Communication Sciences & Disorders

221 Bohannon Hall, 1207 Ordean Court, Duluth, MN 55812

Phone:(218) 726–7974; Fax: (218) 726–8693

Email: cd@d.umn.edu

University of
Minnesota
Duluth

College of Education &
Human Service Professions

Part 12: RFP Clinic Policies and Procedures

RFP Clinic I: Case Management Policies and Procedures

Referral and Admission Procedures

Anyone may access the services of the Clinic.

Discharge Policy

Individuals are discharged from direct services based on the following criteria:

Clinic Access Fees

The CSD Department holds the philosophy that the RFP Clinic should be as accessible as possible to individuals in the community. Increased access allows for the following:

To meet these goals, the RFP Clinic charges clients a Clinic Access Fee, which represents a part of the cost for services rendered and is non-refundable. The Clinic does not charge "fee for service" rates, and thus does not charge the customary market rates for services. The Clinic does not access third-party reimbursements such as insurance, Medicare, or Medical Assistance, and will not process insurance forms/payments.

Clinic Access Fees are reviewed yearly and are based on factors such as operational costs of the clinic, client accessibility, and the amount of university and external funding for clinic operations. See the Fee Policy (Appendix C) for current rates and for the Payment Agreement Form (Appendix C) clients are required to sign.

We do not want finances to be a barrier for anyone wishing to access the services of the Clinic. Through generous financial support of the Edwin Eddy Foundation and other private donors, a Clinic Fee Support program has been established for clients who are not able to pay the Clinic Access Fee. Clients who wish to receive an application must turn in the Notice of Fee Support Program/Application Request Form (Appendix C), at which time they will be given an application. Clients must then turn in the completed Application for Clinic Fee Support by the due date in order to be considered for fee support (Appendix C).

Client Confidentiality

The client-clinician relationship is based on trust. Student interns and clinic instructors are expected to abide by the ASHA Code of Ethics and the Federal Health Information Portability and Accountability Act (HIPAA) when protecting the confidentiality of a client´s health information. It is inappropriate to discuss clients anywhere outside of the Robert F. Pierce Speech-Language-Hearing Clinic. It is inappropriate to discuss clients with any person who is not on a "need to know" basis regarding the client´s care. A student intern or clinical instructor must not reveal to unauthorized persons any Protected Health Information (PHI) obtained from the individual s/he serves professionally without that person´s permission.

Before having contact with clients, students are required to complete the University of Minnesota HIPAA training modules, as outlined in Parts 6, 7, and 8 of the Handbook. The on-line courses are assigned and tracked by the CSD Department HIPAA Coordinator. Documentation of completion must be submitted to the Clinic before client contact is permitted.

The University of Minnesota is a covered entity as defined by the Health Information Portability and Accountability Act (HIPAA). All covered entities are required to implement and maintain safeguards to protect the privacy and confidentiality of protected health information (PHI). All covered entities also are required to report suspected breaches of confidentiality. If you suspect a compromise in safeguarding PHI, report it to the Clinic Director. For more information, please refer to the University of Minnesota Privacy and Security Project.

As part of your educational experience in the University of Minnesota Duluth Communication Sciences and Disorders (CSD) program, you may be permitted access to PHI for educational purposes. You have a personal responsibility to safeguard the privacy and confidentiality of PHI as required by the University of Minnesota.

Using or sharing PHI for any purpose and disclosing PHI to any person not directly associated with my University of Minnesota educational program violates HIPAA and state laws and University policies, which may subject you to University sanctions, civil, and criminal penalties. You are required by University policy to report any suspected or known HIPAA violation or other misuse of PHI to the CSD Program HIPAA Coordinator (Lynette Carlson at 218-726-6151 or lrcarlso@d.umn.edu) or the University Privacy and Security Officer at (612) 626-5844 or jense001@umn.edu.

Email is not considered a secure means of communicating about a client or to a client. It is not acceptable to communicate about a client using PHI in your correspondence to other individuals. This restriction includes banning use of PHI in correspondence with clinic instructors. At times a client or guardian may wish to use email as a means of information exchange. If that is the case, interns and instructors must notify the client/guardian of the risks of email correspondence, must get permission, and must save all correspondence in the client chart, in accordance with the following University of Minnesota Policy: HIPAA Provider/Patient email Communication Working Procedure.

You may only access or view PHI or medical records about clients specifically assigned as part of your education. You are not authorized by the University of Minnesota to access, use, disclose, or share PHI in any format for any purpose not directly associated with your educational program at the University.

No Private Health Informaton (PHI) is to be placed in ePortfolios. Any documents containing PHI must be de-identified before placing the document in ePortfolio. You must remove all identifiers and information not essential to maintaining the integrity of the artifact for purposes of formative assessment.

Client Records

Each client will have a Client Chart established before receiving treatment or assessment.

