RT Blog

Location: Indiana, United States

I became a Professor Emeritus after serving 29 years as a recreational therapy faculty member at Indiana University. I'm a long-time Hoosier, having grown up in Hanover, Indiana. My RT practitioner work was in psych/mental health. After completing my Ph.D. at the University of Illinois, my first faculty position was at the University of North Texas. RT has been a wonderful profession for me as I have had the opportunity to serve as an author and national leader.

Sunday, April 26, 2009

You May Wish to Call Your Rep's Office

Hossier colleague Vicki Scott sent me an email message today telling me that she has been calling our Represenative's office to encourage him (Baron Hill) to co-sign the CMS letter.

As mentioned in my last post, I emailed our Representative's health LA but a more direct approach may be to call. So you may wish to learn from Vicki's lead and call the office of your Representative. When you do have your talking points ready (see them on yesterday's RT Blog post) and ask to speak with the health LA.

I've Contacted Congressman Hill's Staff

I just want you to know that I personally followed up on the ATRA request for each of us to contact our Representative regarding the CMS sign-on letter being sponsored by Representatives Tauscher (D-CA) and Thompson (R-PA). You can see the prior post for more information on the CMS letter.

My Congressman is Baron Hill from Indiana. I sent email messages to his health LA, Joel Bailey, and his overall legislative LA, Lori Pepper. If you haven't communicated with your Representative's office, I would urge you to do so. ATRA is asking Representatives to sign-on to the letter by May 1st.

The major point I made in my emails was tha CMS has provided documentation to Congress that recreational therapy is a covered service -- but hasn't made this clear to health care providers -- and the letter simply asks CMS to do this.

Saturday, April 25, 2009

Your Help Needed Right Away!

ATRA leader Lisa Morgan sent me a reminder to post regarding the Congressional Sign On Letter for CMS. It follows:



Dear RT Colleagues:

Our time is running out to get our U.S. House of Representatives to Sign on our Congressional Sign On Letter that will be sent to CMS. We absolutely have to move quick as we can to get our U.S. Representative to sign on to this letter by May 1st, 2009.
Please see the following list of who has signed on in support as of today.

The following U.S. Representatives have signed on to our Congressional Sign-On Letter:

Sponsors: Rep. Tauscher (D-CA) and Rep. G. Thompson (R-PA)

Ehlers (R-3rd MI)
P. King (R-3rd NY)
Wamp (R-3rd TN)
Coble (R-6th NC)
W. Jones (R-3rd NC)
Schakowsky (D-9th IL)
Baldwin (D-2nd WI)
Butterfield (D-1st NC)
Farr (D-17th CA)

If your Representative has already signed on in support, please send him or her a thank you letter. If you have talked with the Representative> '> s Health Legislative Assistant, please express your appreciation to them for helping you through this process.

For all others Representatives, please follow up with your US Representative> '> s Healthcare Legislative Assistant ASAP. It is critical that you talk to the LA in person via phone to explain our issue and emphasize what it is that we are asking for at this time. Please use the Talking Points to help you explain.

The talking points follow:

(NOTE: This is ONLY for use by Recreational Therapists.
Do NOT distribute to Congressional staff.)

Recreational Therapy

 Recreational therapy is recognized as a critical health service that:

• Restores, remediates, and rehabilitates functional capacity for persons with injuries, chronic illnesses and disabilities;

• Is provided by a qualified recreational therapist and is prescribed and supervised by a physician as part of a treatment plan; and

• Has been demonstrated by evidence-based research to improve the physical, cognitive, social and emotional functioning of individuals who receive the service.

 Recreational therapists are health care providers trained and qualified to design interventions and modalities to achieve a specific medical and functional outcome.

The Problem

 Medicare coverage of recreational therapy services provided in inpatient rehabilitation hospitals and units (IRFs), inpatient psychiatric hospitals and units (IPFs), and skilled nursing facilities (SNFs) is unclear to beneficiaries and providers and creates inconsistent access to these services for Medicare beneficiaries across the country.

 CMS has provided written documentation to Congress (but not providers) concluding that recreational therapy is a covered service in IRFs, IPFs and SNFs and its costs are included in the prospective payment systems in each setting.

 CMS has repeatedly refused to provide clear, unequivocal guidance to providers recognizing recreational therapy as a covered service in IRFs, IPFs and SNFs.

 This lack of clarity has created confusion among administrators, fiscal intermediaries and Medicare Administrative Contractors. This misinterpretation often leads to Medicare beneficiaries being denied access to recreational therapy services when prescribed by a physician as part of the plan of care.

