Blueprint for Action: 2017 ASHA Public Policy Agenda

Download the full Blueprint for Action: 2017 ASHA Public Policy Agenda [PDF].

See additional position statements about issues related to health care and education.

The Blueprint for Action—2017 Public Policy Agenda (hereafter, "the Blueprint") sets forth those issues that are of highest priority for advocacy for and by members of the American Speech-Language-Hearing Association (ASHA). The Blueprint is developed annually by ASHA's Government Relations and Public Policy Board (GRPPB), and it guides the advocacy efforts that are undertaken by the Association and its members. In addition, the GRPPB developed the Blueprint with ASHA's Strategic Objective #5 (Increase influence and demonstrated value of audiology and speech-language pathology services) in mind. For example, the Blueprint calls for increasing reimbursement, demonstrating value and quality of services, expanding telepractice and telehealth by the professions, creating a license compact, reversing insurance denials, and creating equitable alternative payment models.

In previous years, the development of the annual public policy agenda was based solely on the results of a survey fielded to members. During the past 5 years, there has been very little change in the issues that members have ranked on the survey, and we began to see member fatigue in completing the survey annually. Due to decline in member response rates, the survey was not done in 2016, and the frequency for conducting the public policy agenda survey was changed to occur every 2–3 years.

When developing the 2017 Blueprint, GRPPB members reviewed the trends in the survey results for the past 5 years as well as their own collective expertise. The GRPPB consists of members from a diverse background of employment settings, geography, and professional experience. They also reached out to other ASHA committees, boards, and Special Interest Groups (SIGs) to identify policy issues and help determine what issues are most important to members moving forward.

During development of the Blueprint, the GRPPB audiologists and speech-language pathologists (SLPs) conducted separate breakout sessions to consider issues facing each profession. In addition, members of ASHA's government relations staff shared information on the issues that they typically are dealing with as well as the inquiries that they typically receive from members. Finally, discussions were held on the political climate for the upcoming year to help determine what goals may and may not be possible to achieve.

The 2015–2016 timeframe was a very successful year for advocacy. We saw two federal bills signed by President Obama: (a) the Steve Gleason Act, which allows greater access to speech-generating devices and (b) the Every Student Succeeds Act (ESSA), which reauthorized and replaced the No Child Left Behind Act. In addition, the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act repealed the sustainable growth rate formula for Medicare and replaced it with a new payment formula based on quality, clinical improvement, information records, and merit-based pay. Substantial progress has been made toward reauthorizing the Early Hearing Detection and Intervention Act. At the state level, ASHA and member advocates were successes in addressing numerous issues, some of which included licensure, telepractice, hearing aids, scope of practice, and insurance coverage. These and other successes led the GRPPB to make changes in the 2017 Blueprint.

The changing landscape for reimbursement, practice, and accessibility of more affordable speech and hearing devices has contributed to how ASHA will address these issues in the 2017 Blueprint. For example, the National Academy of Science and the President's Council of Advisors on Science and Technology have both recommended a new class of over-the-counter hearing aids and/or devices to treat mild-to-moderate hearing loss.

ASHA must continue to educate members and policymakers on realistic changes to policy and practice necessary to compete in the changing health care landscape and the challenges of practicing in school settings as ESSA is implemented. Issues identified in the 2017 Blueprint are those—after careful analysis—that have been deemed (a) feasible in the current federal and state political climate and (b) a wise use of member resources. Some issues, such as paperwork and caseload reduction, are multipronged and will require policy efforts at the federal, state, and local levels. The success of other issues, such as Medicare opt-out, direct access, and/or limited license physician status, are problematic in the current political climate and within the changing health care industry where topics related to medical home and accountable care organizations are trendsetters moving away from direct access.

The 2017 Blueprint consists of 15 issue objectives. An additional issue was added to the 14 issues addressed in the 2016 Blueprint. That issue, which pertains to the treatment of Social Security benefits for public sector employees, was last included in the 2012 Blueprint but had been removed in subsequent versions of the Blueprint because there was no action on Capitol Hill regarding the issue. Because additional federal legislation has been introduced to address offsets to Social Security benefits for audiologists and SLPs working in school settings, there is a need to address such legislation next year.

The issues in the 2017 Blueprint are divided into the following three categories (a) health care, (b) education, and (c) professional. These types of issues are advocated for and implemented at the federal, federal/state, and state levels. A federal issue may be an act of Congress, a proposed regulation at a federal agency (e.g., U.S. Department of Education, Executive Order by the President). Most of the issues that we address occur at both the federal and state levels. For example, Medicaid is a federal/state partnership between guiding policies that are formulated at the U.S. Department of Health and Human Services and then implemented and altered at the state level. Other issues, such as scope of practice, can include bills at both the federal and state levels. Finally, some issue types—primarily professional—are within the state domain.

Health Care



Foundational Principles

The 2017 Blueprint also contains seven foundational principles:

  1. Ethics
  2. Client care and outcomes
  3. Evidence-based practice
  4. Diversity and Inclusion
  5. Nondiscrimination
  6. Commitment ASHA members (audiologists and SLPs)
  7. Collaboration

Member Advocacy

ASHA members can help move ASHA's advocacy efforts forward by serving as advocates for the professions. 

They can 

  • share the Association's Blueprint for Action—2017 Public Policy Agenda with peers to educate others on the advocacy efforts for 2017;
  • review ASHA's legislative accomplishments in the 2015–2016 ASHA Advocacy Report [PDF];
  • participate in e-advocacy at the federal and state levels through ASHA's Take Action website;
  • learn more about ASHA's Political Action Committee on ASHA's website; 
  • meet with members of Congress in their home districts or on Capitol Hill; 
  • work with state associations to advance state regulation and legislation favorable to members and consumers; and 
  • follow ASHA Advocacy on social media ( Facebook and Twitter). 

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