In NYS a single OT can still supervise a million OTAs, for a while at least.

According to the NYS OT Board, supervision guidance for OTAs in NYS has been placed on hold, at least until the next Board Meeting.

Of course the State Board wouldn't state why there are is no new supervision guidance - just that the previous regulations on supervision remain in effect. This is probably welcome news to many school districts who use models where a single OTR supervises many COTAs across a wide geographic area.

It is my best guess that school districts would have found themselves in the very unfortunate position of being out of compliance with the new regs, which would have impacted their ability to receive Medicaid reimbursement, which would have likely cost hundreds of thousands of dollars if not more in lost revenue.

So you see they HAD to pass these emergency regulations and bypass public comment, but I will do the State Board a favor and help them rewrite their justification (I also fixed their date errors from the letter to the Regents):

Emergency action is necessary for the preservation of the public health and general welfare to immediately conform the Commissioner's regulations to chapter 460 of the Laws of 2011, and thereby ensure that such regulations are in effect on February 14, 2012, the effective date of such law, to implement the new practice and supervision provisions consistent with statutory requirements, EXCEPT FOR WHERE IT MESSES UP OUR ABILITY TO GET MEDICAID REIMBURSEMENT, IN WHICH CASE NOTHING IS A GREATER EMERGENCY THAN OUR ABILITY TO RECEIVE THOSE FUNDS. (italics mine)

Chalk this one up to yet another entry into the category of "Ooops, we didn't stop to think about that."

Expect some changes or clarification to the supervision requirements once the school year ends and once districts have a reasonable opportunity to change their staffing patterns - or once someone instead effectively lobbies the State that the previously recommended 5:1 ratio is not a good idea if it impacts the government's ability to collect Medicaid payments from the Feds. It will be interesting to see if the previously recommended supervision ratio stands now that someone obviously noticed that there are rather large fiscal implications and it will cost more money to implement the new 5:1 model.

Meanwhile, many parents around the state will bemoan the fact this Spring that their children are rarely if ever really seen by an OTR.

The sanitized reporting of the NYSOTA website states: "Regulations regarding supervision of occupational therapy assistants and occupational therapists with limited permits have been placed on hold when last minute concerns were raised regarding the impact the regulations may have on school-based practice. The state board anticipates resolving those concerns and promulgating additional supervision regulations in March or April."

Really, what is wrong with just reporting on the issues so people can understand how this legislative sausage is actually made?

People will be better served having full information about how and why these decisions are made. For the record, I will eat my UDO forms if this didn't have anything to do with Medicaid reimbursement. :D

Updates will be posted as needed.


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