We are discussing 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 part of joining our movement to make things better one conversation at a time.
Let's fix SLP.
All right, welcome back, everybody to the fix SLP Podcast. I'm Megan and Jeanette is unable to join us today. But we do have a special guest Chantal with your with us here today in Australia bright and early in the morning for her before she has to work. Thank you for taking the time to be here.
No worries. Very happy to be here. Thanks for inviting me. Yeah, my name is Chantel. I'm a speech pathologist I've been working for over 13 years now. I mainly work or have mainly worked with adults in rehabilitation. So at the moment, I'm a senior speech pathologist at an outpatient neurological clinic. Most of my work has been in rehabilitation or community based settings.
Awesome, okay. And the reason we're talking to you, you're the first in what we hope to be a series of talking to SLPs from all around the world, because we want to learn how other countries regulate the field of speech pathology. And I am going to sound I always sound like a very egotistical like braggy person when I say this, but I have had the privilege of traveling to all seven continents in my life, and I have a career before speech pathology. And so a lot of that travel was work related. And so because it was work related, I got to see how different governments work and how different systems work. And I lived abroad when George Bush was president, which was not a super lovely time to be living abroad. And I remember when Obama got elected, I was getting like personally congratulated in the grocery store that we had to accomplish that feat. And like all of that trouble has really made me aware that like I grew up in a very US centric system, like when we grow up in this country, we kind of perceive ourselves to be better than everybody else. And we perceive that the way we're doing things is like, the only way to do thing is when in reality, there are so many other ways to do things. And the United States has a lot to learn from other countries. And you don't have to look far to realize that from our medical system to our education system, like we have a lot of broken systems that are really not working. And so that's what I mean, that's kind of what inspired me to reach out to people from different countries just to talk about how speech pathology is regulated, because believe it or not, Asha is not an international regulatory body. Like in Australia, you have Speech Pathology Australia, right? Yep. in you. And that's kind of like, for better or lack of a better way to phrase it. That's like the equivalent of Asha for Australia. Can you tell us a little bit about Speech Pathology Australia?
Yeah. So speech pathology, Australia, I think there are about 14,000 members of Speech Pathology Australia. And yes, so it's our national body. It's not mandatory to be a member of Speech Pathology, Australia, so it is optional. And I've sort of I've had membership over the years, and then I've dropped membership over the years. And I think it's quite dependent on the type of role that you have as to how much benefit you probably get from the association. But I think everything else is fairly similar. So they're the ones that will put out all the policies and procedures. They'll host a number of professional development events. And obviously, they're the people that we go to when we have questions related to speech pathology.
You know, and I can Google it really quickly. Do you know how many speech pathologists are in Australia?
I tried my hardest to find that couldn't get a figure. The best I found was that Speech Pathology Australia estimates that 70% of speech pathologists are members and they currently have about 14,000 members. So that says there's about 20,000 speech pathologist in Australia.
Okay, so they're doing really well if it's a is it 100% volunteer at or do you have to be a member to be because they sell a certification as well? Right?
Yes, sorry. I started looking into that in preparation for this. And I did learn some new information. So it looks like the so we have what's called CPSP status, which is certified practicing speech pathologist. So that's the certification. And it seems to kind of be equivalent to your CCCS. It came, I think the terminology came in July 2022. But before that, it was known as the self, the professional self regulation framework. So it's quite similar. I've got a list of a few of the the differences here, but they took on the term of certification and sort of changed it just recently. The tricky thing is, although it says that it is optional, to be a member, you do need to have certified practicing status if you're working with a lot of the major funding bodies. Now, this is where I said earlier, it really depends what kind of role you have. So for example, at the moment, I'm working in hospital system, I don't need to have the certified practicing status, because every one that I see is covered by public health. So I think I guess maybe 50% of us in the hospital have membership. And I think there's about 25 species and the hospital that I work at. But if you're working anywhere else, where a large portion, or most of the speech pathologists are working out in the community, and working with clients who have other funding, a number of those funding bodies state that you do need to have certified practicing status in order to see these clients. So in turn, a lot of jobs will actually advertise and say that you need to have certified practicing status as a therapist.
So in how much Oh, sorry, go ahead.
Oh, no, you go.
How much does it cost for certification?
