As a low-income community with 76 percent of its students qualifying for the free- or reduced-lunch program, in addition to being located far from the larger cities of Dalton, Calhoun and Atlanta, Chatsworth, GA is not an easy place to recruit and retain highly qualified therapists, including in-demand speech-language pathologists (SLPs).
After one of the district’s five SLPs resigned, the district’s four remaining SLPs were left with too many students on their caseloads. This resource gap also left the district with a large amount of compensatory time to make up over the summer, which cost the district additional funds for the transportation of students and the operation of a school site during the summer, in addition to the cost of the therapists’ services.
Knowing that the district could benefit from another SLP, Allison Oxford, Director of Instructional Support Services at Murray County Schools, began to weigh her options: try to hire a new on-site SLP, enter into a contract with an SLP staffing agency, or implement online speech therapy.
To determine the best and most cost-effective way to serve students with speech and language needs, Oxford ran a cost analysis examining her three different delivery methods.
Hiring a new onsite SLP for the district was difficult and costly. Because of the district’s economically disadvantaged locale and distance from larger towns, recruiting a highly qualified SLP was difficult. Additionally, the district would have to pay for the SLP’s benefits if hired as a full-time employee, which would be an additional expense for the district.
The second option was to staff an on-site SLP by entering into a contract with an SLP staffing agency, which the district has done previously. “We found it very difficult to find a balance between the SLP having to report to their company and them being able to meet our needs,” said Oxford. “If we needed something done, there was a long approval process they would have to follow to get permission. Additionally, there were incidences where our contracted SLPs wrote unreasonable goals or intervention strategies into students’ IEP goals, which then cost our district money to correct.” Additionally, the district is responsible for compensating therapists’ for time spent traveling to and from school sites for therapy. Although the district would not have to pay for the SLP’s benefits because the SLP is a contractor, Murray County Schools’ location made this “windshield time” more expensive for the district as compared to more suburban districts.
The third—and newest and untried—option was using telepractice, or online speech therapy. Murray County Schools Superintendent Dr. Vickie Reed had learned about PresenceLearning’s online speech therapy at an administrators’ conference in California and urged Oxford to consider it as an option.
After conducting research, Oxford organized and directed the implementation of online speech therapy services for 29 students. Although Georgia does not currently provide Medicaid reimbursement for telepractice, the district paid for the services out-of-pocket and still saw financial benefits over contracting with an SLP through a staffing agency or hiring an on-site SLP in the following ways:
Because of Dr. Reed’s recommendation and Oxford’s diligent number-crunching, the Murray County Schools district now receives a superior service for a price that is competitive to contracting additional onsite SLPs.
This cost comparison is particularly compelling considering that they receive no Medicaid reimbursements for online speech services. Further cost savings will be realized if and when Georgia clears the way for districts to receive Medicaid reimbursement for online speech services as 10 other states have done. .