American Speech-Language-Hearing Association 2003 Public Policy Agenda

Issue Objectives | Highest Priority | Priority  | Monitoring | Planning

Issue objectives identified by ASHA members, committees and staff are developed through the GRPPB, chaired in 2002 by Monica L. Ferguson, and prioritized to focus and strategically plan the Association’s advocacy activities. Other 2002 GRPPB members responsible for this agenda include Dennis C. Hampton, Bernard P. Henri, Gloria D. Kellum, Jeri Logemann, Doreen Oyadomari, Suzanne Sommerville, Alicia Stewart and Larry Higdon (monitoring vice president), along with Jim Potter (ex-officio).

These issue objectives are intended to address the major public policy concerns of audiologists, speech-language pathologists, and speech/language/hearing scientists before federal and state governments. 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; and (b) its immediacy and likelihood that meaningful action will occur.

Each of the 2003 issue objectives was assigned to one of the following four categories:

The GRPPB intends to continue setting long-range goals and planning for other relevant issues in an effort to develop and incorporate attainable and measurable objectives into the Association' s annual public policy agenda. The GRPPB will be responsible for submitting an annual report on the success of the 2003 Public Policy Agenda.

It should be noted that these priorities are not absolute. Since no one can predict the course of Congress, state legislatures, or federal and state agencies, the Government Relations and Public Policy Board and GRPP Cluster view the placements as flexible. If a particular issue becomes more visible or appears to be headed toward consideration, the Association's level of activity will be adjusted accordingly.

ISSUE OBJECTIVES

Highest Priority ­ - requires immediate federal or state legislative or regulatory attention and requires major resources on the Association' s part.*

• Refine or modify current Medicare payment and coding policies to promote greater direct patient access and coverage of audiology and speech-language pathology services, particularly direct billing for speech-language pathologists in private practice settings and repeal of the $1500 cap under the Medicare Part B outpatient program.
• Seek expanded coverage of audiological evaluation and audiologic rehabilitation services by audiologists under the Medicare program, and other public or private health plans.
• Promote full funding and reauthorization of the Individuals with Disabilities Education Act (IDEA), including recruitment and retention of qualified personnel, Ph.D. faculty and researchers – with specific attention given to providing services to culturally and linguistically diverse children – and use of a workload analysis model to determine staffing needs.
  

Priority - is important to the Association -- activities to be determined as opportunity and available resources permit.*

• Promote the adoption of the standards in the Certificates of Clinical Competence (CCCs) and in other Association policies and programs (e.g., the Preferred Practice Patterns, Council on Academic Accreditation and Council for Clinical Certification) through federal, state and local laws and regulations governing the professions (e.g., Employment Non-Discrimination Act) with emphasis on linking the CCCs to salary increases for school-based members and to professional licensure or registration.
• Promote policy changes and member resources to expand direct patient access and coverage of audiology and speech-language pathology services in both public and private health plans, such as the Federal Employees Health Benefits Plans (FEHBP) and Blue Cross & Blue Shield plans.
• Seek expansion of early hearing detection and intervention (EHDI) programs and policies by public and private payors through adoption of a model bill to include reimbursement for coverage on screening and re-screening, follow-up audiologic evaluation and early intervention services.
• Promote state and local advocacy initiatives that use a workload analysis model to determine the number of audiologists and speech-language pathologists needed to provide quality services to school children.
• Continue to proactively shape federal, state and local policies on the role of and need for speech-language pathologists and audiologists in literacy programs, as well as promoting further research opportunities by ASHA members, member education and member advocacy resources.
  

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

• Increase availability of clinical research funding opportunities for doctoral candidates through the National Institutes of Health (NIH), Department of Education (ED) and National Institute for Occupational Safety and Health (NIOSH), with emphasis on EHDI and early literacy programs particularly for culturally and linguistically diverse populations.
• Promote access to and coverage of audiology and speech-language pathology services by means of telepractice (i.e., telemedicine/ telehealth/ telerehabilitation) to remote-site health and education settings in legislation, regulation or credentialing processes.
• Support the federal regulations that enforce standards to protect employees from noise-induced hearing loss or injury in the workplace, including the Occupational Safety and Health Administration’s (OSHA) record keeping rulemaking and recognition of audiologists as autonomous professionals responsible for occupational hearing conservation.
• Promote revision of the current Food and Drug Administration’s (FDA) “Conditions for Hearing Aid Sales” and on-line dispensing regulations.
• Continue to promote compliance materials and member resources for the electronic data interchange and privacy standards resulting from the Health Insurance Portability and Accountability Act (HIPAA) with the Centers for Medicare and Medicaid Services (CMS) and the Office of Civil Rights (OCR) within the U.S. Department of Health and Human Services.
• Promote teacher training policies and financial aid for audiology and speech-language pathology graduate programs and students in the reauthorization of the Higher Education Act.
• Promote the broadening of eligibility requirements for rehabilitation services and increased personnel development policies for audiologists and speech-language pathologists in the reauthorization of the Vocational Rehabilitation Act.
• Support revision and reauthorization of the Assistive Technology Act of 1998 (PL 105-394).
• Support federal managed care reform legislation and regulation that eliminates discrimination against private practice audiologists and speech-language pathologists based on license or certification.
• Advocate with the Centers for Medicare and Medicaid Services (CMS), Medicare intermediaries and carriers for the adoption of revised coverage guidelines for speech-language pathologists in dysphagia management, including the exclusion of the modified barium swallow (MBS) from the per diem charges of the Medicare skilled nursing facility (SNF) prospective payment system (PPS), the inclusion of mobile units, and the independent provision of fiberoptic endoscopic evaluation of swallowing (FEES) by speech-language pathologists.
  

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

Develop objectives and strategies for:

• Federal funding assistance of graduate clinical education, including promotion of training and recruitment programs for Ph.D. faculty and researchers, especially from racial/ethnic minority groups, in communication sciences and disorders.
• Support of federal and state legislation and regulations for the licensure and reimbursement of speech-language pathology assistants that are consistent with the Association’s criteria for credentialing SLP assistants and job responsibilities that clearly distinguish assistants from certified speech-language pathologists.
• Expanding professional autonomy and increasing payment for services through federal and state legislation that would classify audiologists and speech-language pathologists as equivalent to physicians under the Medicare fee schedule.
• Developing member education materials and submitting identified diagnostic code changes for the ICD coding systems for audiology and speech-language pathology services to the Centers for Medicare and Medicaid Services (CMS).

For more information, contact Jim Potter  at 800-498-2071, ext. 4125.