Chart Access:

Chart Safeguarding:

Chart Organization:

Each client chart will include the following information, organized in the following manner:

Chart Organization
SECTION

CHART CONTENTS
Inside front cover
  • Enrollment Information Form, updated each semester
  • Summary of Service Sheet, updated throughout the semester with the following information:
  • Date treatment started for the semester
  • Family/client initial staffing
  • Referrals
  • Request for records from other agencies
  • Release of information to other agencies
  • Hearing screenings
  • Phone contacts
  • Testing
  • Family/client final staffing
  • Last date of treatment for the semester
Section I
  • RFP Clinic Semester Treatment Summary Reports, organized chronologically with the most current report on top.
Section II
  • Audiological Information, organized chronologically with the most current report on top.
  • RFP Clinic Audiological Assessment Reports
  • RFP Clinic Hearing Screenings (must be updated annually)
Section III
  • RFP Clinic Speech & Language Diagnostic Assessment Reports
  • Records from Other Agencies
Section IV
  • RFP Clinic Payment Agreement Form
  • RFP Clinic Fee Support Application Form (if client applied)
Section V
  • RFP Clinic Consent & Release Forms
See Appendix to view each of these forms.

Diagnostic Assessment Teams:

Under the supervision of clinic instructors, student interns may participate on RFP Clinic Diagnostic Assessment Teams. The Clinic generally runs two teams, with two graduate students per team. Clients are referred by physicians, school personnel, social services agencies, or other speech-language pathologists. Parents or clients may also request an evaluation for themselves or a family member.

When a referral for an assessment comes in to the Clinic:

  1. the clinic secretary schedules the assessment with one of the two teams.
  2. The clinic secretary sends out a case history form and clinic information to the client. The case history form is to be returned before the date of the assessment, so the assessment team can review it.
  3. Students may obtain the completed case history form from the "Assessment Requests" folder in the cased history file. The case history form cannot be taken out of the Clinic, and must be returned promptly to the file after the student has reviewed it.
  4. The student is responsible for contacting the client a few days before the scheduled appointment to confirm the date and time. For further information on procedures for assessments, refer to the Diagnostic Evaluation Checklist (Appendix C).
  5. The Diagnostic Summary Report (See Appendix C) is to be completed and mailed to the client/family and others designated by the family (written release) within three weeks of the diagnostic evaluation. The instructor may specify an alternative format for writing the report in some instances.
  6. The instructor will evaluate the student´s performance using the Diagnostic Evaluation Form (Appendix D).

Personal Appearance of Student Interns

The personal appearance of all student interns and observers must be appropriate to the professional atmosphere of the Clinic. If you have any questions concerning appropriate professional appearance, please contact your assigned clinic instructor. Student interns are not allowed to chew gum, drink beverages, or eat during management sessions, unless it is a part of planned therapy activities for that session.

UMD RFP Clinic Dress Code Guidelines:

UMD RFP Clinic Dress Code Guidelines

Color:

Individual choice.

Fabric:

Opaque, non-clinging, and easily cleaned.

Style:

Conservative street clothes. Clothing should be neat and clean and in good repair. Clothing should allow for freedom of movement. No tank/halter/midriff/tube-tops. No low-cut tops. No sweatshirts and no shirts with messages, lettering, or logos (except UMD). No blue denim jeans, no stonewashed or faded jeans. No low rise pants. No mini-skirts or shorts of any kind. (Exception: walking shorts which come at least to mid-thigh may be worn in Summer Clinic).

Shoes:

Shoes with low (1") or no heals are recommended. No flip-flops. Footwear must be clean and in good condition. Footwear must be securely strapped to the wearer´s foot, especially when providing care to children, as the wearer may need to move quickly for the child´s care and protection in therapy.

Name Tags:

Must be worn at all times.

Appearance:

Professional personal appearance and grooming are required. No strong colognes or perfumes, as some clients may have scent allergies or find them offensive. Fingernails must be clean and short to prevent glove puncture or injury to the client.

Hair:

Should be neat and clean at all times, and should be styled so as not to obscure the intern´s face from the client´s view during a session. Beards and mustaches must be neatly trimmed.

Jewelry:

Small jewelry items are permissible, unless they are distracting to the client. Interns and instructors will use their discretion in those circumstances, and refrain from wearing jewelry if it is determined they are distracting to the client. No tongue piercing jewelry during sessions as it may distort articulation.

If there is a Dress Code violation or complaint, the student intern´s assigned clinic instructor will inform the student that they are in violation of the dress code. The student intern may be instructed to leave the Clinic until professional appearance is attained. The Clinic does have a limited number of smocks for interns to use as a cover. Repeated violations of the Clinic Dress Code by a student intern will result in a lowered grade for practicum

Scheduling Your Clients for Appointments.

Student interns participate in scheduling of their clients for the semester. Scheduling your clients may be disconcerting, but you will have the opportunity to develop your professional phone skills and planning/organization skills with this task.

You will receive your client assignments before the start of the semester, and you are expected to schedule your client to begin therapy during the first week of the semester. There are different procedures for scheduling clients for Individual Therapy, for Groups, and for Diagnostic Assessment. Depending on your client assignments, you may need to follow different protocols for scheduling your appointments.

The ABCs of Scheduling Individual Clients:

Individual clients typically are scheduled for two 45-minute sessions per week. Plan to have your first appointment with your client during the first week of the semester.

A. Before You Call:

  1. Check the Client Assignment Card for any client time preferences. If you have been given a designated clinic instructor for the client, you will need to coordinate your client appointment time with your clinic instructor´s schedule as well. Clinic instructors´ schedules are posted on their office doors.
  2. Check the Master Room Schedule in the Clinic Office to make sure there is a room available for your session during the time you want to set the appointment.
  3. Pick out more than one potential time that might work for your appointment, to increase the likelihood that one of those times will work with your client´s schedule as well.

