Hey, fixers. I'm Dr Jeanette Benigas, the owner of fix SLP, a grassroots advocacy firm here to challenge the status quo in speech language pathology by driving real change from insurance regulations to removing barriers that prevent full autonomy like the CCC, this podcast is your space to learn, engage and take action in the field of speech language pathology. We don't wait for change. We make it so let's fix SLP, you
Hey everybody, welcome back. It is Jeanette. I've got Preston with me. Preston is in the car, so if you hear any audio issues coming from him, that's what's going on. Hi, Preston,
Hi. I'm driving down Interstate 30 here in beautiful, Little Rock Arkansas, trying to balance both fixing and work. And wow, we have seen a lot of exciting things going on, particular on the legislative front, and I'm really pumped about that.
Yeah, I want to talk about some of that, but before we do we often read an apple podcast review. If you haven't given us a five star rating and review, please do it, please. It really helps people find us. It doesn't do a whole lot otherwise, but what it does do is it puts us into the recommendations for people who are interested in some of the same things as you are, and so that helps us reach more SLPs who aren't necessarily on social media, but I really pay attention to our metrics. And in that rabbit hole, this week, I found some random podcasting website, and I don't remember what it was, but we had ratings and reviews on there, and so there were just two written reviews. So I took a screenshot of them. One is actually from 2023 and one is from 2024 but I wanted to shout these people out because I didn't know they were there. So we've got Julia s who said, amazing work and essential listening for all SLPs, keep up with this one for the betterment of our profession. And Greg Proops said, so informative and transparent really makes you pause and think so. Thank you to both of you, if you're still listeners, sorry, it took like one to two years later for me to read. I just found it. So yeah, first, before we go any further, hot off the press, Arizona just entered the interstate compact. So if you haven't heard our interstate compact episode. Go back a few weeks. We've got Arizona in that's a huge deal. Congratulations, Arizona. It's for real now. That's amazing, but we've got some other things going on in states. Preston.
I kind of want to start with Michigan, if it's okay, because that is being something that it's kind of at the nucleus of fix. SLP, a big part of our team are Michiganders, and the bitty draft bill that we started with last year has now been introduced. It is a very simple bill that it's now been read before the Michigan State House and will be assigned to committee. It's something that we have, I think we've posted about already, so I invite everybody to go have a look. And for those Michigander SLPs that are out there, it's a great time again to get in touch with your state reps, your state senators, and let them know this bill is one that needs a swift passage. And how about unanimous passage of that to again, just reinforce that the SLT is defined by its state license.
Mmm-hmmm. And so it actually has been assigned to committee. It's House Bill, 4484, it's been assigned to committee. We are hopeful that it goes through the house pretty quickly, because it is being spun, it's being co sponsored. We had no idea that was going to happen, and I think that is a result of the work that Michigan SLPs have already done, where they've written to their senators or their house representatives. So it was introduced in the House with one person, Senator Fox, I believe, I hope I didn't mess that up with a
No, it's a representative Fox, but yes, you do have it right?
Okay, a good handful of co sponsors. So we're hoping we see that go through, but then it does have to go to the Senate. So we we have at fix, slp.com, in the top bars, there is one for a call to action for Miss. Again, and you just click that, and what it's going to do is take you to our blog, because I had already blogged about the changes that we've made, and this house bill is an extension of those changes. So what this house bill is going to do, if it's passed into law, it will make it very difficult for Medicaid, in particular, to go back to requiring the CCC, and I want to make sure I tried to be clear with the things that we have posted that we're not in danger of this happening. It's not like someone has threatened it. It's not like they're trying to our knowledge this was just the next step to really solidify and protect Michigan SLPs from needing the CCC. And we'd love to see this happen in every state, but Michigan has kind of been our template for everything else we're doing. So that's all it is. We're not in danger. It's just making sure that it would be very hard for this to get changed. And all it's saying is, all you need is a state license to get credentialed in our state. And so that's, that's what we hope will pass. So I put, what I did was I put an update that says, Click for the update here, so you can see it in the blog, everything that's been done. And then you just click the link at the top, and it will take you to our folder of resources, which is the letter, the instructions, information to contact the people from your house or senate, and we have everything you need right in one place. So that's at the top of fix. Slp.com, just click it, it'll it'll get you everything you need. It really has been the culmination like this. This is almost like the love child of our current team. So you know, you and I met very early on. We had some phone conversations. I sort of connected you with some girls in Michigan who were trying to do something for a long time. I wasn't, I didn't even know what they were doing. Then I kind of, like pushed my way in because it was sort of fix SLP adjacent and and, you know, now we have Michaela and Alexa on the team. You're on the team. It was just the four of us started working together and worked together well, and here we are. So this, you know, it really is. And I think they started having conversations in like, February of 2024, February, March. So we're looking at like 14, 1415, months of work to get to this point. And it's, it's exciting to see, and it's exciting to watch
It is and we've often so we've often said, this is the template Jeanette, this is the guide that we want as we take it into other states, because we have, as we have seen in some other states, those Asha rules and some of this backwards thinking. It's like termites, and you just have to stay vigilant, because once you think that, okay, you know we are heading in the right direction of what defines our profession. It's not this little girl scout badge that you can go out and buy. It's all of a sudden here it comes back again. And so having that template that we can take to other states is very important.
