Michigan SLP Bill - Cutting Red Tape with House Bill 4484

5:27AM Jul 3, 2025

Speakers:

Jeanette Benigas

Alexa Chapman

Preston Lewis

Recording: Rep. Joseph Fox

Music: Happy Birthday by Lenny Kravitz

Recording: Alexa Chapman

Recording: Jeanette Benigas

Keywords:

House Bill 4484

speech language pathology

Michigan licensure

red tape

House Public Health Committee

advocacy

state associations

ASHA

Medicaid

licensure portability

speech therapy

legislative process

grassroots advocacy

state representatives

professional credential.

Welcome to the Fix SLP summer school series, where we're schooling the system all summer long. If you're ready to challenge the status quo in speech language pathology, you're in the right place. Subscribe so you don't miss an episode. And if something fires you up, leave us a message on the minivan meltdown line at fixslp.com. Grab your favorite summer beverage and let's get to work.

Fixer bonus time. Everyone. Preston Lewis joining you, Dr Jeanette Benigas with me, and Alexa Chapman, who also was the star of the week for fix SLP, because this week in Michigan, what happened? We'll let Representative Joe Fox of the Michigan State House tell us all about it.

it. Honored to speak to you this morning in support of House Bill. 4484 this is a common sense piece of legislation and has one simple aim, to cut red tape in the speech language pathology field.

We're all for that. We are all for cutting that red tape. And we'll have some more sound from that meeting. But our bill, House Bill 4484 was presented Jeanette. Alexa, it's great to be in conversation with you. And Jeanette, do we want to do a little music first?

Yeah, I like to do this for people, so I'll just, I'll play it, and we'll let it speak for itself.

I from us and Lenny Kravitz!

Yeah, it's great. That's what we do.

Thanks for taking the time to do this.

Yeah, absolutely.

So status wise, we like to keep all of our fixers updated the bill that we've talked about House Bill, 4484 and Jeanette got some of the text on that. We've discussed it on some previous episodes of the pod. Is basically a clarifying Bill stating that for reimbursement in the state of Michigan, all you need is that Michigan state licensure, which has more rigor, and we can talk about that. But the bill is now before the House Public Health Committee, and it's been presented with some good commentary that you'll hear from my two fellow co hosts and Representative Fox did a brilliant job laying that up before the committee, we got a few very pleasant questions from a couple of committee members that seemed just like interested folks about the field of speech language pathology and where we are. I got the sense, and we'll play a little bit of the sound from you here in a moment. Alexa, you were just calm. You knew your file. You knew why you were there. This was just another step in this long journey for you to make Michigan equitable as far as speech language pathologists, knowing their worth.

Absolutely. So we've been working on this bill. Mikayla and I have been working on this bill, like for over a year. It's been a really long time coming. We've put a lot of work, a lot of time, a lot of advocacy hours calling representatives, calling senators, laying the groundwork for this bill, many meetings with Representative Fox and other senators and representatives. So it's just been a long time coming, and I was really happy to kind of finally come to a head here and meet with Jeanette at the Capitol and present this bill and speak on support of it. It was very much a surreal moment with all of this work and time coming to a head, and it was really, really cool to speak on behalf of it.

So it was really a great opportunity for you to show, I think, and we can demonstrate this via sound, just how prepared you were at committee and you were laser focused. Here's, here's what we heard.

House Bill, 4484, protects and preserves the important changes that mdhs has made, ensuring that private and corporate interests are not embedded into our state law. Our Michigan State license is a rigorous and publicly accountable credential. Licensed SLPs should not be required to purchase certificates from third party organizations in order to provide speech therapy to Michiganders. This bill will lower cost for providers, increase access to care and retain qualified SLPs in our state.

Boom. I mean it, it really is. It's simple.

You just took the words out of my mouth. I was about to say, boom, drop that mic.

Yeah, it's it's so simple. And that's the thing Representative Fox has said and his legislative assistant, this is a simple bill, and it really is you said earlier, Alexa, for you and. And for Mikayla and for us, this has just been a case of telling Michigan, follow the law that's on the books, follow the rules that are there. You do not have to keep doing this. And I, you know, we talked about some of the phraseology of how we're going to present this, and I like that part where you said this kind of protects and preserves what we've accomplished.

