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 45 pages of comments were received and reviewed for the 2005 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 Dennis C. Hampton (chair), Catherine Crowley, Terese Finitzo, Regina Grantham, Ann Horton, Jeri Logemann, Doreen Oyadomari, Kenneth Wolf, Cynthia Terres (public member), Catherine Gottfred (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 2005 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 2005 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 both the work component and the technical component for these services are included in Medicare fee schedule payment rates.
- Promote reauthorization, full funding, and implementation of the Individuals with Disabilities Education Act (IDEA), with emphasis on the recruitment and retention of highly qualified personnel, reducing caseloads/workloads, promoting effective early intervention and outcomes-based practices, and providing services to culturally and linguistically diverse children.
- Promote federal financial aid policies and priorities that support recruitment of students to doctoral programs and retention of Ph.D. 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 or continue to prevent implementation of the therapy cap on speech-language pathology services under the Medicare Part B outpatient program.
- Promote state and local initiatives to assist school-based members in better identifying and utilizing IDEA, Medicaid, and Early Reading funding for their programs, including the use of a workload analysis model to determine the appropriate resources needed to provide quality services.
- Seek expanded coverage of diagnostic and rehabilitation services by audiologists and speech-language pathologists under the Medicare program and other public or private health plans, such as the Federal Employees Health Benefits Plans (FEHBP) and Blue Cross & Blue Shield plans.
- Promote the adoption of the standards in the Certificates of Clinical Competence (CCCs) and other Association policies and programs in federal, state, and local laws and regulations governing the professions, with emphasis on linking the CCCs to salary increases for school-based members and to professional licensure.
- Seek expansion of early hearing detection and intervention (EHDI) programs and policies with emphasis on improved tracking, and reimbursement for screening and re-screening, follow-up audiologic evaluation, and early intervention services.
Monitoring - is relevant to the Association, but will be acted upon only when specific opportunities arise or conditions change member needs and priorities.
- Shape federal, state, and local policies on the role of and need for speech-language pathologists and audiologists in literacy programs, as well as encourage additional research on the role of speech-language pathology and audiology in literacy.
- Increase availability of research funding opportunities 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.
- 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) and other 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), Medicare intermediaries, and carriers for the adoption of revised coverage guidelines for speech-language pathologists in dysphagia management to exclude the modified barium swallow (MBS) from the per diem charges of the Medicare skilled nursing facility (SNF) prospective payment system (PPS), and to include the use of mobile units and the independent provision of fiberoptic endoscopic evaluation of swallowing (FEES) by speech-language pathologists.
- Develop member education materials and submit 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).
- Investigate the growth and acceptance of Health Savings Accounts and their impact on speech 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.
- Study factors that have resulted in vacancies in qualified speech-language pathology and audiology positions in educational and health care employment settings, and develop strategies to fill these vacancies and prevent state legislative or regulatory actions to reduce ASHA member certification/licensure standards.
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