Memphis Speech and Hearing Center Annual Report 2020

MEMPHIS SPEECH AND HEARING CENTER I N PA RT N E R S H I P W I T H U L P S / M ET H O D I ST L E BO N H E U R

DR. LINDA JARMULOWICZ, DIRECTOR | FY2020 PERFORMANCE REPORT

TABLE OF CONTENTS

EXECUTIVE SUMMARY

2 Executive Summary 3 Adjustments to the COVID-19 Pandemic 5 Space 6 Operations 6 Staffing 8 Community Contacts 10 Client Voices 12 In the Community 18 Marketing 19 Memphis Speech and Hearing Center, Inc., Board of Directors

Fiscal year 2020 started off strong. The Memphis Speech and Hearing Center (MSHC) began the first half of the year building on the momentum with which it ended FY19. This report documents a bit of history, some updates and future directions.

23 Productivity 26 In the coming year

Since its beginning in 1947, the MSHC has provided quality services in speech, language and hearing to the Mid-South. MSHC was part of the motivation for the 1988 state designation of the School of Communication Sciences and Disorders as an Accomplished Center of Excellence for research and treatment of those with communicative disorders.

MSHC is the experiential learning laboratory for the University of Memphis School of Communication Sciences and Disorders. It is also an incubator for innovative clinical services and programs. Faculty (clinical and occasionally tenure-track) see patients and clients, supervise students, develop programs and engage in clinical research. Tenure-track faculty often recruit research participants at MSHC. This past year, several tenure-track faculty members saw clients as well, due to the increase in clients waiting to be seen at MSHC and enrollment growth (i.e., students needing supervised clock hours).

Occupying approximately 15,000 square feet on the first floor of the Community Health Building at 4055 North Park Loop, MSHC continues its operational partnership with Methodist Le Bonheur, which has been in place since November 2016. Le Bonheur provides billing through its practice group (UT Le Bonheur Pediatric Specialists, Inc., ULPS), scheduling/building schedules and an electronic medical records system that is compliant with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

FY20, School and Clinic adapting to virtual meetings

MSHC also has its own HIPAA policies and procedures, which were thoroughly reviewed and updated throughout FY20, with the assistance of Janelle Burns, a HIPAA legal consultant. The school and MSHC are a HIPAA compliant entity within the UofM. MSHC has been active in establishing the University of Memphis Interprofessional Community Health Clinic (ICHC), which consists of a range of service providers across the campus. ICHC partners include Applied Behavior Analysis, Counseling, Youth Development, School of Public Health, School of Social Work, Loewenberg College of Nursing and Clinical Psychology.

It is expected that some of these groups will be present in MSHC in the coming year.

Throughout the first three quarters of FY20, MSHC saw increases in productivity and reimbursements, fuller schedules and new programs that serve the communication needs of the Memphis metropolitan area.

The biggest challenge for MSHC, as it was for the nation, was the effect of COVID-19 on the educational, economic and social fabric that we had previously known.

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ADJUSTMENTS TO THE COVID-19 PANDEMIC In early March 2020, the nation was figuring out how to respond to a pandemic. MSHC was no different. As a community-focused, health-related service provider within an educational institution, the Memphis Speech and Hearing Center responded to guidelines established by the following groups: •

Centers for Disease Control

•

American Speech Language Hearing Association

•

Shelby County and City of Memphis

•

American Academy of Audiology

•

University of Memphis

•

Academy of Doctors of Audiology

•

Methodist Le Bonheur Healthcare

In March 2020, the UofM directed students not to return from spring break and all courses moved online for the remainder of the semester. Faculty had two weeks to shift to online teaching or clinical service delivery modalities.

Appointments were canceled, rescheduled or shifted to virtual/telepractice as applicable. By early April, students were being sent home from most offsite clinical training placements. MSHC completely stopped seeing patients onsite.

Speech-Language Pathology (SLP) moved to only telehealth, while audiology provided some curbside service for hearing aids.

By May, the SLP clinical faculty had worked out many of the kinks associated not only with providing quality services online, but also with providing student clinicians clinical education remotely. This was an extraordinary effort by our clinical faculty.

The UofM determined that no students would return for summer classes. Student supervision remained remote, but MSHC audiology services slowly returned beginning in May and increased over June. Staggered schedules and additional safety protocols kept the pace of service delivery slower than pre-COVID-19. This also was an opportunity for our Audiology (AuD) students in their fourth year to continue gaining experience and earn hours since externships were delayed due to COVID-19. There was a backlog of 200 audiology patients waiting to be seen as of August 2020.

MARCH

APRIL

MAY

Students sent home (UofM)

COVID-19 policies established

Shift SLP services online

Coordinate with MLH

MSHC appointments canceled/rescheduled

SLP telehealth

taggered appointments & S additional safety protocols

Audiology drive through services

Onsite COVID-19 screening

No onsite MSHC services

PPE planning and purchasing

Audiology drive through service

Essential audiology services return

Cancel onsite summer group programs

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SPACE

JUNE

Most students still remote SLP teletherapy; begin tele-evaluations Audiology begins to fill schedules onsite

JULYAUG

SEPT

Students return for clinical training in person

Audiology pediatric services at capacity

Audiology adult services at capacity

SLP continue both onsite and telehealth

Limited onsite SLP services; telehealth continued

The Memphis Speech and Hearing Center occupies about 15,000 square feet on the first floor of the Community Health Building. The audiology clinic has six fully equipped sound suites, four hearing aid fitting rooms, two rooms for electrophysiology testing, two hearing screening rooms, two cochlear implant rooms and a vestibular room with one of the only functioning rotary chairs in the city. There is a designated hearing aid work room as well.