Yeah, and what's really important to point out is that Fix SLP as an entity, Fix SLP LLC, is not doing this work. The work done in Michigan happened because Fix SLP inspired three clinicians who didn't know each other to start a conversation, to talk about the problem with Medicaid in their state. And they got their hands dirty, and they dug in, and they started doing the work without us, and what we were able to do as fix SLP was bring your knowledge with Legislative Affairs, and my knowledge of how to kind of lead people and form a movement and really elevate them on our platform. We didn't do the work the Michigan SLPs did the work. We collaborated with them and their team, we were able to empower them, elevate them, fund some of what they did in terms of postage and a couple other things. And so that is where we are, very valuable to these state teams who are collaborating with us. So if there is something that you want done in your state, don't wait for us. Start it. Get a hold of us. States at fix slp.com and we can collaborate with you. We have states that we've launched, but there are a lot of other states where there I have lists of people waiting. They just need a leader, and we can't do that. So if you're inspired. Inspired by what's happening in Michigan and you see a problem in your state, get going. Give us. Give us a shout through the email, and we can collaborate with you.
I do want to do an update on the Lone Star state bill, SB, 905, that we have talked about before. This is the bill that will get rid of the provisional licensure in Texas. But we would like to see that bill amended to where there is an equal recognition, if you will, for reciprocity for SLPs that are coming into Texas, rather than just carrying a certificate of clinical competence, you can carry your state license in there, because, as it stands right now, if you come into Texas and you try to get a full licensure there, should this bill pass, you will have to retake the Praxis if you don't carry the CCC, and we recognize that as a in congruence. So we have a letter that's out there right now on the website to contact members of the Texas House Public Health Committee. The bill has not yet been assigned. I checked ledger scan this morning. There's still not an assignment date for that bill in committee, but we expect that it should be anytime in the next few weeks. So we're keeping an eye on that bill and to try to again maintain that recognition of our state license.
Yeah. And then we have Virginia, Virginia, self proposed getting rid of the CCC in terms of the only option for initial requirements. It was passed. It was put into effect in February. You can go look at that legislation. Now we have that linked up as well at fix slp.com, where it says it now has the or which we ultimately would love to see go away. But hey, Virginia, first first step here is you can have the CCC, or all of the things that would have been required for the CCC, so yeah, a lot going on. A lot of state senates, House of Representatives, everybody's in session. Be paying attention. If you see something, let us know. We'll work with you to see if it's something we should be putting out. We can help support you there. So today, to continue our conversation about pay 1099, W2 we have Elise Mitchell. Elise is the owner of the Therapist Support Betwork, so she's going to talk to us about some contracting things. Thanks for coming on, Elise.
Thanks for having me!
Sure! Why don't we have I prepped you before we started, but we've got a pretty broad audience. I told you. I suspect that a lot of our listeners that were more heavy in the pediatric school SLP population listening to us, so they might know who you are, but our med SLPs are not going to know who you are, and I told you full disclosure. While I recognize you from Facebook, and we're in some business groups together, I don't follow your work, so I imagine there's a good solid chunk of people who don't know who you are, don't know what you do. So I'll let you tell everybody about that?
Yeah, I'm Elise Mitchell. I am a speech therapist. And years ago, 2019 I founded the Therapist Support Network. It is a business where, originally, when I founded it, I focused on just teaching fellow providers how to directly contract with schools. And then I expanded my business shortly after that, to also teach or coach providers on how to basically create their own staffing agencies. So I work really hard to support providers with feeling empowered enough, if they feel compelled directly contract with schools, or even empowered enough to start a small business or to even scale to agency status, with a focus being on provider run businesses. So that is, that's the therapist support network in and of itself. I also for people who are like, maybe I've heard that name, but I haven't heard of the therapist support network. I am the admin of the Facebook group, SLP, ot PT, school contractors. So a lot of people know me from there. And I also have a podcast beyond the big agencies, where I talk a lot about the importance of provider run businesses. So those that's also where people may have heard my name but not have heard my business.