So it cost $572 If you're a member of Speech Pathology, Australia, so that's $572 is for the membership itself. And then if you want to have the certified practicing status, it's not any extra, but you just have to demonstrate that you're meeting the requirements. So the new information I actually found out, which I didn't know was that you can be a certified practicing speech pathologist without being a member of Speech Pathology, Australia. That was new information to me. So yeah, I put that on my stories yesterday afternoon, just to ask, you know, how many speech pathologists in Australia realize that you can have this status without being a member? I don't have a huge account. So I think there's about 70 people who have voted, but 60% of people didn't actually know that. Which is interesting. So I don't think it's common knowledge that speech pathologists don't realize. But the funny thing is, that when I jumped on the website, just to find out how much it would cost, it actually cost more, if you're not a member. So it costs $682, if you want to be if you want that status, and you're not a member of Speech Pathology, Australia, so I tried to get an answer as to why and where the extra money is going. I couldn't get an answer. So I'm just waiting on someone to get back to me from the association because I spoke to a couple of people just to confirm, is that correct? $682. And they confirmed? Yeah, it was.
And that's an annual fee. You have to pay that every year. Correct? Yes. Yes, it's lot. Yeah. Is it common for employers to cover that cost? or No?
No, I don't know of any employees who have ever covered that cost.
Okay, so you have this certification that you have to have to basically? I mean, would you call it like billing certain insurance? Or? Yeah,
yep. So in Australia, I'm not sure if you've heard about the NDIS, which is an S National Disability Insurance Scheme. It's not actually an insurance to
me, like I know nothing about it, because I don't and I'm sure a lot of okay,
yeah. So the NDIS I think that supports about 500,000 Australians with a disability. And essentially anyone under the age of 65, who has a permanent disability is eligible for these supports. So this covers things like therapies that the client will need. It covers things like disability accommodation, covers, things like day programs, support workers to come out and take clients into the community, things like that mealtime aides equipment, communication devices. So Initially, this is really where the bulk of funding comes from, for the clients that we see under the age of 65. So I know in the last job I worked, which is in private practice, about 90% of our caseload was funded by the NDIS.
So government funded so for Americans listening, that would be like if Medicaid didn't have an income cap, and it was available to everybody under the age of 65. And like, you would just if you qualify for services, you would receive them from Correct, yes. Yep.
So we have Medicare as well. But that's separate. So if clients need something that's health related, they can still access the public system, but this is for supports that are needed directly related to their disability. So yeah, we have both. Okay. So yes, this this funding body requires that a speech pathologist in order to be able to build the NDIS, they need to have certified practicing status.
And then, do you have different licenses for the different provinces?
No, it's the same all around Australia, I think, because our population is so small, compared to in America. So I think we're about 26 million in the entire country, which I don't know might be equivalent to some of your states. I'm not sure. Sure.
Yeah. Yeah. Yeah, I think California might be way off, but I think California has like 40 million. Okay.
Yes. Like California has got more people than all of Australia.
Yeah, okay. So, and then also speech, sorry, I'm gonna plug in my laptop Speech Pathology Australia accredits universities, right. So they're similar to Asha in that way, in that they are a membership body. And they sell a certification. And they accredit universities, right.
Oh, I'm not actually sure about that one. Megan, I can see that I can quickly find the answer to that. But
yeah, so every university program has points of difference. But all programs must meet the Speech Pathology Australia accreditation standards for graduating students to be eligible for membership of Speech Pathology, Australia. Yep. Yeah. Okay. And what kind of just tell us about your grad school experience? Did you have to take an exam? Did you have to complete? Like any sort of supervised on the job training before you're fully certified? Like, just walk us through? Like, if you were an undergraduate student, and you are interested in becoming a speech pathologist? What are all the steps in Australia to do that? Yep.
So we can either do speech pathology as a bachelor or a master's. So back when I graduated, I did a bachelor. So that's just four years. It's an undergraduate program, and it's four years of speech pathology. I think masters programs are becoming more. I think there's more master's programs now. So you do your undergraduate, which could be maybe three or four years, and then you do the two year master's program. So
do yes. What's the benefit of having a master's program or master's degree? In Australia?
I think he might start out on a slightly higher salary if you have a master's degree, as opposed to a bachelor slightly higher,
like maybe $10,000 more. A few dollars an hour more.
Couple of dollars now.
That's another huge difference. Okay.
Not huge. Yeah. Um, so my experience Yes, we do exams throughout the whole program, you know, with each subject or unit that we're studying, so we're usually studying eight units per year. That's for a bachelor
and the exams that you're taking Sorry, I'm gonna keep it Yeah. Are they are the universal exams that everybody takes no matter what program you're in, or do the professor's write the exams?
