Inside SLP

In moments of professional frustration, it’s easy to confuse visibility with authority and to assume that the loudest voice is also the one holding the gavel. This episode looks beneath that assumption, tracing the legal boundaries that shape what a national association can (and cannot) actually do.

We explore:
  • The HOA analogy: Why ASHA operates as a private association, not a regulatory body and why it doesn’t have enforcement power over employers.
  • The tying intervention: How the U.S. Department of Education forced a separation between accreditation and certification.
  • The jurisdiction map: Where different kinds of power actually live, from state legislatures to licensing boards to universities.
  • Fiduciary duty: How the law directs boards to protect institutional continuity, even under intense professional pressure.
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Creators and Guests

Producer
Megan Berg, SLP
Megan is an SLP based in Montana and owner of Therapy Insights.

What is Inside SLP?

Inside SLP is a limited series podcast that reveals how our profession came to be and why it functions the way it does. Most clinicians work inside a system they were never taught to see, shaped by decades of history, policy, economics, and unspoken assumptions. This show offers lightbulb moments that bring clarity to the structures beneath our everyday work and opens space for thoughtful, grounded understanding of the field we share.

Megan Berg:

Welcome to inside SLP. This is a limited series podcast about how our profession came to be and where it's heading. Most of us work inside a system we were never taught to see. This podcast is about slowing down enough to understand that system with clarity, calm, and context. I'm Megan Berg.

Megan Berg:

Let's look inside. Over the last few episodes, we've talked about how ASHA built advocacy power and how that power came with long term financial responsibilities. Today, we're going to pause on a deceptively simple question. Not what ASHA should do but what ASHA is actually allowed to do. Because in the heat of professional frustration, we often mistake a loud voice for a heavy gavel.

Megan Berg:

For many clinicians, ASHA feels like the principal's office. It sets the standards for your education, it publishes the ethics codes you have to follow, its credential, the CCC, is embedded in your job requirements, your state licensure laws, your liability insurance, and your salary schedules. When you are a graduate student, ASHA is the entity that looms over your entire future. When you're a clinician, it's the name on the certificate that determines your paycheck. When things don't feel right, when there are training gaps or supervision strain or financial pressure, it makes total sense that our frustration lands at Ash's doorstep.

Megan Berg:

It feels like they are the ones in charge of the weather. But here's the key distinction we have to make if we want to stay sane. Feeling powerful is not the same as being legally authoritative. In our heads, we've built ASHA into a government agency but in the eyes of the law, ASHA is a voluntary nonprofit professional association. It is a five zero one(six).

Megan Berg:

It is not the police. It is not a licensing authority. It is not a legal gatekeeper to your practice. Those roles belong exclusively to the states. That distinction is the difference between a brand you choose to wear and a law you are forced to obey.

Megan Berg:

Let's look at what ASHA is actually allowed to do. ASHA can define and sell a certification product. Think of the CCC less like a rite of passage and more like a protected trademark like organic or fair trade. ASHA owns the brand. They get to set the rules for who gets to put that sticker on their resume.

Megan Berg:

They can set eligibility requirements, publish guidance, and accredit academic programs through the CAA. All of that is legal. It is normal for a nonprofit. But here's the nuance: because ASHA is a private entity, they have a massive amount of freedom to decide what their product looks like. They can change the requirements for the CCC tomorrow and they don't need a vote from the public or a decree from Congress to do it.

Megan Berg:

They just have to follow their own internal bylaws. However, that freedom comes with a hard ceiling. Because they are private, they cannot stop you from being an SLP. They can only stop you from using their specific brand name. If you meet your state's requirements, you can practice.

Megan Berg:

Fact that most employers demand the brand name is a market reality, not a legal one. This is where the misunderstandings pile up and the heat starts to rise. ASHA cannot grant or revoke a license to practice. They cannot enforce supervision requirements in your specific building. ASHA cannot mandate how a university structures its degree.

Megan Berg:

Even the CAA, the accrediting body, operates on standards, not structures. For a long time, the line between the university degree and the ASHA certificate didn't just look blurry, it was non existent. ASHA essentially required universities to require their students to get the CCC. It was a closed loop. If you wanted the degree, you were forced into the certificate.

