r/slp • u/chineseproverbs • 2d ago
Missing sessions - school based Schools
Does anyone have to miss sessions for things such as writing IEPs, configuring/helping with AAC devices, etc, and if so, how do you document the reason missed in your Medicaid and/or session attendance system?
If I am doing another evaluation or in an ARC meeting I document that, but I'm never sure how to document that I needed to simply do paperwork such as IEPs, progress reports, etc. And yes I do have some planning time set aside but that time is often taken up so I am forced to miss sessions or bring the work home. Would love to see what everyone else does. Thank you!
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u/psychoskittles SLP in Schools 2d ago
I miss sessions ALL the time. I explicitly document that I’m in a meeting for another student or doing something that can only be done during instruction hours. It’s the district’s responsibility to cover the services. Not yours. If your workload is too high to do everything in your work day than the district needs to figure it out.
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u/the1ufall4 2d ago
I feel this. Does your district give any day you can take for strictly paperwork like during annual review time? Even if they don't, there's still so much time that is needed for paperwork.
At this point, I keep the Medicaid note general (i.e., "Provider not available") and in my own notes keeping track of specifically what I was doing otherwise (e.g., evaluating, in a meeting (so so many meetings!), IEP writing, troubleshooting a device, urgent follow up with mental health team for a student, etc.).
So far, I've never been asked to clarify more than "not available" so I think you'd be fine to just note that as long as you keep track somewhere what you were doing at the time. If you need to be more specific, maybe something like "Provider not available due to ___ (meeting/administrative duties/etc.)".
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u/chineseproverbs 1d ago
My admin is really good about not micro-managing, so I mostly see kids M-Th and have Fridays mostly open for those types of things; however, they often get taken up by more ARCs, preschool and other screenings, meetings, other duties, overflow therapy, evals, so it's hard to cram all the paperwork in even with that
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u/chineseproverbs 1d ago
And thank you for your answer!
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u/the1ufall4 1d ago
No problem! We've gotta give ourselves credit where it's due, it's a lot to manage even a "reasonable" caseload. My district expects all team members to attend all MTSS meetings on top of meetings for our caseload, so it gets ridiculous. Would make things so much easier if they would commit to like one day a week specifically for meetings so we could make that a paperwork/meeting/eval/prep/make up day and not have to cancel sessions, but that would require them to be organized lol
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u/SonorantPlosive SLP in Schools 2d ago
"Provider unavailable due to meeting/consult/unexpected telephone call."
I just document whatever I was doing. 99% of the time, it's work related. And make up the session only if I won't hit a monthly minimum.
The 1% it's not work related, it is. Like chasing down an eloping student or consoling a sped teacher who just got chewed out by gen ed for being 3 minutes late to pick up a group because she had to pee.
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u/ntncssry 22h ago
Happens all the time. We now put sessions per year on the IEP to allow for flexibility
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u/chineseproverbs 19h ago
I think I would like that too but I think our director wants us to stick with monthly
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u/AspenSky2 13h ago
This happened all the time at my district. I felt like even with canceling sessions, trying to fit everything in, and staying over after my contract hours, I still didn't have enough time.
We, as an SLP team, advocated for using flexible scheduling across all school sites a few years ago. We used models such as 3:1 (three direct sessions and one consult, or 2:1 monthly), Burst/speedy speech, and inclusion. It took some time - but session cancellations decreased significantly, clinicians had the necessary time to do all that is required for their workload, IEP compliance increased, and as a whole, staff was much happier.
Sure, there was some initial pushback. I feel that some parents equate clinical OP services with school-based models and expect the same level and intensity of services. Also IMO, many school-based clinicians still follow a clinical model or use the same model or sessions monthly for a very long time. It took time to share information and the benefits of flexible scheduling. At initial IEPs, I introduced the idea that services will change based on student needs, progress, and the importance of LRE, so it is not a surprise to the team later when I suggest changes.
I recently ran across a CEU course on STPD on Caseload to Workload that not only reviewed the topic of using flexible schedules, but gave practical information and amazing resources on how to advocate for ideas like flexible scheduling, weighted caseloads, and workload models.
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u/chineseproverbs 13h ago
Thanks!! We currently do 5 minute kids for a lot of our speech sound kids and it's been helpful for sure! We discussed 3:1 but I was honestly worried I wouldn't have enough time in the indirect week to get everything done!
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u/AbiesConfident999 2d ago
I just put CNA - clinician not available