After an extensive review of the literature and discussion of both national and state proposed health plans, the committee arrived at the following conclusions: 1. The issues that prompted development of the 1971 American Speech-Language-Hearing Association's (ASHA) Position Statement on National Health Care have not been resolved or altered. 2. Few significant national health plans or policies are being supported by the Bush Administration other than managed-care plans. 3. A national health policy will be driven by the development of state health policies and plans. 4. Implementation of national or state health plans will affect both professions at all service provision sites, including public schools. 5. Five general models apply to all existing or proposed national and state health policies or plans: single payer (e.g., a Canadian-style plan) minimum basic benefits ("play or pay") expanded Medicare or Medicaid benefits rationed healthcare (e.g., Oregon plan) managed care (e.g., health maintenance organizations) 6. There will be continued efforts to eliminate Medicaid mandates. 7. ASHA needs to advocate for the inclusion of rehabilitative services as basic rather than optional services in all health plans. 8. ASHA must advocate for adequate access to quality care regardless of healthcare or education provider setting.
The educational needs of children with hearing impairments are the responsibility of local and state education agencies. Comprehensive audiology services to children include prevention, identification, assessment, habilitation and instructional services, supportive in-service and counseling, and follow-up and monitoring services. Audiology programs in schools must be supported by appropriate and adequate equipment and materials, technical assistance, administrative support, and evaluation and research. The needs of children with hearing impairments are diverse. Therefore, a team approach which includes the school audiologist is the only feasible way to ensure that they receive comprehensive services. Services for children with hearing impairments are greatly enhanced when audiologists are on the educational team. The inclusion of audiologists makes possible the proper interpretation and integration of audiologic data into educational planning for programming. Audiologists bring critical and unique skills and knowledge to the educational setting, thus ensuring the maximal exploitation of residual hearing for auditory learning and communication. Audiology services can be obtained by employing audiologists within the schools or by contracting for their services. Regardless of the service delivery system used, adequate numbers of audiologists must be employed to provide appropriate and comprehensive audiology services to all children.
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