The CCC Dilemma: Making Informed Decisions as Students and CFs

2:33AM Mar 19, 2024

Speakers:

Jeanette Benigas

Keywords:

ccc

asha

cf

slp

megan

state

membership

negotiate

apply

practice

cfx

students

requires

fix

application

working

podcast

benefits

employer

answer

Hey fixers. I'm Dr. Jeanette Benigas, one of the cofounders of fix SLP. Our platform exists to discuss the biggest challenges that are currently holding back the field of speech language pathology. We present the issues with facts and invite you to be a part of joining this movement to make things better one conversation at a time. So let's fix SLP

Hey, fearless fixers, this is Jeanette, welcome back. I am here today doing my first ever solo episode. It has been an interesting couple of weeks for both Megan and I, my mom has been in the hospital, a lot of you know that. And Megan has decided that it is time for her to step back from fix SLP she did send everyone a message on our social media platforms. So if you missed that, please head over to Instagram or Facebook. And check out what she had to say she was not asked to leave Asha did not serve a cease and desist. This is something that she needed to do for herself, Megan and I are still friends, we are still communicating. So as we make this transition, it is smooth, it is just going to take a little while as I get my footing to sort of take over the roles that Megan had carried, I want to give everyone an update on what they can expect moving forward before I jump into today's content. First, I'm not leaving, I am still here. The mission of fixed SLP is not changing. Megan and I had plans for state specific content as her mega spreadsheet rolled out that make a spreadsheet is now in my hands. So that content will be coming. Now that was something she was going to organize. So I have to take some time and pull that together. But you'll start seeing it here in the next few weeks, the sustaining Partnership Program is still going I would like to be clear that I will not be drawing a salary for now or anytime in the near future. Through the sustaining Partnership Program. We rolled that out to try to start helping to pay for some of the expenses that it costs to carry fix SLP including reaching out to a lawyer, I have done that I have reached out to a few lawyers to get rates and to see if there's some type of retainer that needs to be paid. Very specifically, I am starting with someone in the financial arena. I have to be careful what I say and be careful about disclosing those conversations until I hire a lawyer and know what I can disclose because putting out everything that we are going to be doing on air isn't wise, right. Some of that has to stay quiet for a while. But that is happening. I'm working on it again, slowly, Megan and I are transferring bank accounts and I need the card. And so that is all happening it is in the works. If you have not heard about the sustaining partnership program, head over to fix slp.com. This is also in lieu of a Patreon. What you will also hear coming soon are some sponsorships for the podcast, we had been working on that prior to my mom getting sick. So I will be picking that up very soon. And that will also help pay for me and some of the expenses that I have in terms of getting this out to all of you. So do I want to do a solo podcast? Absolutely not I love talking but I also love having a co host. So my plan for the podcast will be to invite co hosts and contributors. So I will be handling that via an application system or or more of an audition type thing. As of this recording. I do not have it set up yet. But when it is ready to go, I will ask you to submit a very short audition tape. So I can listen to you see you and perhaps ask you for some topics that you'd like to talk about. And then as I have my agenda for the podcasts, I will pair up some people with the topics and we'll get you on as a co host. So that way I'm not sitting here talking in an empty room all by myself, because that's part of the fun is having the conversation with people. So that is coming. More than likely I will also be taking volunteers when Megan and I were looking more towards using some of the sustaining partnerships to compensate time. We felt like it was important to also pay people for their time. I think I'm lying if I say that I can do this all by myself all alone for free though as I discover needs, I will be putting out calls for volunteers eventually. We may have some more folks come on as permanent faces on fix SLP But I'm not rushing into anything in terms of replacing Megan, first of all, Megan is irreplaceable, I won't ever be able to do that. And I'm not looking to do that. But finding people to join this team who can bring value in educating and strategizing and putting out content is important. I can't do this alone. So I will be making a slow transition to also finding one or more people to come on as a permanent fixture. But again, I'm not jumping into anything that's going to take time. So for now, it's just me, and hopefully some fun co hosts on the podcast and some volunteers as we need them. And we're gonna keep rolling because there's still a bunch of stuff going on behind the scenes. All right, so today's topic, I want to talk to you about students and CF. This has been something that has been on my mind for a while several episodes ago, I discussed with Megan about the needed change of letting the CCC go and I mentioned that for as long as people are available to supervise students and CF Asha is never going to change. And I believe that because it is one of the last strongholds that ASHA has on this field. As someone who has worked as an externship coordinator at the height of COVID. I understand how hard it is to find placements for students, I understand how hard it is to find quality mentorship. So it's something that I see both sides of very, very clearly. And I understand the issues that go with each side. And I also understand the fear, I understand the fear of the what ifs the unknowns. And so with that a lot of students have gotten nervous CF have started to ask questions. People have reached out to us I personally have appeared on a couple of platforms for students and TFS answering questions. So that's something that I've been working on outside of the public eye and Megan and I put together a really handy document on our website. So if you go to fix slp.com, and you click Resources for SLPs. Currently at the bottom of that list, there is a link that says for students and CFS. At the time of this recording, it is not updated. I spent some time on the phone with ASHA today got some really useful information. And I do need to update that that will be updated. But I'm not sure if it will be before this episode airs. So I will cover the information in the podcast today. And then in the coming days, you'll see those changes reflected on that page. So I took questions on our social media platforms, specific questions from students in CFS, what questions do you have? So I'm just gonna jump right into those. The first question is the CF website makes it seem like you only have 90 days to apply. This is also what my employer told me. And I'm going to combine that with a second question. I can't make sense of the CFX options for certification. It seems like two for the price, two years for the price of one. And so what that person is asking there is what do you pay? And how many years do you get? And I wrapped those questions up together? Because I'm going to give a really long answer that will cover both I called Asha this morning, I called the Action Center and I had a conversation with a lovely, very helpful Action Center employee in the area of certification. I have no idea if she knows she was talking to fix SLP. But regardless, she gave me the facts and I want to pass them on to you. So everyone is on the same page. And then I have some opinions that I can share. So first things first, Once you initiate your CF, you have 48 months to complete it. So ashes outlined for that is 36 weeks, 1260 hours. So that's approximately 35 hours a week. I want to clarify that this is the CFX we are talking about every state has different licensure requirements. And what I recommend is making sure you are intimately familiar with both the state license is what you need to practice in many cases, their professional experience year or whatever they call it is a non negotiable. You have to do those things that your states are requiring in order to get licensed to practice in almost every other situation. And I say almost because there are a couple states that require the CF specifically relationship where there are those 11 states that require the CCC for Medicaid billing so you do have to go through the CF process

