Occupational Therapist Workforce Shortage: Across the State of Iowa, there is a shortage of Occupational Therapists, especially in our rural areas. One solution to addressing this problem is to include Occupational Therapists as one of the recognized professions who are eligible for the Rural Iowa Loan Repayment Program under Code 283–25.1(261). With the addition of Occupational Therapists, the Rural Iowa Loan Repayment Program can be used to its fullest potential by addressing health care workforce needs in rural areas.

Request: Address the shortage of Occupational Therapists in rural Iowa by including them as one of the recognized professions who are eligible for the Rural Iowa Loan Repayment Program.

Unresolved Issues with Medicaid Managed Care: IOTA members provide a substantial number of services to Medicaid patients of all ages across the state. Since the transition to Medicaid Managed Care there has been a significant number of increased barriers for our clients to access occupational therapy services as well as barriers for our providers to deliver the needed services to our patients. Barriers concerning access to services and treatments reduce care management rates and quality of life standards for our clients. When patients experience increased barriers through these programs it creates more challenges and increase costs to care for them. Current Medicaid concerns include:

Pre-authorizations

  • Waiting long periods of time for pre-authorizations, forced to cancel appointments
  • Denied pre-authorizations for nursing home non-skilled residents

Incorrect/deniedpayments

  • Incorrect fee schedules/payments, occupational/physical therapy claims
  • Incorrect credentialing, enrolling providers as the wrong provider type
  • Denied speech therapy claims

Administrative burden

  • Incompatibility with pre-authorization submissions
  • No electronic filing for secondary MCO claims
  • Challenges with the demand of MCO form requirements

Request: Address these barriers to ensure patients can continue to receive care without delays in care and providers can continue to deliver services without additional burdens.

Occupational Therapists are Mental Health Providers: Both occupational therapists and occupational therapy assistants are trained to provide services that support mental and physical health and wellness, rehabilitation, habilitation, and recovery-oriented approaches. Such education includes at least one clinical fieldwork experience in a setting focused on psychosocial issues. There is evidence that occupational therapy interventions improve outcomes for those living in the community with serious mental illness. Such interventions can be found in the areas of education, work, skills training, health and wellness, and cognitive remediation and adaptation. IOTA wants to ensure policy makers fully understand the role OTs play in the delivery of mental health services.

Request: Ensure OT providers are recognized asproviders of mental health services.

Occupational Therapist Workforce Shortage

Across the state of Iowa, there is a shortage of Occupational Therapists, especially in our rural areas. Due to the shortage, hospitals, schools and other agencies have found it necessary to use out-of-state contracted services, which contribute to an increased financial burden. One solution to addressing this problem is to include Occupational Therapists as one of the recognized professions who are eligible for the Rural Iowa PA/ARNP Loan Repayment Program under Code 261. Currently, the program allows Physician Assistants and ARNPs to qualify for loan repayment if they choose to practice in a rural area after they graduate for at least 5 years. With the addition of Occupational Therapists, the Rural Iowa Loan Repayment Program can be used to its fullest potential by addressing health care workforce needs in rural areas.

Rural Iowans NeedAccess to OT Services

Rural Iowa does not have enough Occupational Therapists to provide these essential health care services to care for Iowans in need. Many rural areas do not have a licensed OT in their county. There are only 1,000 licensed Occupational Therapists to cover the entire State; most of them are providing services in urban areas.

According to an independent study by researchers from Johns Hopkins University and University of Maryland, occupational therapy is the only spending category that reduces hospital readmissions. Occupational therapy produces a positive return on investment for hospitals, and it can create a positive impact on rural Iowa. Access to occupational therapy in across Iowa would contribute to individuals continuing to function in their homes and communities and, in turn, could produce cost savings for health care in Iowa.

Occupational Therapy in Iowa

Services:

  • Provide treatment for injured, ill, or disabled patients to develop, recover, and improve skills needed to function in all environments (home, school, work, community, etc.) – for example:
  • Address physical, psychological, and cognitive aspects of a patient’s well-being
  • Evaluate a client’s abilities and environments, create customized goals and intervention, recommend equipment and deliver training for adaptation, and provide guidance and education for family members and caregivers

Education & Licensing:

  • About half of OTs work in offices of occupational therapy or in hospitals; others work in schools, nursing homes, and home health services
  • OTs graduate with a Master’s or Doctorate of Occupational Therapy
  • All states require Occupational Therapists to be licensed, and require candidates to pass the national examination administered by the National Board for Certification in Occupational Therapy
  • The median annual wage of Occupational Therapists in Iowa is $71,150.
  • Iowa currently has 3 programs that will graduate OTs – St. Ambrose University (Davenport), Allen College (Waterloo), Drake University (Des Moines). Additionally, there are 4 programs that graduate Occupational Therapy Assistants – Kirkwood Community College (Cedar Rapids), Indian Hills Community College (Ottumwa), Hawkeye Community College (Waterloo) and Brown Mackie College (Bettendorf).