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Hi, everyone, after recording Ashley, let us know that on January 9, Governor Reynolds proposed changes to Iowa's education system, which would impact the area education agencies or a EAS. Ayesha is working with their lobbyists and school based SLPs to obtain further information and will keep its membership updated as this progresses. Enjoy the episode. Welcome back fixers. This is Jeanette and I am excited to be bringing you our second bonus episode where we get to highlight state membership associations. This is an extra fix, if you will. Today we have Ashley from Ayesha, the Iowa Speech Language and Hearing Association. I wanted to remind you that the views stated today are not reflective of the personal opinions of the guest but instead are representative of the state membership association executive board as a whole. We hope you enjoy hearing about Aisha Hello, Ashley.
Hello, welcome to the fix SLP podcast. We are so excited to have you. I am so excited to be here. Ashley is our second bonus episode, which I'm lovingly referring to as an extra fix. We'll have many extra fixes but one series is highlighting the state association. So Ashley is number two on our list. And she's from Iowa. So Ashley, why don't you tell us a little bit about yourself?
Sure thing. I like that. I'm Ashley. I am the current Ashley logic. I'm the current president of the Iowa Speech Language Hearing Association. I'm in my second year we do a go for two year terms. It has been quite the learning experience. We've had a lot of ups and downs these last couple of years, but I'm really excited to share about what we're doing with you guys.
And are you a practicing clinician?
Yes, I'm sorry. I am adult medical. So I do a little bit of everything. I do mobile fees. I work for a great company out of Kansas City mobile fees. I do some PRN and skilled nursing and I do some PRN in El tak and then this year hopefully I should starting my own
I'm hoping private practice so I have a lot a lot going on. Yeah, that we'll have to talk mobile for us after I pressed off. Oh 100% of that when we first got on. Okay, um, tell us in the fun Do you have a hobby or something you do? I like me I don't have any free time so don't ask me that question. But is there something that you enjoy doing? Yeah,
I do. Um my husband likes to say that I'm I perfect to work with geriatrics because I was born an old woman and a young body because I love to knit and crochet it's kind of my jam, how I relax and get away and stuff for a while. So I have literally like drawers full of yarn and you know, accessories and stuff. So that's kind of how I how I relaxed but that I'm in the car all the time doing fees and traveling so a lot of podcasts or audiobooks hanging out with my kids. That a husky just keeps me you know, full of hair all the time. So yeah,
what do you like to knit or crochet like what's what's your thing?
You know, I'm such a dork. I love to make shawls and like really big scarves, but I never ever, ever wear them. I also don't finish things half the time. So I love to start a new project but I'm terrible at actually like following through and finishing one. Because I'll see I'm like, Oh, I will. This is a pretty pattern. We try this. I'm going to do this one. So I have a lot of half done products. That's part of my New Year's resolution actually is to finish some of the things that I started.
I would love to learn to do that. I tried once my cat found like what I had started and I was a beginner. So it had taken me forever to get what I had done and she unraveled it and I never went back I was like oh
half doors. Yeah. Oh friends and they kept people out there. Alright, let's
let's jump into some some good stuff while you're here. What do you love about your state association? Like what drew you to it? Why did you get involved with just what do you love? I love it. So
our state association has been kind of a part of me Since the beginning, I remember being an undergrad, many, many, many years ago. And it was just expected, you went to the State Conference, you went to the Asia Conference, and you listen to people who were, you know, at the time thought, were smarter than you will ever be. And you tried to learn and follow along and answers, but you know, keep up with, uh, with the commentary and stuff, but it was just what you did. And so right off the bat, nerd that I am, I wanted to be on the board. At some point in my career. I found speech pathology after I tried like 18 different majors, it just kind of fell into my lap. And I was so grateful to finally have, like, you know, a point in life that I wanted to be a part of something to help give back to this profession that I really, really do. Like, on most days. Some days are hard, but most days, I really love it. Yeah, essay, it's always been in the back of my mind to do that. So the opportunity came up in oh, gosh, 2020, for me to join the board as the president elect. So I've been on the boards is going on my fourth year doing that. And it's been, it's been really interesting, I've learned a lot about how it works behind the scenes, there's so much work that goes into these state associations that I don't think anybody who hasn't been on the board can fully appreciate or comprehend. I love the networking, you know, we're so isolated. I'm in the car all the time, and or I'm the only SLP and you know, in the nursing home, or the hospital and stuff. And so it's very, very isolating, as so many of us know. And so, you know, conference time is really the opportunity to get together like, Oh, I've seen your reports, and oh, how are you? And like, all you're in a hospital near me? Oh, that's great. Because let me you know, let me send you some referrals my way and can I call you when I send somebody out for a modified or, you know, call me if you need fees? That kind of thing. So I I love that aspect of it. It's really, really my favorite thing. I like to learning too, but the socializing is kind of my jam. Yeah.