I think the professor's write the exam so they wouldn't be different depending on what university you're going to. Yep. And we also do clinical placements within the program as well. So for a bachelor program, you might do some observation placements in the first year and then perhaps from second year, you might be doing some hands on stuff. So we get marked according to each placement and there are three different types of placements. You have novice, intermediate, and then entry level. And you get a mix of PDF treat and adults placements, you need to do a certain number of each. And we get marked on those, we need to pass those placements in order to get our degree. And the clinical supervisors will use something called the competent. What's it called, I know the shorthand, which is C bas. It's a competency based occupational standards. I am an ER. And so that will assess a therapist will student at the time, different areas of competency, so things like assessments, ability to deliver intervention, lifelong learning, professional practice, things like that. And you need to hit a certain level and be entry level for you to pass and be considered competent and get your degree.
And my understanding, and tell me just from what you remember, there's there's a lot of conversation happening right now about competency based training and how Australia is leading the way and they have these competency based standards. And someone is was explaining to me that like in the US, you have to rate people like on Calypso, there's this rating system, so 1234567, or something, I don't know. But then in Australia, there's like a line. And like you, they literally like put a mark on the line. And as long as you're in the competency range, like you pass, but it's not like you're not giving given a numerical judgment, you're just like, putting a dash on a line. Is that right?
That's correct. Yep. So the line, it's just marked by it will have novice at one end, intermediate in the middle, and it will have entry level. And we get descriptions of what it would look like to be at each level. And we get examples based on what part of competency that you're assessing. So yes, you need to get, you need to be close enough to the entry level point in order to pass. Yep.
And then 5 million questions. Like Asha always talks about the big nine, and I can't rattle them off, but you know, dysphasia, fluency, all those big nine, yeah. Is there a similar thing in Australia where your competencies are based on different areas?
Yes, there are. I can't remember all of them as well. But yeah, things like voice and fluency and speech and language. Yes, so students do need to mark those off. The thing is, though, in reality, with placements, you don't always get experience across all of those different areas. Because you're also supposed to have, you know, experience with assessment as well as delivering rehab as well as providing education. And again, it's quite dependent on your caseload. So sometimes you need to get creative with the student in helping them figure out how else they can demonstrate their competency if they haven't been able to do it with an actual person. Okay.
And then, is it difficult to get placements? Like, do you have somebody? Are there people at the universities who are responsible for finding placements? Do you find your own placements? How does that work?
So there is a person at university and their specific role is to find students placements. For as long as I can remember, I hear from universities all the time that it's very difficult to find student placements, I think it's getting more and more difficult because we've had a huge increase in the number of speech pathologist, which I think in part is due to the rollout of the NDIS. So we can't even we can't quite meet demand that's out there at the moment. So more programs are opening up more graduates. And because a lot of our roles is working in private practice, I think it's trickier to get placements there because you know, taking on students from a financial perspective, there is no benefit there is usually a loss. So it's really taking on students to benefit you know, the therapist, and it is, you know, I enjoy taking students because I think it's great for your own personal knowledge and growth. But it's not always appealing as a business. And so I believe that they are struggling at the moment now when I graduated 13 or so years ago, students were not under any circumstances allowed to directly contacts organizations to ask if they could do a placement. I believe that has relaxed because I've had a few students that I've known previously reached out to me personally desperate for a placement. Sorry, I think they are relaxing that a little bit just because it is so difficult.
Gotcha. Okay, so you you Do the clinical placements during your Gretz or during your bachelor or master's program? Yep. And then do you take a national exam? No, no national exam. The degree is enough. You've been graded on all of these competencies, which I would argue, like, in the US, we have a national exam. And I'm like, why do we need a national exam when we are already graded on the competencies, because an exam doesn't really fit speech pathology, like it's not a black and white science, there's a lot of art to it, that needs to be evaluated. So okay, so you don't have a national exam, and then you graduate. And then and then what happens. And
then you apply for a job. And you can usually go into a sort of new graduate role. So they'll have a lot more support that sometimes you can go into a grade one role, which is a step up from a new graduate. But yeah, it's trying to implement
and when they advertise these jobs, are they advertising them as a new grad or step one? Is there like a universal system for that?
