Good News for Bill on CFY Provisional Licensure

By: Karen Sheffler

November 17, 2015

CFY Provisional Licensure Bill Brought Back to Life!

By Karen Sheffler, MS, CCC-SLP, BCS-S of SwallowStudy.com

CFY Provisional Licensure Bill H.228: An Act Providing for Provisional Licensure for Speech-Language Pathologists for their Clinical Fellowship Year.

CFY Provisional Licensure Bill H.228: An Act Providing for Provisional Licensure for Speech-Language Pathologists for their Clinical Fellowship Year.

The week of November 9, 2015 was a great week for Speech-Language Pathologists (SLPs).

You may have heard that there were 14,008 attendees at ASHA’s Annual Convention in Denver, Colorado! (Follow #ASHA15 on Twitter.)

Did you know that SLPs and SLP graduate students also packed into a hearing room at the Massachusetts State House in Boston on November 10th? These SLPs, some brightly clad in red T-shirts, were testifying and supporting the CFY Provisional Licensure Bill H.228. Never before had the senators and representatives seen T-shirts made in support of a bill! That is the creativity of the SLP!

SLPs, Representative Collins, Representative McMurty testifying in front of the Joint Committee on Consumer Protection and Professional Licensure to release Bill H.228 favorably from committee.

SLPs, Representative Collins, Representative McMurty testifying in front of the Joint Committee on Consumer Protection and Professional Licensure to release Bill H.228 favorably from committee.

Please read my prior blog, as well as the background and testimonies section below, for more details on this effort that was initiated by Barbara Wilson-Arboleda, MS, CCC-SLP (Professional Voice Specialist & Clinical Coordinator at Massachusetts Eye and Ear Infirmary). Years ago she went to her representative from Dedham, Representative Paul McMurtry (11th Norfolk District), when she was unable to hire her student intern upon the student’s graduation.

My take-home message from being part of this experience: One person can really make a difference.

Representative McMurty stated: “It’s sort of monumental, I would say, Barbara bringing something to my attention, staying the course and really building a coalition and a group of supporters.”

If the Joint Committee on Consumer Protection and Professional Licensure votes to favorably release the CFY Provisional Licensure Bill H.228 from committee, then it will pass through 1-2 other committees prior to being brought to the house floor for debate and vote.

May is “a great goal to set,” per Rep McMurtry regarding when the bill may become a law. However, we have to continue networking and writing to support it’s successful passage through the committees. Over 5000 bills are filed each session, and “only a small handful pass into law,” reminded Rep McMurtry. He advised college deans and university leaders to network and write letters, so that when their students graduate in May of 2016, they can obtain a provisional license and find healthcare jobs in the state.

Rep McMurtry stated that he hopes to “marry the bill” with a resolution to celebrate May is Better Hearing and Speech Month (BHSM). Raising awareness within our legislature has begun, thanks Representative Nick Collins. In his testimony, he shared a moving story about his “rockstar SLP” who helped him overcome his stuttering. He stated that he would not have had the confidence to run for office had the state’s licensure issue “taken away” the talented SLP who helped him for 15 years.

After the hearing, Rep McMurty took a group of SLPs to the House of Representatives Chamber to see the podium where Representatives Benson, McMurty and Collins will debate the Bill H.228. Representative McMurtry also shared the fascinating facts that John F Kennedy and Martin Luther King, Jr spoke from the center podium in the picture below.

Massachusetts House of Representatives Chamber where hopefully our Bill H228 will be debated and passed into law by May 2016!

Massachusetts House of Representatives Chamber where hopefully our Bill H228 will be debated and passed into law by May 2016!

Let this be an inspiration for the other states (listed below) who are in the same predicament as Massachusetts.

  1. Colorado
  2. Connecticut
  3. Hawaii
  4. New York
  5. Pennsylvania
  6. Alabama
  7. Tennessee
  8. Washington, DC

More Background & Testimony on the Issue:

Summary of the problem:

Eight states and Washington, DC have no CFY provisional licensure for an SLP who needs to begin his/her Clinical Fellowship Year (CFY). These SLPs cannot obtain healthcare jobs in these states, as Medicare, Medicaid and many 3rd-party payers require a license in order to bill for services. After receiving a Master’s degree and completing all the necessary requirements, “we are forced unwillingly to find jobs in other states,” testified Dayna Fisk, a graduate student from Northeastern University.

Bill H228 will allow SLP CFYs to stay in Massachusetts to obtain healthcare jobs. Without a provisional licensure, the CFY may leave the state for a healthcare job. "Let us stay; Let us work; Let us help," says the T-shirt.

