2018 Original Letter and Response
Read Marissa's Rocheleau's 2018 letter to the ASHA Board of Directors, with 350+ SLP signatures discussing the difficulties faced in the field and ways ASHA can help advocate for its members. Also read ASHA's full response.
2018 Original Letter to ASHA
Marissa Artman, M.A., CCC-SLP
[Address Redacted]
(317) 225-8349
07/30/2018
​
Board of Directors
American Speech-Language-Hearing Association
2200 Research Boulevard
Rockville, MD 20850
​
Dear Board of Directors:
​
I am writing you today both as a concerned member of our profession, but also as a representative for a larger group of a speech language pathologists with similar concerns. My own experience in coming to this mindset grew out of several years of work in schools, private practice ownership, and telepractice contracting, with many unsuccessful attempts to grow my career in the medical and academic fields of speech. In preparing to bring the following points to your attention, I have also spoken with many dozen speech pathologists who themselves work in schools, outpatient clinics, private practice, skilled nursing facilities, hospitals, contract positions, and academic research. This is to highlight that the petition of this letter is not indicative of select disenfranchised clinicians, but instead a pervasive shift in the field felt by professionals and even students in all capacities of speech language pathology.
​
On online forums such as www.reddit.com/r/slp, you can find a swath of new posts each day from careworn clinicians asking for help, struggling with mental health, and even considering leaving the profession. As one of those clinicians myself, I know this decision comes with a heavy heart after the many passionate hours devoted to becoming a speech language pathologist and the pride we take in contributing to a field that truly changes lives. I would encourage you to read more about the status of our field from the perspective of these on-the-ground professionals, but below I have highlighted some of the most frequent discussions found in talking with other speech pathologists.
· Many speech pathologists find it difficult to find full-time work with benefits. This results in highly trained clinicians and educators relying on spousal benefits, multiple part-time jobs, or supplementary work unrelated to the field to make ends meet.
· There is an unsustainable model of productivity and practice driven by third party payers and cost-cutting measures that causes faster turnover and burn out in professionals. In turn, this adversely affects our clients by reducing the quality of their service and continuity of care.
· While job reports indicate a growing need for speech pathologists, there is a disparity in the money available to fund these positions, resulting in lower paying positions, increasing contract positions without benefits, and a surplus of applicants in the job market.
· An alarming number of positions are being filled by staffing agencies without regard to the quality of care or goodness of fit of the clinicians hired, thereby again increasing turnover. This also reduces the amount of money going into the pocket of clinicians, while increasing costs to schools, clinics, and hospitals. It is especially alarming to see ASHA directly partnering with and endorsing agencies.
· At the bottom of all this, there is a lack of representation from our paid electors to lobby for appropriate workloads, healthcare coverage for clients, and licensure compatibility in an increasingly global world.
​
To address these issues, we strongly implore ASHA to more actively champion us as our leader in making meaningful change not only in the everyday lives of its members, but in the quality of services and impact that clients and the public experience because of our ability to succeed professionally.
​
We believe the following suggestions can help combat these concerns in an active, appreciable way.
​
· Make direct recommendations on caseload and workload sizes to unions and employers.
· Make strong lobby partnerships with healthcare and insurance organizations for better payment reimbursement for speech pathology services.
· Look toward the future of telepractice regulations in relation to licensure and reimbursement.
· Discontinue direct partnership with staffing agencies and disincentivize employers from using poor quality hiring practices resulting in high turnover.
· Actively campaign for better work-life balance in the profession, including a push for more full-time jobs and/or jobs with benefits, mental health awareness, and public awareness for the breadth and importance of what speech pathologists do.
​
Thank you for reading this letter and its enclosed concerns. We know that in taking the time to do so, you are actively listening to your constituents and taking steps to address the needs of the profession in a time of great growth and change. We would not write you if we did not care deeply for the profession and believe it was worth working toward a better future of all aspects in speech, hearing, and science.