Yes, it used to be a little bit more universal. Usually, they will advertise it as a new graduate role. Yes. And then we have grade ones, which is a step up from that, then we have grade twos. And then we have grade threes, which is equivalent to senior, but it's if this is consistently used in the public health system. But in private practice, they can determine how they, I suppose they can determine what the job title is going to be. So you could be a senior therapist and just have a few years of experience. Whereas in the hospital system, and according to the award, usually, you'd have about seven years before you can apply for that role. Unless you're unless you're very competent, and then you can put in an application, but at the moment, it's yeah, it's not universal.
Okay, and then I'm gonna ask this, because I'm sure everybody listening is maybe gonna want to know this. But like, are you comfortable talking about like, do you pay for health insurance? Like, how does your health care system work in Australia? I know, you've mentioned that there's a private part of it and a public part of it just yet, tell us I think it would be helpful just from like, an everyday person, like how you live in Australia in seek health care?
Yeah, yep. Um, so we have yet public health system, which is Medicare, but we also have private health as well. So if you're over 31, and you're earning a certain amount of money, I can't remember what the cap is, or I'm gonna guess maybe it's 180,000 for a couple, and maybe it's around 90,000 for a single person, there abouts. So if you're earning about that much, you should have private health insurance, you should be paying for that. And if you don't pay for that, then you get charged extra, you get taxed extra. It's called the Medicare levy surcharge. So you
know why this surcharge is or like, what an average health care plan would cost per month?
I'm not sure how much private health would cost I've been think someone's thrown around a finger that maybe it's a couple of $1,000 per year potentially. per person. I'm not sure if that's accurate. Yeah,
the average I just Googled this. So this is an Australian website that's saying about $250 a month. Okay. Yep.
Does that seem more than a few grand a year? Yeah, no, that sounds about right. So I should have private health insurance, but I've just been lazy in getting onto it, which means that I'm actually paying extra with the Medicare levy surcharge. So I think the standard surcharge might be around 1.5% of my income, or everyone's income. So that goes towards actually funding Medicare. And then I'm paying extra I'm not even sure how much extra I'm paying maybe it's an extra 1% On top of that, because I don't have private health. If I did get private health, it would work out to be that I'm paying about the same but I would get obviously the added benefits of having private health, if that makes sense. And what are those added benefits just like
barely not gonna make you do it.
Maybe shorter wait times for service cuz, you know, if I needed surgery or things like that, I guess being a younger person and being healthy, I don't need a lot of medical services right now. So I just sort of go to my GP as needed. A lot of GPS will bulk bill, which essentially means that it's fully funded by Medicare. More and more practices, I think a going private. So it's not as common, but that's definitely for people who are have a low income, then they can access a bulk build service where they don't need to pay to go and see their GP. But let's say if they needed a surgery that wasn't urgent, they would be on a waitlist for a very long time. Whereas if you have private health, I think you can access that quicker.
I see. Okay. Oh, yeah. $90,000 per individual or $180,000 per family? Yeah. So if you make less than 90,000, what does it look like? Let's say JP, somebody, let's say somebody has a stroke, what would be the difference in care between private and public? Um,
so with private? Now, I'm not actually, I'm not actually sure, because a lot of the clients that I would see post stroke when I was working in the community, and in an outpatient setting as well, they're still eligible for NDIS funding, so they get their own funding package where they can purchase the services, but they have a
disability at that point. So yes, category. Okay. Yep. And
I haven't worked in an inpatient setting for quite a while. So I'm not quite sure what the difference in carries in the inpatient setting, but perhaps that's, that's where the difference might be. I do know that just in general, Australia does have quite good health care, even if you don't have private health insurance. So yeah, I'm not immediately aware of the big differences. For someone like that. I
just think like, when you live in the United States, and the whole health care debate comes up, and we look at other countries like there's there tends to be this like, dramatized image of everybody else, and all these other countries, just waiting years and years and years to see a doctor. And I just don't think that's the reality. And so I think that I mean, it's just, oh, go ahead.
I think it can be if you're waiting for something that's not considered urgent, but I think the urgent conditions, and people have had a brain injury and stroke and things like that, you know, services tend to happen fairly quickly. And they get access to that without needing to pay for those services. Because I have heard about the US and needing to pay when you go into a hospital or paying when you have a baby or you go to emergency and you have to pay I'm not aware of needing to pay for me like I had my baby in hospital in a public hospital. I didn't need to pay for that. If I go to emergency. I don't need to pay for that. So yeah, I think it is quite different. Yeah.
