Board of Directors Meeting Report: October 19-20, 2012
ASHA’s Board of Directors (BOD) met at the National Office on October 19 and 20. Following are highlights of the Board’s discussions.
President’s Opening Remarks
President Shelly Chabon convened the meeting at 1:00 p.m. on Friday, October 19. She welcomed the five newly elected Board members: President-Elect Elizabeth McCrea, Chair of the Speech-Language Pathology Advisory Council Perry Flynn, Vice President for Science and Research Howard Goldstein, Vice President for Academic Affairs in Speech-Language Pathology Shari Robertson, and Vice President for Audiology Practice Donna Fisher Smiley. They will begin their 3-year terms on January 1, 2013. New Board members are invited to participate fully in the discussions of the Board during the October meeting but do not vote. President Chabon also thanked the departing Board members who will be leaving the Board at the end of this year. Completing their terms of service are Immediate Past President Paul Rao, Chair of the Speech-Language Pathology Advisory Council Nancy Alarcon,
Vice President for Science and Research Karen Kirk, Vice President for Audiology Practice Jaynee Handelsman, and Vice President for Academic Affairs in Speech-Language Pathology Jeanne Wilcox.
Chief Executive Officer Arlene Pietranton highlighted several items from the written report that was sent to Board members in advance of this meeting:
- Convention registration is currently at about 8,000. We are about 400 registrants ahead of where we were at this time last year. All indications are that our Special Events will be very well attended, since we asked registrants to let us know if they were planning to attend. We are almost at capacity for the Opening Session and have about 500 people who are planning to attend the First Timers’ Orientation. We are at capacity for the Service Activity, which will involve the Minority Student Leadership Program participants taking on leadership roles with members who have volunteered to participate.
- A very different looking and easier to use ASHA Leader will be in members’ hands in early January of 2013. It’s been 12 years since the last design and content makeover. Key features of the new Leader were developed in direct response to member feedback provided on readership surveys. These features include a smaller, newsmagazine size that is more portable and easier to share and store than the current format and a dynamic integration of ongoing social media content from members into print and online columns and features.
- MS's proposed administrative rule on the Physician Fee Schedule includes a provision that could affect SLPs billing Medicare Part B. Under the Physician Quality Reporting System (PQRS) CMS will, in 2015, begin levying fines against providers (including SLPs and audiologists) who fail to report the quality measures contained in the PQRS system. Although the fines will not be imposed until 2015, whether the fines will be levied depends on whether the provider submitted the relevant measures in 2013. In addition, it looks like new outcomes measures will be required in 2013 as well, and those measures will need to be included in billing documents after July 1, 2013, or payment for the services will be denied by Medicare. A communications plan is being developed to handle the messaging around this topic and will be launched as soon as the final administrative rule is published in November.
- There have been extensive communications about the benefits of Special Interest Group (SIG) membership. The communications (ads, e-mails, direct mail, etc.) stress the professional networking benefits with the ASHA Community, access to great information in all issues of Perspectives, and the opportunities to earn low-cost CEUs. The best time for members to join a SIG is during the dues renewal process, when joining is easy and online.
- Stan Dublinske, ASHA’s Senior Advisor for Planning, will be retiring after 35 years of service. President Chabon and the entire Board thanked Stan for his many years of service and significant contributions to the Association.
Clinical/Professional Doctorate Report
In 2011 the Academic Affairs Board (AAB) was asked by the ASHA Board of Directors to evaluate the pros and cons of a post–master’s optional clinical doctorate in speech-language pathology. As part of developing 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. Vice President for Academic Affairs in Speech-Language Pathology Jeanne Wilcox reported preliminary results of the survey at the August meeting and the full report was posted to the BOD collaboration site in October. At today’s meeting, the Board discussed the full report.
Among the conclusions of the report are that there is a national and global proliferation of professional and clinical doctorates across disciplines. Additionally, there appears to be growing interest among a number of academic programs in communication sciences and disorders (CSD) to develop post–entry level clinical doctoral degree programs in speech-language pathology. It is important to note that the AAB found a high degree of agreement across survey and focus group respondents and consensus conference attendees that there is a substantive need for and interest in the degree and a significant need for standards and accreditation for these degree programs. Based on the results of the report and from subsequent discussions, the AAB recommended that ASHA’s Board of Directors ask the AAB to conduct a feasibility study in collaboration with the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) regarding accreditation of post–master’s level clinical doctoral degree programs in speech-language pathology so that the BOD can make an informed decision about the advisability of the CAA’s accrediting of such programs. It’s important to note that ASHA does not develop clinical programs nor can ASHA tell an educational institution to create such a program.
