Board of Directors Meeting Report: August 3-4, 2012

The Board of Directors (BOD) of the American Speech-Language-Hearing Association (ASHA) met on August 3 and 4, 2012, at the ASHA National Office. Following are highlights of the Board's discussions.

President's Welcome/Chief Executive Officer Update Highlights

President Chabon convened the meeting at 9:15 a.m. and introduced ASHA's newest Board member, National Student Speech Language Hearing Association (NSSLHA) National Advisor Carlin Hageman. President Chabon welcomed all the Board members and thanked them for their continued service to the professions and ASHA. She also thanked the Board for their willingness to continue to experiment with a different schedule for BOD meetings that strives to make the best use of Board members' time and travel schedules. This schedule will be evaluated after the meeting, and it will be determined if this approach might be used for future Board meetings. Besides the written summary provided to all Board members, Chief Executive Officer Arlene Pietranton updated the Board about a number of items:

• She introduced Neil DeSarno, PhD, CCC-A, ASHA's new Chief Staff Officer for Audiology. Neil's first day at ASHA is today.
• Attendance at Schools Conference 2012, which was recently held in Milwaukee, was 1,008 attendees.
• The National Association for Hearing and Speech Action (NAHSA)-ASHA's consumer-focused affiliate and a 501c3 organization dedicated to public education-recently launched "Speak Up About Hearing Loss," a national broadcast public service announcement (PSA; in English and Spanish versions). The campaign is based on results of a poll of members of AARP and ASHA. The campaign attracted strong interest at its broadcast media launch this past May. A total audience of approximately 12 million tuned in as English and Spanish outlets nationwide interviewed two ASHA members about the campaign. Since then, stations across the country have been airing the PSAs. As of June 30, PSAs have been distributed to major media markets coast to coast and have aired nearly 22,000 times, most often on English language radio and, second, on English language television. The combined English language/Spanish language audience has been approximately 105 million.
• The Performance Assessment of Contributions and Effectiveness of Speech-Language Pathologists (PACE) was developed in response to member requests and rapidly developing state policies regarding accountability measures for school-based speech-language pathologists (SLPs). The objective was to identify a value-added model designed for SLPs or one that specifically accounted for the unique contributions of SLPs. You can find the PACE document and related PowerPoint and checklist resources on this web page.
• The ASHA Leader is nearing the end of a design and content makeover; the first issue of the new Leader will reach members in early January 2013. Key features were developed in direct response to member feedback provided by recent readership surveys. Changes also capitalize on the best practices of news magazine publishing for associations. These features include the shift in format to a smaller size, which is more portable and easier to store; enhanced navigability through a series of colorful running tabs across the tops of pages; an interior table of contents to set off sections; and consistent placement of columns and departments from issue to issue. 

Elections Update

Immediate-Past President Paul Rao reported on the 2012 election process, which determined the new Board members and Advisory Council members for terms starting in January of 2013. He reported that election participation by members has been between 3.75% and 6% since 2007. In recent years, 2009 had the lowest member election participation rate (3.76%) and 2007 had the highest (5.77%). In 2012 the participation was 3.97%. The Board discussed ways to increase member participation in elections. 

Mission Statement Discussion

At the May Board meeting, following a suggestion by a group of members who have the BRS-S (i.e., the designation for recognition as a specialist in swallowing by the Specialty Board on Swallowing and Swallowing Disorders), the Board discussed changing ASHA's mission statement to include the terms swallowing and balance, while maintaining the original sense of the mission. A team, including Vice President for Planning Barbara Moore and ASHA staff, presented the Board with options for altering ASHA's mission statement to take into account the views of these and other members. At today's meeting, Barbara reported back and reminded the Board that the purpose of a mission statement is to describes the organization's purpose (i.e. why the organization exists), describes what the organization does (i.e. how do we fulfill our organizational purpose), and who the organization serves (i.e., who is the primary customer/stakeholder).  She also reported that it should be a fairly stable statement, and not one that changes frequently, and it is unlikely to change unless the focus of the work of the organization changes significantly. The Board decided to continue the discussion of the various options presented by the team on the BOD collaboration site, decide on a draft by the October Board meeting, and then circulate the draft for peer review to members. 