Yeah. Yeah. I mean, this could be a whole other. Just talking about health care. And the systems that we have, but yeah, we have a very, very broken system that benefits like financially benefits very, very few people sell insurance programs, and the money that is spent on subsidizing those and tax breaks and all that that could just be spent on the public health care system. Yeah. Like, we wouldn't have a lot of issues that we have. But that's my own personal opinion. And I guarantee you that many people listening to this probably disagree with me, and that's okay. Yeah. Okay, so you don't have to have any sort of like, ASHA has this clinical fellowship year where you have to have a nine, they call it a year, but it's really nine months, because that's how long a school year is. Okay. And there's no like evidence to show that nine months means anything. It's just how long the school year is. So they have to like have supervised hours during their first nine months of working, but Australia doesn't have to, it's just you. You're, you're evaluated based on those competencies, you get your degree. Yeah. And then you can choose to pay for the certification if you need it or not. Yeah, then you get your job.
Yes. And the new graduate year, you would have more support than any other year, but we don't there's no requirement for an unlimited number of supervised hours. Yeah.
Yep. Okay, and then how do people in Australia feel about Speech Pathology Australia? Are they in support? Are they indifferent? Take it or leave it, hate it.
Um, general vibe. General vibes. I feel like people don't have My strong opinion one way or the other that I know of now, it's funny because when I posted this question to my Instagram story,
so your handle is at distanza community, right? That's right that dysphagia community Yeah. People want to find you at dysphasia community. Yeah.
I actually got the most replies I've ever gotten on any of my stories. Usually, I maybe get one or two people commenting on my story in words, usually I'll just get a reaction and emoji. But I've had 11 people reach out to me so far, wanting to know, Okay, how did they get this status without being a member or just being really surprising? Really, I didn't know this. So and I've started a conversation with another species here in Australia. And it seems like some of us are sort of keeping up with the conversations that you all are having over in the US about the CCC isn't I think it's making us reflect a little bit more on our organization. So there's, you know, maybe some quiet conversations happening, but definitely nothing out in the open, like you're doing, which I think is great. So I would say, traditionally, my feeling is that people have been, you know, rather indifferent towards Speech Pathology Australia. And I don't get the money to
feel indifferent. Like if I had to write a check for over $500. Every year, I'd be like, where's this going? Probably because I'm writing over that amount every month in health insurance. But like, I would want to know, where's it going? What does the money doing? Like? Why do I have to pay this every year? All the questions that we're asking right now about the CCC but
and look, I might I might be wrong. And it's just the species that I've spoken to? And I guess because we're not having these open conversations, I guess I really don't know. But that's just my feeling. If I think about, you know, the small number of conversations I've had with my colleagues and the general vibe, I don't know if it's an Australian thing, sometimes, you know, we get told this is what you need to pay. And so we kind of just pay it without thinking too much about it. But I don't know, maybe that's going to change. So
one question that we get a lot is, but do I need my C's if I move abroad? And basically the answer to that is like, No, I mean, to clarify, like Asha does not regulate the world. Asha does not regulate international standards for speech pathology. They do not regulate government requirements, anywhere, including the United States. Russia has nothing to do with. I mean, they try they try to influence it, they spend money lobbying it, but they don't. They're not directly tied to government regulation. So there's this agreement for the mutual recognition of professional association credentials. And so if you have the CCC, you could move to Australia. And you could get the certification that Speech Pathology Australia sells. Yep, easily. And then that would allow you to work in Australia, but you could also work in Australia without it technically. Yeah. Yep. You would just need your degree. Right?
Yep. You need to pay extra if you want to work with the certification. Do you mean with the certification or sorry, without certification issue?
But yeah, you just need to. So that you could you can work without, as well with your degree and work without? Yeah. And then for people wanting to move to from Australia to the United States? It's ridiculous. Because like, yes, you could use your speech pathology, Australia certification to get your Asha certification. And then you could get a state license, but you can't just move to the US get your CCC and work. You have to have a state license. And then what's weird about that, too, is when you go to the state licensing board, a lot of people have run into issues where because Asha, has spent money lobbying the state licensing boards. The language says something like must have completed a master's level degree in speech language pathology from a university that is accredited by basically Asha or the CA. And so then people moving into the United States, they might have everything they need, but because they didn't go to a CA accredited, accredited university, they then have to make a verbal or written case to the board to try to get their degree accepted for a state license. So okay, it's kind of a mess. And I personally think that the conversation shouldn't miss this there'll be like, are these certifications exchangeable, but governments should be talking to each other. And governments should be making plans of what that competency and what those requirements should look like. Because at the end of the day, these certifications, they're just products that are benefiting these organizations financially. And as a speech pathologist, if we truly want like mobility across states within the United States, we need to figure out interstate compact. And then if we want mobility across borders, we need to figure out an international compact, and not be relying on these certifications to do that. But again, just my personal opinion, lots of personal opinions today.
