Showing posts from January, 2012

'Non Traditional Fieldwork' runs face first into proposed New York State regulations

My sensitivity for the challenges of being an Academic Fieldwork Coordinator runs quite deep; I held that position at a college for three years and experienced the difficulty with finding student placements. There never seems to be enough fieldwork placements, there are challenges with finding places that will provide a quality experience for the student, and although there have been efforts to incentivize practitioners to take students that does not overcome the practical obstacles. The repeating theme that the occupational therapy profession is not yet grasping is that there has to be some kind of understanding that services provided by students are not the same as services that are provided by licensed professionals. This has been a recurring theme for Medicare reimbursement of services provided by students. Fieldwork educators are very familiar with AOTA's efforts to establish clarity in these rules. There is a parallel pushback against allowing student provided services t

Are three hour autism training courses helpful?

I received an email today from an agency that provides three hour training courses on autism required by the NY State Office of Teaching Initiatives (OTI) for all candidates seeking a Special Education Classroom Teaching certificate. The three hour course is popular because it is frequently used by CSEs as a training mechanism for educational staff who are working with children who have an autism spectrum diagnosis. I think the intent here is good - many professionals and paraprofessionals who work in special education may not have a lot of information about specific conditions and presumably anything that provides some information might be helpful. Parents who come to my office often verbalize frustration that the aides or classroom staff in schools are not adequately prepared to understand their children's needs. I assume that this dissatisfaction is what drives families to private practitioners in some cases. I have an interest in certification so I got to wondering what this

Understanding upcoming changes to early intervention and preschool services, Part 1

Early intervention and preschool services to children who have disabilities will be scrutinized heavily in the upcoming year and many reforms are being discussed. This summary is a general outline of some of the salient drivers that are impacting reform efforts in New York State. I strongly recommend starting your reading with the Reforming Mandates, Reducing Costs report that was written by the New York State Association of Counties . This report was submitted to the Medicaid Redesign Team last year to provide input about the unsustainable increasing costs of these programs. Mandated Medicaid costs are crippling County budgets, and have been for many years. Most recently the State entered into a settlement agreement with the Federal Government often referred to as the State Plan Amendment. This settlement is the contract between New York State and Federal government whereby the State agrees to administer the Medicaid program in accordance with Federal law and policy. This agree

Tear down the wall: Broken models of mental health service delivery

I have a longstanding interest in Systems and their impact on our ability to care for people. In 2005 (I can't believe I have been blogging that long) I wrote a blog entry about foster care policy and its impact on occupational therapy. I try not to get outraged on a daily basis because it makes it a little challenging to maintain focus. If you think about foster care too much though it is hard not to get a little upset. These Systems are populated by well intentioned and kind people who have to do yeoman's work to make the System run. The problem is not with the well intentioned and kind people who work within these Systems - the problem is with the System creators who have set up a structure that in my opinion fails to meet the needs of the people being served. That's not so good. Mental health care Systems are notoriously poorly designed; we have systemic problems like homelessness and poor care coordination and uneven access to care. The Systems are so poor that the