It 100% does. I think that there was always just a little bit of fear in Michigan, because those rules and guidelines that mdhs set out to change in November, you know, it ensured that we don't need the CCC in order to bill Medicaid. But there was always this little bit of fear that mdhs could change their minds at any time, so this bill really sets to protect and codify that change so they can't just change their mind, and it's protected by a law. So that's the whole point and purpose of this is to preserve the work that we've done in the state of Michigan.

And then to transition over to Jeanette. Who Jeanette? I mean, when you show up and you're ready to go to battle, you really did dress for success.

That's right, went to Macy's the day before, and I pulled my shit together. I don't always look like this.

It won't show on the pod, but let me tell you, she was you both looked lovely, but Jeanette was in full battle mode, and this is some of what you would have heard if you'd been in committee.

As our profession has grown. The American Speech Language and Hearing Association, or ASHA, has expanded its influence too, while ASHA has helped to define who was an SLP in the mid 20th century, states have since taken those guidelines to establish 50 state licensing boards, including Michigan in 2011 this change has left some confusion among government agencies, employers And insurances about the difference between ashes certification and a state license. House Bill 4484 makes one thing clear, in Michigan, a state license, not a private certificate, is the official credential to practice as a speech language pathologist. A Michigan license ensures public oversight, ethical accountability and consumer protection, the essentials in healthcare, and I might also add, is more rigorous to maintain than the CCC.

Great, more rigorous, better accountability. It's there and it clarifies. It cuts through the mysticism about what is a license. What does this mean? And Michigan represents the culmination of efforts by two outstanding fixers who wanted this early on, and Jeanette i i was not in Lansing. I was watching the meeting back here in Little Rock and just seeing that preparation, and it's, it's just like, wow, there, there's a strategy there, and everybody is in position doing exactly what they were meant to be doing and what they prepared for, and you didn't disappoint as usual.

Thanks. I just think things are going so well in Michigan that when Fix SLP started, we had no idea what that would look like. And as things unfold in Michigan, I think this is exactly what Fix SLP should look like. I think for the future, hopefully we are collaborating more with state associations, but for now, as we kind of put this our stake in the ground as a grassroots advocacy firm here to help represent the people who have boots on the ground, I think we just go full speed ahead and we just show people what we're here to do, and we go do the damn thing like this is exactly what we would love to do in every state. And I'm just so proud of Alexa and Michaela, who I've mentioned before, but I never know what people are listening to. They didn't know each other before this. They met because of a communication channel that we had early for Fix SLP, they decided we're going after this, and they did it. They just did it. They didn't wait for what is fix. SLP, doing about this. They were Fix SLP, we use that hashtag a lot. We are. SLP, it's not. We are ASHA, it's not we are Fix SLP, we are. SLP, and they just, they just did it. They got together, they figured it out, and then we started walking beside them and helped fund a couple things and attended meetings with them. And it was just the perfect synergy of taking their dream and taking our dream of like helping and just meshing it. Together, and there's still more steps, which I'm sure you'll cover, but this was a awesome first start, and I can't wait to meet new people and do this in other states. It's, I just got goose bumps. I just, I can't wait to do this some more, because it's, it's, it's a great dopamine hit, but also it's something to be so proud of. Just us and Alexa, Michaela and you, Preston, you helped, you helped us write our speeches, and all of those people in Michigan who sent letters to their reps, it wasn't just Michaela and Alexa, it wasn't just Jeanette using her mouth. It wasn't Preston helping to write speeches. It was every single person in Michigan who responded to their call of action that got us right here to this podcast today.

And we anticipate next month we'll see a vote, and based on the feedback we've got, it looks like a very positive vote. We're going to hope for that looks good, and that will get approved out of the House Committee, goes before a full vote of the house, not there long after, and then over to the Michigan Senate, and this bill, ideally, in two or three months time, will be on the desk of Governor Whitmer and signed into law. And so the full process will have come full circle, and we can take this and move on to the next state and make it happen over and over and over and repeat that process of success. I am curious. You know that that committee hearing room, it's it's different in every state, and it's often different in every committee hearing about how many people are there? Alexa, when you were there that scene. Were there nerves there? What did it feel like in the room with the amount of people in there and the microphones kind of kind of set the scene for us?