B. Making the Call:

  1. Call the client or parent/guardian to schedule the appointment. Check the client form to see who the contact person is for making the appointment, and ask to speak with that person.
  2. If you get a voicemail, do not leave specific identifying information about your client. This violates HIPAA.
  3. Do not give your personal phone number. Give the clinic number: 218-726-8199.
  4. Inform them that they will receive a letter in the mail that includes the following: :
    • Parking pass
    • Map and Directions to the clinic
    • Clinic Access Fee and Fee Support Program
    • New clients also will receive a case history form to complete.
  5. Care Provider Recommendations: Interns and clinic instructors do not provide transport to the clinic and do not provide personal cares to clients. If the client has a care provider, please inform them of our expectation that care providers attend and observe therapy.
    • During the first week, care providers must stay for the sessions in order for the RFP Staff to become familiar with client needs and burden of care.
    • If potential client care needs exceed staff abilities for basic assistance, care providers may need to attend all sessions for client safety; otherwise, we encourage care providers to observe sessions at least periodically, to help the client carry over their communication skills outside of therapy.

Sample Script for Initial Phone call to client:

Hello, my name is __________________ and I am calling from the RFP Clinic. May I please speak with _________________? Thank you.

Hello, I am the student intern who will be working with _____________. I calling to set up therapy appointments for the upcoming semester. Clinic starts the week of ____. I would like to set 2 sessions per week. Each session will last 45 minutes.

The times I have available are ____________________. Will that work for you?

In the event that you are talking to a family member/care provider: please address the need for the care provider to stay for appointments during the first week, and possibly thereafter, depending on the client´s care needs.

Please plan to stay for the sessions the first week. It will give you a chance to meet us and help us understand the client´s needs. After the first week, if you wish to attend sessions less frequently, we can talk about that possibility. We want to ensure the client´s safety and comfort, and as their care provider, we may need your assistance to do so.

Thank you and I look forward to meeting you and _________________.

Sample Script for Initial Phone call, and reach a voicemail:

Hello, this is ______________ calling from RFP Clinic. I will call again. If you need to reach me, please call 218-726-8199. Thank you.

Scheduling clients for Groups:

  1. Group times generally are set and are not flexible.
  2. If you are asked to contact a client for a group, be sure you know the group time and location, and the purpose of the group.
  3. If you get a voicemail, do not leave specific identifying information about your client. This violates HIPAA.
  4. Check the client form to see who the contact person is for making the appointment, and ask to speak to that person.
  5. Do not give your personal phone number. Give the clinic number: 218-726=8199.

C. After the Phone call:

After you have called the client and confirmed a therapy time or confirmed they will be attending a group, you have important administrative duties to complete.

  1. Reserve a therapy room.
    • If you have scheduled a client for individual therapy, you must sign up for a treatment room on the ROOM SCHEDULE in the clinic office.
    • Carefully follow the directions regarding the maximum number of sessions that can be scheduled at the clinic within each hour.
    • Interns who have Groups or Assessment Team assignments do not need to reserve a room, as these set appointments have already been written on the Room schedule.
  2. Enter your client on the Master Schedule.
    • For ALL clients (individual and group), fill in the information requested on the CLINIC MASTER SCHEDULE in the clinic office.
    • When you write your client information on the form, the clinic secretary sends out the clinic information packet and parking pass to your client. If you do not complete this form, your client will not get the information they need to come to the clinic.
    • You will need to return to this form during the semester to fill in the date therapy started AND the date therapy ended.
  3. Enter your client´s appointment time on your instructor´s schedule.
    • Write your last name and your client´s initials in the appropriate spaces on your assigned clinic instructor´s schedule.
  4. Schedule a weekly meeting with your assigned clinic instructor.
    • Your assigned instructor has a schedule on their office door. Write in your name and block off a weekly 30-minute meeting time with your clinic instructor on the INSTRUCTOR SCHEDULE.
    • If you have more than one clinic instructor, you will schedule individual meetings with each of them.
    • Plan to meet with your clinic instructor in advance of your first session with the client. This may require you to schedule a special meeting time with your clinic instructor for the first week of the Semester, outside of your typical weekly meeting time.
  5. Thoroughly review your client´s chart, with special attention to the most recent Semester Treatment Summary and recommendations. If your client is new, please see the clinic secretary about setting up a chart.
  6. Prepare to record clock hours. Put a daily clock hours sheet for that client under your name in the Clock Hours Binder in the clinic office.
  7. Get a client folder for your daily lesson plans. Folders are available in the clinic office and are color-coded by instructor. Code it with the following initials on the cover: supervisor/intern/client. Write the appointment time and room number on the cover.
  8. Hand in Client Assignment Card to clinic secretary and let secretary know the client schedule.

Diagnostic Assessments and scheduling:

Diagnostic Assessments occur at set times during the week. The clinic secretary schedules clients for Diagnostic Assessments and informs the assigned team of the pending appointment.

Procedures for Semester Therapy

Specific due dates for the following items are listed on the Clinic Itinerary (See Appendix C). Timely completion of these items is a part of the student´s final clinic grade for the semester.