Megan Berg:

I sat down with an audiologist who lived through the moment that that loop was forcibly broken. This is Angela Lovenbrooke, former president of AAA, ASHA fellow, former ASHA board directors member, and recipient of honors of the academy.

Dr. Angela Louvenbrouk:

Your master's degree programs are accredited by ASHA, CAA. And and you should take I mean, I have some testimony before the Department of Education about the CAA because the CAA used to require as a condition of accreditation that the c's had to be part that the c's

Megan Berg:

had dead? That used to be a thing?

Dr. Angela Louvenbrouk:

Yeah. We went in hours and hours of testimony, and the Department of Education told ASHA they had to stop, which is when this whole business came about that, oh, yes. You you you have to have a supervisor who has the Cs only for students who wish to get their Cs.

Megan Berg:

Did you catch that? The US Department of Education stepped in and told ASHA they had to stop. Why? Because legally, that's called tying. You cannot use your power as an accreditor, the person who says a school is good, to force people to buy your private product, the CCC.

Megan Berg:

The Department of Education essentially said, You can't have a monopoly on the profession. You have to allow the university to be an independent house. This is why today the CIA operates on standards, not structures. A university is an independent entity. They choose to build their degree to match ASHA's certification requirements because that's what the market demands and what students want.

Megan Berg:

But legally, the university holds the hammer. ASHA just holds the yardstick. They can tell a school what a student should know but they cannot legally mandate how that school is built. The fact that it still feels like a monopoly is a testament to how powerful the brand has become, not how much legal power ASHA actually holds. This is why when clinicians call ASHA with concerns about unethical or unsafe working conditions, they are often told to contact their state licensing board.

Megan Berg:

To a clinician in crisis, that feels like a brush off. It feels like deflection. But in reality, it's jurisdiction. Imagine you live in a neighborhood with a homeowners association. The HOA has rules about the color of your front door and how short your grass should be.

Megan Berg:

But if a crime is committed on your street, the HOA doesn't show up with handcuffs. They can't. They don't have the legal power to arrest anyone. You have to call the police. Calling ASHA about a clinical ethics violation is like calling the HOA to report a robbery.

Megan Berg:

They can kick the person out of the club but they can't take away their right to stand on the sidewalk. Only the state government holds that legal muscle. When we demand that ASHA fix clinical settings, we are essentially asking the HOA to build a jail. They literally don't have the blueprints for it. Here is the part that is emotionally exhausting for many clinicians.

Megan Berg:

Certification has been woven so tightly into our employment and reimbursement that it feels compulsory, even when legally it's not. If your employer says you must have your CCC to work here, that is a contract contract between you and your boss. ASHA didn't sign that contract. Your state legislature didn't sign that contract. But because ASHA has been so successful at marketing the CCC as the gold standard for over seventy years, employers use it as a shorthand for competent.

Megan Berg:

The gap between voluntary on paper and required in practice creates a massive amount of friction. We feel trapped in a system that we didn't choose and we look for someone to hold accountable. But when our frustration is aimed at an institution for things it legally cannot do, like regulating the behavior of a private rehab company, the result isn't reform, it's burnout. We end up screaming at the HOA for not fixing the city's potholes. We see this boundary clearly in the case of Bogus B.

Megan Berg:

Asha. We'll dive deep into this later in the season but for now, look at what the case revealed. When the structure of the CCC was challenged in court, the legal system didn't look at whether the CCC was fair or good for the profession. It didn't care if clinicians felt unheard. It looked at the nature of the organization.

Megan Berg:

The court essentially told the profession, ASHA is a private club. If you don't like the rules of the club, you don't have to join. The fact that your boss or your state says you have to join doesn't transform ASHA into a government regulator. This was a watershed moment. It confirmed that ASHA is allowed to limit its membership and tie certification to those dues because they are providing a private service.

Megan Berg:

The court didn't say that the system was perfect, it said it was lawful. That distinction is super uncomfortable because it means there is no Supreme Court of SLP coming to save us. We have to understand the limits of the players involved. Understanding what ASHA can't legally do doesn't excuse the problems in our field but it does change how we talk about them. People often come to me with questions like, Why can't ASHA give me a straight answer on supervision ratios?

