Inside SLP

When we ask why change inside SLP feels so difficult, we often look to policy debates or leadership decisions. This episode looks instead at the financial architecture underneath it all and why long-term obligations shape what an institution can realistically risk.

To understand ASHA’s caution, we examine the scale of the organization and the financial commitments that anchor it in place.

We explore:
  • The 5-to-1 gap: What ASHA’s financial scale looks like compared to the American Occupational Therapy Association.
  • Long-term commitments: How maintaining a defined benefit pension plan created enduring revenue requirements.
  • Exit costs: Why unwinding decades-old obligations isn’t as simple as restructuring fees or programs.
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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 been separating things that often get blurred together: certification, licensure, and authority. Last time we talked about what ASHA can't legally do and why so much frustration comes from assuming that they have power where there are actually limits. Today, we're stepping into the next layer. We're going to talk about money, not in a sensational way and not to assign blame.

Megan Berg:

We're going to talk about structure how long term financial obligations, including pension commitments for ASHA's corporate employees, shape what an organization can realistically change. It's about understanding the pressures this system is operating under so we can finally see why it feels so rigid. To understand the why, we have to look at the material reality of the organization. Let's compare ASHA to its closest peer, the American Occupational Therapy Association or AOTA. Both professions have roughly 180,000 clinicians in The United States.

Megan Berg:

According to twenty twenty four IRS filings, ASHA reports approximately $184,000,000 in total assets and an annual revenue of $75,300,000 AOTA reports about 39,300,000 in assets and $22,000,000 in revenue. When you divide that out by the number of clinicians, ASHA holds nearly $1,000 in assets per practicing clinician and AOTA holds about $200 That's a five to one difference in financial scale. If you are a clinician wondering why ASHA feels like a massive, immovable corporation while other associations feel like professional clubs, this is the reason. ASHA is operating at a completely different level of institutional weight. And it brings us to the real question: When an association holds that level of assets, what is that money supporting?

Megan Berg:

Is it all for advocacy and modernization? Or is a significant portion of that financial skeleton built to support long term obligations? To answer that, we have to look at the Great American Retirement Shift. Understand ASHA's math, you have to understand the two different ways Americans have historically funded our old age. First, there is the defined benefit plan, the classic pension.

Megan Berg:

In this model, you work for thirty years and the organization promises you a specific monthly check until the day you die. The math is simple for the worker but incredibly complex for the employer. The employer has to guess how long you'll live, how the stock market will perform, and how much money they need to have in the bank thirty years from now to keep that promise. In this model, the organization carries 100% of the risk. Then there is the defined contribution plan, the four zero one ks or four zero three b.

Megan Berg:

In this model, the employer might put some money in a bucket, you put some money in a bucket and ideally the bucket grows. When you retire, whatever is in that bucket is yours. If the market crashes the day before you retire, that's your problem. In this model, the individual carries 100% of the risk. For most of the twentieth century, pensions were the gold standard.

Megan Berg:

They were how you kept good employees. They were seen as the moral responsible way to run a company. ASHA, being a responsible organization, set up a pension for its staff. But then came the nineteen seventies. Inflation was high, the market was shaky, and the government was worried that companies were making pension promises they couldn't keep.

Megan Berg:

In 1974, Congress passed the Employee Retirement Income Security Act, which basically said, if you promise a pension, you have to fund it properly and we are gonna watch you like a hawk. Suddenly, pensions became a massive administrative headache and a legal liability for employers. Then in 1978, a small boring change was made to the tax code section four zero one k. It wasn't meant to revolutionize the world. It was meant to be a minor tax break for executives, but American corporations looked at it and saw an escape hatch.

Megan Berg:

Throughout the nineteen eighties and nineties, the big pivot happened. Thousands of organizations from IBM to small nonprofits froze their pension plans. They told their employees, We will honor what we've already promised you but from now on you're on a four zero one ks. They offloaded the risk from the company's balance sheet and onto the workers' shoulders. But ASHA did not pivot.

Megan Berg:

ASHA is one of the very few organizations of its size that chose to maintain a defined benefit structure for its employees. And I want to be clear that this is a crucial distinction. We're not talking about a pension for you, the SLP who is a member of ASHA. We're talking about a pension for the ASHA corporate staff in Rockville, Maryland, the accountants, the lobbyists, the administrators. At the time, keeping the pension was likely seen as a point of pride.

