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Using information obtained from ASHA members, the Legislative Council identified issues of concern related to culturally and linguistically diverse populations, programs and services in the schools, and use of technology. Based on these issues, the Executive Board identified three Focused Initiatives and associated outcomes. The Focused Initiatives received special resource allocations for the years 2001-2003. National Office staff developed specific work plans to achieve the desired outcomes. The Focused Initiatives; the associated work plans for 2001, 2002, and 2003; and progress reports for each year are available.
Many of the strategies planned for 2003 will not be completed until the end of 2003. Therefore, it is not possible to conduct a comprehensive impact evaluation at this time. To conduct an impact evaluation of the 2001-2003 Focused Initiatives, measurable Indicators of Success have been identified for each Focused Initiative. These Indicators of Success will be used to determine if ASHA has achieved the desired outcomes as included in the Focused Initiatives.
Following is an interim progress report related to some of the work plan strategies implemented and the accomplishments through the third quarter of 2003 for each of the Focused Initiatives.
For additional information related to the ASHA Focused Initiatives, contact Stan Dublinske, Senior Advisor for Planning at sdublinske@asha.org.
FOCUSED INITIATIVE: Culturally/Linguistically Diverse Populations
ISSUE: Demographic and caseload changes related to culturally/linguistically diverse populations require the acquisition of knowledge and skills by ASHA members to meet the needs of these groups, the provision of additional and improved services to these populations, and an ASHA membership that reflects the culturally diverse groups in society.
OUTCOME 1: Increase the number of racial/ethnic minority members of ASHA.
2003 Strategy Update
1. Developed documents titled "Compendium of Exemplary Practices by Colleges and Universities in the Recruitment, Retention and Career Transition of Communication Sciences and Disorders (CSD) Professionals," "Exemplary Practices in Recruitment, Retention and Career Transition of Racial/Ethnic Minorities to Communication Sciences and Disorders (CSD)," and "Minority Student Recruitment, Retention, and Career Transition Practices: A Review of the Literature." These documents are on the ASHA Web for member access.
2. Developed ad campaigns targeting African American and Latino populations and disseminated print ads, web banner ads, and posters promoting the professions to targeted Historically Black Colleges and Universities, Hispanic Serving Institutions, and other selected colleges/universities with large African American and Latino populations.
3. Developed a recruitment kit to provide academic programs with quality recruitment materials that include posters, web banners, and ads.
4. Developed and distributed book covers promoting the professions to high school students from culturally diverse backgrounds.
5. Developed and piloted an Online Mentoring Portal with the Minority Student Leaders that can now be used for other groups of students and new professionals.
6. Developed a "how-to" manual on CD-ROM for dissemination to state associations for replicating the Minority Student Leadership Program at the state level.
OUTCOME 2: All ASHA members will have access to ASHA resources developed to facilitate the acquisition of cultural competency for increasing and improving service delivery to multicultural populations.
2003 Strategy Update
1. Developed web-based self-assessment tools for use by speech-language pathologists and audiologists to evaluate their cultural competence for providing clinical services.
2. Adapted and translated the "How Does Your Child Hear and Talk" brochure into Spanish and Chinese, and "Newborn Hearing Detection and Intervention," "Noise: Bad for your Hearing, Bad for Your Health," and "Hearing for a Lifetime" brochures into Spanish., that are available through ASHA Product Sales. Another brochure, "Communication for a Lifetime," has been translated and will be available by year-end.
3. Sponsored a keynote speaker for the Schools Conference on "Cultural Humility: A New Approach for the Age of Cultural Competence."
4. Developed a brochure on bilingual language development for parents/consumers entitled "Learning Two Languages" and "El Nino and El Bilinguismo" that is available in English and Spanish through ASHA Product Sales.
5. Developed a CD-ROM titled "African American English: Structure and Clinical Implications" that is available for members through ASHA Product Sales.
6. Developed self-study instructional videotapes on "Cultural Competence in Audiology Practice" and "Working with Interpreters to Serve Bilingual Children and Families" that are available for members through ASHA Product Sales. "Assessment of Bilingual Learners: Language Difference or Disorder?" will be completed by year-end.
7. Developed a module focusing on multicultural infusion in academia that has been included in the Council for Academic Accreditation (CAA) Site Visitor update/calibration meetings and training manual. Supplemental resource materials for faculty members are being posted to ASHA's website.
8. Compiled data on phonological and syntactic structure for 7 foreign languages, including Spanish, Chinese (Mandarin and Cantonese dialects), Vietnamese, Hmong, Arabic, Korean, and Bosnian, for use in developing technical assistance material for ASHA members.
FOCUSED INITIATIVE: School-Based Programs and Services
ISSUE: A full scale, multi-faceted approach at the federal, state and local levels is needed to address ASHA member concerns indicating that many service programs in the schools require caseloads for speech-language pathologists and audiologists that are too high in number to provide quality services, that salaries are not commensurate with the specialized knowledge and skills needed to provide quality services, and that many state and local policies impede the ability of speech-language pathologists and audiologists to provide quality services in the schools.