The Solution

 Ask your Representative to “co-sign” the Congressional letter (or send their own version) when it is ready for support and signatures.

House sign-on letter champions are: Reps. Tauscher (D-CA) and Thompson (R-PA).

 For IRFs, the letter directs CMS to simply clarify that recreational therapy meets the definition of the 3-hour per day therapy guideline that appears in Section 110.4.3 of the Medicare Benefits Policy Manual (MBPM), Relatively Intensive Level of Rehabilitation Services.

 In addition, for IPFs and SNFs, the letter requests that CMS publish its often-stated recognition that recreational therapy is a covered service and that the costs of providing these services are incorporated into the prospective payment systems in these settings.

 This clarification will not cost the Federal Government more than is currently spent for patients in these settings because the services are already covered in each setting and the costs for the services are already built into each respective prospective payment system.

Make sure you point out that you will remain in touch with the health staff member regarding their decision to support the letter (or send their own).

If you have not sent your letter of request yet, it is real important that you call your Local Office or the Washington DC Office and ask for the name and email address of your Representative> '> s Healthcare Legislative Assistant. Explain to this LA what our issue is and that you would like to send your letter to them explaining the issue in detail along with the actual Congressional Sign On letter for their review. Tell them that our Deadline is May 1st. This is why you would like to send the information directly to the LA so that they can present to your Representative and ask for their support prior to the deadline. If you fax your letter only at this point or send through the congressman/woman> '> s website, it may get lost in the large amount of information the offices receive and will not be able to be processed before our deadline.

If you need help on what to do, please ASK! Email or call one of the following to assist you:

Lisa Morgan: 423-634-1674 or lisajomorgan@comcast.net
mailto:lisajomorgan@comcast.net> or lmorgan@siskinrehab.org
mailto:lmorgan@siskinrehab.org> Dr. Thom Skalko: 252-347/6840 or
SKALKOT@ecu.edu > Diane Skalko: 252-347-6839
or SKALKOD@ecu.edu

Thank you!

ATRA Federal Public Policy

Thursday, April 23, 2009

Reaction to ATRA's Use of Eletronic Communications

I was pleased to see comments from Mike Sutherland and Danny Perry on the recent post regarding a need for more eletronic communications from ATRA. Do you suppose ATRA leaders take the time to check in on the RT Blog and, if they do, will ponder the idea of using more eletronic communication?

Tuesday, April 21, 2009

April 25th ATRA Deadline

I just heard from ATRA. The extended deadline for submitting a presentation for the ATRA Annual Conference is April 25, 2009 (this Saturday).

Call for Manuscripts from AJRT

The American Journal of Recreation Therapy Editor, Linda Buettner, has sent out a call for manuscripts. The announcement follows:

American Journal of Recreation Therapy, an independent double-blind peer-reviewed print and online journal, welcomes original research manuscripts that contribute to the field of therapeutic and recreational therapies in the management of rehabilitation and quality of life for disabled persons of all ages. The journal also receives and publishes original papers regarding all uses of recreation therapy, as well as articles on the legal and regulatory issues surrounding this important field.

Manuscripts are accepted for review as original clinical or basic science research, case reports, clinical reviews, literature reviews, practical application, inservice updates and letters to the editor. Manuscript submission is handled electronically. To submit a manuscript, please follow this link to http://ajrt.allentrack2.net. For additional author guidelines and instructions please visit the journal's webpage, www.recreationtherapy.org

Extended Call for Papers for ATRA Conference

On Tuesday, April 14, 2009, I posted a message that the call for papers has been extended for the ATRA Annual Conference (October 2 - 6, 2009). I promised to seek information on a deadline for submission -- which I have done through the ATRA Office. Unfortunately, the ATRA Office wasn't able to provide a firm date but said they would get back to me. I'll let you know when I hear something.

It is my belief that many RTs are doing great things in terms of the interventions they are providing but that they don't present what they are doing so other RTs can benefit. I hope if you are one of these RTs that you will consider submitting to do a presentation at ATRA.

Monday, April 20, 2009

Why Not RT Webinars?

I got an announcement of a webinar being provided by BlazeSports and the U.S. Paralympics. It will be April 29, 2009 at 2:00 EST and is entitled: “Working with Adapted PE Teachers: Partnership, Recruitment and Mandates.” Jeff Jones, Director of Education and Training for BlazeSports America, was listed as a contact for further information at jjones@blazesports.org

Reading this I wondered if special recreation can conduct webinars, why can't recreational therapy provide them? I don't know that any RT webinars have been held. I would hope that a university might experiment by offering a webinar for RTs or RT educators.