I had a thought as you were, you were mentioning that because I did have a look to see what actually the jobs are saying at the moment. So I went and had a look at like the last 15 jobs that have been posted for speech pathologist. And there's really a mix in terms of what they're saying is required. So some will say that they just you just need a bachelor or master's degree in speech pathology. Most of them say you need to be a current member of Speech Pathology Australia, but then a few of them say that you need to have eligibility for speech pathology, Australia membership. Now, I went to have a look back at all of my old applications from before 2014, because I've kept all of them. So I know what the selection criteria were for the jobs. So I have 14 applications back when you had to apply to multiple places to get a job, whereas it's not the same now, only one of those jobs I applied for required me to have spa membership. So they all used to say that you just needed to be eligible for speech pathology, Australia membership, but you didn't need to have it. So I think this seems to be changing. What that tells me.
Yeah, I mean, that's similar language to a lot of the state regulations that say, CCC or equivalent. And I, I do think there's some force in the government that's they don't like attaching themselves. And I speaking about the US government, like they don't like attaching themselves to certification products, because they know, they can change on a whim, you know, they're completely reliant on this external organization to define their own requirements, and they don't like being put in that position. And so that's what I've seen with a lot of state licensing board requirements is that equivalency language, so they're not completely wrapped up in somebody else's certification business.
Yeah. It's something else, I just want to correct as well, that I said before. So I just mentioned before that the NDIS stated that all states that you need to be a certified practicing speech pathologist in order to build I believe that stipulation is for people who are registered NDIS providers, because you can also be an unregistered provider as well and still bill the NDIS. And actually, the vast majority of people who do who are providers are not registered. So I had a look at the stats, and it's between 85 and 90% of providers are unregistered, which would technically mean that you don't need to have the status in order to build that. I just wanted to correct that.
Hmm. So so help me understand what that mean, like they're, they're working in a facility that is registered, like the facilities were just relayed, what's the benefit of being registered?
I think the main benefit of being registered, it's just meant to provide an assurance to NDIS clients that you're getting the quality service and that all the therapists are meeting a minimum standard, because the client gets the funding package. I think the NDIS is changing. I think they're making some announcements at the moment. But they were given a funding package, it could be a total of $50,000 for the year, it could be $200,000 for the year, and they're able to spend that money however they want. So they might say, Okay, I want to use 20 hours for speech, I want to use 10 hours for physio, I want to go to a day program three days a week, some gets to decide that the person government is like that you have this disability, here's your bucket of money. Yeah. And they get to choose their providers. So yes, being registered is meant to provide them with assurance that you're getting a quality service, but yeah, only 10 to 15% of providers a registered I think it's quite costly. Okay.
Oh, interesting. So they're using the certification as a way to vet people, even though the degree is enough, and then they're charging more money. But it sounds like consumers don't really put a lot of stock in if you're registered or not?
Well, I'm not sure there is one. There's one caveat to that, because in the US is complicated, and I'm not sure if anyone fully understands it here in Australia, and they're always changing it and tweaking it. I mean, I think it's a great thing a lot of people have access to funding that didn't have access before. But there's still things that sort of that need to be tweaked. But you can manage your NDIS plan in in different ways. And there's three different ways. One of the ways is in the AAA managed. And if you do have a plan that's NDIA, managed, you are restricted to just using registered NDIS providers in that case. But the other two types of plans, you can use whoever you can choose whoever you want, and
managed. Does that mean that they're deciding how the money is spent, or what is managed to lead?
So for example, if you want to self manage your own plan, then you just you make all the decisions, you choose the providers, you pay, the bills, the invoices, things like that. If you want to be plan managed, you employ a Plan Management Agency, and that person will sort out all of the payment funds, everything needs to go through them and really managing it. Yeah. Yeah. Yeah.
Fascinating. Yeah. It's like a whole other world. It's full of beautiful, amazing world that I look at from across the ocean. Like, why can't we have? But I know, I know that I'm that sounds. It's not that simple. Every system has its problems and challenges. And it's not like there's a perfect system out there just waiting to for everybody to latch on to it. But right. It's not without its faults, and it's it's undergoing an overhaul,
I think because they, they didn't predict it was going to cost this much. And I don't think it's sustainable the way that it's running. So yes, current overhaul is on way. Yeah.