Bill H.228 will allow SLP CFYs to stay in Massachusetts to obtain healthcare jobs. Without a Mass CFY provisional licensure, the CFY may leave the state to find a healthcare job. “Let us stay; Let us work; Let us help,” says the T-shirt.

Testimonies in Support Bill H.228:

1. Dayna Fisk noted how local connections and networks created by students during graduate school are severed when job opportunities in the state are limited. Additionally, if MA residents leave the state for graduate school, they are unable to bring their skills back home upon graduation.

2. Fisk reported how many graduates interested in healthcare obtain CFY jobs in the schools (which do not require licensure), but then they are less trained as medically-based SLPs if they want to switch back to healthcare later. (Note: SLPs complete a 9-month CFY in any area of the field to obtain a Certificate of Clinical Competence and a state license.)

3. Sarah Vu, SLP Clinical Supervisor at Easter Seals Massachusetts, agreed that SLPs in their CFY need this 9 months of medically-based training, rather than “jumping back (into healthcare) after the CFY to practice solo without mentorship.” Vu also noted that this is a growing area of need with our aging baby-boomer population.

3. Barbara Arboleda also described the CFY as “additional structured mentoring.” See prior blog regarding how the graduate school experience alone cannot fully prepare students for complex medical and dysphagia-related jobs.

4. Cynthia Wise Wagner, Clinical Services Manager of the Voice, Speech and Swallowing Service at the Beth Israel Deaconess Medical Center in Boston, testified how our top hospitals are training our students for 6-month internships but cannot hire these qualified SLPs upon graduation. The provisional licensure will not cost the state anything, as it will actually bring in more licensure fees. However, the lack of this provisional licensure has cost the hospitals if they are forced to hire people with no prior direct training or pay for moving fees to hire therapists from out of the state.

5. Sandy Cohn Thau, Director of Clinical Education and Graduate Program Director at Emerson College, noted that Massachusetts has 6 highly-regarded institutions that offer a Master’s degree in Speech-Language Pathology. The students who learn here tend to want to stay here, so the CFY provisional licensure would open up the job market for all these students.

6. Briana O’Neil, Vice President for Advocacy from the Massachusetts Speech-Language-Hearing Association (MSHA), testified that the Clinical Fellowship Year is 1,260 hours of a mentored professional position that is required by ASHA. These SLPs have met all prior requirements to provide for and bill for services.

7. Arboleda reminded that CFYs are NOT students; therefore, they should be allowed to bill for their services. Wagner used the analogy that when a doctor graduates, she/he can bill for services. Without this change in the law, these graduates who want to stay in healthcare are “virtually un-hireable,” per Arboleda.

8. Representative Collins testified: “Bring our state in line with the 42 other states. States that take away our talent.”

What can I do now?

Representative Jennifer Benson and Senator Barbara L’Italien co-chair the Joint Committee on Consumer Protection and Professional Licensure. They were both extremely welcoming and supportive! Benson advised the attendees that if they did not have a chance to testify at the hearing, then they should send in written testimony. She noted that all written testimonies will “go into the decisions we make.”

Please email your written testimony in support of the CFY Provisional Licensure Bill H.228 to both L’Italien and Benson:

Barbara.L’Italien@masenate.gov, or use the link in her profile on the Commonwealth of Massachusetts website.

Jennifer.Benson@mahouse.gov, or use the link in her profile on the Commonwealth of Massachusetts website.

Thank you for your action. Thousands of future Speech-Language Pathology graduates will thank you. Citizens who will benefit from a well-trained healthcare work force will thank you too. Let’s get this done by May 2016!

Follow @SwallowStudySLP on Facebook and Twitter for updates. Hashtags: #LetUsStay, #BillH228, #SLPeeps, #SLP2b.

Update as of May, 2016:

Per Barbara M. Wilson Arboleda, MS CCC-SLP, here is the status of CF Licensure Bill (which is now H.3879).

  1. The bill was released favorably from the Joint Committee on Consumer Protection and Professional Licensure.
  2. Then the bill was recommended positively out of the Joint Committee on Health Care Financing.
  3. Next, the bill needs to go through the Ways and Means Committee. Barbara is working with Representative Paul McMurtry to ensure that the bill works its way through this step.
  4. Finally, there are internal “parliamentary processes,” that will hopefully move the bill through before this legislative session ends in July.

Barbara will keep us posted on if further actions are needed from us.