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Alum’s Advocacy Helps Expand Access to Speech-Language Pathology Services in Hawaii

A photo of Kauai with the ocean in the background.

Kauai, Hawaii.

Consider being in charge of all the staffing and operations needs for three skilled nursing facilities. Now, imagine that these facilities are run on a remote island, and that your applicant pool is further limited by licensing mandates.

For Kristina Fuentes (MS ’10), Director of Rehabilitation at Aegis Therapies in Kauai, Hawaii, this hypothetical is a reality. “I face unique challenges, especially when it comes to attracting and retaining specialists and healthcare professionals,” the Department of Communicative Sciences and Disorders alum said. 

Beyond working in a remote location, Fuentes has grappled with Hawaii’s lack of provisional licensing for speech-language pathology master’s graduates completing their clinical fellowships in the state. Without this provisional licensing, aspiring speech-language pathologists (SLPs) cannot bill many insurance companies for the services they provide while working in a healthcare setting. 

With many local graduates choosing to complete their clinical fellowships (CFs) in a non-healthcare field or on the mainland, Hawaii’s healthcare system was losing potential SLP candidates – not to mention that out-of-state graduates were disincentivized from seeking employment in Hawaii. 

Fuentes saw the impact of this legislative obstacle on clients as well. “More importantly than the impact on staffing and job opportunities, I saw so many clients getting delayed services, not enough services, or no services at all just because of the lack of local speech-language pathologists,” she said.

After attending a conference in Oahu and speaking with several graduate students expressing their inability to stay and work in Hawaiian healthcare, Fuentes was inspired to advocate for change. Through the Hawaii Speech-Language-Hearing Association, Fuentes was introduced to a committee that had previously initiated state legislation aimed at expanding provisional licensing for SLPs during CFs in Hawaii.

“I was able to use our smalltown Kauai connections to get a meeting with Representative Dee Morikawa from the Hawaii House of Representatives,” said Fuentes. Ultimately, Morikawa paired up with Hawaii State Senator Ron Kouchi to introduce new companion bills to further elevate the provisional license issue within the Hawaiian government.

A Facebook post from the Hawaii Speech-Language-Hearing Association that reads "Please read and share: CALL TO ACTION"

A social media post from the Hawaii Speech-Language-Hearing Association advocacy campaign encouraged the NYU Steinhardt community to join the conversation and help expand Hawaiian licensure.

After months of coordinated advocacy efforts organized by Fuentes and her colleagues, the Hawaiian House and Senate passed the legislation, paving the way for graduating SLPs to have provisional licensure during their CFs and provide Hawaiian clients essential services in a timely fashion.

Reflecting on this proud moment, Fuentes shared her advice for professionals looking to create change in their own communities. “Talk with your colleagues – you never know what connections you can make that will help you on your journey. Don’t be afraid to reach out to people in positions that can help you, and most importantly, don’t give up!”