Yeah. You're making me think I go to the Pennsylvania State Association, and I volunteered for them. But you're making me think, man, why aren't I going to the Ohio one? And do it's money?
It's all money, right? Like you can Ohio, you know, many?
Oh, God money. I know, it's, we can't function without it. I
know. I know. So I'm Megan. And I have not like I'm volunteering. But neither one of us have been on the board of our state association. So we've been learning in this process, too. We have not mentioned this yet. But why don't you just for our listeners explain what the President Elect is versus the president. Like we learned there's this whole like three P's thing, that we had no idea. And so we once we got this idea of highlighting the state associations, so when we we learned about it? So let our listeners know what that is? Because I'm betting most don't know.
Absolutely, yeah. So if you join, at least also Iowa runs. So if you join the board here in Iowa, and you're like, I want to be in charge, I want to be the president. It is a six year commitment. So it is two years of being the president elect two years of being President, and then two years of being past president, while you are president elect, you are kind of learning the ropes, seeing how it's how things move. Maybe you've been on the board before, so you have an idea. Or maybe you're like me, who had never been on the board and just kind of got thrust into this position, because they're like, Hey, would you want to do this? And I have a hard time saying no. So it's kind of like our current president elect, I'm trying to use this as like a mentorship opportunity for him. So we have an audiologist coming on as our president elect, which is super exciting. And so he and I, we collaborate on things, we talk about stuff, make a plan so that when I transitioned out of this position, he can move right on and it's super our past president position is more a, they're a non voting member of our Board. They're more like, can I call you say, Hey, how did you guys handle this? What do I do more of a collaborative kind of situation there but and then they're also on the board of our past president is also on the board for our foundation, which is supplies on scholarships and things to our student members. So that's how it works in Iowa anyway. So it's a it's a commitment. I
don't know. I don't know. I assume most have all three. It seems that way. But not all of them. Do. I think we've encountered one or two that don't quite operate like that. But I assume like what the past president serves on is probably different in every state and how they operate. But it seems like most states have a three piece that we've Yeah, we've gotten to learn about. So that's been interesting. Okay, so what is Megan and I, obviously, we've fallen into this advocacy role. So one thing we want to talk about with you is one area of advocacy that your state has undertaken in previous years, that has made a difference for clinicians.
Yeah, so we've had quite a bit of things going on an Iowa right now a couple of years ago, one thing we were really kind of fighting against was, I don't want to use word fighting, but trying to figure out for it with music therapy, I don't know if other states go through that as well. But they're wanting to Bill, you know, 9507, to treat, you know, Speech Communication voice. And we're like, no, no, no, no, no, that's, you know, our purview we did finally, after, I think we went round and round in the legislature for probably a decade, maybe they, we finally got languages that everybody would vote was but was happy with. And so speech, that 9507 is still the purview of speech therapy, and not for our music therapists. So that was a big win for us.
I have goosebumps, I legit, that's amazing. That is one of my areas, that obviously, we can only do one thing at a time, Megan and I are going to be around for 47 years, just gonna be doing this podcast at like 87. And the young clinicians are gonna be like, Who are these old ladies? Because there's so many things that we want to do. But protecting our codes is so close to my heart. It's really something that I would love to see us take on as the nationwide group of so yeah, however, that looks. So I'm assuming that code protection is unique to Iowa only? Yes, yes. I don't know if people realize that or not either. And this is why we have a lot of these encroachment issues, especially in our corner of the world with dysphasia. Oh, yeah, occupational therapists, but like the one company that I had to leave, because they were forcing their SLPs to train OTAs and giving them an eight hour course. And then they had to mentor and
you know exactly what company you're talking
about that too. And we start recording, but that I might one of my regional managers lives right behind me and our kids play all the time. And we've talked to him. He's a PT, and we've talked about this multiple times, he always says Genet, you guys need to start protecting your codes. He's like, physical therapy has done an excellent job of that chiropractors can't build our codes anymore. He's like, You guys would be be ahead if you could just protect your codes. And I was like, you know, he's right. So good for you. Doing that you take on this, that dysphasia code Next, get it go.