And now I'm embarrassed, because if I would have known you had a podcast, I would have binged it in preparation. So now I'm gonna have to do some post binging. We'll make sure that's linked up as well. If people are interested, we'll put that in the show notes for everybody. I want to say for every, all of our med SLPs don't zone out because contract. Directly is where it's at in terms of making money. And I think we have some different challenges in the med SLP space, because we are largely held to the compensation rate of Medicare. But I have friends who are very successfully contracting with places, really, specifically, a friend of mine in North Carolina is in the middle of negotiating contracting with a hospital. I do PRN work at a an acute care center. I'm, I love doing it because I'm I do on call once a month, and then sometimes fill in when he goes on vacation, but typically when I'm on call and I get called in, it's to go to the ICU. So I get to see not that I want people to be sick, but I get to see really sick people, which, you know, we're not seeing in home health when I was doing that. But the man that I work for is his own company, so he contracts with the hospital as the speech therapist. Everybody else is in house at the hospital except for him. I'm just going to shout him out, Hey, Gary. Gary has this business where he just contracts straight with the hospital and cuts out the middleman. So I have a feeling anything that you are going to say will be generally applicable to everybody. Absolutely, absolutely, yeah, yeah. So I'm going to read you a question. This was very timely. It came in five hours ago on Facebook. This was in response to last week's episode. So if you're listening in real time or you're catching this a year from now. Just bump back a week. So this is episode 79 bump back to Episode 78 and listen to the episode with Meredith Harold. So this was on one of the Video Preview clips that we posted, and this, SLP, said, as an SLP, why is this unique to SLP compared to other professions? And what she's talking about is the move towards 1099, versus w2 but then what she says is also, if you're working for a school district, you are salary, you are never hourly, and we know that's not true, right? Yeah, all of that for people who don't quite get it,
Yes. So first of all, there actually are hourly employee positions working with schools. There are every now and then, particularly in rural districts. So there are even employee positions that are hourly, but the shift to 1099 isn't unique to SLPs at all. But what is unique is how vulnerable our profession has become to this topic. The reason I say that is because we are a mandatory service at schools. So schools are required to have SLPs, but unfortunately, so many schools pay SLPs on a teacher pay scale. And you know who doesn't pay on a teacher pay scale? Other Other settings, hospitals, etc. And so therefore it is profoundly difficult for schools to require in house or to to have in house providers. So they have to turn to other avenues so many of the times because they can't incentivize SLPs to work in house. And SLPs, I think, are one of the more talked about, because in that situation, we are you, we are often the ones that have full time roles, as opposed to PTs and OTs in schools, many of the time they have part time roles. And so they, just, in my experience, more easily gravitate to 1099, right, because of just the way the scope of practice works and qualification in schools, SLPs in particular, our roles there are often full time, and so we're in this weird space. So it's being talked about about a lot more with SLPs, because it's not unheard of that schools can't recruit and schools turn to an outside source. What is being more commonly talked about is that outside source doesn't have to be a large agency. That's what it has been, and it doesn't have to be that. And so that's where the topic comes in. That's why I started my business. That's why so many of us are advocating so with the salary, schools absolutely will pay hourly their contract services when they contract out, when they can't recruit in house. That is typically when hourly compensation comes up,
Yeah, and I, I'll insert here too. I did start as a school. SLP, yeah. And I've seen a couple comments here and there, not just with this content, but with other content as well. It comes up that, oh, you can't negotiate if. Your school? SLP, they're on steps, and I am here to say that is not always true. For my first job, for my CF, I worked for a private practice, but they contracted me into a school. And for my second job, they gave me that step. So I even had a comment recently that if you move from district to district, you start back out at step one, not always true, and if you are getting a job in a rural area, you can use that to your advantage. So I negotiated. I had two offers. One offered me $5,000 less than the other, and so I played them back and forth between each other and the one that offered more. I even got them to give me a step of credit for the year that I had done before in the schools. So take on those steps, take on those negotiations. Educate yourself.
Well, and I also think it's so important and the internet is as someone that admins of Facebook group and that I mean so much, my life is on social media. The tough thing with schools is I see it all the time. I see a comment that's like, oh, schools won't negotiate. And when you talk to that individual, they've worked with three districts. And I think one of the unspoken things, or maybe it's spoken about, and I just didn't hear about it until I was really in it is districts change. Districts vary. And so if you see a comment like that, don't let that shut you down, because just because that individual had an experience with their school, that wouldn't budge. And also, states are so different, like states where school SLPs are unionized, totally different than like here in Missouri, how school SLPs are treated. And so I do really challenge people, when you see those comments to like, remember, schools have a lot in common, but they differ a whole lot, particularly when it comes to human resources and what they allow and don't allow and so just take that with a grain of salt.
Well, Elise, I want to congratulate you for finding such a niche business. It's such a great time. I mean, 2019 how fortuitous was it that you came up with something at a time when so many SLPs were being challenged, so many SLPs wanted to make that change in their career and navigate into something that was surrounded by so much mysticism, and you have tried to light the pathway there great website, by the way. So I guess my question I'll back into is for an SLP out there that maybe their current job in a school isn't fitting where they are, if they're salaried, been with the district for a while, or the circumstances their job is soured, or maybe somebody in the med field who wants to take that jump into contracting, aside from contacting you, what's what do you tell them when they want to get started, to go into that contract world? How do they start?
That's and thank you so much for the compliment. So the big thing, and this is, this is where I'm so glad that you asked this. This is such a good question, because the big thing that people don't realize is you start by actually communicating with a school. That's one of the first steps. Obviously, like, you want to have an idea of what you're going to say to them. You don't want to, you know, call them up and Flounder and be like I am a med SLP, and I've never seen students, but I want to offer these services like you don't want to do that. You do want to have a general pitch, something very simple, like, my name is so and so, and I'm really passionate about serving the community. I saw you guys had a vacancy. Are you having a hard time recruiting for that? Because I do contract and would love to support you. The reason why that's one of the first steps outside of crafting like a basic pitch of your services, and obviously, if you are going to form a business entity, you do want to have an idea of if that name can be used. But the reason why talking to schools is so near the top is because the school sales process is quite long and bureaucratic. I know that doesn't probably surprise anyone that schools complicate things. And so by putting yourself out there, you have time to set up a contract, you have time to do to set up a rate. Because honestly, that first call is just hearing, if they're open to it, you're going to do a completely separate thing where you actually tell them your rate, et cetera. And that might be a month from when you made that phone call. It might take five different phone calls to actually get a hold of the special education director or your state equivalent. And so one of the first steps, besides like organizing yourself, so you don't sound like a newbie is talking to schools, because it is. It's a long process. And I get that misconception a lot where people are like, I started my website and did this and did that and invested so much money in coaching, and I'm like, okay, but have you talked to anyone? That's where it's a little bit different. Like your standard private practice model.
