues over the past few weeks What is ASHA’s role in addressing the issues members are facing as a result of school closures? First, ASHA is here to provide technical assistance on your behalf related to practice, public policy, and ethics Over the past month, we have been working to keep track of changes in key laws and regulations, especially around licensure, privacy, and the utilization of telepractice Because public policy changes have taken place simultaneously on the federal, state, and local levels, a rather complex patchwork of laws and regulations across the country has emerged, governing practice and the provision of school services Tonight our panelists will offer a broad perspective on service delivery, assessments, documentation, employment, and ethics issues, and will provide some examples that are informed by their geographic location, and/or their professional expertise However, it is important to note that specific questions related to these issues are largely dependent upon the state and locality in which you work Therefore, we strongly recommend that you first and foremost engage your state and local agencies about the laws and regulations that apply to you We also recommend that you access ASHA’s COVID-19 resource page where you will find constantly updated federal guidance and state specific information about laws, regulations, practice considerations, licensure, and telepractice policies Finally, we recommend that you contact ASHA with specific questions Throughout the town hall you will see the email addresses for teams that are ready to answer your questions about clinical practice, ethics, licensure, and reimbursement We are here for you, and we are willing to work with each and every one of you In addition to technical assistance related to practice and public policy, ASHA is also here to provide you with assistance on ethical considerations I’d like to ask my colleague Donna Euben to offer some additional information and details Donna? DONNA EUBEN: Thank you Jeff Yes, I want to just to tell you a little bit about our ethics program and how you can reach us at [email protected] We also provide technical assistance via email and phone calls, and we are here to serve you, and we are responsive in terms of providing materials, contacts, and information We also provide educational materials, including statements, issues in education, everyday ethics blogs which just had an analysis of COVID-19 and the ethical considerations for audiologists and speech-language pathologists And we also are always tracking issues that need to be reflected in our Code of Ethics, and so we will be learning throughout this pandemic what issues we need to make sure are reflected in our Code of Ethics down the line, and we will look forward to working with you to make sure that that happens JEFF REGAN: Great, thank you Donna Beyond technical assistance, ASHA is also here to advocate on your behalf To support or influence public policies that have an impact on your practice or the delivery of school services Towards this end, we have undertaken a number of activities and efforts over the past month, including, but not limited to supporting nearly $31 billion in emergency funding for education programs, including $13.5 billion for K through 12 programs alone, and $3 billion for states to distribute at their discretion This funding was included in the Cares Act which was signed into law on March 27th We’ve also been advocating for an additional $12.8 billion in emergency funding specific to IDEA and special education, while noting the need to ensure that states and local education agencies have the flexibility that they need to support you in working to achieve student IEP goals to the greatest extent possible during this time We’ve also been advocating for additional guidance and explanations on how states, districts, and personnel can successfully navigate the requirements under IDEA, under FERPA, under HIPAA, in group service delivery, in order both to maintain FAPE as well as to help students achieve their goals to the greatest extent possible And then finally, we continue to support a balanced approach with respect to seeking

limited waivers for IDEA and Section 504 Including whena appropriate transition of children from Part C to preschool, minimum state complaint procedures, maintenance of effort, initial evaluations, reevaluation, IEP development review and revision, as well as resolution processes ASHA’s advocacy is continuous, it’s evolving, and most importantly it takes direction from you Therefore, I encourage each of you to remain engaged with us Contact us to share your narratives and perspectives as this pandemic continues to evolve and needs continue to surface And please consider partnering with us in advocating for policies that allow you to keep and to do your jobs during this difficult time And we have many opportunities for you to engage in our advocacy efforts through our ASHA Take Action website So with that, we will now turn to our first topic for tonight, which is a very important topic on the emotional, mental, and physical health and wellbeing of you during this time of uncertainty, during this time of pandemic And so I’ll kick things off by asking Julie, Donna Smiley, and Michele to consider the following question How should we manage stress associated with being asked to go into homes to conduct therapy or assessment, and is this even allowable? So Julie, Donna, Michele, any one of you, feel free to respond Thank you JULIE MALONE: I can’t speak for all school districts, but I can speak for my own, in that we worked for putting together a Memorandum of Understanding, specifically to COVID-19 that, that laid out some parameters for what is appropriate I would like to remind people that if Gen Ed providers are not being asked to, to do something, that you might wanna consider what you’re being asked to do Most likely you’re all under the same contract, and, and have the same rights and, and provisions as Gen Ed teachers JEFF REGAN: Great Thank you very much Julie Donna or Michele MICHELE HOPKINS I would like a […] at that DONNA SMILEY: You go ahead Michele MICHELE HOPKINS Okay, I would like to say that… also like we were talking about earlier, that it basically would fall into what your local educational agency is doing for all students And, one thing that our school division is recognizing is that the safety and the health and the… um… the mental strain on our students and staff is something that we really do not wanna overwhelm them with So we have constructed a schedule of expectations of really about structuring a day with 4 hours of time spent on the areas such as communication, instruction, collaboration, and professional development And within that, we are also saying that our staff, and we’re stressing to them that they have flexibility, and they have… the… we understand that working in the, working in the home environment is much different than working in a school environment where you can compartmentalize And so we’re allowing them the flexibility of that schedule, what that looks like, and also letting them know that this is an unprecedented time, and we are not expecting perfection, we’re all just doing the best that we can, in recognizing that and communicating with your staff about that is important DONNA SMILEY: I would say Jeff, that… certainly each of us has to do what we feel is safe, and to take care of our self first And certainly, if your district or… the, the… program that you work for is asking you to do that, and you do have concerns about safety, to certainly speak up about that, to let your supervisor know that that is a question that you have And then I think on the flipside of that, if it is something that you’re being asked to do, and that you’re comfortable with, that we also remember to give our families and our students and the people that we serve a lot of grace during this time, so that they are not uncomfortable with us coming into their home if that’s something that we’re being asked to do

