American Speech-Language-Hearing Association 2008 Public Policy Agenda

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. Expanding its peer review process, nearly 800 of comments were received and reviewed for the 2008 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 Susan Brannen (chair), Roberta Kreb, Joan Mele-McCarthy, Ninevah Murray, Kathleen Peterson, Linda Tepperman, Cynthia Terres (public member), Carolyn Wiles Higdon, Debra Sears, 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 2008 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. And 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 2008 Public Policy Agenda.

Issue Objectives

Each issue objective 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.

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

• Promote increased funding of Individuals with Disabilities Education Act (IDEA) with emphasis on achieving the following outcomes: 1) maximizing student outcomes through the establishment of manageable caseloads utilizing a workload approach; 2) including participation in early intervening activities using the Response-to-Intervention model (Part B); 3) increasing access to appropriate early intervention services (Part C), and 4) increasing efforts to recruit and retain qualified SLPs and audiologists to serve children (Part D).
• Promote state/federal financial aid policies and research funding opportunities, and collaborate with state agencies/CSD programs to support increased recruitment, including culturally/linguistically/ gender diverse candidates, to become students in masters and doctoral programs, as well as to support recruitment and retention of clinicians in educational and healthcare settings.
• Promote autonomy for the professions through direct patient access to audiology and supplier status (direct billing) of speech-language pathology services for Medicare beneficiaries, and ensure that appropriate professional work and technical components for these services are included in Medicare fee schedule payment rates.

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

• Seek expanded coverage, appropriate eligibility criteria, and adequate reimbursement for assistive devices, and diagnostic, habilitation and rehabilitation services from early detection and intervention (EHDI) to across the age span, provided by audiologists and speech-language pathologists under public and private health plans.
• 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.
• Promote the adoption of the standards in the Certificates of Clinical Competence (CCCs) to ensure that ASHA member standards are maintained in state legislative and/or regulatory actions, and to link the CCCs with salary increases for ASHA members.
• Promote use of a growth model to assess students with disabilities and meet the requirements of annual yearly progress (AYP) under the reauthorization of the No Child Left Behind (NCLB) Act, and consider legislative or regulatory remedies for inconsistencies created between NCLB and IDEA.
• Promote access, coverage and payment of audiology and speech-language pathology telepractice services to underserved health and education settings through 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.

• 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 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.
• 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 modification of the Social Security retirement benefits laws (e.g. Government Pension Offset and Windfall Elimination Provision) for employees in the public sector (health care and education) and influence current regulations and future legislation.
• Support federal and state policies for the regulation of bachelor level personnel that are consistent with the Association's criteria for appropriate training, supervision, and the delineation of job responsibilities to clearly distinguish them from licensed and certified audiologists and speech-language pathologists.
• 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.
• Investigate 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.

• Promote the importance of classroom acoustics and its impact on literacy, language and learning through collaboration with ANSI, federal and state departments of education, and national, state and local school board associations, teacher unions and the ASHA membership.
• 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.
• 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.