Sincerely,
Marissa Artman, M.A., CCC-SLP
ASHA #14023891
​
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Nancy Neilan Schafer, M.A., CCC-SLP #01005037
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Jill Shook, M.S., CCC-SLP #12159813
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Carrie Steenbergen, M.S., CCC-SLP #12056119
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Leslie Fraser, M.S., CCC-SLP #01032823
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Jena H. Castro-Casbon, M.S., CCC-SLP #12101414
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Jeanne Farina, M.A., CCC-SLP #12096006
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Lisa Gargaro, M.A., CCC-SLP #14258830
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Christina Hanks LeBlanc, M.A., CCC-SLP #01101918
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Carol Lovelace Wadley, MCD, CCC-SLP #01080721
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Elisheva Samuels, M.S., CCC-SLP #12085421
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Sharon Weisberg, M.S., CCC-SLP #14115903
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Christina Morales, B.S., SLPA #35960
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Casey Ruffin, M.S., CCC-SLP #14078849
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Dino Atikovic, M.S, CCC-SLP #14115140
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Debra Carol Porter, M.S., CCC-SLP #12017978
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Lori Carozza, M.A., CCC-SLP #09141455
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Michelle Miller, M.S., CCC-SLP #14033432
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Nissa Harrell, M.S., CCC-SLP #14180891
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Christin Schroeder, M.S., CCC-SLP #14038850
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Sarah Karmacharya, M.A., CCC-SLP #14049944
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Mary Reynolds-Gilmore, CCC-SLP #01097764
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Aizel Agustino, M.A., CCC-SLP #14128411
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Alicia Martin-Cowger, M.S., CCC-SLP #14146960
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Stefanie Rutledge Apple, M.A., CCC-SLP #14029990
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Hadasah Chapman, M.A., CCC-SLP #14067007
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Lauren Pontoppidan, M.A., CCC-SLP #14055512
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Bryan Gilstein, M.A., CCC-SLP #14051737
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Lea A. Carey, M.S., CCC-SLP #12062379
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Jan Hobbs, M.S., CCC-SLP #12099274
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Roman Konovsky, M.A., J.D., CCC-SLP #14113692
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Amy Schiwitz, M.S., CCC-SLP #12156506
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Meghan Powers, M.S., CCC-SLP #12159864
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Vannessa Neunder, M.A., CCC-SLP #141008613
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Leslie Buck, M.A., CCC-SLP #12062854
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Leigh Carrico Mann, M.S., CCC-SLP #12061439
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Carrie Elliot, M.A., CCC-SLP #14038684
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Jessica Irving, M.S., CCC-SLP #12061211
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Paulina Louie, M.A., CCC-SLP #12129726
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Sabrina Shepherd, M.A., CCC-SLP #07121
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Sarah Sung, M.A., CCC-SLP #14093798
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Jennie Larsen-Fritcher, M.S., CCC-SLP #12103977
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Catherine Hambly, M.A., CCC-SLP #12060087
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Donna Moore, M.A., CCC-SLP #12138188
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Natalie Waldman, M.A., CCC-SLP #14056888
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Ellen Nee, M.S., CCC-SLP #12003690
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LisaRose McCabe, M.A., CCC-SLP #12153030
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Diana Harmon, SLP #01068245
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Kelly M. Kuehl, M.A., CCC-SLP #12073236
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Jayne Corey, M.A., CCC-SLP #12154010
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Kacy Kreger, M.A., CCC-SLP #14107520
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Elizabeth Guyer, undergrad in NSSLHA
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Kathleen C. Kelsay, M.S., CCC-SLP
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Amanda Orchekin, M.S., CCC-SLP #14039118
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Elizabeth Glover, M.S., CCC-SLP #12097535
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Jill Odle, M.S., CCC-SLP #12040446
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Amanda Lett, M.A., CCC-SLP, BCBA #12116252
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Janet Dudley, M.Ed., CCC-SLP #09126643
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Jennifer Hawkes, M.S., CCC-SLP/ATP #12083074
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Caroline Tobias, M.S., CCC-SLP #14089471
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Angie Chandlee, M.A., CCC-SLP/L #12141718
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Stephanie Price, M.A., CCC-SLP 14024003
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Amanda Myers, M.S., CCC-SLP #09147480
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Georgia Garcia, M.S., CCC-SLP #12148294
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Amanda Davis, M.A., CCC-SLP #14050457
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Lori Robinson, M.A., CCC-SLP #12057575
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Lauren Mossman, M.A., CCC-SLP #14039809
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Diane Merkel, M.A. CCC-SLP #01101921
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Kelly Williams, M.S., CCC-SLP #14090408
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Helen Long, M.S., CCC-SLP #14037378
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Denise Durbin, M.S., CCC-SLP #12033043
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Maureen McGuire, M.A., CCC-SLP #00777037
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Shana Dodgson, M.S., CCC-SLP #14091182