Megan Berg:

It was a pro worker move for the staff. Because ASHA kept its pension plan active long after other organizations fled to the 04/2001, they locked themselves into a different financial reality. Based on public filings, ASHA now maintains a pension fund for its employees of roughly $100,000,000 Think about that number. That is more than double the total assets of the entire Occupational Therapy Association. This $100,000,000 is not a savings account they can dip into for a new marketing campaign.

Megan Berg:

It is a legal obligation. Under federal law, ASHA must keep that fund healthy. If the stock market dips and that fund drops below a certain level, ASHA is legally required to pour more money in to top it off. This creates what is called institutional gravity. When you have a $100,000,000 promise to keep, your number one priority isn't innovation or professional reform.

Megan Berg:

Your number one priority is revenue stability. You cannot afford a bad year. You cannot afford a drop in membership. And most importantly, you cannot afford to mess with the one product that everyone has to buy. This brings us to the friction we all feel.

Megan Berg:

ASHA's most predictable and renewable revenue streams are recurring dues and certification maintenance fees, which are recognized as deferred revenue and renewed annually. Certification maintenance, whether tied to membership or paid independently, creates stable cash flow that supports the organization's fixed obligations. In this context, dramatically reducing or destabilizing certification revenue would not simply reduce discretionary spending, it would threaten the institution's ability to meet long term fiduciary obligations embedded decades ago. This is why change feels like it hits an invisible wall. When you hear ASHA leaders talk about protecting the value of the CCC, they aren't just talking about clinical excellence.

Megan Berg:

They are talking about protecting keeps the lights on and the promises paid. This is not about bad actors or villains. It's about fiduciary duty. Under corporate law, the Board of Directors has a legal duty to the corporation first. They are legally bound to ensure the organization stays a going concern, an accounting term for a business that is assumed will meet its financial obligations when they become due.

Megan Berg:

If a board member suggested a plan that put the employee pension fund at risk, they wouldn't just be bold. They would be committing corporate waste. They could be held personally, legally, liable. ASHA is tracked by its own history. The exit fee to change the system is now so high that the only way the institution knows how to survive is to maintain the status quo.

Megan Berg:

They are riding a bicycle that can never stop because the moment it stops, the financial weight of the last fifty years will tip over. There's one more tension I want to name because many people have told me the same thing over the years. You need to get involved from the inside if you want change. That advice isn't wrong but it's incomplete. The moment you step into a formal role within an institution like ASHA, even as a volunteer, your role changes.

Megan Berg:

You don't just bring your personal convictions with you, you also inherit fiduciary responsibilities. You are no longer speaking only as a clinician, you are speaking as a steward of the organization's survival. That does not make people dishonest, but it does make them constrained. And it explains something many of us have felt but struggle to name, the way conversations change once someone crosses that threshold, the language becomes formal, the urgency slows, certain options quietly leave the table. It also helps us see why meaningful change often can't rely solely on insider advocacy.

Megan Berg:

Structural systems rarely redesign themselves from within the same rules that kept them stable. I want to be very clear here. Having a pension plan for your employees is not evil. In many ways, it's a more ethical way to treat staff than a four zero one ks. But we have to be honest about the trade off.

Megan Berg:

We, the clinicians, are the ones funding that trade off through our certification fees. We are the subscribers to a system that was designed in a different era of American labor. I want to end this episode by naming a few things that can all be true at the same time. Number one, ASHA has done important work for this profession. Number two, ASHA's corporate employees deserve a secure retirement just like we all do.

Megan Berg:

And three, the way that retirement is funded creates a massive pressure to keep the certification system exactly as it is. None of these truths cancel each other out. But financial structures don't appear out of nowhere. They grow around something older. Before the CCC was a $100,000,000 revenue stream, it was just a fragile idea.

Megan Berg:

Next time we're going back to that moment, to a time when certification was contested, resented, and openly challenged. Because once you see how legitimacy was built under pressure, you start to understand why the system looks the way it does today. I'm Megan Berg. This is inside SLP. And next time, we'll begin at the beginning again.

Megan Berg:

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 therapy insights dot com slash inside SLP. I've also put that link in the show notes for easy clicking.

Megan Berg:

If you want to understand this 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. This podcast reflects my own research, analysis, and interpretation.

Megan Berg:

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.