President's Message: The Importance of Your State Audiology Organization

Author: Victor Bray, MSC, Ph.D., FNAP

It was a little over a century ago, in 1915, that Patrick Geddes coined the term to Think Globally, Act Locally. While that idea was initially applied to community planning and conservation of resources, it directly applies to us today. The “Global” objective is that the Medicare Audiologist Access and Services Act (MAASA) legislation that needs to be passed for the nation by way of a unified House bill (H.B. 1587) and Senate bill (S. 1731) that is signed by President Biden in this 2021-2022 cycle.

As for “Local”, Tip O’Neill said so many times: ‘All politics is local’. Passage of MAASA does not just happen in Washington, DC. It happens, or does not happen, in each of the 435 House district seats and each of the 100 Senate seats across the United States. Everyone reading this presidential message has the ability to influence at least three of the 535 Congressional votes: your representative and your two senators.

All legislators respond to the constituents and the needs of their constituents. In advocacy for MAASA, the constituents are you, your colleagues, your patients, and their communication partners. All elected Congressional representatives work hard to understand the points of view of their constituents and to pass legislation that meets the needs of their constituents. This is no secret or surprise as this strategy is the path to their reelection. You must educate your legislators that this is an important constituency issue and become involved to advance the legislation.

In communicating with the three legislators who represent you, you need to (a) be able to describe the three legs of MAASA (Medicare beneficiary direct access to audiologists, reimbursement for Medicare-covered treatment services performed by audiologists under their state-defined scope of practice, and Medicare reclassification of audiology to practitioner status). But more importantly is for you to be able to personalize the problems with the current rules and regulations. You will be most effective when you describe how the proposed legislation will resolve the problems you are having. For example, in the recent ADA/AAA/ASHA Town Hall, 83% of the participants reported that Medicare coverage policies prevented them from providing medically necessary rehabilitative services to Medicare beneficiaries, 93% reported that their Medicare patients have difficulties obtaining the physician orders mandated for coverage, and 67% reported being in contact with physicians who did not understand the need for, or even the reason for, a physician order for a hearing evaluation to be performed on a Medicare beneficiary.

As part of your in-state advocacy, join your state audiology academy or audiology association and motivate them to formally endorse MAASA. Then have the academy/association leadership team send advocacy letters to their U.S. senators describing the importance of the legislation combined with the endorsement demonstrating wide-spread support for the legislation. Next, organize your local audiology community that live and/or work within a Congressional House district. Write a joint letter to your U.S. representative asking for a meeting to discuss MAASA and the legislator’s co-sponsorship of the legislation. Attach to your letter copies of the endorsements from your state academy/association.

Another reason to get involved in your state audiology association is because your scope-of-practice (SOP) is defined by your state licensure act, not by federal statute, and not by your national professional organization. Is your SOP to diagnose and treat hearing and balance disorders or the more limiting ‘nonmedical’ diagnosis and treatment of hearing and balance disorders? Does your SOP allow cerumen management, or do you work in a state where cerumen management is considered a semi-invasive medical procedure and not within the SOP of an audiologist? Does your SOP allow telehealth for audiologists (tele-audiology) or does it prohibit any audiology interactions that are not face-to-face? All of these issues are important today and will be more important with the passage of MAASA. While MAASA will make much needed Medicare coverage updates for the diagnosis and treatment of audiologic and vestibular conditions, cerumen management, and tele-audiology, you will not be able to provide these services if they are not allowed under your state SOP! Membership and active state advocacy efforts are essential for advancing your professional goals and the goals of the profession!

ADA strongly supports your membership in your state audiology association. ADA encourages all members to join and be active in state audiology associations. To show our support, ADA will discount its fellow and associate membership dues for first-time members by the amount of their paid 2021 state dues, and ADA will discount AuDacity conference registration fees by the amount of paid 2021 state dues for all renewing fellow and associate members.

Think Globally to achieve MAASA for the nation-- and Act Locally to secure MAASA from your Members of Congress, and to protect your SOP and bring it into alignment with MAASA’s components.