  1. Read the client chart
    • Become thoroughly familiar with their communication diagnosis, the course of past clinical management, and any relevant information regarding the client´s status from outside referral sources.
    • You need to know the information in the folder so well that you can readily answer questions about the client that your clinic instructor may ask.
  2. Check the date of the last hearing screening.
    • Hearing screenings are repeated every 12 months for returning clients. New clients should be screened during their first visit to the clinic.
    • If the client, the student intern, or the clinic instructor suspect a change in the client´s hearing status, or if the client twice fails a hearing screening, the client is scheduled for an audiological evaluation at the Clinic. There is no additional charge for this audiological evaluation if the client is receiving speech/language therapy at this Clinic.
    • If the client has undergone an audiological evaluation at another clinic, the intern should request a release of information from the client in order to obtain the evaluation report.
  3. Update the Enrollment Information Form.
    • Have the client complete or update the Enrollment Information Form (Appendix C). This form requested updated information regarding emergency contacts, medications, allergies, and personal preferences.
  4. Write a Daily Lesson Plan.
    • A Daily Lesson Plan See Appendix C) is written for each therapy session.
    • The therapy plan should include your session objectives, the procedures you will employ to meet those objectives, and the activities you will use in your session.
    • Your Daily Lesson Plan should include client initials only (no names) and should not include any other client Protected Health Information (PHI).
    • Keep all therapy plans in your colored client folder, with the plan for the current session on top.
    • Submit your client folder to your clinic instructor before your therapy session, by placing in their mailbox in the clinic office. Your instructor will place the folder in the "Returns" bin in the student work room after the session, where you may collect it.
  5. Plan for an Initial Client Conference.
    • The purpose of the Initial Client Conference is to talk with the client/family regarding their priorities for treatment for the semester. This conference takes place within the first week of therapy, and lasts about 15 minutes.
    • Schedule this conference in conjunction with your clinic instructor.
  6. Create a Semester Treatment Plan (See Appendix C). You will create the Semester Treatment Plan you have reviewed the client chart, obtained information about your client in your first 2-3 sessions, and held the Initial Client Conference. Use the Clinic Lab Computers to write your report using the standard format, which includes the following:
    • Status at the beginning of the Semester
    • Semester Objectives
    • Rationale for choosing each of the Semester objectives. Each objective should be based on consideration of:
      • Relevance to client´s needs
      • Client´s present status, baseline information
      • Past accomplishments in therapy
    • Methods/Procedural Approach/Instructional Sequence for achieving each of the objectives. The Methods should reflect:
      • Your understanding of task and client response hierarchies
      • Your understanding of learning principles and developmental sequence
      • You measurement plan: What data or observations will you obtain and how will you implement measurement across time to track your client´s behavior change? How will you use the data or observations to help you make decisions about the clinical management program?
    • You must discuss your Semester Treatment Plan with your clinic instructor, revise if necessary, and have the Plan approved by your clinic instructor by signature and date. Place the final approved plan in your client´s chart in the clinic office. This Semester Treatment Plan is the foundation for the Semester Treatment Summary you will create at the end of the Semester.
  7. Hold a Client Staffing.
    • After your clinic instructor has approved your instructional program, you must arrange a conference with the client/family to discuss the plan for the semester.
    • It may be appropriate to include others who are involved with the client, such as a personal care attendant. Inclusion of others should be done only with the consent of the client or guardian.
    • Document the Staffing in the chart on the Summary Sheet in the client´s chart.
    • This meeting is recorded as STAFFING on your Daily Clock Hours sheet, and does not count toward your total accrued clock hours.
  8. Demonstrate Evidence Based Practice.
    • Demonstrate evidence of research on your client´s communication disorder or difference, and research on your treatment approach.
    • Abstract the article or text on the Journal Review Form (See Appendix C), or as specified by your clinic instructor.
  9. Complete an outside observation of your client.
    • The purpose of the outside observation of your client is to increase your understanding of their communication effectiveness and participation when out of the therapy setting.
    • During the semester, arrange at least one visit outside the clinic. Outside visits could include observing the client at home, nursery school, preschool, sheltered workshop, etc. Use care and discretion to arrange an observation in a safe setting.
    • Write up your observations on the Out of Clinic Observation Form (Appendix C) and submit it to your supervisor for review and discussion.
  10. Maintain your Client File.
    • Summary Sheet: The Summary Sheet is in the front cover of the client chart.
    • Client Master Sheet: Remember to write in the first and last dates of therapy for the semester.
    • Release of Information: If additional client information is needed from other agencies, or if the client/family requests the RFP Clinical Records be sent to another agency or person, the client or guardian must sign the Consent to Release Private Data form (Appendix C). The form must include information specifying the agency, purpose, and the date initiated. Only one agency/individual may be listed per form. The RFP Consent forms are valid for one year only, so it is imperative to check the dates on the form to ensure it is current.
    • Hearing Screenings: Client hearing screenings are to be updated annually, and the results placed in the client chart. The Hearing Screening Form (Appendix C) is an official record and should be completed in pen and signed by the intern and the clinic instructor.
    • Enrollment Form: Clients review and update this form at the beginning of the semester, but interns may need to give clients additional opportunities to update the form if client circumstances change over the course of the semester.
  11. If you or your client must cancel a session:
    • If YOU must cancel a session, you are responsible for notifying the client and for arranging a make-up session.
    • If the CLIENT must cancel, offer to arrange a make up session.
    • Notify your clinic instructor and the clinic secretary if a session is cancelled.
    • Place a note on the Emergency Board in the clinic office, indicating which client´s session is cancelled for which date. In the event of a clinic evacuation during the scheduled therapy time, the Emergency Officer will know who is/is not in the clinic that day.
    • If a client misses sessions without notice or misses numerous sessions, talk with your clinic instructor. You may consider writing a contract with the client, specifying the expectations and what will happen if the client continues to miss therapy appointments.
  12. Record a therapy session.
    • Before you can record a session, you must have permission to do so. In order to receive services, clients of the RFP Clinic must sign the Consent and Release to Audio and Video Tape (See Appendix C), agreeing to be recorded for educational and therapeutic purposes. This form is kept in the client´s chart.
    • Your clinic instructor will specify how many times you need to tape your sessions.
    • Your supervisor may require you to critique your clinical skills using the Written Audio/Videotape Analysis form (See Appendix C) or another assessment tool.
    • It is helpful to record a session early in the semester and record a session near the end of the semester, and compare your performance. This is an excellent means of formative assessment, and your reflections may be used as an Artifact in your ePortfolio.
  13. Write a Semester Treatment Summary Report.
    • Near the end of the semester, student interns initiate the Semester Treatment Summary Report (See Appendix C). The rough draft of the report is due approximately 2 weeks before the end of the semester. The final copy of the report is due on the final day of the semester.
    • The Clinic Lab Computers are used for writing all client reports.
    • Obtain your clinic instructor´s signature on the final copy.
    • Place the signed report in the Semester Treatment Summary Reports file in the clinic for the clinic secretary to process. Do not file the report in the client´s chart.
    • Attach addresses for whomever the report is to be sent. Be certain there is a CURRENT Consent to Release Private Data form signed for any agency or individual to whom the report will be sent.
  14. Fill out a Client Candidate Card (See Appendix C).
    • Client Candidate Cards are filled out for ALL clients, whether or not they are returning for therapy.
    • Place the completed card in the designated file in the clinic office by the DUE DATE (usually about 3 weeks before the end of the semester).
  15. Hold a Treatment Summary Staffing.
    • Before the end of the semester, hold a Summary Staffing with your client/ family, supervisor, and other parties as designated by the client or guardian. The purpose of the staffing is to discuss the client´s progress and review recommendations.
    • Relevant information should be recorded in the Semester Treatment Report.
    • Record the date of the staffing on the Service Summary Form in the client´s chart.
    • This meeting is recorded as STAFFING on your Daily Clock Hours sheet, and does not count toward your total accrued clock hours.
  16. Complete your Clock Hours Documentation Follow the Clock Hours Procedures as outline in Appendix A.
  17. Complete your final case administrative duties
    • Record the date of the final therapy session on the Master Schedule. Record the total number of sessions the client attended.
    • Organize the client´s Chart.
  18. Return CRC items and Clinic Materials
    • Students are responsible for returning all items checked out in their name, or paying the replacement cost for the items.
    • If a student does not return all items or pay the replacement cost of items not returned, they will receive an Incomplete for Practicum and a HOLD will be placed on their student records. They will not be allowed to register for further courses until the matter is resolved.
  19. Clean the Clinic.
    • Each student is assigned to a team of students who will be responsible for organizing and cleaning a part of the clinic facility on a DAILY basis.
    • At the end of the semester, the team must thoroughly clean and organize their assigned areas.
    • Each student who has signed up for a clinic bin for the semester must now clean out their bin, unless they will be in practicum at the RFP Clinic the following semester.

