ABC Therapeutics Occupational Therapy Weblog

Conference slides! Hi and thank you for stopping here to look at the slides for my presentation at the 2019 CAOT conference!

I was wondering today how many students were paying attention to the early presidential primary activities.  During Joe Biden's kickoff presidential rally in Pittsburgh yesterday he discussed the problems with over-credentialing and how it can serve to restrict competition in the marketplace. He framed his basic presentation in context of lower wage earners and Union jobs, but does his argument apply to health care other middle income licensed occupations? "They do the same thing with occupational licenses. Why should someone who braids hair have to get 600 hours of training? It makes no sense. It's designed to keep the competition down. Look, folks, you can't just transfer your licenses across one state to another. They're making it harder and harder in a whole range of professions all to keep competition down." He also talked about reclassification into exempt categories in order to prevent paying overtime.  That made me think of all my col...

It is easy for occupational therapy practitioners who have been embroiled in the intraprofessional debate about entry level credentials to lose sight of a larger perspective.  Sometimes the closer you are to a concern, the more challenging it is to understand the more broad ramifications of something that happened. The grass roots effort that pushed against a mandated escalation of the entry level degrees in the occupational therapy profession made a very broad social and cultural statement.  It was a historic example of a professional group that argued against some of its own leadership in an effort that ultimately serves the more broad public interest.  It was an amazing testimonial to the nature of occupational therapy practitioners, their common sense and pragmatism, and their interest in fairness, diversity, and inclusion on many levels.  The effort highlighted the very best of the occupational therapy profession, even if it was a contentious and at times d...

An analysis of the recent motion to update policy E.6 Entry Level Education is offered for consideration. Please refer to the following for background information: A Motion to Update Policy E.6 Entry-Level Education of Occupational Therapists and Occupational Therapy Assistants and also AOTA's claim to authority over entry level degree requirements ROADMAP FOR UNDERSTANDING THE ISSUE: To understand the problems with the wording changes you need to read and understand the first policy as it is written in the policy manual.  Then you have to read and understand the motion that was submitted to update.  Then you have to read and understand what the RA actually passed.  All of this has to be considered in context of an unknown relationship between AOTA and ACOTE.  There is no way to dive into the weeds of this issue without reading all of the materials.  There is simply no way to condense it. +++ The original policy E.6 states The motion ...

During the last year, minutes from the Board meetings of the American Occupational Therapy Association indicate that there has been discussion on two matters that have an important impact on the Wilma West Library, home of the collected resources that catalog the history of occupational therapy. Around last year, discussion apparently started getting more specific related to sale of AOTA's current building.  In May 2018 the board authorized the (re)allocation of funds necessary to pay off the mortgage on the building and exploration of new sites for the organization's operations.  It is unclear if a new location has been identified, but in the recent February 2019 meeting a current board member will provide consultation regarding redesign and build out of the new space, indicating that the process is moving forward. Also noted in the February 2019 minutes is that AOTA will take sole responsibility and ownership for the Wilma West Library, excluding graduate theses and ...

Occupational therapy started on a simple premise - that man, through the use of his hands as they are energized by mind and will, can influence the state of his own health.  That statement was provided to the profession by Mary Reilly, our greatest theoretician. It is a simple concept, borne out of a core philosophy of pragmatism and infused with a dose of all the good intentions of the moral treatment movement.  If you carefully read that core philosophy of occupational therapy you will hear the Emersonian reverberations of self-reliance: 'Trust thyself: every heart vibrates to that iron string.'  That is what occupational therapy seeks to nurture in the spirit of people: Independence, harmony with the self, harmony with nature, and a satisfaction in authentic work and effort and purpose and meaning. Occupational therapy is a concept that was designed to create solutions for the problems of living - and was field tested in the settlement house projects of Chic...

Perhaps the greatest point of misinformation that is routinely spread when academicians discuss the 'need' for escalating the entry level degree to the doctoral level is that master's level OT programs can vary between 80 and 100 credit hours, depending on the school.  This is not a factual statement.  There are some OT schools that are configured in a 4+1 or 3+2 model and the number of graduate credits is only around 30-40.  In these schools, the bulk of the occupational therapy curriculum is delivered at the undergraduate level. Throughout the conversation, I have heard educators and practitioners both attempt to get AOTA and ACOTE to acknowledge that not all educational programs are experiencing the same kind of 'credit pressure.'  People use different terms to describe this concern; most explain it in terms that some programs are requiring more credits than are necessary or perhaps even typical for granting a masters degree. It is true that some pr...

What does it say about a group of professionals that can't agree on what titles to use to describe themselves? Several years ago I wrote a post entitled " Why students will be making elevator speeches to define occupational therapy for the next 100 years ."  The issue behind this is that some occupational therapists believe that the public does not recognize what the profession does and that it is important to have a handy 1 minute description.  The post describes the fact that the profession serially re-defines occupational therapy and that the constant tinkering with definitions contributes to the confusion. The problem that some people in the occupational therapy profession have with their self-identity now extends to the title that they want to use to represent themselves and whether or not they want to even use the national credentials that they have earned and that have given them the right to apply for state licensing. One point of genesis of this problem...