I know. Oh, God, there's so many dysphagia things.
I mean, I know in pediatrics too. It's, you know, there's a lot of that going on, you know, in their corner as well. I've heard it and I've seen it. I just don't follow it as closely. But yeah, I think across the board, speech therapy codes need to be protected for speech therapy really only period. Absolutely. But for you guys for doing that. Oh my gosh, that's amazing. Okay, so is there anything that you're working on right now in terms of ad advocacy.
So we're, we're a little bit in a holding pattern right now. So our government decided they're going to reorganize and restructure everything, all of our departments are going from like 43 departments in our state government to like 16. I might be off on those numbers. We don't have final stuff yet. But they're getting rid not of our license, but of our licensing board. So, right now, we have licensing board for Speech Pathology and Audiology. They are talking about, what they want to do is remove that board and put us under the Board of Medicine, which is not ideal, for many reasons, and have like, you know, one SLP or one audiologist act as a, you know, advisor to the Board of Medicine, but ultimately, like any type of licensure, reprimands, or changes to licensure would be under the purview of the Board of Medicine, and they will only quote like ask our opinion about things which is not ideal. We're trying to they are putting PT and OT under the board of rehabilitative medicine, which is a better fit for us as well. It's not perfect, but if everybody's going to lose out on this, we might have We'll be grouped with PT OT, and at least we have some type of similar. Right? stuff going on. Yeah. So it's really interesting right now everything is kind of up in the air, depending on where all this falls, you know, when they when they first came out with this, you know, we submitted, you know, public comment, you know, we don't agree with losing this, we have a very unique job that we do that encompasses, you know, not just, you know, the medical side, we have school based, we have private practice, we have all of these different areas that we cover. And so putting us in a corner in a pocket where people who don't understand what we do, or deciding our fate is a really scary thing. Yeah. So we reached out to, you know, to the board to the legislature to, you know, we submit a public comment. We haven't heard a lot back, our lobbyists are in the know, and they're kind of keeping us informed about what's going on right now, it does sound like we have people are in favor of like, oh, it makes sense for speech to maybe move under this rehabilitative board versus the Board of Medicine. It's still not a perfect fit, obviously. But it's kind of where we're at right now. And I think until that all gets straightened out, we're in a little bit of a holding pattern. Just because that's sort of like the big agenda thing that our governor wants to pass and get going. That makes sense. Yeah, in an attempt to, you know, streamline things.
Yeah. Is there anything that clinicians can do in Iowa to better support this effort? Or is it just in their hands now, and you're waiting for the final decision?
I think I don't, I'm not 100% Where we're at right now, it's been kind of messy and unclear, I don't think it ever, ever, ever hurts to reach out to, you know, your Congressman's to your local representatives to make sure that they're aware of like, hey, there's consequences to what we're doing. This is where I work. These types of folks on these boards aren't really going to understand what we do. You know, being under the guise of Department of Inspections and Appeals versus Health and Human Services. The the goals, they're two are very different. And so what does that mean going down the road? We're not 100% Sure. So I think, you know, reaching out to your legislators, your representatives to, you know, say, hey, we have concerns about this. I know, he has already submitted, you know, letters of concern and things. But we're also concerned too as
well. We have fixers fixers, if you're listening, send a letter to your ladies, Iowa only, it's not going to help if you send it from like, California, but hey, well, folks, if you have a state license in Iowa, go send a letter to your state representative. Let them know what you think. And hopefully you guys can get that taken care of give us an update when you know, just so yeah, absolutely. I'll be and then I would be really interested to see Yeah, or if there's something else if there's some other advocacy effort that we could be talking about, for you let us know. So once once you get through this, is there an agenda for the future? Are there things that you'd like to continue to improve in Iowa that you anticipate might be on a future agenda to try to obtain?