RFP Clinic II: Responsibilities Toward Colleagues

In keeping with professional conduct, it is inappropriate to write or say anything which may discredit professional colleagues or members of allied professions, other than based on adequate objective evaluation of their work. This includes statements concerning fellow students, faculty and staff.

Communication

  1. Notify the clinic instructor of important developments concerning your client, such as:
    • all schedule changes
    • client or intern absences (two unexcused absences, and the client will be dismissed)
    • noteworthy phone contacts about your client
    • new information about your client
  2. If you are concerned about your relationship with your assigned clinic instructor, arrange a meeting with the clinic director to talk about your concerns. Be prepared with possible solutions to the problem. The clinic instructor is available to mediate a meeting between you and your clinic instructor for resolving any conflicts.
  3. If you are concerned about your relationship with the Clinic Director, you may direct your concerns to the Department Head.

Conferences

  1. Arrange for regular conferences with your instructor, usually one per week.
  2. Keep your conference appointment, and be on time.
  3. Come to the conference prepared to discuss your client´s progress and your clinical skills development.
  4. Be prepared to discuss your journal review, your session videotapes, your outside observations, and other projects as assigned by your supervisor.

Cleaning

All interns, faculty and staff are charged with keeping the Clinic clean and safe.

Equipment and Materials

  1. CRC materials are to be checked out for a maximum of one week. Be sure you use the proper procedures for signing out and returning materials.
  2. Client charts are to be signed out with an OUT card, and are not to be removed from the Clinic.
  3. Check to make sure the speaker in the observation room has been turned off and all materials, trash, toys in the observation room are removed after your session.
  4. If you recorded your session, check to make sure you turned off your equipment after the session.
  5. Follow the Infection control procedures for cleaning your therapy room after your session and for cleaning any contaminated toys or equipment.

Clock Hours Accrual

In order for the clinic instructor to make meaningful observations and for students to obtain some sense of the clinical process, the student interns should see each client for at least 80% of the total possible clock hours scheduled for that client. If the actual number of clock hours falls below this criterion, the student intern and clinic instructor may choose from among the following alternatives:

  1. Fulfill clock hours expectations by signing up for more diagnostic sessions.
  2. Schedule make-up sessions with the client. If the clinic instructor is unable to observe directly, the student in responsible for recording the session for the instructor to review.
  3. Set up a contract with an inconsistent client, leading to possibly discontinuing the client and requesting a new client assignment.
  4. Take an incomplete for the semester and continue practicum the following semester.

