December 16, 2013
This is another in a series of occasional ASHA Chief Executive Officer Updates. These Updates are intended to provide ASHA members with a more in-depth view of various National Office (NO) units, key member services and initiatives, and names and roles of ASHA staff. Information about staff changes and NO recognitions/awards is also included.
Many thanks to those of you who provided feedback regarding previous Updates or made suggestions for future CEO Updates.
ASHA’s 2014 Public Policy Agenda
The public policy agenda (PPA) is developed annually by the Government Relations and Public Policy Board subject to approval by the Board of Directors and serves as a blueprint for advocacy efforts taken by the Association. Development of the PPA is based heavily on member input. The PPA is divided into three broad areas of advocacy: issues at the federal level, issues at the federal and state level, and issues at the state level. You can review full details of the 2014 PPA, but I thought an overview of the issues and ASHA’s initiatives for the coming year would be of interest to members.
Medicare Reimbursement and Coverage Policies
ASHA members who treat Medicare beneficiaries constantly face the challenges of working with the Medicare system. In response to these challenges, ASHA will
- advocate for equitable reimbursement for audiologists and SLPs and coverage for beneficiaries of Medicare health plans,
- promote an alternative payment policy for Medicare outpatient therapy services to eliminate the reimbursement cap placed on speech-language pathology services,
- support reform of the sustainable growth rate formula to provide a more permanent solution in determining reimbursement under the Medicare Part B fee schedule,
- support Medicare coverage of audiologic diagnostic and treatment services as well as the right of audiologists to opt out of the Medicare program,
- support the right of SLPs to opt out of the Medicare program,
- represent both audiologists and SLPs before the Centers for Medicare & Medicaid Services and on AMA coding committees to ensure the maintenance and/or expansion of appropriate values, coverage, and reimbursement rates.
Reauthorization of Federal Education Legislation
Federal law provides guidance related to the roles, responsibilities, and funding of school-based services. The three major federal education laws are the Individuals with Disabilities Education Act (IDEA), the Elementary and Secondary Education Act (ESEA, aka No Child Left Behind), and the Higher Education Act (HEA). ASHA will
- advocate for reauthorization of IDEA and ESEA and promote the inclusion and funding of speech, language, literacy, and hearing services and devices in all federal legislation;
- support consistent language and common terminology, including use of the term highest qualified provider in IDEA and ESEA;
- seek opportunities to include SLPs in federal literacy policies;
- seek opportunities to include audiologists and SLPs in HEA provisions.
Federal and State Level
Funding and Practice Issues for School-Based Services
The climate of school-based audiology and speech-language pathology is characterized by staff shortages, increased paperwork, and greater workload and caseload demands. To support members in school settings, ASHA will
- promote adoption of appropriate accountability/evaluation measures for specialized instructional support personnel (SISP) in educational settings through collaboration with members, stakeholders, and decision makers at the state and local levels,
- oppose cuts in education funding;
- seek alternatives to help reduce the paperwork and administrative burden on school-based audiologists and SLPs,
- advocate with states to implement federal standards related to IDEA Part B and ESEA,
- advocate for states to adopt IDEA Part C Infants and Families Program requirements,
- advocate for waivers in IDEA Part C maintenance of effort to help keep states in the program while granting them temporary funding flexibility,
- promote reallocation of IDEA Part D funds so that they align with the needs of ASHA's school-based members and graduate academic programs.
Hearing Health Care
In following our vision to make effective communication, a human right, accessible and achievable for all, ASHA will advocate for consumer access to safe and effective hearing health care services, devices, hearing aids, and environments. ASHA will
- support hearing aid tax credit legislation to increase affordability of hearing aids;
- support Food and Drug Administration (FDA) regulations and guidance documents related to Internet and retail sales of hearing aids and personal sound amplification products (PSAPs) and Federal Trade Commission (FTC) oversight of deceptive advertising by sellers of PSAPs;
- support reasonable, cost-effective regulations and standards set by the American National Standards Institute (ANSI) and the Occupational Safety and Health Administration (OSHA) to prevent noise-induced hearing loss;
- promote a comprehensive system of children's hearing health care services, including implementation of the Early Hearing Detection and Intervention (EHDI) program, with specific focus on comprehensive follow-up, appropriate intensity of intervention, and coordinated management across state and federal agencies;
- advocate adoption of state hearing screening standards for school-age children;
- advocate provision of insurance coverage of hearing aids, cochlear implants, implantable hearing devices and other related devices, equipment, and diagnostic and treatment services for children.