In fact, a webinar would seem to be a very good mechanism for information sharing among RT educators. Perhaps following the June Curriculum Conference a webinar could be held to give a conference update and allow further discussion.

Idea -- More ATRA Communications Needed

I regularly receive email messages from the Recreation Therapists of Indiana and from a couple of national organizations. I also receive a monthly eletronic newsletter from another organization.

I occasionally receive an email message from ATRA. Usually it is from Thom Skalko regarding some public policy conference call or action. But I wonder if ATRA could not do much more with eletronic communications.

When I was an ATRA officer, those of us on the Board believed we were continually communicating with the members as to what was going on. But we regularly received feedback from members that they felt they were not receiving information on ATRA activities. Now that I am not on the Board I am better understanding the feelings that members had about not receiving information about what is happening with ATRA and within RT in general.

Now that we are able to communicate so easily through eletronic communications, I wonder if it would not be a good idea for ATRA to do more in terms of getting out to the membership. Why not more regular emails to the members? Why not publish a monthly ATRA Newsletter? Or how about distributing a monthly update to the members from the ATRA President?

ATRA has long prided itself on being a grassroots organization. To me being a grassroots organization means regular and open communications among the members. I really do wonder if our national organization is taking full advantage of the means of communications available to us today. What do you think?

Saturday, April 18, 2009

Claypool Director of HHS Office on Disability

From DisabilityInfo.gov:

The Department of Health and Human Services (HHS) has announced the selection of Henry Claypool as director of the HHS Office on Disability. Mr. Claypool has 25 years of experience developing and implementing disability policy at the federal, state, and local levels, and he has personal experience with the nation's health care system from the perspective of an individual with a disability.

Friday, April 17, 2009

Position Opening at Temple

Temple University's Department of Therapeutic Recreation is seeking a full-time faculty member for a one-year Non Tenure Track appointment for the 2009-2010 Academic Year. This position primarily involves teaching undergraduate and graduate (masters) students preparing to practice as recreation therapists. Additional duties include collaboration on departmental projects along with pursuing one's own scholarly activities. Qualifications include, at minimum, a master's degree (PhD preferred), previous teaching experience, and the national credential - CTRS. Experience as a practicing recreation therapist with expertise in pediatric healthcare, developmental disabilities, or physical rehabilitation, including adapted sport and recreation, is desired.

The Department is located within the College of Health Professions, which also includes communication sciences and disorders, health information management, nursing, kinesiology, occupational therapy, physical therapy, and public health. Metropolitan Philadelphia is a dynamic environment with diverse health care and human services agencies that provide exceptional learning opportunities for students and faculty, as well as a vibrant place to live and recreate. Please visit www.temple.edu/chp/ to learn about Temple, the College of Health Professions, and the TR Department. Further information on this position can be obtained by contacting Dr. Shank at (215) 204-6278, or at jshank@temple.edu.

Screening applications begins immediately. Send cover letter, a list of 3 references, and vitae to TR Search Committee, Box 062-55, Suite 304, 1700 North Broad St. Philadelphia, PA. 19122. Temple University is strongly committed to Affirmative Action and Equal Opportunity and encourages qualified women and members of minority groups to apply.

Wednesday, April 15, 2009

Mental Health Services and Cutural Competence

From Mental Health America comes a call to end mental health disparities:

Mental Health America Calls for Action to End
Mental Health Disparities
Culturally Competent Services Can Remove Barriers

ALEXANDRIA, Va. (April 15,2009)— In recognition of National Minority Health Month, Mental Health America is calling for action to end the disparities that exist for people of color in need of mental health care and treatment.

The month of April was designated as National Minority Health Month in response to Healthy People 2010, the Surgeon General’s 10-year health objectives for the nation issued in 2000, which include a focus on the elimination of health disparities among different segments of the population.

Even more than other areas of health and medicine, the mental health field is plagued by disparities in the availability of and access to its services. Financial barriers often prevent too many Americans from receiving mental health care, regardless of whether or not they have insurance.

Nearly a decade ago, then-U.S. Surgeon General Dr. David Satcher described the striking disparities in mental health care for racial and ethnic minorities.

“We have allowed stigma and a now unwarranted sense of hopelessness about the opportunities for recovery from mental illness to erect these barriers. It is time to take them down,” he said in 2001.

“Communities of color continue to have less access to mental health services than White Americans and they are even less likely to receive needed services and receive poorer quality care when they receive it,” said David L. Shern, Ph.D., president and CEO of Mental Health America. “We have to take action to permanently remove barriers and ensure all Americans have access to mental health care.”

