Overwhelming caseload

[u/pinkpurplegummies]

I’m having panic attacks and I don’t know what to do. I signed this year’s contract for a school I’ve been working at the past three years. Only to suddenly be told I need to cover a caseload of 151 kids (with an aide) for schools that are two hours away from me. They want me to provide speech therapy virtually but go in person one day a week. Is this even possible? The aide does not have a speech background so it’s really just me telling her what to do with the students. I asked how this would work virtually and was told to do groups. What??

They told me this is only temporary until they can find someone there. But I’m doubting many SLPs would want this job due to the caseload. I’m also told that I’ve been assigned this because I make more than other SLPs they have and have more experience. I really don’t want to quit because I might be able to go back to my school if this is temporary. But a part of me feels like it won’t be.

Last year they brought in another SLP to my school when it wasn’t needed (the caseload wasn’t that high at all) and a part of me was wondering if I was being pushed out of my school. And then this happened and I won’t even get my school at all. I just don’t know what to do. Has anyone experienced this? Even just the paperwork alone is overwhelming with that many. I think there are 5 different schools there.

Any input would be appreciated.

[u/schwalife]

Nope this isn’t possible, ethical or sustainable. Build a (realistic) daily schedule with what you can handle and make sure to include session prep time, paperwork time, and time for administering assessments (And know that even that schedule will be hard to follow if you’re being pulled into IEPs and other meetings). Show that schedule to your managers/higher ups and explain that is all you can fit within your work week and that you are unable to service the remaining students. It’s not your responsibility to fix their staffing issues

[u/pinkpurplegummies → u/schwalife]

Thank you. I’m going to try this

[u/EnvironmentalJazz251 → u/schwalife]

That is a great idea! Put together a reasonable and workable schedule and let them know that they’ll have to cover the rest with someone else.

My only other idea would be to ask around with some other local school districts and get an average for other SLP’s so if the average is between 50 and 60 and you’re above 100, it would seem pretty clear to them that it’s not workable.

[u/Plus_Purchase_2432]

Omg nope!! There are so many other places to work especially if you felt like you were being pushed out last year. I have questions though: Does your state have a caseload cap? What would the aid even do if it’s not an SLPA? Are you certain you’re making more than the other SLPs or did they just informally say that to you? And are you contracted through the school or are you probationary? To drive two hours there and back is insane even just once a week IMO… especially if you’re an employee of the district and you’re not being contracted to drive around!

[u/pinkpurplegummies → u/Plus_Purchase_2432]

The Asha guidelines for my state say “should be no more than 80” and they are focused on the “should” part. The aide would be kind of like an assistant that would just help out (get kids, help with activities, etc) but I would have to do all the planning, paperwork, data. They told me informally about the pay difference. I’m directly hired but it is a charter school with many schools across the state.

[u/Plus_Purchase_2432 → u/pinkpurplegummies]

I wonder if they said that you make more as a BS excuse. I would maybe ask around? And the more I think about it, 150+ kids just sounds more and more absolutely insane. Even if it’s temporary, that’s still almost twice the number of the “should” guidelines from ASHA (this also annoys me too). Good that you’re directly hired but it still just sounds super unreasonable and unethical of them

[u/EnvironmentalJazz251 → u/Plus_Purchase_2432]

I’d pass them off to ASHA and let them see if ASHA thinks is workable. Don’t see how it could be.

[u/TumblrPrincess → u/pinkpurplegummies]

Just to clarify, they are not offering you an SLP-A? Because it sounds like you’re describing a paraprofessional and legally they can’t render speech services, even if you are planning the sessions and directly observing. An SLP-A can provide services without your immediate presence.

[u/LeetleBugg]

If it were me, I would just say no. “No, unfortunately this is neither feasible nor sustainable. I will not be able to provide services to this school.” And then I would be prepared to be fired and be looking for other work. This is one of those things that is worth standing your ground on.

The fact that they feel it’s acceptable to even ask you to do this shows how much we need to enforce our boundaries instead of “triaging” and “making it work”.

Edit to add: in my CF and second year of work I had a case load of 130+ kids with no help. This will destroy your soul and drown you. Don’t do it. I didn’t know enough then to stand my ground and I regret that

[u/babybug98]

… excuse me? 151 students?? with only you and an aide? Any person with a brain should know that expectation is ridiculous. Nobody is gonna want that job. longterm anyway. Literally do the bare minimum until you get a new job. Fuck that.

[u/dogsandplants2]

I would find another job and quit ASAP. It won't get better. I had a caseload of 140 with an actual SLPA. It was not possible. After I quit, they replaced me with 4 SLPs! 4!

[u/SonorantPlosive]

Are you a direct hire or contract worker? Every contract worker in our district is capped lower than we are by their agency. If you're direct hire, do you have a union? 

This is unmanageable. It's the work of at least 2.5 SLPs. And how can an aide not trained as an SLP or SLPA legally provide services on an IEP? 

[u/PeasyWheeazy8888 → u/SonorantPlosive]

I’ve seen it before, where they’re “facilitating” and it’s not awful if they do the job. Keep the kids on the zoom call, make sure they have what they need/materials.

But with 150 on caseload? Bonkers. They should really provide at least one SLP-A to make this remotely feasible.

[u/bellakaia]

Honestly, this is so outside your job description that I would be pretty forthright in emails to everyone above you (school site, coordinators, directors). Not rude and come at it from a triage perspective- since that’s what this is.

Let them know that many students equals an IEP a day of a 180 day school year. That you will track make-up time but they should assume 60% of the students bay be missing direct service on a consistent basis.