So I got there pretty early, and I waited in the lobby, and then I walked up with Spencer, who is representative Fox's, his secretary, his assistant, and he kind of brought me into the room, and it was very similar to, like what I imagined a courtroom would be, where there's like a long table of people, and then there's like a hearing table, and then there's everyone watching. So it was pretty full, and all of the representatives were sitting there. It was very surreal. It was very, it was just a wonderful moment, really, because we worked so hard to get there and to be able to go in front of the committee and present this bill that we've all worked so hard on was very surreal. It was very, it's kind of like what Jeanette said. It was very much a dopamine hit. It was amazing to watch and to present. I was very proud. I feel very blessed to be able to go and present this in front of so many people, and we've spent so many hours and so much work to get here. It was an amazing experience.

the setting of seeing the state representatives up on the dais, and we got a couple of questions. As we mentioned, Jeanette, one of the comms challenges that I've often sort of put forward to our team, and particularly to you sometimes, is that when we talk to politicians, we talk to these people, we have to really keep it in lay terms, and we can't go too deep. As I was watching you answer some of the questions I could see you just you took it and ran with it, and you kept it in very informative terms. But also it was not in Speech Language pathologies. And I sense that that you know, intuitiveness in you, it just shined through.

It was like the little angel and devil on my shoulders, like talking into my ears because the words were coming out of my mouth, but the words of Preston were going in my right ear. That said, keep it simple. Don't get too deep. And one of those questions, oh my gosh, I could have, I could have lectured all day. They asked Dr Benigas A question about dysphagia. And you know, that's what I teach. It's what I do. I have a fees company in nursing homes, and it was a more specific question about Medicaid and servicing seniors and nursing homes, asked by a nurse. Actually, she was just wonderful representative. Thompson, yes, thank you. I couldn't remember her name, and I knew that she knew what I was talking about, but nobody else did. And I really could have gotten into the weeds, but Preston was you were just right there on my ear, like saying, Keep it simple. Keep it simple. But I was excited to have that question. They didn't know that they were tapping into my area of expertise. And I just think that couldn't have worked out better.

And our bill was not the only SLP fair on the menu for the committee, as the speech language pathology compact Bill was followed our presentation, and that led to some interesting confluence of different personalities in the room. Jeanette, wanna you? Speak on that point.

I have to be nice, right? I'm not calling them out yet, right?

No, I mean, it's, it's really up to you. I think that, you know, for the Fix SLP crowd, we are, we've talked about the compact before, and we are very pro compact. And this is a, you know, long process that has had a lot of great stakeholders go do the input. It is free and independent of the certificate. It aims to get that licensure portability that we all seek in today's economy, with travel therapy, with telehealth. And it was good to see that bill coming before Michigan, and there were some interested stakeholders there. But I guess what was a little bit peculiar, and we're still, you know, we're new, and that's when I made the speeches and talked about the message for the day. Jeanette, I was looking at where we started. I'm like, this was like, a year ago. And so this is so fast moving, because we've got people that are so passionate and are really hard working. The compact has been churning along for a little longer, but Misha had the lobbyists there, and they had a representative there. And you can turn in comment cards in committee, which are sometimes you can speak about something, or you can just say, I'm here and opposed. I'm here support. And in the case of what we got was a neutral card from mishas liaison there, Dr Kelly Pierce, and then I'm so I'm so proud of my fixer friends here. I just have to brag on them during the Compaq presentation. They get to the end and Fix SLP has two positive cards in support of the Compact. So it's sort of like, you know, you can't help us celebrate what we're trying to do here, which is a common sense thing that affects us all, and we get a neutral card. But you know what? We are going to be positive here. We are going to stand by what you're doing because we believe in it, because it's for the best, for our profession. Unfortunately, we didn't get that endorsement. But you know, we're we're still young, we're still plucky and trying to find our way. And you know, hopefully someday that'll change.

