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Presenters: Adrian Mamikonian, Claire Stephenson, and Gila Cohen-Shaw 1  

Explain the basics of telepractice/telehealth Describe what is needed to provide telehealth/telepractice

Describe the day-to-day life of a telepractitioner Summarize different options for becoming an independent telepractitioner

Learning Outcomes

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You will be able to:

CCC-SLP & Senior Clinical Practice Director

Placement Manager Adrian Mamikonian Claire Stephenson

• Over 6 years of experience working with students in a telepractice setting

• Previously the Rehab Director for a group of skilled nursing facilities

• Experienced in both school and hospital settings

• More than 20 years of experience placing clinicians in new careers

• Oversaw the hiring of SLPs, OTs, and PTs as Director of Recruiting with Progressus Therapy

• Well-connected to allied health professionals across both school districts and healthcare

CCC-SLP & Lead Clinician

Gila Cohen-Shaw

• Certified Listening and Spoken Language Specialist

• Specializes in working with students with hearing loss

• Managed programs at not-for-profit organizations and rehabilitation centers

• Founded a private practice, A-V First Therapy Services

• Involved in interviewing talented clinicians for telepractice

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What is Telepractice/Telehealth?

What is Telepractice/Telehealth?

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Telepractice/Telehealth:

The delivery of therapy services at a distance through the use of technology.

Past & Present

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Over 1 million sessions and growing

Effectiveness documented in the literature, and we see it every day!

Picture-phone circa 1972

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What Is the Research Supporting Telepractice/Telehealth?

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ü  Research on telepractice dates back to the 1950s ü  Research on telepractice delivery of speech-language therapy

dates back to 1992 ü  Dozens of peer-reviewed journals indicate telepractice is as

effective as in-person therapy

How Effective are PresenceLearning Services?

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2013 -14 School Year74% 77% 75% 65% 66% 50% 64% 69% 60% PresenceLearning Students:

2014 -15 School Year

National Average

Speech Sound ProductionSpoken Language Production

Spoken Language Comprehension

P R E S E N C E L E A R N I N G S T U D E N T P R O G R E S S B E AT S T H E N AT I O N A L AV E R A G E

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Why should you start learning about telepractice?

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Where can you find telepractice being used?

School Hospital

Home Clinic

Clinicians’ Pains • High caseloads

• Long commutes or “windshield time”

• Excessive paperwork

• Work-life balance

• Moving/travel

• Burnout

• Want more time delivering therapy

Why Telepractice/Telehealth?

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Clients’ Pains • Shortages of qualified clinicians

• Difficulty finding specialists

• Staffing hard-to-serve edge cases: home-bound, hospital-bound, medically-fragile

• Keeping the “I” in IEP

Why Telepractice/Telehealth?

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What’s Needed?

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C O M P U T E R

Q U I E T , P R I VAT E E N V I R O N M E N T

P R I M A RY S U P P O R T P E R S O N

W E B C A M H E A D S E T

T E C H S U P P O R T

I N T E R N E T

N E T W O R K P R A C T I C E M A N A G E M E N T

VIDEOCONFERENCING S E C U R I T Y

PROGRESS TRACKING

C O N T E N T

C L I E N T S

Choices for a Telepractitioner

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Pros Cons

Own Your Own or Small Private Practice +  Flexibility & control

-  Client acquisition -  Payments & collections -  No colleagues or support

Traditional Staffing Agency

+  Support infrastructure +  Clients provided +  Colleagues

-  Limited choices of locations & client

Hospitals & Clinics +  Billing & payments covered -  Limited control of caseload & schedule

Dedicated Telehealth Providers

+  Flexibility & control +  Wide choice of clients +  Supportive infrastructure

-  Requires organization, self-discipline and motivation

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Success Factors for Telepractice/Telehealth Providers

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Success Factor: Client Candidacy

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Who can be served via telepractice/telehealth?

•  Populations we’ve worked with: – Students with autism spectrum disorder – Students with Down syndrome – Students with hearing impairment – Students who use AAC devices – Articulation and language-impaired students

•  Best practice: If contraindicated, refer for in-person services

Client Candidacy: Group Therapy

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•  It is easy to provide group sessions online

•  2 to 4 students can join in a group session

•  More than 2 students typically need an additional computer

•  Students can be paired with other students from different schools within the same district

May involve wide-angle lens to capture the student in a natural environment or working with their parent on the floor

Following coaching/ consultative model

Client Candidacy: Early Intervention

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More Than Direct Therapy

IEP Meetings & Case Management

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ü Using IEP systems ü Scheduling and facilitating

online IEP meetings – Video conference via platform

gives ability to demonstrate student activities

– Phone conference as a backup ü On-going collaboration and

communication

Evaluations and Assessments

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Speech Language Assessments

GFTA-3, KLPA-3, Arizona-3, CELF-5, CELF-5 Screener, CELF Metalinguistics, CELF-5 Reading & Writing Supplement, CASL, CELF 4-Spanish, BESA, PPVT-4, EVT-2, CCC-2, SSI-4

Occupational Therapy Assessments Beery VMI, Sensory Profile 2, Sensory Processing Measure, School Function Assessment

Socio-emotional & Behavioral GARS-3, Adaptive Behavior Vineland, ABAS-II, SIB-R, ABS-S: 2, BASC-2, CBCL, Conners CBRS, BASC, ACTeRS, Vanderbilt, Devereux, BRIEF, etc.

