American Speech-Language-Hearing Association 2011 Public Policy Agenda

Introduction

The ASHA Government Relations and Public Policy Board (GRPPB) are charged with developing an annual public policy agenda (PPA) that prioritizes the advocacy activities of the Association and, in particular, the Government Relations and Public Policy (GRPP) Cluster.

Issue objectives were identified by ASHA members, committees, and staff. Expanding its peer review process, over 2,700 comments were received and reviewed for the 2011 agenda. The issue objectives were then developed through the GRPPB and prioritized to focus and strategically plan the Association's advocacy activities. The GRPPB members responsible for this agenda are Linda Jacobs-Condit (chair), Ellen Estomin, Wayne Foster, Diane Golden, Charlette Green, Mary Hooper, Ryan McCreery, Joan Mele-McCarthy, Sharon Ringwalt, J. Timothy O'Neill (public member), Thomas Hallahan (monitoring vice president), and Lemmietta McNeilly (ex officio).

The issue objectives are intended to address the major public policy concerns of audiologists, speech-language pathologists, and speech, language, and hearing scientists. Each issue objective for the year is assigned to one of four priority levels based on (a) its importance to the Association's members and/or those they serve, (b) level of resources required to make progress, and (c) its immediacy and likelihood that meaningful action will occur.

Each of the 2011 issue objectives were assigned to one of the following four categories:

Highest Priority

requires immediate federal or state legislative or regulatory attention and requires major resources on the Association's part;

Priority

is important to the Association—activities to be determined as opportunity and available resources permit;

Monitoring

is relevant to the Association, but will be acted upon only when specific opportunities arise or conditions change member needs and priorities;

Planning

requires a concerted planning effort in order to develop specific objectives that can then be prioritized and acted upon.

The order of the issue objectives within each category is not a reflection of their relative level of importance or the resources expended throughout the year. It should also be noted that this list of issue priorities is not absolute. Since the course of Congress, state legislatures, or federal and state agencies can change, the Government Relations and Public Policy Board and GRPP Cluster view the placement of these objectives as flexible. If a particular issue becomes more visible politically or appears to be headed toward consideration, the Association's level of activity will be adjusted accordingly.

The GRPP Board has further organized the 2011 issue objectives into three categories: Policy (including service standards and coverage issue objectives), Funding (reimbursement and appropriations issues), and Personnel (recruitment, retention, and encroachment issues). New to the 2011 PPA are narratives that accompany each issue objective to help better describe the types of advocacy initiatives to be undertaken in the coming year.

The GRPPB also engages annually in strategic planning to address both emerging and long-range issues. This facilitates the preparation of attainable, measurable objectives for the Association's annual public policy agenda. The GRPPB will be responsible for submitting an annual report on the success of the 2011 Public Policy Agenda.

Highest Priority

Policy

• Ensure that private and public insurance policies do not exclude habilitative coverage of S/L/H services and equipment solely because those services can be provided by schools or other educational/developmental providers.¹
• Promote IDEA and ESEA policies that lessen the paperwork burden, increase service delivery efficiencies, address the role of SLPs and Audiologists in general education, special education (IDEA Part B), and early intervention (IDEA Part C), and support professional development (IDEA Part D).²

Funding

• Advocate for ESEA as a funding source for early intervening SLP/A services to support struggling learners, for all school districts.³
• Promote comprehensive Medicare audiologic reimbursement benefit for diagnostic, monitoring, and rehabilitative services, which could include direct access and tele-health services.⁴
• Increase recruitment and retention of a diversity of professionals in all settings.⁵
• Promote improved public and private coverage policies, regulations, and reimbursement rates for audiologists and speech-language pathologists across the age span including preventative, diagnostic, monitoring, habilitative and rehabilitative treatment, services, and equipment.⁶  

 Personnel 

• Recognize highly qualified SLP/teacher status under ESEA and restore highest qualified provider status under IDEA.⁷

Priority

Policy

• Develop alternatives or prevent implementation of the therapy caps on speech-language pathology services under Medicare Part B outpatient program.⁸
• Promote policies that ensure appropriate billing by IDEA providers for reimbursement by Medicaid and/or other insurers for speech, language, hearing services, and equipment.⁹
• Promote and support re-authorization of Early Hearing Loss Detection & Intervention (EHDI), with specific focus to comprehensive follow-up and coordinated management.¹⁰
• Support U.S. Access Board adoption of regulations for classroom acoustics using ANSI 2002 standards as part of ADAAG for new school building construction and/or renovations.¹¹

Funding

• Ensure that appropriate professional work and technical components for audiology and speech-language pathology services are included in Medicare fee schedule payment rates.¹²
• Promote access, coverage, quality standards, and payment of audiology and speech-language pathology tele-practice services to health and education settings through legislation, regulation, or credentialing processes.¹³
• Support increased IDEA and ESEA funding for services, equipment, and professional development related to students with speech, language, and hearing needs.¹⁴

Personnel

• Establish, promote, and disseminate model language that delineates a career continuum ladder for the professions that clearly specify the education, training, competencies, and supervision required.¹⁵
• Further the adoption of the CCC to ensure that ASHA standards are maintained across federal, state, legislative, and/or regulatory/licensing actions.¹⁶

Monitor

Policy

• Continue to develop and submit identified diagnostic code changes for the ICD coding systems for audiology and speech-language pathology services to National Center for Health Statistics.¹⁷
• Support federal policies and funding that address the prevention of noise-induced hearing loss.¹⁸
• Support laws and policies (such as ADA, ENDA) that promote non-discrimination based on disability, gender identity, sexual orientation, race, religion, age, and cultural or ethnic heritage.¹⁹

Funding

• Monitor the impact, utilization, and maintenance of federal ARRA stimulus funds on speech-language-hearing programs, services, and research.²⁰
• Support modification of Social Security retirement benefit laws (Gov't Pension Offset & Windfall Elimination Provision) for public sector employees who are in a non-Social Security retirement system.²¹

Personnel

• Support the use of speech-language pathologists and audiologists in leadership roles or as consultants within state agencies to (1) support the needs of students with communication impairments; (2) address legislative, regulatory, technical assistance, and professional development needs of speech-language pathologists, audiologists, educators, and families.²²
• Monitor the impact of free-trade agreements, such as North American Free Trade Agreement (NAFTA) and Central America Free Trade Agreement (CAFTA), on the supply of qualified bilingual speech-language pathologists and audiologists in the United States.

Planning

Policy

• Support U.S. ratification of U.N. Convention on the Rights of Persons with Disabilities.²³

Funding

• Increase availability for research funding opportunities and evidence-based practice through the Nat'l Institute of Health (NIH), Dept. of Education (ED/OSEP), Agency for Healthcare Research & Quality (AHRQ), Veterans Health.²⁴