Introduction
The ASHA Government Relations and Public Policy Board (GRPPB) is charged with developing an annual public policy agenda 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. More than 90 pages of comments were received and reviewed for the 2007 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 Kenneth Wolf (chair), Susan Brannen, Catherine Crowley, Regina Grantham, Kathleen Peterson, Tara Smith, Linda Tepperman, Cynthia Terres (public member), Carolyn Wiles Higdon, DeAnne Wellman Owre (monitoring vice president), and James Potter (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, and (b) its immediacy and likelihood that meaningful action will occur.
Each of the 2007 issue objectives was 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 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 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 2007 Public Policy Agenda.
ISSUE OBJECTIVES
Highest Priority - requires immediate federal or state legislative or regulatory attention and requires major resources on the Association's part.
- Promote direct patient access to audiology and speech-language pathology services for Medicare beneficiaries, including direct billing and ensuring that appropriate professional work and technical components for these services are included in Medicare fee schedule payment rates.
- Promote increased funding of the Individuals with Disabilities Education Act (IDEA 2004), with emphasis on establishing workloads/reducing caseloads to maximize student outcomes including participation in early intervening activities using the Response-to-Intervention model (Part B), increasing access to effective early intervention services (Part C), and recruiting and retaining fully qualified personnel to serve children and adolescents appropriately (Part D), particularly those from culturally and linguistically diverse populations.
- Promote state and federal financial aid policies and research funding opportunities that support recruitment of individuals to become students in doctoral programs and retention of doctoral faculty and researchers in communications sciences and disorders graduate programs, with emphasis on culturally/linguistically diverse candidates.
Priority - is important to the Association; activities to be determined as opportunity and available resources permit.
- Repeal, develop alternatives or continue to prevent implementation of the therapy cap on speech-language pathology services under the Medicare Part B outpatient program.
- Promote advocacy efforts to assist school-based members in better identifying and utilizing funding, (such as IDEA, Medicaid and Early Reading) to provide quality services to children.
- Seek expanded coverage of diagnostic, habilitation and rehabilitation services, and assistive devices, provided by audiologists and speech-language pathologists under public and private health plans.
- Promote the adoption of the standards in the Certificates of Clinical Competence (CCCs) to prevent state legislative or regulatory actions to reduce ASHA member standards, and link the CCCs to salary increases for ASHA members and to professional licensure.
- Collaborate with states and CSD academic programs to produce more qualified speech-language pathologists and audiologists to help mitigate shortages in both educational and health care settings.
- Seek expansion of early hearing detection and intervention (EHDI) programs and standardization of appropriate eligibility criteria for audiologic and speech-language evaluation, early intervention, and habilitation services.
- Promote access to and coverage of audiology and speech-language pathology telepractice services to remote-site health and education settings in legislation, regulation, or credentialing processes.
Monitoring - is relevant to the Association, but will be acted upon only when specific opportunities arise or conditions change member needs and priorities.
- Influence federal, state, and local policies to promote the role of and need for speech-language pathologists and audiologists in assisting students achieve success in literacy and support additional research on the role of speech-language development and skills on literacy.
- 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 the Employment Non-Discrimination Act (ENDA) legislation and Association policies that promote non-discrimination based on gender, race, sexual orientation, cultural or ethnic heritage.
- 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 online dispensing regulations.
- Advocate with the Centers for Medicare and Medicaid Services (CMS) and administrative contractors for the adoption of revised medical review guidelines for speech-language pathology and dysphagia.
- Develop education materials for ASHA members and submit identified diagnostic code changes for the ICD coding systems for audiology and speech-language pathology services to the National Center for Health Statistics.
- Investigate the growth and acceptance of Health Savings Accounts and their impact on speech-language and hearing benefits.
Planning - requires a concerted planning effort in order to develop specific objectives that can then be prioritized and acted upon.
- Support federal and state policies for the regulation and reimbursement of bachelor-degree graduates, assistants, and aides that are consistent with the Association's criteria for appropriate supervision, credentialing, and job responsibilities, and that clearly distinguish them from licensed and certified audiologists and speech-language pathologists.
- Promote use of a growth model to assess students with disabilities and meet the requirements of annual yearly progress (AYP) under the reauthorized No Child Left Behind (NCLB) Act, and consider legislative or regulatory remedies for conflicts created between NCLB and the Individuals with Disabilities Education Act (IDEA) that impact children served by ASHA members.
- Determine the impact of "free-trade" agreements, such as North American Free Trade Agreement (NAFTA), Central American Free Trade Agreement (CAFTA), (and the planned North American Union) on how they impact the supply of qualified speech-language pathologists and audiologists in the United States.
- " Determine the impact of the Social Security retirement benefit laws (e.g. Government Pension Offset and Windfall Elimination Provision) on ASHA members and the need to influence current regulations or future legislation.
- Increase availability of research funding opportunities and systematic evidence-based reviews through the National Institutes of Health (NIH), Department of Education (ED), Agency for Healthcare Research & Quality (AHRQ), Veterans Health Administration (VHA), and National Institute for Occupational Safety and Health (NIOSH), with emphasis on Early Hearing Detection & Intervention (EHDI) and early literacy programs for culturally and linguistically diverse populations.
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