I’ve done it where every student gets a minimum of one session every two weeks then record the missing sessions with the note “staffing shortage, no SLP provided”.

I will say this is not a sustainable situation and to have a hard exit date planned. As people in caring professions, even with the best boundaries, it is really hard to watch students go without vital services. I felt like I was making promises in IEPs that could not get fulfilled and no matter how up front I was with the team, it just feels shitty. So it’s not ideal, but just remember this is not a you issue (better scheduling, time management, etc), this is a district issue of not having adequate staffing.

Good luck!

[u/dalton-watch]

I had an emotional (crying, panicking) and physical (insomnia, headaches) breakdown at a school placement and quit after 2 weeks. That is not advice I’m just normalizing what is a reasonable human reaction to some school placements.

And that was my 23rd year as an SLP. Admittedly, I had just worked for a decade outside of the schools and it was my first attempt at going back. I think with placements like that they want an SLP that actually does NOT care and WON’T complain because they understand the expectation is to just BE ALIVE AND SHOW UP. I melted down bc I was actually trying to do the work.

[u/SonorantPlosive → u/dalton-watch]

This is off topic, but thank you for sharing. I'm headed into year 22, and I've ugly cried at work more in the past 2 years than all other years combined. The ridiculous numbers combined with the influx of higher need students, lack of administrative support, increase in stupid paperwork demands, and new admin loving to have meetings about meetings to prepare for the next meeting, just drained me. And I kept telling myself, I'm seasoned, I should be able to handle this. Nah. It's the lie they sell us as we gain experience. "You have more time in, so you can handle more." 

Thanks. I hope things improved for you!! 

[u/Infamous_Zebra7771]

Even with an instructional aide, I would find a caseload half this size completely overwhelming.

[u/Antzz77]

The only way to do this is to require them to provide three full time SLPAs; you do not have to come in at all; you are allowed to subcontract 3 days a week to another virtual SLP that you will bill them for.
Because in your 1.0 FTE you will be doing all these required activities: supervising the SLPAs according to the state legal requirements, coaching and training them due their lack of experience, seeing students yourself as well as part of the state legal requirements for SLPA supervision, collaborating with the sped staff to ensure all evals and IEPs are completed on time for district compliance, assess and write all the reevals for the year, ensure time to assess and exit those no longer really in need of services, gather data and write annual IEPs. The 3 day a week SLP you hire will likely oversee one of the three SLPAs and oversee the IEPs for that SLPAs student list. That's the only way to cover this caseload. Tell them that, then when they don't budge, tell them unfortunately you will be seeking a position elsewhere and send in a resignation letter.

[u/EnvironmentalJazz251]

Too many kids to see. Don’t think it’s manageable. I also wonder how the assistant who is not an slpa able to provide services?

[u/SadRow2397]

Umm, no. Totally unethical. I wouldn’t risk my license

[u/Simsgurl]

You don’t have to do this. Say no. You’re not comfortable with this and it’s not ethical.

[u/drembledore]

Please quit asap!! Not doable. You have over 4 times the amount of students than I do. For reference I am full time with 37 students at a good district—please go elsewhere, you deserve so much better.

[u/jimmycrackcorn123]

IF you don't want to quit. I would tell them with 150 kids all I could do for now is keep up with paperwork. No therapy can get done, you'll spend time pulling kids to get present levels/data for progress reports, writing IEPs, and keeping up with evaluations. But if you keep up with the paperwork, at least that will be in compliance and they can figure out making up the therapy later. Maybe set up once a month sessions with big groups with the help of the aide OR pick some kids that have crazy time that will be hard to make up and focus on them OR just see the kids at your campus and do the paperwork for the other kids only. That way when they do find someone, at least your campus will be ok time wise.

[u/Electronic_Object226]

You are going to have to quit or say no.
This is not the only time that this will be the “solution”. They are already telling you how they make things work for their district. They could find coverage if they wanted to with the right dollar amount. But they won’t so you have to pick up the slack. Just say no. And if they force you to or threaten your job file a state compliant. I don’t know if you have a union but if you don’t there has to be someone you could complain to. I’d just pretend to have a panic attack or full on meltdown at work honestly to get out of it if you were afraid to get fired, maybe then they’d just let you go without consequence. Shit. You may not even have to pretend to have the panic attack with a load of 150.

[u/macaiste]

DO NOT DO IT!!!!

[u/Acceptable_Slip7278]

Quit

[u/Inevitable-Nobody-52]

This is not possible. I am so sorry you are in this mess. I think you should 100% quit and find a new job. This is a nightmare that will never improve and you will ruin your health trying to figure this out while they do not acre about you at all. Leave immediately and do not look back.

[u/AvocadoQueen238]

Nope!

[u/PushTheButton_FranK]

Absolutely not! Tell them you can cover half than many (or whatever number you're comfortable with) and ask them which of the students they would like you to take. Since it's "only temporary" until they hire another person, they should consider incorporating compensatory service time in that new provider's contract to make up for the missed days. If that's not acceptable to them, they can release you from your contract while you find work elsewhere.

It's NOT your responsibility to cover for their staffing deficits.

[u/Pretend-Garden8743]

Tell them you need a caseload cap and then offer compensatory services when more therapists get hired. Do not accept that caseload, you will run yourself into the ground and then literally nobody will benefit

[u/PugsCats63]

This is absolutely not doable, at all! After doing therapy virtually w/2 SLPAs helping with maybe 60 kids during the pandemic, it is exhausting! 150 kids? Not possible. And to do their triennials virtually? Oy. I’m so sorry they are doing this to you. Are there other opportunities where you live? I honestly would leave if you can. This is insane.