Goals. Goals. What I really hope is that these state organizations see that we're not here to take them down. In fact, we've been supporting them from the beginning. We are their biggest cheerleaders. You know, this week has been fun, but also difficult, as I have heard from people in other states that have had some really unfortunate state experiences directed towards Fix SLP, but we'll work through that. We'll rise above it. And you know what, at year five, maybe they're coming to us instead of ASHA, we got a perhaps an ASHA mole posting on Facebook, stirring up some fix. SLP, controversy, and all of our fixers came to our defense, but I did write in the comments, and I'm sure it got buried. But I have big goals for fix. SLP, my head is 90 years above where my body sits today, and I would love to have a Fix SLP foundation. I've already named it. I already have the name in my head. And, you know, to give state organizations grants, maybe higher than the grants that ASHA gives. To give clinicians who want to do work in their states grants. You know, these are things that, as soon as we figure this all out, we can do this. And so five years from now, maybe we are working with state organizations, but for now, we will continue to celebrate them and support their work and just let them know that we're not foes, we're friends, we're you know, we're here to be a part of it, and we understand that there's a lot of fear in the profession, especially when it involves ASHA, and these state associations are afraid to interact with us, because what will ASHA do? And the truth is, ASHA can't do anything, but I think it's going to take a while for people to realize that.

And what I would say, I was not there, but I talked to you both, and missions, representative, lobbyist, person and, you know, liaison, whatever title that Dr Pierce would claim. What I would love to say her, because she wouldn't really even make eye contact with the two of you. It was just persona non grata. I'm neutral, you know, I can't do this because, you know, God forbid Asha finds out, and then I, you know, get voted off the ASHA party island. But what I would say to Dr Pierce, and I said to, you know, folks, we we tried to reach out to Misha early on, Alexa, the thing that they're missing is that zeal of SLPs that are just shackled. They're shackled by that system of fear, and they want to break out and do something different, and to fight for reimbursements, to fight against case caps, to fight for what the licensure means in the state, to, you know, modernize our system, where we get away from situations like we have with CMS, Dr Pierce, you're missing out, because right here. Alexa Chapman, this is someone that you want knee deep in issues in Misha, and they're Mia, I think they're missing a huge opportunity, Alexa, and I'm glad you're on our team, but I wish they had your skills too.

And I'd say also, Mikayla, you know, Mikayla is not on this today. She Michaela, she was killing it somewhere else this week.

Yeah.

Mikayla planned and executed a camp with friend of the movement, Jordan LeVan, a camp for kids with apraxia of speech in Michigan. And they got volunteer SLPs and volunteer students, and they, you know, they had tons of supplies donated. And I wish I could have been there just to be a camper, but we don't want to leave out Michaela, because she is equally as aggressive as Alexa with advocacy work and taking these state issues on. And you know, Misha should have her as well. Dr Pierce is miches advocacy chair, or committee chair, so that that is her role, and that is the type of person that we all should be besties with, I feel but they make decisions.

And avoid eye contact. Social pragmatics, there are a work in progress, apparently.

We could have reached out and hugged her. We were standing that close. We were sitting in the front row. So when people walked away from that table, our feet were inches apart as they walked by us and she literally put her head down

And remind me, Alexa, when you went through the MDHHS process, I think that it was a cool reception from Michelle on that issue as well, wasn't it?

Yeah, it wasn't. They weren't really in support of what we were doing.

Why? Why? Why? Because all you wanted was that clarity of really just follow the rules. I mean, it was similar to Arkansas, where, if you really go by because I, as I recall, Michigan's answer was, well, we go by federal law. And it's like, oh, well, great. You know, the federal law doesn't require a CCC. There are other options in there. And it was like pulling teeth to get anyone to recognize that.

I think I have a screenshot somewhere in my phone, but it was I got a response, something along the lines of, as as a courtesy, will respond to this email, but you have to be a member in order to have some sort of correspondence. And I am not a member of MSHA.

I think that's what it was. I think I remember you sharing that.