JEFF REGAN: Great, thank you Donna So in terms of the…Memorandums of Understanding So I’ll go back to what Julie had mentioned before How often, and I guess it depends in part on how long the pandemic lasts, but often are these Memorandums of Understanding, or these agreements, or these, uh, the guidance that districts are putting out, how often are they being revisited by administrative staff, and how much input do our members have in their development to begin with? JULIE MALONE: Okay, so I’ll start off with that I think, I think it, it varies from, from district to district And of course, we have a lot of members who are in states that are, are not unionized In my particular district, we have a bargaining team that went, wi—virtually met with, with the district to review what it was that they wanted We… we received a lot of assistance from the California Teacher’s Association with language that would help protect our members Unfortunately, our original memo did not have very much information on Special Education, as I’m sure it’s not a surprise that Gen Ed seemed to be a, a priority because it’s the largest number of students But I do feel that we’re gonna be revisiting that and making sure that we do address all the issues that we’re, we’re facing with dealing with kids with special needs, mod severe programs, autism, the, the kiddos that are, are gonna have a little bit harder time with the distance learning model being different, and needing a lot of assistance from home So I have a feeling that if we’re not writing a secondary one, we’ll definitely be revisiting every couple of weeks of, if things aren’t working JEFF REGAN: Um-hm Thanks Julie MICHELE HOPKINS I, I can just say for my school division, that we are developing communication with parents with regards to how we would define a free and appropriate public education at this time, because the Office of Civil Rights has talked about the flexibility of providing FAPE during COVID-19 And so we have talked about how that will look, and we will, and we have talked about how schedules will be modified and services will be modified during this time JEFF REGAN: Okay, thank you Dr. Hopkins Thank you Well I think we’ll move then now to our second topic for tonight And it’s a fairly large topic . . DONNA EUBEN: has—Jeff, before— JEFF REGAN: Oh of course, yes DONNA EUBEN: Be—I’m sorry If I can just add, (Um-hm) I know that people don’t really think of emotional, mental, and physical health as an ethical issue But it is an ethical issue You can’t be expected to uphold your ethical obligations to deliver quality services (Um-hm) if you’re not taking care of yourself So, for those of who watch Parks and Recreation, the other Donna says “Treat yourself,” but really, you need to take care of yourself to be able to take care of others And, we feel like that’s an ethical consideration for you all JEFF REGAN: Thank you Donna And it’s a very… very good point, well taken by all of us So Any other final thoughts on emotional, physical, and mental wellbeing before we move on? Okay Well, we will then now move onto our second topic for tonight And as I had indicated a minute ago, it’s a rather large topic, and one with a lot of implications and interesting directions during this time And that has to do with service delivery, as well as the ethical considerations around service delivery during this pandemic As I know Dr. Hopkins had mentioned a moment ago, the Department of Education has put out guidance making it clear that a free appropriate public education or FAPE, may be provided consistent with the need to protect the health and safety of students with disabilities, as well as educational audiologists and SLP’s providing special education and related services during this time And there has been a rather great degree of flexibility that the Department has given around ensuring the continuation of FAPE Our FAPE being a civil rights issue And to that end, FAPE may include, as appropriate, Special Education and related services delivered through distance instruction, provided virtually online, or telephonically Of course this raises the larger issue of telepractice, and telepractice for educational audiologists as well as for speech-language pathologists in the schools And so I would like to put out a question to the whole panel around how you define telepractice

How you might have incorporated telepractice into your own professional work recently, um, and then also where to get training to learn more about telepractice So, it’s an open question Whoever would like to go first is welcome to do so JULIE MALONE: Well I think that your state agencies, your, your state associations are a great place to start with the, for the training piece I know that 42,000 speech-language pathologists participated in a, in a teletherapy webinar a couple of weeks ago It was free for, for California Speech and Hearing Association members I don’t know about other associations They were very fast to get information out to members who were worried So I would, I would start with the education piece, with whatever is being offered by your state association for free or little cost I think school districts are also asking the question of what kind of educational needs you have to move forward with this new model And I think people have to be willing to, to put themselves out there and say what they actually need, and what kind of technological help they need if they’re not technical But that’s where I would start with, the educational ASHA also has the free, the free PD right now that they’ve made available to all members as well, (That’s right) and that’s another great place to go DONNA EUBEN: Right JEFF REGAN: Right MICHELE HOPKINS I know as I was preparing for how to roll this out for Alexandria City Public Schools, I actually took the definition of telepractice from ASHA, and used that definition to define what telepractice was And then I went on to explain how ACPS was going to use that, and what platform we were going to use, and whether that platform was HIPAA compliant and FERPA compliant And then also, you know, we… you have to check state by state to see what your telepractice guidelines are But that information helped us craft an informed consent piece to provide to parents to give us, give us consent for virtual means, or alternate ways to provide instruction Also, I would like to say that our staff, as we’ve closed for the first 4 weeks, our staff took webinars They took the free webinars and the telecom conference that was offered And so that was a professional development to learn what telepractice was and how to create materials And so they got training that way And there are also very—a lot of free, as we were hearing before, free resources And so that helped us to get started JEFF REGAN: Thank you . . TRACY SIPPL: Could I—oh sorry Um, in terms of the schools as well, ASHA offers a lot of continuing education And through the telepractice website, and ASHA’s telepractice website, I believe some of those, the, the courses are free at this point I would also recommend if people have the opportunity too, with the pandemic, that I realize that that’s probably not the case, but there is a training program out in Maine, a telepractice training program that’s accredited through the American Telemedicine Association that offers training as far as you know actually being on site There are also different webinars that are available, again through ASHA, as well as other… um… what’s the word I’m looking for? People, in terms of blogs that talk about telepractice They usually offer some type of training as well And also be aware that there are telepractice consultants out there that can help you with learning the platform, that type of thing JEFF REGAN: Um-hm DONNA SMILEY: I think that some of the telepractice applications for school based or educational audiology would include, uh, since we, some of us may be, may provide some direct service or therapy to a student, but we also do a lot of troubleshooting with amplification I know our team has offered within our state to provide troubleshooting even to families if they want to call us Because if the child’s hearing aids aren’t working, or they’re cochlear implant’s not working, we’re happy to help connect them in, with their clinic-based audiologist, or maybe troubleshoot some of their assistive technology So that’s, that’s been one application that we’ve used in terms of educational audiology JEFF REGAN: Great, thank you Donna We do have a question that has come through from, um, our attendees

