It’s A Jobs Issue!

By: Karen Sheffler

May 14, 2015

by Karen Sheffler, MS, CCC-SLP, BCS-S of

Call To Action: HELP change Massachusetts laws to allow SLPs and Audiologists to obtain provisional licensure at the START of the CFY. This will help them find jobs in Massachusetts.

“It’s a Jobs Issue,” 

stated Cynthia Wagner, MS, CCC-SLP, BCS-S (Clinical Services Manager for the Voice, Speech & Swallowing clinic at Beth Israel Deaconess Medical Center in Boston).

Wagner inspired Boston-area Speech-Language Pathologists (SLPs) to take political action at a Boston Dysphagia Rounds in 2015.

What is the Issue?

Massachusetts is one of only 9 states (see list below) where an SLP with a Master’s degree cannot get a state licensure immediately after graduation to start her first year of work! This first year is a Clinical Fellowship Year (CFY), where the newly graduated SLP works full-time for a 9-month “supervised practice period” under a CFY supervisor.

If the SLP has successfully completed the clock hours of supervised clinical practicums, obtained a Master’s degree, and passed the national examination, then he/she should be able to receive a provisional license to start working immediately within the Massachusetts healthcare system.

Wagner noted how facilities cannot hire our well-trained students upon graduation, as without a license that speech pathologist cannot legally bill Medicare for services. (Read More: Medicare Coverage of Students and Clinical Fellows.)

I trained graduate-student clinicians for over 12 years here in Massachusetts, even switching from 3-month to more extensive 6-month-long hospital placements. I never realized that after graduation, they could not get hospital, rehabilitation or skilled nursing facility jobs due to the inability to get licensure. If the CFY wants to start in the healthcare setting, he/she would have to leave the state. Believe it or not, some employers have been willing to skirt the issue and claim “ignorance” regarding this licensure problem.

Barbara Wilson-Arboleda, Speech-Language Pathologist, has been fighting to change the law.

From 2009 to 2010, Arboleda and a Dedham, MA representative, Paul McMurty wrote legislation to make SLPs and Audiologists eligible for provisional licensure at the START of the CFY.

The bill: CFY Licensure Bill H.228. An Act Providing for Provisional Licensure for Speech-Language Pathologists.

However, the bill died in committee back then.

Good news: The bill is being brought back to life! There is a hearing scheduled for November 10th at the State House, Hearing Room 1A at 1:00pm. (Date is confirmed for 11/10/15.) The key is to drum-up a lot of support in the SLP community prior to then. We need to highlight our Bill H.228 out of the 5000 bills that are filed every session.

“We need help to get a bill through the house,” stated Wagner. She and Arboleda are fighting even harder. “It will take a village to change this law. This is our year,” per Wagner and Arboleda.

What should I do?

  1. Contact your House of Representatives member in your town by looking here:
  2. Call and email your representative to ask him/her to draft a letter of support to Jennifer E. Benson, Chairwoman of the Joint Committee on Consumer Protection and Professional Licensure, requesting that they “release the Bill H.228 favorably from committee.” This asks them for the bill to be brought to a vote in house.
  3. Click Here to go to the ASHA Advocacy page to see how you can Take Action on issues that matter most to you.
  4. Urge others to do the same. Use social media!
  5. Call Jennifer E. Benson, The Chairwoman. Phone: 617-722-2014. Fax: 617-722-2813. Email her your letter of support:
  6. This is OLD news now: Clear your calendar and come testify: Hearing is November 10th , State house, Hearing Room 1A, 1:00. Please let Barbara Wilson Arboleda know if you plan on attending:

More thoughts:

We have 6 excellent graduate school programs for Speech-Language Pathology in Massachusetts. Many of these graduates have been have received special skills in our medical settings, but they have to leave the state due to a lack of legitimate hiring opportunities in healthcare.

It is not only a jobs issue, but it could become a Massachusetts healthcare crisis in the future.

Our growing population of people over the age of 65 will need our full array of diagnostic and treatment skills in the areas of speech, voice, language, cognition, and swallowing. Getting enough therapists into our rehabilitation centers and skilled nursing facilities is not only a matter of communication, but also of life-and-death when it comes to preventing dysphagia-related and aspiration-related critical illness and it’s consequences.

See An Aging Nation: The Older Population in the United States

Between 2012 and 2050, the United States will experience considerable growth in its older population (see Figure 1).2 In 2050, the population aged 65 and over is projected to be 83.7 million, almost double its estimated population of 43.1 million in 2012. The baby boomers are largely responsible for this increase in the older population, as they began turning 65 in 2011 By 2050, the surviving baby boomers will be over the age of 85. The aging of the population will have wide-ranging implications for the country….The projected growth of the older population in the United States will present challenges to policy makers and programs, such as Social Security and Medicare. It will also affect families, businesses, and health care providers.”

Does my state have a provisional licensure status for a CFY?

The following states DO NOT provide licensure for CFYs:



Washington, DC



New York


Alabama and Tennessee are listed as “Registration.”

The following states do not require a supervised practice period (CFY) for state licensure! Scary!


North Dakota


In closing:

Thank you in advance for spreading the word. The only way to ensure that this bill gets out of committee is to act now. The bill will need support from the whole SLP community. I had no problem getting my provisional licensure in Wisconsin right after I graduated in 1995. I then started working at a skilled nursing facility in a small town outside Madison, Wisconsin. How many small town healthcare facilities in Massachusetts cannot find therapists due to this issue? How many future CFY-SLPs will we be helping?

Speech-Language Pathologists in Massachusetts,


  1. Contact your House of Representatives member in your town by looking here:

  2. Call and email this representative to ask him/her to draft a letter of support to Jennifer E. Benson, Chairwoman of the Joint Committee on Consumer Protection and Professional Licensure, requesting that they release the Bill H.228 favorably from committee.” 

  3. Urge others to do the same. Use social media!

Need it easier: Cut and paste this form letter:

Dear Representative ______,

As a Speech-Language Pathologist/Audiologist working in Massachusetts, I urge you to support the Bill H.228: An Act providing for provisional licensure for speech-language pathologists and audiologists.

Please send a letter of support for this bill to: Jennifer E. Benson, Chairwoman of the Joint Committee on Consumer Protection and Professional Licensure. Her email is: Please urge her committee to release the Bill H.228 favorably. Then the bill can be brought to the house for a vote. 

Massachusetts is one of only 9 states in the nation that do not allow Speech-Language Pathologists to obtain licenses immediately after graduation. In order for these highly trained individuals to find healthcare jobs, they have to leave our state. Many Speech-Language Pathologists working in Massachusetts have spent years training our graduate students, only to see this talent leave the area.

See article: for more information on the topic.


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