if you plan on working and billing in that state. So in almost every other situation the CF is going to be optional. That isn't something that needs to be a priority while you do need to pay attention to it, and you do need to pay attention to the requirements, the state license is the one that you are going to need, aside from those few exceptions to practice as a speech language pathologist. Okay, so now that we're clear, let me jump back to the answers here. So once you start that CF, you have 48 months to complete it. And I asked very specifically about the application, when should you apply to Asha, as it relates to your CF timing. And what the person told me actually surprised me, I always thought you applied at the beginning. And as it turns out, your application can go in before, during or after the completion of your 36 weeks, 12 160 hours. Once you put the application in, and you initiate that with ASHA, you have two years to start the CFX. So if you do it at the beginning, and you don't start right away, maybe you can't find a job, maybe life happens and you can't get started. Maybe you're moving or you're waiting for some type of provisional license in your state, there's a million reasons why you might not start right away. But once you apply, if you haven't yet initiated working, you have two years to start the CFX from the time the application goes in. Once you do that, and this is according to the Action Center person that I spoke with, once you do that the clock starts ticking on the years that you get so that second question, I can't make sense of the CFX options for certification, it seems like you get two years for one, according to the Action Center person that starts when you put in the application. So what she said was, I'm recording this in March. She said if you're starting right now, in March, you wouldn't finish your CF until December. And she said it would be smart for you to wait until after you're done. She said then you'd have that two year membership all through 2025 and 2026. So hopefully that makes sense. So for the person who asked that second question, it seems like two years for the price of one it is but also they're charging you $500. So really is it too for the price of one, I don't know. So you can hold off on that application, the application doesn't have to go in at the beginning, it can go in at the end. The actual person center that I spoke with said once you apply for that CF, you will get an ASHA card it says that you are an applicant in process. That's all that it says. So it's, it's remember, the CCC is not a license to practice, you aren't doing the CF to get license to practice, you're doing the CF in order to be able to purchase their proprietary CCC product. So really, it's just a card that says you're in progress, it doesn't do anything for you. So you don't really need that card. But when you complete when you finalize, when everything is signed off and your CCC purchase has been completed, you will get a new card that shows your membership status. And we'll get to that in a few minutes. So now I'm going to jump to that first question. The website makes it seem like you only have 90 days. And this is what was throwing me off, as well as Megan, we had talked about this multiple times. And I think this is the information on our website that is incorrect. It was our assumption that when you finished your hours, you had 90 days to put that information in to get the CCC that is not correct. The 90 DAY TIME bar is for the mentor, not the student. The 90 DAY TIME bar is for the mentor, not the student. So once you have initiated your application with ASHA, whether that be at the beginning, the middle or the end, eventually, you will put in your time worked, you will put in your mentorship hours, you will put in the mentor information. Once those hours are put in the mentor has 90 days to sign off on that CF. And that is to keep the process moving. Because it would be awful. If you completed that CF. You put all of your stuff into the application portal. And then the mentor never signed off. And then what happens? So at that point, it's really transferring the responsibility to the mentor and Asha will hold them accountable. What she told me is they start sending emails they start to Taking care of getting that person to sign off. So if the person doesn't sign off right away, they are doing the follow up, which is great kind of takes the responsibility off you. And hopefully that mentorship relationship was great. And they sign off right away. But sometimes things happen. Sometimes things happen, and you just you don't have a good relationship, the relationship is strained, getting follow up from that person is hard. So Asha takes care of that for you. So that person has 90 days to sign off. So you can move towards purchasing the CCC. If that's what you wish to do.