So who does an SLP, first reach out to often? Is it going to be an HR? Is it going to be the special education director? Who's often that first point of contact?
Another good question. So it is actually the special education director. I have found that reaching out to Human Resources tends to confuse the school, they think you want to be an employee, and then they feel like you did a bait and switch, and then we just lost trust. And trust is so essential when contracting as a business owner, so the most important person to reach out to is the special education director, or whatever your state calls them. Every state calls them something a little bit different, and just letting them know, and making it very clear that you are a business owner and you support districts that have a difficult time recruiting by contracting. So I try to make it very, very clear in the beginning so nobody feels misled. We all know that I'm talking about 1099, services, and I'm not talking I'm not that magical unicorn that's going to fill that, you know, w2 role that they've had for five years.
I'm going to ask you another question that is probably on everyone's mind. One of the first things is somebody's going to wonder, when they pick up that phone and call that coordinator, is if the coordinator says, Well, yeah, we could use some contracting to help. How much do you charge? Do you have that money conversation right at the top, or do you have a kind of a nice way to Jedi mind trick that thing in there to where it's a longer conversation.
So my number one is, when you make that call, your call to action should be when's a good time to sit down and discuss. That's the goal that is, like the number one goal, because most of the time when we do get a hold of them finally, or when we get like, what I call a gatekeeper, which is their admin, and they are, their whole goal is to keep that sped director from hearing from the massive amount of staffing agencies out there. And so you got to kind of work your way in the call to action. First, I try to make it like when is a good time that we can sit down and discuss further. And my hope is then I have some time to craft rate, because it's almost like going to the car lot and like you just randomly are looking at that minivan. That's the life I lead. If someone comes out and they're like, it's $40,000 it's probably not, it's probably way more expensive. I don't know, but you know, it's almost like, whoa, whoa, whoa. I wasn't ready with that. Said, I have had the occasions where the minute I call, particularly in the northern states, where communication is a bit more direct, when I have called, and they've been like, what do you charge? So I do recommend having that rate on standby. And if you guys are comfortable, just because it I get a little into the numbers and give the formula. I do have a podcast episode where I give the formula, if people are comfortable with that, just it's like a 20 minute thing.
We'll link it all up, send it to me. We'll get it in the show notes too. I'll jump in, though, as you're talking, I'm glad I told med SLPs to stick around. I have just decided whatever module or whatever I have to buy from you to listen to this in full I'm doing because essentially what I do as an endoscopist, I have a mobile fees practice is contract with nursing homes for fees, and getting contracts is the hardest part of my job. If I could double the amount of contracts I had right now, which isn't very many, but it's enough to keep myself afloat since I've left academia, but I am having a hell of a time getting more contracts. And so everything that you're saying is applicable to what I do. And so if I could even pick up like two extra nuggets of advice. I will thank you forever. So you just gained a new customer. I don't have any interest in going to the schools, but I'm going to buy your stuff. That leads me to a question that I get a lot, and this we're so far away from why I asked you to come on. We're going to circle there in a few minutes when you are talking rates, because this is my biggest barrier. There is local comp, not local competition. There is a company out of North Carolina that has bought up a ton of independent mobile fees practices and mobile modified swallow study bands, and they charge $300 in assessment, which is outrageous if you've been paying attention on social media. Couple weeks ago, a really well respected person that I follow said, SLP, should be charging $2,000 for an independent school assessment, and here I am with this huge skill, not that being in the schools isn't skilled, but I've got a $20,000 piece of equipment with a high level skill, and all I can get, before taxes and expenses, is $300 No, I can't sustain a business on that. So what do you do when someone says, "Well, x, y, z, doesn't charge as much." How do you fight back again?
It's an important topic, and it might be a little bit different, because, well, it might not, depending on who you're competing against, but we do get that with schools, particularly with certain staffing agencies that very obviously are relying on volume. With schools in particular, actually, with anyone. I think it's really important to set yourself up as a valuable provider. I actually was funny enough. I had a mini course shown to me in my ads the other day that was like $27 and it was and like, the next day, I spent over $1,000 on a social media person, and they were both social media, but my mind was like, I don't want to spend $27 that's not like, or it's like $28 it was like, like, that's, I want like, a true solution. And so I'm going to go ahead and go with the more expensive one, because I needed something that's going to solve my problem. And so I think it's really important. I encourage anyone that is in because it's a mental thing. It gets in your head to lie, to bullet point your value out there. And I like to compare. Most people have a target in a Walmart. And there is this thing that these entities have built, in my opinion, where one is associated with value and one is associated with something different, bouginess, I don't even know. I don't know greatness
One is unshowered and pajamas, and the other one is associated with Stanley ups and yoga pants.
And once you see this in our world, you can't unsee it. And there is nothing that is is safe from essentially being exposed to this. We have situations where we do pay more because the value. And so I heart, I advocate for contractors to tap into that, and with schools, in particular, those staffing agencies that are charging little, what do we know now? What do we know when they charge little, they pay little. What happens when you pay little? You lose stability. So leaning into your value and your mission, you know you value continuity of care. You value clinical knowledge and spending money on continuing develop or continually developing yourself. And so leaning into those values, and I am seeing schools lean into because they've been a victim of it, they've been a victim of the structure that is, we charge nothing, so we pay nothing. So we have high turnover. We have providers that have been placed here, that are from a different territory that's lower paying. So leaning in one to your value and leaning into relationships, people will pay more for a quality relationship. People pay more for trust, and so I highly recommend it. I know I'm being really wordy. My call to action with this one is bullet point your value. And remember, there are a ton of people out there that shop at Target and Costco. I am one of them.