And it’s a question that can probably be best asked of Donna Euben And that is, how is it ethical that we are being asked to provide teletherapy without any training and not appropriate equipment, including confidentiality? DONNA EUBEN: It is a very… complicated, uh, question, and it is, I know, incredibly frustrating for many folks who are out trying to deliver services, and being hit with all of these demands Uh… you know, the Code of Ethics provides that you need to be trained and competent in what you are teaching And in this kind of situation, most likely it’s your employers who are responsible for providing that, those training opportunities for you So you, you know, your, your, you have the obli—ethical obligation to feel competent and skilled in what you’re doing And so, it really behooves you to have conversations with your supervisors, your special education directors, to figure out a way to get you the training that you need to deliver quality services quickly, so that you can be servicing the students, but in a way that you also feel that you’re upholding your ethical obligations Privacy and confidentiality, yes, you’re right, those are big issues You know privacy and confidentiality are really not, you know, we don’t think about it that much when we’re seeing our students face to face in schools, But when we’re starting to see them remotely, it raises so many different issues under FERPA, under HIPAA, have the parents provided informed consent, what was that, did that informed consent, how broad was that informed consent, did it include remote services, what’s in the IEP, uh… did they sign a FERPA consent form, or waiver form So you’re right, all of those issues are triggered as well So, you know, you, you really identified all the issues to be concerned with, as well as of course, wanting to comport with your state law, with your school district’s rules, with any collective bargaining agreement provisions, and… of course under our Code of Ethics, we also do define what telepractice is And we say that telepractice includes everything except providing delivery services solely by correspondence That is, you can’t provide remote services solely by written communications, email or snail mail And so, we also would hope that you would look to the Code of Ethics in terms of shaping what kind of telepractice services you’re providing JEFF REGAN: Great; thank you Donna And, if I could just ask sort of a follow-up question that was asked from an attendee Is it ethical and equitable to provide services via telepractice only to some on your caseload due to various reasons, such as limited technology for the family, family choice, etcetera? DONNA EUBEN: Uh, you know that also, you’re askin’; all the right questions and all the tough questions And I know that school districts are struggling with this since public education laws require equal access to education And so, I think, you know, uh, you are the professionals, and it’s your ethical obligation to keep the welfare of your students, your clients, paramount., And for those who do not have let’s say Wi-Fi accessibility, or, the technology, to work with your colleagues and your supervisors to figure out what other venues might exist to deliver services Whether it’s, you know, packets of materials, exercises that you know parents can do with their children at home If there’s some way to deliver services not remotely that will keep as well your health and safety, make your health and safety, and to make sure that your clients are healthy and safe as well JEFF REGAN: Great, thank you Donna, thank you very much Um, another . . JULIE MALONE: Uh, could I . . JEFF REGAN: oh Julie, go ahead please JULIE MALONE: Yeah So, um, I’m gonna quote a, a past president we had, and say that there’s always an opportunity in crisis And I think as SLP’s, we always have a concern that the district doesn’t understand what

we do, they don’t understand how we’re different And there is an opportunity here to train our administrators and, and others that we work with in how we’re different This is a perfect opportunity to do that, and share that with them, and make sure I mean, for them to understand that we’re not just talking HIPAA They are, they are paying attention to that, but are they listening to FERPA and COPPA? Are they paying attention to that? And understanding that we are answering to ASHA, we answer to our state association, we answer to, in, in California, teacher credentialing department We also answer for a state license if we have one of those And that we are working as SLP’s, with a variety of agencies, trying to make sure that, that we meet the mandates of all of those And so when one group relaxes a regulation, did every other group that we’re responsible to relax that regulation I forgot to add in of course, our school district that we’re responsible to as well And it, and it is our job at this point in time to educate people as to, you know, not only the educational piece that we need, but also meeting all of those mandates, and making sure that we’re protecting our license, that we’re being ethical, that we’re doing all the things that we need to do moving forward Making sure that, that confidentiality is, is maintained I know that Donna brought up the Informed Consent, and that’s, that’s a huge concern I think in the districts, they’re afraid to come right out and say, well this may not be HIPAA, FERPA or COPPA complaint, but this is what we’re offering, do you want it So I, those, those are things to have conversations with your district about as you move forward through this process And it’s okay if your district says no to some of these things But if you have it in writing that you’ve asked, and you’re, you’re wanting to do the right thing, I think that’s helpful DONNA EUBEN: And I think you raise a really important point, and that is to document, document, document All of these conversations and issues you raise, you know, you are the professionals You ha—uh, you are to exercise your independent clinical judgment in recommending what services are and are not appropriate for your students Just because you can provide telepractice doesn’t necessarily mean that telepractice is appropriate for all of your students And you have the obligation to evaluate the services that are available and determine whether they’re gonna be effective or not So if you have say a, you know a hearing impaired student and there’s no captioning available for the telepractice service, that may not be the right vehicle or service delivery method for that particular student And so to document those efforts, to make sure that you’re trying to deliver the quality services that you think are most appropriate, and to engage in that conversation to basically hold the, the concerns of your clients up, upfront, since many times people don’t understand the responsibilities of educational audiologists and SLP’s And… should understand and defer to your professional judgment JULIE MALONE: One other thing that I’ve heard as a concern is that districts believe that if the parent logs their child onto any number of, of opportunities, Zoom, anything else, that that is considered informed consent, because they’re agreeing to get online And I think that we as SLP’s need to be very careful as we move forward with this, because the parent’s understanding of what that looks like for Gen Ed is one thing, and it’s not the same for us And, and we, again, we have a big educational piece with, with the powers that be to make sure that they understand why we’re different JEFF REGAN: Abso . . DONNA EUBEN: Yes And I would certainly raise those concerns in writing And there are obviously additional security con—uh, features that you can use to make Zoom more private and more confidenti—confidential, but you still yes, have FERPA and HIPAA to comport with, as well as the Code of Ethics, and whatever your state laws provide JEFF REGAN: Um-hm Dr.Hopkins? MICHELE HOPKINS I was gonna say too, and, um… please make sure to ask your administrators these questions Because, sometimes there could be things going on behind the scenes that are really addressing that, but have not been communicated to you as of yet So, because I know for the State of Virginia, there is, um… definitely a discussion about equitability of services, and that we know that there’s a technological divide between our communities And so school divisions are really working with their IT departments, they’re getting,

