MSHA members in action.

MSHA Committees


Past President Jennifer Rindal
President Catherine Drescher
President Elect Lezlie Pearce-Hopper
Secretary Shelby Midboe
SLP at Large- Kathleen Delapp-Cohn
Audiology at Large Kristy Foss
Treasurer Sharlene Schmidt Report
Honors Kathleen Delapp
Political Action:   Jessica Reynolds Report
Licensure:   vacant
UM Liason   Amy Glaspey
Ad-Hoc Committees
Summer Institute  Diane Simpson Report
SEAL:   Janis Hayes-Strom Report
Fall Convention:   Catherine Drescher

Jennifer Closson Report
SMAC/STARS:   Carol Morse Report
Advisory Council Crystal Dvorak, Jenny Lee Nitz

Prevention Diane Simpson Report
Community Outreach:   Leah Jacobsen Report
CSPD Jennifer Closson Report
Website:   Emily Stafslien Report
Public Relations:   Kitty Griffin Report
Student Coordinator/SCHWA:   Amy Glaspey Report
Scholarship: Shelby Midboe report
U of M/Schwa Rep. Carlee Johnson
CEA Anne Juel
CE (MSHA Only) Mary Callahan
Website Design Corinne Earl
Region Coordinator 1  Marilyn Thaden-Miles City
Region Coordinator 2  Laurie Grisham-Great Falls
Region Coordinator 3
Region Coordinator 4  Jennifer Pierce-Butte

Lezlie Pearce-Hopper Helena
Region coordinator 5

If you would like to join a committee or the board, please contact the current MSHA President!

Current Committee Report

COMMITTEE REPORT MSHA March 2017 Meeting (2)


President – Plans and resides over all Executive Board meetings, represents MSHA in all matters affecting the membership, oversees the annual convention (planning and execution) and maintains contact with the Montana Licensure Board regarding vacancies and other issues.  One year term.

President-Elect – Oversees all standing and ad hoc committees, collects committee reports for Executive Board meetings, audits the Treasurer’s books on an annual basis and represents MSHA in all matters affecting the membership in the absence of the President.  One year term, becomes President the following year.

Past-President – Submits nominations for vacant Executive  Board positions, conducts the election of Board members at the annual convention, reviews and coordinates the Bylaws of the organization and acts as liaison between the Executive Board and the university programs.  One year term following the Presidency year.

Secretary – Keeps accurate minutes of all Executive Board and annual business meetings, acts as chair of the Membership and Publications committees, and oversees the accounting of membership.  Two year term.

Treasurer – Maintains the financial books for the organization, writes all checks and keeps track of  income and expenses; prepares and presents organizational budget to the membership at the annual business meeting; submits financial information to outside agency for audit and reports the result back to the Executive Board.  Two year term.

Audiology Member at Large – This position is typically held by the MAG President.  Acts as chair of the Ethics committee, and reports all violations of the MSHA Code of Ethics to the Executive Board.  One year term.

SLP Member at Large – Acts as chair of the Honors committee, reviews nominations and submits them for approval of the Board.  One year term.

Student Representative – Acts as a bridging agent between the organization and the students enrolled in University SLP and Audiology programs.  One year term.


ConventionTo plan a program for the annual Fall Convention.

Political Action Committee – To study and evaluate all regulations, legislation, and recommendations which might affect the speech and hearing profession or program and to help prepare and support such regulations and recommendations as will be beneficial to the profession; secure the services of a lobbyist with Board approval and act as liaison between the lobbyist and the Board of Directors.

Membership and Publications CommitteeIn conjunction with Administrative Assistant, process all applications for membership and exercise general supervision over matters related to membership, subject to reversal if necessary by majority vote of the Executive Committee;  compile, edit and distribute the MSHA Communicator and MSHA Directory and other assigned official publications, in conjunction with Administrative Assistant.

Honors Committee – To receive and review recommendations for and to select persons to receive the honors of the Association; confer MSHA Awards to recipients at MSHA Annual Business luncheon.

Continuing Education Committee – To administer MSHA’s sponsorship of continuing education programs in conjunction with Administrative Assistant.