On the speech-language pathology side, there are five large therapy rooms and 23 smaller rooms. About half of the rooms are designed and equipped specifically for use with adults or children. The larger rooms have observation rooms adjacent to them for families and/or other observers. Most rooms have sinks. An instrumentation room contains equipment for speech measurement, both at the acoustic and motoric levels. The recently acquired videostroboscopy unit is located in this space. Many of the therapy rooms are equipped with cameras and microphones which connect to a central recording system for recording sessions, students, and supervisors.

Separate infection control rooms and space for storage and materials are maintained by both audiology and speechlanguage pathology. The two professions share family counseling rooms, file rooms, business offices, and a large reception area.

Group programs discontinued until further notice

By July 2020, speech-language pathology services such as voice therapy, voice evaluations, alternative and augmentative communication (AAC) assessment and therapy, and some adult services transitioned back to the physical clinic. Because evaluations were the most difficult services to offer online, there were about 50 clients waiting for SLP evaluations in August.

Students adapted to additional safety protocols with a variety of masks and shields.

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OPERATIONS The MSHC and ULPS/Le Bonheur team continued to work together throughout the year to address challenges, improve workflow, and improve lines of communication with ULPS personnel. This partnership was especially helpful during the pandemic when new policies and procedures needed to be established and implemented.

AUDIOLOGY

SPEECH-LANGUAGE PATHOLOGY

Linda Jarmulowicz, PhD CSD Dean and MSHC Director

Jennifer P. Taylor, AuD Director of Clinical Services in Audiology

Previously challenging areas – credentialing and establishing new student access to ULPS systems – were successfully resolved in FY20. However, the MSHC office staff was in flux most of FY20, which was a concern on all sides. Having only two office staff positions does not allow for cross-training and puts MSHC’s business in jeopardy if one of the two are indisposed. ULPS/Le Bonheur staff frequently provide additional support.

Jennifer P. Taylor, AuD MSHC Operations Co-Coordinator

Eileen Smith, AuD

Marilyn Wark, MA Director of Clinical Services in SpeechLanguage Pathology

Casandra Banks, AuD

Julie Marshall, MA

Erin Frazier, Clinic Coordinator*

Matthew Hollis, AuD

JoClaire Merrill, MA

In the second half of FY20, there were concerns about timely billing raised that will continue to be addressed into the next year. ULPS will be implementing new billing systems in the coming year. The current clinic coordinator, Feliza Vasquez, has a good working relationship with our Le Bonheur partners and will be consulting with them as the new billing systems are implemented.

Marqwesha Carr-Lewis, Office Associate*

Sarah Warren, PhD

Becca Moore, Office Associate*

VA Contract: *(p/t) Hannah Beth Scott

STAFFING In FY20, three UofM employees staffed the MSHC business office – a full-time coordinator and two full-time office associates. These business office staff are the first contact and ‘face’ of the clinic. They interact with clients for scheduling, explanation of benefits, checking in and out, obtaining and sharing medical information with other providers, and following up with clients. The MSHC office team also collects intake forms, payments and oversees the accuracy of billing information. They work with the clinical faculty and students who are seeing clients; the directors of clinical services; and the operations coordinators from CSD, Le Bonheur and ULPS. Graduate students also cycle through the business office to learn about the business side of their professions. The office staff, with guidance from our Le Bonheur and ULPS partners, remains key to the financial success of MSHC. Two MSHC staff transitions occurred in FY20. One of the office associates, Marqwesha Carr-Lewis, and the clinic coordinator, Erin Frazier, left their positions. The office associate position was filled with Rebecca Moore in fall 2019.

The coordinator position was vacant from March through June. A search to fill the position was initiated in March, but was put on hold during spring 2020. MSHC functioned with two office associates in the last quarter of FY20. The new clinic coordinator is Feliza Vasquez.

Unfortunately, with the University’s budget concerns heading into the 2021 fiscal year, the vacant office associate position was eliminated. There is concern that two people to staff the MSHC office leaves little opportunity for crosstraining. Careful study of responsibilities and reasonable distribution of tasks will be completed to support operational efficiency. It is hoped that as revenues pick back up, a part-time office support person can be added to the team.

In the previous year (FY19), several part-time temporary clinical instructors, supervisors, and service providers were hired to address the wait list for services, to expand, and to provide additional supervised experiences for graduate students. All of the part-time clinical instructors continued their roles in FY20. Dr. Matthew Hollis shifted to a full-time position at the beginning of this report period. Table 1 provides a list of MSHC staff.

Two tenure-track faculty members were credentialed so that they could develop client bases in their areas of research and assist with clinical education for the school’s growing clinical classes. Dr. Sarah Warren developed the Midsouth Cochlear Implant Program in conjunction with Dr. Jennifer Taylor. Dr. Miriam van Mersbergen developed the Clinical Voice and Vocal Health Program, which is overseen mostly by Amy Nabors. Both programs are aligned with the UTHSC Otolaryngology Group, which provides referrals to MSHC.

