Resources Available Comparison of Responsibilities of OT&PT Practitioners in School-Based Practice (published Feb. 2010) o

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1 Hw Many is T Many What is an Apprpriate Caselad in Schl Based Practice? Ohi Occupatinal Therapy, Physical Therapy, and Athletic Trainers Bard What is a Caselad? Every student assigned t an is part f the s caselad under OT&PT laws and rules The OTPTAT Bard s definitin f caselad ODE s definitin f caselad ODE caselad = maximum # f students t whm an individual therapist may prvide direct services OTPTAT Bard caselad = all students fr whm have ultimate respnsibility must nt prvide/supervise care fr a higher number f students than that fr which skilled care by licensed practitiners can be delivered Ohi OTPTAT Bard 2 Is ODE Aware f the Difference? Yes and N. Bard and ODE have met extensively ver the past 7 years Bard (and prfessinal assciatins) have tried t educate ODE staff n licensing laws and rules Althugh ODE staff might understand the difference Has this knwledge reached the actual districts? In many cases, the answer is n Bard develped resurces t be used by licensees when cmmunicating with their districts Ohi OTPTAT Bard 3 1

2 Resurces Available Cmparisn f Respnsibilities f OT&PT Practitiners in Schl-Based Practice (published Feb. 2010) Outlines the rle f the therapist and the assistant in schl-based practice Determinatin f Apprpriate Caselad fr Schl- Based OT and PT Practice Psitin Paper (published June 2011) Describes factrs t be taken int accunt when determining an apprpriate therapy caselad Frequently Asked Questins Crrespndence Lcated in Bard Meeting Minutes All f these are available n Bard website Ohi OTPTAT Bard 4 Where are the Resurces n the Website? Ohi OTPTAT Bard 5 ODE Rule (H) Requires apprpriate prfessinal licensure must be licensed pursuant t the apprpriate sectin f the Ohi Revised Cde must be licensed pursuant t the apprpriate sectin f the Ohi Revised Cde prvide services under the supervisin f the in accrdance with their respective practice acts. ODE Office fr Exceptinal Children Infrmatin available at Ohi OTPTAT Bard 6 2

3 ODE Rule (I) Service Prvider Ratis fr Delivery f Services Determinatin f ratis fr individual service prvider must cnsider scheduling and time demands, including, but nt limited t: All areas f service prvisin t children w/ and w/ disabilities including screening, assessment, cnsultatin, training, interventin design, educatin interventins Time fr planning Severity f each child s needs Additinal time fr diagnstic testing and classrm bservatin, crdinatin f prgram, parent, staff and agency cnference re: individual children, staff develpment activities, fllw-up and demands f an itinerant schedule including number f buildings served and distance between buildings Ohi OTPTAT Bard 7 Summary f Factrs Impacting Ratis Severity f disabilities f students served Time required fr dcumentatin, planning, meetings, assessments, interventin develpment, parent/schl staff training Ttal range f therapist respnsibilities t include supervisin f assistants Number f building served and miles between buildings In essence, apprpriate caselad cnsiders the therapist s wrklad, nt just summing up the IEP minutes Ohi OTPTAT Bard 8 Hw Des Supervisin f Assistants Impact Determinatin f Ratis? A review f therapists and assistants respnsibilities prvides insight Ohi OTPTAT Bard 9 3

4 Wh Can Receive OT r PT Referrals? Wh Can Perfrm Evaluatins? 1. Interpret referrals t ccupatinal therapy/physical therapy 2. Cmplete evaluatins & interpret/analyze the evaluatin data. Write reprt fr ETR 1. Refer all requests fr ccupatinal therapy/physical therapy t an OT r PT, respectively 2. Cntribute t evaluatin prcess by gathering data, administering standardized tests &/r bj. meas. tls, & reprting bservatins Ohi OTPTAT Bard 10 Wh Writes the Gals? 3. Cllabrate w/ IEP team (may include ), t develp IEP gals/bjectives & determine if services required fr student t meet IEP gals & access general curriculum 3. Cllabrate with and IEP teams t assist in develpment f IEP gals/bjectives Ohi OTPTAT Bard 11 Wh is Respnsible fr the Plan f Care (PC)? 4. Develp, interpret, & mdify the plan f care in cllabratin with t determine which prtins f plan will implement Nte: OTs use treatment/interventin plan interchangeably with plan f care 4. Cntribute t & cllabrate in preparatin, implementatin, & dcumentatin f plan f care can select treatment activities accrding t the plan f care Ohi OTPTAT Bard 12 4