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Lucy Windevoxhel, M.S., CCC-SLP #12028356
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Mary Kathleen Galbraith, M.A., CCC-SLP #14064179
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Nichole Schrader, M.S., CCC-SLP #14032459
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Catherine Kadechka, M.A., CCC-SLP #14100767
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Jennifer Wagner, M.A., CCC-SLP #14053845
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Samantha Obermeyer, M.S., CCC-SLP #14176855
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Dawn Cotter-Jenkins, M.A., CCC-SLP #12026690
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Andrea Nigara, M.S., CCC-SLP #14172190
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Mary Treuer Del Ojo, M.A., CCC-SLP #14103254
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Anthony Steusloff, M.S., CCC-SLP #14116435
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Erica Hawks, M.A., CCC-SLP #14052447
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Kirsten Thomas, M.S., CCC-SLP #14297173
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Joselynne Jaques, M.Sc., CCC-SLP #01097618
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Quincey Lloyd, M.A., CCC-SLP, CAS #14056715
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Rebecca Mayes, M.S., CCC-SLP #14030478
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Elaine Rau, CScD, CCC-SLP #00179424
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Christina Bourland, M.S, CCC-SLP #01126723
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Samantha Williams, M.S., CCC-SLP #14040197
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Rhonda Kaczor, M.S., CCC-SLP #12039776
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Nicole Mossman, M.S., CCC-SLP #14176321
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Katrina Paschall, M.Ed., CCC-SLP #14010506
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Kaci Mueke, M.S., CCC-SLP #12158364
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Ashley Casucci, M.S., CCC-SLP #14047655
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Megan Pince, M.S., CCC-SLP #14094307
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Frances Quinn, MCD, CCC-SLP #12018220
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Stephannie Brajot, M.A., CCC-SLP #12154623
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Kayla Rivoli, B.A., Student Clinician #1424354
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Alycia Canavan, M.A., CCC-SLP #14031142
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Taryn Tatum, M.S., CF-SLP #14229688
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Michelle Lachman, M.S., CCC-SLP #14011080
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Sarah Waderich, Graduate Student
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Nazli Blackwell, M.S., CCC-SLP #14264731
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Kathleen L. DeYoung, M.A., CCC-SLP #001100172
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Tracy Ferguson, M.S., CCC-SLP #14194131
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Lilly Lichaa, M.S., CCC-SLP #14011466
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Renae Green, M.S., CCC-SLP #12128039
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Somary Vilaysing, M.S., CCC-SLP #12133414
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Michael Halsted, M.S., CCC-SLP #14131088
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Jennifer Dow, M.A., CCC-SLP #12050328
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Johnetta Hammonds, M.Ed, CCC-SLP #12153086
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Catherine Reynolds, M.A., CCC-SLP #01097429
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Ashton Standford, M.A., CCC-SLP #12157760
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Jennifer Porachan, M.A., CCC-SLPA #14148973
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Shelly Williamson, M.S., CCC-SLP #01107356
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Stacy Puckett, M.S., CCC-SLP #12111622
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Annie-Laurie Hoppe, M.S., CCC-SLP #12088304
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Maya Hill, M.A., CF-SLP #14244560
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Alease Holden, M.S., CCC-SLP #14128821
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Marissa Brenzer, M.S., CCC-SLP #14031153
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Christine MacManus, M.S., CCC-SLP #12003828
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Abigail Spiese, M.S., CF-SLP #14153716
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Donna Kay Locke Tracy, M.S., CCC-SLP #12056945
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Daphne Dawson, MCD, CCC-SLPA #12043521
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Alexis Bolivar, M.A., CCC-SLPA #12135637
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Katherine Powers, M.S., CCC-SLP #14089684
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Karen Alba-Madden, M.S., CCC-SLP #01020422
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Samantha Broyles Miller, M.S., CCC-SLPA #12158781
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Amanda Merlin, M.A., CCC-SLP #14029936
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Amy Mullins, M.S., CCC-SLP #12045187
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Haylee Hollifield, M.S., CCC-SLP #14117696
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Kortney Babington, M.A., CCC-SLPA #12158509
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Victoria Kerr, M.A., CCC-SLP #00947234
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Angela Cure, M.A., CCC-SLP, BCBA #12111707
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Stephanie Kriebel, M.S., CCC-SLP #14055373
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Julie Fechter, M.S., CCC-SLP #14046416
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Shannon Ward, M.A., CCC-SLP #14069887
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Kelly Wilson, M.A., CCC-SLP #14109463
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Noreen Tsai, M.S., CCC-SLP #111543
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Lauren Boyette, M.S., CCC-SLP #14175403
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Isha Vaishampayan, M.S., CCC-SLP #14179881
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Melissa Pana, M.S., CF-SLP #14133986
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Val Lorenzo, M.S., CCC-SLP #01113083
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Hannah Werner, M.A., CCC-SLP #14042101