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ADMINISTRATIVE

John Sandidge, MA

Feliza Vasquez, Office Associate

Vicki Haddix, MS Justine Steele, MA (p/t) Darlene Winters, MA (p/t) Katherine Mendez, MA

Danielle Keaton – Le Bonheur Director, Outpatient Rehab & Developmental Services

(p/t) Amy Nabors, MA

Sheila Climer – Le Bonheur MSHC Operations co-coordinator

Miriam van Mersbergen, PhD

Shannon Tacker – ULPS

Head Start Screenings: (p/t) Valentina Taran, MA

Jessica Harrison – ULPS

(p/t) Jessica Balderson, MA (p/t) Rebecca Vergo, MA

*part of the year

In addition to the services provided and billed through ULPS/Le Bonheur, MSHC had several contracts in place during FY20: 1. Veterans Administration Contracts to provide hearing evaluations

• Dedicated part-time audiologist assigned to these

• Pay per service 2. C ontract with Porter-Leath for MSHC to provide speech-language and hearing screening in Head Start programs throughout Memphis

• Part-time speech-language pathologists hired to coordinate and administer the screenings

• Pay per service 3. Contract with UTHSC Otolaryngology Group/UTMP to provide voice services

• Paid monthly on per diem rate 4. Contract with Le Bonheur Audiology to share audiology facilities at MSHC

• Canceled/delayed due to COVID-19

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COMMUNITY CONTACTS

MANY SLP PROGRAMS ARE AVAILABLE THROUGH TELEHEALTH

MSHC provides an extraordinary array of services to the community. There are few places for clients to go for some of the programs MSHC offers. The referral network is growing as people around the city are seeking out MSHC services.

Some of the referrals to MSHC come from: • • • • • • • • • • • •

Semmes Murphey Baptist Hospital Methodist Hospital Le Bonheur Hospital St. Francis Hospital VA Hospital Church Health Center Christ Community Regional One Cordova Pediatrics Pediatrics East Laurelwood Pediatrics

• •

• • • • •

Memphis Children’s Clinic Memphis and Shelby County Pediatric Group Raleigh Group Memphis Oral School for the Deaf Vanderbilt University Voice Center UTHSC Otolaryngology Boling Center for

• • • • • • •

Developmental Disabilities, UTHSC Southern College of Optometry OUT Memphis Angel Program at Holy Rosary Shelby County Schools Achievement School District Charter Schools Private Schools

• • • •

• • • •

Head Start Programs Vocational Rehabilitation TN Disability Services Brooks Rehab Hospital, Jacksonville, FL Dr. Mona Shete Lion’s Club Self-referral Word of mouth

CURRENT SERVICES AND PROGRAMS AT MSHC SPEECH-LANGUAGE PATHOLOGY Aphasia Boot Camp Intensive summer rehabilitation Read-n-Rec Summer language and literacy program PlayBaby!

Toddler language stimulation and parent coaching Language Learning Lab Adults with Down Syndrome Tiger PALS Group for children with autism/social-communication impairments

AUDIOLOGY Mid-South Cochlear Implant Program*

Auditory processing evaluation and treatment

Tinnitus rehabilitation

Hearing evaluations

Auditory processing evaluations

Clinical Voice and Vocal Health Program*

Evaluation and fitting for hearing aids

AAC evaluations, training and therapy

Hearing screening

Spanish/bilingual pediatric language evaluations

Vestibular/Balance evaluations

Adult & pediatric speech and language therapy

Tinnitus evaluations

Adult & pediatric speech and language evaluations

Newborn hearing evaluations

Transgender voice development

Adult audiologic rehabilitation

Swallowing disorders rehabilitation Alaryngeal speech training Fluency/stuttering programs Reading/Literacy & Language Accent modification *In partnership with UTHSC Otolaryngology Group

Clinical Faculty at the MSHC from left to right: Dr. Eileen Smith, Dr. Casandra Banks, Dr. Jennifer Taylor, Julie Marshall, Marilyn Wark, John Sandidge, Justine Steele, Vicki Haddix and JoClaire Merrill 8

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CLIENT VOICES Hearing from MSHC patients and clients and learning about their successes reminds us of why MSHC’s work is important. There were numerous adjustments in service provision from face-to-face to telehealth in the last part of FY20, but our clinical faculty rose to the challenge. An anonymous survey was sent to SLP clients or families who transitioned to telehealth. These are the responses:

I was very hesitant about beginning my son’s therapy over zoom. But I am very glad to report that we have been beyond pleased with how everything was set up. Through videos and observation we have seen a huge difference in my son’s speech, and we are just so thrilled!

Client testimonial about teletherapy at MSHC

Words cannot describe my gratitude or the difference she has made and continues to make.

Excellent—best there is, best that can be imagined, the reason why we were there.

She is a wonder in our lives.

Clients and their SLPs during the pandemic

The clinician & her “students” have been so creative, dedicated & gone to great lengths to personalize our sessions.

I have had a wonderful experience with this program. I came from a different clinic of speech pathologist for my 2-year-old son my husband and I were not pleased with.

Coming to this location has been nothing short of a blessing. From the moment we came, everything was easy. Our speech pathologist listens to my concerns, validates me as a parent, loves and laughs with me about my son, and educates me.

The program has been beneficial in providing me with the knowledge and resources I need to reinforce language at home and meeting my son where he is at. It has been beneficial to learn how to incorporate language in our daily lives and letting my son lead our interactions.

