Ask Me About OT
By Rebecca A. Bowling, MS, OT/LT, State Policy Intern,
Elizabethtown College, Pennsylvania
From left, Elizabethtown College students Crystal Nealis, Senator Rick Santorum (R-PA), Rachel Halton, and Rebecca Bowling.
My first trip to Capitol Hill was on September 27, 2005, for AOTA's Capitol Hill Kick-Off Day.
At the time I was finishing an optional third fieldwork at AOTA with the State Affairs Group. I was nervous about meeting with my Senators, but after a briefing from AOTA's legislative staff, I felt confident.
I had meetings with representatives from the two Senators from my home state of Pennsylvania: Senator Arlen Specter (R-PA) and Senator Rick Santorum (R-PA). As I proudly displayed my "Ask me about OT" button on my jacket, I had to keep in mind that regardless of how much the Senators' staff members knew about legislative issues, I most certainly knew more about occupational therapy. I was accompanied by two students, Rachel Halton and Crystal Nealis, from Elizabethtown College, my alma mater.
The bills we were advocating for were the Medicare Access to Rehabilitation Services Act of 2005 (H.R. 916/S. 438), Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005 (H.R. 3373/S. 1405), and Home Health Qualifying Services (H.R. 3022). Many therapists are aware of H.R. 916/S. 438 because it repeals the $1,500 cap on Medicare outpatient occupational therapy services imposed by the 1997 Balanced Budget Act (P.L. 105-33). These therapy caps are currently in moratorium, which is set to expire December 31, 2005, allowing the cap to be implemented on January 1, 2006.
The Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005 (H.R. 3373/S. 1405) states that to qualify as an inpatient rehabilitation facility (IRF), 75% of the facility's admissions must have a primary diagnosis in 1 of 10 conditions. Rehabilitation facilities want to maintain IRF status because it qualifies them for Medicare payments. Currently, to maintain IRF status, 50% of a facility's admissions must fall within the specific diagnosis; the bill proposes increasing the percentage to 75% within 2 years after the bill is passed. AOTA is concerned about this bill, commonly known as "the 75% Rule," because the list of qualifying conditions does not include many arthritis-related conditions and criteria has not been updated since it was implemented in 1983. This is a concern to the profession because we want all patients to have equal access to rehabilitation care in an inpatient setting. The last bill we were lobbying for was the Home Health Qualifying Services (H.R. 3022). This bill repeals the requirement that a patient must receive skilled nursing, physical therapy, or speech therapy before qualifying for occupational therapy services. H.R. 3022 makes occupational therapy an equal skilled service for home health coverage under Medicare.
Our first meeting for the day was with Specter's health legislative correspondent in the Hart Building. Specter has historically supported occupational therapy and was honored at the Pennsylvania Occupational Therapy Association conference in 2004. We already knew Specter is a cosponsor of the Medicare Access to Rehabilitation Services Act of 2005 (H.R. 916/S. 438) and were pleasantly surprised to discover that he was planning on cosponsoring the Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005 (H.R. 3373/S. 1405). This made our job easier and we thanked the legislative correspondent for the Senator's support. We also explained the relationship between occupational therapy and the Home Health Qualifying Services (H.R. 3022) in case it appears in the Senate. She was very attentive during our meeting and asked questions to better understand how the bill could affect occupational therapy.
That afternoon we met with Santorum's health legislative staff members. While we were waiting for our meeting, the Senator was mingling with constituents in his office. We took this time to meet him and get our picture taken with him. I took the opportunity to tell Santorum why we were there and why he should cosponsor the Medicare Access to Rehabilitation Services Act of 2005 (H.R. 916/S. 438). I was extremely excited to have the chance to tell the Senator himself why I made the trip to Washington, DC. The meeting with Santorum's health legislative staff also went well. Santorum was one of the two Senators and two Representatives to introduce the Preserving Patient Access to Inpatient Rehabilitation Hospitals Act of 2005 (H.R. 3373/S. 1405), so we focused primarily on why he should support the Medicare Access to Rehabilitation Services Act of 2005 (H.R. 916/S. 438).
Overall, it was a great day. I learned a lot about lobbying and feel confident my next visit to Capitol Hill will be better yet. If I could give one piece of advice about lobbying, it would be: Do not be afraid! You do not need to know political lingo to be an effective lobbyist. The most important attribute of a lobbyist for occupational therapy is knowledge about the profession and a concern regarding how these legislative issues will affect practice in your state. One simple way for students and practitioners to get involved with these issues is through AOTA's Legislative Action Center. This Web site walks you through current federal issues affecting occupational therapy and allows you to e-mail your members of Congress. It is a great way to ease into federal issues.
Reflecting on my visit to Capitol Hill and my overall fieldwork experience at AOTA, I have realized that too many therapists are disconnected with the profession. AOTA is not just an organization we pay our annual membership dues to; it is an organization driven by us, the members! We have an obligation to ourselves, the profession, and our patients to get involved. Do not let the mundane demands of everyday life prevent you from giving back to the profession of occupational therapy.
Completing my fieldwork experience at AOTA has been energizing, to say the least. I encourage all occupational therapy practitioners to visit AOTA to gain firsthand knowledge of what goes on at the Association's headquarters. I am extremely exciting to be entering a field where there are so many opportunities.
I look forward to the days ahead when I can contribute more to the profession and once again walk around Capitol Hill with my "Ask me about OT" button. But do not wait for people to ask you about OT; be proactive and tell people about the great profession of occupational therapy!