they’re, um, they may be talking with companies, cable companies to provide additional support, they could be setting up hot spots among their schools., They could be setting up, um, equipping vehicles to become hot spots for kids to have access So I think it’s important to ask your administrator exactly what kind of questions you have, because you may have resources that you just have, that you don’t know about yet DONNA EUBEN: And I am aware of school districts that are providing Chromebooks and Wi-Fi, (Yes) to hou—hold—households that don’t have them JEFF REGAN: Um-hm MICHELE HOPKINS Right JULIE MALONE: I’m also hearing though, that districts are prioritizing those as, as they should be considering But some of them are prioritizing upper grades only, which creates a unique dilemma for SLP’s when a majority of their caseload happens to be younger students And so, what I would recommend is that you bring that up as a concern, because I don’t know that that’s always considered by…ad-administrators that are outside of our speech world, and, and let them know that that’s a concern, and also, that students that only, that have a communication device written into their IEP’s, are not the only speech students that are going to need some type of, of device to be able to communicate with us if they’re asking us to provide therapy to students in general We have to have the ability to provide it to all of our caseload the best that we can And not, um…with a packet That’s not gonna work for us JEFF REGAN: Thank you Julie Um, one question that has come in from, uh, an attendee; is a parent or family allowed to opt out of services if your district is providing teletherapy? Our district has said, to not give them the option So I’d be curious to hear perhaps Dr. Hopkins, Julie, Donna, maybe your thoughts on that MICHELE HOPKINS Well, um, we are, before we provide any type of virtual… uh, services, we are going to ask parents for informed consent And for me, for us, that means that the parent understands what telepractice is, and agrees to that If they do not agree to that, then, um… it will become a… a discussion through the IEP process about… service delivery JEFF REGAN: Um-hm MICHELE HOPKINS And compensatory JEFF REGAN: Mm, thank you JULIE MALONE: I think the truth is, parents always have the option They have the option to decide whether they want their kid to participate or not I, I think we’re all aware that no matter how hard we try, there are always gonna be a couple of cases that are probably not gonna be pretty, and…going to be a lot of work to, to work through, um, when we get back to school, But I think that what we’re trying to do is make a good faith effort to do everything we can to support our students during this crisis And it may not meet everybody’s needs, but we didn’t choose to do this, and, and… um, we, we have to do what we have, and, and make it available to everybody And it’s their choice if they wanna participate or not DONNA EUBEN: And I think it is our ethical obligation to give parents the choice You know, it needs to be voluntary and informed consent We need to explain the consequences of providing the, the therapy and services this way, and of not providing services and therapy this way, given the pada—pandemic that we’re working in And then the parents should have the choice JEFF REGAN: Um-hm Donna Smiley, any, uh… thoughts on your side? DONNA SMILEY: I, I think, um… in terms of parents, uh, choices, I think, uh, from, uh, an audiologist’s perspective, thinking about students that have hearing loss, there are lots of issues related here Donna Euben mentioned the issue related to captioning I would say, my message to all of us would be, if we’re going to use any type of teletherapy, that we wanna try to make sure that the student has auditory access if it’s a child that use list—uses listening and spoken language And we may need to, you know make sure that the student is able to auditorily access that information Or if the student uses a manual mode of communication, then we may have to figure out how they’re going to be able to access that Their interpreter that they may have in school isn’t necessarily available in the same way, but maybe they have to be involved in the, in the telepractice issue also JEFF REGAN: Okay thank you Donna This might be a good opportunity to share with everyone this evening And it’s in relation to also one question that was asked around how do telepractice guidelines vary during COVID-19

The answer, again it goes back to, uh, what I had said a few minutes ago, depends upon where you live Depends upon what state you live in, and what additional flexibility, what additional authority has been given to your local education agency To that end, ASHA has continued to develop resources to help our members understand what the landscape is like in their state, what their landscape is like even locally And so on our COVID-19 page, we have developed a telepractice policy tracker that is updated daily, and keeps track of what each state has to say with respect to licensure as well as the ability to offer telepractice services And so I would certainly encourage all of you to visit or COVID-19 site ant to refer to that policy tracker as needed And just this week, we have also finished work on a telepractice checklist for our members, which our School Services Team has put together around what to think about when providing telepractice likely for the first time, in terms of infrastructure, in terms of laws, regulations, clinical best practices, etcetera So, this is another resource that is also on the COVID-19 webpage So, with that said, I’d like to shift gears just for a few minutes There was an interesting question that came in saying, “You’re all talking about telepractice, but this is a larger issue around service delivery during COVID-19 So, but you’re not talking about other forms of access or equity What else could you be recommending for us to consider during this time?” So that would be a question that I would just open to the whole panel MICHELE HOPKINS Well I can speak to the fact that in our district specifically, our third graders through twelfth grade have had access to electronic, um, electronics They have a Chromebook Our K through 2 population does not So with that, we have done a combination of learning packets, and we have…also… said that for our families that do not have access to electronics, that we would communicate through emails, phone calls, um… and also reach out Now the service delivery is going to look a little different It’s not going to be calling and just consulting and coaching parents That may be the start of it, but also to follow up and speak with your… the students on your caseload, to determine if there are ways to collect data on, on goals that you’re working on And we have chosen to really focus on maintaining IEP goals that have been taught already to our students, so that we don’t have a, um, we’re tryin’ to keep a,… a lot of regression from happening And so, we do use pho—um, learning packets I have asked the therapists if they can go in and take a look at it, and adapt it, or create, um… language activities based on what’s in the learning packet to enhance what the student already has, so that parents are not being asked to do additional activities, um… that are coming home So yes, we, we do rely on some packets and some phone conferencing, and we do know that sometimes parents don’t answer the phone if they don’t know what number it comes from So we’ve used, we’ve asked therapists to kind of text parents and let them know who it is “So I’m getting ready to call you,” so that we can keep open lines of communication in a variety of ways We know it’s not the best, but, (Um-hm) we have to have some other options JEFF REGAN: Right, thank you . . JULIE MALONE: Um, I would also add that, um, I like what you said Dr. Hopkins, about… you know adding to the, the pile I think that parents are very overwhelmed We have a handful of parents that are really… you know, demanding and want a lot of activities, And we have other parents who are really struggling with just getting through the, the academic piece that’s given to them And I would encourage people to use everyday type activities and provide the language for parents in those la—those activities that they’re going to do, no matter what every day Getting up out of bed, brushing their teeth in the bathroom Parents probably don’t use the same kind of language that SLP’s would use in, in the descriptive piece to that So that it doesn’t have to be more for the parent, or an added stress, but they’re still getting a lot of language development out of that I would also encourage parents with some techniques for play therapy I mean those kids are going to be playing, so what can they do to enhance their language