Clinical/Professional Doctorate and the Consensus Conference

Vice President for Academic Affairs in Speech-Language Pathology Jeanne Wilcox reported on the outcome of the Clinical/Professional Doctorate and the Consensus Conference, which was held at the MGH Institute of Health Professions in June. ASHA sent members of the Board of Directors, including President Chabon, and several staff members. The conference program was designed to

• focus on non-entry level programs;
• focus on the philosophical, programmatic, and foundational aspects of prospective programs;
• minimize focus on regulatory, accreditation, or certification issues;
• allow for emerging discussion on any areas that the attendees wished to pursue, including those listed above.

It is anticipated that more detailed reports will be developed in the coming months and shared with attendees of the Consensus Conference, as well as with the leadership of ASHA, the Council of Academic Programs in Communication Sciences and Disorders (CAPCSD), and the Academic Affairs Board (AAB). 

Jeanne also reminded the Board that the AAB has been assigned by the ASHA Board of Directors to evaluate the pros and cons of a post-master's clinical doctorate in speech-language pathology. As part of their report, the AAB sought feedback through a survey of master's-level, ASHA-certified, speech-language pathologists on level of interest, intentions to pursue, and the perceived need for and value of an optional post-master's clinical doctorate in speech-language pathology. She reported several interesting conclusions that can be drawn from the data.

• Response patterns are similar across the various work settings.
• There is a general receptivity to an optional clinical doctorate.

There is a strong sense among the respondents that, if there were an optional clinical doctorate, the program should have standards and accreditation. Jeanne shared the results of that survey in preparation for the Board's receiving a full report from the AAB in October. 

MedPAC Update

Chief Staff Officer for Speech-Language Pathology Lemmie McNeilly, Chief Staff Officer for Science and Research Margaret Rogers, and Director Rob Mullen of the National Center for Evidence-Based Practice in Communication Disorders (N-CEP) discussed a report ASHA is preparing for submission to the Medicare Payment Advisory Commission (MedPAC). The report proposes that the Centers for Medicare and Medicaid Services (CMS) undertake a pilot project to assess the feasibility of using National Outcomes Measurement System (NOMS) data as the basis for an alternative payment system for speech-language pathology services under Medicare Part B. ASHA staff from Speech-Language Pathology Health Care Services, Government Relations and Public Policy, and N-CEP worked collaboratively with ASHA's Health Care Economics Committee to prepare the proposal. MedPAC is an independent agency established by the Balanced Budget Act of 1997 to advise the U.S. Congress on issues affecting the Medicare program. Congress has mandated that CMS collect outcomes data on Medicare claims forms; ASHA believes that NOMS could be useful to support that effort. 

Input From Members Regarding ByLaws Changes and Other Matters

The Board reviewed feedback that was received from members regarding two proposed Bylaws changes: to amend language to make it clear that International Affiliates are eligible for Fellowship and to add a representative from the U.S. Territories to each of the Advisory Councils (ACs). After discussing that feedback and the resolutions, the Board voted to approve both Bylaws changes. The Board also discussed a comment received from a member regarding the need for an increased focus on clinically relevant research by school-based professionals. Board members shared ideas for assisting school-based professionals in conducting relevant research; this topic will be discussed further in future Board meetings. The Board also briefly addressed a member's query about why those with dual certification are not permitted to vote for Board members in both professions. The Board decided to put this topic on the agenda for the October Board meeting. 

The ASHA Community

Online Collaboration Manager Jill Straniero demonstrated the ASHA Community platform and shared plans for enhancing the capabilities of the Community in 2013. Jill discussed plans to increase communication to members about the many benefits of the platform and to encourage members to update their Community profiles. Board members provided feedback and expressed enthusiastic supportive of the plans and activities. 