RFP Clinic III: Infection Control Policies and Procedures

Purpose

The following procedures are imperative to provide an atmosphere of safety which minimizes the risk of the spread of serious disease for clients, students, and staff.

Administrative Responsibility

Cleaning and Disinfection Procedures

  1. Disinfecting Materials and Work Surfaces
    • Treatment materials and work surfaces require disinfecting when they have been soiled or contaminated with any body fluid.
      • Treatment materials include toys, games, storage boxes, etc.)
      • Work surfaces include tabletops, floors, light switches, mirrors, windows, Seating surfaces, doorknobs.
      • Body fluid includes blood, mucous, emesis, urine, feces.
    • It is the responsibility of the student intern who provided the services to clean and disinfect materials as needed. Student interns are to wear gloves when disinfecting any item or surface contaminated with body fluid.
      • Wash the contaminated item or area with soap and hot water
      • Mix together a chlorine solution of 200 parts per million (1 Tablespoon household bleach per gallon of water).
      • Disinfect the item or area with the chorine solution.
  2. Tabletops, Work Surfaces, Seating Surfaces
    • It is the responsibility of the student intern who provided the services to clean at the end of each therapy session.
    • The student will use the cleaning materials provided in each therapy room.
      • A spray bottle containing a chlorine solution of 200 parts per million (1 Tablespoon household bleach per gallon of water) is available in each therapy room.
      • Students are to spray and wipe tabletops, seating surfaces, doorknobs, light switches.
  3. Hand Washing
    • All personnel must wash hands
      • before beginning work
      • before and after eating
      • after using the bathroom
      • after blowing their nose or coughing
      • after each patient contact
      • before and after removing gloves
    • Hand washing protocol:
      • Turn on the faucet.
      • Use continuous running water
      • Wet hands.
      • Apply soap.
      • Lather hands, wrists, forearms.
      • Rub vigorously for 30 seconds, paying particular attention to fingers and nails.
      • Rinse thoroughly.
      • Dry thoroughly with a paper towel.
      • Using a second paper towel, turn off the faucet.
  4. Food Preparation Utensils
    • Students who use the kitchen for therapy responsible for cleaning the kitchen area and materials which they used.
    • Use disposable drinking cups, utensils, and serving dishes for use by clients.
    • Sanitize all multi-use food preparation utensils using the following 4 step process.
      • Wash with soap and water in the sink.
      • Rinse in hot water.
      • Sanitize in provided dishpan, using chlorine concentration of 100 parts per million (1/2 Tablespoon per gallon of water).
      • Place on drain board to dry.
  5. Pocket Talker & DAF Headsets, artificial larynges
    • Students who use the headsets and artificial larynges for therapy are responsible for cleaning them after each use.
    • Clean the headsets and the artificial larynges using antiseptic towelettes, available in the kitchen.
  6. Audiological Equipment
    • Portable Audiometers: Earphone cushions and headbands should be wiped down with a clean, dry paper towel. This should be done between clients as well. Before the first use of the day, the earphones should be wiped with disinfecting towelettes included in the portable audiometer case. Hands should be washed between each client.
    • Audiology Booth: Earphone cushions and headband should be wiped down with a clean, dry paper towel and disinfecting towelettes. Before each client, the earphones and headband should be wiped down with a clean, dry paper towel. Hands should be washed before and after each client.
    • Audiology Lab Area: Disposable gloves should be used whenever performing otoscopy, middle ear immitance testing, and OAE testing. All impedance tips, probe tips, and otoscope specula should be placed in a container of Sporox after use, for sterilization. The tips should sit in the solution overnight.
    • Disposable gloves should always be worn when handling personal hearing aids, earmolds, and FM systems.
  7. Augmentative/Alternative Communication Equipment Students who use the AAC Equipment with for therapy are responsible for surface cleaning of the equipment.
    • Students are to follow the manufacturer´s suggested cleaning protocol specific to the device they used.
    • AAC devices should be cleaned, following manufacturer´s directions, after each therapy session.

Glove Wearing Procedures

Diaper Changing

Care providers are responsible for changing a client´s diapers. Care providers are to be instructed to bring the child to the bathroom. In the event that a student intern must help a child with a diaper change, observe the following procedure:

Food Preparation Activities in Therapy

If food preparation activities are used as a part of a therapy or diagnostic session, the following procedures will be used.

Play Water Table

Direct Care Provider Precautions

RFP Clinic IV: Fire Safety

Emergency Board: The Emergency Board in the clinic office is a checklist of all clients and personnel who are expected to be in the clinic at any given time. In the event of an emergency, the Clinic Safety Officer uses this list to ensure all parties have evacuated the Clinic and are accounted for in Ordean Court. To ensure the accuracy of this list on a daily basis, interns must posted a dated note on the board if:

  1. The therapy session is cancelled for that date
  2. Therapy time has changed
  3. Therapy location has changed, and you will not be in the RFP Clinic

If you discover a fire or see smoke:

  1. Remove or alert anyone in immediate danger. Interns and staff/faculty are responsible for assisting clients to evacuate.
  2. Confine the fire by closing the door. Leave other doors open for the fire fighters.
  3. The designated evacuation exit for the Clinic is the exit to Ordean Court. Do not attempt to use the elevator.
  4. Report the fire:
    • Pull the nearest alarm box, located in the hallway next to the elevator.
    • Call 911 from the nearest safe telephone
    • Have someone meet the fire department at the Ordean Court entrance.
  5. Fight the fire only if the fire is small, you are trained to use the fire extinguisher, several people are available, and it is safe. Fire extinguishers are located next to both doors to the Clinic.