Gotcha. Okay, I know you have to get to work. So what else should we know about speech pathology in Australia, in general, or specifically, or things that you would like to see changed?
Um, well, I have a question for you. Before I get into that, if that's okay, I just wanted to know a little bit more about how, or what you have to demonstrate in order to get your CCCS. Because I was interested to know if it's similar or different to what we have to do in Australia to get this certification.
Yeah. So you have to have a master's degree from a university that's accredited by the CA. And the Council for academic accreditation is run by Asha. And you have to in that time, you have to accumulate 400 clock hours of supervised clinical work by somebody who pays for the CCC. And then you have to complete the national exam called the Praxis which is run, I mean, the Praxis they write all of the tests for all the teachers in the United States. So we're kind of like crammed into the teacher tests, basically. I mean, they're SLP questions, but it's run by that company. And then you have to do that nine months of clinic like supervised work, so you're, it's your first job you're getting paid, you're probably getting paid less, because people think they can pay these clinical fellows less money. And the supervision is really like chickens basically, like you don't have to be in the same facility. You just have to, like the supervisor has to observe them for a certain handful of hours and provide feedback over the course of nine months. And that all has to be documented. And then that all gets sent to Asha. And then you pay like 512 bucks or something. And you get your initial certification. And then the only way to maintain it is to pay 199 every year and do 10 hours of professional development every year.
And do you need to submit evidence of the professional development?
No. Okay. They do. They theoretically do random audits.
Yeah. Okay. Yeah, so that part it that's the same as here. So in order to meet this certified practicing status, one thing is you need to have demonstrate recency of practice. So just making sure that you have been working for X amount of time. Recently, we don't
have that. So like somebody could get their CCC, they could go off and do something else, whether it's have a kid or travel the world or do some other job for 20 years. And as long as they're paying that 200 bucks every year like they could reenter the field with no questions asked. Okay,
yeah, no, we have that recency of practice. And then the other thing is, we need to do certain number of hours in terms of professional development. So I believe it's 20 hours of professional development that we need to do. But yes, we don't, we don't need to submit evidence about we just need to tick a box declaring that yes, we have done it. And then we have a certification. And we have random audits as well.
Gotcha. Yep. And I was thinking about the price tag that you guys have to deal with. And I guess, you know, there's people, there's SLPs in the US who have to pay for the CCC, and then they have to pay for a state license. And then they also have to pay for some education department. Piece of paper. So it's like, I bet a lot of selfies of us are probably paying the same amount just to different people. But
yeah, a lot of money. It is a lot of money. And yeah, I've you know, had different opinions on how much I found that useful over the years, depending on what role I've been in. So when I started in a private practice role, where I was building up the speech pathology team, I found it quite helpful to be a member and have access to all of those resources in doing that. And at the moment, I found it, it's been, it's been good in the sense that they do provide a fairly large discount to members for their professional development events. But I guess they can set the price however they want and and make it more appealing to members. Because I just had a look at some of the most recent PDFs they've got at the moment. So there's one PD that is $1,080 for members. But $1,620 For non members. There's another PD that's $49 for members, but $99 for non members. So there is a fair price difference between member and a non member, which obviously makes it more appealing to try and get that discount, otherwise, you're paying a lot more. And it's been variable, I would say in terms of you know, the quality of PDs. Over the years during COVID, there wasn't a lot I found particularly relevant to my caseload. But lately, there have been a few good ones. So I'd say that's probably what I get the most out of my membership these days is that discount to access the PD,
run by Shell solid marketing on their part. Also thinking like because speech pathology in Australia and Asha, they, they're both in this situation where they're, they have all these conflicts of interest. Like I think, Asha, I can't obviously can't speak on their behalf. But I wonder if part of their justification for the certification is like, collectively as a field, these annual fees are helping fund, you know, the practice analysis and the competency standard rewrites and all this stuff. But I'm like, is it I mean, I, I just think that university accrediting bodies should be self sustaining. And if it really does cost, you know, 10s of millions of dollars to accredit universities than that cost should be on the shoulders of universities like that should be its own organization that is self sustaining, that charges universities, whatever it costs, to accredit those universities, and then there should be a separate body, that's just membership, where all they do is they're responsible to the needs of the members. And they have to earn that trust and respect and they have to advocate on behalf of members the way that members want them too. And that should be its own self sustaining thing. And then if you know if a profession wants a certification for whatever reason, which we all know I don't think is necessary. But if if the profession wants that that should be its own body like all of these should be completely separate and the budgets should be separate in the in the way that money is spent should be completely transparent. And yeah, all need to sustain their own interests and their own financial needs. So another so bucks