Ethical Practices Committee –  To present future amendments to the Code of Ethics to membership for majority approval by written ballot; process alleged violations of the Code of Ethics according to the Ethical Practice Committee Statement of Practices and Procedures; publish the Code of Ethics along with procedures for processing alleged violations in the Directory of Montana Speech Pathologists and Audiologists.

Public Relations Committee – To raise public awareness of the profession by promoting speech/language pathologists as the field experts in the areas of communication disorders; develop and disseminate information about communication problems to the public and other professional organizations through activities such as Better Speech and Hearing Month, professional brochures, etc.

Nominations Committee – To solicit nominations from the membership for each available MSHA office and each expiring Board membership.

Licensure Committee – To serve as liaison between the Speech Language Pathology and Audiology licensure board and membership of the Association.

Committee Reports for 4-19-2016 MSHA Executive Board Meeting

Membership- Shar Schmidt

As of 4-17- 15: 76 Students, 131SLPs, 23 AUDs, 7 DUAL, 3 Speech Aides Total: 240

As of 6-9- 2015: 79 Students, 134 SLPs, 25 AUDs, 7 Dual, and 3 Speech Aides Total: 248

As of 9-2- 15: 80 Students, 148 SLPs, 25 AUDs, 7 Dual, 3 Speech Aides Total: 263

As of 10-12- 15: 91Students, 162 SLPs, 25 AUDs, 7 Dual, 6 Speech Aides: Total: 291

As of 12-9- 2015: 96 Students, 164 SLPs, 24 AUDs, 7 DUAL, 9 Speech Aides: Total 300

As of 1-20- 2016: 39 Students, 92 SLPs, 16 AUDs, 2 DUAL, 6 Speech Aides: Total 155

As of 4-14- 16: 43 Students, 112 SLPs, 17 AUDs, 3 Dual, 6 Speech Aides: Total 181


February 2016 – Mailed out to 121 members, 62 noncurrent members and emailed to 96 students, 1

audiologist and 1 SLP. Following the mailing I was expecting to get an influx of membership renewals but that

really didn’t happen as you can see from the numbers listed above.

Political Action: Jessica Reynolds- see below


Ethical Practice: Lisa Cannon

No report.

Licensure: Jessica Reynolds, Rachel Stansberry

The group interested in this issue met with our lobbyist. The Economic Affairs Interim Committee will meet on April 14. Jessica Reynolds and Lezlee Pearce-Hopper will represent us at this meeting. This committee is charged with addressing license fees for all professions. Lezlee did a great write up for this committee and Abby (our lobbyist) recommended that we share this with the committee member who may propose legislation in the next session.The newly seated licensure board meets on April 29.  We sent out a survey to members to get opinions and support forour position on lower fees.  Rachel and some students from Missoula plan to attend this meeting.  We have a proposed contract from our current lobbyist for the next session. Her fees have increased to $7000.  We received a  grant from ASHA to work on this issue.

MSHA Legislative Update-Jessica Reynolds

On April 14, the Economic Affairs Interim Committee (EAIC) of the Montana Legislature met to consider proposals for restructuring professional boards in Montana. The committee heard testimony from a representative of the Federal Trade Commission recommending adoption of active board supervision in line with current legal guidelines. This would require professional boards in Montana to be supervised by an impartial party outside of the market. In addition, Lezlie Pearce Hopper and Jessica Reynolds proposed changes to the current board structure on behalf of MSHA. The proposal included adopting a model based on Colorado’s recent license fee structure, which includes yearly audits by the state treasurer. MSHA also proposed allowing online license applications and renewals, prorating renewals, and allowing renewal cycles to reflect CEU cycles. The EAIC will meet again this summer to discuss proposals.

Ad Hoc Committees

Summer Institute: Diane Simpson

Nothing to report.