Overall, only one-third of Americans with a mental illness or a mental health problem get care. Yet, the percentage of African Americans receiving needed care is only half that of non-Hispanic whites. Nearly one out of two Asian Americans/Pacific Islanders have difficulty accessing mental health treatment because they do not speak English or cannot find services that meet their language needs. One national study found that only 24% of Hispanics with depression and anxiety received appropriate care, compared to 34% of whites. Twenty-four percent of Native Americans lack health insurance, compared with 16 percent of the U.S. population.

Did You Know?

Did You Know?

Mental Illness can strike anyone! It knows no age limits, economic status, race, creed or color.

1 in 5 Americans will experience a serious emotional disturbance in their lifetime.

1 in 33 children and 1 in 8 teens experience depression.

Suicide kills more Americans than homicide.

(source: Mental Health America)

Tuesday, April 14, 2009

ATRA Conference October 2 - 6, 2009

I just received an announcement on the RTI Listserve indicating that the call of papers had been extended for the ATRA Annual Conference in Minneapolis in October. The deadline for submission was not clear however so I'm seeking further information and will pass it on when I get it.

Sunday, April 12, 2009

Article on Effects of Physical Interventions

A review of research has shown the effectiveness of physical interventions in improving activity limitations for people with spinal cord injuries. For full information on the article go to:

Harvey, Al., Lin, C., Glinsky, J. V. & Wolf, A. De. (2009). The effectiveness of physical interventions for people with spinal cord injuries: A systematic review. Spinal Cord, 47, 184–195.

Thursday, April 09, 2009

RT Openings in California

From the RTI listserve comes this position opening in California:

Job Posting
Full-time Recreation Therapist positions are available at Coalinga State Hospital in Central California.

Job duties include facilitating groups, participating in Treatment planning, completing Rehab assessments,planning events and activities for patients, and monthly paperwork.

Coalinga State Hospital is a new facility treating sex offenders. The current starting salary is $54,000+/year. Live or phone interview provided to qualified applicants. Openings will be available for years due to activation...Great opportunity for new grads or experienced therapists.

For more information go to: http://www.dmh.ca.gov and click on “State Hospitals,” “Coalinga State Hospital,” “Human Resources,” “How to get a State job,” and the link for the application form “STD 678.” Mail your application to Personnel, Coalinga State Hospital, P.O. Box 5000, Coalinga, CA 93210.

You may also contact Amy Pfenning, ATR at APfenning@csh.dmh.ca.gov or Evelyn Catano, MT-BC, Chief of Rehab Therapy at 559-934-3780 for more information.

Tuesday, April 07, 2009

Top Ten Books in Positive Psychology

I had a post this week regarding Barbara Fredrickson's new book, Positivity. Her book is one of ten recently recommended books on positive psychology.

As I discuss in the new 6th edition of my book, Therapeutic Recreation Processes and Techniques, (Austin, 2009) positive psychology contains much that can be applied in recreational therapy. If you are curious to learn more about positive psychology you may want to take a look at what follows.

The March "Coaching Toward Happiness" eletronic newsletter contained a list of the top ten positive psychology books. Here they are:

A Primer in Positive Psychology by Christopher Peterson.
Happiness: Unlocking the Mysteries of Psychological Wealth by Ed Diener and Robert Biswas-Diener
Positivity by Barbara Fredrickson (see yesterday's RT Blog post for more information).
The How of Happiness: A Scientific Approach to Getting the Life You Want by Sonja Lyubomirsky.
Thanks! How the New Science of Gratitude Can Make You Happier by Robert Emmons.
The Happiness Hypothesis: Finding Modern Truth in Ancient Wisdom--Why the Meaningful Life Is Closer Than You Think by Jonathan Haidt.
Stumbling on Happiness by Daniel Gilbert.
Happier: Learn the Secrets to Daily Joy and Lasting Fulfillment by Tal Ben-Shahar.
Happiness: A History by Darrin McMahon.
Quality of Life Therapy: Applying a Life Satisfaction Approach to Positive Psychology and Cognitive Therapy by Michael Frisch.

Results from Educators' Meeting?

I don't know why, but today I woke up wondering what would result from the Educators' Conference to be held this summer at Oklahoma State University. I guess I have to admit that I have been concerned about the outcome for some time and today's thoughts were just a continuation of that.

The ATRA Curriculum Conference held in the mid-1990s resulted in an ATRA publication listing the competencies needed for RTs. A revision of this publication was put out by ATRA last year. I sure hope that something tangible results from this summer's conference.