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Vivian Tisi, M.A., CCC-SLP #14067749
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Jenna Stewart, M.Ed., CCC-SLP #14030311
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Amanda Kett, M.S., CCC-SLP #12120366
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Lindsey Tallerico, M.S., CCC-SLP #12084218
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Sabrina Hosmer, M.A., CCC-SLPA #14037043
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Stephanie Westinghouse, M.A., CCC-SLP #12072752
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Lisa Paxton, M.S., CCC-SLP #01122018
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Breanna Allor, M.A., CCC-SLP #12149948
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Randall Habovsky, M.A., CCC-SLP #14050677
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Casey Switzer, M.S., CCC-SLP #1411644
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Jamie Narkun, M.A., CF-SLP #1248923
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Cheryl King, M.A., CCC-SLP #01042393
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Carol Steffen, M.A., CCC-SLP #01006449
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Jessica Xander, M.S., CCC-SLPA #14114069
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Jessica Robinson, M.S., CCC-SLP #12154217
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Tonya Parsons, M.S., CCC-SLP #14087928
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Melanie Ramirez, M.S., CCC-SLP #12151263
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Ashley McCurry, M.A., M.S., CCC-SLP #14065879
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Kimberley Behling, M.A., CCC-SLP #12105745
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Kelly Worthy, M.S., CCC-SLP #12111111
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Kelsey Mealey, M.S., CCC-SLP #14086637
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Kristen LaBeau, M.A., CCC-SLP #14099121
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Laura Anderson, M.S., CF-SLP #14284220
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Blanca Hatem, M.A., CCC-SLP #12115929
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Morgan Le, M.A., CCC-SLP #12151091
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Vanessa Gonzales, M.A., CCC-SLP #12102850
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Jacquelyn Matthews, M.S., CCC-SLP #12158806
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Ceola Odom, MCD, CCC-SLP #6690
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Caitlin Jones, M.S., CCC-SLP #12149884
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Alexandra Boo, M.A., CCC-SLP #12064987
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Mary Cebalt, M.A., CCC-SLP #14089572
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Adam Reres, M.A., CCC-SLP #14053783
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Natasha Gordon, M.S., CCC-SLP #12087059
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Cheryl Ware, M.Ed., CCC-SLP #12117713
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Kathrine Keegstra, M.S., CCC-SLP #14033035
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Amanda Christensen, M.A., CCC-SLP #14073975
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Sondra Kohn, M.S., CCC-SLP #01092509
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Veronica Jaime, CCC-SLP #12115892
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Stephanie Cohen, M.A., CCC-SLP #12035014
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Meghan Betz, Ph.D., M.A., CCC-SLP #12040035
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Valerie Mason, M.S., CCC-SLP #12139241
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Andrea Manghiuc, M.A., CCC-SLP #12154316
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Lauren Fox, M.S., CCC-SLP #14225514
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Lyndsey Swaffar, M.Ed., CCC-SLP #14056428
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Jocelyn Davis, M.S., CCC-SLP #14060766
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Caitlyn Carey, M.A., CCC-SLP #12121777
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Natalie Lorbecki, MSEd., CCC-SLP #14044036
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Ellen Holloway, M.A., CCC-SLP #12034571
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Kimberley Hurley, M.A., CCC-SLP #12051359
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Elizabeth Griffin, M.S., CCC-SLP #14098343
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Laura Dabney, M.A., CCC-SLP #12156375
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Michelle Torres, M.A., CCC-SLP #12143288
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Michele Spiro, M.M., M.S., CCC-SLP #14094004
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Janelle Perkins, M.S., CCC-SLP #12126312
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Marina Vertleyb, M.A., CCC-SLP #12018988
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Amy Locke, M.S., CCC-SLP #14174417
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Rebecca Bristow, M.S., CCC-SLP #14108113
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Ruchi Kapila, M.S., CCC-SLP #14089288
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Christa Holloway, M.S., CCC-SLP #12071665
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Julie Bogaards, M.S., CCC-SLP #01095275
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Cecilia Vellozo, M.S., CCC-SLP #14111833
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Shauna Reynolds, M.S., CCC-SLP #14042614
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Caitlin Gallup, M.A., CCC-SLP #12158159
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Kim Stephens, M.Ed., CCC-SLP #12083146
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Theresa Powers, M.S., CCC-SLP #12116922
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Nancy Sheets, MSP, CCC-SLP #01105502
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Olivia Rhoades, M.A., CCC-SLP #14106561
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Amy Scott, M.S., CCC-SLP #12026281
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Alexandra Schechter, M.S., CCC-SLP, BCaBA #14067025
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Karen Pallies, M.A., CCC-SLP #01020992
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Rebecca Green, M.A., CCC-SLP #14064837
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Samantha Determan, M.S., CCC-SLP #14041403
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Sharon Jensen, M.A., CCC-SLP #12013750
