Thursday, May 14, 2015

A critical juncture for the New York State Occupational Therapy Association

The New York State Occupational Therapy Association is planning to make significant changes to its bylaws and governance in the very near future.  Since so little information has been available on these changes I took the initiative to gather data so that occupational therapists in NY would have more information to assess these proposals.

I will begin my analysis with an apology, because it is my longstanding belief that to be an appropriate critic one needs to be a member of the group that is being held to scrutiny.  For purposes of transparency I will divulge that I ceased my NYSOTA membership approximately ten years ago in protest of inappropriate accounting practices.  However, I remained in close contact with many therapists around the State who continued their participation with the membership association.  Many of these members are currently upset about the proposed changes to governance.  Some don't want to make their protest public and have given me copious information to analyze about this topic.  I believe in transparency and openness that can lead to improvement, and that is why I am sharing the information that was given to me.

To begin with, it is important to know background demographics about occupational therapists in NY State.  According to the New York State Office of the Professions as of January 1, 2015 there were 12,254 occupational therapists and 3,912 occupational therapy assistants.  That is a total of 16,166 occupational therapy practitioners in NY State.

According to NYSOTA documents that I have reviewed, there are 548 occupational therapist members (4.5% of all NY OTs), 168 occupational therapy assistant members (4.3% of all NY OTAs), 1,308 student members, and 19 'other' members.  As students are not practicing professionals they should be excluded from any calculations.  So, there is a total of 716 practicing OT/OTA members (4.4% of all NY practitioners).

Social disengagement in traditional membership structures was brought to the forefront of attention in Putnam's classic work Bowling Alone.  The occupational therapy profession in NY State reflects this trend.  During the period of time from  2006 through 2014 NYSOTA OT/OTA membership declined 24%.  Most of that loss is declining OT membership; in fact, OTA membership increased over that time period.

The challenges associated with diminishing membership caused the American Occupational Therapy Association to attempt governance restructuring several years ago.  Those efforts failed when they were voted down by the Representative Assembly.  Unfortunately, records of those discussions have been purged from the AOTA website and can no longer be viewed there.  My recollection of those conversations are that many people were concerned that elimination of the RA and replacing it with another structure was considered inadequately 'representative' for members.  I always considered it unfortunate that AOTA leaders were not able to successfully explain to members why a different structure was needed, or to present a structure that was palatable.

Based on an analysis of the proposed changes to the NYSOTA bylaws it appears that a similar proposal for governance restructuring is being attempted.  Below are some highlighted and important changes:

Districts are being eliminated.  NYSOTA will be governed by 9 people.  Four will be officers elected by the members, four will be members-at-large elected by the members, and one will be appointed by the elected Board members.

This is a very unusual configuration because the distributed membership around the State is very uneven.  Additionally, allowing the vote of students who represent the largest membership block sets a problematic scenario where academics who know those students and are responsible for giving them grades have a lopsided advantage in elections.  Having one person randomly appointed to the Board is also unusual and leads to questions about why such a configuration would be suggested. Aside from geographic concerns, OTAs are also notably absent from Board representation.

2. Another immediate concern is a proposed change in the stated purpose of the association.  The current bylaws state that NYSOTA is "dedicated to the advancement of the occupational therapy profession and to the improvement of the quality of occupational therapy services."  The PROPOSED bylaws state that NYSOTA will be to "promote the OT profession within the State of NY, to promote and advance education, training, and research in the profession, and to engage in any other such activities determined to be advantageous to the Association and its members."  This is a dramatic and different role for the membership association and completely steers away from the previous purpose that explicitly sought to improve the quality of OT services.

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There are additional troubling elements to this restructuring plan given the historical financial context of the membership association.  There were longstanding accounting difficulties dating back many years and at one point prior to 2006 caused the resignation of the NYSOTA attorney and several members of the Executive Board because of non-compliance with standard accounting practices.  Those concerns were never really explained to the membership and to my knowledge the resignation letters of the attorney and some members of the Executive Board were never shared with the membership.  This was a troubling lack of transparency.

