Tuesday, October 31, 2017

Changes to CMS. Changes to future OT licensure: Why I am Not Worried

Whether you have heard about proposals related to future OT and OTA students requiring higher level degrees or changes to how therapy services will be paid (i.e. Medicare coverage within skilled nursing facility settings) or Concerns about Medi-Cal coverage cutting therapy access...proposals will cross our practice path many times in our lifetime...and more change will call for adaptability within the lifetime of our practice.  

Some practitioners are worried, angry, and scared.  Practitioners are asking: "What will this mean for me?" "Will I be able to practice?" "Will I have a job?" "Will there be enough diversity in our profession?" "What about all the baby boomers receiving rehabilitative and habilitative services?" 

"What does this mean for the future of the profession?" 

To be honest, I'm not worried. I know, I know, some of you are thinking: what! Is this woman crazy?!

Yes, you heard right. I'm NOT WORRIED. SO why? Why am I not worried?

Number one: Graditude
Number two: I can’t afford to worry 

Is it scary? Of course. Will I settle for it? No. 

Graditude: I get to practice this profession! I love what I do as an OT too much to accept what doesn't align with my practice priorities. I cannot do as others say or back down if my gut says this isn't right. I have to take action instead with what aligns with my professional priorities. 

Don't get me wrong, it is initially worrisome when I hear the news because my first reaction like anyone else to any news of change is fear.  Fear that someone else has control over my profession. There's a fear that comes over us that we will lose a job, have less opportunity for work if others take over and more work to be done to show our worth. 

Any change is scary but here's the good news: We don’t have to settle for changes we are not comfortable with. We can take action towards what we need and want, always. When it is not perfect in result, we can and will adapt around them.  

Let's back up a bit before I tell you what you can do to take action for yourself: I want to define my definition of the word adapting because to some, adapting is interpreted as settling and dealing with change.  The kind of adapting I am referring to is not one where I settle or having that belief of "that's just how it is." 

Instead, adapting will mean reflecting on myself to convey a message more effectively, in order to pursue what I want.  Okay, let's get back to some good things to possibly reassure you at this time of scary things happening.

Here are some reasons why I am not worried:

* Because when I walk into a state OT conference annually, I see our state association giving us tools to breakdown barriers we face in daily practice.  

When I talk with OT's at these conferences (who spend their free time being representatives in governing affairs), I am not worried.

When I also see the lobbyists at these conferences who believe and advocate for our profession, on our behalf on the state and national level, I am not worried.

* When I run into other practitioners and speak one on one with those OTs and OTAs who have a differing perspectives on the things I cannot see, I am not worried. I have faith each practitioner will follow suit in helping to speak up, just as our representatives do.Their passion for their practice gives them the courage to speak up in time of need; it also gives me the strength to keep going too. 

I have faith each practitioner's passion for what they do will speak louder for action in advocacy, in turn, overriding acceptance or settling for what is or what might be their future. 

I see what happens when we are greater in numbers; coming together as a community of occupational therapists.  It is stronger than standing alone in our clinics or facilities; our voice is louder together.  The more dynamic it is, the more comprehensive our message is for getting things done. Perspectives from all angles brings inclusivity of everyone's concerns, which breaks down the barriers we are facing today. 

I have to say, bluntly, I believe these roadblocks are there because we were not more involved when things were and are going right.  The barriers are exactly what we need to push back.  

If the changes being proposed pushes therapists hard enough, they will fight back.  There will be no settling as long as we do it together as a unit. 

I am not worried because all therapists will get involved.  There will not be lurkers watching and reading the updates of proposals, only waiting on the sidelines for all things to crumble. Practitioners will comment on proposals, convey their wisdom from their personal experiences and will get engaged with the effective people who influence these decisions.

I am not worried.

* I am also not worried because there are ways to intervene. After all, would I have a job if I didn't have an intervention to address my client's occupational barriers? 

Sure sometimes we have to try another way of doing things to get the results we need. There is always another intervention to the barriers we face if we don't succeed in the first try.
Not one intervention fits all barriers so that's why I want to share a few of the interventions that improve the ability to be heard and minimize concern for changes that we may not see so optimal.

Here is why I cannot afford to worry and three ways to adapt to the proposed changes. 

(credit for my motivation to write a post about this goes to one of our very own occupational therapy colleagues who is an advocate on a governing level for my state, Sabrena McCarley):

1. Become Besties 
with your Local Legislators:


They don't know you and they most certainly do not know what a occupational therapist is. In fact, every legislator, senator, governor, and representative on a governing level do not know who you are, what you do and why it is valuable.  