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Samantha Meehan, M.S., CCC-SLP
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Laura I. Favela, M.S., CCC-SLP #12116906
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Tracey Warren, M.S., CCC-SLP #01068015
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Jacalyn Dungca, M.S., CCC-SLP #14111294
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Sarah Carter, M.A., CCC-SLP #14111975
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Andrea Hallfrisch, M.A., CCC-SLP #14099595
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Andrea M. Szwabowski, M.H.S., CCC-SLP #12040670
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Jamie Sager, M.A., CCC-SLP #14175416
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Melissa Schofield, M.S., CCC-SLP #12109989
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Monica Ayrod-Waasdorp, M.Ed., CCC-SLP #01089607
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Laura Strauch, M.S., CCC-SLP #01101770
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Sarah Sprague, M.S., CCC-SLP #14095469
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Teranya Boykins, M.S., CCC-SLP #12078999
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Heather Wynne, M.A., CCC-SLP #14037269
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Shondra Ferrell, M.A., CCC-SLP #12038311
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Kristin Golde, M.A., CCC-SLP #01111416
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Kailey Creech, M.S., CCC-SLP #12154659
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Jessica Kelley, M.S., CCC-SLP #12057974
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Andrea Ballard, M.S., CCC-SLP #14032249
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Megan Berning, M.A., CCC-SLP #12156529
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Jennifer Johns, M.A., CCC-SLP #09147679
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Denise Hernandez, M.S., CCC-SLP #12144249
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Jenna Hassanzadeh, M.Ed., CCC-SLP #12153033
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Kathleen Desiderio, M.A., CCC-SLP #12109548
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Lauren Morrison, M.A., CCC-SLP #14039873
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Elissa Polland, M.S., CCC-SLP #12079002
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Carla Schoonover, MCD, CCC-SLP #12058856
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Mandy Render, M.S, CCC-SLP #12125985
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Tiffany Trask, M.A., CCC-SLP/L #14037899
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Whitney Porter, M.A., CCC-SLP #12132632
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Veronika Radziwill, M.A., CCC-SLP/L #14034703
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Heather Brown, M.S., CCC-SLP #12070863
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Jill Lundgren, M.S., CCC-SLP #14053487
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Katie Golden, M.A., CCC-SLP #12149358
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Susan Roncevich Rose, MSP, CCC-SLP #01020936
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Valerie Saucer, M.S., CCC-SLP #12147164
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Alyssa Guthrie, Graduate Student
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Frances Weldon, M.A., CCC-SLP #12000355
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Sara Laughlin, M.A., CCC-SLP #12007506
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LeeShell Lewis, M.S., CCC-SLP #12061291
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Kasia Richardson, M.A., CCC-SLP #12118864
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Casey Quinn, M.S.Ed., CCC-SLP #14033482
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Lacy Vannorsdel, M.A., CCC-SLP #14105947
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Kelsey Paul-Charlson, M.S., CCC-SLP #14055260
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Sally Flynt, M.S., CCC-SLP #14084675
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Heather Treece, M.S., CCC-SLP #12152076
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Kat Tomas, M.S., CCC-SLP #24157
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Bailey Womack, M.S., CCC-SLP #14081582
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Brittany Jaramillo, M.A., CCC-SLP #14089718
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Amber Aschwanden, M.A., CF-SLP
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Tessa Rasmussen M.S., CF-SLP
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Meghan Ballis, B.A., Student Clinician #14181970
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Kera Coon, M.A., CCC-SLPA #14050772
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Sarah Henderson, M.A., CCC-SLP #12102531
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Janie Brown, M.S., CCC-SLP #14036155
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Kimberly Herrejon, M.S., CCC-SLP #14051186
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Brittany Hart, M.S., CCC-SLP #120749011
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Lauren Clabaugh, M.S., CCC-SLP #14114544
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Stephanie Betjemann, M.A., CCC-SLPA #12090810
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Lindsay Scherbarth, M.A., CCC-SLP #12156377
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Elizabeth Lynch, M.S., CCC-SLP #12065170
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Courtney Jacobs, M.Ed., CCC-SLP #12082038
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Mary Humphrey, M.A., CCC-SLP #01066214
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Megan Rains, M.S., CCC-SLP #12144220
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Jessica Lee, M.A., CCC-SLP #14037770
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Gretchen McGinty, M.A., CCC-SLP #12156937
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Katie Smith, M.S., CCC-SLP #12154445
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Sarah Roberts, M.S., CCC-SLP #12127468
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Jamie Leardi, M.A., CCC-SLP #09131364
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Chelsea Silverman, M.A., CCC-SLP #14088677
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Cerise Karmondy, M.A., CCC-SLPA #41YS0075600
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Kristen Desjardins, M.S., CCC-SLP #12109180
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Cassandra Pietrus, M.A., CCC-SLP #12158331