while they’re doing that? That doesn’t require any kind of technology from, from us And I would also agree with, with telephone and, and email Those are modes of communication that have always been acceptable for us JEFF REGAN: Great, thank you Julie And as a sort of a follow-up to what we’ve been talking about We’ve been talking about technology and as well as giving different resources to parents, giving different suggestions to parents A question, uh… came up saying, “Do you have any suggestions in providing speech-language support for preschoolers who don’t have access to computers or Wi-Fi?” I think we’ve addressed that already But also, ‘Or whose parents do not speak English.” So, any thoughts on that second half of that question? JULIE MALONE: So that’s the first question I asked my principal today Um, I also asked the district I’m fortunate I that my principal is, is bilingual, and has offered to help in any way Has offered to pay for services I understand that there are several on demand interpretation companies, and I would imagine that also would work for ASL And that’s going to be an issue of letting your, your administrators know who that’s going to be required for, and putting that into place But I… don’t see that being a, a huge issue It’s a little more work for us to coordinate an extra person to bring in, but there shouldn’t be any reason why we can’t accommodate that kiddo JEFF REGAN: Um-hm, thank you Julie Alright Well we have, uh, time for one more question before we move on And that’s a question that was asked earlier around can a local education agency define direct or indirect services MICHELE HOPKINS Yes Um… a local education agency can define that And also I would like to say if you… also are billing for Medicaid, um, you may find that your Medicaid guidelines in your state define what indirect and direct services are Because for Medicaid in Virginia, we cannot bill for indirect services So when we are providing activities for parents to coach students, and we’re not doing any direct instruction at that time, we are not billing that, because that is considered consultation under the Virginia regulations, and not direct So you’d have to check with your state, and, um, see what that definition is And your supervisor JEFF REGAN: Good, ‘kay thank you, Thank you Well thank you, I think this has been a, uh, very, uh, informative part of this evening’s town hall One topic I’d like to just revisit very briefly before we move on, and we touched upon it in multiple ways over the last maybe 25 minutes, has been FERPA, and, uh, it’s relationship with HIPAA And certainly over the past month, we have seen a number of HIPAA penalties relaxed During the pandemic But it’s important to note that FERPA does remain in effect And that schools and school districts must obtain prior written consent of a parent or an eligible student, to disclose personable, identifiable information from student records under FERPA, and that those laws are still in place So we do have, uh, guidance from the Department of Education available on our COViD-19 resource page, that dives into some greater detail about the applicability of FERPA, as it does tai—pertain to COVID-19 And as several of our panelists have said earlier, fundamentally, it does remain every school district’s responsibility to provide informed consent forms to parents Whether it’s for group therapy, if the group therapy is determined by an IEP, or whether it’s also for the provision of telepractice So thank you again I think we will now move on to our next, uh, topic for tonight, our third topic, which is centered on assessment as well as ethical considerations related to assessment And so to kick things off for this part of the town hall, I’d like to offer this question again to the entire panel for consideration What constitutes an appropriate practice for assessment in the time of COVID-19? DONNA SMILEY: Jeff if I might, I would like to start as the, uh, as the lone audiologist on the, um, call JEFF REGAN: Yeah DONNA SMILEY: I’ve had a lot of questions, and I have participated in a couple of town halls that the Educational Audiology Association has conducted And one of the things that we are getting, um, asked about a lot would be hearing screenings,

because there are definitely some constraints during this time Um, I would like to give a shout out to some colleagues in Colorado; Dr. Lisa Cannon specifically, because she and her colleagues have developed some information that they’re using, and have shared with many of us And I think that information might be available on the Colorado Department of Education website But during this time, especially in states where you’re not able to physically see the student, which in many of our case, in our states that is the case We cannot necessarily be in the same space with a student There really are no… evidence based ways to screen hearing And so that, that we, that don’t require us to be in the same space with the student So, some of the recommendations that we’re hearing and that we’re making, at least within Arkansas is that, um, you certainly wanna review the child’s records If you are, for example, trying to transition a child from Part C to Part B, or from preschool to school age, to kindergarten, review the records, see if you can, you know, get with the parent, try to get some information about that And then, and then, very much document that you were not able to do a, a proper hearing screening, but that at the time, and at which school resumes, that you want that to be on the list of things that need to get taken care of at that time There, there might be some kids who you just have to say… you know, we’re so concerned about hearing loss that maybe we have to… figure out something different But in many cases, we… we know how important hearing is, but, and we don’t wanna stop further services, but we just have to, this is certainly not something that we, any of us were equipped to do So, that’s just some suggestions of ways that people might handle that JEFF REGAN: Great, thank you very much Donna Anybody else have any, uh… just sort of maybe a macro perspective on assessment, uh, and best practices during the pandemic? TRACY SIPPL: I know our SIG 18, our Telepractice Coordinating Committee, sorry, um, had held a web chat back in September, and we had 2 representatives from Pearson that were answering questions at that time You know, they know the question comes up quite often for speech-language pathologists in the schools, is to, uh, administering assessment via telepractice You know, um… allowed And the response that they tend to provide was the fact that some of the studies or, excuse me, some of the assessments have had… research studies that show evidence of score equivalency of face to face versus telepractice assessments And the fact that if you are providing, the CELF is actually one of those, you… should be comfortable in reporting those scores You still wanna cite the fact that the telepractice assessment was done via telepractice If you’re using an assessment that has not been validated, um… in terms of resulting in scores that are equal to that of face to face administration, you could also provide that information in your assessment report, and just documenting that the delivery was through telepractice, the test was administered in a standardized manner, and of course you’re gonna consult your administration manual in order to, before you even begin providing the assessment But you can also discuss, if you felt that the client was responsive, if they were focused, and those types of things And if there were any other, um, exceptions to how… how the assessment went overall, if you felt like the student was very distractible compared to what it would have been face to face, those are things you can also mention in your report JEFF REGAN: Oh thank you Tracy DONNA EUBEN: And I guess just in a macro sense, just in terms of general ethical and legal considerations I, and I think someone mentioned this You wanna look at the assessment and see if you can provide it remotely You wanna get, uh, make sure you have the publisher’s permission if that’s what your, is required You wanna make sure that you can provide the test without an interpreter or an aid remotely And also I, you know, what we’re hearing a lot now is that, um, at least some kids don’t have the privacy or the con—the privacy to be able to focus upon such assessments remotely, given the structure of their households So… what kind of factor that might be in, in terms of getting accurate test results JEFF REGAN: Oh, thank you Donna Looking at the questions that have been asked from attendees There has been some interest expressed specifically around assessments for preschoolers, as well

