Volume 21, Number 4
New York State Occupational Therapy Association Special points of interest: > NYSOTA conference 2010
119 Washington Ave· Albany, NY 12210 · Phone: (518) 462-3717 · Fax: (518) 432-5902 · www.nysota.org · email: email@example.com
> NYSOTA on Facebook > Tim Kennedy wins his primary in Eerie County > Worker’s Comp > District News > School Based OT
Inside this issue: President’s Message
WC Treatment rules
Focus on Capital District 5 NYSOTA on Facebook
Focus on MNYD
Focus on NFD
School based OT
President’s Message EXECUTIVE BOARD 2010/2011 OFFICERS President: Izel Obermeyer, OTR/L firstname.lastname@example.org
President—elect: Melissa Callahan-Whelan, OTR/L
Vice-President: Joan Whitesell, OTR/L email@example.com
Treasurer: Mary Shea, OTR/L, ATP firstname.lastname@example.org
Secretary: Peggy Lounsbury, OTR/L, FAOTA email@example.com
STANDING COMMITTEE CHAIRS Legislation & Gov’t Relations: Jeffrey Tomlinson, OTR/L, CSW, FAOTA firstname.lastname@example.org
Continuing Education: Tammy Boire, OTR/L email@example.com
Membership: Julie Nastasie, OTR/L, SCLV firstname.lastname@example.org
As I am starting my last year as President of NYSOTA, I would like to call on each and every Occupational Therapy Practitioner in New York State to celebrate with me this profession we all love.
limited resources to better the profession in the state. We should all say No, when people expect us to go with the flow; we should all show Year-round commitment to the profession; we should all Stand for our clients above all; we should all Offer a helping hand, especially when it is not asked for; we should all Try harder to make our profession better; we should all Accept our collective shortcomings and grow our profession because we do, and above all—we must BE NYSOTA.
I am an occupational therapist because it makes me … N ever say No, no matter the problem Y ear-round commit S tand for my clients when they can’t O ffer a helping hand T ry harder I hope that NYSOTA will continue to grow as a proA ccept my own shortcomings and grow fessional association to be the strong voice that OT But above all, it makes me a better occupational practitioners in NYS deserve and should expect. therapist because I volunteer for NYSOTA. Sincerely, Every day when I work on the business of NYSOTA, I Izél Obermeyer (OTR/L) know it can and will affect the professional lives of thousands of Occupational Therapy Practitioners in President of NYSOTA: The New York State NYS and beyond. What we do as an Association Occupational Therapy Association matters and that is why we work diligently with
Web Content Manager: Dave Merlo, COTA, CPRP email@example.com
Public Relations: Claire Richardson, OTD, OTR/L firstname.lastname@example.org
Newsletter Editor: Gloria Lucker, OTR/L, BCP, FAOTA email@example.com
DISTRICT CHAIRPERSONS Capital: Elaine Hill, OTR/L firstname.lastname@example.org
Central: Piper Crawford, OTR/L email@example.com
EDITORIAL – BEING PASSIONATE ABOUT NYSOTA I have been a NYSOTA member for more than 50 years and I am as passionate about this organization as I was when, as a student, I joined MNYD. In those ancient times, membership was mandatory for students, but I was enthusiastic about my professional organization. MNYD provided me with financial assistance in my Senior year, enabling me to pay for some of my field work expenses. When I had a “paying” job, I happily returned the money, with interest. The association sponsored student gatherings for students from Columbia and NYU. We acquired our “professional” roles by hanging out with OT’s and learning from these role models.