I'm a proud target mom, and I would be a Costco mom if we had one. And don't even think I have not thought about getting a membership to drive 45 minutes to Canton, Ohio, or 45 minutes over the border to cranberry, Pennsylvania, to be a Costco mom. I I'll do it. I haven't yet, but it probably will happen. I'm sick of Sam's Club.
I know. And even when something is at both of them, I'm like, if I see it at Costco, there's like, a psychological thing where I'm like, this is obviously trending!
Target, the the Bullseye's playground or whatever, for three to one to $5 those products are way better than the competition that Walmart has put out in the front obviously. All right, let's we're so far off track.
So for those out there that want to make that change, basically, I think I know some of the answers. But what are the advantages of deciding you're going to go your own way? You're going to set up your own company, versus going to one of those staffing agencies? How much better is it? Tell us about it.
So choosing to go your own route, first and foremost, I'm going to answer and like choosing to go your own route, and then I'm going to give an alternative to someone that's like, oh, I don't love how that feels, because there's actually, there's another option besides agency. So choosing to go your own route. First of all, let's talk about the pros. The biggest pro, in my opinion, is you get to keep 100% of the profit, except for what the IRS takes, which. Is a good amount. Just so everyone knows, taxes are still a thing, but outside of taxes and your business expenses, you do get to keep that profit and you really going at your going your own route and directly contracting with schools is out of the the three paths right school employee working for someone else, or starting your own. Starting your own is hands down the path where you have the most autonomy and most control. I even put it in contracts. This is what I do, this. This is it. You know, you signed it. This is my scope. You can put caseload caps in there. You can put what you will do or won't do in there, although I will say just so everyone knows, I used to put, like, no bus duty in there. Schools that are paying contractors do not want you doing bus duty. So I actually did. I could take that out because schools are like, we don't want you out there. You're not our salary staff. So first, you get to keep the profit. Second, you have the most autonomy. And third, I really like how it pairs with a private practice model, because especially pediatric private practices, where you have that dip when the school year starts, this can be kind of that other revenue stream that sustains your business throughout the year. Because there are small, small contracts, it actually really bodes well, too with niche providers like our AAC, people out there that are like, this is all I want to do. I actually have a company that I send schools to that just provides AAC, because that's not my area of expertise. So it pairs really well with that. So it's, it's just, it's such a great setup for someone. Also, if you're like me and you're like, I want to be a business owner, but I don't want to work in the summer. That was really big for me. I've always wanted my summers off. For those of you who follow me, you know, I'm a hobby farmer, I have cows, I have kale, like it's a whole thing. And so summer off is really important to me to accommodate my hobbies and and my children, I guess I should probably mention they. They're there too. So that is direct contracting. You get autonomy. You get to set your rate, you get 100% of the rate. And then, of course, you pay your taxes and business expenses after that. And it pairs, well, it's a revenue stream. If you got some other things going on, it kind of pairs, well, beautifully with that. So I do want to talk about the con, because that's really important to me to, like, set it straight with people, because I don't think it's for everyone. The cons first and foremost, in my opinion, I do find with healthcare, in particular, I do have the benefit of being under my my husband's insurance, and so I've never had to navigate that. It is something to navigate, and I recommend. There are people who do it, and I have customers that I've coached that do it and do have their own insurance. But it's it's hard to if you are someone like a single parent that needs that salary, that needs that reliability and that health care, I would, I would take that into consideration before you make this leap and really look at it. And then the other con that I like to tell people is, unless you have a great school connection, this doesn't fall into your lap. You do have to put yourself out there. You do have to sell. And if that's uncomfortable for you, I wouldn't recommend this route, because even if you do have a great connection and you're with that school. If you want to expand and grow this revenue, you're going to have to sell, sell at some point. Now, it's not as daunting as it seems. A lot of it's really relationship building once you do make that first call, um, I the this bed directors that I've sold to are some of my closest friends. Still to this day, you develop such a good relationship, but making that call, it's a whole psychological thing, and not everyone wants to do that and navigate that. So that's one of the cons.
It's also not intuitive. I experienced that with my own business. I don't have the skill of exactly what you said, selling myself, and I also have, while it can be a benefit for fix SLP, I think I have a touch of the neuro divergence where I'm very black and white and just say it like it is, and I don't sugarcoat shit. That's hard when you're in a professional environment trying to sell yourself and your business, I have trouble navigating that. I'm not afraid to say it, because where did I learn how to do that? And with this ADHD, my brain is just not the same. So it I think it makes it even, like a touch harder. It doesn't mean it can't happen. I have contracts, but it's harder for me. And like I said, not intuitive guy, I'm gonna have to learn I, you know, every day is a learning experience. So yeah, you have to be prepared for that. I thought it would be way easier than it is.
