1. S PRING 2015: R EPRESENTATIVE A SSEMBLY U PDATE TOTA D ISTRICT M EETINGS M ARCH, 2015

2. Objectives After this session participants will be able to: Discuss motions for the Spring 2015 meeting, April 15 & 16 in Nashville Locate & review materials for the Representative Assembly Discuss past motions and activity of the RA Describe how to write a motion for consideration by the RA Review the benefits and opportunities of AOTA

3. There is a long history of active AOTA leaders from Texas: Robert K. Bing - President of AOTA Charles Christiansen - Vice President of AOTA Esther Bell - Secretary of AOTA & Commission on Practice chair Reggie Campbell - Speaker of the RA of AOTA and on Executive Board Diane Puccetti - Vice Speaker of the RA & served on Executive Board Georgiann Laseter - AOTA State Association Presidents & Executive Board Cindy Jones - Chair AOTA State Association Presidents & Executive Board Pat Ramm - Chair of Standards Review Committee of AOTA Hope Keeney- Chair of Nominating Committee AOTA Beatrice Abreu – Board of Directors AOTA Kitty Reed - Chair of Ethics Commission of AOTA Shirley Wells - Chair of Standards and Ethics Commission of AOTA Francie Baxter – Speaker of the RA of AOTA Brent Braveman – Secretary of AOTA Leadership in TOTA & AOTA

4. Leadership Opportunities: AOTA & TOTA

6. Makeup of the RA Commission on Education (COE) Commission on Practice (COP) Ethics Commission (EC) Commission on Continued Competence & Professional Development (CCCPD)

7. AOTA Membership Total voting membership as pf December 2014 was 51,532. Texas has 2462 members which represents 4.78% of the membership.

8. To Review RA items RA items are under the About AOTA Volunteer Leadership Representative Assembly

9. Spring 2015 Meeting Motion 1: Occupational Therapy License Portability and Compact(s) Motion 2: Request of Military Representative position to be added to the Representative Assembly (RA) Motion 3: Delineate the role in case management for OT in primary care and mental health Motion 4: Formal statement on provision of Assistive Technology and Complex Rehabilitation Technology

10. Occupational Therapy License Portability I move that the Representative Assembly Leadership Committee establish an ad hoc group to investigate the merits of establishing a professional license portability and\or compact(s) in Occupational Therapy (OT). The membership of the ad hoc will include representatives from OT and OTA and will consult with the Association’s State Affairs Group as the liaison to state regulatory boards on professional trends and issues. The ad hoc will complete its investigation and make a recommendation to the RA at the Fall 2015 meeting. Fiscal:$3309

11. Motion 1: Rationale Therapists who work and/or maintain licenses in several states must deal with the challenges of compliance across differences in practice acts and licensing regulations The limited resources of some state boards can delay or extend time periods for processing of license applications, Advances in technology and emerging telehealth regulations help to promote health care reform goals, but also give rise to issues with licensure License portability and compacts are time-relevant issues whose value has been recognized by other health care disciplines Promotes the Strategic Plan by “building the profession’s capacity to fulfill its potential and mission”

12. Military Representative position to the Representative Assembly (RA) I charge the Speaker of the RA to develop a Military Representative position as a permanent position in the Assembly to be effective by the fall of 2015 online RA meeting.

13. Role of OT in case management for primary care and mental health I charge the Speaker to appoint an ad hoc committee beginning the summer of 2015 to delineate the role in case management for occupational therapy in primary care and mental health. – Identify what is currently practice related to OT’s as case managers, identify the gaps in OT practice in case management. – Identify the specific steps or strategies needed to position occupational therapy practitioners in case management. – Identify strategies to raise awareness in the medical community and public concerning the role of occupational therapists in case management. – Possibly recommend a position paper in case management Fiscal:$1225

14. Rationale Motion 3 The practice of occupational therapists (OTs) allows for the role of case managers, however, the profession recognizes the need for OTs to better define their role in the new model of care which is primary care and in mental health With the Affordable Care Act will come significant changes to the manner in which health care will be transformed and delivered in the United States The patient-centered medical home (PCMH) is a significant component of the ACO and ongoing management of all patient needs. These needs include patient compliance with care: receive preventive screenings, enhanced access for acute illness, evidence-based management of chronic illness, care coordination and integration of behavioral health needs. Case management is a collaborative process of assessment, planning, facilitation, evaluation and advocacy for options and services that meet an individual, family and caregiver’s comprehensive health needs Occupational therapy has a unique perspective involving a holistic view of a person. Occupational therapist (OT) need to better define their role in these new models of interdisciplinary care

15. Formal statement on AT and Complex Rehabilitation Technology We move the following Main Motion be adopted into AOTA policy: Occupational therapists are key members in the AT and CRT interprofessional service delivery team. Occupational therapists are leading professionals in assessing and implementing the use of advanced rehabilitation technologies to enable, preserve and optimize mobility, accessibility and function … Whereas, Occupational therapist-recommended AT/CRT devices are critical to patients/clients with disabilities to address and prevent body structure and functional limitations to maintain or increase their activity and participation in society; Resolved, The American Occupational Therapy Association supports access to and funding of AT appropriately suited to the patient’s/client’s needs including but not limited to CRT for people with disabilities; and, Resolved, Licensed occupational therapists should be recognized and appropriately paid for providing clinical services related to AT/CRT.