Also, the growth we have seen in my son since starting in April has been mind blowing! He started with saying a lot of single words, rarely using two words, and progressed to saying phrases and really expressing himself. I was skeptical of this program, but after having done the program and seeing the results and the growth, I am so thankful we went with y’all! Needless to say, I love everything y’all do!

PATIENT/CLIENT PERSPECTIVE

[Client] looks forward to his therapy and always tells us what they did. He wants to share what he has learned with family and friends.

The service has been wonderful and the staff is awesome.

Clients and their SLPs during the pandemic 10

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IN THE COMMUNITY For several years, MSHC students have participated in speech, language and hearing screenings at Head Start programs in Memphis. This work is contracted through Porter-Leath. In 2019-20, 65 students and six clinicians served 2,222 infants and preschoolers in Shelby County in 45 schools.

MSHC and the graduate students in the school printed, laminated and delivered communication boards to area hospitals to assist patients on ventilators or in isolation communicate with families and hospital staff. More than 250 were distributed in spring 2020.

Several clinical faculty members shared their expertise with members of the broader community.

AUDIOLOGY Dr. Jennifer Taylor, AuD, CCC-A, Director of Clinical Services in Audiology • Serves on the Memphis Regional Newborn Hearing Screening/Early Hearing Detection and Intervention (NHS/EHDI) Task Force.

• Co-developed the Memphis EDHI Training Program that provided quarterly trainings to local speechlanguage pathologists, audiologists, Tennessee Early Intervention (TEIS) coordinators and teachers.

• Provided audiological services and supervision to trainees at the UT Boling Center for Developmental Disabilities one day a week via a LEND grant.

• Co-developed and refined the Auditory Processing Clinic and treatment program.

• Co-developed the University of Memphis Mid-South Cochlear Implant Program.

• Grew the off-site placement options to accommodate the increasing audiology class size.

• Faculty co-advisor for the 50th Mid-South Conference on Communicative Disorders.

• Faculty co-advisor for the University of Memphis Student Academy of Audiology (SAA).

• Faculty co-advisor for the University of Memphis National Student Speech-LanguageHearing Association (NSSLHA).

• Nationally, serves as the Vice President for Organizational Advancement for the Council of Academic Programs in Communication Sciences and Disorders (CAPCSD) 2018-21.

• Nationally, serves as a site visitor for the Council of Academic Accreditation (CAA) 2018-21 .

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• Nationally, served as the Hearing, Balance, Tinnitus – Assessment and Intervention: Pediatric topic chair for American-Speech-LanguageHearing Association (ASHA) Convention 2020.

• Nationally, serves as the Supervision and Precepting topic co-chair for the American Speech-LanguageHearing Association (ASHA) Convention 2021.

• Nationally, serves as the monitoring officer for the Diversity, Equity and Inclusion Task Force for the Council of Academic Programs in Communication Sciences and Disorders (CAPCSD) 2020-21 • Past president of Junior League of Memphis, serving as an advisor on the Community Program Research and Nominations committees.

• Serves as Centennial Planning co-director for Junior League of Memphis 2019-22.

Dr. Casandra Banks, AuD, CCC-A, Clinical Assistant Professor in Audiology

• Participated in Healthy Memphis Initiative with Church Health.

• Organized the Studebaker Lecture Series, two allday seminars in fall 2019 for all graduate students in CSD and community members interested in the topics.

• Topic 1: Business of Audiology, Dr. David Zapala, Mayo Clinic-Florida.

• Topic 2: A Semester in a Day-The Basics Every Student Needs to Know About the Business of Audiology, Dr. Kim Cavitt, Owner of Audiology Resources.

Dr. Eileen Smith, AuD, CCC-A, Clinical Assistant Professor in Audiology • Past President of the Tennessee Academy of Audiology.

• Organized regional meetings to keep local audiologists informed of important legislative issues at the state level.

• Provides audiological services to members of the Mid-South Lions Club and is active in the Memphis Regional Newborn Hearing Screening/Early Hearing Detection and Intervention (NHS/EHDI) Task Force.

• Provided OSHA hearing screenings for UofM Physical Plant employees.

• Supervised student clinical labs for course work in the vestibular and occupational conservation course taught by Dr. Deborah Moncrieff.

• Developed the Vestibular/Balance Laboratory at MSHC that is unique in the surrounding area for diagnostic services provided.

• Continues to update and work with local physicians in research and clinical support for their vestibular patients.

Dr. Matt Hollis, AuD CCC-A, Clinical Assistant Professor in Audiology • Moved from part-time to full-time at MSHC. • Has provided audiology services to the Mid-South for over a decade with a focus on provision of amplification and diagnosis of vestibular disorders.

• Consulted with Tennessee Academy of Audiology on development of patient-facing website to provide information on audiology services and providers in local communities.

• Assists with annual OSHA hearing screenings for UofM Physical Plant employees.

• Provided audiology services to the UofM’s Sound Fuzion, a group of student musicians.

• Worked to adapt AUSP 6016 (Introduction to Audiology) as an online class when public health concerns precluded holding in-person classes.

• Continued to emphasize to students the importance of clinical best practices and how they improve both patient outcomes and business metrics.

• Developed MSHC Tinnitus Management Group and worked with graduate audiology students to provide a much-needed service in the Memphis community.

