Board of Directors

Meeting Report—August 2008

Kate Gottfred, President

Opening Remarks

President Kate Gottfred welcomed the Board members to their third face-to-face meeting of the year. She thanked the Board for all the work they do between meetings via electronic means. She noted that doing much of the Board's work electronically allows the Board more time during their face-to-face meetings to discuss critical issues affecting the professions and the Association.

Executive Director Update Highlights

Executive Director Arlene Pietranton provided the following highlights:

• Functional Communication Measures

On August 5, 2008, the eight Functional Communication Measures most commonly used in ASHA's National Outcomes Measurement System (NOMS) were endorsed by the National Quality Forum (NQF). Endorsement by NQF means that ASHA will now work with the Centers for Medicare and Medicaid Services (CMS) to recognize the NQF-endorsed measures for reporting by speech-language pathologists (SLPs) under the Physician Quality Reporting Initiative (PQRI). Under PQRI, Medicare providers are eligible to receive a bonus payment for submitting NQF-approved quality measures. CMS currently recognizes the NOMS and the Functional Communication Measures as appropriate tools for documenting patient improvement related to the therapy cap exceptions process. Also, CMS has indicated that it would be unlikely to include any existing outcome or performance measures in any new payment schemes without NQF endorsement, so this clears the way for the potential use of these measures in the development of alternative payment systems.

• ASHA's Strategic Pathway to Excellence

Staff continues implementation of activities necessary to make the transition to full implementation of the Pathway. A major activity has been development of the Performance Measures and Targets (metrics) and collection of baseline data that will be used to determine whether the Strategic Objectives included in the Pathway are accomplished. Based on the Performance Measures data, periodic reports on progress made in achieving the Strategic Objectives will be provided. The initial successes resulting from the Pathway relate to using the Pathway to determine priorities; focusing on ASHA's overall strategy, generating low-cost and cost-free ideas to effect desired changes; and enabling staff and volunteers to see their contribution to the Association's overall strategy.

• ASHA Schools Conference

The Schools Conference continues to grow. This year's Conference was held in Orlando, Florida. The first Schools Conference was also held in Orlando in 1999, and had 213 paid participants, compared with 799 this year. The 2008 Conference had a total attendance (including exhibitors, speakers, staff, etc.) of nearly 900.

• Association Management System (AMS)

Implementation of ASHA's AMS (netFORUM) is a strategic initiative of ASHA's Strategic Objective to Improve Technology and Infrastructure. Focusing our Information Systems and staff resources on this set of projects has resulted in making progress on the technology infrastructure needed to conduct ASHA business. The following modules have been completed: PAC Fundraising, Events Registration, and netFORUM upgrade. Other modules expected to be completed in 2008 include: Continuing Education, ASHA Professional Development, Certification Maintenance, and ASHA/NSSLHA Dues Renewal.

• ASHA Web Site

ASHA continues to update its Web site to provide enhanced professional content and easier access to site content. There is a monthly average of 3,625,791 page views on ASHA's Web site, 681,850 visits to the site, and 402,335 visitors. Answers to many questions asked by members related to audiology, speech-language pathology, academic affairs, specific speech and language disorders, reimbursement, and ASHA awards can be found on the Web site. Members are encouraged to go to the ASHA Web site to obtain professional and Association information.

ASHA Budget

• 2008 Budget Report: The Board reviewed the second-quarter budget report. At this time, trends indicate that ASHA will have a positive bottom line for 2008.
• Preliminary 2009 Budget: The Board discussed the preliminary work being done on the 2009 budget. Initial projections for the 2009 budget indicated that there were $2.3 million expenses over revenue. ASHA policy requires the development of a balanced budget. The 2009 budget that will be discussed by the Financial Planning Board has been balanced and will have a small positive bottom line. Following review by the Financial Planning Board, the budget will be submitted to the BOD for final approval.
• Conflict of Interest Policy: The Board reviewed the revised Conflict of Interest Policy. The policy would ensure that ASHA volunteers act in the best interest of ASHA and that they maintain the confidentiality of information entrusted to them by ASHA. The Board approved the Conflict of Interest Policy. The Board also passed a motion indicating that all BOD members must sign the Conflict of Interest statement and that it would be sent to all other ASHA volunteers.

ASHA's Committee and Board Structure

The Board discussed current ASHA policy related to the BOD's role and responsibilities with standing committees and boards. ASHA bylaws state, "The Board of Directors may establish and dissolve standing committees, boards, councils, ad hoc committees, working groups, and other entities necessary to conduct the Association's business, and designate and change their charges and determine their size, member qualifications, and terms." The ASHA Committee and Board Handbook states, "Each committee established by the BOD works with an appointed BOD member who serves as the Monitoring Officer and brings all necessary committee recommendations to the BOD for information purposes" and "Standing committees, boards, and councils are established by resolution and are appointed to fulfill specific charges designated by the BOD. Their work is directed by a Monitoring Officer on the BOD." The Board expressed a commitment to maximize the relationship between the Board and ASHA's committees, boards, and councils.