Seal: Janis Hayes Strom

The SEALs from each state have a monthly conference call and also meet at the summer ASHA Schools Conference. The conference this year will be in Minneapolis and will be a joint conference with the ASHA Medical Summer Conference. The main topic for the April conference call was “Successfully Building Bridges With Your Department of Education.” SLPs from Nevada delineated the steps they took to Increase Interaction and cooperation with their Dept. of Education. The main points were: increasing communication, specifying who was responsible and working toward common goals. A powerpoint of their presentation is attached.
Another discussion involved Music Therapists who can be licensed in some states providing speech and language therapy.
Several SLPs from other states reported Music Therapists are providing metronome therapy and other therapies that fall under the skill set of the SLP and they are addressing it with their licensure boards. No SLPs in Montana have contacted me about Music Therapists providing therapy that is not in their scope of practice.
Another group that SEALs have been discussing for several months are  ABA therapists with various credentials providing speech therapy , doing things such as “echoics” and telling parents that use of Assistive technology will make their child never talk. In my personal experience we were told that children enrolled in an early childhood Autism program called STAR in Billings could NOT receive any speech therapy services because we would not be following the ABA protocol and their trainers were better suited to provide speech and language services. As a result we now have some of those children in elementary school who are nonverbal or not functionally verbal when they could have received early intervention from SLPs.
SEAls from every state submitted their determination of eligibility for Special Education and related services. There was a lot of discussion about the wide variability in requirements. The requirements are not consistent across states or even across districts and CO OPS in Montana. Most states included something about “Communication impaired”  or “Speech/Language Impaired meaning a language disorder in the areas of morphology, syntax, semantics and/or pragmatics/discourse which adversely affects a student’s educational performance and is not due primarily to an auditory impairment. Montana does not specify which assessments are required in most districts. Many other states used the following: The problem shall be demonstrated through functional assessment of language in other than a testing situation and performance either below 1.5  or 2.0 (depending on the state) standard deviations, or the 2nd to 10th percentile (also depending on the state) on at least two standardized language tests, where such tests are appropriate, one of which shall be a comprehensive test of both receptive and expressive language. When the area of suspected disability is language, assessment by a certified speech-language specialist and assessment to establish the educational impact are required. The speech-language specialist shall be considered a child study team member. When it is determined that the student meets the eligibility criteria according to the definition AND requires instruction by a speech-language specialist only, the student shall be classified as eligible for speech-language services.

Fall Convention: Jennifer Rindal, Rachel Stansberry,

We have secured the Great Northern in Helena for October 20-22.  October 19-we have a room for the board meetingOctober 20-21 we have rooms for an MSHA/MASP track and one for the audiology track. October 22 we have a room for an all day Medical SLP track What still needs to be decided: When will we hold the business meeting? Who will handle the poster session? Who will handle the silent auction? Who will handle the social? Who will handle the vendors? What is our budget for expenses both site and speakers?  What fees do we need to charge to cover our expenses?

Scholarship Committee: Rachel Stansberry, Shelby Midboe, Alex Warehime

Recognizing that some applicants from last year may re-apply, the scholarship committee selected new writing prompts for this year's scholarship and got the application out to UM students in early March. Applications are due May 2nd, and the committee is looking forward to making two selections for this year. Winners will be notified on June 1st.

StAMP/StARS: Carol Morse


Lisa Satterfield has moved on to be working in the field of Audiology rather than as Director of Health Care Regulatory Advocacy and the StAMP in ASHA. Our new person is Sarah Warren. I will introduce her by listing her accomplishments in ASHA. Sarah Warren, MA Director, Health Care Regulatory Advocacy. Joined ASHA March 14, 2016. Has worked on regulatory and legislative issues for 10 years in the therapy/rehabilitation space including at the American Medical Rehabilitation Providers Association and American Physical Therapy Association.Focused on Medicare Part A and B issues including implementation of MACRA and the IMPACT Act, responding to proposed rules, monitoring MMR implementation, audits and appeals, and quality measurement development and reporting. Submitting a proposal for the Convention with Renee Kinder on the Medicare appeals process.

1. Manual Medicare Review

Update February 09, 2016

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), signed into law on April 16, 2015, extended the therapy cap exception process through December 31, 2017 and modified the requirement for manual medical review for services over the $3,700 therapy thresholds. MACRA eliminated the requirement for manual medical review of all claims exceeding the thresholds and instead allows a targeted review process. MACRA also prohibits the use of Recovery Auditors to conduct the reviews. CMS has tasked Strategic Health Solutions as the Supplemental Medical Review Contractor (SMRC) with performing this medical review on a post-payment basis. The SMRC will be selecting claims for review based on:

 Providers with a high percentage of patients receiving therapy beyond the threshold as compared to their peers during the

first year of MACRA.