I have been informed by several members that those accounting concerns were remedied by a consolidation of finances that now allows centralized auditing.  That consolidation has not gone without criticism from some districts and members.  A look at the recent balance sheet indicates some concerns.  According to available documents, net income has been in the red for seven of the last nine years.  In the last two years, net income has been near a $60,000 loss each year.  Expenses averaged approximately $100,000 per year from 2006 through 2012, but jumped up above $150,000 for each of the last two years.  Clearly, something is dramatically changing to cause such an increase in expenses in the last two years.  This significant increase is financially unhealthy, particularly given the historical instability of conference revenue which is being relied upon more and more on recent balance sheets.

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The sum of this analysis is that NYSOTA is at a critical juncture.  A governance change that appears to be less representative than before is being proposed, but the previous structure was admittedly unwieldy.  The Board seems to be at war with some of its own districts, stating that at least three districts should have been dissolved according to provision of current bylaws.  That may be true (details are unknown to me at this time), but this is not a healthy situation.

Expenses are rapidly increasing, dues paying membership is rapidly decreasing, and (free) student members inflate the membership rolls.  The very purpose of the association is being re-defined.

My recommendation to the NYSOTA BoD is to slow track their proposed changes and explore new methodologies for inclusive planning to meet this acute crisis.  The fact that several sources from different districts are leaking out documents to me should be an indicator of the heightened dissatisfaction from the dwindling membership that remains.  I expect some criticism for putting this information out for people to see, but my motivation is to create a context where members will be involved, represented, and able to participate in some consensus decision making.  NYSOTA has not been healthy for many years, and a change is needed that will involve a much greater level of participation from ALL OTs in NY State - members or not.

Right now, that is apparently not happening.

As I have previously done, I willingly offer my time and abilities to help solve these very challenging problems.

5 comments:

VP NYSOTA said...

As the Vice president of NYSOTA since 2014 and a proud NYSOTA member for over 22 years I felt the need to comment on this post. I have served on the NYSOTA executive board on and off for my entire career over 22 years and had the privilege of serving under your wife Caroline.

Sadly much of the information in this blog is inaccurate. In addition a lot of clarification and information is missing as well. However, I am not surprised as we are at a crossroads of change which puts many people in an unease state. Looks like they were pretty selective on what was shared. I see you mention transparency throughout this blog as well. For the year that I have been attending the meetings everything is discussed. Sometimes when something does not go the way someone wants it too it gets communicated inaccurately and ineffectively.

I sat a board meeting where our attorney was present over a year ago speaking about the structure of NYSOTA and the need to change our bylaws to help us operate better. I respected his recommendation as he is the expert with this, so as VP and in charge of bylaws I began the process.

The board has been coming up with creative ways to increase membership. For example spring CE day, the first one was last year and we had a net loss of around $140 dollars. This year May 2, over 100 clinicians attended with a net gain of over $7000. NYSOTA annual conference the past 2 years have been so successful and have made nice profits. Our management company took over the running of the annual conference 2 years ago..

I can tell you that as the VP of NYSOTA the members have been reaching out to me and feel that a change is needed, they are excited about the possibilities of this organization.

So the "members' you are referring to may not be representative of the NYSOTA membership, but maybe a few disgruntled members for some reason.

I hope that anyone that reads this blog understands that there is much more to this. Please feel free to reach out to me as I am always there for the NYSOTA members.

Thank you and respectfully submitted.

Donna Frazier VP NYSOTA



VP NYSOTA said...
This comment has been removed by the author.
Christopher Alterio said...

Thank you for commenting and I encourage you to submit any corrections if you think what I have published is incorrect. I also invite you to answer any of these specific concerns about representation that have been raised. Thanks again for your comments

Caroline said...

Donna,
I too felt the need to post and comment.
I agree with Chris' analysis.
I think the board should listen to the concerns that have been expressed and review all the evidence and base there decisions on hard data when considering a major venture or from changing a programmic direction. Hopefully ,having solid facts to determine which direction to take will best serve the membership as a whole.
Regards,
Caroline Alterio

Christopher Alterio said...


Hi Donna,

I don't reject any posts. If you are having difficulty posting feel free to email me your comments and I will post them for you.

Chris