Cognitive Ability and Achievement Assessment Coming Fall 2016!

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Follow the Rules of Your Professional Organization

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American Speech-Language Hearing Association

American Occupational Therapy Association

National Association of School Psychologists

National Association of Social Workers

Telepractice Laws & Licensing

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The Future is Here

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Your Next Career Move: Telepractice

Considering Becoming a Telepractitioner?

Who are Telepractitioners?

Master’s Degree

State Licensed

Professional Credentials

School Experience

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Personas of Telepractitioners

NNoott--QQuuiittee RReettiirreeeess

NNoo--NNoonnsseennssee PPrroovviiddeerrss

EExxttrraa--EEaarrnneerrss FFaammiillyy--FFlleexxeerrss MMoovveerrss AAddvveennttuurreerrss

Different Settings for Telepractice

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Education Health Care Private Practice

Telepractice Arrangements

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Telepractice on your own

Telepractice with a telehealth organization

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To work with PresenceLearning, you need strong communication skills, must be comfortable with technology, and have school-based or hospital-based experience. BUT… … you do NOT need prior telepractice experience!

What Kind of Experience Do I Need?

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What Licenses and Certifications Do I Need?

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Local state license Licensed in state(s) where your patients are located

Appropriate national certification

More scheduling flexibility = More placement opportunities

What Hours Can I Work?

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School Hours Health Care Hours

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•  PresenceLearning takes care of matching our providers with their patients

•  Our placement team makes recommendations based on where we see the most demand and growth

•  Our placement team walks you through the license application process

•  As an independent contractor, you choose the assignments you want to accept

Cross-Licensing & Match-Making

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Working as an Independent Contractor

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ü  You are responsible for your own business expenses, taxes, equipment, and liability insurance

ü  Not a salaried position; does not offer employee benefits

ü  Compensated on hourly rate for direct and indirect time

ü  Your requested hours are not guaranteed; however, you are free to have another job

Getting Started With Teletherapy

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1. Placement Specialist

3. Therapy Platform

5. Telehealth Institute

2. Online Community

6. Professional Development

4. Clinical Mentors

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Day in the Life of a Telepractitioner: Practical Realities

My Story

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Healthy Skepticism

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Is it effective? Will I be able to connect with the kids?

Will I feel good about the work? Will it be mediocre?

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Why Telepractice is A Great Fit for Me

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Using technology that kids are comfortable with

Reaching kids and families

Meeting like-minded people all over the U.S.

Access to other SLPs and professionals

Learning opportunities Balancing work and life Professional rejuvenation Personal fulfillment

A Day in the Life of a Telepractitioner

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Hours billed = 9

✔✔ Review and respond to emails

✔✔ Complete IEP paperwork & prepare for any IEP meetings or assessments

✔✔ Send out consents to evaluate or meeting invites

✔✔ Set up therapy room

✔✔ Connect with teams

✔✔ Serve students with therapy

✔✔ Close out day by reviewing email and preparing for next day

Today’s Schedule

Vast Library of Therapeutic Activities

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Adding Custom Content

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Signing In

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Starting the Video Feed

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Whiteboard Tools

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Chat Box

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Team Write

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Large Screen Mode

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Games, Stamps, & More!

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Progress Tracking & Notes

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Progress Tracking

Notes

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Tips For Working Remotely

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Create an online “circle of support”

Connect with respected colleagues

Schedule team meetings

Weekly check-in with teachers & coaches

Communicate with students and parents

via any means of communication allowed

Be available, involved, & request to be invited to

SPED/SLP meetings

•  5th year practicing at the district

•  From “Sally Skype” to “Partner”

•  Patience, good communication, and education are key

•  PresenceLearning now serving 600 kids in the district, including kids using AAC devices

•  Consults with district SLPAs

Case Study: Oregon School District

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ADD IMAGE

Conducting Remote IEP Meetings

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Assessments

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One of Many WOW! Stories: Elias’ Story

One of Many WOW! Stories: Elias’ Story

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Final Thoughts on Being a Telepracticioner

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“I feel so positive about what I do and I think that that level of enthusiasm is

contagious to both the kiddos and the other SLPs that I work with…”

“At the end of the day, I feel really good about what I've

accomplished.”

I took a chance and it worked so well for me. I see colleagues who are in the same place [I was previously] and I'm so happy I'm not there.

My advice for anyone who would be willing

to try telepractice is to do just that - to try it!

PresenceLearning has opportunities (FT & PT) for: •  SLPs •  OTs •  School Social Workers •  School Psychologists

Interested in Becoming an Online Provider?

Refer your colleagues: plearn.co/apply-to-pl

new realities

new choices

#SPEDAhead

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PresenceLearning

new realities

new choices

#SPEDAhead

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