Yeah, yeah. I get that. I get people that will email me and they're like, Oh, I called one school. It didn't work out. I'm like, oh. Oh, when I managed a sales team, they had to make 30 calls a day. Now that was in a large staffing agency space. That was a very large agency, but like that was the expectation. I think the goal was five full time equivalent in contracts a month. And so it was a it's a lot of putting yourself out there, which, again, can be done. And I think schools are starting to crave hearing from providers, and not these sales guys that work for the staffing agencies. I think it's so refreshing to have that. And so it can be done. But you do. You gotta put yourself out there. And if you are someone that's like, Nope, I'm breaking out in hives listening to it. Then you know you could choose another path. So the next path I advocate for, if you were like, Oh, those cons are too tough for me, is choosing to work for a provider run staffing agency. And they are out there. They are not as noisy. They are not paying for as many ads. They don't have the recruiters blowing you up, and so it can be hard to know that they're out there, but they are, and that's why I'm I love what informed jobs is doing, because that's so beautiful. But those provider run agencies where that's great for someone that's listening to this, and you're like, I'm done with the schools. I don't want to work with schools anymore. I or I want to work with them, but not for them, right? Like, I would love to be in this environment, have my summer off, but, like, get me out of this. But you're also listing the direct contract stuff, and you're like, someone can take a portion of my money if it means I don't have to sell. You know, if that's you, there is an option, and it's not necessarily working for these mega companies. There are more and more provider based companies doing this, and they're doing it really, really well, and you're with a provider. And a lot of these large agencies are founded by investors or tech people, and they're not founded by someone that understands our field and has the same incentives and values that we do.
My friend that I mentioned at the top of the episode, who's working on contracting into a hospital, does this. She has a mobile fees practice, but to expand her income, she is contracting into schools, and she's hiring people. And I, I'm such a fan of her, because she pours into her people. And I know it more from the med SLP space, where she has reached out to me and said, my new hire is lacking this what CEUs are out there that you know of that would be good for me to purchase, to give to her. So you know, she's investing in these people. And I imagine that's happening in the school space as well, that you have someone supporting you directly, and then the perks of getting the materials, workload, caseload caps, those types of things that you're not going to experience if you're working directly for the school, right? Yes,
Exactly, exactly.
I have a question, and I don't know if you're feeling this yet. Elise in the field that you're in and some of the people you're advising, but recently read an article in the Wall Street Journal about the money crunch that school districts are feeling right now because of the COVID, funds have been cut off. So some schools are finding that, in some cases they are overstaffed, maybe not with SLPs, but in some areas, they are. So there is a money crunch that's starting to happen to our school districts. Is this starting to come up with some of your clients where they're feeling that in some of their job searc hes?
It is so it's come up, and I haven't had any, or I've had people bring it up with their states and specifically how their states are treating employees like we had some legislative changes in Missouri that impacted SLPs, and it was really unfortunate. That's where I've heard about it, I think in general, I've heard about the uncertainty. And one thing that I've seen and that I'm watching is oftentimes when school budgets are impacted, the employees are impacted, and they do tend to turn towards a contract model because they are able to then not pay for benefits, blah, blah, blah, blah, blah. And I don't know if that's what's happened, because more we have seen more and more schools are turning to a contract models. And I can't tell if that's because of a shortage or because of funding, or what exactly is happening, but I do think it's going to continue to be a topic, particularly in some states where funding is prioritized differently.
Perhaps all the more reason a contract model might be the most nimble option right now for districts that are facing budget shortfalls.
That's what I was just going to say, too. We can take use this to our advantage.
Yeah, I always have a hard time saying that, because I obviously profit off right? Like, you're going to be fine. Just come, come with me, but then, but it is, it has, and I do think that that's why, um, because when I started this coaching business, honestly, it was because I didn't want to grow an agency. I had been in the agency space. And for me, I was like, look at all these rural schools that have a need around me. What do I do? I don't want I don't want that. I want my summers off with my cows. You know, I'm I'm a small girl. And so I was like, I'm just going to coach others how to do it. And I never imagined that it would grow to what it did. And I think a lot of that is because of this movement towards contracting in so many of our areas.
I want to point something out there that I think is important for people to hear. And this doesn't have anything to do with contracting. This is more about the SLP space, and we see it with what's happening with Meredith and informed jobs. You what I'm doing with fix SLP? Not everybody, but I think there's a subset of people out there who want to grow businesses or movements in the public eye and be on social media and maybe find themselves in a position like you and I are, where we're doing some things here that seem to be a little bit bigger. And the key is that you identified a pain point in our field, and you enjoyed doing what you are doing, and you stepped into your gifts and your talents and what you were created to do, And you did it, and it blew up right? Same, same kind of thing. I've got a big mouth. I love to advocate. I don't like injustice. When I figured out fix SLP, and started posting and started this podcast, it was never to be doing what we're doing now, but I found a pain point, and I stepped into my talents, and I started educating people and working with other clinicians. And now look where we are, and so people who are listening, what is the pain point in speech language pathology, and how can you make a difference? And when you do those things, you're going to help our field change for the better. You're going to help us grow. You're going to help other clinicians who are looking for the thing, the solution to the pain point that that you have the answer to, and you need to not be afraid. You have to just do it. And so when you just did it, Elise, did you quit your job? Were you all in, or were you doing both for a while?
