Hello from the Advocacy Committee!

As we reported at Convergence, CSHA Advocacy is more active than ever. We have six advocacy committees pursuing six different issues. In fact, our sixth committee was established by the CSHA Board of Directors just prior to the conference. This most recent addition to CSHA Advocacy is the Episodic Care Committee. Chaired by Deborah Swain, this committee is working to understand the implementation of Episodic Care as a reimbursement model by insurance companies.

While the Episodic Care model is not new (it has been used extensively in rehabilitation), its broad application to developmental disorders is concerning to CSHA. Episodic care refers to treating specific health problems with a predetermined and finite plan of care without the expectation for on-going services. In recent months, CSHA and ASHA have been contacted by members who are voicing concerns regarding how Kaiser Permanente is implementing Episodic Care to provide services for children with developmental communication disorders. This implementation is resulting in authorization for limited sessions, dictation of elements of the plan of care and early dismissal despite SLP recommendations according to reports among other concerning practices. SLPs have reported that these practices are creating an ethical dilemma as clinical recommendations are at odds with payor source procedures.
In partnership, CSHA and ASHA held an initial meeting with Kaiser Permanente representatives in January to voice the concerns of our members. It was a positive meeting and a productive way to open up lines of communication between CSHA/ASHA and Kaiser Permanente regarding this issue. We look forward to future opportunities to communicate our concerns regarding episodic care models with Kaiser and other health care insurance providers.

The Episodic Care committee is working to schedule follow up meetings with Kaiser Permanente representatives to understand how this model is being implemented and to share with Kaiser the evidence behind speech and language therapy for children with developmental communication disorders. In addition, the committee will be embarking on an effort to educate consumers about the benefits of early interventions on communication and cognitive development and the evidence-based practices of speech-language pathology in the context of early intervention. It is important to the committee that decisions made regarding speech and language services be based on evidence and science rather than a pre-determined treatment plan. CSHA is fortunate to have such a dedicated group of SLPs leading this advocacy effort for our association and our profession.