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SLPs Resuming Services in Private Practice and Health Care During COVID-19

SLP private practice is not one business model (e.g., freestanding clinics, contracts and consulting, mobile site-to-site procedures, physically going to homes or other facilities). In addition, health care services vary from setting to setting. Considerations for in-person practice and high-risk procedures may differ depending on the way services are provided.

Note: This list is not intended to be exhaustive and will be updated as additional information and opinions become available. 

  • It is preferable to employ a day-by-day, data-driven assessment of the changing risk–benefit analysis to influence clinical care delivery. Clinicians are encouraged to avoid blanket policies and instead rely on frequent review of data and emerging evidence, independent clinical judgment, and site-specific understanding of the medical and logistical issues in play. 
  • Consider that although COVID-19 is a clear risk to all patients, it is but one of many competing risks for patients requiring speech-language pathology services. Thus, clinical procedures should be considered not based solely on COVID-19-associated risks but, rather, on integration of all information, including the risks of not receiving speech-language pathology care to prevent negative consequences such as aspiration pneumonia and rehospitalizations. 
  • Consult  updated guidance [PDF] from regulatory agencies such as the Centers for Medicare & Medicaid Services (CMS) for additional information.
  • Have a set of established procedures in place for monitoring the health of staff, clients/patients/families, and others who enter the building. Staff and clients/patients/families need to know about health monitoring efforts and protocol.
  • It is not unusual for young clients to use “high-touch materials” in assessment and treatment sessions, especially when clients are in groups and the materials are key to facilitating achievement of therapy targets. Therefore, disinfecting materials and manipulatives between client/patient uses is very important.
  • A client’s/patient’s ability to see the clinician’s mouth and facial expressions is important when providing services. Given the proximity of clinicians and clients/patients when services are provided, PPE is key to reducing coronavirus transmission. It is recommended that administrators provide staff with appropriate PPE (quality and quantity), including gloves, clear face masks, eye protection, and plexiglass barriers, if possible.
  • Establish a process for immediate handwashing or the use of hand sanitizers prior to entering or when exiting waiting/treatment rooms. Although using hand sanitizer is permitted, handwashing is the preferred method, if available.
  • Telepractice is an alternative to in-person service and should be considered, if feasible and appropriate.
  • SLPs should check with payers about reimbursement and are encouraged to check their professional liability insurance coverage to determine coverage of telepractice services, if such services are implemented. The first resource below provides state-by-state tracking information regarding laws and regulations for telepractice and licensure policy information. The second resource provides tracking for commercial insurers’ policies related to telepractice. Both are updated daily or as information becomes available. The third resource tracks state updates for Medicaid reimbursement. Members should check with state licensure boards, state departments of education, and payers for additional clarification.

Resources

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