The AOTA reckless plan to open up all state occupational therapy practice acts
reckless. adjective(of a person or their actions) without thinking or caring about the consequences of an action." reckless driving "On February 6-7, 2017, AOTA convenedan ad hoc committee. This group was charged with the task to explore current experiential requirements for OTs and OTAs.As a result, the ad hoc group recommended a new model of experiential education that makes several disruptive changes including changes to the length of fieldwork and creation of a post-graduate first year practitioner resident program. Under this plan, graduates would complete the certification examination and practice under a limited lic...
Source: ABC Therapeutics Occupational Therapy Weblog - March 20, 2018 Category: Occupational Health Source Type: blogs

Do pain management programmes really influence “ doing ” in daily life?
In this study by Persson, Eklund, Lexell & Rivano-Fischer (2017), the aims were to assess longterm changes in MPI profiles over the course of a year; to look at associations between “Adaptive Coper” profiles at follow-up and improvements in occupational performance; and to look at factors at baseline that might be used to predict changes over time. Participants were, as usual, attending a tertiary pain management centre at a University hospital. They took part in a 21 day programme (oh the luxury of time!), and were seen by a team working together (oh the luxury of a co-located team!) including a psychologi...
Source: HealthSkills Weblog - March 18, 2018 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Clinical reasoning Cognitive Behavioural Therapy Coping strategies Groupwork Interdisciplinary teams Occupational therapy Pain conditions Research Assessment disability function Health healthcare pain management Source Type: blogs

Thinking the worst – and willingness to do things despite pain
This study didn’t incorporate contexts of activity – the why question. I think that’s a limitation, however, examining values is not super easy, however it’s worth keeping this limitation in mind when thinking about the results. The results suggest that when someone is willing to do something even if it increases pain, or while pain is elevated, this has an effect on their performance, disability, the interference they experience from pain, and their mood. The results also suggest that catastrophising, while an important predictor of pain-related outcomes, is moderated by acceptance. My question now...
Source: HealthSkills Weblog - March 11, 2018 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Clinical reasoning Coping strategies Occupational therapy Pain conditions Professional topics Research Resilience/Health Science in practice biopsychosocial disability function h Source Type: blogs

Using more than exercise for pain management
In the excitement and enthusiasm for exercise as a treatment for persistent pain, I wonder sometimes whether we’ve forgotten that “doing exercise” is a reasonably modern phenomenon. In fact, it’s something we’ve really only adopted since our lifestyle has moved from a fairly physically demanding one, to one more sedentary (Park, 1994). I also wonder if we’ve forgotten that exercise is intended to promote health – so we can do the things we really want or need to do. Remembering, of course, that some people find exercise actually exacerbates their pain (Lima, Abner & Sluka, 2017...
Source: HealthSkills Weblog - March 4, 2018 Category: Anesthesiology Authors: adiemusfree Tags: Assessment Chronic pain Clinical reasoning Coping Skills Coping strategies Occupational therapy Pain conditions Physiotherapy Research Resilience/Health activity biopsychosocial function Motivation pain management rehabilitat Source Type: blogs

Annual NY early intervention post
Early intervention providers in New York State should be aware that when Governor Cuomo does not get what he wants he just tries to cram it down everyone ' s throat via legislation - repeatedly.Blogging about the annual attacks on the early intervention programgot boring around 3 years ago.  At that point in time the State Fiscal Agent (SFA) that is costing the taxpayers of NY millions of dollars in contract fees was only collecting 15% of monies billed for services.  In 2016 nearly 85% of claims submitted by the SFA to private insurers were denied.Now in 2017,82% of claims submitted by the SFA to private insurer...
Source: ABC Therapeutics Occupational Therapy Weblog - March 3, 2018 Category: Occupational Health Tags: health insurance OT practice Source Type: blogs

One-session instruction in pacing doesn ’ t work
In this study, the “tailored” group underwent seven days of monitoring using an accelerometer, the results were downloaded, analysed and an individualised pacing plan developed by the therapists. The plan was intended to highlight times when the person had high or low levels of activity (as compared with their own average, and averages drawn from previous studies of people with the same diagnosis), and to point out associations between these activity levels and self reported symptoms. Participants were then provided with ideas for changing their activity levels to optimise their ability to sustain activity and ...
Source: HealthSkills Weblog - February 25, 2018 Category: Anesthesiology Authors: adiemusfree Tags: 'Pacing' or Quota Chronic pain Clinical reasoning Coping Skills Coping strategies Occupational therapy Pain conditions Research function Motivation pain management self management Therapeutic approaches values Source Type: blogs

Analysis of occupational therapy leadership statements on student debt and the doctoral mandate
The occupational therapy profession is joining thecredential inflation bandwagon through the mandate of its membership organization AOTA and its educational accrediting subgroup ACOTE.  Proposals are in place toadvance the entry level for occupational therapists to the doctoral level.  A companion proposal to advance the entry level for occupational therapy assistants to the baccalaureate level has been made but isin temporary abeyance.It is important to analyze the statements of the leaders and future leaders of these groups in order to understand their positions on these topics.  Additionally, it is import...
Source: ABC Therapeutics Occupational Therapy Weblog - February 24, 2018 Category: Occupational Health Tags: OT Education Source Type: blogs