The Board thanked the AAB for their work developing this comprehensive report and accepted it. The Board asked that a resolution be developed detailing the costs associated with having the AAB conduct a feasibility study in collaboration with the CAA regarding evaluation and possible accreditation of post–master’s level clinical doctoral degree programs in speech-language pathology. Once that resolution is developed and presented, the Board will have further discussions and make a decision about pursuing this course of action.
One of the objectives within ASHA’s strategic plan (the Strategic Pathway to Excellence) is to strengthen strategic relationships with targeted organizations that provide mutual benefit, increase ASHA’s influence, and further ASHA’s mission. Included within the priorities established by the Board of Directors related to this objective is to identify opportunities for collaboration with the World Health Organization (WHO). The ASHA–PAHO proposal is a joint collaboration effort with the Pan American Health Organization (PAHO), which is the Regional Office for the Americas of the WHO. The ASHA–PAHO project is designed to strengthen the knowledge and capacity building of professionals, institutions, and/or organizations that address communication disorders in the areas of speech, language, swallowing, and hearing and rehabilitation (including early detection of communication disorders). The project calls for the development of joint activities involving technical cooperation and usage of content experts selected by ASHA and PAHO to conduct training and educational programs in the countries of Honduras, El Salvador, and Guyana. The project is expected to benefit ASHA in a number of ways, including by
- enhancing the knowledge about and the importance of the professions of speech-language pathology and audiology worldwide;
- improving the process for educating ASHA SLPs and audiologists in the United States by providing a more global perspective and more knowledge and skills about providing services to diverse populations;
- providing opportunities for ASHA members interested in international issues to serve as experts in programs endorsed and supported by the project and to share experiences with colleagues and students;
- facilitating ASHA’s qualification as an applicant for a nongovernmental organization to work with PAHO.
After discussion, a motion was presented to the Board recommending that ASHA pursue the ASHA–PAHO project. The motion was passed.
2012 Financial Report
Vice President for Finance Carolyn Higdon and Chief Staff Officer for Operations Chuck Cochran presented a status report on ASHA’s current operating budget as of September 30, 2012. Dues revenue is higher when compared to 2011, resulting from an increased number of members and ASHA’s high retention rate (98.5%). ASHA is showing positive revenue over expenses so far this year and is forecasting total revenue will exceed expenses for 2012.
2013 Proposed Budget
The Financial Planning Board (FPB) met in September and reviewed the proposed 2013 budget in detail. The proposed 2013 budget, which projects modest positive revenue over expenses in 2013, was presented to the Board with the FPB recommendation that it be approved. For 2013, with the expected growth in membership, we are forecasting an increase in dues revenue. No dues increase is planned for 2013. A modest increase in non-dues revenue is also forecasted. The budget also reflects a small expense increase in 2013. The Board voted to approve the 2013 budget.
Dual Members: Ability to Vote for Candidates of Both Professions
The Board recently received a request from some dually certified ASHA members asking that they be allowed to vote for candidates from both audiology and speech-language pathology professions. ASHA’s current bylaws require that dually certified members or members without certification “shall declare the area (audiology or speech-language pathology) for which they wish to vote.” After discussion the Board decided that a bylaws resolution should be developed indicating that dually certified members should be allowed to vote for candidates from both professions. This resolution will first be communicated to members and then voted on by the Board at the next opportunity for a bylaws change (January of 2013).
BOD 22-2012 CFCC Specialty Certification Bylaws Change
At the August Board meeting, Vice President for Standards and Ethics in Speech-Language Pathology Jennifer Watson shared the recommendations of the BOD Subcommittee on Specialty Recognition appointed to explore the value and feasibility of establishing clinical specialty certification. The recommendations reviewed at that meeting included:
- Establish a clinical specialty certification (CSC) program to replace the current clinical specialty recognition program.
- Administer the CSC program through the Council for Clinical Certification.
- Adopt the core standards for specialty areas in the CSC program delineated in Addendum E to the Report.
- Implement the plan for completing practice analyses for each current (as well as future) clinical specialty board presented in financials in the report.
- Create a transition team to develop a plan for transitioning from the current specialty recognition program to the CSC program.
- Evaluate the effectiveness of the CSC program 5 to 8 years after completion of the initial practice analysis.
At that meeting the Board decided that a resolution based on these recommendations should be developed for consideration by the Board. That resolution, BOD 19-2012, was approved by the Board in September. Since resolution BOD 19-2012 moved responsibility for the CSC program under the Council for Clinical Certification, a bylaws change was required to implement this resolution. At today’s meeting, the Board reviewed feedback provided by members regarding this bylaws change and discussed the impact of this change on the Association. The vast majority of members expressed support for the resolution. After further discussion, the Board voted to approve the resolution.