Yeah, that's, you know...

pay to play

I... yeah. I mean, it comes down to that, and it's, it's like, I've always said, people say, Well, why didn't you get involved with Asher, or do a committee, or, you know, do your state chapter. I was never invited. And I think at some point, you know, at the state level, especially, you have to say, Hey, can you come in and help us with this? Because we need help with this. And you feel, you know, you seem to have a skill set and a passion for this. So rather than this just, and that's the thing, we're supposed to be communication specialists, damn it. Rather than sending this cold, very, you know, oh, you're not a member, you know, we don't want to hear from you. Rather than that, how about sending something that says we recognize your passion, let's have a meeting. Let's sit down. And in that meeting, you can say, look, in order for us to get behind something, we do have to have it be part of a membership, but we really like the direction you're going. We want to have further conversations with this. You know, Can you can you sign on with our team? And let's run with this. But I don't think that meeting happened.

What a good way to grow your membership association, too, right? Inviting people in like that. And I want to clarify, we have had some phenomenal states on this podcast. So if you're a new listener, a new follower, go back. We haven't done any in 2024 but we did, or I'm sorry we haven't had any in 2025 yet, there are some who would like to come on. But in 2024 we had several, and maybe even 2023 I don't think so. Just 2024 there were at least five states that have come on, and not every state association operates like that. I they they would now all be past presidents, but I have had some excellent conversations, some with who have stayed in touch with us, conversations with some of these past presidents who their their state associations that they have represented, take on the view that they represent all SLPs in their state, whether they're members or not, and I think that is a great way to operate, because ultimately, the work that you're doing is going to impact all SLPs in your state. So with that attitude, I think that you're more likely to have people pay attention to what you're doing, and potentially. You join your membership association.

I think if I had had a different experience, I likely would have joined. If I thought it was something that was going to be super beneficial, collaborative, I likely would have joined. But so is my experience,

And I can't tell you right now. I won't name names, but Jeanette knows what I'm talking about. We have had state associations on the pod, but we've also heard from people that are part of state association boards that have reached out anonymously and said, gee, we would like to talk, but we just can't. And that goes back to that fear element, but Jeanette, I know you've had those anonymous conversations.

I've had quite a few, quite a few, mostly presidents, some still active, some now past. But there's value in having those conversations with me too. You know people have shared information that we have kept close to the vest. We have people who have said, now's not the time, but we'd like to affiliate, not necessarily affiliate. That's not the right word, collaborate, communicate. Yeah, we'd like to collaborate with you down the road, but we're still working on some of these foundational fear issues in our state. First, we totally respect that. And you know it's it's going to be a process where we've done a lot in 21 months. Give us another 21 Jeanette for President of the world? No, I'm just kidding. You know it's, it's going to be a process, I think. But, yeah, we reach people can reach out to us anytime we're really good at keeping information quiet. I feel like I've become the keeper of the SLP secrets. Over the past two years, got a lot of secrets, and my memory is awful, so don't worry about it. It's I'm gonna forget them. But...

That works so naturally for me as well. Because, you know, I have a background. My undergrad degree was not in communication disorders, it was in journalism. So I learned journalism law. I worked at a news radio station at one time, I reported on stories, and I would have to go on background with people where you had sources that you couldn't reveal. And so it kind of feels natural to me as well when someone says, Well, I can't, you know, reveal my identity. Okay, you know, I can keep a confidential source. And so that's another skill set that we had to flex here in the Fix SLP world.

Yeah, we're Fix SLP is interesting. You know, we're not a 501c3, we're not a nonprofit. Multiple lawyers have advised us not to become one for various reasons. We're not journalists, but we do a lot of research and reporting, and we try to live by those standards where we always have credible sources for the things that we post on our content. We don't always put the source, but they're always available. If people ask, we're doing advocacy, we're doing legislative work. Are we lobbyists? What are we? I don't think there is a category for us at the moment, at least the CPAs I've talked with and the lawyers I've talked with haven't been able to find any organization who does things the way that we're doing them. So that's also an interesting part of this journey, is we are really designing the template for what it looks like when people take matters into their own hands and get stuff done. I guess I don't know it's, it's been interesting. So, yeah, we do kind of abide by those journalistic laws, even though we only have one journalist on the team. Yeah, it's just, it's an it's been an interesting journey, to say the least.

But right now, I would say more than anything, it's five people who won't take no for an answer.