may sorry, I didn't answer your question from before when you said what do you want to see changed about speech pathology, I definitely don't have time to mention everything that I would like to see changed, but it's just it's definitely something Then I'm super passionate about, I think I can list off a few things. I think firstly, for me, I think I would really like to see a change in the training programs. So if I think about how I was taught to do speech pathology in areas like dysphagia, for example. And best practice now, with everything that I'm learning, it is so completely different. And I do understand that universities have a certain amount of money, and maybe they can't update the curriculum every single year. But I feel that there is a huge gap, especially when I was working in a different role in a senior role in private practice, and we're getting new graduates come through, and they just did not feel prepared for the caseload that they got, essentially. And I think that the training programs that we have, because I'm still getting feedback from your new graduates that are coming through, and in a lot of way, they're not changing, I think it's really focused towards the speech pathologist who is working in a hospital setting, essentially, it's not really tailored to therapists who are working in the community, because a different approach is required for that it's not tailored to therapists who are working with clients with developmental disability, it's a very big focus on on abi, to a lesser extent progressive neuro. So that's something that I would love to see change over time. I think also just more respect that our profession better understanding. I got really tired of trying to constantly advocate for our profession, to someone who was not a speech pathologist. And it's can be really difficult to explain what we do and the complexities of what we do. And I don't think a lot of us fully understand that ourselves. And it's starting to realize and reflect the complex nature of what we do. And perhaps we weren't prepared well enough for that. So I would love for people just to understand what we do a lot more. I'd love more guidelines as well. I talked to my friend who's a GP and you know, they've seen a certain condition or they want to check medication, they'll just click guidelines. What are the guidelines say on this on this, I don't feel like we have a set of guidelines to go to we have a few random guidelines here. And they're all in different places. But there's not like a central point. And we spend so much time trying to deliver evidence based practice, because the evidence is all over the place. And more real estate KPIs as well, we are not physios, we can't just go into a bit of exercise. Get out. I know, it's more complicated than that no offense to physios. But the kind of preparation that we need to do before a language based session or a communication session is enormous. We can't do back to back sessions if we're doing language sessions and cognitive based sessions, because that is draining. Talking to someone for hours and hours is not the same as doing a physical activity back to back. So I just wish that we would stop getting compared or put in the same boxes as the other therapists when their disciplines are so completely different. I have loads more, but that's why I'm trying to give them that's what's off the top of my head.
It's so interesting, because I think I mean, I'm just I was nodding my head the whole time. And it's like, these are all kinds of universal issues for speech pathology right now. And I don't think as speech therapists, we can wait for Big Daddy Asha or Big Daddy, whoever to come in and fix these problems for us. Like, we can join forces. And we can find ways to fix these problems ourselves at a local level. And we can connect with people across the globe. And we can continue having these conversations. And yeah, keep working to fix this up.
Yeah, I mean, can I say thank you so much to you, and Jeanette for creating this because it's really opened my eyes. There's a lot of things I've been thinking about, over the years, as I get more experienced, and really reflecting and wondering, is it just me thinking this way? And both of you have voiced so many things that I've been concerned about, or, you know, at the forefront of what I want to change as well. So thank you so much for being so brave, and just putting it out there because you're right, I think it doesn't actually seem to be just concentrated to one particular country. This is the it's a worldwide thing for speech pathologists, I think we're feeling quite similar about things. So it's yeah, thank you.
Yeah, thank you. Thanks for engaging with us on Instagram. It's fun to meet you sort of in person. And hopefully I can see you next time. I'm in Australia. Where are you?
I'm based in Victoria. So down the bottom of Australia, so if you make it to Victoria, let me know.
Yeah, yeah. Last time I was there I drove from. Let's see if I get this right, Melbourne, Brisbane. Yeah, so I'm drive. It was really fun. Yeah, great. Okay, and then people if they want to ask you more questions, is that okay? If they reach out to you on Instagram at dysphasia community? Well, they stay. Awesome. All right. Well, thank you so much for your time. It's nearing the afternoon for me and you're just getting your day started. So yeah of luck with your day at work today.
Thanks again. Have a good afternoon. Thanks. All right. Bye
