State of the States in 2008 Successes Despite Tough Economy Policy Analysis
Policy Analysis  |   September 01, 2008
State of the States in 2008
Author Notes
  • Janet Deppe, director of state advocacy, can be reached at
    Janet Deppe, director of state advocacy, can be reached at×
Article Information
Regulatory, Legislative & Advocacy / Policy Analysis
Policy Analysis   |   September 01, 2008
State of the States in 2008
The ASHA Leader, September 2008, Vol. 13, 1-9. doi:10.1044/leader.PA2.13122008.1
The ASHA Leader, September 2008, Vol. 13, 1-9. doi:10.1044/leader.PA2.13122008.1
A number of state legislative initiatives of benefit to speech-language pathologists and audiologists were thwarted this year by budgetary concerns and partisanship. However, some successes occurred in the area of mandated insurance coverage for hearing aids and services for individuals with autism. A few other states successfully stopped legislative and regulatory initiatives detrimental to ASHA members. At press time, significant legislative or regulatory efforts were still pending in other states. Following are a few highlights.
Hearing Aids
Gov. Ritter signed S.B. 57 into law June 3 requiring that insurance providers cover medically necessary hearing aids for minor children. Coverage includes a new hearing aid every five years. It also stipulates that the insurer offer the same annual deductible and copayment as all other covered benefits within the insurance policy.
Delaware passed legislation this year mandating that insurance companies provide coverage for hearing aids of up to $1,000 per ear, every three years for children and adults up to age 24. Members of the Delaware Speech-Language-Hearing Association, along with parents and representatives of the State Disabilities Council, testified on behalf of the legislation. H.B. 379, which would have expanded eligibility for hearing aids by providing a hearing aid loaner bank, was stricken (see The ASHA Leader, Aug. 12).
Autism Coverage
Arizona’s H.B. 2847, signed into law March 21, stipulates that hospital service organizations, medical service organizations, group and disability insurers, and contractors that offer insurance coverage shall not exclude or deny coverage for treatment based on a diagnosis of autism spectrum disorder (ASD). In addition, insurers cannot impose dollar limits or deny medically necessary services provided by a licensed or certified provider.
Gov. Rell signed legislation (H.B. 5696) on June 5 requiring insurance coverage of therapies for ASD—including speech-language treatment—for eligible individuals through age 26.
In May Gov. Crist signed a comprehensive autism bill (S.B. 2654) mandating that group health insurance plans provide coverage for diagnostic screening, intervention, and treatment of children with ASD through age 18. Covered services include speech-language treatment, occupational therapy, physical therapy, applied behavioral analysis, and other medically necessary care. Health insurance plans may not deny, restrict, or refuse to issue or reissue coverage because of an ASD diagnosis. Eligible individuals must be diagnosed with ASD by age 8 or younger and services must be provided to children through age 18 and those older than 18 but still in high school. In addition, coverage may not be subject to deductibles, dollar limitations, or coinsurance payments that are less favorable than those applied to other covered physical illnesses under the plan and benefits may not be denied based on the fact that provided services are habilitative in nature.
H.B. 2727 established a task force to research ways to ensure that parents and children diagnosed with ASD receive appropriate services and support through public and private resources. The governor vetoed the bill after the legislature passed it in May, but legislators overrode the veto.
Gov. Jindal approved H.B. 516/S.B. 241 on June 12. This law provides that any group, family group, blanket, or association’s health and accident insurance policy must include (as a standard or option) covered benefits for speech-language pathology services and physical and occupational therapy. Offering these services as standard benefits also meets the requirements of the law.
S.B. 768 created a commission on ASD within the Missouri Department of Mental Health. The commission will be composed of 23 members, at least one of whom must be an SLP.
New Hampshire
New Hampshire passed H.B. 1634, which establishes a council on ASD designed to coordinate services for individuals and their families. It also provides legislative oversight of the council’s activities.
Salary Increases
Oklahoma currently provides a salary bonus for SLPs and audiologists working full-time in educational settings. On May 16 Gov. Henry signed H.B. 2731, which provides pro-rated bonuses to qualifying SLPs, audiologists, and school psychologists employed by school districts on a part-time basis.
H.B. 1 dispenses more than $2 million to school systems providing salary supplements to school-based SLPs and audiologists holding the ASHA-CCC. It was signed into law in July. The supplement is $5,000 annually for SLPs and audiologists who are full-time public school employees and maintain their certification, provided the legislature and department of education continue to fund the initiative.
North Carolina