Hudson-Taconic: Pete Kennelty, COTA firstname.lastname@example.org
Long Island: Aline Schwartz-Chesner, MPH, OTR/L email@example.com
Metropolitan: Melissa Callahan, OTR/L, IMC firstname.lastname@example.org
Niagara-Frontier: Peggy Frye, OTR/L email@example.com
Rochester: Chris Stavisky, OTR/L firstname.lastname@example.org
Westchester Laurie Olson, PhD, OTR/L email@example.com
Fortunately, I have never lost my passion for the profession or my dedication to the professional organization that makes it possible for me to practice. My mentor, Frieda Behlen, emphasized the importance of professional involvement. I have always believed that, as professionals, we are expected to be active in our state and national organizations. Being a volunteer in NYSOTA and AOTA allows me to “pay back” for the privileges of being part of this amazing profession. No one gets “paid” for volunteer work but the benefits are tremendous. So, join NYSOTA, pay your dues, contribute a little more, donate some money to NYSOTAPAC, and volunteer to do something to be part of our professional community. Gloria Lucker, NYSOTA NEWS Editor
Volume 21, Number 4
Legislative News: OTAs Face a Sudden Shift in School Policy In April 2010 the New York State Department of Health entered into an agreement with the federal Health and Human Services Department regarding Medicaid coverage for School and Pre-school Supportive Health Services. The agreement included requirements that occupational therapy services “must be provided by: a New York State licensed and registered occupational therapist…” and “a certified occupational therapy assistant (COTA) “under the direction of” such a qualified licensed and registered occupational therapist, within his or her scope of practice under New York State law.” NYSOTA did not learn of this new agreement until it was brought to their attention by some members in June. In New York there are many occupational therapy assistants who either never took the occupational therapy assistant examination by the National Board for the Certification of Occupational Therapy, or have chosen not to maintain their certification. The new Medicaid agreement, effective retroactively to September 2009, reached the school districts at a time of great financial crisis as state and local budgets face large deficits and schools are left with decreased funding. The school districts throughout New York are making every effort to maximize their Medicaid reimbursement for related services. The new Medicaid agreement then led to many OTAs losing their positions in schools around the state. There are two reasons for the school districts’ reaching this decision to terminate their use of occupational therapy assistants. The first was that the school districts interpreted the language in the new agreement to require the use of “COTAs” certified by NBCOT. The second reason for the termination of both OTAs and COTAs is the agreement’s definition of “under the direction of” a licensed occupational therapist. The definition lays out specific supervision requirements that are consistent with supervision regulations currently under development by the state board for occupational therapy in New York.
all occupational therapy practitioners in New York, to achieve and maintain the highest competencies and subsequent credentials, we felt that the new Medicaid agreement provided no advanced warning for the profession, nor any grandfathering clause. NYSOTA quickly went to work, and with the assistance from Chuck Willmarth at the AOTA, we argued that the Medicaid agreement language far exceeded what was required by federal statute. In addition, we argued that the occupational therapy practice act provided for the certification of occupational therapy assistants by the Commissioner of the State Education Department. NYSOTA’s efforts were successful. In August the New York State Department of Health and the State Education Department issued a memorandum clarifying the credential requirements for occupational therapy assistants. The memorandum states that, “Occupational therapy assistants providing school supportive health services must be certified by the New York State Education Department.” This has resulted in some OTAs being able continue their current employment in schools.
EXECUTIVE BOARD AOTA REPRESENTATIVES Downstate: Beth Chiariello, OTR/L firstname.lastname@example.org
Alternate Downstate: Mary Walsh OTR/L email@example.com
Upstate: Michelle Cullen, OTR/L firstname.lastname@example.org
Alternate Upstate: Peggy Frye, OTR/L email@example.com
MANAGEMENT OFFICE & ADMINISTRATIVE OFFICE Jan Dorman, Amy Slater, Jessica Alexandra Poole firstname.lastname@example.org
ADDITIONAL CONTACTS Licensure
NYSOTA is now working with individual cases regarding the implementation of the supervision requirements set forth in the agreement. In such a tense and difficult financial environment school districts are being very cautious in their efforts to comply with the new Medicaid agreement. Jeffrey Tomlinson, OTR, MSW, FAOTA
State Board for OT email@example.com
Tim Kennedy, an Occupational Therapist from Western New York, ran in this election for the 58th district of the New York State Senate. We are proud to congratulate him on his victory. He is now the highest elected official an OT has ever been, in the New York State Senate.
Great Job, Tim!!