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Stephen Heacock, M.S., CCC-SLP #14079297
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Evelyn Szaflarski, M.H.S., CCC-SLP #14046542
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Julia Ng, M.S., CCC-SLP #14128253
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Debra Olberding, M.S., CCC-SLP #00637828
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Michelle Collier, M.S., CCC-SLP #146007742
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Kimberly Clanton, M.S., CCC-SLP #14082711
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Katherine Gigstead, M.S., CCC-SLP #12091091
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Jamie Blanchard, M.A., CCC-SLP #14050904
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Sarah Lewis, M.S., CCC-SLP #01095434
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Samantha Dickinson, M.A., CF-SLP
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Crystal Carroll, M.S., CCC-SLP #14063462
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Mara McLoughlin, M.S., CCC-SLP #12153250
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Sara Castro, M.A., CCC-SLP #14034359
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Rashida Lake, M.A., CCC-SLP #14109248
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Nicole Walfall, B.S., SLPA #3360
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Rachel Platt, M.S., CF-SLP #14095589
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Christine Generous, M.S., CCC-SLP #01023772
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Sarah Sexton, M.A., CCC-SLP #14001884
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AnneMarie Hendren, M.A., CCC-SLP #01071080
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Patricia Stith, M.S., CCC-SLP #01107631
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Jamie Harlan, M.S., CCC-SLP #12136066
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Lori Smith, M.A., CCC-SLP #09148474
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Mardee Kohlmann, MsEd., M.A., CCC-SLP #14098706
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Hadley Regal, M.S., CCC-SLP #14030975
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Claire Mulligan, M.S., CCC-SLP #14042589
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Rachel Ryan, M.A., CCC-SLP #14039387
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Nichole Baldwin, M.A., CCC-SLP #25552
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Karelys Carrion, M.S., CCC-SLP #14043398
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Elizabeth Diaz-Moreno, M.S., CCC-SLP #12075740
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Judith Hale, M.A., CCC-SLP #00834333
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Latifah Alexander, M.S., CCC-SLP #14116123
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Amanda Gleeson, M.S., CCC-SLP #12113309
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Jessica Hatterman, M.S., CCC-SLP #14052988
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Sandy Ritts, CCC-SLP #12144559
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Lillian Bischel, M.A., CCC-SLP #12059763
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Marissa Campbell, M.S., CCC-SL #14069455
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Julie Jackson, M.S., CCC-SLP #09125758
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Shemeka Cusack, CF-SLP #5190
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Shannon Hanes, M.S., CCC-SLP #12055031
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Lauren Koczarski, M.S., CCC-SLP #12132442
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Kasena Kafka, M.A., CCC-SLP #14037505
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Samantha Rehe, M.S., CCC-SLP #14197559
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Rhonda Malinksy-Rockwell, CCC-SLP/CED #12049521
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Sarah Annunziata, M.S., CCC-SLP #12127992
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Teresa Sadowski, M.A., CCC-SLP #0102487902
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Rachel Neugroschel, M.A., CCC-SLP #14159134
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Mackenzie Graham, M.S., CCC-SLP #14091169
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Christina Semonick, M.S., CCC-SLP #14147080
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Caitlyn DiJoseph, M.S., CCC-SLP #14197860
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Karen Jacobsen, M.S., CCC-SLP #01099109
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Kathleen DiLella, M.Ed., CCC-SLP #12006247
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Susan Phillips, M.S., CCC-SLP #01061045
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Michael Maloney, CF-SLP #14244635
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Nancy Spivey, M.S., CCC-SLP #01001390
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Katelyn Castillo, B.S., Graduate Clinician #14255165
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Tamika Liddell, MA., CCC-SLP #12094861
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Kelly Allison Kalus, M.S., CCC-SLP #1105322
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Kathleen Rose-Le, M.S., CCC-SLP #09142340
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Shunnae Baker, M.S., CCC-SLP #01131818
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Ann Marie Johnston, M.S., CCC-SLP #14007666
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Gail Walter, M.S., CCC-SLP #12122591
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Angela Mooney, M.S., CF-SLP #14256085
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Katrina Stahl, M.A., CCC-SLP #14064408
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Lisa McDermeit, M.Ed., CCC-SLP #01114214
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Diana Shiroky, M.S., CCC-SLP #14179479
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Karena Martin, M.S., CCC-SLP #12069928
ASHA's Initial Response
07/31/2018
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Dear Marissa,
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Thank you for your thoughtful letter via the InTouch contact system. We value all feedback from members, and are working to respond to your letter. Since it covered a lot of ground in terms of the workplace and practice issues mentioned, I'm working with some other staff members to hopefully address your concerns in a meaningful way, with an equally thoughtful response. Please know that your concerns have been added to the full report to the Board on all InTouch queries and concerns, which is to be presented at the August board meeting.