Reimbursement has been a big issue with Medicaid, especially for our peds folks, they are being denied across the board. For if they've had speech longer than a year, now they're getting maybe, you know, maybe one visit a month, you know, one visit every six months we've had, we have a wonderful liaison to the board who's been working in private practice with peds forever and she's had meetings with, you know, the different Medicaid companies here in Iowa because we're privately funded Medicaid. And she's had a lot of meetings but not a lot of success. Which other places that I've heard kind of going through this to same thing, we'll talk but nothing really
changed outside it and we I talked like I was involved. I was not involved at all. We just got it changed in Ohio. And a couple days I am interviewing the woman Her name is Brianna. I'm where I'm doing another extra fix with Brianna so she can talk about her process. No listen to that. I don't know when that will release yours will probably come out first and then you know anybody listening look for another extra fix with Brianna who got the Medicaid rates significantly changed in Ohio and now she's gathering the troops to do private insurance next. That is amazing woman is on fire. I
Ah, I love that. Sweet
Okay. So, every year, you know, the agenda in states kind of changes, how does your state sort of figure out their agenda, what they want to advocate for what they're going to do that year? Walk us through that? How does that work?
So we do strategic planning every three to five years or so. So that helps kind of guide what we're starting with. And then, depending on what kind of pops up, you know, you go in with a plan, and then, you know, the legislature decides they're going to pop up with all this stuff that you have to come out for against. And a lot of times, you know, our goals get sidetracked, because, you know, they've proposed some ludicrous stuff about you know, only, you only communicate one way, you know, something ridiculous like that. Of course, we have to come out against that, and, you know, parents choice and all of these things. So, it's been a little bit of a challenge. We did get our interstate, we had our interstate compact passed, which was fantastic. We kind of got to piggyback on the back of OT with that. And then people who bring stuff to our attention. So reimbursements a huge one, Medicare, Medicaid, how can I get them up but Medicare, but Medicaid and you know, private insurance, that kind of thing for me, the other thing is pay rate here in state of Iowa, which is notoriously low. And I I'm sure you know about all of that. And again, legislatively, I'm not 100% Sure what we can do about it, but just bringing awareness to what it should be. And comparing and being open about those things is important, I think for
all of us well in getting those reimbursement rates up to right because at the end of the day, it drives pay. It's not every week, I don't know if you listened or listeners, if you haven't heard make it an I did a a limited series podcast before we did this called other SLPs pockets, where we talk about negotiating rate of pay and advocating for yourself in that way. But at the end of the day, some employers they can only pay you so much, you have to keep the lights on you have to pay the rent for the building or you know, the equipment and the toys and the insurance and there is a cap like not everyone can make $100 an hour, especially in Ohio, nine to 507 That was 32. When change reimbursement for Medicaid, how do you pay anybody with that? So it's I think it starts with getting reimbursement up and then that, you know, there can be a trickle down effect from there. But this is years worth of work. As our you know, cost of living continues to go up and rates continue to go down. It's I mean, I was just gonna say it's a whole other podcast, it actually is. It's a really good one guys I listened to it go listen to it actually is a whole other bias. So I'm gonna skip our next question, because you said something where, you know, sometimes members will bring things to your attention. So when members want to bring something to the state Association's attention, how can clinicians best communicate their ideas and concerns to the association? And then once they do that, what do you guys do with it? How how do you receive those and what do you do with them? Yeah, so the best way to to communicate with us is to
email Aisha at Aisha dot work, try to keep it as simple as possible. So isa J, and Isa j.org. That goes directly to our Executive Director, Suzanne, who is a lifesaver and not an SLP, or an audiologist, but organized, which is God knows we need it. So she will send that on to us. So we have VPS, for medical, for schools for Audiology. And so part of their jobs is to, you know, receive these queries, look at them, respond to them, get more information, we get stuff about, you know, how many CPUs we need, can they all be online? We get stuff about, you know, can we build this and this on the same day? You know, what limitations do you see EFS have in the state of Iowa licensing type thing. You can also, you know, email the licensing board to for those types of questions. I think some people get confused that the licensing board and the state association are the same thing. Yeah. They Yeah, we do. And I totally get it because I think I thought that until I joined the board, which is embarrassing to say, but they're not. So we can always you know, help direct people, you know, that direction. And in doing that, we've learned a lot of things too. We're like, Oh, this is such a huge problem like I didn't know until somebody asked that I would doesn't reimburse fees Medicaid at all. There's that I mean, I'm like wait Well, I'm I figured it was bad, reimburse. But but I didn't realize it was zero. But they'll let you do it for free. You're allowed to do it. You just I believe so. Yeah. I
mean, who? But no,
right. But yeah, I mean, it's it's a whole whole thing. So that was that's, you know, again on the agenda of things to get fixed and past and to get us, you know, taking care of these people.