Selective use of statistics to support a flawed advocacy position on Medicare therapy cap repeal
This is a recurring theme - what should occupational therapists focus on when they are making decisions about services?  Should they focus on the people that need services, or should they focus on the amount of money being spent?These ethical choices have been discussed in this blog before.This question also applies to the latest situation with the repeal of the Medicare therapy cap and the resultant payment differential that has been applied to OTAs.When attempting to develop an advocacy position - should the occupational therapy profession measure impact in terms of lives affected or in dollars spent?  Here is ...
Source: ABC Therapeutics Occupational Therapy Weblog - February 23, 2018 Category: Occupational Health Tags: health insurance OT practice Source Type: blogs

Senate HELP Committee Holds Hearing on Opioids and the Impact on Families
Conclusion In a moment of rare bipartisanship, Committee members came together to agree that additional funding was needed to address the opioid crisis and provide opioid use disorder (OUD) sufferers with adequate anti-addiction resources. The bipartisanship ended, however, Democrats specifically criticized recent budget cuts by the administration and recommended that additional federal funding should be directed towards Medicaid and other health care institutions that work to support the families of opioid users.        Related StoriesHouse Holds Hearing on Opioid CrisisState of the...
Source: Policy and Medicine - February 22, 2018 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

One way of using a biopsychosocial framework in pain management – vi
I could write about a BPS (biopsychosocial) model in every single post, but it’s time for me to explore other things happening in the pain management world, so this is my last post in this series for a while. But it’s a doozy! And thanks to Eric Bowman for sharing an incredibly relevant paper just in time for this post… One of the problems in pain management is that there are so many assessments carried out by the professionals seeing a person – but very little discussed about pulling this information together to create an overall picture of the person we’re seeing. And it’s this aspect ...
Source: HealthSkills Weblog - February 18, 2018 Category: Anesthesiology Authors: adiemusfree Tags: Assessment Back pain Clinical reasoning Low back pain Pain conditions Professional topics Research Science in practice biopsychosocial disability function Health healthcare pain management rehabilitation Therapeutic approache Source Type: blogs

When your honey-do list involves analysis of Medicare expenditures
The title explains my role in all this fully.A rather complex report was commissioned by AOTA that involved data related to the distribution of fee for service therapy spending in the Medicare program, as well as how different cap thresholds would impact the system.  The report also breaks out information about where spending is happening based on place of service.Now the reason why I was given this task is because if you read the report, and my first paragraph, your eyes might already be glazed over.  My purpose will be to put all of this in very plain language.Here are the three primary takeaways from this repo...
Source: ABC Therapeutics Occupational Therapy Weblog - February 13, 2018 Category: Occupational Health Tags: health insurance OT practice Source Type: blogs

The curious incident of the changing dates and content of web pages.
I was a little surprised to see a message from AOTA today that statesAfter the late-night release of the bill, the following day, Tuesday February 6, while the Senate was still creating its version of the budget package, AOTA reached out to our Congressional champions to oppose these provisions, and, alongside the American Physical Therapy Association, proposed alternatives to the OTA provision —alternatives that would have stopped its adoption or minimized its impact.Additionally, on Tuesday AOTA changed all grassroots advocacy messages related to the repeal of the therapy cap, to include details of the OTA payment chan...
Source: ABC Therapeutics Occupational Therapy Weblog - February 13, 2018 Category: Occupational Health Tags: health insurance OT practice Source Type: blogs

One way of using a biopsychosocial framework in pain management – v
Theories are an important part of scientific development. Theories are essentially a collection of propositions or hypotheses that build a picture of what is in order to predict or control or somehow explain what’s going on. The extent to which a theory’s predictions represent what actually happens, given a set of circumstances, allows us to place more or less faith in the adequacy (or perhaps accuracy) of that theory. The problem with social theory is that there are so many complex interactions between variables that it’s very hard to generate hypotheses that represent what actually goes on in the world ...
Source: HealthSkills Weblog - February 11, 2018 Category: Anesthesiology Authors: adiemusfree Tags: Chronic pain Clinical reasoning Pain conditions Professional topics Research biopsychosocial disability healthcare pain management values Source Type: blogs

Deconstructing the sausage - Analyzing provisions for therapy assistant payment differentials
It is commonly stated that the process of legislating is like making sausage - you generally don ' t want to see how it happens.The therapy community was recently disappointed with the announcement that facilities would have to code their Medicare B claims with a modifier and would receive payment at 85% of the standard rate whenever that therapy was delivered in whole or in part by an OTA or PTA.  This is hard coded into legislation - and is not a rule or regulation.  For reference, this is included in the legislation that has been called "The Bipartisan Budget Act of 2018."The addition of this requirement was i...
Source: ABC Therapeutics Occupational Therapy Weblog - February 10, 2018 Category: Occupational Health Tags: health insurance OT practice Source Type: blogs

This week's timeline for the #StopTheCap effort
Thanks to the efforts of the American Occupational Therapy Association, beginning in 2022 occupational and physical therapy assistant Medicare reimbursement will be cut by 15%.  Oh, and they solved the cap problem for PT and speech therapy by doing so.Per a CBO report from February 6th, 1.2 billion of the 6.45 billion cost to repeal the therapy cap would be offset by the reimbursement changes.Let ' s get the background here.  Therapy caps have been in place for many years, and for nearly every year there has been an exceptions process that worked around the cap.  This was a bigger problem for PT and speech, ...
Source: ABC Therapeutics Occupational Therapy Weblog - February 9, 2018 Category: Occupational Health Tags: health insurance OT practice Source Type: blogs