OUTCOME 1: Increase the number of states that use total workload time activities, including but not limited to IEP meetings, administrative tasks, diagnostic time, paperwork, consultation, planning time, and frequency and duration of direct clinical service to determine the number of cases that can be adequately and appropriately served.
OUTCOME 2: Increase the number of states that link the ASHA Certificate of Clinical Competence through legislation and regulation as a means for salary increases for school-based ASHA members.
OUTCOME 3: All school-based ASHA members will have access to information about evidence-based practice related to provision of quality services and access to ASHA products, information, and activities necessary for full implementation of IDEA.
2003 Strategy Update
1. Continued work of the State Education Action Team with the following states on obtaining salary supplements and caseload/workload issues: Oklahoma—bill submitted to recognize advanced certification for a salary supplement; Rhode Island—bill passed to provide financial assistance for speech-language pathologists seeking the Certificate of Clinical Competence; Virginia—State Board of Education has recommended reducing caseload size from 68 to 60; and West Virginia---working with the State Board of Education, State Department of Education, and the West Virginia Education Association on issues related to personnel shortages.
2. Worked with the Kansas State Speech-Language Hearing Association and Kansas school districts to pilot and implement activities related to ASHA document titled, A Workload Analysis for Establishing Speech-Language Caseload Standards in the Schools.
3. Developed a video and audio enhanced document on successful, member initiated, advocacy initiatives. The document will be placed on the ASHA Web site for access by members.
4. Awarded grants to the following state speech-language-hearing associations to initiate salary supplement activities: Indiana-$3,000; Nevada-$5,000; Oklahoma-$10,000; Rhode Island-$7,000; West Virginia-$5,000. A grant in the amnount of $6000 was awarded to the Kansas Speech-Language-Hearing Association to work on caseload/workload issues.
5. Continued support of the State Education Advocacy Leaders (SEALs) network by holding conferences calls to discuss IDEA reauthorization, Medicaid billing, caseload/workload, salary supplements, and reimbursement opportunities.
6. Provided financial support for SEALS to conduct in-state activities related to IDEA, salary supplments, and caseload/workload issues.
7. Provided information related to the ASHA document , A Workload Analysis for Establishing Speech-Language Caseload Standards in the Schools via presentations made at meetings in the following states---Arizona, California, Florida, Illinois, Indiana, Kansas, Kentucky, Maine, Minnesota, Missouri, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Texas, Virginia, and Wisconsin. In addition, presentations were made at the Council for State Association Presidents, the ASHA Schools Conference, and an ASHA teleweb seminar was held.
8. Obtained member input to define and clarify barriers and challenges in urban and rural settings related to caseloads, salary supplements, and implementation by holding two focus groups (one on urban issues and one on rural issues) at the ASHA Schools Conference.
9. Initiated/maintained liaisons with other national organizations by exhibiting at the National Education Association convention; having the National Association of State Directors of Special Education (NASDSE) president as a keynote speaker at the Schools Conference; holding discussions with Voices, a parent group; and, participating in a policy summit for COPSSE (Center for Personnel Studies in Special Education).
FOCUSED INITIATIVE: Use of Web-based and Advanced Technology (Web Portal)
ISSUE: ASHA and its members need to improve their use of Web-based and advanced technology to enhance the provision of personnel preparation, provision of clinical services including telepractices, and program administration and to provide value-added programs and services for members, consumers, and the public by making available general and customized knowledge, information, e-commerce, and advanced electronic communication capability.
OUTCOME 1: ASHA’s Web site will be recognized as the national and international portal for obtaining knowledge, information, and other resources related to communication sciences and disorders, and speech, language, and hearing for audiologists, speech-language pathologists, speech, hearing, and language scientists, consumers of service, and the general public.
2003 Strategy Update
1. Received recognition for Web site excellence several times in 2002 and 2003. Association Trends, a weekly association trade publication, recognized ASHA's web site as the Best Association Web Site in 2002. The Society of National Association Publishers (SNAP) gave ASHA a total of five medals in the 2002 and 2003 Excel Awards program for excellence in design, members-only area, in-house electronic advertisements, and editorial content.
2. Completed a redesign of the ASHA Web site based on an ASHA Web usability and accessibility study. The design increases the ability of members to locate information via the navigation system and dramatically increases the overall accessibility of the web site for those who use assistive technology such as screen readers. The new design also enhances the perceived value of ASHA membership by grouping all member-only content in a single, easily identified member-only area.
3. Deployed a new Web site search engine that provides support for integration of the ASHA thesaurus and allows fine tuning of search results for improved results when Web site users search for information.
4. Conducted a record-setting online forum Q&A on the topic of Oral Motor Treatment in September. Six special interest divisions participated in developing and hosting the event. This event generated the highest level of traffic in the ASHA member forums ever recorded.
5. Developed systems for publishing HTML versions of ASHA journal articles in 2004. PDF versions of journal articles have been available on the ASHA web site since 2001.