If you hear the fire alarm or someone informs you of a fire:

  1. Place your hand on any closed corridor door. If cool, leave the room; if hot, signal for help.
  2. Walk quickly—don´t run—to the nearest safe exit. Escort any clients in your care.
  3. Alert others to the emergency on your way out.
  4. Leave the building and move away from the building entrance. Do not re-enter the building until the "all-clear" signal has been given.

Burn Prevention

RFP Clinic V: Medical Emergency Procedures

Purpose:

The purpose of the procedure is to ensure prompt treatment of any sudden illness or accident.

Procedure:

  1. In the event of a life-threatening medical emergency:
    1. Initiate first aid.
    2. Establish the need and begin CPR
      • If you are not qualified in CPR, ask for assistance. One faculty/staff with current CPR certification will be available in the Clinic at all times of patient care.
      • If you are trained in the use of an AED, a device is available in the Marshal Performing Arts Center.
    3. Obtain the aid of the clinic instructor.
    4. Other staff and students are to assist with the following:
      • Call an ambulance at 911. Specify Ordean Court as the entrance to the Clinic. Give the following information to the emergency dispatcher, staying on the line until the dispatcher says it is permissible to hang up:
        • Victim´s name
        • Age
        • Any known medical conditions
        • Current condition, pulse, breathing, skin color, bleeding
        • Present location and phone number
        • Other information requested by the emergency dispatcher
      • Check the Client Enrollment Form. If the client is the person in need of assistance, their Chart has emergency contact information and personal information that will be helpful with the 911 call.
    5. Keep calm and keep the person lying down.
    6. Contact the emergency contact person listed in the client´s chart (Client Enrollment Form). If the person is not a client, contact their family if possible.
    7. Immediately after the person is transferred, contact the Clinic Director and fill out an Injury Report, located through the UMD web site.
  2. In the event of a non-life-threatening situation:
    1. Advise clinic instructor and ask for assistance.
    2. Initiate First Aid using items available from the kit located in the office cupboard.
    3. Call ambulance as necessary. Dial 911. See above.
    4. Contact the emergency contact person listed in the client´s fill on the Client Enrollment Form. If not a client, ask the person whom they would like you to contact.
    5. Immediately after the incident, contact the Clinic Director and fill out an Injury Report, located through the UMD web site.

RFP Clinic VI: Vulnerable Adult Documentation

According to the Minnesota Department of Human Services, health care settings have three important roles with regard to protective services:

  1. Reporting of the person identified as having a need for protective services.
  2. Evaluating the person´s needs within the health care provider´s area of expertise.
  3. Providing care to the person within the health care provider´s area of expertise.

It is imperative that all clients, regardless of treatment setting or living situation, are assessed as to their potential vulnerability to abuse or neglect. Not only do clients need to be identified as vulnerable or not; if the client is determined to be vulnerable, the situation must be addressed formally by identifying steps which are taken to reduce vulnerability, and identifying methods used to inform people in the client´s environment to more appropriately communicate with the client.

All statements regarding a client´s vulnerability are to be made initially in the evaluation report. Document any changes in status in the Treatment Summaries and the Summary of Service Sheet.

RFP Clinic VII: Mandated Reporter Responsibilities

Student interns and clinic instructors are considered mandated reporters of abuse by Minnesota State Statutes. If a client is reporting abuse or if the student intern or clinic instructor suspects abuse, it must be reported.

The Minnesota Department of Human Resources has a RESOURCE GUIDE FOR MANDATED REPORTERS available on their web site for further information.

RFP Clinic VIII: Responding to Siezures

A number of clients at the RFP Clinic may have a history of seizures or may have a medical history which increases their risk of having a seizure. In addition to responding to the medical emergency as outlined in Subsection V, the following precautions are recommended by UMD Health Services (August 2005):

What to do if a person has a seizure:

  1. Look for medical information identifying a seizure disorder or epilepsy.
  2. Protect the person from nearby hazards.
  3. Loosen tie or shirt collar and take off glasses.
  4. Place a folded jacket or pillow under the person´s head.
  5. Turn the person on their side to keep airway clear.
  6. Reassure the person when consciousness returns.
  7. If the person has no history of a seizure disorder, recommend medical assessment.
  8. If a single seizure lasts less than 5 minutes, ask if a hospital evaluation is wanted.
  9. If multiple seizures or if one seizure lasts 5 minutes or more, call an ambulance.
  10. If the person is pregnant, injured, or diabetic, call 911 at once.

What NOT to do:

  1. Do not put anything in the person´s mouth.
  2. Do not try to hold the person´s tongue; it cannot be swallowed.
  3. Do not try to give liquids during or just after a seizure.
  4. Do not use rescue breathing unless breathing is absent after seizure activity subsides.
  5. Do not restrain the person.

For further information, please visit the Epilepsy Foundation of Minnesota Web site.