Changing Healthcare Landscape Summit Update
It is widely acknowledged that health care, and especially the economics of health care, is undergoing dramatic changes. Although momentum for these changes has been developing over the past decade, concrete changes in health care delivery and payment are imminent. Factors pressuring these changes include the unsustainably increasing cost of medical care, the Patient Protection and Accountable Care Act of 2010 (ACA), and increasing demands for quality, efficiency, and accountability by regulators, health care rating organizations, accrediting bodies, employers, commercial payers, and the public. In order to be proactive in responding to these changes, ASHA convened a Changing Healthcare Landscape Summit, held October 5–7, 2012, to address the many present, pending, and proposed issues that face practitioners and the discipline of communication sciences and disorders.
The purposes of the summit were to
- provide a forum for knowledge transfer, open discussion, and deliberation about the rapidly changing health care landscape;
- discern specific implications of health care reform with regard to all aspects of the professions of speech-language pathology and audiology and the discipline of communication sciences and disorders;
- identify a set of options and seek consensus recommendations for a strategic course of action to respond to challenges and opportunities posed by health care reform in the areas of
- professional practice
- research and data needs
- professional preparation
- member education and interprofessional education
- dissemination of information that energizes individuals to become catalysts for change;
- determine ASHA’s role in proactively safeguarding the professions in light of the changing landscape in health care.
At today’s board 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 reported on the results of the summit and the executive summary report submitted by the planning committee.
For audiology, the recommendations from the summit encompass areas such as the potential need to educate audiologists about the importance of patient-centered care, the need for an extensive registry of patient data related to audiological services, the need to develop tools that would allow practitioners to accurately collect and mine data related to patients’ auditory and vestibular impairment, the need to develop a mechanism to make hearing aids available to everyone who needs them, and a need to change the Medicare reimbursement structure related to allowing for comprehensive care (prevention, identification, intervention, treatment, rehabilitation, and management).
For speech-language pathology, the recommendations from the summit encompass several areas such as the need to reconsider and expand the clinical paradigm, reframe/rebrand the profession, enhance quality and outcomes measures and management needs, modify professional preparation, and increased member education.
The Board voted to accept the executive summary report provided by the summit planning committee and agreed that it should be distributed to all attendees of the summit and then posted on ASHA’s website. The Board also decided to create a Board subcommittee to review the proposed recommendations and decide on next steps and priorities for implementing these recommendations. President Chabon asked the following Board members and CSOs to serve on this subcommittee: Past President Paul Rao, President-Elect Patty Prelock, Vice President for Academic Affairs in Audiology Neil Shepard, Chief Staff Officer for Speech-Language Pathology Lemmie McNeilly, Chief Staff Officer for Science and Research Margaret Rogers, and Chief Staff Officer for Audiology Neil DiSarno.
Board Member and Chief Staff Officer Reports on Trends and Issues
Vice President for Speech-Language Pathology Practice Gail Richard updated the Board about the peer review process currently underway for the speech-language pathology associate scope of practice. The committee is on track to complete the process by the end of the year and plans to present the document to the Board in January.
Chair of the Speech-Language Pathology Advisory Council Nancy Alarcon shared a spreadsheet provided by Ellen Fagan, director of continuing education, showing the breakdown of CE provider course levels. It showed that of the more than 5,000 courses, 70% are at the intermediate level, 17% at the introductory level, and 10% at the advanced level. She wanted the Board to be aware of this data.
Chief Staff Officer for Communications Marty Rome provided preliminary results of a survey sent to pre-registrants of the ASHA Convention. One of the questions sought to help the Board better understand member reasons for failing to vote in ASHA elections. The data are consistent with past surveys and reinforce the challenge of generating increased interest in elections when all the candidates are seen as equally qualified.
Chief Staff Officer for Multicultural Affairs Vicki Deal-Williams shared information about the pending Supreme Court decision regarding affirmative action. The decision may have an impact on the number of historically underrepresented racial/ethnic minority students available to enter the CSD professions and how students are selected for admission into a number of programs intended to recruit and retain diverse populations into the discipline and the Association.
Chief Staff Officer for Science and Research Margaret Rogers updated the Board about the status of using the National Measurement Outcomes System as the reporting system for the Physician Quality Reporting System (PQRS). Members will be communicated with about these changes after the final rules from CMS are issued in November 2012.
Vice President for Academic Affairs in Audiology Neil Shepard mentioned that a subcommittee on supervision has been created. It will be chaired by former president Sue Hale, and the first meeting will likely be early next year.