5 Wh Supervises an Assistant? 5. Prvide initial directin, peridic cnsultatin, cllabratin, & inservice training t & dcument supervisin prvided t review & csign the treatment/daily ntes f the 5. Dcument interventin/therapy sessins & respnse t interventin and cllabrate w/ re: student needs & prgress and interventin plan. must ensure that review & csign treatment/daily ntes Ohi OTPTAT Bard 13 Wh Assesses Prgress? 6. Review student prgress with C-sign prgress reprts t indicate review & cllabratin with 6. Cmplete peridic prgress reprts t be reviewed & c-signed by Ohi OTPTAT Bard 14 Can the Cmplete the Peridic Assessments? 7. Cmplete assessment/analysis fr peridic review & cllabrate w/ IEP team t develp new gals & determine if services still needed Write discharge summary/plan when services are discntinued Relying slely n inf gathered by assistant des nt meet criteria fr assessment/evaluatin... culd fall belw minimal standards f care 7. Prvide data fr assessment & participate in IEP team cllabratin fr peridic review Prvide inf t the fr use in discharge plan when services are discntinued Ohi OTPTAT Bard 15 5

6 Respnsibilities f Supervising Therapist Only the therapist may delegate the Plan f Care Must be able t be reached by telecmmunicatins at all times Develpment f Plan f Care and assignment f apprpriate elements t assistant Ensure that assistant understands Plan f Care and implements it as therapist intended Review and c-sign all f the assistant s dcumentatin, including daily therapy ntes Review, re-assess, and change Plan f Care as child makes prgress Ohi OTPTAT Bard 16 What Des Therapist Supervisin f the Assistant Require? Therapist must meet with the assistant n regular basis OT Rule (C) Supervising OT must meet with assistant: (1) at least 1x/week fr assistants in first year f practice r (2) at least 1x/mnth fr assistants beynd first year f practice PT must see client: (1) upn request f PTA; (2) when treatment plan change is needed; (3) prir t any planned discharge; (4) in respnse t change in medical status Therapist must be familiar with the plan f care, functin, and status fr every student t whm the assistant prvides direct services Ohi OTPTAT Bard 17 Key Takeaways OTs, PTs, OTAs, PTAs must fllw respective prfessinal practice acts has ultimate respnsibility fr students served by an assistant whm they supervise must nt prvide supervisin fr mre students than they can prvide skilled care must review and c-sign all prgress ntes written by the assistant this requires cllabratin between therapist and assistant Relying slely n infrmatin gathered by the assistant withut review des nt fulfill the therapist s bligatin t prvide apprpriate standard f care OTAs/PTAs d nt have their wn caselads separate frm that f the supervising therapist Ohi OTPTAT Bard 18 6

7 S Is There a Rle fr Assistants? Abslutely! OTAs and PTAs are licensed prfessinals wh prvide skilled and valuable services in all settings, including schl-based practice Cllabrative relatinship between the therapist and assistant enhances care and ensures that students receive quality services Therefre, time fr therapist/assistant cllabratin must be cnsidered when determining respnsibilities f therapists and assistants Ohi OTPTAT Bard 19 Bard s Psitin n Caselad Determinatin All respnsibilities f the therapist & assistant must be cnsidered when determining an apprpriate therapist caselad This includes bth direct and indirect services t students This includes services t regular educatin students, such as RTI services, IAT meetings, bservatins, and evaluatins # f students t whm supervising therapist prvides direct service must be reduced as # f assistants the therapist supervised increases Why? Because this increases the # f students fr whm the therapist is respnsible Therapist must ensure prvisin f apprpriate services Ohi OTPTAT Bard 20 Bard s Psitin n Caselad Determinatin Therapist must nt serve &/r supervise service fr mre students than he/she can prvide skilled care This includes infrmed directin f all aspects f services prvided by the assistant The Cde f Ethical Cnduct requires licensees, regardless f practice setting, t maintain the ability t make independent judgments and strive t effect changes that benefit the student OAC (B)(9) fr OT; OAC (A)(2) fr PT Ohi OTPTAT Bard 21 7