Megan Berg:

Or Why does ASHA always tell me to talk to my state licensing board about reimbursement? To a clinician in the thick of it, this feels completely like a brush off. It feels like ASHA is passing the buck. But the reality is that the definition of competence and the legal authority to practice has been left entirely up to the states. To address issues we want to work on, we have to stop walking into the wrong rooms.

Megan Berg:

If we want to change the reality of our daily work, we have to understand who holds the hammer for each specific problem. If your problem is caseload caps or school salary scales, that is your state legislature and your state Department of Education. ASHA can provide guidance papers but they cannot sign your contract. If your problem is supervision requirements or license portability, that is your state licensing board. They are the only ones who can change the law of the land in your zip code.

Megan Berg:

If your problem is a master's degree that didn't prepare you for medical SLP, that is the CAA, the accrediting body, and the University Board of Regents. If your problem is a private company forcing you to see 12 patients a day, that is a labor law and contract issue. ASHA does not have a police force to audit private businesses. This is where the SLP blueprint starts to look very different from our colleagues in physical therapy. To join APTA, you are required to join your state chapter.

Megan Berg:

They've structured their power to ensure that when a battle happens at the state capital, where the licensing laws and caseload rules actually live, the state association has the money and the professional staff to fight it. ASHA chose a different path, a centralized national model. We have a massive, well funded national engine in Maryland but our state associations are left as voluntary add ons. They are often run by exhausted volunteers on shoestring budgets, easing their weekends to lobby for our entire profession. So when we hit a crisis, we look to the national office for a fix they don't have the jurisdiction to provide while our local associations are trying to fight a forest fire with a garden hose.

Megan Berg:

This isn't about letting anyone off the hook, it's about putting the hooks into the right places. When we know which room to walk into, we stop wasting our breath in the national hallway and start realizing that the legal muscle is at the state level. It's just that we've left that muscle largely underfunded and unattended for decades. So if ASHA can't legally force change and if states don't coordinate nationally and if universities aren't required to fully embed clinical training, why does the system stay so stable? Why is it so difficult to rethink these structures even when so many clinicians feel the strain?

Megan Berg:

At this point, it's tempting to answer with emotion but there is another layer we haven't looked at yet. One that doesn't live in policy or law, it lives in accounting. An organization's first duty is not to its members' feelings, it is to the entity itself. Under the legal principle of fiduciary duty, the board is bound to protect the organization's assets and ensure it can meet its long term promises. If they prioritize a popular member demand at the expense of the organization's solvency, they aren't just making a bad choice, They are committing corporate waste and could be held legally liable.

Megan Berg:

To the law, the institution's survival is the only non negotiable. Next time, following the money. We're going to look at the hidden gravity of the association's finances, the 100,000,000 staff pension fund, and why the financial stability of the brand might be the real reason the system stays so rigid. Sometimes the answer is in the ledger. I'm Megan Berg.

Megan Berg:

This is inside SLP. If you are finding this podcast informational and helpful, please leave it a rating in a written review. This helps other people find the show. My intention with these episodes is to help us all move forward as a profession and the more we all understand how the system works, the more we can move forward together. If you'd like me to present this information to your workplace, grad program, or SLP book club, please contact me at therapyinsights dot com slash insideslp.

Megan Berg:

I've also put that link in the show notes for easy clicking. If you want to understand the system more deeply, I invite you to learn about the PACT survey, a national effort to capture how SLPs, audiologists, employers, and consumers experience our profession. You can sign up for updates at pactsurvey.com. That's pactsurvey.com. PACT stands for perspectives and accountability credentialing and training.

Megan Berg:

This podcast reflects my own research, analysis, and interpretation. It is not affiliated with, endorsed by, or produced in collaboration with ASHA or any other professional association. Historical information referenced in this episode is drawn from publicly available sources, including the book The First seventy five Years: An Oral History of the American Speech-Language-Hearing Association (1999), by Russ Malone, former Public Information Director for ASHA, along with publicly available legislative records and archival materials. Any errors or interpretations are my own.