So if someone wants to join your association, what can clinicians in your state expect as a member,
anybody can join, we have several different types of memberships. So you have like a regular member, we have student membership, we have first year professional membership, second year professional membership, retirement, and they're all at different prices. So like your regular membership runs 110 a year. Students, it's 35. For shear professionals, I think it's 35. Retirees, I think, is 70. Right now. So we want to make it as easy as possible for people to join the association. And so we try to keep our prices down as much as we can. But we do have expenses, lobbyists are expensive, we wouldn't know have a clue what was going on, without, without our lobbyists, they really keep us in the know. And so we and they do a great job. So you know, paying for those paying for our executive director who we would not be around without Suzanne, there's just there's so much to running, you know, a nonprofit, a group like this, because there's there's taxes and and convention planning and like how to negotiate a contract for a hotel, like all of this, like, stuff that SLPs you know, again, we're SLPs, we don't we don't do that. But it's so having that is really important. We are trying to be really transparent with our members so that they know what's going on what their money is getting them. So we do our convention, that's a member benefit, you get a good reduced price for that for at the convention. And then five or six times a year, we're also offering online free CEUs to our members kind of in all of the different areas audiology, medical school based SLP stuff, and that's free for members when then we charge like a nominal fee for non members like $20. Like so we have our lobbyists, they send out weekly emails about what's going on in the Capitol. What's kind of on the agenda, what bills are up for vote, what's you know, what's in committee, and kind of the plan going forward and our legislative session runs from January to usually mid to late April. And so they keep us they keep us going is a really busy time for them.
You know what you guys pay that lobbyist you happen to know. Yeah,
we play them. $12,000 a year. 12,000. Yeah,
that's a steal.
I mean,
we talked to another state privately. He told us $90,000 No. Yeah. Because Megan and I listen, big plans here. We thought we would help crowdsource like crowdfund lobbyists for each state. And when that state was like, I'm not trying to be rude, but how do you plan to do that we pay our lobbyists. $90,000 1000 Oh, just kidding. Maybe we'll just do a podcast instead. Because that's free. Wow. Yeah, that's wild. And maybe there's multiple lobbyists in that quote, but we didn't really dig. We just felt dumb.
I mean, that we have like, three, we have like a, like a group like 3000 for three. Yeah, we could crowd
fund that. That's fine. Because it. That's so funny that that's because I thought we were like way overpaying. I'm like, I don't even know what they're doing for us. And we need to start asking the state associations if they have lobbyists now and how much they cost? Because now I am like, deeply interested in? Yeah,
no. I mean, when you have a nonprofit and you have lobbyists, the cost of what you pay, your lobbyists can't exceed the cost of like what your membership pays to your nonprofit because the IRS doesn't like that. And they're like, Oh, well, you have undue influence. If you have like, you're making the same amount, or less than what your dues are for your members, if you're paying more do your lobbyists is like, you can't that's not that's not their nonprofit. I don't know what the what the actual saying is, though, you can get in trouble for that. Interesting.
So if you make if you get more members, you can pay your lobbyists more and do more things.
I don't know, necessarily.