No, so I was doing both. I had left, I had left my roles because I was with a staffing agency, a large one, and I reported directly to investors, and I left that role. And when I left that role, I was under a series of pretty strict non compete, non disclosure stuff. And so I had to be very careful, but I was able to do kind of executive coaching with other investor run staffing agencies. And so I left that role actually thinking I was completely done with school staffing. And I was like, This is the worst space ever. I can't afford to be a school SLP, so I meandered, and then it just kind of stumbled in my lap where I could directly contract with a school. And when that happened, and like I said, there was just so many rural schools that needed me, and I was like, What do I do? What do I do? That's when it kind of hit me that I was like, Oh no, no, no, I am not done with schools. I am done with investors. They can all go away. And I was just consistent. And so once that hit, once that dawned on me, I was like, hmm, I'm going to teach SLPs to do exactly what I'm doing. And I kept contracting. I also professionally meandered. I did some weird things. I did sales for, like, a fellow influencer. I went, I went wild. I like, there were, there were years where Elise was wild. I just, like, did all these random things. But I kept my contracting, and then I started this just to, like, train a few Missouri SLPs on how to do it themselves. And so to get to your question, I kept both. I never saw it becoming what it was, and honestly, there are still times I'm super uncomfortable with what it's become. I as much as it may not seem like it on my Instagram, I absolutely hate being on social media like. I, I want people knowing my name. I just went on my food with my cows, but there are so many students out there and goodness, like so many wonderful SLPs and OTs and everyone out there that can do such good in this world. And so, yeah, I, I, I didn't anticipate it, and I kept my contracting, because that was really what I wanted, until this grew so much that and it felt like if I didn't do it, nobody was going to do it. And so that I was like, alright, we're doing this. I'm going to get in front of the camera and make some reels.
And that's important for people to hear too that if you're starting, and I don't know what you coach, but if you're starting a contracting business, or you're starting a side job, if you're trying to put things out on social media, this stuff doesn't pay right away, right? You know, I started my because this is how crazy I am. I started my aerosolizing procedure business in the middle of COVID 2020. Was when I started my business. I did not get my first contract for an entire year. So for an entire year, I was sitting on my equipment and my skill and had no business because and I knew that I wasn't done, but I wanted to keep moving forward. And I unfortunately, had the and I say unfortunately because my my dad dying was what sort of funded my business. But I had the means, very luckily or unfortunately, to kind of sit on a business for a year without a loan, on a scope that wouldn't have been the case had to take a loan. But, you know, I worked as a full time professor. I worked and fix, SLP, we're still not making money. I shared that with you earlier that I I'm we're making some money through affiliate codes right now, but it's not a lot. And I, like some of us, just made 100 bucks for the first time. And so I still worked as a full time professor until I was able to grow my scope business enough that everything kind of lined up and I was able to leave my job. So know that you're navigating that too. It's a lot of late nights. Probably you're you're trying to grow a contracting business like you're talking about late nights, early mornings, hopefully not a lot of tears, but maybe, like, it's, you have to get gritty.
Mm-hmm, yeah, especially if so when you independently contract, there's not as much that, like when you're the person that's like, Oh, I'm just serving the school. I mean, you have the school stuff where it's like, late night progress note type thing, but an invoice thing can be a beast. But if you are someone, I do get people that sign up for coaching calls with me, or purchase on my products and like, I just want to be a CEO, which I'm like, good for you. I love it, but you do have to hire and have so many contracts before the percentage of what you get after you pay your provider is enough to sustain your income, and you do. I see that a lot with my customers. They're like, I'm done with speech therapy. And I'm like, I get it. I respect it. It can be hard, but you have to. I mean, for most of us, if we want to gross over six figures, usually that's four full time equivalent contracts, if you're staffing them with someone else, if you're going to pay well enough to keep providers around. And so there's that too, that if you're going to build a staffing agency, there is a good amount of time in there that you're also serving students until you get an or you have a business loan. If you do want to go that route, but it takes a good amount of contracts to kind of get to that level where you can step away with that said you can, you can absolutely get there. So that is where that comes in, just kind of those realistic expectations that it takes time when you're wanting to build a larger business.
So Elise, we're talking about money. We're talking about 1090, nines, w2 profit, the thing that our audience cares the most about is their money. And I know that because those are our posts that go viral when we talk about SLPs, profits and income, those are, those are the topics that people are paying attention to. And I think we all know this. We don't really need to say it out loud, but I think it would be good to talk about just a little bit. We've got these investor back staffing models. We have these large contracting agencies, and what they really do is prioritize the profit for everyone except the SLP, and then, how do we make more money? How do we get a raise every you know the joke is, but it's not a joke. The only way to get a raise in this field is to change jobs. So can you talk to us a little bit about that? How you know, with what? How those models are prioritizing profit for everyone but us, and then how we can, obviously, we, and we talked about a little bit already make more money contracting ourselves.
