ASU faculty members advocate for better access to speech and hearing help for Arizonans
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The impact of Arizona State University goes far beyond its four campuses.
Consider Arizona Senate Bill 1741, which was signed into law in June.
The bill allows Arizona’s adults in the Arizona Health Care Cost Containment System (AHCCCS), the state’s Medicaid insurance, to receive outpatient speech-language therapy and cochlear implants, which were previously not covered.
Three champions advocating for the law were current and former ASU faculty: Victoria Clark, a clinical associate professor in speech and hearing science in the College of Health Solutions and president of the Arizona Speech-Language-Hearing Association; Denise Stats-Caldwell, a clinical professor in the College of Health Solutions; and Kathleen Peterson, who was a clinical assistant professor in ASU’s Speech and Hearing Sciences Department from 2011 to 2015.
“We’re doing this, as speech language pathologists and audiologists, after hours,” Stats-Caldwell said. “But it aligns with the ASU Charter, which is about making a local impact and being socially embedded.”
ASU News spoke with Stats-Caldwell about the law and how it benefits both individuals and the state of Arizona.
Note: The following interview has been edited for length and/or clarity.
Question: Let’s start here: How did you get involved with this legislation?
Answer: (In 2020) I was working in the role of speech language pathologist at Banner MD Anderson Cancer Center. And what I noticed was that we would have otherwise healthy people getting mouth and throat cancer who were at their maximum wage-earning capacity. They would have lifesaving measures to manage the cancer, but they would be left with trouble talking or trouble eating and drinking. If they were unemployed due to their challenges talking, they would be on AHCCCS. Under that system, they were not able to get speech therapy, regardless of the medical necessity or the potential for improvement.
What that meant was that our hands were tied for this subset of the population. We could not support their return to talking, eating and drinking. And that in turn kept them on state resources, including AHCCCS. I called AHCCCS at one point and found out that was the state law.
Q: What did you do next?
A: I joined the Arizona Speech-Language-Hearing Association and took the issue there.
Q: Let’s talk about the bill. How, precisely, will it help people?
A: It’s going to have a large impact on individuals. Obviously, if you can’t talk well or eat and drink, that’s a huge negative impact on quality of life. It’s also a barrier to people practicing autonomy, being employed, earning an income and decreasing their reliance on state resources.
Q: This law is good for the state as well, right? For example, the annual cost for 20 patients if they remain on permanent feeding tubes is $200,000. Ten therapy sessions with AHCCCS is $897.
A: In the long run, what’s good for the person is good for the state and the economy because AHCCCS is funded by federal dollars and some state dollars. So we had a strong fiscal argument. For example, in the mouth and throat cancer population, if we can provide preventative swallowing therapy — depending on the patient of course — we have good success at keeping people off permanent feeding tubes. The management and care of those tubes, not to mention the specialized food that goes into them, is very expensive. It’s a lifelong commitment and not without its medical complications. For cochlear implants, it’s the same thing. If people can’t hear, they have a hard time working and making their own appointments and so on.
Q: You mentioned swallowing therapy. What are some of the other speech services that can now be offered to adults through AHCCCS?
A: Another really important therapy is cognitive therapy, which is typically provided by a trained speech language pathologist who specializes in that area. You will have people who are in car accidents or have concussions due to sports injuries or falls who now may have trouble with short-term memory organization, like reasoning and planning their day so that they're on time and are meeting their responsibilities. They may look fine on the surface level but when challenged with even simple problem-solving tasks, they struggle. They pose the greatest favorable prognosis for responding to cognitive therapy, but we were unable to provide it before under AHCCCS.
Those patients often had to go to outpatient clinics operating under the umbrella of one of the large health care organizations, and for reasons not all of which are in their control, they’re not able to provide the therapy.
Q: This sounds like a win-win, for the state and for those AHCCCS patients who need speech therapy and cochlear implants.
A: It is. When you’re thinking about little “a” advocacy for an individual person, we try not to think about the money. We have to, but that’s not what is most important. But when you’re thinking about big “A” advocacy, it always involves big money. So it would be irresponsible for us not to consider the fiscal impact on the state economy.
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