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Regards,
Lisa Cole
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Lisa M. Cole
Chief Staff Officer, Communications
American Speech-Language Hearing Association (ASHA)
Thank You Response to ASHA
08/06/2018
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Thank you, Lisa. I know that I and the many members who have signed on to this letter and watched its development appreciate you taking the time to craft a thoughtful response. I would encourage the board to review the website for an updated list of signatures, as the list has grown significantly since I initially submitted it. We are very hopeful that this opens up a true dialogue between ASHA and its constituents with productive, appreciable ways that we can all make a difference in our field.
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Sincerely,
Marissa
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ASHA's Full Response
08/15/2018
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Dear Ms. Artman,
Thank you to you and the additional ASHA members that signed on to your letter to the ASHA Board of Directors (BOD). Your letter was shared with the BOD and I coordinated with several staff across the office to provide information that addresses your concerns. Please connect with us to continue to work on these professional practice and work place issues that are affecting speech-language pathologists. Please see the attached letter and share it with the other speech-language pathologists.
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Sincerely,
Lemmietta McNeilly
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Lemmietta McNeilly, Ph.D., CCC-SLP, CAE, ASHA Fellow, FNAP
Chief Staff Officer, Speech-Language Pathology
American Speech-Language-Hearing Association (ASHA)
FULL RESPONSE LETTER BELOW
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August 15, 2018
Dear Marissa,
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Thank you for contacting the ASHA Board of Directors with your concerns about several issues within the profession of speech-language pathology (SLP). We appreciate your thoughtful comments you shared on behalf of the other ASHA members. Clinical practice in SLP certainly presents several challenges in the current climate of policy changes, fiscal and human resource limitations that affect service delivery in both educational and health care settings. SLPs are making huge differences in the lives of students, clients and patients every day. As a member-centric organization, ASHA is committed to supporting you and all of our members in meaningful ways. Please allow me to provide some information about the work ASHA staff and volunteers do related to your concerns.
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Advocacy and providing access to tools and resources that enhance professional practice are core elements of ASHA, which is the national, professional, scientific and credentialing association for speech-language pathologists and audiologists. ASHA works to advance the influence and demonstrated value of services provided by our member speech-language pathologists to lawmakers and policymakers in Washington, D.C., as well as state capitals across the nation. As we live in a time marked by political uncertainty, sharpened ideological divisions, and shrinking budgets, it is especially important that both the value and quality of SLP services are understood and reflected in relevant laws and regulations.
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ASHA employs government affairs and public policy experts that advocate on behalf of our members. These experts undertake a number of critical activities including:
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building strategic relationships with influential lawmakers and policymakers;
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engaging in robust policy analysis and development;
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communicating with ASHA members, lawmakers, policymakers, and the general public;
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creating opportunities for ASHA members to become advocates, and;
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building and sustaining strategic coalitions with allied stakeholders.
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ASHA is actively addressing several issues of critical importance to speech-language pathologists, which include equitable reimbursement for services rendered, robust school funding, and reasonable productivity standards. While recognizing the challenges of the current political environment, ASHA continues to seek opportunities to advance these issues with members, who offer critical clinical expertise and compelling stories. We also have a multiyear Value of the CCCs campaign that targets employers to educate them about the certificates of clinical competence.
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In advocating for the professions, ASHA also understands the challenges created by unreasonable expectations of productivity applied by many employers in certain settings. Unrealistic productivity standards and administrative demands for service delivery driven by reimbursement rather than the needs of consumers is a fundamental problem with aspects of the current health care system. In addition, challenges are also visible in educational settings. ASHA has engaged actively with industry leaders in health care to address this problem. For example, ASHA led the effort to collaborate with AOTA and APTA to develop the Consensus Statement on Clinical Judgement to support its members in efforts to push back against unreasonable administrative mandates.
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Such mandates infringed on their clinical judgement and drove the focus on productivity as a reflection of billable minutes rather than the full scope of work that is meaningful to client care. Similarly, ASHA led the development of the Compliance Reporting document to provide additional information and resources for members to address problematic circumstances they are faced with in their employment settings. While these resources are helpful in addressing problems in clinical settings, ASHA also has engaged with industry leaders and stakeholders such as the Department of Justice, when for example, administrative mandates from companies have illegally usurped the clinical judgement and authority of speech-language pathologists to determine the course of treatment for their clients.