Medicaid Reimbursement and Coverage Policies
ASHA members will see significant changes in the Medicaid program due to health care mandates in the Patient Protection and Affordable Care Act (ACA) and federal initiatives related to entitlement reform. To help members, ASHA will
- advocate for coverage of services provided by audiologists and SLPs, including maintaining funding for services mandated by the federal Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program, ensuring that services are based on the needs of the individuals served and establishing reasonable beneficiary eligibility requirements in traditional Medicaid and managed care organizations;
- advocate for appropriate policies and regulations of Medicaid covered services in schools and other settings;
- promote reimbursement for devices, including but not limited to hearing aids, cochlear implants, other implantable devices and related equipment, and augmentative and alternative communication (AAC) devices.
Patient Protection and Affordable Care Act (ACA)
With passage of the ACA, states are faced with the challenges of implementing the law's requirements. ASHA will
- advocate with the Center for Consumer Information and Insurance Oversight (CCIIO) for federal monitoring and enforcement of essential health benefit requirements for coverage of habilitative and rehabilitative services and devices,
- advocate for appropriate coverage of habilitative and rehabilitative services and devices within state health insurance exchanges,
- advocate for the role of audiology and speech-language pathology in emerging service delivery models, such as accountable care organizations and coordinated care.
Private Health Plans Reimbursement and Coverage Policies
Private health plans vary significantly in their coverage policies, reimbursement rates, and interpretation of federal and state regulations. ASHA will continue to
- advocate for coverage of services provided by audiologists and SLPs and provide input to coverage policies in private insurance,
- assist members with insurance appeals for medically necessary services.
Telepractice is an appropriate model of service delivery for the professions of audiology and speech-language pathology. ASHA will
- advocate for the recognition and coverage of appropriate services delivered through telepractice,
- advocate for Medicaid coverage of appropriate services delivered,
- monitor opportunities to advocate for funding through federal and state legislation and regulation with private health plans.
Loan Forgiveness as a Recruitment and Retention Tool
ASHA supports strategies to increase recruitment and retention of audiologists and SLPs through financial aid and loan forgiveness. We will continue to support state legislative efforts to adopt loan forgiveness provisions for audiologists and SLPs.
ASHA will continue to advocate for a comprehensive (single) license for each of the professions of audiology and speech-language pathology in each state, which would allow members to practice in any setting and improve licensure portability across states.
ASHA supports the adoption of model licensing language and implementation of a service continuum that defines the credentials and competency requirements for audiologists, SLPs, speech-language pathology assistants (SLPAs), and audiology assistants.
State departments of education (DOE) and/or state education agencies hire individuals to implement DOE policies, assist with educator questions, and provide training and support to the field. ASHA, in collaboration with state associations and organizations, will support member efforts and states seeking qualified audiologists and SLPs as consultants to the DOE and promote the retention of qualified audiologists and SLPs who are currently serving as employees/consultants to state agencies.
ASHA members can help move ASHA's advocacy efforts forward by serving as advocates for the professions. You can share the Association's PPA with peers to educate others on advocacy efforts for 2014, participate in e-advocacy through ASHA's take action website—where the Association asks members to contact Congress about key issues affecting the professions, and sign up to be a Grassroots Captain—needed from every congressional district and state across the country.
National Office Staff Updates
The following individuals are new to the ASHA staff since October 21, 2013:
- Nabil Ahmed, Network Engineer
- Sharon Barton, Membership & Sales Account Manager
- Ashley Bonorden, Meeting Support Specialist
- Gwen Fortune-Blakely, Director, Enterprise-Wide Marketing
- Cheris Frailey, State Education & Legislative Advocacy Director
- Ginger Harrison, Certification Operations Associate Director
- Heather Lewis, Meeting Support Specialist
- Cheryl Manley, Associate Business Systems Analyst
- Rhoni Rakos, User Experience Designer
The following individual has left ASHA to pursue other opportunities:
- Marva Smith, Certification Operations Manager (retired)
National Office and ASHA Awards
- The Corporate Volunteer Council (CVC) of Montgomery County presented ASHA with its 2013 Medium-sized Business Community Service Award. Each year, CVC selects one small, medium, and large business for recognition based on its demonstration of true passion for corporate volunteerism. CVC's membership comprises a broad cross section of roughly 70 businesses, universities, nonprofit groups, and local government agencies.
- The ASHA Community was awarded a "2013 Community of the Year" by Higher Logic, a provider of online communities for ASHA and 425 other associations, users' groups and businesses. Some of the statistics that were cited when ASHA received this award in December included:
- more than 69,000 members have used the ASHA Community,
- more than 8,000 have added information to their profile,
- more than 3,500 have a profile picture,
- almost 4,000 downloaded the ASHA Community Mobile App,
- and more than 57,000 posts have been created.
The Next CEO Update
Cost Savings at the National Office