While NYSOTA strongly urges their members, and
Workers’ Compensation Treatment Rules Released for Public Comment In June, revised treatment guidelines regarding the shoulder, the neck, the mid and lower back and the knee were released as part of a Notice of Proposed Rule Making in the State Register, essentially making the treatment guidelines into regulations, effective in October. The revised guidelines incorporated a few of the suggestions from NYSOTA, but they continue to lack many of the interventions provided by occupational therapy. The guidelines can be downloaded at www.wcb.state.ny.us/ content/main/wclaws/Proposed/Proposed_Part324_325.jsp In March 2007 Governor Spitzer directed administrative and regulatory reforms in Workers Compensation. The Governor directed the Superintendent of Insurance to lead an effort with the Chair of the Workers' Compensation Board (Board) and the Commissioner of Labor to develop medical guidelines to account for modern diagnostic and treatment techniques and evidence-based standards of medical treatment and care. An advisory committee (also referred to as a Task Force) comprised of representatives from the Insurance Department, the Board, and the Department of Labor, and a few medical professionals selected by labor, business, and the Insurance Department. There was no representation of occupational
therapy, physical therapy or chiropractics. By November 2007, the advisory committee developed medical treatment guidelines for the back, neck, shoulder, and knee. These areas were selected as a priority because most of the workers' compensation medical costs are related to treatment for injuries to these body parts. NYSOTA shared the draft guidelines with members, solicited feedback and compiled specific feedback on the treatment guidelines. NYSOTA specifically noted the lack of support in the guidelines for many interventions provided by occupational therapy, including evaluation and alteration of occupation and work station, client education, work simulation/hardening, pain management, activities of daily living training, and sensory reeducation. Between 2008 and 2009 NYSOTA met a number of times with the Medical director, the executive director and staff of the Workers Compensation Board. The Workers’ Compensation Board invited NYSOTA to recruit therapists to participate in a pilot study of the treatment guidelines. However, efforts to find therapists willing to participate in the study was unsuccessful. The Workers’ Compensation Board has indicated it’s willingness to periodically review and amend the guidelines when peer-reviewed published evidence supports additional treatments.
Volume 21, Number 4
From the Capital District Capital District-NYSOTA hosted a special event “Bridging the Gap Social” for Sage and Maria college students on June 4th at the Albany Marriot Wolf Rd Several area clinicians attended sharing their Experiences as an OT or OTA. Lots of discussions were had with our local graduates regarding different aspects of job searching, job experiences and develop some networking connections.
AnnMarie Chiappinelli, Lori Pandolfo, Gwen Rudnick. The gap between school, graduations and employment is often a challenging one, our spring fling developed new
friends and contacts to decrease the gap by bridging our relationship between Capital District OT’s and OTA’s and Students!
Special thanks for all those who participated, Elaine Hill, Tammy Boire, Mr. Sylvain LaFond, Mrs. Deb Garrelts, Margot Elaqua, Sandy Jung, Kim Daily, Mavis Kelley, Beth Gillespie-Kehoe,
The new ‘face’ of NYSOTA, and other cyber explorations ….. NYSOTA is happy to announce many new projects this fall, one of them being our newly updated Facebook page. We are happy to announce that the page has been updated and has new user advantages that were not there previously. Check out the site now to see how you can engage in discussions with colleagues, get updates on legislative changes and state and national events which influence the profession of OT in NY State. We would welcome input on how to improve use of this medium and
other cyber mediums that we should explore. Another exciting ‘cyber’ venture that we are excited to announce is our online continuing education events. We have entered into a working relationship with OTAdvantage and they are assisting us in offering online classes to ensure that we expand our educational options and offer potentially less expensive education options that attending one day seminars. The
first class is currently available through the NYSOTA website as is entitled “Everyday Use of the Occupational Therapy Practice Framework”, a class that was previously offered at the 2009 NYSOTA conference. The class is currently being offered at $29.99 for members and $39.99 for nonmembers. Keep watching the website to see what other courses will be coming soon, and if there are courses you would like to see let us know, wither through the Facebook page, or sending NYSOTA an email.
