RA Motion 3 Title Change for Certified Occupational Therapy Assistant

To: Task Group

From: Originator, Dr. Karen Crane Macdonald, Ph.D., OTR/L

Date: March 11, 2009

Subject: Additional comments

Hello to the Task Group! This has been an interesting process, I have been receiving much feedback from many places. My state RA Rep, Connecticut, Irene Herden, had suggested a focus group in order to discuss issues. The following incorporates feedback from that recent meeting (coordinated by Mickey Reed, Chair of OTA Program at Housatonic Community College in Bridgeport , CT; attended by about 20 people: local clinicians, past graduates and current students.)

I have also discussed this with colleagues who are clinicians, educators, researchers, and program chairs. One was a COTA, then OTR, and is soon to finish OTD!

I will be pleased to be involved in whatever capacity you may need and may be contacted at:

198 Glenbrook Road

Bridgeport, CT 06610

(203) 371 – 1909

Thank you all for your involvement in this important matter.

Name Change for Certified Occupational Therapy Assistants - Motion 3

(I will refer to as familiar COTA and OTR distinctions)

  • Intention – help profession of occupational therapy to survive and grow through support of all levels of practice.
  • Intention – assure provision of excellent, effective “hands on” intervention to clients. COTA’s are currently paid at 2/3 rate of OTR’s for their services, showing that they are recognized for providing excellent work.
  1. Maintain level of COTA practice (want to assure it remains)
  2. Employers who have a choice of lesser salary may prefer to hire COTA.
  3. Must be able to attract students to Educational programs.
  4. Meets a need for individuals who WANT a 2 year, specialized end degree with guarantee of excellent, secure job. Many cannot enter a masters program due to financial or time constraints; many WANT COTA level of job position, without administrative responsibilities and with increased opportunity for direct treatment.
  • Reactions to Title COTA
  • Assistant implies hands on aid to OTR.
  • People interpret as if nurse assistant or aide.
  • Certified – nowadays, connotation of very brief intensive training, ranging from one full day to completion of a few courses.
  • Consumers refusing treatment from “An Assistant.”
  • Inquirers to COTA program often turned off by title, needs much explanation.
  • Colleagues make comments about the word Assistant, especially regarding meetings and reports.
  • Technically, both OTRs and COTAs are certified by NBCOT, and both are listed on the register, confusing.
  • Timing is NOW
  1. Centennial Vision – increase awareness of needs of COTAs as a vital component of our population of practitioners.
  2. Marketing terminology of “branding” is popular, consumers are aware of constantly changing titles to more accurately portray a product or service, i.e. Personnel changed to Human Resources.
  3. JOBS NOT FILLED BY OT PRACTITIONERS ARE FILLED BY OTHERS who have much less training and skill for scope of practice.
  4. EG. Job coach//therapeutic exercise specialist//ADL manager//medical supplies expert.
  5. Issue dovetails with other Motion 1 for AOTA 2009 RA.
  • Possibilities for alternate title

Occupational Therapy Associate Practitioner.

Licensed Practicing Occupational Therapist.

Credentialed Occupational Therapy Associate (submitted by student, preserves COTA lettering).

  • Obstacles anticipated
  • OTR’s threatened…
  • Cost, but AOTA has spent immense sums on other changes, i.e. publicity logo of Living Life to the Fullest; OT Practice Framework…
  • AOTA has already adjusted all necessary documents when the entry level was changed to graduate level, so the process is established…

Summary

Name change would:

Attract more students to COTA educational programs, yielding

Increased graduates filling jobs to provide occupation based intervention, helping to demonstrate the need for OT services in medical and community based positions, yielding

Increases in OT departments, yielding

Increasing jobs for OTR’s as supervisors/managers, yielding

Increased quantity of overall OT services provided, yielding

Increased possibilities for funding and time for evidence based research development and dissemination of findings, yielding

Increased visibility of effective OT in varied settings, yielding

Increased consumer/agency/reimbursor recognition of value and need for OT services, yielding

The preservation and advancement of the profession of occupational therapy.

  • Other issues
  1. COTA responsibilities:
  2. Integrate and apply all from OTR evaluation.
  3. Develop therapeutic relationship.
  4. Observe all actual skills and match to therapeutic activity/occupations/adaptations/equipment required.
  5. Assist client through whole process of goal development, modification and attainment, all while client has varying skills with each session
  6. All within a complex system of client/family/staff, and meeting requirements for information provision or teaching, documentation, and meetings.
  7. (My point is, that COTAs are very highly trained, and have a high level of responsibilities, within a universe that is unique for every client.
  8. COTA self image

COTA’s are highly respected and consistently demonstrate impressive expertise in direct intervention which requires compassion, creativity, and flexibility along with application of a large, wholistic body of knowledge.

They are valued by consumers, family members, and other health care providers.

Relationship with OTR role

As always, it seems to be “just fine” in practice with appropriate role delineations, but “on paper” overlap appears tremendous, AOTA has been struggling with for years, i.e. Taxonomy document.

Specified roles and boundaries should be identified for independent practice, supervision, etc, but this may be challenging due to state by state differences in licensing laws.