Last year I wrote several blog posts about the devastating advocacy position taken by AOTA to remove the Medicare therapy caps that caused a 'paygo' impact on services provided by occupational therapy assistants. In short, the Bipartisan Budget Act of 2018 lifted the Medicare therapy caps and was 'paid for' by an agreement that OTA services under Medicare Part B would have to be paid at 85% of the standard rate whenever that therapy was delivered in whole or in part by an OTA. Professional lobbyists and policy analysts at AOTA were surprised by this 'last minute' inclusion of a payment differential even though the House Rules Committee clearly included this language in the document summary that was sent to the CBO for scoring prior to the legislation being passed.  As a result of their inattention, no one was alerted to this dangerous language, no one could advocate against it, and OTA practice was severely damaged.  It was a colossal and inexcusable poli...

Three years ago a controversial bylaws change was suggested for the American Occupational Therapy Association that granted the Board of Directors powers to revoke memberships based on complaint of other members and a finding of 'cause.'  This issue was fully discussed and documented in this blog at the time of the release of the proposal. As is the rule for all Bylaws changes, they need to be voted on by the membership, which happens at the subsequent Business Meeting.  That meeting happened in Chicago at the annual conference and is summarized in these minutes  with a synopsis of the specific issue at hand following: President Stoffel recognized Dawn Sonnier, Chairperson of the BPPC, to present a summary of the proposed Bylaws revisions. Chairperson Sonnier moved to adopt the revised Association Bylaws. President Stoffel opened the floor for discussion. The following members rose to speak to the motion: – Reggie Campbell (TX) spoke in opposition. Nicholas Han...

CLICK ON PHOTOS TO ENLARGE It is important for the occupational therapy profession to understand that there was close collaboration between the RA leadership and the AOTA Board of Directors leading up to the Fall meeting.  As such, the Board of Directors may have been able to shape and form the agenda and the response to motions long before they ever were formally discussed by the RA members. The reason why Motion One on dual entry was killed was by what appears to be coordinated table setting engaged in by the AOTA Board of Directors, facilitated by the RA Leadership team, and then followed by those RA members who bothered to participate. Timeline:  8/14/18: AOTA signals to ACOTE that it still supports the doctoral single point of entry but just lacks the evidence to support the decision. 8/23/18: AOTA member contacts RA rep about dual entry motion. 8/24/18: Speaker Debi Hinerfeld indicates that AOTA staff are working "behind the scenes" to guide RA members in ...

I am receiving email asking for assistance in drafting specific language for RA Motions related to the entry level educational mandates.  Here are my suggestions - please work with your RA representatives and each other to coordinate efforts. II. BODY OF MOTION: I move that the Representative Assembly revise Policy E.6 to read as follows:  PURPOSE: To state the education required for entry into occupational therapy.    IT SHALL BE THE POLICY OF THE ASSOCIATION THAT:   1. The Association recommends and supports entry-level education at the associate and bachelor degree level for occupational therapy assistants.   2. The Association recommends and supports entry level education at the master’s and doctoral degree levels for occupational therapists.    3. Consistent with the Association’s desire to improve practice, education, and research, the Association will take active steps to promote new programs and to assis...

I am going to try to keep this simple, but the underlying message is critical for occupational therapists. The recent announcement from AOTA that places the entry level degree requirement decision of ACOTE in abeyance was a surprise to most people, whether they agreed with the decision or not. This post is not going to address the background of the issue, or the reasons for the AOTA reversal, or what some of the controversial elements are.   I want to focus on the response of some OTs who disagree with the decision, most notably program directors who lead academic programs that have to deliver the curricula. I agree with the fact that some academic programs who were set to follow through on the increase to entry level degrees are left in a difficult situation.  These are a couple of the legitimate complaints that I truly understand: 1. Financial resources have been expended in order to transition their programs. 2. Time and energy has been expended in order to transit...

ACOTE released their version of the timeline of their OTD accreditation decision and AOTA released their statement along with the MOU - and now the two sides sit in opposition with the fundamental question being "Who is responsible for setting the entry level educational standards for the occupational therapy profession?" The quick and easy answer, that apparently may be wrong, is ACOTE. The more probable answer, buried in documents available on the AOTA website, is the Representative Assembly of the AOTA. The policy of the AOTA, as determined by the Representative Assembly, sets the entry level educational requirements for the profession. The next logical question is: Does the Representative Assembly have this authority?  Yes, it does, and this authority is directly granted in the Bylaws: Does ACOTE have the authority to set AOTA association policy, specifically related to entry level educational requirements for the profession?  No, it does not, and this is ...

On January 29, 2005, the Accreditation Council for Occupational Therapy Education and the American Occupational Therapy Association entered into an agreement that has been commonly referred to as their ' Memorandum of Understanding (MOU). ' As background for understanding this process it is important to consider the relationship between the national member association and its credentialing arm, which is technically a separate organization.  As I have stated for many years, in my opinion, AOTA and ACOTE are functionally indistinguishable.  ACOTE is an "Associated Advisory Council" of the AOTA Executive Board.  It is notable that intertwined relationships exist between the two groups since the creation of the credentialing group. ACOTE has its own Board of Directors, but ACOTE itself is staffed by AOTA employees who all answer to the AOTA Executive Director, who answers to the AOTA Board of Directors. Accreditation income generated by ACOTE amounted to ove...