H.B. 2436 was assigned to a conference committee on June 19. This budget bill includes a provision for SLPs and audiologists who are nationally certified at the master’s-degree level and employed by the public schools to be paid on the school psychologist salary schedule. Salary increases range from $126 per month for master’s level to $253 at the doctoral level. ASHA’s state advocacy team will continue to monitor the progression of this bill.
Licensure Changes
Three states do not regulate SLPs—South Dakota, Colorado, and Michigan. The Michigan Speech-Language-Hearing Association (MSHA) is actively involved in advocating for the passage of licensure through S.B. 493. At this writing, MSHA’s Government Relations Committee has worked with the Michigan Medical Society and the state department of education to develop language regulating the professions. The bill prohibits persons from engaging in the practice of speech-language pathology unless licensed by the state Department of Community Health (DCH); prescribes licensure criteria including a master’s or doctoral degree in speech-language pathology; and allows SLPs to perform swallowing-related assessment, treatment, and procedures such as endoscopy when referred by a physician. It also stipulates diagnostic testing of swallowing be performed in collaboration with or under the supervision of a physician and indicates when an SLP needs to refer a patient for medical testing.
The bill requires the DCH to promulgate rules, prescribes continuing education requirements to maintain licensure, and creates the Michigan Board of Speech-Language Pathology. MSHA has attempted to pass licensure legislation in the past; the current bill, now in the state’s Senate Health Policy Committee, has overcome many obstacles that had prevented it from moving forward. Michigan’s legislative session runs through December; MSHA is confident that it will pass this session.
Certification Questions
In April the Maryland State Department of Education (MSDE) sent a letter to the Professional Standards and Teacher Education Board requesting a repeal of certification for SLPs, audiologists, physical therapists, and occupational therapists. The letter requested the repeal to clarify the requirements for certification for individuals holding state license. This action was in response to the comprehensive licensure bill passed in 2007, which required that all SLPs and audiologists hired after Oct. 1, 2007, obtain a license. SLPs continuously practicing before Sept. 30, 2007, were granted a license through a grandfather provision.
The Maryland Speech-Language-Hearing Association (MSHA) became concerned about the ramifications of the loss of certification. Specifically, it was worried about the loss of representation by the teachers union with regard to collective bargaining and contract negotiations. MSHA members were also concerned about the potential loss of connection to the educational community. MSDE acknowledged the impact on SLPs’ representation by the teachers union.
The Maryland Board of Examiners sent a letter opposing the proposal and MSHA formed a coalition of health-education providers to address the proposal. Following many comments and testimony from providers, the Maryland State Teachers Association, and parents, MSDE withdrew the proposal. MSDE received more than 2,000 comments opposing the proposal (see The ASHA Leader, Aug. 12).
Special Education Services
Rhode Island
Despite efforts by the Rhode Island Speech-Language-Hearing Association (RISHA), the state Board of Regents approved limiting special education services for children with “speech-only” disorders.
Under the original September 2007 proposal drafted to bring Rhode Island into compliance with IDEA ’04, speech-language pathology and audiology services would no longer be considered a “special education” service. Instead, speech-language services could be considered only a “related service,” meaning that speech services could not be provided as a stand-alone service for children whose primary disability was speech- or language-related. Only those children with speech impairment in addition to another disability could receive speech-language pathology services under IDEA. An amendment to the proposal was adopted defining “special education” to include speech-language pathology services for students up to age 9. After that age children will no longer be eligible for stand-alone speech-language pathology services.
RISHA continues to oppose this controversial regulation and will explore any legal remedies available under IDEA (see The ASHA Leader, Feb. 12).
Stay Connected With ASHA

The state advocacy team, which works with recognized state associations under the new direct state liaison model, contributed to this report. Members of the team are responsible for maintaining regular communication with the states in their regions. Contact the appropriate ASHA staff member with any state advocacy questions.

  • Northeast (Connecticut, New York, New Jersey, Maine, Vermont, New Hampshire, Massachusetts, D.C., Maryland, Rhode Island, Ohio): Rend Al-Mondhiry,

  • Southeast (Virginia, West Virginia, North Carolina, South Carolina, Alabama, Arkansas, Georgia, Florida, Tennessee, Kentucky, Mississippi, Louisiana): Janice Brannon,

  • West (Montana, Oregon, California, Washington, Utah, Wyoming, Idaho, Hawaii, Alaska, Nevada, New Mexico, Arizona): Eileen Crowe,

  • Midwest (Illinois, Indiana, Wisconsin, Michigan, Nebraska, North Dakota, South Dakota, Minnesota, Missouri, Kansas, Oklahoma, Iowa, Texas): Janet Deppe,

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September 2008
Volume 13, Issue 12