16. Rationale Motion 4 Occupational therapists are leading professionals in assessing and implementing the use of these advanced rehabilitation technologies to enable, preserve and optimize mobility, accessibility and function in the area of mobility related activities of daily living while exercising vigilance in the prevention of secondary disabilities. Occupational therapy practitioners bring a distinct skillset to AT/CRT, addressing needs through a holistic and client-centered approach and providing environmental interventions that facilitate client safety, independence, and participation in daily life occupations within an environment. People with disabilities commonly require assistive technology (AT) as the highly customizable tool or device to compensate for their their medical and functional limitations. Complex rehabilitation technology (CRT) is a subset of AT including but not limited to individually configured manual wheelchairs, power wheelchair systems, adaptive seating systems, alternative positioning systems, and other mobility devices.

17. Rationale continued Occupational therapist recommended CRT devices are critical to patients/clients with disabilities to address and prevent body structure and functional limitations to maintain or increase participation in society. Our profession should demonstrate a continued commitment to AT and CRT with a patient/client centered focus within a societal context Patient/clients living with long term disabilities often are dependent on complex rehabilitation technology to meet their seating and wheeled mobility needs to achieve independence and functioning While technology has evolved, a disparity remains for patient/clients in need of this technology due to a number of barriers that limit access. There also exists opportunity to further differentiate the role of the OT and rehab technology professional (RTP) in the CRT service delivery process to further codify the different roles.

18. Other Action Items Commission on Education (COE) – Move to approve the revised position paper titled “The Value of Occupational Therapy Assistant Education to the Profession”. – Move to approve the new position paper titled “The Importance of Interprofessional Education in Occupational Therapy Curricula”.

19. Ethics Commission Move that the revised Occupational Therapy Code of Ethics (2015) [Code] be approved – The term “Social Justice” was removed. Although, based on survey results, most members support the use of this term and the concepts within the principle, the Commission made a significant effort to consider the concerns raised by a few. As a result, a Justice section which is closely linked to the four-principle approach dominating clinical ethics was utilized.

20. C ommission on Continuing Competence and Professional Development (CCCPD) Move to approve the revisions to the document: AOTA Standards for Continuing Competence Move to approve the revisions to the document: AOTA Guidelines for Re-Entry Into the Field of Occupational Therapy

21. Prior RA Meetings & Actions November 2014 March 2014 June 2014 (special session)

22. Fall RA Activity: (On-line) November 10 th -24 th, 2014 (Passed) RA Coordinating Committee (RACC) standard operating procedures: including “attachment A” which outlines the types and processes of document development. – Guidelines – Position Papers – Statements – Standards

23. Other SOP and Documents Commission on Continuing Competency and Professional Development (CCCCPD) SOP (Passed) The Philosophy of Occupational Therapy Education (Passed) with one word change from “institutions” to “groups”

24. Commission on Practice Documents Complex Environmental Modifications (Passed) Seating and Wheeled Mobility (Defeated)

25. Summer Special Meeting June 2014 The RA recently held a special online meeting from June 13-25, 2014. The primary purpose was to hold an election for two RA leadership positions: Agenda Chair and Recorder. Ingrid M. Provident, EdD, OTR/L was elected Agenda Chair and Emily Pugh, MA, OTR/L, LHRM won the election for Recorder. They will be members of the RA Leadership Committee (RALC) and started a 3 year term on July 1st. In addition, the COE Standard Operating Procedures with attachments outlining responsibilities of the Academic Leadership Councils for OT and OTA Programs respectively were passed with a substitute motion to reinstate the voting rights of the student representative on COE.

26. Spring 2014 Meeting Approved the document The Role of Occupational Therapy in Primary Care Adopted a position in support of programmatic accreditation of professional degree programs in OT and recommended that ACOTE consider developing accreditation standards for post-professional OTD programs Approved the following SOPs/JDs: Representative JD OTA Representative JD Agenda Committee SOP Credentials Review & Accountability Committee SOP RA Leadership Committee SOP Commission on Practice SOP Commission on Continuing Competency and Professional Development SOP Board & Specialty Certification SOP

27. Other Topics: OTA Education Recommendation 1: Following a thorough review of the issues and stakeholder feedback, the Committee is recommending that the entry-level degree requirement for the occupational therapy assistant remain the associate’s degree at this time. The Committee recognized that there are a number of factors and key data supporting a move to the bachelor’s degree including expanded breadth of OTA practice, increased content requirements, and emerging practice models. However, the Committee noted that there was not sufficient evidence that the institutions sponsoring the existing OTA programs would be able to successfully make the transition at this time and if the key stakeholders (e.g., students, higher education providers, clinical providers, etc.) can afford the associated increased costs.