You know, it's a tough topic, because I want to go ahead and say like this is not a personnel issue, and I say all of this with respect to providers that are inside that system, I never want to shame a provider for working with those agencies. We make the decisions we have to make for our families and our loved ones. But this so this is not a personnel issue. This is not about the providers that are in there. When I do talk negatively about staffing agencies, it is about their structural setup, which I think you hit on beautifully with your question. So it's important to just discuss this. I think investors appeared in the staffing agency space because investors are very heavy in what we call the ed tech space. So our sped softwares, our billing softwares, investors kind of reign supreme. And the next thing you know, they're in the staffing space, which is very different than our ed tech. And what I can say, with investors, their priority is profit, as you mentioned, unfortunately, with schools, what are what is our priority as an as a provider, outcomes? Our priority is good to get those kids off the caseload. Guess what's not profitable getting kids off caseloads. So there's a mismatch. There's a misalignment with our incentives when investors get involved. And that doesn't mean all investors are bad. I've had a very few that were great, everyone that was really good, that I worked with in the past, back when I was in that space. But, you know, there's just, there's a misalignment in incentives. And what happens is these investor run staffing agencies build businesses that can scale. What involves scaling, right, recruiters? Um, building a tech software. We see that a lot in our virtual staffing agency space, having really onboarding people really quick to where they can fill these contracts really quickly. So onboarding specialists, getting people in there. We don't actually know if we have a contract for them, but we got people so when we do have a contract, they can start really quickly, and we start making money quicker. And so all of these things cost money, right? And they take profit. And so when you look at the things needed to scale, who gets the short end of that the provider, and then what we have is we have a provider that took a role. And honestly, a lot of times providers took, they think they took one role, and then a different contract comes through, or there wasn't actually a role when they applied, which is so unfortunate. And so you have providers that are in a role that they may not have signed up for, or they're in a role that you know, once they see that hourly rate, especially 1099, and they pay their self employment taxes they realize is not sustainable, so they have to leave a mid a contract mid year. And so that's where, unfortunately, because of this structural setup that is flawed, because of that misalignment and values, you have providers that their their service is impacted because they can't stay in that role, or they're burnt out, or they have a recruiter pulling them to another role because this other role pays higher, and so they got to get started sooner, and we'll just do comp time with this one school that pays lower. So you have, you have this problem with investor run agencies, and I can tell you from experience, because I've reported to them, investors want profits and they want profit margins. That tends to be where they focus. They don't focus on like, how many students did we dismiss from this caseload? How many minutes did we decrease? There's just the misalignment. And for in my experience, you know, how do we bring SLPs back to this space? How do we put the power back in the hands of providers. One is we have tough conversations like this that are tough because, you know, I've worked with some really awesome SLPs that are working for these companies, and I've met great recruiters that work for these companies. I met them at ASHA, had a blast. You know, the great people, but their structures flawed. So we have tough conversations and hold these staffing companies accountable. If investors are involved, we need to discuss where incentives should lie. It just it is, what it is. And also, I think we need to challenge our staffing companies to operate leaner and to maybe challenge this, like really scalable model, where we have all these people writing RFPs and these sales people and all of these people pulling from the person who provides the services pay. I think, I think we challenge that. Can we just, like, start something that says, stop using recruiters that call us like, I I've tried to, I've tried to start that. I'm so done with that. It just drives me crazy.
We have put it out there that you should. Give them the business at the very least if they require the CCC in a state where it's not required. So it's a fun game to play with those people, where, because a lot of times they won't even know so they have to go find out. And then you're like, you give them a whole ear full of education. And my thought process with that is, if those staffing companies are requiring it, and it is impacting their ability to get new providers, eventually they're going to change their requirement, and it will be the recruiters who go back to the agency and say, Hey, I think we need to take a look at this, because it's hurting their income. You know, recruiters are paid on people they can recruit. If they're having trouble recruiting people because people don't have the CCC, they're going to change the policies. Yeah, that's my thought process on that. So we love to give them the business.
I know... I, you know, I like that. That's a mindset shift for me, because I've kind of been ignoring them.
Oh, get your script. Save it in your notes on your phone, and then when they message you or email you, you just copy pasted it. Eventually I'm going to need to put that in a blog. I've started blogging. It's when I'm in hyper focused mode. I will blog about, like, the most asked questions. So hey, if you've never seen our blog, everybody head to fix. Slp.com, and you can go to the menu and there is a blog link, but yeah, eventually I'll have to put that script in a blog.
Well, I, anyway, I, I've got nothing else other than to tell you. I just really love what you're doing. I think it's fantastic.
Thank you. Thank you for, I've been a fix, SLP, for a really, really long time. And so...
We've got a good team. We each kind of bring unique ideas and talents to it. And Jeanette, she's got this fire that just burns within her every day, and a wellspring of energy. And I hope that, you know, we can modernize some things about our profession, and kind of just have some people looking at it not so top down institutionally, and really kind of doing some of the things that you're doing, which is empowering ourselves individually, to go out there and really kind of finally break that salary curve, and also just find ways to advocate for reimbursements at a granular level. Because what we've been doing now for the past 15 to 20 years, is it's not had great results. And so we're gonna have to look at some different things.
All right, I think we probably need to wrap up. You said that you created a code for our fixers, so one of the ways that we have started to bring in income is through affiliate codes. We have not posted them as of this recording, but they will be pinned to the top of our social media eventually. So if there is someone you have heard on one of our podcasts, or, you know, some related content that we've had, a bunch of people have given us affiliate codes, and we don't really talk about them, so we're talking about them now this will be linked up in the show notes, but you have an affiliate code with with us, which is nice, because people can get a discount on your stuff, and then we can make a little money. So that's what I'm using to pay the team, because we don't use sustaining partnership to pay the team.
So if you guys use the code FixSLP, it works on any of my products that will give you 10% off. And anyone who knows me knows that I do not offer discounts in any other ways, because it contradicts what I teach about charging your value. And so this is really affiliates, really the only way to get any sort of discount on anything I do so any of my products, fix SLP, will work, and you will save 10% in addition to giving back to this wonderful team for having me and letting me utilize their marketing outlet.
Love it. Thanks. Elise, we really appreciate you bringing your knowledge today. We talked before we maybe we might have you back in the fall. We'll see where we head. Preston, you got anything else?
I don't thank you so much.
All right, we'll see you next week. Thanks for fixing it!