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Showing posts from April, 2014

The problem with the way occupational therapists address mental health issues

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Yesterday I saw Daniel who was mad at his mother for lying to him - something to do with whether or not he could play his Nintendo DS - I am not sure.  He spent most of the time under the table so we couldn't complete much of an evaluation.  But this is what I could surmise through interview:

Daniel is 13 years old and his mom brought him to see me because she is concerned that he has a 'sensory processing disorder.'  The referral from his physician indicated that his diagnosis was bipolar disorder, r/o paranoid schizophrenia, oppositional defiant disorder, and ADHD. Of course the schizophrenia concerns are very preliminary but Daniel has reported seeing black caped shadowy figures scratching at doors and windows ever since he was old enough to talk.  He states that the combination of Lithium and Seroquel mostly keeps things in check.  His mom isn't so sure, because the family is walking around on eggshells for fear of contributing to his spiral into an emotional pit o…

Update on early intervention coding and paraprofessional service delivery

Two years ago I blogged about NYS Department of Health emails that instructed the field in use of Level II HCPCS codes.  At that time I stated: 
Promoting use of Level II HCPCS codes can only mean they are incredibly misinformed and clueless OR they are throwing in the towel with trying to get reimbursement and they intend on replacing skilled services with services provided by non-licensed people with 'generic' developmental training.
It seems that we have received an answer in the form of a final response to a systems complaint initiated against the NYC Department of Health and Mental Hygiene on the topic of Embedded Coaching.  Click here to read that determination.

The allegation was that in NYC providers were being forced to address functional IFSP outcomes that fell outside of their scope of practice.  The Department of Health's determination was that NYC was in violation of 10 NYCRR 69-4(f)(3) regarding use of individualized approaches and they were also in viol…