RFP Clinic IX: Procedures for Recording Therapy Sessions

Consent to Record

Clients must agree to having therapy sessions recorded for the purposes of education and therapeutic intervention. The signed consent is located in the client´s chart.

Recording with Video Equipment in Child Therapy Rooms (VHS equipment)

Recording with Video Equipment in S/T/U

Most important: Never, never, never change the channels! These units are ready to record!

Recording with DVD Equipment

RFP Clinic X: HIPAA Implementatin Procedures

The Robert F. Pierce Speech-Language-Hearing Clinic in the Departmentof Communication Sciences and Disorders at the University of Minnesota Duluth adheres to all guidelines established by the University of Minnesota to comply with rules of the Health Information Portability and Accountability Act (HIPAA). The central goal of these guidelines is to secure Protected Health Information (PHI) from unauthorized access and release.

  1. Definitions
    1. PHI includes:
      • Any individually identifying information (name, address, telephone, email contact).
      • Information about the clinical case, including history, test results, diagnosis, treatment plan, recommendations, and other pertinent details related to case service delivery.
      • This information may not be released to unauthorized users in any form (e.g., orally, in written form, or electronically) without signed formal written consent (Consent to Release Private Data).
    2. Authorized access to PHI is granted to:
      • Departmental Clinic Instructors and Faculty
      • Departmental Graduate and Undergraduate Interns working with a client
      • Departmental undergraduate students assigned to observations for course requirements
      • Departmental Faculty consulting with an instructor or student on a specific case
      • Departmental Support Staff assisting with clinical administration or record keeping (e.g., reception staff, practicum student assistant)
      • Contracted professionals to provide clinic services under grant projects
    3. Unauthorized access:
      • External supervisors or providers not a part of the Department of Communication Sciences and Disorders. These parties may only have access to this information with signed formal consent (Consent to Release Private Data).
      • Casual parties (roommates, family, friends, and co-workers).
  2. Implementation Strategies
    1. Every client who attends the RFP Clinic will sign a Release for Clinical Education Purposes at the time of the first visit. This release expires 10 years from the date of signature. Individuals who are not willing to sign this release may not be seen for services through the RFP Clinic. Clients may contact the clinic instructor or the clinic director for more information regarding this policy.
    2. All Protected Health Information (PHI) for all clients who attend the RFP Clinic will be secured by the faculty, staff, and students in the Department of Communication Sciences and Disorders. No PHI and no original clinic records (test forms, raw data, videos, protocols, reports) or folders may leave the Department Facilities in Montague and Bohannon Halls. These must always be kept secure in the personal possession of the authorized user, or in a supervisor´s office or a central filing cabinet in a locked space. In nonpublic areas (e.g., filing cabinets, schedule books, billing records, etc.), every faculty, staff, and student must secure records that contain PHI (e.g., locked storage, password protected computer files, shared networks). All clinic reports must be generated on the designated clinic shared network using strong passwords that will change yearly. To minimize risks involved in bringing charts to Bohannon Hall, students are encouraged to use the computers in the Montague Hall clinic facility rather than in the Bohannon computer lab to generate clinical reports containing PHI. When clinical reports are printed, they must e removed promptly from the printer and must never be left unattended.
    3. Interns will follow the procedure of using a clinical code to prevent unauthorized access to PHI. Students may take copies of case-related paperwork (e.g., daily treatment plans) to other study areas or to their home to work on them, but they should never include discernable identifying information. Use clnic codes instead, as specified below. Students and clinic instructors also rely on electronic communications for case-related planning, feedback, and paperwork. Again, use clnic codes only. Do not store PHI on hard drives. In all case-related paperwork leaving the Department or being left in unsecured places such as the unsecured department mailboxes (chart notes, daily tx plans, feedback regarding sessions, e-communication), replace individual identifiers with the 6-letter code to "de-identify" clinic records:
      • Initials of the clinic instructor
      • Initials of the intern
      • Initials of the client
        • Example: Instructor Jane Doe and intern Sam Jones work with client Carol Smith:
    4. Code: JDSJCS
    5. Faculty, staff, and students will prevent unauthorized access to PHI (verbal, written, or electronic) by maintaining case confidentiality. Remove individual identifiers from all public areas, including reception areas, clinical suites, offices, and student rooms. Discussions about specific aspects of a clinical case are permissible for person´s on a "need to know" basis, with no identifying information being released to unauthorized users. Be mindful of departmental settings that are vulnerable for breach of confidentiality, including the observation room, student workrooms, waiting areas, hallways, public copy machine, your backpack, and space outside the clinic rooms. Do not make verbal remarks about the client or related clinical information in the presence of anyone other than an authorized user.
    6. If a HIPAA clinical guideline is violated, notify your clinic instructor and the clinic director immediately. Our Department will work together with the client and the University Privacy and Security Office to remediate any breach as efficiently as possible. The person held in breach of security may be subject to discipline by the University of Minnesota.
    7. Students, staff, and faculty will complete University of Minnesota HIPAA training before client contact. In addition to meeting the RFP Clinic guidelines described above, all authorized users are required to complete the University-directed on-line HIPAA training prior to beginning any clinic work. You will receive University email confirmation after you have completed the coursework. Please print the confirmation of completion and submit to the document to the clinic secretary as a record of your HIPAA training.

CSD Department Approved: 04/28/03

Approved by Privacy Officer (JK): 06/05/03