There is no time limit for the submission of the CF. So that was my question, do you have to apply within the 48 months do you have to apply within the 90 days? And the answer is no, you could start your CF today and finish in nine months, and not apply for four more years or five more years or six more years. So there is no time limit for the submission of the CF ours to purchase the CCC. But there are some caveats. If you've been following us for any amount of time or not, you might know that the practice scores are only good for five years, what the person at the Action Center told me is if the practice score expires, and you haven't applied for the CFX, you may need to repeat the CF. After I got off the phone with her and I was preparing this that did not make sense to me. What made sense was that you would have to retake the practice. But if you are someone who has not applied or you're someone who chooses to wait, you start getting towards the expiration date of that practice score, you may want to give the Action Center a call. And really you should always call to confirm the things that fix SLP tells you just to be sure, but at that point, you may want to call and see, hey, if I don't apply before XYZ date and my practice score expires, if I want to apply down the road, will I have to repeat the CF according to her that answer would be yes. So that's one timeline you need to pay attention to is how current is your Praxis score, and are you going to be applying before it expires? Another situation and these are so person specific is maybe you start that CF, you don't finish within the 48 months life happens. Maybe you have kids or you move or you know you get sick and then 10 years down the road, you want to finish, you would have to start over because you've exceeded that 48 months. There's another little caveat there that there's no time limit for submission. But if you've started and then you pick back up later, and it's been too long, also that would be outside of the practice score windows. So you'd be taking the practice again, which could then mean it triggers a new CF again, you'd have to call to confirm that. So hopefully that makes sense. And that response now that it's clarified from Asha is going to guide one or two of my answers moving forward. The next question is I really don't want to get my CCC, but my employer requires it, what can I do? Well, you have a couple options. If you don't want to get the CCC, but your employer requires it, you can find a new job. That's a little bit extreme. We're not really living in an SLP world yet where there's tons and tons of jobs that don't require the CCC. So unless you know of something that's a good match for you both in benefits package and setting and distance from your house. And all of those things we consider when we're taking a job unless there's something available, quitting probably isn't a viable option. But that is option number one, you can quit and you can go somewhere else. Option number two is that you get the CCC and that's okay. It's a choice. Everybody has the choice. But what I would do with that is begin to educate that employer that they are requiring a proprietary product for you to practice that is not required in your state. So I'm assuming that the person that asked this question doesn't need the CCC in the States or to bill Medicaid. So if that's the case, start educating. And then if they're not going to budge, start trying to get reimbursed for that CCC. If they're going to require something that isn't needed to do your job. They should be paying for it. So at least if you're going to have to get it try to get that reimbursement so that way the financial burden does not fall on your shoulders. We do have resources at fixed slp.com. There is a letter written by our friend Brooke Richardson that you can use to start educating your employer as well as a PDF that you can give them in that conversation. So hopefully you find that useful. Everything on our website is free. So head there, grab those if you are someone who wants to educate. So the person who asked that question didn't define if they were a CF or already a CCC holder, but another option is to join without membership. So if you're a CF and you're moving towards getting ready to apply for the CCC because your employer requires it, you can get certified without the membership. Which leads me into the next question. I'm a current CF, can I apply for Asha non membership the first time to save money? The answer is yes, you would apply for that CCC. Without membership, it doesn't save you a whole lot of money on the current pay schedule. It's $26. I think in 20 to 25, it becomes $28. But it