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Recent developments and changes in the way of post-acute care services are reimbursed by Medicare provide opportunities for speech-language pathologists to demonstrate value to health care systems and outcomes beyond discrete therapy minutes. ASHA is working aggressively with other stakeholders to take advantage of the changing payment incentives to eliminate the emphasis on productivity as a reflection of billable minutes but rather to consider the overall impact of member services on quality service delivery and patient outcomes. While productivity considerations are unlikely to go away entirely under the new payment systems, there is an opportunity to use the changes to the advantage of members and the clients they serve, and to define the value metrics for the profession.
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Staffing shortages due to inadequate funding at the local, regional, state and federal levels contribute to the pressures speech-language pathologists experience regarding caseload and workload metrics. As the national association representing audiologists and speech-language pathologists, ASHA is best suited to address larger scale policy and funding issues that are influenced by federal policies and programs. To that end, ASHA continues its advocacy efforts to increase dedicated federal funding for the Individuals with Disabilities Education Act (IDEA) [link provided unavailable] as well as several other funding streams and programs critical to improving funding for school-based services at all levels. These efforts have helped to establish the resources necessary to address one of the main pressures resulting in unreasonable expectations for the workload of school-based members.
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Additionally, ASHA regularly meets with Department of Education officials as well as Medicaid decision-makers at the Centers for Medicare & Medicaid Services (CMS) to discuss the importance of adequate funding for school-based services. However, the recent tax legislation enacted by Congress places increase pressure on school funding by making it harder for local and state governments to raise revenues. ASHA's advocacy team is working diligently with Congress to highlight this problem and to urge the investments necessary in education to ensure students receive the public education to which they are entitled. We lobby members of Congress, provide comments and feedback to federal agencies and work in national coalitions focused on education and education funding. The connection between manageable workloads and funding is direct; funding is a priority within the ASHA Public Policy Agenda [link provided unavailable].
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Several ASHA teams include speech-language pathologists (e.g. Government Affairs and Public Policy, Clinical Issues, Health Care Services, School Services, as well as the Office of Multicultural Affairs) that provide professional consultation and technical assistance to members. ASHA staff regularly provide information based on education and expertise.
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The content of ASHA's Professional Development opportunities is informed by the common issues noted during professional consultations, such as ASHA survey results, and other sources of member data that describe clinical and professional needs. An example of a recent collaboration with decision makers that brought longstanding issues of school-based members front and center is the ASHA Schools Virtual Town Hall, which occurred during the second week of August. School leaders (two principals), district leaders (former assistant superintendent and a superintendent), state leaders (two state education advocates), and a National Education Association union representative comprised the panel that presented feasible solutions to the issues as well as describing how individuals in their respective roles could collaborate to foster systemic change. The longstanding issues addressed were school funding, high caseloads, excessive paperwork, and barriers to varying service delivery methods. The town hall was recorded and will be made freely available to interested parties in the Trending Topics section of the School Service Team's webpage by the end of August. We encourage the use of this resource by ASHA members, ASHA staff, and other stakeholders to adopt or adapt solutions posted to address similar issues faced by SLPs in schools across the nation.
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ASHA recognizes that productivity demands and high caseloads put undue stress on speech-language pathologists and lead to burnout. While we have highlighted several advocacy efforts that are happening at the federal, state, and industry-wide levels, we know that you are fighting to demonstrate the value of your services each day to administrators in different clinical settings. ASHA has resources for school-based and health care-based speech-language pathologists that can support your grassroots advocacy efforts and clinical practice.
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Please also connect with the ASHA professional practices staff of speech-language pathologists anytime via phone (800-498-2071) or email (schools@asha.org; healthservices@asha.org). We absolutely want to work with you in your efforts and help you create meaningful change in your workplace and are open to ideas.
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On a different note, you also inquired about ASHA's corporate partnership program. This program offers companies marketing opportunities and the chance to develop a relationship with ASHA members. However, partnership is not an endorsement or recommendation of any product, service, program or organization. The goal is to generate revenue beyond member fees that provides funding for ASHA to offer more programs, services and opportunities for members. We would be happy to talk to you more about the corporate partnership program and the nature of relationships with the different organizations if you have additional questions.
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We hope the information presented in this response letter is helpful to you and other speech-language pathologists that added their names to your letter. We would like to continue to engage with you to effect lasting changes in clinical practice. Please let us know if we can be of further assistance.
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Sincerely,
Lemmietta McNeilly, PhD, CCC-SLP, CAE, FNAP
Chief Staff Officer, Speech-Language Pathology
American Speech-Language-Hearing Association
2200 Research Boulevard
Rockville, MD 20850-3289
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