28. OTA Education: Recommendations Recommendation 2: The Committee is recommending that there be only one entry-level degree as a pre- requisite for the single national certification exam for the occupational therapy assistant. Recommendation 3: The Committee is recommending that the Association develop and implement a plan in the next 2 years that articulates clearly defined strategies to ensure that the profession is prepared to succeed if the profession should choose to move to a bachelor’s requirement for the entry-level degree for the occupational therapy assistant. This plan should at a minimum address the following:

29. Defeated Spring 2014 Charge the President to request that OT and OTA Program Directors appoint or elect a representative to serve on the RA as a member with voice and vote Charge the CCCPD to develop a student version of the Professional Development Tool and to seek the collaboration of ASD in the development of the student version o the tool. Charge the Speaker to have the RALC appoint an ad hoc committee within the RA to review and develop leadership initiatives that will foster leadership skills within the RA and facilitate succession plans for growing leadership for future leaders across the profession.

30. Other Issues & Discussion

31. Writing a Motion Generally, RA motions are due by the end of December before the face-to-face meeting I. INTRODUCTORY INFORMATION A. DATE B. TITLE OF MOTION C. ORIGINATOR(S) Include the name of the individuals(s) or group(s) submitting the motion and the address, telephone number, fax number, and e-mail address of either the individual originator or one member of the group.

32. II. Body of motion A motion should state clearly who is being charged to do what by when. It may or may not include qualifications of how and where. The RA can charge only the RA Officials, the RA Leadership Team, bodies of the RA, AOTA Officers, and Board of Directors. The RA cannot directly charge the executive director, Association staff members, or organizational advisors of the Board of Directors

33. III. Rational Using a maximum of six bullets, briefly state the reason(s) for the motion and add accurate information that directly supports the motion. Within one bullet, identify how you believe the motion addresses the Association’s strategic priorities and the Centennial Vision. Information on the Strategic Plan and Centennial Vision can be found on the AOTA Web site at these links: – www.aota.org/governance/bod and – www.aota.org/news/centennial. Please limit the Rationale to 250 words. – A sample motion is posted on the AOTA Web site at – www.aota.org/governance/ra/sample. www.aota.org/governance/ra/sample IV. Fiscal Implications – To be completed by AOTA

35. AOTA advocacy influences Congress

36. Leadership examples Joint document related to caseload to workload for school based practice developed by AOTA, ASHA, and APTA National Association of Home Builders (NAHB) Certified Aging in Place (CAP) advisory board Expand Home Fit Programs with AARP Seats on all five Joint Commission Professional and Technical Advisory Committees Older Driver initiatives and Car Fit Advisory Committee of the Rehabilitation Research and Training Center (RRTC) Patient Centered Outcomes Research Institute American College of Occupational and Environmental Medicine's

37. The 9 certification areas are as follows : Board Certification (OT) Gerontology Mental Health Pediatrics Physical Rehabilitation Specialty Certification (OT & OTA) Driving and Community Mobility Environmental Modification Feeding, Eating, and Swallowing Low Vision School Systems

38. Benefits of AOTA Membership AOTA is the only national association exclusively interested in occupational therapy AOTA offers continuing education to members at a 30% discount AOTA has 11 Special Interest Sections devoted to sharing practice innovations

40. Centennial Vision Mission Statement The American Occupational Therapy Association advances the quality, availability, use, and support of occupational therapy through standard-setting, advocacy, education, and research on behalf of its members and the public Vision Statement AOTA advances occupational therapy as the preeminent profession in promoting the health, productivity, and quality of life of individuals and society through the therapeutic application of occupation Centennial Vision We envision that occupational therapy is a powerful, widely recognized, science-driven, and evidence-based profession with a globally connected and diverse workforce meeting society's occupational needs

41. Comments & Questions? Timothy A Reistetter OTR, PhD Texas RA representative tareiste@utmb.edu 409-772-9441

42. Other Texas Motions Motion 1 TITLE OF MOTION Postpone any further action on the 2014 AOTA Board of Directors Position Statement on Entry-Level Degree for the Occupational Therapist, until the Representative Assembly can clarify lines of authority in initiating, amending, or rescinding Association professional standards and policy. Motion 2 TITLE OF MOTION Development and publication of educational materials to increase stakeholders/members understanding of the alignment of Association Bylaws, Policy, and Procedures and how these documents serve to guide and direct Association governance and decision making process related to professional policy and standards. Motion 3 TITLE OF MOTION: Development and Adherence to “Rules of the Day Policy and Procedures” to govern & monitor posting on AOTA OT Connections Discussion Board issues related to Association Bylaws, Policy, Representative Assembly, AOTA Director and/or Other Official Association Business