Board Activities at Convention

Board of Directors Manager Marty Moore reviewed the Board's schedule for the 2012 ASHA Convention in Atlanta in November. BOD involvement is expected in various activities beginning on Wednesday and ending on Sunday morning with a Board meeting. Board members will also be attending a variety of sessions and activities as presenters, participants, and active supporters and will be available at the Member Forum and at a new ASHA Volunteer Village and Lounge at various times throughout Convention. 

Financial Performance

Vice President for Finance Carolyn Higdon updated the Board regarding ASHA's financial performance through June 2012. She reported that dues income is ahead of last year's as a result of further growth in membership and ASHA's high retention rate. Non-dues revenue is running slightly behind 2011. Expenses are slightly under budget. ASHA is operating at positive revenue over expenses for 2012. Carolyn reported that she anticipates ASHA will be on budget this year and that no dues increase is anticipated for 2013. She also reported that the audit of ASHA's 2011 financials is complete. ASHA received no concerns from our auditors. The audit report will be available for Board review soon. The Board also had an opportunity to review the new 990 prior to its public release this year. Carolyn also reported that the ACs had discussed suggestions for non-dues revenue during the month of May. These suggestions were compiled and are posted on the collaboration website for the Board to review. The suggestion list and survey results are being considered by the Financial Planning Board for follow-up recommendations in September 2012. 

Property Update

Chief Staff Officer for Operations Chuck Cochran reported that sales of the townhouses that are being developed on the previous ASHA headquarters property at 10801 Rockville Pike are progressing faster than expected. As of July 18 of this year, 61 townhomes had been sold. Since the beginning of the project, ASHA has received about $6.5 million from StreetScape (the developer) and expects to receive a total of approximately $24 million when the project is completed in 2014. Chuck also reported that ASHA has leased two other portions of the fifth floor of the National Office building. He reported that approximately 4,000 square feet of space remain on the fifth floor. This is a desirable square footage for this market, so we expect we will be able to rent it out and have the fifth floor space fully rented soon. 

Changing Health Care Landscape Summit

In October of last year, the Board was provided an overview of the changing landscape for reimbursement of health care services, which demonstrated the dramatic changes coming in health care that include areas such as value-based purchasing rather than volume pricing, bundled payment models, changes driven by the Affordable Care Act, diagnostic coding changes, movement towards the International Classification of Functioning, Disability and Health (ICF) framework, and a belief by MedPAC that primary care physicians should be better compensated at the expense of other practitioners. As a result, it was proposed that ASHA hold a summit to engage leaders and stakeholders and to develop plans to take appropriate action. At today's meeting, Vice President for Academic Affairs in Audiology Neil Shepard, Immediate Past President Paul Rao, and Chief Staff Officer for Speech-Language Pathology Lemmie McNeilly updated the Board about the plans for the Changing Health Care Landscape Summit, which will include 70 invited participants and take place October 5-7, 2012, at ASHA's National Office in Rockville, Maryland. Outcomes of the Summit will be disseminated to ASHA members through a variety of venues, including postings on the ASHA website, articles in The ASHA Leader, and sessions at the ASHA Convention. 

BOD Specialty Recognition Subcommittee Report

Since the appointment of the Clinical Specialty Board in 1995, the outcomes of ASHA's clinical specialty recognition program have been monitored and evaluated through a variety of mechanisms. Assessment outcomes have supported the need to revisit the current structure of the clinical specialty program and explore ways to enhance the program. Most recently, a Board of Directors Subcommittee on Specialty Recognition was appointed to explore the value and feasibility of establishing clinical specialty certification as discussed in the July 2011 report to the BOD from the Council for Clinical Specialty Recognition (CCSR). Following multiple conference calls, one face-to-face meeting, and conversations with the CCSR, Council for Clinical Certification, each of the specialty boards, and psychometric consultant Dr. Mike Rosenfeld, the subcommittee submitted a report that included specific recommendations to the Board. Vice President for Standards and Ethics in Speech-Language Pathology Jennifer Watson shared those recommendations and led a discussion about them. The recommendations are:

1. Establish a clinical specialty certification (CSC) program to replace the current clinical specialty recognition program.
2. Administer the CSC program through the Council for Clinical Certification.
3. Adopt the core standards for specialty areas in the CSC program delineated in Addendum E to the Report.
4. Implement the plan for completing practice analyses for each current (as well as future) clinical specialty board presented in financials in the report.
5. Create a transition team to develop a plan for transitioning from the current specialty recognition program to the CSC program.
6. Evaluate the effectiveness of the CSC program 5 to 8 years after completion of the initial practice analysis.

After extensive discussion, the Board decided that a resolution based on these recommendations should be developed for consideration by the Board. 

Board Member and Chief Staff Officer Reports on Trends and Issues

Vice President for Academic Affairs in Speech-Language Pathology Jeanne Wilcox reported that the AAB met in April and is working on a number of issues, including strategies for addressing PhD shortages, clinical personnel shortages, faculty shortages, and the clinical doctorate in speech-language pathology. 

Vice President for Science and Research Karen Kirk updated the Board regarding ASHA's Research Mentoring (ARM) Network, which consists of three programs: (1) Pathways, aimed at those at an early stage of their research careers, (2) Lessons for Success, targeted to PhD students, postdocs, and junior faculty, which includes more intensive training for emerging scientists, and (3) the Clinical Practice Research Institute, created for established researchers and designed to facilitate the development of clinical trials, scale-up studies, and implementation research. She also shared information about ASHA's grant reviewer training program. 

Vice President for Speech-Language Pathology Practice Gail Richard reported that the Speech-Language Pathology Assistant (SLPA) Scope of Practice document has been drafted and is out for select peer review. She said that the document will then go out for wide-spread peer review later this year. 

Vice President for Academic Affairs in Audiology Neil Shepard updated the Board regarding the resolution (BOD 14-2012) to establish an Ad Hoc Committee on Supervision charged with developing specific recommendations as to the knowledge and skills needed for training individuals in supervision. The Board has received feedback from members through InTouch forms and directly from the Board of Ethics and the Council for Clinical Certification. In light of the feedback received, the original resolution will be withdrawn and a new resolution will be developed. 

Chief Staff Officer for Multicultural Affairs Vicki Deal-Williams provided an overview of some issues related to diversity and inclusion currently surfacing on the political and social landscape related to lesbian, gay, bisexual, and transgender (LGBT) populations, immigration, and race. The Office of Multicultural Affairs staff is continuing to monitor trends. Board members were asked to continue to pay attention to members' concerns related to these issues, opportunities to reinforce the Association's commitment to diversity and inclusion, and any need for future discussions by Association leaders.

Vice President for Planning Barbara Moore mentioned that ASHA is exploring a proposal to strengthen our relationship with the Pan American Health Organization (PAHO). PAHO is the part of the World Health Organization (WHO) that manages programs in conjunction with organizations headquartered in any part of the Americas. 

Nancy Alarcon, Chair of the Speech-Language-Pathology Advisory Council, pointed out that there is additional feedback for the Board that has been posted to the collaboration site from the Advisory Council members, and she thanked the Board for their efforts to regularly review that feedback. She and Wayne Foster, Chair of the Audiology Advisory Council, are regularly reaching out to AC members to solicit feedback for the Board on a variety of issues and welcome suggestions at any time for additional topics to explore. 

Vice President for Standards and Ethics in Speech-Language Pathology Jennifer Watson reported that discussions are taking place within the Committee of Chairs of Standards and Ethics and the CFCC regarding disclosure of information during initial application for reinstatement and renewal of certification.