Legislative News •
Jeff Tomlinson, NYSOTA: Legislation and Government Relations Coordinator
Medicaid Utilization Controls for Chronic Conditions
In June, Marcy Buckner at AOTA brought to NYSOTA’s attention New York State legislation passed as part of the budget process that charged the Department of Health to develop Medicaid utilization controls for occupational therapy and physical therapy treatments of “chronic conditions.” The legislation allowed for “prior approval of services and utilization thresholds or other limits.” NYSOTA arranged for a telephone conference with Department of Health staff, NYSOTA and AOTA staff. The Department of Health reported that they had developed “Rehabilitation Ser-
vices Policy Guidelines.” Second, they are implementing prior approval requirements for treatment services. However, these standards for approval are quite rudimentary and reasonable. In addition, the department had no plans at this time to implement utilization limits. The (Medicaid) Rehabilitation Services Policy Guidelines set provider qualifications; definitions of duplication of therapy, evaluation, long term therapy services, maintenance services, restorative therapy; and coverage criteria. NYSOTA is reviewing these guidelines now and we will be submitting comments and suggested changes. Jeffrey Tomlinson, OTR, MSW, FAOTA
From the District Joyce Sabari to receive coveted Abreu Award from MNYD The Abreu Award is named after Betty Abreu, a former NYU professor and author. Ms. Abreu was very active in the OT community and generously donated profits from the sales of her books to the MNYD. The Abreu Award honors a member of MNYD of NYSOTA who serves the profession in the New York City area through education, research, practice or service to clients. Every year MNYD hosts a holiday party and the award ceremony. This year’s honoree is Joyce Sabari, I am delighted to nominate Dr. Joyce Sabari, Chair of the Occupational Therapy Program in the College of Health Related Professions, for the 2010 Abreu Award for service to MNYD of NYSOTA. Joyce has made significant contributions to the Occupational Therapy profession in all aspects outlined in the Abreu Award: research, education and practice. She has held various positions of leadership within the district and state association for over the last 30 years. 1977: Annual Conference, Co-chairperson, Hospitality Committee; member, Program Committee-
1977-1981, Chairperson, Metropolitan New York District Legislation Committee 1978-1980, Chairperson, Statewide Legislation Committee 1978-1980, member, Executive Board 1994 to 1998- Chairperson, Metropolitan New York District Nominations Committee Currently, she has been instrumental creating the first “Stroke Study Group” of occupational therapy practitioners in the New York City area. She serves as member and advisor to this group. She is also a Fellow of the AOTA and has been recognized nationally for her contributions to the profession. This year, Joyce has been selected as the recipient of the prestigious SUNY Chancellor’s Award for Excellence in Teaching .This is a SUNY system wide award recognizing her for outstanding teaching, mentorship of students, and innovation in curriculum and course design and teaching methods. She clearly meets both the eligibility of the award but more importantly, she possesses the spirit, of the Abreu Service Award.
Volume 21, Number 4
From the District: NFD GATHERS TO SPEND AN EVENING WITH JEFF More than 100 practitioners and students gathered at Buffalo Psychiatric Center to spend a few hours with Jeff Tomlinson, NYSOTA Legislative Chair, discussing Legislative Issues and Trends Impacting OT Practice in New York State. An enthusiastic audience listened as Jeff outlined the history of our practice act and talked about future expectations for NYSOTA. Jeff was, as always, passionate about the subject and implored attendees to get involved, join NYSOTA, support efforts for legislative reform, and participate in Lobby Day. Jeff explained the role of NYSOTPAC in supporting our legislative efforts and encouraged everyone to support the PAC. Excellent refreshments were provided by The Way Program, Work Appreciation for Youth Program at Baker
Victory Services, a community based program directed by an occupational therapist. Earlier in the afternoon, more than fifty practitioners and students met with Jeff to discuss the future of Mental Health practice in Western New York. A lively discussion followed with future plans for group meetings and program planning. The group discussed professionalism, communication, continuing education, and community involvement.
