Showing posts from February, 2013

A response to Hinojosa's "The Evidence-based paradox."

Jim Hinojosa (2013) wrote an interesting essay in the recent AJOT entitled "The evidence based paradox" which was published in "The Issue Is..." section.  I believe that this is an important article to read and discuss. I was a little concerned when I was reading the article because although he took some rather specific steps to tread cautiously and he did not go so far as an outright rejection of an evidence-based model there is still danger in propelling our thinking backward when you express the kinds of concerns that he expressed. Hinojosa outlines barriers to EBP including possible inapplicability of the established levels of evidence given the important qualitative and individualized nature of OT practice.  He correctly references the revised model that Tomlin and Borgetto (2011) presented that has already addressed this concern.  Tomlin and Borgetto (2011) proposed a model of a 'Research Pyramid' that includes and expresses a value for qualitative

Open letter to the NYS Early Intervention Program

It is important for families to understand how dysfunctional our municipal entities are in administering healthcare systems.  The current problems with the municipal early intervention program underscores ABC Therapeutics' commitment to providing private services for families through their own health insurance plans.  Still, there is a need for a municipal system that serves as a social safety net - I am just not sure if there will be any providers willing to work in those systems if things continue down this road.  -CJA Brad Hutton, Director New York State Department of Health Bureau of Early Intervention Empire State Plaza Corning Tower, Room 287 Albany, NY 12237-0660 February 14, 2013 Dear Mr. Hutton: I am in receipt of the recent email announcement regarding cut off dates for transfer of responsibility for early intervention billing from the Counties to the State that will be effective 4/1/13. There is a concerning lack of information in this em

ACTS wins injunction for early intervention conflict of interest regulation

There is a preliminary injunction regarding the Early Intervention arms length (conflict of interest) regulations.  The new regulations that prohibit agencies from both evaluating and providing services will apparently not be in effect until a final decision in the case is granted.  Municipalities are now waiting for actual BEI direction on how to proceed. For background: 1. The NYS Developmental Disabilities Planning Council has a good compilation of links describing the adopted changes HERE 2. My blog post supporting the regulations and additional justification for that support can be found HERE 3. You can view the ACTS press release HERE .  I have a copy of the order granting the injunction but am having some technical difficulties getting it uploaded onto my server - so I will provide a link as soon as I am able. The order is very interesting and the Court essentially found that there was merit to the argument that the Governor overstepped his authority and bypassed the

Something I want every parent to know when they come to see me

For the entire day I have been on cute overload.  Two ridiculously cute infants and then six ridiculously cute toddlers and preschoolers all came through my doors today for OT.  Another therapist saw several ridiculously cute grade school students later in the afternoon. They were all so cute that by the end of the day I was practically giddy. Then at the very end of the day I saw an older child who we all absolutely love.  He is also ridiculously cute.  He has a severe disability and is nonverbal and for whatever reason he had a full blown crisis and put his foot right through my wall.  That never happened before with him - but of course we have had lots of experiences over the years when kids come in and have behavioral difficulties and become really upset.  Parents sometimes feel embarrassed or sometimes mad or sometimes frustrated and sometimes they feel all those things at the same time. As my friend settled and the parent readied him to leave I said, "We will see you ne