 Therapy provided in skilled nursing facilities (SNFs), therapists in private practice, and outpatient  physical therapy or speech-language pathology providers (OPTs) or other rehabilitation providers. Of particular interest in this medical review process will be the evaluation of the number of units/hours of therapy provided in aFor CY 2015, the limit on incurred expenses (therapy cap) is $1,940 for physical therapy (PT) and speech-language pathologyservices (SLP) combined and $1,940 for occupational therapy (OT) services.

2. ALJ Delay

The Office of Medicare Hearings and Appeals (OMHA) which manages the third level of the MedicareAppeals process, the Administrative Law Judges (ALJs), held an appellant forum on February 25, 2016.During the forum, Chief ALJ Nancy Griswold released the most recent numbers associated with thebacklog. In FY 2015 OMHA received over 240,000 requests for a hearing and each ALJ team is able toprocess approximately 1,200 appeals a year. The backlog is estimated to be approximately one million requests for hearings and providers can expect to wait at least two years to have a hearing. OMHA also announced the expansion of the Settlement Conference Facilitation (SCF) pilot to Part A claims. This process brings together the appellant (e.g. the provider) and CMS through a mediator toachieve a settlement on claims pending a hearing. The SCF was developed in 2014 and was limited toPart B claims until this year. In the two years SCF has been available only 2,000 Part B claims pending a hearing have been resolved. Full details on the SCF can be found on the OMHA website at

2. Recovery Audit Program Changes Effective January 1, 2016

In November 2015 CMS announced a series of changes to the Recovery Audit program, including revised Additional Documentation Request (ADR) limits. Many of these changes were effective January

1, 2016. A full list of these changes can be found on the CMS website at Data-and- Systems/Monitoring-Programs/Medicare- FFS- Compliance-Programs/Recovery- Audit-Program/Downloads/Recovery- Audit-Program-

Enhancements11-6- 15-Update- .pdf.

3. CGS CGS, a Medicare Administrative Contractor (MAC) recently issued guidance on their website

implementing an erroneous interpretation of Medicare guidelines for the provision of services in a SNF.

These guidelines are as follows: I participated in a presentation to state presidents with 2 of my StAMP colleagues in February. News from CGS Skilled Nursing Facility: Documentation Required to Bill Speech Therapy Services — When billing for speech therapy in the Skilled Nursing Facility (SNF) setting, the patient's medical record mustcontain documentation proving medical necessity for the service.

 Patients who have been transferred to a SNF from a covered hospital stay must be treated in the

SNF for conditions that were treated or arose during their qualifying hospital stay.

 If there is no indication that the patient received speech therapy during their hospitalization,

speech therapy should not be billed by the SNF.

 If however, the patient's condition changes while they are in the SNF, and the need for speech

therapy can be documented as medically necessary, then and only then should the SNF bill for

speech therapy.

Reference: CMS Medicare Benefit Policy Manual (Pub. 100-02) chapter 8, sections 10 & 30.2.2.


Code 97532 – Cognition

 There has been a correct coding edit (CCI) which precludes speech language pathologists from billing 97532 and

92507 on the same day. However, this was originally implemented for the Medicare program, and some

Medicaid programs have allowed this practice in the past. Note, these codes should not be billed on the same

day. Margaret Ann (GA) thought that Georgia still allowed this practice, but Laurie verified (after the call) that

this is not allowed.

 Many states allow for the practice of billing 97532 and if not allowed, whether cognition is allowed but billed

under 92507. WV, NC do allow for cognitive treatment, billed under 92507. Robin will follow up to see if the

taxonomy for the SLP allows billing of 97532.

Physician signature required for service

 SLPs do not require a physician’s referral for evaluation and treatment, unless required by the payer.

I have submitted my name as a potential panel member in a Medicaid panel training course during the 2016 ASHA

Conference in Pittsburgh. I would represent the state of Montana and report and answer questions about Medicaid

in Montana.

