The ongoing occupational therapy identity crisis: 2019 edition

What does it say about a group of professionals that can't agree on what titles to use to describe themselves?

Several years ago I wrote a post entitled "Why students will be making elevator speeches to define occupational therapy for the next 100 years."  The issue behind this is that some occupational therapists believe that the public does not recognize what the profession does and that it is important to have a handy 1 minute description.  The post describes the fact that the profession serially re-defines occupational therapy and that the constant tinkering with definitions contributes to the confusion.

The problem that some people in the occupational therapy profession have with their self-identity now extends to the title that they want to use to represent themselves and whether or not they want to even use the national credentials that they have earned and that have given them the right to apply for state licensing.

One point of genesis of this problem is with s…

A sad prediction that is coming true for occupational therapy assistants

Last year I wrote several blog posts about the devastating advocacy position taken by AOTA to remove the Medicare therapy caps that caused a 'paygo' impact on services provided by occupational therapy assistants.

In short, the Bipartisan Budget Act of 2018 lifted the Medicare therapy caps and was 'paid for' by an agreement that OTA services under Medicare Part B would have to be paid at 85% of the standard rate whenever that therapy was delivered in whole or in part by an OTA.

Professional lobbyists and policy analysts at AOTA were surprised by this 'last minute' inclusion of a payment differential even though the House Rules Committee clearly included this language in the document summary that was sent to the CBO for scoring prior to the legislation being passed.  As a result of their inattention, no one was alerted to this dangerous language, no one could advocate against it, and OTA practice was severely damaged.  It was a colossal and inexcusable policy an…

When leaders fail to lead.

Three years ago a controversial bylaws change was suggested for the American Occupational Therapy Association that granted the Board of Directors powers to revoke memberships based on complaint of other members and a finding of 'cause.'  This issue was fully discussed and documented in this blog at the time of the release of the proposal.

As is the rule for all Bylaws changes, they need to be voted on by the membership, which happens at the subsequent Business Meeting.  That meeting happened in Chicago at the annual conference and is summarized in these minutes with a synopsis of the specific issue at hand following:

President Stoffel recognized Dawn Sonnier, Chairperson of the BPPC, to present a summary of the proposed Bylaws revisions. Chairperson Sonnier moved to adopt the revised Association Bylaws. President Stoffel opened the floor for discussion. The following members rose to speak to the motion:
– Reggie Campbell (TX) spoke in opposition. Nicholas Hantzes, Legal Counse…

How a motion to affirm dual levels of entry for occupational therapy was killed by the leaders of the AOTA.


It is important for the occupational therapy profession to understand that there was close collaboration between the RA leadership and the AOTA Board of Directors leading up to the Fall meeting.  As such, the Board of Directors may have been able to shape and form the agenda and the response to motions long before they ever were formally discussed by the RA members. The reason why Motion One on dual entry was killed was by what appears to be coordinated table setting engaged in by the AOTA Board of Directors, facilitated by the RA Leadership team, and then followed by those RA members who bothered to participate.


8/14/18: AOTA signals to ACOTE that it still supports the doctoral single point of entry but just lacks the evidence to support the decision.

8/23/18: AOTA member contacts RA rep about dual entry motion.
8/24/18: Speaker Debi Hinerfeld indicates that AOTA staff are working "behind the scenes" to guide RA members in their intera…

A Motion to Update Policy E.6 Entry-Level Education of Occupational Therapists and Occupational Therapy Assistants

I am receiving email asking for assistance in drafting specific language for RA Motions related to the entry level educational mandates.  Here are my suggestions - please work with your RA representatives and each other to coordinate efforts.
I move that the Representative Assembly revise Policy E.6 to read as follows: 
PURPOSE: To state the education required for entry into occupational therapy.   
IT SHALL BE THE POLICY OF THE ASSOCIATION THAT:   1. The Association recommends and supports entry-level education at the associate and bachelor degree level for occupational therapy assistants.   2. The Association recommends and supports entry level education at the master’s and doctoral degree levels for occupational therapists.    3. Consistent with the Association’s desire to improve practice, education, and research, the Association will take active steps to promote new programs and to assist existing programs to develop in ways that are congruent with the preparation o…

When the shoe is on the other foot.

I am going to try to keep this simple, but the underlying message is critical for occupational therapists.

The recent announcement from AOTA that places the entry level degree requirement decision of ACOTE in abeyance was a surprise to most people, whether they agreed with the decision or not.

This post is not going to address the background of the issue, or the reasons for the AOTA reversal, or what some of the controversial elements are.   I want to focus on the response of some OTs who disagree with the decision, most notably program directors who lead academic programs that have to deliver the curricula.

I agree with the fact that some academic programs who were set to follow through on the increase to entry level degrees are left in a difficult situation.  These are a couple of the legitimate complaints that I truly understand:

1. Financial resources have been expended in order to transition their programs.
2. Time and energy has been expended in order to transition their program…

AOTA's claim to authority over entry level degree requirements

ACOTE released their version of the timeline of their OTD accreditation decision and AOTA released their statement along with the MOU - and now the two sides sit in opposition with the fundamental question being "Who is responsible for setting the entry level educational standards for the occupational therapy profession?"

The quick and easy answer, that apparently may be wrong, is ACOTE.

The more probable answer, buried in documents available on the AOTA website, is the Representative Assembly of the AOTA.

The policy of the AOTA, as determined by the Representative Assembly, sets the entry level educational requirements for the profession.

The next logical question is: Does the Representative Assembly have this authority?  Yes, it does, and this authority is directly granted in the Bylaws:

Does ACOTE have the authority to set AOTA association policy, specifically related to entry level educational requirements for the profession?  No, it does not, and this is very clear in …