as assessments for students transitioning from pre K to kindergarten One member asks “Can you discuss tele-assessments for preschoolers? I work for an urban public school, and have concerns about the validity and equity of these assessments For example, something like giving a DAYC-2 via tele assessment may not be valid or equitable, if a family has no or few toys.” MICHELE HOPKINS I’m gonna say that I think that it’s important to have a discussion with your supervisor about how you would document that if you’re going to do assessments during in a virtual manner, or if your school division has made a decision about that I know that in Alexandria City Public Schools, we know that we are not exempt from federal guidelines or mandates in order to hold all of our meetings on time However, how that meeting and what’s discussed in that meeting, and the outcome of that meeting, can be discussed in the, within the COVID-19 realm And what I mean by that is that you can still meet, and you can still go over the existing data that you have You can still talk about what you need in order to make a determination whether there’s an adverse educational impact or not However, our school division, uh, is not doing any assessments during this time, because we feel that it is an equitable, uh, equit—equity issue, and so we’re saying that… we may recognize the need for the assessment, and that we will do the assessment, however, we will… do that if the parents give us opportunity to extend to when we get back into school to complete it so that we can make sure our measures are valid and equitable (Um-hm) Um… but however, if you, if your school division is not going to do that, then I think that you should note in your report that, how this assessment was given, under what type of environment, and that should be described in the report JEFF REGAN: Mm, thank you DONNA EUBEN: Document, document, document JEFF REGAN: Yup And it’s important also to note that… there have been extensions under the IDEA timeline And this is something that was just intimated a minute ago Extensions can be made through discussions with parents So it is important for our members to know that that flexibility is one of many flexibilities given to them during this time One final question, and it’s sort of on the backend with respect to what guidance do you have in regards to completing upcoming annual reviews for students during school closures in regards to assessment, such as obtaining data for present levels, etcetera? JULIE MALONE: Well I think like Dr. Hopkins said, you really need to work with your… administrators and find out what direction they want you to go They’re going to tell you what their expectations are and, and, and what their thinking is going to happen If it’s something that you ethically feel like you can’t accomplish, then that’s a, that’s another conversation to have with them But I would look to your school district for direction on that JEFF REGAN: Thank you Julie Any final comments or thoughts on assessment before we move on? Mkay Well we are now going to turn to our fourth topic for tonight And it’s something that we have been… talking about at various points already this evening, and that is documentation and ethical considerations “Documentation, documentation, documentation” might be one of our cheers for this evening But it’s very important that during this time of national emergency, especially when FAPE requirements remain in place, the flexibilities that have been given in order to ensure continuity of FAPE It is very important for our educational audiologists and SLP’s to keep detailed documentation about their interactions with students Everything from what they’ve tried to do, to what barriers they’ve faced, as well as to what progress has been made during this time And so, to kick off the discussion here, one question that we have heard again in various venues coming into the town hall this evening, is “How can I keep student records safe at home?” And this is something that I would be happy to open up for the entire panel, if anybody has any comments or has any perspective on it TRACY SIPPL: I think that, um… it’s important to consider it as if you were working on site You know, what would you do there to keep your records confidential? So not having papers laying out in the area where other family members pass through If you have an office space, to be able to keep those records and documents in that room with a door that you can close or lock, or in a file cabinet that you can close or lock

Also making sure that… any documentation you may have available on your desktop not be visible to anyone else So, and that’s one of the things that I, um, usually push very strongly is the fact that, it’s at all possible to provide telepractice in a room that’s designated for telepractice, so that you have a door that you can close to eliminate any of those types of interruptions or disruptions But also, um, for confidentiality purposes as well, JEFF REGAN: Um-hm Thank you Tracy DONNA EUBEN: Um, under the Code of Ethics, uh… we talk about the need to keep, uh… the records of students and files confidential And again, in this pandemic, we really have been looking to what are the kinds of security provisions, um, you have in your offices, and how can you replicate them in a home setting So encryption, password protection, um, make, making sure you don’t give your password to others If you can have a locked room or a locked file cabinet, or a locked briefcase, but something to ensure that the records aren’t just laying out for other people in the household to see JEFF REGAN: ‘Kay, thank you Donna So one question that comes to mind as we’re talking about documentation, is sort of this renewed focus And… thinking about what life will be like, what service delivery might be like beyond the pandemic Do you see any potential sort of long term changes to documentation practices that are put into place now because of the pandemic? DONNA SMILEY: I think, uh, uh, to, to steal a little bit from something that Julie said earlier I think we have to see the opportunities here I think one of the discussions again that we have had within the educational audiology world, is that… you know, this may push us to… to have more electronic types of records that can be stored securely, and then that we can access from a computer, um… in a way that does not disclose that information But I think there’s an opportunity here for us to… post pandemic, to… look at how we keep records for students JEFF REGAN: ‘Kay, thank you Donna JULIE MALONE: Um, I was gonna share that one of the things that I, I learned a couple of weeks ago in the midst of this was… mail merge And, um, if you happen to be a, a Google user, or have a Google suite like my district does, there are several add-ons that you can access And it allows you to, you know, at least for an overall letter, write one, but customize it for every single student It does it automatically But the beautify of the mail merge is actually the documentation piece And there are several different add-ons that you can use A colleague of mine shared that she was using Yam, and it told her every time a parent actually opened the document that was sent And all of that had an electronic stamp on it And, you know, I struggle a lot of times getting parents to respond or saying that they didn’t receive something And so I have a feeling that moving forward I will probably continue to use some of the add-ons to the email that allow me to keep better record in my own email of what’s going out and coming back from parents JEFF REGAN: Thank you Julie We have had one question come in from, uh, our viewers this evening And the question is, “What are your recommendations for collecting data and progress monitoring on goals? JULIE MALONE: So that’s a discussion I’ve had with a number of SLP’s that I work with, looking at some of the options for providing therapy online, the different games, boom cards, things like that that have data trackers, and talking again about whether or not those have those privacy components that we wanna make sure that we maintain So those things are out there to help you maintain data collection I think the question is whichever one you’re using, whether it’s compliant with the, with keeping the children’s privacy JEFF REGAN: Great, thank you So and another question that we have fielded previous to the town hall but relevant to this discussion Some school districts are requiring recording of sessions, in some cases to protect the school district in the future from a liability standpoint “How do I address concerns of privacy and easy access to video files?”

