JCPSLP Vol 23 No 3

Professionals and Support Services Award 2020 (Fair Work Ombudsman, 2021). For NDIS purposes, supervising speech pathologists and/or hirers may also need to determine the level at which an AHA should charge clients to comply with the NDIS Pricing Rules (2021). Before commencing paid work, student AHAs must obtain appropriate working with children checks. These vary state to state, with some states (like NSW) requiring different clearances for volunteering versus paid work. Are student speech pathologist AHAs hired as employees or contractors? AHAs and supervising speech pathologists need to know: • who is hiring the AHA—is it a private practice, an agency, a client directly, or another person or business; and • whether the AHA is entering an employment or contracting relationship with their hirer. Each arrangement should be documented in a contract that spells out the nature of the relationship and sets out each party’s rights and responsibilities. Several important legal, tax, superannuation, business and compliance consequences flow from what the legal arrangements entail. AHAs who are hired as independent contractors, for example, are in business for themselves and must comply with general small business and tax laws, and with applicable health laws (e.g., with respect to infection controls, insurance arrangements, marketing activities, and working with NDIS participants). Without experience and advice, laws and regulations can be hard to navigate, apply and comply with. Unfortunately, ignorance of the laws is no excuse for noncompliance. Contracting student AHAs should seek advice on their business, legal, and compliance obligations before starting work. Further information can be found on the SPA website (SPA, 2020b) supervised by a qualified speech pathologist when providing speech pathology-related services Clients (including NDIS participants) have a number of consumer rights in relation to the quality and safety of the services they receive. Among other things, services must be provided with acceptable care and skill or technical knowledge and be fit for purpose. From a health law perspective, speech pathologists and AHAs (as health practitioners) must provide services in a safe and ethical manner. Student speech pathologists working as AHAs must not provide services that are outside their experience or training or provide services that they are not qualified to provide. Clients (including NDIS participants) have a right to choose their health care providers, and to be informed about their qualifications and experience. They have the right to receive services safely and competently, and to assume that the person or people providing services know what they are doing. To comply with consumer, health and NDIS laws, and to satisfy professional and ethical obligations to clients, a qualified speech pathologist must supervise an AHA’s speech pathology-related work regardless of who employs or contracts with the AHA: Student speech pathologists employed as AHAs must be

• Under the SPA Code of Ethics (C of E) ( (2020a), qualified speech pathologists must ensure that any AHA they work with is supervised appropriately (SPA, 2020a, 1.3). • Some student AHAs are hired by non-speech pathologists. In these cases, a key practical question arises: who will pay for the required supervision by a speech pathologist? Even the most talented and knowledgeable student AHA requires significant, direct supervision by a speech pathologist to ensure the safety and quality of the services provided to clients. General oversight, mentoring, coaching, “tick the box” or remote file audits are not sufficient supervision practices for student speech pathologists working as AHAs. Nor is supervision of speech pathology-related work by someone who is not a qualified speech pathologist. Student speech pathologists working as AHAs should ensure they are insured adequately Working with clients involves legal risks. Students may be at risk of being sued by clients, regulators, employers, hirers, or others (e.g., for negligence, breach of contract, consumer guarantee breaches, or workplace safety, National Code of Conduct, NDIS, and other compliance violations). Clients may also lodge complaints with health complaint regulators, the NDIA Commissioner, and/or Speech Pathology Australia. Students should ensure they are insured adequately to mitigate the potential financial impact of these risks: • In vocational placements, the relevant university and private practice will have agreed insurance arrangements in place to protect students. Usually, the university’s public liability insurance will cover students for work conducted on their placements. • Outside of vocational placements, the situation is more complicated: – Students should investigate whether any insurance arrangements are in place and, if so, whether they are covered by them. – If students are employed by a private practice or agency, they may be covered by their employer’s insurance arrangements when acting within their contracted scope and in accordance with their employment contracts (but see below). – Student speech pathologists working as AHAs who are hired as independent contractors are less likely than employees to be covered by the hirer’s insurance arrangements. Much depends on the specific terms of the hirer’s insurance policies and the contract. • In general, students (and speech pathologists) should be careful about relying on someone else’s insurance arrangements to cover their work. For example: • insurance policies may be cancelled for a number of reasons outside the student’s control, not cover the scope of services provided by the student, or be inadequate financially. • employers or hirers may become insolvent or forget to pay their premiums, voiding or limiting cover; and • the hirer (or its insurance company), when faced with a claim or litigation, may decide to join or claim against the student. • For all these reasons, students should seek advice and consider buying their own insurance for speech pathology related AHA work.

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JCPSLP Volume 23, Number 3 2021

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