• Provided clinical education to audiology graduate students using practical clinical experiences and a weekly classroom session.

• Participated in newly developed MSHC Cochlear Implant Program: completed coursework and attended cochlear implant manufacturer trainings.

• Served as member at large for Tennessee Association of Audiology (TAA).

• Provides hearing assessments in the Memphis Community (churches, schools, health fairs).

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SPEECH-LANGUAGE PATHOLOGY Marilyn Wark, MA, CCC-SLP, Director of Clinical Services in Speech-Language Pathology • Presented a paper at the Mid-South Conference on Communicative Disorders with Kelli Owens, Tawni Ballinger and six participants in the 2019 Aphasia Boot Camp describing the program. The presentation was well received and lead to many referrals to the program.

• Assisted in the development and marketing of the first virtual Aphasia Boot Camp.

• Assisted clinical faculty and students in managing the changes for service delivery to telehealth due to COVID-19.

• Arranged for simulation training and negotiated off-site placements during the COVID-19 crisis to ensure that the spring and summer graduates could complete their program on time.

• Added 14 new off-site clinical preceptors to manage the increase of students in the program.

• Coordinated with area hospitals to deliver communication boards during the pandemic.

• Coordinated the Porter-Leath Head Start contract to provide speech-language and hearing screenings for children ages six months to 5 years of age. This contract provided 1,306 clock hours for students and generated over $38,000.

• Invited external reviewer for two individuals applying for promotion to clinical professor: one from Auburn University and one from Purdue University.

• Served on the Topic Committee for Supervision and Precepting for the American Speech-LanguageHearing Association 2020 Convention.

• Served on the Health Advisory Board for Porter-Leath Children’s Services.

• Served on the clinical education committee for the Mid-South Interprofessional Health Education Collaborative (MIHEC).

• Served on the steering committee of the University of Memphis Interprofessional Community Health Clinic.

• Oversaw development and approval of continuing education units (CEU) for the school and community.

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Vicki Haddix, CCC-SLP, Clinical Associate Professor in Speech-Language Pathology • Promoted from Clinical Assistant to Clinical Associate Professor in SLP. • Second full year of TN Talks Grant funded by the State of Tennessee Department of Education: Building Capacity for Communicative Competence (BC3). x T his project focuses on informing educators in West Tennessee about alternative and augmentative communication (AAC) to better serve the children in public schools who need AAC support. x S helby County: professional development for teachers, teaching assistants and related service providers in five schools until February. x H aywood County: monthly meetings with SLPs until February.

• Contributed resources to Tennessee’s Department of Education documents to schools and significantly increased the resources and training available on the TN Talks website.

• Began an AAC Community of Practice in February, which meets monthly to share resources and discuss AAC issues in the Memphis community. Participants include people who work in schools, early intervention, hospital settings and private practice.

• PrAACtical AAC posts: • Growing AAC professionals: When learning meets service. Blog posted on May 21. praacticalaac.org/praactical/growing-aacprofessionals-when-learning-meets-service.

• Growing AAC professionals: Learning about safeguarding practices. Blog posted on May 28. praacticalaac.org/ praactical/growing-aac-professionalslearning-about-safeguarding-practices.

• AAC in the Cloud June 23: Haddix, Warren & Reese. (2020). The Tennessee Talks grant: Building AAC capacity in Tennessee public schools.

Presented at the AAC in the Cloud conference.

• NJ Virtual EdCamp June 8: Haddix (2020). What will AAC professional development look like in the fall?

Discussion facilitated at the NJ virtual EdCamp.

• MidSouth March 5: Merrill & Haddix. (2020). AAC, ABA & SLP: Making alphabet soup for preschoolers with ASD. Paper presented at the Mid-South Conference on Communicative Disorders, Memphis.

• ATIA Feb. 1: Haddix (2020). Hands-On Activities for Teaching AAC: How and Why. Paper presented at the Assistive Technology Industry Association conference in Orlando, Fla.

• Advised students in planning the 51st Mid-South Conference on Communicative Disorders. x Implemented cost-saving measures. x P lanned for modified modality to accommodate continued COVID-19 restrictions. x Both on ground and online opportunities.

• Adapted therapy to telehealth in spring 2020.

• PIE Jan. 28: Haddix, Reese, Warren & Taylor.

(2020). An AAC-AT overview for the special education administrator. Paper presented at the Partners in Education conference in Nashville.

x A ttended numerous trainings and continuing education on telehealth.

• TAAT Dec. 5: Haddix, Reese, Warren, & Ricks.

(2019). The Tenneessee Talks grant to build AAC capacity in schools. Poster presented at the Tennessee Association for Assistive Technology conference in Franklin, Tenn.

x Assisted clients with logistics.

x H uang, Slaughter & Haddix. (2019). AT in the IEP process: Consideration vs evaluation. Panel discussion held at the Tennessee Association for Assistive Technology conference in Franklin, Tenn.

• West TN SpEd Sept. 20: Haddix & Allen. (2019).

Getting started with AAC: Tips and resources.

Paper presented at the West Tennessee Special Education Conference. Memphis.

Julie Marshall, MA, CCC-SLP, Clinical Associate Professor in Speech-Language Pathology • Serves as faculty co-director for the University of Memphis National Student SpeechLanguage-Hearing Association. x Coordinated student body throughout the year. x U pdated leadership roles and responsibilities for the 2020-21 cycle.