I will be attending AASHA Connect in Minneapolis in July. Feel free to contact me with questions or issues in

Medicare or Medicaid.

Carol Morse

Committee Chair

Advisory Council: Crystal Dvorak  Jenny Lee Nitz:

The SLP Advisory Council met in Rockville Maryland at ASHA headquarters March 19 th -20 th . We once again spent a day on Capitol Hill meeting with a staff member in each of Montana’s legislative delegates office. The 12 issues that are upcoming and of interest to ASHA were given to each office in the form of a legislative brief with ASHA’s position and contact information. Members can look these issue over on ASHA’s website under Advocacy and Federal Issues Briefs. Crystal Dvorak, Montana’s Audiology Advisory Council member, was present at the meetings. During the day and a half meeting of the SLP Council consisted of gathering information and viewpoints on issues such as the Strategic Pathway goals and objectives, IPP/IPE Strategic Objective, Willful Blindness, ABA and SLP working collaboratively, and Speech and Language Disorders and SSI Disability. It was a busy and interesting meeting.

Prevention: Catherine Off and Diane Simpson (Chair):

The Prevention committee is continuing to feature a prevention/awareness topic each month.  This month is AutismAwareness Month.  We will be doing lots of things for May is Better Speech and Hearing Month.

Community Outreach: Leah Jacobson:


12/14/15: $250 approved to Emily Tiry for hearing aid accessory assistance (requested by Kristy Foss).

12/14/15: $250 approved to Brandi Deming for hearing aid accessory assistance (requested by Kristy Foss).

1/7/16: $245 approved to Zack Sagrilla for hearing aid repair assistance (requested by Tina Hoagland).

3/3/16: $269.99 approved to Cody Nulliner for Dynavox Compass App (not covered by Medicaid) requested by

Michael Crews.

Available balance in Community Outreach fund as of 4/5/16 is $432.46.

CSPD: Jennifer Closson

Nothing to report.

Website: Diane Simpson/Bridgette Watters/Rachel Stansberry

We met with our web designer, Corrine Earl at the end of February and discussed changes we'd like to see to the website. We asked the web designer to focus on the home page and use the California Speech and Hearing Association as a template.  We also hoped to get some guest bloggers and some input from the medical SLPs. Recently the home page has been updated, but overall it is still not where we want it to be.

Public Relations: Kitty Griffin

Planning on sending out an email this summer to poll the members on what products they may like to have for the Fall convention. Still have quite a few clipboards to sell.

Student Coordinator/SCHWA: Amy Glaspey

verbal report at meeting

Telepractice-Diane Simpson

Valeria approved the telepractice offering as a MSHA offering. In March, Diane and Rachel offered four hours of trainingto students at UM and they will offer the four hour training on April 19 (2 hours) and May 3 ( 2 hours).  We are both committed to supporting those who use telepractice in Montana.

Continuing Education: Valeria Schmauch

Recently, I received a productivity report from ASHA which quantifies the course offerings that have been registered from MSHA.  As you can see, we were in the”middle of the pack”, but the performance review reveals that improvement needs to be made in the areas of disclosure statements, and in the area of brand block and CEU statement.  All these areas were corrected prior to ASHA approval of the offending course offering.  I’ll need to be more careful, in submission to increase the compliance score.
The one “high’ note in this report is in the area of participants per offering.  We have a slightly higher number of participants than the median.

Committee Reports 1-26-2016

Convention Site

chair:  Rachel Stansberry
members:  Theresa Metropoulous, Bev Pickett
2016 Convention will be at the Great Northern Hotel in Helena Montana October 20-22, 2016.  We have space for Thursday, Friday and Saturday for both audiology and speech language pathology tracks. We have space if we want to partner with MASP.


chair:  Rachel Stansberry
members:  Brigette Waters, Diane Simpson, Corinne Earl
We surveyed MSHA members at the end of December and received 10 responses.  Here are the highlights:
70% of respondents used the website to register for convention
80% used it for renewing membership
90% used it to find info about MSHA
60% prefer to get info from website over facebook.
Attached are responses for what people liked, what they would like changed.
We will use this info to make changes. We are also trying to get bloggers for the site and to get board members trained on how to log in and update the site. Corrine continues to be our web page manager and we are covering our costs by an ASHA grant. This grant is good through June. We will need to determine how to cover costs after that.