They also would think you are stalker-like and creepy for coming out of no where when all of a sudden you have a favor to ask of them like a little thing of needing their vote on a decision that impacts our professional future.  

That's why we have to build a relationship with them first by becoming their bestie. 

It's like dating: we don't traditionally walk up to the door of someone we are crushing on and ask them to marry us before introducing who we are, getting to know about them and sharing a part of you and your history, your passions, your interests, your daily life.  Of course we wouldn't rush to the alter right away, that's why we would treat those who can help us get things done on a profession end the same way as our potential partner.


Get on their email list ( they will not spam you) This is to stay informed of their local events so you can attend. This is were you will shmooze, say hello and build a relationship over time.  Soon enough they will know what you do and who you are and realize you are the reason why they will still be able to do self care when they have a barrier get in their way one day.  Be sure to get on each of these representative's lists to be there before you need to be.

1. Google: "find your legislature" followed by typing in your state

2. Type in your zip code 

3. Click on their site

4. Join their email list

5. schedule out their events when they inform you to attend

6. schmoose, get to know them and let them get to know you

7. repeat #6 over and over again

I also recommend identifying who is your point of contact federally as well for your county. Go here as well: 

To be your accountability partner in this, I need you to do me a favor:
When you finish step one, I will know you did this by tweeting me a screenshot of your newsletter request completion at my twitter handle here and say in the tweet "I'm their go-to OT." 

Don't have twitter? That's okay post your screenshot on Instagram instead with the same comment ( do not forget to tag me so I know you did it).

2. Comment on the proposals 
(sent to you by your state and national associations that ask for your comments).

This is not only an email you find from your association but this applies for those facebook group posts and newsfeed shares that have your state or national association indicating a memo or link about the topic of interest.  


because if no one comments on the proposals from our profession, it is assumed no one has an opinion about followed by the assumption that the proposal must be fine and dandy to more forward. 

If you comment, the more diversity in perspective regarding the issue can be considered.  That is why your voice counts, every single one of your voices. 


ALL can comment! You do not have to be a member of an association to have access in the proposal comments; this is put out to the public. The OT association acts as the messenger of these because they have to be on alert of anything that impacts change in our profession. 


Anytime you see a link provided by state and national OT associations for opinions and comment requests for proposals, take the five minutes to fill them out, FIVE MINUTES!  That's .003% of your day every once in a while to contribute your valuable opinion on the subject matter 

Accountability moment: tweet me #OTadvocacy each time you do this.  The proof is in the pudding, do your part in creating the mixture.

3. Email your state and national associations 
(to comment on their proposals or course of actions):


see the "why" in #2


Everyone!  Being a member of your state and national association is critical....however, you are a OT or OTA practitioner who has a valuable opinion in the matter of decisions.  

It is spoken by the wise Lena Llorens at the most recent OT conference (during her Q and A session I attended):  

"I hope they think about this wisely" while sharing her thoughts about the concern for diversity in the decision to upgrade the degree level for incoming OT and OTAs.  

Share your unique perspective on the items of discussion that causes you to have questions, concerns or otherwise. 

Our association representation will not know how you feel if you do not speak up about it or share your solutions.


Because there are many states with all types of contacts combined for each, I cannot list them all here so these are the chair titles you need to find:

* professional development and leadership chair
* Advocacy and Governmental Affairs chair
* practice and ethics chair
* political action committee chair

To locate them, 

1. Google your state OT association

2. Find the contact us button.

3. Search for the contacts above

Then contact national: Contact here

Now it says in their description that non-members are encouraged to join to support the future of OT (where messages typed there by non-members cannot be answered by staff).  

I of course would love for you to be a member too for many reasons but, that is not the point of my post today.  WHAT YOU NEED TO DO - Call and leave a typed message on that form anyway; it does not mean they ignore your inquiry if you do not get a response back. Your voice does influence their decision making.  It shows you care about your profession and you have an additional voice speaking up for change.

Accountability moment: you know what to do

Closing thoughts:

When the alarm goes off that there is smoke indicating a fire in our professional pathway, we rush around to find the fire extinguisher ( we react to danger).

More real talk for you today is: It is more of an alarm to me for practitioners to react rather than proactively respond. 

It is important to be in the know before there is a problem or a decision made.
To be involved in your future when things go scary is essential but do you know what is more important than that?  

BE THERE when things are going good too. BE THERE ALWAYS.

Proactivity from each of us will support our ability to practice. 

It’s never too late to get involved, get connected and support the validity in your worth.

- with hugs and support, 


PS: If I can ask for a favor of you: Please share this post with your colleagues who are feeling defeated about changes that come their way. They may find one of these interventions to be useful.

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