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Snort-worthy: NYS makes EI providers prove financial hardship before they will pay.
Here is some follow-up information for parents who are wondering why their children are on a waiting list for the NY State Early Intervention Program.  As indicated in earlier posts, there are fewer providers available to deliver services because many have left the early intervention system.  The program has directly contributed to a systematic destruction of small businesses operated by therapy providers around the state.  Those who remain are large agencies who are now beginning to be cash-strapped and others who happen to have a level of uncommon/savvy navigation skills that allows them to operate amidst ...
Source: ABC Therapeutics Occupational Therapy Weblog - May 23, 2013 Category: Occupational Therapists Tags: health insurance Source Type: blogs

Tinfoil hat analysis: Crypto-eugenics and the autism community
I believe in science and I also believe in scientific advancement.  I have stated before that I am not a Luddite even though I sometimes take positions that might cause people to question.I am having another Luddite moment though.About a year ago I wrote a cautionary post to the autism community, advising them to embrace the DSM-V changes that would make diagnosis more difficult.  In summary the post was a tinfoil hat analysis of eugenics and disabilities and reflected on what we have seen happen in the T21 community.  Today I am thinking that embracing DSM-V changes  is not enough to provide appropriat...
Source: ABC Therapeutics Occupational Therapy Weblog - May 1, 2013 Category: Occupational Therapists Tags: Disability rights OT practice Source Type: blogs

Mixing up chickens and eggs: A response to Fleming-Castaldy and Gillen
In the recent AJOT Fleming-Castaldy and Gillen wrote an interesting article entitled "The issue is: Ensuring that education, certification, and practice are evidence based."  In the article, they examine why outdated neurophysiologic techniques are promoted in the profession of occupational therapy as opposed to more current and evidence based motor learning and motor control theories.  They argue that outdated models based on Bobath and Brunnstrom have no place in contemporary practice.In spirit I agree wholeheartedly.  There are many techniques that are still present in contemporary practice and we hang on...
Source: ABC Therapeutics Occupational Therapy Weblog - April 29, 2013 Category: Occupational Therapists Tags: OT Education evidence-based practice OT practice Source Type: blogs

A reminder about human agency and self reliance
There has been some noise and distress in social media circles with the recent advertisement run by MSNBC regarding 'who should be responsible for raising children.'  Here is the video:This academic/pundit has since walked back some of her comments, stating that people just didn't understand the nuanced nature of what she was saying about 'collective' efforts in raising children.I suppose that if she wanted her message to be that we need to 'build a world together' that she should have said that in the original message instead of a bizarre statement that we need to 'break through our kind of private idea that kids bel...
Source: ABC Therapeutics Occupational Therapy Weblog - April 11, 2013 Category: Occupational Therapists Tags: Disability rights philosophy OT practice Source Type: blogs

NYS and the last second document drop on the early intervention program
If you pay attention to the news you will notice that Governor Cuomo is on a self congratulation tour for an on-time state budget.  However, what is not mentioned in his self congratulation is the systematic dismantling that is occurring with the State's Early Intervention program and the devastation to social service programs that is left in the wake of his policies.Families need to be aware because as of April 1 there are many providers around the State who are no longer sanctioned to be early intervention providers.  Additionally, for those who have elected to remain in the system, there has been an absolutely...
Source: ABC Therapeutics Occupational Therapy Weblog - March 29, 2013 Category: Occupational Therapists Tags: health insurance OT practice Source Type: blogs

How citizen participation impacts regulation of a profession
I just got back from a meeting where the NYS Office of the Medicaid Inspector General informed a County that there was inadequate documentation of supervision and that a number of claims were therefore ineligible for reimbursement.At this exit interview I made the following speech to the OMIG auditors:Thank you for the opportunity to participate in this exit interview.  I have been an occupational therapist for over 25 years and I have experienced many audits from CARF, CORF, JCAHO, NYSDOH, IPRO, and many others. Generally when there is an allegation of violation there is also an accompanying citation of the regu...
Source: ABC Therapeutics Occupational Therapy Weblog - March 26, 2013 Category: Occupational Therapists Tags: policy health insurance Source Type: blogs