proves the point, it does prove a point. No one requires Asha membership to practice, you do not need it, you would lose access to benefits such as the journals and car rental discounts. We've we've covered some of those before. But all of the ASHA benefits are available on their website. So make sure you're sure that you don't want access to those benefits. And if those benefits aren't something that you care about, then sure join without the membership, I have heard that the CCC without membership is on the initial application. Every year thereafter, your renewal will come at that rate. So if you later decide that you want the membership, you'll have to switch it, I'm assuming and this is a complete assumption. And you know what assuming does, but we're gonna go with this because it's to the benefit of Asha, I'm assuming that every year they give you the option on the application to switch to membership, that's just a guess. But if you were to join with a membership, and you later want to get rid of the membership, you have to call them it is not on the application. So yes, you can apply without membership to save money. And if your employer requires the CCC, you don't want it and you don't need the benefits don't get the membership. The next question was when getting a CF? Is it worth the trouble to try and negotiate getting the CCC paid by the company? Yes, that's part of your benefits package, you absolutely should negotiate that and negotiate it as part of that benefits package and get it in writing, the more knowledge you have about the requirements to practice in your state. And the more knowledge that you have about what's required of you in your state, the more powerful your negotiation can be. So asking if the CCC is reimburse upfront is good information to have. Remember, you are interviewing your potential employer as much as they are interviewing you. In many cases, they need you a lot more than you need them. So negotiating that benefits package upfront is absolutely something that can be done, Megan and I had another project called other SLPs pockets. It's a limited series podcast, we talk a lot about negotiating that kind of stuff over on that series. So if you want to check it out, you can get some good tips there. But I would I would try negotiate getting the CCC covered. And you need to get it in writing. Get it in writing, because if it's only verbal, the conversation never happened. And later, they can come back and say, well, we never said that, or you know, whatever. So getting it in writing, any benefit that is spoken to you that you are told has to be in writing. So yes, you should negotiate that. Just know that it's hard if you live in a really condensed area where there's a lot of people applying for the same job and you're negotiating for that CCC and for other people aren't, you're less likely to get it doesn't mean you won't get the job, it's okay to negotiate. They just might say no, because they have four other people willing to take the job without that reimbursement. So that's why it's important for all of us to be negotiating for the things we need as clinicians, because when people are willing to do the job without the things we need, it makes it harder for the rest of us to negotiate and advocate for ourselves. So that's a soapbox on other SLPs pockets. I'm going to step off of it now because I wanted to keep this one shorter, since it's just me. Why does the certification cost approximately $500? The first time? I don't know, I suspect it's because of that two years benefits package. However, it's always been expensive. So that's a great question, though, to call and ask what am I getting for this amount of money and why is it so expensive compared to the yearly renewal? That would be an interesting answer to have. This wasn't a question, but I did want to address it. Somebody else said I just got this CCC and I'm feeling a little bummed about finding more of the truth about Asha and you know what? It is a bummer. It is I think it's a bummer to a lot of people, whether they're students or they've been practicing in the field for 3040 50 years. A lot of the things that we have discussed on fixed SLP is new and a lot of people are going through a lot of thoughts and emotions trying to make sense of what they're learning and trying to figure out how it applies to their lives and their jobs. And in some instances, their identity. And it's tough. This is all tough, everything we're doing is tough. But you know what, it doesn't mean that you are not going to be a great SLP. It doesn't devalue all of the work that you've done, it doesn't mean that you aren't going to change lives. What it means is,