License Fee Issue

chair:  Rachel Stansberry
members: Jessica Reynolds,  Lezlee Pearce Hopper, Jenn Closson, Ellen Sue Diamant-Rink
 No surprises, we are still waiting for the licensure board to meet. The Executive Office had said they would meet at the end of January, but by the time she reached out to the board members, they couldn’t clear their schedules in order to attend both a training and a board meeting.  The last I heard was that the meeting would occur at the end of February.

2. Our lobbyist, Abigail, sent this email:

The agenda for the Feb. 4-5 Economic Affairs Interim Committee is now available, and there is no scheduled discussion on the SB 390 study.  However, I just got off the phone with the committee staffer, Pat Murdo, and she is going to have on the April agenda a full discussion on not only the board authority to raise fees, but also the state authority to exercise oversight over the boards.  Pat and I will stay in communication as she develops the April agenda, but I think we can be on stand-down for the February meeting.

I would like to discuss with you all the ideas we spoke about at the December meeting—education for up to 21 (the Pope bill from 2015) and speech-language pathology aide authorization.  Specifically, I’d like to discuss how we can be working on those in the interim and what other groups we might be partnering with.  Is there some time in the next few months when I could sit down with the board to discuss?  Thanks.  Hope the new year is treating you well so far.


3. It would be great if any or all of you would send a request to the board members, respectfully requesting a meeting in which they address the fee issue.  Specifically request that we keep the fee and go to a two year renewal.  Here are the names and emails of the current board.


ASHA SEAL report-Janis Hayes-Strom attended the SEAL meeting in Phoenix this summer at the Schools Conference. A main topic of discussion was the new requirement of some districts for SLPs to make up missed sessions. Some  are requiring SLPs to make up missed sessions regardless of the reason. ASHA recommendations are that it is the district’s responsibility and not the individual SLPs, as others who provide services listed on an IEP such as SPED teachers are covered by a sub and not expected to make up the time themselves. They recommended offering summer school services, and stated that particularly if an SLP is using a contract granted personal day or there is a filed trip or she is at a meeting he/she should not be making up the time herself.

Other topics of discussion were the reauthorization of EDHI, and caseload/workload. Some school based SLPs have over a hundred on their caseload and SEAL members adamantly stated ASHA needs to more aggressively address this issue. SEAL members also have monthly conference calls, and during the most recent call we discussed the great increase in doctors writing prescriptions for speech evals and speech services in the schools. Some thought it was a good trend as physicians were actually cuing into speech and language disorders, while others expressed concerns that these children may not qualify or be in need of school based services because we must show educational impact.

The next ASHA Schools conference will be in Minneapolis in summer 2016 and ASHA is looking into combining it with the Health ASHA summer conference as so many SLPs work in multiple settings.

Janis Hayes-Strom, M.A. CCC-A/SLP

(406) 671-3132

The ASHA Audiology Advisory Council met in March in Washington DC for traning and grassroots advocacy by lobbying congress on Capitol Hill. Most recently the main focus is on reauthorization of EDHI, which passed the house and is headed for the senate. ASHA is collaborating with ASHA-recognized state speech-language-hearing associations to advocate for consistent, fair, and comprehensive coverage of rehabilitative and habilitative services and devices in each state’s health insurance marketplace. ASHA has developed a comprehensive advocacy guide, Essential Coverage: Rehabilitative and Habilitative Services and Devices, to be used by state associations and interested members, which explains the integral role audiologists and speech-language pathologists have in providing services to clients who require rehabilitation and habilitation services. It also provides clinical examples for when audiology and speech-language pathology services are medically necessary under the rehabilitative and habilitative services and devices benefit category. State association leaders can now use the document to advocate for more robust and comprehensive coverage in their state for rehabilitative and habilitative services performed by audiologists and speech-language pathologists.

Janis Hayes-Strom, M.A. CCC-A/SLP