President Shelly Chabon asked for a discussion regarding the opportunities for members to share information with the Board through the InTouch With the Board form that is posted on the website and included in Board reports and other communications. Besides the InTouch form, any member can send a private message to a member of the Board through the ASHA Community. The Board reiterated that it welcomes and encourages member input, and would like to make sure that members are aware of the many ways they can contact the Board with suggestions or questions.
National Student Speech Language Hearing Association (NSSLHA)–ASHA Integration Update
In 2011 ASHA and NSSLHA agreed to an integration plan designed to maintain NSSLHA’s autonomy and enhance ASHA and NSSLHA’s ability to better engage all students. As part of that process, ASHA has assumed fiduciary responsibility for NSLLHA, while NSSLHA will remain a separate organization under the ASHA umbrella with its own Board and student-led Executive Council.
NSSLHA National Advisor Carlin Hageman (who joined the Board in 2012 as part of the NSSLHA–ASHA integration agreement) and Chief Staff Officer for Multicultural Affairs Vicki Deal-Williams updated the Board about the increased collaboration between the two organizations, including a number of operational changes in areas such as publications, membership outreach, and most significantly positioning NSSLHA as the provider of student content for the ASHA Convention. An edition of NSSLHA Now! that will be available to students attending the Convention will highlight content targeted to students, and NSSLHA will benefit from additional Convention sponsorship. The student pages of the ASHA and NSSLHA websites are being integrated to form co-branded web pages with student-focused content on the ASHA site.
ASHA and NSSLHA are working toward an online membership application for NSSLHA that will streamline applications processing for NSSLHA membership and allow further consideration of changes to NSSLHA’s membership structure. Next steps include the completion of the revision of the NSSLHA Bylaws by their Executive Council and then the formation of the NSSLHA Board of Directors.
ASHA Mission Statement Review
The Board recently received a letter from a group of members requesting that a reference to swallowing be added to the mission statement. As a result of that request, at both the May and August meetings, the Board discussed changing ASHA’s mission statement to include the terms swallowing and balance while maintaining the original sense of the mission. The Board asked a team, including Vice President for Planning Barbara Moore, Chief Staff Officer for Multicultural Affairs Vicki-Deal Williams, Chief Staff Officer for Communications Marty Rome, and Senior Advisor for Planning Stan Dublinske, to present the Board with options for altering ASHA’s mission statement taking into account all of these factors.
At today’s meeting, Barbara reminded the Board that a mission statement is a statement that describes the organization’s purpose (i.e., why the organization exists), describes what the organization does (i.e., how we fulfill our organizational purpose), and who the organization serves (i.e., the primary customer/stakeholder). The mission statement should be a fairly stable statement that is unlikely to change unless the focus of the work of the organization changes significantly. After some discussion, the Board decided to distribute a new draft mission statement to members for widespread peer review before the end of the year.
2013 Public Policy Agenda
Vice President for Government Relations and Public Policy Theresa Rodgers and Director of Government Relations George Lyons presented ASHA’s 2013 Public Policy Agenda (PPA). Issue and policy objectives were identified by ASHA members, committees, and staff. This year, members of the Government Relations and Public Policy Board (GRPPB) worked collaboratively with ASHA staff to revise and improve the survey tool utilized. Respondents were asked to read each of 20 issue objectives, which were presented in random order in the survey, and to rate what they believed to be its priority level. ASHA staff received usable input from 4,055 individuals and/or groups. Overall, this represents a 77% increase in the number of usable responses from a year ago. This was the highest number of useable responses ever received from the survey.
The 2013 PPA identifies 11 broad issues and policy areas of concern to members. The issue objectives were developed through the GRPPB to focus and strategically plan the Association’s advocacy and policy initiatives. The Agenda focuses on issues facing the professions at both the federal and/or state levels. The GRPPB undertook this work with a common understanding that underlying each issue objective in the PPA are foundational principles, such as ethics, diversity, evidence-based practice, and a commitment to client care and outcomes, that provide a common thread throughout the agenda. The 11 broad issues are as follows:
- Medicare Reimbursement and Coverage Policies
Federal and State Level
- Federal and State Funding for Services - School Based Members
- Hearing Health Care
- Loan Forgiveness as a Recruitment and Retention Tool
- Medicaid Reimbursement and Coverage Policies
- Patient Protection and Affordable Care Act
- Private Health Plans Reimbursement and Coverage Policies
- Comprehensive (Universal) Licensure
- Service Continuum
- State Consultants
These issues address the major concerns of audiologists, speech-language pathologists, and speech, language, and hearing scientists before federal and state governments.
After discussion and recommending a minor change to the document, the Board voted to approve the 2013 PPA. Members interested in reviewing the 2013 PPA can find it at www.asha.org/Advocacy/2013-ASHA-Public-Policy-Agenda/.