you have options. What it means is you don't need Asha, to be your best SLP self. What it means is, you could probably save some money and take the power back and be autonomous, which is amazing. Do you have to do those things? Nope. If you want to do those things, can you Yep. So don't be bummed. Feel empowered, because you have information to start moving towards choices for your future. And you don't have to make any choices right now. But in five or 10 years, your circumstances might change. And you might not want that CCC and that's fine. In our best world, you would just be able to not get them, and it would never be a thing. So don't be bumped. And that's gonna lead me into this very last question. The last question I want to address is Why do you think grad schools place so much importance on Asha requirements and licensure? And this is a very layered answer, what we need to do is start changing the language, the language that begins at that graduate school level, which is you are working hard to earn the CCC, you are working hard to meet these requirements. And really, you leave school thinking that the CCC is a license. And that's not true, what you're actually working hard to do is obtain a state license just like every other medical practitioner. So the idea that the CCC is your ultimate professional goal is so antiquated. It continues to be used by university faculty for a couple of reasons. One, because they're operating from an outdated mindset, it used to be that you had to get the CCC to practice because we didn't have state licensure boards in every state. And we had to have some kind of structure to protect us and to guide us. And so that thing was the CCC. But in 2016, the last state licensing board was established. And that fully transferred the power of our profession to our state licensing boards, whether people like it or not, that's how it is. And that's how it is in every medical profession. So some of our not so biggest fans always push back and say we can't leave it up to the states will fall apart. And that's just not true. You don't see every other profession falling apart every other profession, especially as PT and OT, which is what we often compare to, they're all doing just fine. They're doing just fine with their state licensing boards controlling their profession. So that might be one reason is because they just haven't realized what we are all learning. Now. Another reason might be that they personally choose to support Asha and the current model of certification instead of licensure. They just might not want to hear or know the truth or or want to support it. And so when you're hearing this outdated perspective from your school, it's not that these folks, your professors, your clinical instructors, it's not that they're lying to you. Sometimes they really just don't know that the CCC is redundant and doesn't offer additional regulations or competency standards above what your state license requires. Unfortunately, because of the long standing influence of Asha and the CCC on our profession, it really is a common misconception that purchasing the CCC to practice legally is required. And that's just not true. So we need to break that cycle. And it's going to be the students coming out of school, the CS who are really taking a step out and say, You know what, I don't want this. I don't need it. I don't want it. I choose not to get it. And then what the rest of us need to do are two things. This is twofold. One, we need to break the stigma. There used to be a huge stigma around not having the CCC and this isn't an us versus them. This isn't an I'm better than you this needs to be. We are all autonomous clinicians practicing with our state license, who may or may not choose to purchase a product just like we may or may not choose to purchase prompt. We may or may not choose to purchase em DTP heck, we might choose to purchase superduper products over a competitor right? We You choose what we purchase. And there needs to be no judgment from our colleagues surrounding our choice. And so that's thing number one that out here in the field, we need to start reducing and removing that stigma thing. Number two is we need to start creating a world where these students and CTFs can leave school and come to a safe place where they can find a job. Which means that even if we choose to keep the CCC, we need to keep fighting and educating to make it not required. So the people who want to leave school without the CCC have a place to work. And so that the rest of us have the choice, should we decide we don't want the CCC anymore. And so that's huge. If people are leaving school or completing their professional experience here and choosing not to get the CCC, we need a place for their valuable skills to be applied. So hopefully that makes sense. So I think that's why grad schools play so much of an importance on Asha requirements and licensure because less than a decade ago, there were states that didn't have a licensing board. And that's how it was structured. And it takes a long time to implement change. And we just need people speaking up to make those changes. So hopefully this was helpful to you if you're a student, or if you're a CF, or if you're a mentor who's trying to walk your student or CFO through this thought process. Hopefully that all makes sense. Now I want to finish up with my advice. And this is just my advice. This is only one opinion, there are certainly no wrong answers here. But if you're someone who feels strongly about not getting the CCC, or if you're not sure that you want to get the CCC, I would go ahead and think about it. The first thing you need to do is look into your state licensure requirements. For the professional experience here, you need to do that, you absolutely need to follow that to the letter of the law and get that done. What you should also do is take a look at the ASHA CF requirements. And make sure that as you go through your professional experience year that you are also paying attention to what you would need to do if you apply for the CCC. So make sure that you're covering both bases. If you are working in a place that does not require the CCC, then you have time you have all the time in the world to decide if you want to apply for your CCC. And the way that things have been changing in this field a year or two years from now, everything could be completely different. And you might get to a year from now and realize I really don't need it, I'm really going to be fine without that product. I'm fine. And you might choose to never apply. Or you might move, you might change jobs, you might find yourself in a place where you have to get this CCC or even you want to get the CCC, you had some time to think about it. And you thought you know what that is something that I want, then apply. So give yourself some time and some grace to really think through it. If you're not working in a place where you don't need it, you have the luxury of time, there is no time bar, the only thing that you are going to need to pay attention to is that Praxis score because remember, if it expires, there is that outstanding question do you have to repeat the CFX, then you'll have to retake the Praxis. If you're working in a place where the CCC is required, then you just have to get it and you don't have the luxury of time. But if you have the luxury of time, take the time, you'll also need to pay attention to certification standards. Those are the academic standards. If the academic standards change, or you know that they will be changing, you will have to call your school and see if your program completion matches what you will need to apply often they change things like science and maths. So maybe you have a biology credit, but they change it to chemistry and you don't have any chemistry on your transcript. And you don't apply for the CCC and those academic standards change. Then when you do apply, you are held to the standard in place at the time of application. So you would need the chemistry class and you would have to go back to school. So pay attention to that too. If you're sitting on that application you haven't applied and you know the academic standards are changing. Make sure you look into your completion and what's coming up so you know where you stand educated decisions are good decision. So be educated on what you have, what's going to be needed and how that impacts your choice. Finally,