MICHELE HOPKINS I will speak on that And, um, as I said earlier, you really should share your concerns with your administrator with regards to what your needs are as a speech-language pathologist or an audiologist Because not all administrators understand and; understand that perspective And so I think that’s important because with our division we have decided not to do any recordings when it comes to a direct therapy type of situation However, if you wanna do a recording to talk about how to coach a parent through how to enrich the language activities that are going on in the home, that’s fine But recording students, we have chosen not to do that So I think it’s really important to share your concern and what you, about confidentiality and, and what that means to you DONNA EUBEN: And again, I think it raises the whole informed consent issue and the parents understanding, and that it being voluntary And then also I think, as, uh, the school district needs to have some policy about what happens to those recordings and what, what privacy settings are gonna be on them so they don’t get abused or disclosed in some inappropriate way JULIE MALONE: And along those same lines, most districts have a form that, that parents already sign about photography and video and whether it can be used, and if it’s only internal versus something that can be seen outside of the school So I would also look at those records before doing anything as well A parent may have already said no JEFF REGAN: Mm, thank you Julie And we’ve obviously been talking a lot, and for very good reasons, about protecting the privacy of students, and student privacy Another sort of a flipside to the coin related to this issue is the question of how do I protect my privacy as a provider from families For example, they know what my house might look like And they now know who my family members might be, when before the pandemic, that may not have been the case So any thoughts on protection of provider privacy? TRACY SIPPL: Could I speak to that? JEFF REGAN: Sure, absolutely TRACY SIPPL: I think it comes down to the fact again, having that, that telepractice space, a room available The idea is, and I, with the pandemic it’s a little different I think because you have so many con, con, conflicting different, um, variables coming into the equation But, by having that secure space or that quiet space with a door, um… that alleviates a lot of those issues of people coming in And I, I know there’s different aspects that can pop up, especially if a clinician has other children at home needing to find somebody that would watch the children, or that type of thing But if you can provide services from a quiet space, um, there should be no reason that you children come in, and are seen in the background You want your background to be as professional looking as possible, so like having a, a trifold screen up, or using, you know, having your back up against a wall, or your desk against a wall to be able to kinda keep some a that professionalism, but also some a that confidentiality on your end as well JEFF REGAN: Great, thank you very much Tracy DONNA SMILEY: One of the probably low tech options for, uh, protecting your privacy if you’re gonna use your own personal phone, um… to contact parents, you certainly, and, and you don’t want them to have your telephone number, then using some of those ways to block the caller ID And you may have to tell the family, this is how I’m gonna call you; it’s gonna, it’s gonna show up this way But on a lot a smartphones, you can set that in your phone settings Or if you’re using a, a landline, or, or even on a cellphone, you can use *67 and it will block your caller ID And sometimes that’s a, a wall that we need to put up in order to protect our privacy, and to protect our, our free time JEFF REGAN: Great, thank you very much Donna MICHELE HOPKINS You can also use applications through Google that will give you an alternative number (Um-hm) that is attached to your number that you can call that will remain constant when you’re talking with families too Because sometimes, um, I know some people look at their phone, and if they see it’s something, someone who’s masked their number, they won’t answer So, to get around that as well, you can get an alternate number JULIE MALONE: Well, and in addition to that, if you’re having to have a parent return your phone call to make, to schedule a session, you can use *67, but you’ve gotta give them a number that they can reach you at (Right) And so that, that Google number alternative means, um, comes in handy with that

JEFF REGAN: Great, thank you very much Thank you very much Well I think we are ready now to move on to our fifth and final topic for tonight And that’s the very important topic of employment of these, uh, and ethical considerations around employment during this time And so, uh, to begin, certainly can ask the entire panelists, or, or the panel members this question How can contract employment safeguard themselves against issues like being let go during this time? So, any thoughts on that question? DONNA SMILEY: This may seem to be a little bit Pollyanna, but, I do think that again, we have an opportunity to try to demonstrate, especially in, in a contract situation, the value that we bring to the table in seeing students And I can certainly think about that as an audiologist that participates in contracted services But I also think this would be true for contracted speech pathologists And I think it’s, it’s a time for us to think about how can we interface with our, uh, regular ed colleagues? How can we provide, um… um… activities for families? How can we support other staff, and help them kind of think about ways to, uh, enrich their activities? So I think it, it’s something that has made me think long term about how we make sure that the services that we provide, as well as the resources that we provide, that they have some value and that we’re certain to share with our schools that we contract with, what, what we bring to the table JEFF REGAN: ‘Kay, thank you Donna JULIE MALONE: I’m gonna take a guess that contractors are gonna be very busy once everybody goes back to work, delivering compensatory services to students (Laughs) JEFF REGAN: ‘Kay A very good point Well, I can take this opportunity also to, uh, let all of our members know that Congress has been looking at the small business side, the contract employee side of the pandemic And in ASHA we talk a lot about impacts on our members in school settings, as well as in healthcare settings But also there’s the component of our members who are contract employees, who are members of our small business owners Or members who own their own private practices, and provide services in school settings And so the Cares Act which I had mentioned at the beginning of this evening, which was passed into law at the, uh, end of March, had a number of provisions contained within it to provide some disaster relief and disaster assistance to those individuals to those small businesses that have been negatively impacted by the pandemic And so we have again on our COVID-19 page, a reference tool that provides some additional information around potential resources that are available to independent contractors and small businesses And those resources include a $350 billion paycheck protection program that is in effect through the end of June It’s a program that provides eligible entities with government backed interruption loans which could then be forgiven if the borrow, borrower keeps employees on its payroll In addiction—in addict—in addition to the paycheck protection program, there’s also the Economic Injury Disaster Loan program, which now provides both grants and loans to eligible entities that have been impacted by the pandemic There are also a number of tax credits that are being put into operation, into effect for this year And again, we will continue to update this information as more guidance comes out of, uh, the Trump administration And as more information is known (Pause) So, any other thoughts on employment during this time? Any other comments, related to employment retention? DONNA EUBEN: Um, I know that we’ve been receiving a lot of calls from working parents You, um, SLP’s or audiologists who work in schools who, you know, used to have to juggle during snow days, working and taking care of children, or elderly parents, and now… it’s just a regular thing

And how to work during the day delivery stu- services to students while taking care of children fulltime., because childcare and schools are closed Um… and… what kind of flexibility there can be given that they have to deliver services to students at the same time as they’re taking care of their children And I didn’t know Jeff, if you wanted to talk a little bit about the Families First Coronavirus Response Act as, you know, perhaps something that would be of help to parents who…to providers who wanna take some family leave JEFF REGAN: Yes Now the—Donna, that’s a very good point to raise The legislation that was passed a couple of weeks ago does provide mandatory paid, uh, sick leave for individuals And so, it does speak to the government, the federal government at least, trying its best in the current political environment, in the cur—in the current, uh, environment and pandemic to try to give some relief to employees as well as to providers who are negatively impacted by the pandemic And as we know, the pandemic has an impact across the spectrum, through our professional and personal lives We do have a question that has come in from the attendees “What about getting our employers to help us offset the costs of online therapy materials, such as boom cards or iPad apps? Anybody have any thoughts on that? MICHELE HOPKINS You should contact your administrator and talk about what your needs are, as a department or as a group Because all school divisions do have budgets, and… they can allocate resources But they only, they know what their resources are But I think you should start there JULIE MALONE: I think that school districts are gonna be very concerned with spending what they would consider to be additional funds, um, in light of what’s happening with our economy right now But one of the things I would ask my district is if they have document cams that, that you could take home and use Therefore, you could use material that you, you normally would, and be able to access them with, without so many costs TRACY SIPPL: And there are actually quite a few, uh, free resources online From using like your own picture cards that you maybe had in your tele, or therapy toolbox so to speak, to…even doing a Google search to find free resources, educational resources There are a lot of free things out there that you can implement and use for telepractice MICHELE HOPKINS I know that Teacher Pay Teachers oppo—offering, um, free membership until the end of the schoolyear, if your administrator looked into that for you, to help out with people JEFF REGAN: ‘Kay, thank you And, uh… one final question comes to mind too And of course we don’t have a crystal ball, but knowing that this pandemic is going to have both near term and long term impacts on a variety of elements pertaining to school based services Any thoughts on sort of maybe a longer term impact that the pandemic has on the workforce, especially for educational audiologists and school based SLPs? MICHELE HOPKINS I will say for my school district and what I see happening, I see that telepractice may have implications in the future on how we provide services, even when we’re back on, back at school Um… to have access, or, or to give additional points of access for families I know that this was brought up like a couple of years ago, and there was a concern about you know, how the community would take it But I think now, that we’re forced into coming up with alternate ways, is gonna open a pathway and open a discussion for alternate means to provide therapy JULIE MALONE: I agree And especially when you start thinking about like our home hospital type students Um… usually, you know they’re, they’re a one off in a certain location compared to your caseload at a school site And I think that that might give SLPs especially with high caseloads, a lot of flexibility while still meeting student needs JEFF REGAN: Thank you Michele, thank you Julie Did have one final question that we have time for come in from one of our attendees Do we know how compensatory minutes will be addressed? Is that something that, uh…Michele, Julie, have been discussed within your school districts at all? JULIE MALONE: I think we’re expecting it I think we’re expecting that it’s, it’s going to come I think, uh, again, we wanna offer as much as we can, um… and, and, and avoid it as

