American Speech-Language-Hearing Association

Success Story: Returning SLP-Generated Medicaid Funds to the SLP Budget

Ellen Estomin, SLP
Pittsburgh Public Schools, PA

About Ellen's path to success:

What did you do?

I began exploring ways to increase benefits for the SLPs in my district. At that time, the state education department was investigating participation in the Medicaid program. I decided to study the Medicaid regulations to determine what SLPs could and could not bill for and to determine if our services would generate enough money to make the program worthwhile.

Following a series of meetings with my supervisor, union officials, and superintendent's office, I was able to convince my district to allow SLPs to bill for Medicaid services with the assurance that the fees generated would return to the district Special Education budget for use by the district SLP staff.

What were your greatest challenges?

There were three challenges that I faced. The first was to gain a thorough understanding of the Medicaid program and how implementing the program would impact student services.

Next, I needed assurance from the appropriate decision makers that, once the program was implemented, the funds generated by SLPs would be returned to the speech-language pathology budget and would benefit its staff. To convince my supervisor, I knew that I needed to pursue a plan that would identify the benefits not only for the SLPs, but also for the district. According to the plan, the Medicaid funds generated would be used to provide reimbursement for professional development, updated assessments and treatment materials, and a laptop computer for each SLP. The district would receive increased revenue from Medicaid and increased retention of qualified staff.

Finally, I had to develop a proposal for the union committee on burdensome paperwork to show how union members would benefit from the program despite the increased paperwork. I was able to convince the committee that the increased benefits for staff would offset the amount of additional paperwork that was required.

What was the outcome of your effort?

We decided to implement the Medicaid program as a pilot project. We started with about 10 SLPs providing services to Medicaid-eligible children. After one year, the SLPs involved in the project met with the remaining staff and convinced them to participate. They argued that the benefits of having Medicaid-generated funds returned to the SLP budget clearly outweighed the increased paperwork.

The benefits have been remarkable! Every SLP in our district has a laptop computer that is upgraded regularly. Our district also maintains a generous professional development fund, which our SLPs use to further their professional skills and maintain their license and certification. We established a library of assistive devices and have an impressive inventory of current assessment and intervention materials. Best of all, we have established a committee of SLPs who determine, on an annual basis, how the funds will be spent.

As the department supervisor, I am able to use our professional development fund as a recruitment tool, although, since the establishment of the program, our retention rate is high and staff turnover is low. We have even had a number of staff leave, only to return a few years later!

What advice would you give others?

Do your homework and become a knowledgeable resource. It is also important to determine your goal and be able to articulate it. Be willing to compromise to reach this goal. Take the time to establish and build relationships with the decision makers in your district as their support will be critical in achieving your goal.

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