I tend to think that holding the CCC at least once in the environment that we're in is wise. So paying for it one time holding it one time is probably a good idea because you don't know what your life is going to be Are you in 10 or 20 or 30 years, and there really, truly might come a time when you want or need that CCC. So it's not a bad thing to complete that professional experience here, apply for the CCC once, hold it for a year. And you do have to hold it for 365 days one full year, and then you can let it go. And what that does for you is it puts you in the reinstatement category. So if you were to let it go, and then decide down the road, that it's something you want back, the requirements to get it back are different than the requirements to get it for the first time. So there's the new application category, which is what a CF is in. And then there's a reinstatement category, which is what people are in who have held the CCC, let them lapse and then when it back. So I hope all of this was helpful for you. I'm sorry that it's not the same energy. There's so much more energy when there's two of us here to bounce things off each other. But I didn't want to hold up the content any longer. I wanted us to get back on a regularly scheduled weekly podcast. I have one bonus episode in the can that will be coming to you later this week or next week. And so you can start expecting to see more of what you're used to from fix SLP just starting with this little episode to get us going. So thank you. Thank you for all of your support and your patience. Please pop over give us a five star review. If you like what we're doing click Subscribe. So the newest episodes are always right in your queue and I will talk to you all next week. Thanks for fixing it everybody. Bye bye.