Speech-language pathologists in Michigan have learned an important advocacy lesson: Sometimes the squeaky wheel does, indeed, get the grease.
Four years ago, Michigan SLPs celebrated when the state legislature passed a law establishing licensure. I remember the exact moment I found out: I received a phone call on Dec. 19, 2008, at 2 a.m. from our lobbyist (I did tell her to call any time day or night!), who said, "You guys did it, you got the votes." We were excited and relieved that the decades of advocating for licensure in Michigan had come to a close—or so we thought.
In April 2012, a report from the Michigan Office of Regulatory Reinvention proposed that the state deregulate 10 professions, including speech-language pathology, taking away what we worked so hard to accomplish. I remember where I was that day, too, sitting in a hospital waiting room (my father was having surgery), making phone calls, sending e-mails and reading articles to get more information.
The report found there were "at least 18 occupations that did not require regulation. These regulations provide little or no significant protection to the public." The report also indicated there would be no "clear harm to the public if they were treated by an unlicensed speech pathologist." The report was part of an attempt by the governor's office to reduce unnecessary cost to and involvement of the government in a variety of occupations, and indicated that, "According to a 2007 study, Michigan is the sixth most heavily regulated state with respect to occupational licensing." The report estimated that each occupation regulated by a state would experience a decrease in the rate of job growth by an average of 20 percent.
We felt targeted, frustrated and angry. We respect the committee's desire to reduce government expense and agree that some professions may not need government regulation, but we disagree strongly that speech-language pathology should be included in this proposal, for many reasons:
- Consumers need protection from those unqualified to work in our field, and incompetence will cause harm.
- Without licensure or a law to define the practice of speech-language pathology, there is no avenue of recourse for those harmed by unqualified providers.
- Without licensure, consumers in Michigan lose access to qualified care.
- Having a license in the state will not decrease the job rate or cause professionals to leave the state; the majority of our membership worked hard to obtain licensure.
- Every other state requires a license or another similar qualification to protect consumers.
- SLPs will experience a loss of income because increasing numbers of insurers require providers and agencies to have a license to be eligible for reimbursement.
With these facts in hand, the Michigan Speech-Language-Hearing Association jumped on this issue, kicking and screaming, as soon as it surfaced. With support from ASHA, we launched an extensive grassroots effort to stop the legislature from passing a law that would implement the report's recommendation and deregulate speech-language pathology.
According to an ASHA Leader column by 2008 ASHA President Kate Gottfred, there are four building blocks of successful advocacy: accountability, knowledge, preparation and information. Using this framework—which has been very beneficial for MSHA's advocacy committee in the past—we decided that our entire organization, along with ASHA, would take on the accountability of advocating for the retention of licensure and hold the Office of Regulatory Reinvention accountable for the statements they made about the profession of speech-language pathology.
With our lobbyists' knowledge of the political system and key players, and our professionals' knowledge of the field, we gathered information that led to a grassroots plan. We decided to focus on educating legislators about SLPs' qualifications and scope of practice, potential harm to a client and consumer protection:
- We sent letters from ASHA and MSHA to the governor and his staff, as well as to all members of the House Regulatory Reform Committee, the body that would introduce and proceed with legislation to deregulate.
- We contacted MSHA members to let them know about the report and the grassroots efforts to block deregulation.
- We provided speaking points for members to use when calling or writing to their legislators.
- We continue to provide ongoing information about the advocacy efforts on our website and in newsletters.
At this point, we have had success in delaying the deregulation. As our lobbyist describes, the issue is just not on the legislature's radar screen—they're not even talking about it. In an election year, officials didn't want to touch an issue with so much opposition. We will continue to monitor the state legislature for any signs of a law to put this proposal in action.
All advocacy efforts are learning experiences, and this one is no different. We know now the importance of ongoing use of a lobbyist, continual communication with ASHA, frequent committee phone and e-mail contact and frequent contact with colleagues. We've also started to have quarterly meetings with our lobbyist to plan and execute further steps in the legislative process. Mostly, we have learned never to feel safe from an undesired change and about the unpredictable nature of our political climate.
In a 2004 ASHA Leader article, Nancy Swigert said, "...advocacy for yourself and your patients doesn't always result in the solution you hoped for. But without advocacy, it's unlikely you'll ever solve the problem. Take the first step. Make up your mind to move forward toward getting what you need." That, we can do!
View state-by-state requirements for licensure at our "State-by-State" page.