It seems to me that RT educators have not taken the lead when it comes to establishing solid national curriculum requirements. As a result, two things have happened. One is that NCTRC has been the organization that has established curriculum standards. The second is that any number of weak university RT professional preparation programs have continued to exist.

I certainly would encourage RT educators and practitioners to use the conference to produce some much needed changes in RT curricula. Without such a result the conference will produce nothing but wasted effort!

Monday, April 06, 2009

Openings in Indy & Ft. Wayne

From the RTI listserve comes this announcement:

Meaningful Day Services, Inc. is seeking part-time and full-time Recreational Therapists to provide home and community-based services for individuals throughout the lifespan with Developmental Disabilities. We serve individuals through the Indiana Medicaid Waiver and First Steps Early Intervention program.

Indianapolis--Full-Time and Part-time
Ft. Wayne--Full-Time and Part-time

Must be credentialed (CTRS) through NCTRC.
Valid Driver's license and reliable transportation.

Job Description:
Our therapists conduct standardized assessments for each client, attend interdisplinary team meetings, develop and implement treatment plans and interventions using a multi-modality approach to train treatment objectives, educate families and caregivers on TR processes and techniques, and document measurable client progress on a quarterly basis. Our therapists primarily work with their client's in the client's home or in the community to train objectives based on assessment findings of functional skills/abilities and leisure interests. Quality Assurance studies are conducted bi-annually to determine the outcomes of TR services and practices to ensure we are providing the best possible treatment to our consumers.

Medical Insurance
Moving cost assistance for out-of-state hires
One paid conference annually
Free CEU opportunities at company trainings
Stipend for therapy supplies
Paid travel time
Technical assistance
Flexible hours
Opportunities for professional growth (Mentoring; Project Management)

For more information regarding our company and the services we provide, or if you would like to apply online, please visit our website at www.meaningfuldays.com.

If you would like more information regarding the position, please contact the Director or Recreational Therapy:

Mandy McQueeney, Phone: 317-709-2772 Email: mdmcqueen@comcast.net

Positive Reaction to NYSTRA Conference

I just read a most positive post from Mack on "TR Said, RT Said" on the Therapeutic Recreation & Recreation Therapy Forum. The post was on the 2009 NYSTRA Conference held in Saratoga Springs.

Mack specifically mentioned three speakers that were particularly outstanding: Deborah Silver, Vincent Bonadies, and Robin Gallagher. He also mentioned that the conference was enhanced by a talk by Jerry Jordan.

It was great to read such an enthuiastic reaction to the conference and the speakers. I'm going to pass on the names of the outstanding speakers to ATRA.

New Book -- Fredrickson's Positivity

I recently purchased a new book by Barbara Fredrickson titled Positivity. Fredrickson is a distinguished professor at UNC - Chapel Hill and a leading researcher in the area of positive psychology.

I've just begun to read the book but I can already sense it springs from her "broaden and build" theory that has a great fit with recreational therapy. The link between Fredrickson's theory and RT is explained in my book Therapeutic Recreation Processes and Techniques (Austin, 2009).

I'll let you know more of my reactions to Positivity as I read it. I'd be interested in comments from others who may have already read the book -- or initial reactions by those, like me, who are just getting into it.

Friday, April 03, 2009

Upcoming Meetings

April 8 - 10, Southeast Symposium, Myrtle Beach, SC
May 13 - 15, CTRA Annual Conference, Calgery
June 19 - 20, TR Educators Conference, Oklahoma State University
October 2 -6, ATRA Annual Conference, Minneapolis

Thursday, April 02, 2009

Karan Donation for Yoga Therapy Program/Study

In yesterday’s USA Today newspaper was an article on fashion designer Donna Karan donating $850,000 to Beth Israel Hospital to refurbish a room to be used for yoga therapy and to conduct a research study on the impact of yoga therapy on patients with cancer.

I’m wondering if recreational therapists will conduct the yoga therapy program. If anyone has information on the program at Beth Israel please pass it along via the RT Blog.

Wednesday, April 01, 2009

Submit Ideas for Disability Research

This year for the first time, the federally mandated Interagency Committee on Disability Research (ICDR) is utilizing an innovative Web-based approach to collect online disability research comments to assist in developing a federal disability and rehabilitation 2010 research agenda.

Sign up to submit your recommendations on what you believe are critical research issues related to disability. Recommendations will be accepted March 27-April 17, 2009.

To sign up go to: http://www.icds.us/stakeholders/signup.sdpx

This opportunity seems like one that RT researchers should take advantage of.