"We are building the plane while we are flying it."
The New York State Early Intervention Coordinating Council was scheduled to meet a couple days ago but the meeting was cancelled and a subsequent video/teleconference was scheduled for today, 3/15.  The original meeting was rescheduled to 4/18, but that may still change based on member availability.It is difficult to not be cynical, but did they cancel the meeting to limit participation and comment prior to their 4/1 switchover when NY State takes responsibility from the Counties for administration of the program?  I asked people in the Bureau of Early Intervention in Albany and they told me that they thought t...
Source: ABC Therapeutics Occupational Therapy Weblog - March 16, 2013 Category: Occupational Therapists Tags: Disability rights health insurance Source Type: blogs

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 establishe...
Source: ABC Therapeutics Occupational Therapy Weblog - February 23, 2013 Category: Occupational Therapists Tags: evidence-based practice OT practice Source Type: blogs

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, DirectorNew York State Department of HealthBureau of Early InterventionEmpi...
Source: ABC Therapeutics Occupational Therapy Weblog - February 14, 2013 Category: Occupational Therapists Tags: ABC Therapeutics health insurance Source Type: blogs

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 HERE3. You can view th...
Source: ABC Therapeutics Occupational Therapy Weblog - February 12, 2013 Category: Occupational Therapists Tags: health insurance Source Type: blogs

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 ...
Source: ABC Therapeutics Occupational Therapy Weblog - February 7, 2013 Category: Occupational Therapists Tags: ABC Therapeutics OT practice Source Type: blogs

Good job Wisconsin OTs!
This letter from Teri Black WOTA President is worth re-publishing.  Diligence for these kinds of threats is imperative.  I doubt this is the last time we will see something like this - and it serves as a demonstration of the potential weaknesses.  Too many states lack the resources to meet this kind of issue head on and practitioners need to be more engaged.Good job on this one, Wisconsin! ACTION ALERT RESOLUTION!  It Worked!!From Teri Black WOTA PresidentThank you to those who wrote to your local school board members.  The resolution by the Wisconsin Association of School Boards to create a new le...
Source: ABC Therapeutics Occupational Therapy Weblog - January 28, 2013 Category: Occupational Therapists Tags: OT practice Source Type: blogs

Destruction and deconstruction of occupational therapy documentation
In the novel 1984, Winston Smith had the responsibility to take old documentation that no longer was determined to reflect current reality and then dispose of that documentation down a 'memory hole.'  I don't know how often most occupational therapists think about the things they write.  I think about it a lot.  In part I spend a lot of time thinking about it because I have this pragmatic issue with where I have to store all of my patient files.  When I worked for other institutions I never worried about the long term storage of my documentation.  I would write things, and eventually they would end...
Source: ABC Therapeutics Occupational Therapy Weblog - January 19, 2013 Category: Occupational Therapists Tags: ABC Therapeutics philosophy OT practice Source Type: blogs

New regulations promote risk of FERPA violations
I mentioned a while ago that I was going to write about FERPA violations that I see on a regular basis.  There are new regulations in New York that promote electronic record keeping by educational programs, so now seems like a good time to document some of my experiences in the last couple years related to FERPA violations.As background I will report that I am a strong proponent of technology and I believe that technology applications provide us with excellent opportunities to improve efficiencies in service delivery.  I am not a Luddite.  Or anything even remotely similar.  However, parents should take...
Source: ABC Therapeutics Occupational Therapy Weblog - January 15, 2013 Category: Occupational Therapists Tags: Disability rights policy Source Type: blogs

Public systems continue march toward paraprofessional service delivery models
The subtitle to this should be:A Wisconsin case study of how the system REALLY feels about the value of therapist training, licensing, and certification.I am going to pick on Wisconsin today, but this is a problem that people need to be aware of because it stretches beyond the borders of that state.What does a municipality do when there are rules to follow and they can't meet the mandates of the rules?Make up their own new rules, of course!Wisconsin bureaucrats demonstrate their true Machiavellian nature when they allow otherwise unqualified teachers in the classroom in the presence of personnel shortages.  They are n...
Source: ABC Therapeutics Occupational Therapy Weblog - January 8, 2013 Category: Occupational Therapists Tags: policy health insurance competency OT practice Source Type: blogs