Sunday, October 23, 2016

Working as a Team: Supporting Rehabilitative Assistants


The Frenzied SLPs are back this month with posts about working as a team, and we are truly a team, working together to bring you materials, ideas, and inspiration. Teamwork takes many forms with many different people and I am very excited to hear the different perspectives that will be shared! Thank you to Sparklle SLP, Kelly of Speech2U, and Lisette of Speech Sprouts for once again keeping the Frenzied SLP team organized!  

It seems counter intuitive sometimes. Special education is founded on a multidisciplinary teamwork model and yet it how it unfolds in schools is often the complete opposite. The reasons are many: lack of team time, huge caseloads, minimal/no administrative support, paperwork burdens, pride, you name it. Despite this, the fact remains, effective programs have effective teams, who know how to work together and respect each member's unique talents and contributions.

A frequently overlooked member of highly effective special education teams is the paraprofessional also known as a rehabilitative assistant. These bastions of support and patience are integral for SLPs and OTs. Rehab. assistants spend all day with our most highly involved students supporting them in the classroom, supporting hygiene needs, helping with transitions, lunchtime, and offsetting behavioral difficulties. In order for the work rehab. assistants do, to be eligible for medicaid reimbursement in our state, they must be supervised by a "licensed practitioner of the healing arts." It must also be very clear that the work they do with our students NOT be academic in nature. In fact, when I post those sessions I sign that "I certify that activities being billed under rehabilitative assistance for the above student(s) (...) on the dates specified (...), for which I am knowledgeable of the service provision, and provide weekly consultation to the aide, are not classroom instruction or academic tutoring, but are therapeutic in nature and are necessary for the maximum reduction of each student’s physical/mental disabilities." 

For many years the rehab. assistants, case managers, and special education administrators in our district balked at this supervisory piece. SLPs were even told that there aren't any "medicaid police." Well, we know that is not the case and I for one, finally decided I had worked too hard to earn my degree, Cs and license to lose it to egos. I now insist on weekly consultation where the rehab. assistant and I discuss how they can support student goals in the classroom. In order to document consult times I created a log sheet that allows for entering the date of the consult, comments, and initials. Having written proof certainly eases my anxiety around signing off on rehab. assistant support in the classroom. You can get it here for free! 


This takes care of the consult documentation, but the larger issue is how to utilize rehab. assistants in the most effective way possible. During my initial conversations with rehab. assistants, it became abundantly clear that the majority of support being offered to our students was academic. This was a huge concern. As a result, I enlisted the support of one of our paraprofessionals extraordinaire in order to create a planner for rehab. assistants. I am really happy with the result! So now during our consult time rehab. assistants share concerns, ask questions, and describe how students are functioning in the classroom and are able to keep it all organized between meetings. In this way, I am able to provide suggestions, strategies, and supports for students. The Paraprofessional Paperwork Planner has forms for notes, communication, a to-do sheet, strategy form, a calendar, planning sheet, glossary of common SLP and OT terms, and more. The best part? It contains several editable pages! You can find this planner here in my TpT store, Doyle Speech Works 

It appears that the rehab. assistants I supervise are receptive to this more structured consult and are appreciative of the planner. I am hoping this allows us to truly support our students in the most effective way possible using common language and consistent supports.

How do you team? Link up with the Frenzied SLPs and share your successes or struggles. We are after all, a team!


12 comments:

  1. What a useful resource! I had never heard of rehab assistants before, so I know where to go if I ever have one!

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    1. Do any of your students have one on one aides? We refer to them as rehabilitative assistants for medicaid reimbursement.

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  2. What an informative post! We also don't have rehab assistants.

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    1. These are one on one aides. You don't have them for your more involved students?

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  3. It's so important for everyone to collaborate for best outcomes for our students. I love that you set aside time for that, I know how difficult that can be.

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    1. It is very dififcult and very time consuming. It is also proving beneficial and I am comforted in knowing I am doing what the medicaid law requires.

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  4. Annie, your commitment to structured consultation is admirable! While I don't take on this role in my setting, I am truly certain both parties benefit from this set-up. Most of all, your students get a huge payoff!

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  5. Wow! That looks like a great resource!

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    1. Well, I gave it to all the rehab. assistants in our building after much "pressure" to create it. I haven't seen one in use as of yet! Funny how that is.

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  6. I've never worked with Rehab Assistants, but it sounds like you've got it down to a science! If I ever have one, I know where to go for suggestions!!

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    1. Don't your students have one on one aides? Maybe we just call them something different. As rehab assistants they can submit for medicaid reimbursement under the supervision of a licensed practitioner of the healing arts (us).

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