• Served as faculty co-advisor for the 50th MidSouth Conference on Communicative Disorders. x T he spring conference brings nationally recognized speakers from around the country to give CEU-generating sessions to Mid-South practitioners. x T here were approximately 500 attendees at this year’s conference. x O versaw the financial aspect as treasurer (student) was sent home due to COVID-19.

x M odified activities and created new activities to address client needs.

x M odified schedules to accommodate 100% supervision requirement for teletherapy.

Katherine Mendez, MA, CCC-SLP, part-time Instructor in Speech-Language Pathology • One of a small number of bilingual speechlanguage pathologists in the State of Tennessee, Mendez provides speech and language services to Spanish-speaking children and families in Memphis and the surrounding area.

• Specialized in assessment and treatment of language-based literacy disorders and has grown this aspect of the clinic significantly in the last year. x T ypically runs the Read-n-Rec camp in the summer, which was cancelled this year.

• Became certified to administer the Autism Diagnostic Observation Scale (ADOS).

• Partnered with Justine Steele, MA, CCCSLP to develop new programming for MSHC in the area of developmental and selective mutism diagnostic services.

• Moved all therapy services online during the pandemic. Found creative solutions to remotely evaluate children’s language online.

• As a certified special education advocate, Mendez consulted with various clients and attended multiple IEP meetings.

• Serves as member of the Memphis Early Literacy Consortium.

• Presented at the 50th Mid-South Conference on Communicative Disorders and as a guest speaker at the Bodine School.

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JoClaire Merrill, MA, CCC-SLP, Clinical Associate Professor in Speech-Language Pathology • Promoted from Clinical Assistant to Clinical Assistant Professor professor in SLP. • Expanded the PlayBaby! program for young children in need of language stimulation.

• Continued the Autism, Behavior, and Communication (ABC) program that she developed as a cotreatment model with applied behavior analysis. x P lans to re-envision this as TigerPALS (preschoolers acquiring language skills) to emphasize a focus on the communication needs of preschool children with autism.

• Developed a social skills group for early school aged children with autism.

• Supervised 399 individual, 303 group and 85 telehealth therapy sessions.

• Provided 39 hours of continuing development, 21 of which were in the provision of telehealth.

• Provided innovative therapy online using green-screen technology.

• Assumed role of Continuing Education Unit (CEU) Administrator for the school and the UofM Chapter of the National Student Speech, Language, Hearing Association.

• Presented at the 50th Mid-South Conference on Communicative Disorders: x M errill & Haddix. (2020). AAC, ABA & SLP: Making alphabet soup for preschoolers with ASD. Paper presented at the Mid-South Conference on Communicative Disorders, Memphis.

Amy P. Nabors, MA, CCC-SLP, part-time Clinical Instructor in Speech-Language Pathology • Expanded voice services in the Clinical Voice and Vocal Health program. Since the pandemic began, Nabors has been able to provide clinical voice services both in-person and via telehealth.

• Specialties include evaluation and treatment of individuals with voice and upper airway disorders, including singers and other voice professionals.

• Often works with patients who have neurological, degenerative, and functional voice and breathing disorders.

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• Worked with laryngologist Dr. Sandra Stinnett from UTHSC Otolaryngology Group, providing services and clinical education in a busy and growing ENT clinic.

• Assisted Dr. Miriam van Mersbergen with the Health for Artists Meet & Greet event in February 2020. x S he will continue to be involved with the University of Memphis Arts & Health Symposium once that is rescheduled around the current COVID-19 pandemic.

• In conjunction with the National Spasmodic Dysphonia Association, Nabors kickstarted the Mid-South Spasmodic Dysphonia Support Group in fall 2020.

• In addition to providing clinical therapy and student education, Nabors is heavily involved with Memphis performing arts and music groups and has been nominated for several Ostrander Theatre Awards.

John Sandidge, MA, CCC-SLP, Clinical Assistant Professor in Speech-Language Pathology • Oversees the Swallowing Disorders Rehabilitation Program.

• His program for Transgender Voice Development was featured in High Ground News in March 2019.

• Provided intervention services to pediatric clients with autism and other communication disorders.

• Assisted in revision of preschool speech and language screening process (fall 2019) for Head Start Preschools, with the end result of reducing the number of false referrals to Shelby County Schools.

• Served as the second SLP supervisor for the PlayBaby! program with JoClaire Merrill.

• Certified to administer Autism Diagnostic Observation Scale-2 along with Katherine Mendez, allowing MSHC to be another option for parents seeking developmental evaluations (in English and Spanish).

• Developed selective mutism evaluation protocol with Katherine Mendez (unable to begin due to COVID-19).

• Presented with Katherine Mendez at the 50th Annual Mid-South Conference (Question the Test).

• Elected president of the UoM’s CSD Alumni Chapter.

• Spearheaded the formulation of teletherapy evaluation procedures to ensure diagnostic appointments were able to continue during COVID-19 restrictions.

Darlene Winters, MA, CCC-SLP, part-time instructor • Has provided services at MSHC for more than 10 years.

• Runs the well-established and popular Language Learning Laboratory (LLL), a literacy program for adults with Down syndrome. x Spring 2020 was the 17th semester of LLL. • Serves on the University of Memphis Institute on Disability (UMID) Advisory Board.