Damn straight,

And we didn't. So Alexa, congratulations about what happened in Michigan. So let's visit again once the bill becomes law and we already, I don't know if Alexa know this, we already had one state senator from another state reach out and wants to review this bill, wants to see the committee meeting and how it went, and we tentatively have a date on the books to visit with that state senator about making this process happen in their state. So it is proliferating. And I think Alexa, you were, you were there at the birth.

Yeah. And I just have to say, like, the amount of like, head nodding when we were reading our speeches, how just, like, sensical this is, and how codifying it is with our with with what's already in place. A lot of people were very much in agreement with this bill and where we were going with it. Truly I was I don't get nervous very often, and I don't I was more flustered than anything, because while Alexa got there early, true to who I am, I was. Walking in and sitting down as representative Fox was already starting that clip that you heard covered in rain, despite my every effort to get up early and be there. This is ADHD folks. Welcome to my life. But so I didn't have time to be nervous. So I didn't know what I was going to feel, but I felt almost welcomed. I felt almost like I was talking to a friend who maybe challenged me a little bit, but was just asking for the reasons why I was doing something. I didn't feel challenged. I just felt warm. Is the word, don't you think Alexa like, especially Representative Thompson, and is it Dubois, debo?

representative Thompson and Representative DeBoer were the two that asked the questions, which I really appreciated.

Yeah, it. Representative DeBoer asked a great question that you answered, and then I jumped in on and I just felt like they were, like our proud moms just there to Pat us on the back. It was great. So I did, I did appreciate that atmosphere of welcomeness, and I bet it's not like that in every state or on every committee, but that's truly what it felt like for me.

And Representative DeBoer is a co sponsor of our bill as well. I wanted to put that point in there. Yeah, yeah. So this has been great, guys. I'm excited. I Is there anything else before I send us off?

I don't think so for me, I just really want to quickly say one more time, just so it's nice and clear, because it might have gotten lost in our conversation. This was just us introducing this bill to the Health Policy Committee in the Michigan House of Representatives. They will vote it through, hopefully in a couple weeks, and then it goes to the full Michigan House. We don't foresee a problem with that. We have representative Fox sponsoring the bill, and then 11 additional co sponsors, and it is a simple majority vote. So as long as the majority of the vote is yes, it will then move through to the Senate, where there is a another, if I'm understanding this correctly, a Senate Health Policy Committee, where it will have to go through that and then to the floor of the full Senate and then to the governor. So we have sort of a long road ahead, but there's a lot of support. We're not foreseeing a ton of pushback. It's interesting. We didn't bring this up, but the day that our bill was assigned a number, Ash's lobbyist for Michigan did reach out to Representative Fox's office to let them know that they would remain neutral on the bill. It was our understanding that they were going to be there because of the compact, but they were not. So there is a it's not a secret. There is a quiet joy in me that knows ASHA sort sort of has to sit and watch this happen, because the minute they oppose, at least publicly, they know that we will crush them, because they continue to maintain that they don't lobby for the CCC to be required for anything, and if they come out against this, or even make a peep that they're not for this. They are doing the exact thing that we say, that they do. So we have a nice position here. They could get into the ears of people quietly, and maybe they've already done that, but we didn't see that come out in this health policy meeting. So I'm excited to see where it goes. I will keep making that four and a half hour drive up there just to watch this thing happen. Spencer had said, we can bring you in on Zoom to testify. And I was like, hell no, boy, I am coming to this Okay, I did a 13 hour round trip meeting to Delaware one day just to sit in a state board meeting. I am coming to testify in person. I will go to Macy's and buy a freaking dress. Okay, I wear pajamas and scrubs every day. I will buy a dress. So, yeah, I'll keep going to watch. It was just, it was great. So thanks for everybody who supported and who's been listening and following along. And let's do this in your state. Let's do it. I'm ready. Don't ask me to be there at 9am I will be late, but if we could make it 7pm I'll bring snacks.

I think that's a good place to bring it to an end. And Jeanette, you're welcome to jump all over me if you don't like this ending. But for DR, Jeanette Benigas, I'm Preston Lewis, and we specifically want to say to Mikayla and to Alexa, thanks for fixing it!

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