Flexibility to respond to key issues characterizes ASHA's 2013 public policy agenda and advocacy efforts at federal and state levels.
The 2013 agenda does not prioritize the issues—unlike previous agendas—enabling ASHA staff to address matters such as Medicare legislation, health care reform, reauthorization of federal education laws, and licensure as they arise in Congress, states, and regulatory agencies.
"No one can predict the course of Congress, state legislatures, or federal and state agencies," said Ellen Estomin, chair of the Government Relations and Public Policy Board (GRPPB), "so we need to be able to address issues as they occur or when an opportunity arises."
The agenda, approved by the ASHA Board of Directors in August, includes 11 broad issues of concern to audiologists, speech-language pathologists, and speech, language, and hearing scientists. GRPPB developed the agenda with input from a survey of ASHA members. ASHA received usable input from 4,055 individuals and/or groups, a 77% increase from last year.
The agenda is grounded in six foundational principles:
- Preservation of the highest standards of ethics.
- Commitment to quality client care and outcomes.
- Continued research in speech, language, and hearing science to promote evidence-based practice.
- Commitment to diversity and nondiscrimination.
- Commitment to members' services and benefits, including seeking reasonable workloads and paperwork reduction.
- Collaboration with other organizations and membership groups to achieve public policy goals.
The most pressing federal issues are related to Medicare:
- Equitable reimbursement for audiologists and SLPs.
- An alternative payment policy for Medicare outpatient therapy services.
- A comprehensive audiology Medicare benefit that includes diagnostic, monitoring, and rehabilitative services, as well as an opt-out provision for providers.
Federal and State
The agenda also includes several issues that call for advocacy at the federal and state levels:
- Federal and state funding for speech-language and audiology services provided in schools. As Congress and states seek to curtail education funding, ASHA will advocate for reauthorization and funding of the Elementary and Secondary Education Act (ESEA) and the Individuals With Disabilities Education Act (IDEA), as well as for the inclusion of speech, language, and hearing services and devices in federal literacy legislation. ASHA will support consistent language and terminology, including the term "highest qualified provider" in ESEA and IDEA; the adoption of appropriate accountability and evaluation measures for audiologists and SLPs; and reduced paperwork and administrative burdens. ASHA also will advocate for states to adopt IDEA Part C Infants and Families Program standards and waivers in Part C maintenance of efforts requirements.
- Promotion of hearing health care services and devices. ASHA will support hearing aid tax credit legislation, which will enhance consumer access to safe and effective hearing health care services, devices, and hearing aids, and will encourage stricter federal regulation and oversight of the sale and marketing of hearing aids and personal sound amplification products. We will support cost-effective regulations and standards to create workplace and school environments that facilitate hearing and prevent noise-induced hearing loss. Support for a comprehensive system of children's hearing health care services is also on the agenda, including implementation of the Early Hearing Detection and Intervention program, adoption of state hearing screening standards for school-age children, and insurance coverage for hearing aids and cochlear implants.
- Provisions in the Patient Protection and Affordable Care Act. ASHA will support states' inclusion of habilitative and rehabilitative services and devices provided by audiologists and SLPs as "essential health benefits" under the act. As Medicaid enrollment expands under the act, ASHA supports coverage of services provided by SLPs and audiologists, including services mandated by the federal Early Periodic Screening, Diagnosis, and Treatment program as well as hearing aids, cochlear implants, and augmentative and alternative communication devices.
Other state/federal issues on the agenda include:
- Support for private health plans' equitable reimbursement and inclusion of services and devices provided by SLPs and audiologists.
- Recognition of and reimbursement for services delivered through telepractice.
- Student loan forgiveness and/or federal loan interest incentives as a way to recruit and retain qualified personnel in schools and health care settings.
- Maintenance and expansion of Medicaid reimbursement and coverage policies.
ASHA will also advocate for several issues at the state level, including:
- Support for comprehensive, universal licensure that would allow members to practice in any setting and improve portability across state lines.
- Adoption of model licensing language and implementation of a service continuum that defines the credentials and competency requirement for SLPs, audiologists, and assistants.
- In consultation with state associations and advocacy groups, the hiring and retention of SLPs and audiologists as employees and/or consultants to state agencies to advocate for appropriate accountability measures, clearly defined roles and responsibilities in the professions, and suitable workloads.
GRPPB members include Ellen Estomin (chair), Maria Dixon, Catherine Gottfred, Regina Grimmett, Paul Kilney, Sharon Ringwalt, Luis Riquelme (ASHA-PAC member), Robert Turner, Shelly Victor, Nancy Mellon (public member), Theresa Rodgers (vice president of government relations and public policy), and George Lyons Jr. (ex officio).