• Serves as President and Artistic Director of Company d (nonprofit), a nationally recognized dance company of young adults with Down syndrome. x C ompany d received a grant to tour “Let it be a dance” with the Iris Orchestra. x T he school visits involve collaboration with teachers in language arts, social studies and music to address core curriculum standards, and social and emotional learning.

• Active representative at the Community Partnership Roundtable hosted by Hutchison School. x F or nonprofits, arts organizations, schools, industry advocates with outreach as part of mission.

• Continued development of the Transgender Voice Program, with an average enrollment of at least six clients at any given time.

• Presented on Transgender Voice at Mid-South Conference 2020.

• Despite COVID-19 closure of the clinic, able to retain 90% of clients via telehealth.

• Joined the Tennessee Association of Audiologists and Speech-Language Pathologists (TAASLP) Foundation Board earlier this year.

• Served the school on an average of three CSD committees.

• Explored possibility of seeing Laryngectomy patients at the VA Hospital.

Justine Steele, MA, CCC-SLP, Clinical Assistant Professor in Speech-Language Pathology is the most recent fulltime hire at MSHC • Became clinical assistant professor in speech-language pathology.

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MARKETING

MEMPHIS SPEECH AND HEARING CENTER, INC., BOARD OF DIRECTORS

Continued efforts to make the community aware of the services offered at the UofM/MSHC were cut short due to the pandemic in spring 2020.

The mission of the MSHC, Inc. Board of Directors is:

• An advertisement was posted in the White Station High School Choir program for fall 2019.

To support the efforts and programs of the Memphis Speech and Hearing Center and the School of Communication Sciences and Disorders and to make communication services accessible to all.

• Recruitment fliers were made for MSHC specialty clinics and circulated to area doctors’ offices, clinics, clinicians, and health fairs.

MSHC, Inc. Board had 10 active members in FY20.

• Commercial Appeal article on communication boards.

Executive Team:

• Spring 2020 University of Memphis Magazine article on the 50th Anniversary of the student-run Mid-South Conference on Communicative Disorders.

Mark Cary, President

Senior VP, FHN Financial

Colleen Canale, Secretary

Community Advocate

• Posts on the MSHC Facebook page were updated every two or three weeks during FY20.

Cynthia Johnson, Vice President

Community Advocate

Jodi Fontana, Treasurer

VP of Accounting, Orgill, Inc.

x T opics were related to general speech, language and hearing issues; to specific featured programs at MSHC; or to events related to the MSHC mission. x Most engaging were topics on : x MSHC converting to telepractice: 49 engagements x Language and literacy: 78 engagements x Communication boards: 110 engagements x In FY20, MSHC gained 106 Facebook followers • In the coming year, MSHC’s website will be redesigned with a more user-friendly patient focus.

Members: Anne Conrad

Attorney and Community Advocate Dr. Boyd Gillespie

Chair, UTHSC Department of Otolaryngology Deborah Harris Regional Manager for Exceptional Children and Health Services, Shelby County Schools

Elizabeth Martin Speech-Language Pathologist; Junior League of Memphis Representative Allison McBride

Manager, International Paper Shannon Tacker

CEO, University Clinical Health

Community Affiliates: Geoff Calkins

Journalist, Daily Memphian 18

Shaundra Gatewood Special Educator; Junior League of Memphis Representative 19

As a continued source of support and advocacy, the MSHC, Inc. Board of Directors contributed a record $57,754 to clients who had financial barriers to communication health through the Client Assistance Program (CAP). This is a 36% increase in the amount of CAP-provided support in the previous fiscal year ($42,542). These funds allowed clients to receive services and purchase necessary devices, such as hearing aids and communication devices.

In FY20, a total of 64 individual patients were helped with CAP funding that went toward 601 procedures. In FY18 and FY19, 34 and 58 patients respectively were recipients of CAP funds.

Figure 1 illustrates the historical distribution of CAP funds since FY2012. The expected target of $50,000 for FY20 was exceeded. It is expected that FY21 will continue at high levels, possibly exceeding $60,000.

(CAP) funds since FY2012. The expected target of $50,000 for FY20 was exceeded. It is expected that FY21 will continue at high levels, possibly exceeding $60,000.

Figure 1. CAP Distributions

In FY20, MSHC/CSD received 76 applications for client assistance, which was down 23% from the previous year of 99 applications. Of those who applied, 64 (84.2%) were new applications while 12 (15.8%) were renewals.

Based on the need, clients could be approved to receive between 20% and 80% of the cost of service and/or devices.

Of the 61 patients/clients who qualified, most were approved for 80% assistance, as illustrated in Figure 2.

Figure 2. Levels of support to CAP clients in FY20.

I wish to express my appreciation to the Board of Directors for the grant in the Client Assistance Program. It will allow me to continue to obtain the best possible solution for my severe hearing issues. I have been a client of the Memphis Speech and Hearing Center since 2006.

The doctors and other staff and students that I have encountered have always impressed me with their knowledge, professionalism and caring attitude for clients.

BENEFICIARY PERSPECTIVE

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CAP RECIPIENT – TESTIMONIALS “My family was going through some difficult financial times. Our son really needed the services offered through the UofM Speech and Hearing Center, but we simply couldn’t afford it anymore. The Client Assistance Program (CAP) made it possible for our son to continue therapy. Early intervention is essential, and it wouldn’t have been possible for us to give our son the good start he deserves without the CAP assistance. Now we are back on our feet financially and can pay for it ourselves. Thank you CAP, and thank you MSHC!!!!”