I think they already did part of it for us, but we could actually, you know, this is a I'm a little off kilter tonight anyways, and you can cut this out, because so Suzanne, our Executive Director, she sent an email to me and Kevin, my president elect, she's like, Hey, we're going, she's going over the budget with our treasurer, Iowa Ayesha will be defunct in two years, we don't have any money left,
we shouldn't cut out, your members need to hear that the people in your state, this is what, listen, all of the state associations are struggling. And this is why we want to highlight you guys and and just, you know, get what you're doing out. So people can think about maybe investing, if they have the money to do it, investing that money into the state, and potentially even volunteering to get stuff done. Because it takes everybody and we're never going to see change in the field. Like protecting the codes like you did in Iowa or changing Medicaid rates, like happened in Ohio, those things are never going to happen, if we don't have these associations, helping us do it. And so it's so important. I, you know, this is going on everywhere, we've been talking to a lot of states, I don't think you're alone there. And that's why it is, it's an emergency, if we want state associations to be helping us advocate for the things that we need, we need to get involved, and we need to pay our dues. And 110 isn't really that much. That's affordable. And you know, the state membership cost is all over the board. But I love that you said too, is that first and second year member price I heard that's the first I've heard that. And that's awesome. Because coming out of school, you know, you're just getting like maybe your first place by yourself or you know, buying a car and like paying for your first year professional experience, which looks like a lot of different things and a lot of different states. And there's, you know, people think, Oh, I've got a college, I'm gonna make a lot of money. But then you Hello adulting you get hit with a lot. So it's absolutely, that's great, too for for new grads, who are first year and second year professionals. That's amazing. That's 30 Yeah, and you can spend that at a nice dinner if
you have a way no way. Yeah, we want to make it as easy as possible for people to you know, to transition and to come out and to be in to be part of this. And I know, I do, I remember the first time was like, I gotta pay how much money to Asha, and this and my state license and they want this to like, that's crazy. But of all the things of all the people that we have to pay for all the stuff, your state association is the one doing the work, who can do the stuff that's going to affect your life day to day. And so if you're looking for a smart place to put your money, put it there, put it in your state association, we have over 1600 registered SLPs in the state of Iowa, and less than 300 are a part of our state organization, we absolutely have room to grow. If you guys can do the math on that we have 300 people, EMS 110 bucks a year that math ain't math in no. So we will be if we do not get I mean it is dire if we do not get members, we will not exist. That's just the long and the short of it. And we won't be able to provide the CPUs, and we won't be able to provide that now, those networking opportunities.
Now that we've guilted them, where can they go? They can go to www.asia.org. Okay, you can absolutely join right from there, you'll have access to our member directory. You can find SLPs across and audiologists across the state. We can do. Again, we offering CEUs. We're offering networking opportunities, advocacy opportunities, you can join our membership committee, you can join our advocacy committee, you can join our committee for our annual Hill day that we're having coming up in March. So there's lots and lots of opportunities you can go from listening right now to being the president elect on the next cycle, just like Ashley did not involved to almost president. That's exactly right. If you're gonna just dive in you might as well do it all in head person by fire. Um, exactly. So how about socials? Do you have socials? Do you have handles that you could give me? Do we have socials? We're on Facebook.
I was Speech Language Hearing Association on Facebook. And then we do have Instagram but we don't use it probably as much as we as we should. We're working on that. All right, Ashley,
is there anything else you want our listeners to know? Anything else you want to talk about?
Um,
really the only other thing I wanted to do was just to say one other thing I know this is an SLP podcast and I love being an SLP but I do want to shout out audiologists in our state. We our last conference, we had an October had almost an equal number of SLPs. And audiologists attend, which is amazing. We also had our largest student turnout ever, which was also amazing. We have on our board, we have to open board positions as well, if anybody's listening, we'd love to have you apply for a couple of board positions, same thing I should, and I should.org for email, if you're interested. And then the honor board we have, let's see 123 We have half of our board as audiologists. And that's really exciting. Again, I know as an SLP podcast, but we're doing some really exciting things for Audiology, too.
So we're all working together.
I have a smattering of listeners we've you know, we have a physical therapists who reached out to us and asked us to post to the top of our socials what the CCC is, oh, they're right back and say, Listen, we scream and shout about offending speech pathologist. There's nothing more we'd like that would be the number one offense if this is what the CCC is, yeah. So we have listeners from all over the world. But also then like there's just a little smattering. So maybe an audiologist will hear this. And that's great. All right. Well, if that is it, everybody had to i should.org. At least everybody who's in Iowa, join volunteer, they need execs. Reach out to your legislator, lots of calls to action here for Iowa. Thank you so much for doing this with us. It just brings me so much joy to be highlighting you guys. And again that, you know that advocacy that previous advocacy is still like, hell, it's almost nine o'clock at night here, but I'm pumped up.
No, I'm so glad this was so great. Thank you so much for allowing us give us opportunity to highlight what we're doing here and hopefully that'll help us keep trucking along. Yeah.