8 Caselad Limits ODE Operating Standards therapy persnnel may prvide direct services t n mre than 50 schl age children with disabilities (r 40 preschl children with disabilities) Bard s psitin is that number f students t whm therapist prvides direct services shuld decrease as number f students t whm supervised assistant prvides direct services t increases It is nt reasnable t expect a therapist t prvide direct services t 50 students and t supervise multiple assistants wh are prviding direct services t additinal students Ohi OTPTAT Bard 22 Respnsibility f Educatinal Agencies If an educatinal agency adheres t rule (I)(1), it wuld bring therapist caselad clser t a level that s in alignment with the therapist prviding service nly t the number f students fr whm they can prvide skilled care. This is the standard required in the therapists respective prfessinal practice act Paragraph (I)(1) gverns the additinal factrs that must be cnsidered when determining the apprpriate caselad fr a therapist Ohi OTPTAT Bard 23 Missin f the Bard The Bard s missin is t prtect the cnsumers f OT and PT services In schl-based practice, Bard must ensure that students receive care cnsistent with safe and ethical practices Licensees are required t reprt t the Bard any entity that places them in a psitin f cmprmise with their cde f ethical cnduct OAC (B)(12) fr OT; OAC fr PT Ohi OTPTAT Bard 24 8

9 Ptential Vilatins f ORC Regardless f practice setting, the therapist must prvide adequate supervisin t assure that treatments fllw safe, ethical, and effectual standards Regardless f practice setting, the licensee shall maintain the ability t make independent judgments and strive t effect changes that benefit the patient/client (OAC (A)(2) & 7-08 (B)(9)) Licensee must reprt any entity that places the licensee in a psitin f cmprmise with the cde f ethical cnduct (OAC & 7-08 (B)(12)) Ohi OTPTAT Bard 25 Ptential Vilatins f ORC Failing t assess and evaluate a patient s status (OAC (B)(5)(a) & 7-08 (C)(1)(a)) Prviding substandard care as an by exceeding the authrity t perfrm cmpnents f therapy interventins selected by the supervising (OAC (B)(5)(g) & 7-08 (C)(1)(c)) PTAs are nt qualified t interpret physician referrals, cnduct client evaluatins, write plans f care, r perfrm discharge evaluatin/summary (OAC (B) & 7-02 (A)) Ohi OTPTAT Bard 26 Ptential Vilatins f ORC Supervising is accuntable and respnsible at all times fr the directin f the actins f persns supervised (OAC (A) & 7-04 (A)) Ohi OTPTAT Bard 27 9

10 Occupatinal & Physical Therapy Bard s missin is t prtect the cnsumers f ccupatinal & physical therapy services Bard gets invlved when it appears that its licensees are nt prviding adequate services t its clients What shuld prfessinals d when they are required t maintain a caselad that is greater than that fr which they can safely and effectively serve? Reprt the situatin t the Ohi Department f Educatin Reprt the situatin t the Ohi OTPTAT Bard fr investigatin Ohi OTPTAT Bard 28 Wrking with Yur Administratrs Knw the ODE and the OTPTAT laws and rules Knw the cntent f the teacher cntracts Dcument/quantify hw yu spend yur time Time study shuld include time spent in IAT, evaluatins, ETR/IEP meetings, cnsultatin, etc. Time study shuld be dne ver mre than ne week Use the OTPTAT Bard s resurces Use the resurces f yur prfessinal assciatin Advcate fr yurself Ohi OTPTAT Bard 29 Cntacting the Bard Internet: Phne: Fax: Mail: Ohi OTPTAT Bard 77 S. High Street, 16 th Flr Clumbus, OH Twitter: Ohi OTPTAT Bard 30 10

11 Discussins Ohi OTPTAT Bard 31 11