“The Client Assistance Program made the difference between me replacing my lost hearing aid or going without hearing. I would never have been able to afford it without assistance due to losing my job during COVID-19.”

“Being on the financial assistance program was such a blessing. It came at a very hard time in my life when I was transitioning to who I am today. I had very few funds, but finding my voice was such a big part of being myself. It made my visits affordable and I was able to achieve my goal and encourage others to do so as well.”

“The Client Assistance Program helps me to afford my supplies and the service done to my hearing aid.

Medicare does not cover any of the work that needs to be done.”

“Without this program, I could never have gotten my daughter’s new hearing aid. I am a single mother caring for myself and my daughter (who is disabled).

The process was easy, especially being limited with English. It was a relief to find help for us in in our language and affordable care.”

PRODUCTIVITY Productivity of the faculty and staff who work in MSHC can be measured in several ways. Procedures, charges and appointments ebb and flow with the academic calendar, with higher numbers always corresponding with the academic calendar, when students are present. The lower months typically are January, May, August, and December.

MSHC saw patients/clients in 5,249 appointments, and billed 7,066 procedures in FY20. Overall when comparing FY20 to FY19, the number of appointments was almost identical, but procedures billed at MSHC were 8% lower in FY20 than in FY19.

This lack of change in annual patient traffic is remarkable because for the last four months of FY20, during the pandemic, MSHC slowed down its volume significantly. Thus, the first half of FY20 was particularly strong.

The slight decrease in billed procedures may have been tied to a snag with the Le Bonheur billing system that was discovered in early 2020. A new internal billing system was being selected by UT Le Bonheur Pediatric Specialists, Inc. (ULPS) at the end of FY20.

In Figure 4, total procedures are compared for FY19 and FY20. The effect of the COVID-19 pandemic was dramatic and deep through the final four months of FY20. Nevertheless, considering the momentum before the pandemic, there is Figure 4. Total procedures by months for FY19 and FY20

“The program helped my sister to get the help she needed. Insurance ain’t always enough. She could not budget to handle any more and needed help.

Ya’ll were there to help her. And you did it without shaming her and that is important in life. People look down on people who admit they need help and that is why we don’t ask. But I am glad the young lady was there to see beyond and ask.” - Aphasia Client

From the educational side, speech-language pathology clinical faculty in MSHC provided 6,125 supervised clientcontact hours to students in FY20 (up 20% over FY19). In audiology, clinical faculty provided 3,418 supervised hours (nearly identical to FY19). The increase in SLP supervised hours was the result of additional services offered and the enrollment increase in SLP graduate students.

• 5,259 Completed Appointments • 7,066 Completed Procedures • 9,543 Supervised Student Hours

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IN THE COMING YEAR Memphis Speech and Hearing Center enters FY21 in the midst of a pandemic. The pace and delivery of services and education have changed, possibly for an extended time. Many group programs were suspended, and the hope is that in FY21 they will be able to return in some form.

EXPAND

Mid-South Cochlear Implant Program

RE-ESTABLISH Pediatric Audiology Tinnitus support group

Audiologic Rehabilitation support group

Social Skills group

Aphasia groups Bootcamp in summer; family support groups; semester small groups

Language and Literacy programs Read-n-Rec summer program; comprehensive assessment and treatment plans

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PARTNERS AND STAKEHOLDERS

PARTNERS AND STAKEHOLDERS •

UTHSC Otolaryngology

•

School of Social Work or other professionals

•

Client demand for services; patient waitlist

•

CSD clinical education opportunity

•

Professional community

•

Church Health Center/Crosstown

•

Patients in need of hearing healthcare

•

UTHSC Otolaryngology

•

University of Memphis Rudi E. Scheidt School of Music

•

Le Bonheur Children’s Hospital

•

CSD clinical education opportunity

•

Physicians in Memphis

•

Interprofessional: counseling

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CSD clinical education opportunity

•

Physicians in Memphis

•

Client demand for services; patient waitlist

•

Interprofessional: counseling

•

CSD clinical education opportunity

•

CSD clinical education opportunity

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Professional community

•

Audiologists in Memphis

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Public and private schools

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Public and private schools

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Autism networks in Memphis

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Autism networks in Memphis

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UofM Counseling/Social Work/ICHC

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UofM Counseling/Social Work

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CSD clinical education opportunity

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CSD clinical education opportunity

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Professional community

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Patients with aphasia or head injury

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Interprofessional Community Health Clinic

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Families

•

Southern College of Optometry

•

Physicians in Memphis

•

Occupational therapy

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CSD clinical education opportunity

•

UTHSC Otolaryngology

•

Occupational Therapy/Le Bonheur

•

Southern College of Optometry

•

Public and private schools

•

Homeschool networks

•

Client need/demand

•

CSD clinical education opportunity

Hearing Services Clinical Voice and Vocal Health Program

Autism and Selective Mutism Assessments

Interprofessional Services

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4055 North Park Loop Memphis, TN 38152 901.678.2009 memphis.edu/mshc

The University of Memphis is an Equal Opportunity/Affirmative Action University. It is committed to the education of a non-racially identifiable student body. UOM356-FY2021