FOCUSED INITIATIVE: Use of Web-based and Advanced Technology (Telepractices)
ISSUE: ASHA and its members need to improve their use of Web-based and advanced technology to enhance the provision of personnel preparation, provision of clinical services including telepractices, and program administration and to provide value-added programs and services for members, consumers, and the public by making available general and customized knowledge, information, e-commerce, and advanced electronic communication capability.
OUTCOME 2: All ASHA members will have increased knowledge and access to ASHA products, information, and activities related to the use of telepractices in the delivery of clinical services in audiology and speech-language pathology.
2003 Strategy Update
- Conducted a telephone seminar on "Telehealth Service Delivery in Speech-Language Pathology and Audiology" in collaboration with the Rehabilitation Engineering Research Center at the National Rehabilitation Hospital.
- Presented a seminar on telehealth in speech-language pathology and audiology at the meeting of the National Association for Home Care.
- Awarded three grants in the amount of $4000 each to organizations that have successfully implemented telehealth programs. Grants were awarded to Integras Health, Oklahoma City, Utah State University, and the Technology Access Foundation in Fargo, ND. Each organization is to develop materials that will showcase their telehealth program for ASHA members that wish to initiate a telehealth program.
- Established a working Group on Telepractices to develop ASHA policy documents on telepractices.
FOCUSED INITIATIVE: Health Care Reimbursement (Added for 2003)
ISSUE: Coverage rules and reimbursement rates are increasingly affecting access to, and scope of services provided by audiologists and speech-language pathologists.
OUTCOME 1: ASHA members will have access to information and tools to effectively negotiate with private health plans to ensure appropriate coverage criteria and equitable reimbursement rates.
2003 STRATEGY UPDATE
1. Developed an instructional module on how to advocate/negotiate for private health plan coverage for speech-language pathology and audiology services that was presented in the following states—Nebraska at the State Advocates for Reimbursement (STARS) "boot camp," Florida, Hawaii, Wyoming and Oregon. A post-ASHA convention session will be held in Chicago.
2. Update actuarial information regarding the per member, per month average costs for covering audiology and speech-language pathology services in health plans.
3. Developed promotional information related specifically to reimbursement including existing ASHA/non-ASHA tools and resources related to private health plan coverage for speech-language pathology and audiology. The information will be placed on a new ASHA Web site on reimbursement (e.g. Medicare, Medicaid, private payers, and coding) for access by members.
4. Developed a database to track coverage and reimbursement policies of health plans, insurers and employers for use in developing a Healthcare Report Card.
5. Developed the State Advocates for Reimbursement (STARS) network. 40 states plus the District of Columbia have appointed a representative. A reimbursement boot camp was held in May for the STARs. A listserv and community forum has been established. The STARs have finalized their goals for 2004.
OUTCOME 2: Increased number of employers that cover comprehensive speech-language pathology and audiology services in their health benefits package.
2003 STRATEGY UPDATE
1. Developed a "how to" check list to encourage and help members approach their employers about including speech-language pathology /audiology services in their insurance coverage. The checklist is available to the membership through Action Center and on the ASHA Web site.
2. Developed and sent letters and supporting documentation to 10 human resource organizations requesting better coverage for speech-language pathology and audiology in health benefits packages.
3. Worked with the UAW on increasing coverage for speech-language pathology and audiology in their health benefits package prior to their negotiations with auto manufacturers.
4. Developed the 2003 health plan report card that ranks 6 health plans in terms of their coverage of audiology and speech-language pathology services.
OUTCOME 3: Increased number of states introducing legislation that mandates appropriate coverage of audiology and speech-language pathology services.
2003 STRATEGY UPDATE
1. Developed model bills for mandated insurance coverage for hearing aids for children, mandated coverage of speech-language pathology and audiology services, and mandated offering of services.
2. Exhibited at the annual meeting of the National Conference of State Legislatures and promoted mandated speech, language, and hearing health benefits. Over 500 contacts on this topic were made. Attended the Council of State Governments meeting to promote mandated speech, language, and hearing health benefits.
3. Awarded grants to four state speech-language-hearing associations to pursue passing of legislation to mandate insurance coverage for speech-language pathology and audiology services. Grants were awarded to Kansas-$7,000; Tennessee-$4,875; Florida-$4,400; and Virginia-$5,000.
OUTCOME 4: ASHA members will have access to information and tools to help them effectively navigate state funded insurance programs (e.g., Medicaid, CHIPs) at the state and local level to ensure appropriate coverage criteria and equitable reimbursement rates.
2003 STRATEGY UPDATE
1. Recommended that a technical report and position statement be developed regarding supervision of bachelor-level speech-language clinicians providing services, with future development of guidelines and a knowledge and skills document specific to services in the schools.
2. Reviewed Office of the Inspector General (OIG) reports that continue to unearth problems during their ongoing investigations into school-based billing of Medicaid services. Based on the OIG findings, information needed by ASHA members will be prepared regarding Medicaid compliance.
3. Prepared information on extant ASHA Medicaid resources for inclusion on the ASHA Web site related to reimbursement and developed a logo and slogan to use to market ASHA’s Medicaid resources.
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