JCPSLP Vol 21 No 2 2019 DIGITAL Edition

Terms of trade Terms of trade can relate to both the service provider and the patient/client. In terms of the engagement of services, what is the structure or nature of the engagement of service; i.e., employee vs subcontractor vs private practice owner? Depending on the nature of the arrangement, considerations such as superannuation, travel costs and associated charges, provision and replacement of equipment need to be taken into account. Clear communication via a terms of trade document (i.e., cost of service, payment terms, person responsible for account, service provision inclusions, timeframes for written documentation, reports/letters, etc.) explicitly sets out the expectations of all parties. The mobile service provider may need to obtain a memorandum of understanding (MoU) if regularly using a room, e.g., at a school, etc. The MoU should clearly state what is included in the use of the facility. It should be clear whether there is a fee involved, what insurance cover is included, where patients/clients wait, pay, etc. If service providers are entering homes, etc., their terms of trade should clearly outline what is included in the service, insurance, appointment cancellations, funding obligations and legitimate claiming, etc. Advice for patients/clients, in writing, of the fee structure for initial and any subsequent sessions, reports or telephone communication should be provided. Details of how and when patients/clients are to pay are also important to set out. It is also important to ensure patients/clients know when, where and how to contact the speech pathologist if the site of service provision varies from day to day. Documentation of informed, written consent for the clinical screening, assessment and management via mobile service provisions are important to obtain. Service providers must also gain written consent to exchange information and provide details of where reports, etc., will be sent. This includes permission to include the general practitioner, school and any other relevant people or agencies. Where a number of different locations are used, it is essential to ensure suitable facilities are available for the provision of appropriate service delivery. This should include routine consideration of issues such as privacy; ensuring comfort in appropriate physical conditions – e.g., a quiet environment, suitable air conditioning or heating, etc.; space to include the presence of parent/s or guardian

or the ability for an approved third party to monitor the interaction if a child is being assessed or the person being assessed or treated lacks capacity (e.g., intellectually or physically disabled or those who are considered vulnerable). Further, when using a range of facilities, basic services such as cleaning need to be monitored. This includes cleaning and hygiene maintenance of equipment and toys, etc., when the speech pathologist is not present to supervise this process. Other As mentioned at the beginning of this conversation, all the ethical considerations required of any speech pathologist must be adhered to in the case of mobile services. However, they need to be carefully monitored because of the potentially varied nature (at least geographically) of the service and thus the increased potential for breaches of ethical standards. All providers must ensure they are familiar with each element of the SPA Code of Ethics (2010) and ensure that all the professional standards are upheld in the provision of the mobile service delivery. This includes maintaining accurate record-keeping, punctuality, transparency in service costs, the provision of quality standards and continuing competence, confidentiality, consent, safety and welfare, professional reputation and attention to any possible conflict of interest. Supervision is also an important ethical obligation. Those engaged to offer a mobile service (i.e., via employment and subcontracting arrangements) should be provided with adequate and sufficient mentoring and supervision of cases to ensure best practice. For those with concerns or queries, SPA members have access to the Senior Advisor Ethics and Profession Issues at the SPA National Office, Trish Johnson, who has a range of experience with a multitude of ethical queries. Susan Block is a senior member of Speech Pathology Australia Ethics Board. Tristan Nickless (@tristo_talk) is an elected member Speech Pathology Australia Ethics Board. Richard Saker is a community representative SPA Ethics Board. Correspondence to: Susan Block Senior member of Speech Pathology Australia Ethics Board email: S.Block@latrobe.edu.au

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JCPSLP Volume 21, Number 2 2019

Journal of Clinical Practice in Speech-Language Pathology