Picture by: Danielle Pellegino Jo Schweitzer, Jamie Balmuth, Allison Smythe, Regina Yazbeck, Maureen Jones, Samantha Nusbaum, Danielle Pellegrino, Susan Nochajski, Jeff Tomlinson, Shaina Garner, Lindsay Ritzenthaler, Keara Savage, Danielle Cippola, Samantha Louise, Sonya Eskew, Kathleen Albert, Tara Rudkoski
School-Based Occupational Therapy: Big Shifts as 2009 Medicaid Compliance Policies Are Implemented and as RTI Takes Hold By Laurette Olson PhD OTR/L (LOlson@Mercy.edu)
School Based Occupational Therapy practitioners have adapted their practice over the years with changing demands in schools. Our profession has kept pace with each new law, amendment or interpretation of law to provide educationally related OT services for children and youth. Our services are frequently sought by educators and parents as the knowledge and skills of occupational therapy practitioners are recognized as key for supporting children’s school participation. In a relatively short amount of time, we have gone from having a small presence in schools, treating only children with severe disabilities, to schoolbased occupational therapy being offered to children in general and special education and school-based OT practitioners being one of the largest groups of occupational therapy practitioners. Once again, public education is changing in dramatic ways, both nationally and in NYS. There are new pressures and demands for all professionals working in schools including occupational therapists and occupational therapy assistants. If you are a school-based OT practitioner, you may have already participated or are scheduled to participate in the required NYS Department of
Education training designed to educate administrators and service providers on the overall NYS Medicaid Compliance Program as well as on specific policies for service provision and documentation. Key changes in policies include the new requirement for MD prescriptions for evaluations and the greater specificity in the prescriptions received before service provision. The new Medicaid in Schools compliance policies are provoking major shifts in how school-based practitioners allocate time. Service providers must keep daily session notes. IEP Direct is developing the capacities for therapists to keep Medicaid compliant daily notes within students’ IEPs online. OT practitioners are also being required in some school districts to keep daily session notes for all students receiving services through their Committee of Special Education through IEP Direct. In addition, the new Medicaid in Schools policies concretely define how OTAs need to work under the direction of an OTR including how an occupational therapist interacts with each Medicaid eligible student whom an OTA provides services and the OTA(s) supervised. OTRs must now see these students at the beginning of treatment and periodically throughout treatment. The OTR has to spend the time necessary to “ensure students
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are receiving services in a safe and efficient manner in accordance with accepted standards of practice” (NYS ED, September 2010). OTA supervision and an OTR’s ongoing involvement in the treatment of each student must be officially documented. For more information, go to the Medicaid –in – Education homepage: http://www.oms.nysed.gov/medicaid. Response to Intervention (RTI) practices in schools throughout the country and NYS continue to grow. This is presenting occupational therapy practitioners with new practice opportunities as well as new challenges. More and more OTs are facing increased demands for participation in RTI related instructional support teams, as well as for the provision of screenings and monitoring of students in general education as public schools implement RTI educational practices. Once again, we need to shift. Though Response to Intervention (RTI) may not seem relevant to all school-based OTs as they may not be included in school district plans for implementing RTI, RTI will impact the practice of all occupational therapy practitioners. It is time to learn more about RTI and to develop RTI consistent practice patterns for supporting best practice and good time management. RTI is a general education process that is structured to provide systematic, research-based instruction and intervention within classrooms and within the general education curriculum. RTI integrates assessment with instruction so that students struggling with skill development are identified and provided with instruction aligned with their learning needs rapidly. RTI is conceptualized as a 3 tier educational process in which Tier 1 represents
the general education curriculum. Through universal screenings, children requiring Tier 2 monitoring and differentiated instruction are identified. If children don’t demonstrate progress over the course of a period of time ranging from 6 weeks to a few months, children are assessed in greater depth at Tier 3 and additional supports and services are offered. Students may be referred to special education at this level. RTI has been applied most often to reading instruction and models for applying it to mathematics instruction and behavior are also developing. To learn more about RTI, go to www.ideapartnership.org or www.rti4success.org. AOTA also has some good practice resources related to RTI. On my Mercy College faculty page (https://www.mercy.edu/academics/faculty-directory/facultydetail/?g=LOlson), you will find a link to my professional portfolio. I have posted the handout from the 2010 AOTA conference workshop, Developing the role of OT in RtI: Embedding Fine Motor Skill Development into a District Wide Kindergarten Curriculum, that I co-presented with Jennifer Freudenberg MS OTR/L. It may provoke your thinking about RTI. I’ll be posting more information about my experiences and thoughts about developing best practice in RTI in my professional portfolio. What are your experiences with the challenges and opportunities in RTI? NYSOTA wll be posting a discussion forum on the website for practitioners to share their experiences. Please visit www.nysota.org and look under the School-based Practice community. Submitted by Laurie Olson (PhD, OTR/L)