much as possible But I think that there are gonna be some families that there won’t be any avoiding it Um, but I’d also like to remind everybody that during this time, to go slow, to go fast Everybody is really excited I think, and, and… and anxious to get started with this And I think we, we, we jump into it slowly, start learning some of the pitfalls, start learning some of the positive things that are gonna come along with it, and then start building on that And then I think we’re gonna have a much more positive experience, instead of that of just rushing to just do everything all at once (Um-hm) And I think that when parents see that, that progression, and that, that therapy is improving, and that the system is improving, um, I think you might have fewer parents asking for compensatory I think they might also appreciate the learning that they’re going to get, and how they can support their child more at home when they’re not in therapy JEFF REGAN: Excellent, thank you Thank you Well, um… we have, uh, now come to the end of our discussion period I think the time has gone by very quickly, but I also think it has been time that has been very well spent First and foremost, I would like to take this opportunity to thank ASHA’s Audiology Practices and SLP School Services Teams, especially my colleagues Regina Zappi and Jaumeiko Coleman for their extraordinary efforts in planning this evening’s engagement with all of you I would also like to thank each of our panelists for joining us this evening And I would like to invite ach of them to make some closing remarks before we close out So, we can start with Donna Euben Donna? DONNA EUBEN: Oh I was gonna go last because I’m the staff person JEFF REGAN: Oh (Laughs) DONNA EUBEN: Well, let me just say that it’s a, a privilege and an honor to work for ASHA and work for you And to reiterate that… we realize that this is ethics in the real world, and we’re eager to work with you and to learn from you And please do reach out We are here to service you Thank you JEFF REGAN: Great; thank you very much Donna And certainly thank you for all of your insights tonight around the ethical implications associated with these topics that we’ve talked about Donna Smiley? DONNA SMILEY: Yes I, I would just like to say that, um… I hope that, that those of us who work in this field will take some time to take care of ourselves, and that is, uh, probably more challenging these days Even though we may be spending a lot more time at home, we may be spending less time taking care of ourselves So, take a break occasionally Do the best that you can for your students IDEA and, and all the other regulations certainly weren’t written for this timeframe And, you know learn something new and fun Do something with your family, or learn online And, this may be more than you wanna know about me, but during this pandemic time, I’ve had my 17 year old teach me how to play 5, uh, 5 card poker, which I can’t even call the right thing, but, uh, Texas Hold ‘Em So, for those of you on the call that know me, next time I see you we’ll play some Texas Hold ‘Em But take care of yourself JEFF REGAN: (Laugh) Thank you very much Donna Julie? JULIE MALONE: I would piggyback on that We are saying that we wanna give parents grace, but we need to give ourselves grace as well We’re good therapists, we know how to do that I think we can transition that to a telepractice model We might not be perfect at first; I don’t think anybody’s expecting perfection I think we just wanna serve our kids the best way that we can until we get through this, and, and we’re gonna come out the other side JEFF REGAN: Great, thank you very much Julie Michele? MICHELE HOPKINS Yes, I would also like to reiterate what was said earlier That this is a time that is unprecedented You are not going through this alone All of the states and LEA’s are going through this at the same time And we all do not know, you know, what the future holds All we can do is plan for now So be flexible, be good to yourself, and know that you have to let go of perfection and having all of the answers, because we just don’t right now JEFF REGAN: Thank you very much Michele And Tracy? TRACY SIPPL: It’s been an honor to be here tonight and be a panelist I wanna thank you for that Um… I guess with my closing remarks, I’d just like to remind you that you have the clinical skills You have those speech and language, your, your mental tooth, uh, toolbox to be able to… provide those services

So really the telepractice aspect of it is just another form of service delivery So rely on those skills, rely on, um… and fall back on the feeling that you know, you know, you know how to deliver those services, it’s just a matter of using a different, um, modality And also incorporate parents, if, if at all possible This is like the op—perfect time to work with students and bring in those carry over skills, the parents actually get to see what their children are doing, and, and integrate them as much as you can, because a lot of them are very willing and able to participate in the therapy session So use them as your hands and, and it, it can be a learning process for everybody JEFF REGAN: Fantastic; thank you very much Tracy Well, in closing, I would like to thank each of you for attending the town hall this evening And I would like to also thank each of you for what you do each and every day in your communities to make a positive impact on the students you serve This evening you heard broad, and informed perspectives on a number of important topics around service delivery, assessments, documentation, employment, related ethics issues However, as I intimated earlier, given the patchwork of laws and regulations that have emerged nationwide, it’s important to note again, that specific questions related to these issues are largely dependent upon the state and the locality in which you work Therefore, we encourage you first and foremost, to continue engaging your state and local education agencies about the laws, the regulations that apply to you Please continue to access and visit our COVID-19 resource page, where you will always find constantly updated federal guidance, and state specific information And finally, please do not hesitate to contact us This town hall will be available on our website within a week, and it will not be our final engagement with you going forward I know there are additional discussions about doing something specific to telepractice as this pandemic evolves The bottom line is that we are all ASHA, and we will all work through this together So stay healthy, stay safe Thank you and good night (The others say goodnight.)