ASHA Property Update

• 10801 Rockville Pike Property: Centex—the national home builder expected to buy the Rockville Pike property—recently withdrew. The Board received a thorough update regarding the consequences, of which the highlights are: (a) by virtue of its withdrawal, Centex forfeits to ASHA a $4 million deposit as well as studies and engineering drawings of the Rockville Pike property that are valued at more than $1 million and that increase the market value of the property; and (b) we have begun to receive calls from other brokers and developers about the property, which we anticipate will lead to new purchase offers. Staff and ASHA's property consultants will continue to work closely with the Financial Planning Board and the Board of Directors to determine and execute a favorable sale of the property that achieves ASHA's financial objectives.
• Leasing update: A portion of the fifth floor of the ASHA office has been leased to a law firm that will be moving in this October. Leasing of this space provides ASHA with additional non-dues revenue.

Committee on Honors (COH)

Under the new governance structure, the BOD has responsibility for review of ASHA committee, board, and council operational procedures. As part of the review process, the Board appointed a subcommittee to review the revised set of Operational Procedures submitted by the Committee on Honors. The Board will review and discuss the Operational Procedures and provide their recommendations to the COH.

ASHA Strategic Pathway to Excellence: Strategic Themes/Pillars of Excellence

ASHA's Strategic Pathway to Excellence includes four Strategic Themes (Pillars of Excellence): Two Professions, One Discipline; Scientifically Based Professional Practice; Advocacy; and The Member Experience. As part of the Board's agenda for 2008, one of the Pillars of Excellence is being discussed at each BOD meeting. During this meeting, the Board continued discussion on the Scientifically Based Professional Practice Pillar and discussed the Advocacy Pillar. Highlights of the discussions follow:

• Scientifically Based Professional Practice

The Strategic Result for this Pillar is: "ASHA strengthens its leadership in the generation, dissemination, and translation of research into the clinical practice of Audiology and Speech-Language Pathology."

The Board participated in a facilitated discussion of ASHA's role in and commitment to the need for promoting clinical practice research and ensuring the availability of data for use by members, policy makers, and program administrators as they make decisions related to reimbursement/funding, resource allocation, and programs and services. It was agreed that ASHA has a role as a facilitator/convener for members, academic programs, funding agencies, and groups that need funding; that it needs to continue its commitment to obtain longitudinal outcomes data for adults and children; and that it needs to maintain its role and commitment to advocacy related to having scientifically based professional practice.

• Strategic Theme: Advocacy

The Strategic Result for this Pillar is: "ASHA's organizational and grass-roots advocacy efforts lead to significant change in the promotion and advancement of the interests of the professionals in human communication and those we serve."

The Board discussed personal and organizational advocacy, and participated in a focused discussion on ASHA's advocacy role related to personnel shortages. Specific questions discussed were "What is ASHA's commitment to increasing the pool of CCC-qualified personnel?" and "What is ASHA's commitment with respect to the continuum of service providers?" Major themes that came from the discussions were:

• A need to embrace the continuum of service providers.
• A need to consider academic models and the potential for increasing capacity for preparing an increased number of graduates.

The Board also discussed the relationship between advocacy and research as related to coverage and reimbursement for speech-language pathology and audiology programs and services, including outcome and utilization data. Questions discussed included "What is ASHA's commitment to increasing clinicians' engagement in evidence-based practice?" and "What data do we need currently and in 5 to 10 years to advocate effectively on behalf of the professions?" Major themes that came from the discussions were:

• A need to review NOMS to determine whether it can be made more effective in collecting needed advocacy data related to children and adults.
• A need to collect longitudinal data related to professional/clinical practice activities (e.g., treatment, type, frequency, and intensity) that can be used in advocating on behalf of SLPs and audiologists and for persons with communication and related disorders.
• A need for a protocol that can be used for evaluating emerging areas of practice.

It also was noted that recent graduates are more knowledgeable about and aware of the importance of evidence-based practice.

Critical Issues

The Board continued discussion of the critical issues identified by ASHA members on the 2008 Critical Issues Survey and by the Audiology and Speech-Language Pathology Advisory Councils during their March 2008 meetings. Issues discussed were:

• Marketing/branding
• PhD shortage
• Salaries
• Personnel shortages
• Workload/caseload
• Highest qualified provider
• Academic/clinical education preparation
• Reimbursement
• Collaboration with allied and related organizations

The BOD discussed the criteria that could be used to prioritize the critical issues on which ASHA should allocate its resources. Although ASHA is working on all of the critical issues identified by members and the Advisory Councils, the BOD identified three that need special focus in the allocation of ASHA resources: personnel issues/shortages, marketing and branding, and reimbursement and funding. They also discussed how the issues relate to ASHA's Strategic Pathway to Excellence.

Speech-Language Pathology Assistants

The report of the Ad Hoc Committee on Speech-Language Pathology Assistants (SLPAs) was reviewed by the Board. The report examined seven issues that will need further consideration as ASHA contemplates the future of SLPAs' relationship to the profession of speech-language pathology and the Association; the issues are whether ASHA should:

• Promote the acceptance of SLPAs
• Consider recognition of Speech Language Pathology Assisting programs
• Consider the establishment of associate level membership
• Promote the 2004 Guidelines as the basis for SLPA requirements in states
• Promote continued education of SLPs and SLPAs on the topics of cultural competence and supervision
• Advocate for funding and reimbursement on health care, private practice, and schools
• Promote the professional continuum

The BOD agreed to move forward in exploring these issues in regard to the use of SLPAs.