Legislation, Public Policy & Licensure: What can YOU Do?

1. Legislation, Public Policy & Licensure: What can YOU Do? Dawn De Vries, DHA, MPA, CTRS Grand Valley State University devridaw@gvsu.edu Handouts at: www.gvsu.edu/tr

2. Session Description • In this session, participants will increase their understanding of public policy issues relevant to recreational therapists both at the state and federal levels. Current efforts will be discussed, as well as issues such as state licensure of recreational therapists.

3. Learning Outcomes Participants will be able to: • Identify 3 current public policy issues facing the field of recreational therapy. • Describe the state of licensure for recreational therapists in Michigan. • Explain 1 action to take to advocate for recreational therapists in the public policy arena.

4. Experience with Public Policy Introductions

5. Public Policy 101 Quiz • Public policy refers to… • Government action taken in response to public problems • The main reason government gets involved in addressing public problems is to: • Ensure that the public good is maintained & protected • Each state has ___ senators representing its citizens. • When I hear the word “public policy”, I want to: _______ • Which age group has the highest voter turnout rates? • The U.S. election system is called the: • Electoral College • True or False: Everything I need to know about public policy, I learned from School House Rock.

6. Public Policy 101 • “policy” -> standard • “Policy” -> course of action • Language of government • Objective = achieving public good • Oriented towards a desired state/goal • Based on decision and information available • Dynamic on where at in the election cycle • Short term focus (2 years)

7. http://youtu.be/FFroMQlKiag?list=PLcprapTD03KftZ5Ta2aPuh03feYCmR3Gjhttp://youtu.be/FFroMQlKiag?list=PLcprapTD03KftZ5Ta2aPuh03feYCmR3Gj Public Policy 101

8. Public Policy 101 How are Public Policies Made? • Problem identified • Agenda set • Acknowledgement • Solutions • Environment • Policy formulated • Policy adopted • Policy implemented • Laws (acts) • Regulations • Directives • Guidelines • Policy evaluation • Policy modification or termination

9. Public Policy 101 The Players General Local vs. State vs. Federal governments HR = bills introduced in the House S = bills introduced in the Senate • Citizens • Organizations • Lobbyists • Government agencies • Congress people – House of Representatives & Senate; committees • President

10. Public Policy 201 The Nitty Gritty of Bills • Congress person who has idea becomes sponsor of bill and gives it to the clerk . • Clerk assigns a number. • Distributed by GPO • Assigned to committee for study by Speaker of the House • Committee studies bill, hears testimony • Committee may release bill with recommendation to pass, revise, or lay it aside (tabling) • If released, it goes on a list of bills awaiting action (can limit debate or prohibit amendments) • Goes to floor for consideration, reading of the bill.

11. Public Policy 201 The Nitty Gritty of Bills • Enrolled bill signed by Speaker of the House and then the Vice President. • Sent to President for consideration – 10 days to sign or veto. • If vetoed, can still become a law with a 2/3 majority vote by Senate and 2/3 majority vote by the House • If passes by simple majority, moves to Senate. • Follows same process. • Moves to conference committee to work out differences between both sides of Congress, • Once approved, printed by GPO (process called in enrolling). Clerk from introducing house certifies the final.

12. WHAT ISSUES ARE IMPORTANT TO RT RIGHT NOW? WHAT’S HITTING US ON THE HEAD AND NEEDS OUR ATTENTION? Issues facing RT

13. Higher Education

14. Outcomes & Evidence based practice

15. research

16. Workforce development

17. Improve Coverage of RT

18. Medicare • Funding • Baby Boomers • # of workers to retirees • Regulatory issues • Consistency? • LTC • Coverage • Lack of clarity • Intensity of service

19. Inpatient Rehabilitation Facilities • Medicare statute does not list services covered in an IRF • Regulations require IRF to provide “core services”: • Rehabilitation nursing • Physical therapy • Occupational therapy • Speech therapy (as needed) • Social or psychological services (as needed) • Orthotic and prosthetic services (as needed) • CMS has been unwilling to add recreational therapy to above list.

20. HR 4755 • http://youtu.be/7HLYoRVttP8 Why is this significant? How does this impact the field of recreational therapy? • https://www.govtrack.us/congress/bills/113/hr4755 Why is it important for MI recreational therapists to act?

21. Chance of getting past committee? 2% Chance of being enacted? 1% PROGNOSIS?

22. Steps to Take • Get educated on the issue and understand the potential impact • Contact your congressperson asking for their support • Educate/introduce RT and its value to constituents • Send the sample letter • Send them an email or website comment • Follow up with them • Call if you need to • Ask for a meeting • Tell others about it and encourage them to contact their congress person • Contact them again if you don’t get an answer • Vote in November

23. Sample Letter

24. Medicaid • Early Intervention Services • Educational settings • SCHIP • Auto insurance (MI) • Children’s Special Health Care • Other issues?

25. RT/TR? WHO ARE WE? WHAT DO WE DO? HOW DO WE DEFINE OURSELVES? WHAT MAKES US DIFFERENT FROM OTHERS? Professional Definition

26. Licensure

27. What is it? • A legal, non-voluntary process regulated by state government • Grants permission to people in a profession to practice • Attests that those who are licensed have a minimum level of knowledge and skill • State must regulate the practice in some way • Goal = protect the safety, health and welfare of the public by ensuring certain level of competency • Joint Task Force on Licensure – NCTRC & ATRA • Different than CTRS credential

28. Licensure More of What is it? The Process Use recognized standards Collaborate with NCTRC and ATRA Establish committee to study legislative process, needs analysis, potential sponsors Considerations: Portability Reciprocity Scope of practice Definitions and terminology Review previous legislation • 4 states have licensure • New Hampshire • North Carolina • Oklahoma • Utah • Washington and California have Protection Acts • DC has registration • Approximately 2 about to seek licensure (NY, IN, PA) • Another 8-10 actively working on licensure

29. Where’s Michigan?

30. The Power of One Voice A Call to action

31. WHAT CAN YOU DO? WHAT WILL YOU DO? Self-Reflection

32. How can I make a difference? • Not just about you, but about us • Join a professional organization • Network • Define your philosophy • Identify your issues and concerns. • Articulate your positions • Make contacts with your legislators. • Gather resources and information about RT, benefits, outcomes • Gain support of others

33. Tips: Communicating with Legislators Maximize . . . To do. . . Use regular language Keep it short Distinguish between facts vs. values, analysis vs. advocacy Be practical Articulate the issue Translate the solution into a strategy - “this is what it means” Summarize the rationale & impact -“this is why this would help” Mention consequences – “this is what will happen if action is not taken” • Expertise • Personal stories • Passion • Network • Leadership • Credibility

34. The Power of One Voice • You can make a difference! • Take the next step to advocate and advance the profession of Recreational Therapy.

35. Questions? Wrap up

36. Resources • For Materials to promote RT, visit http://www.nctrc.org/employerinfo.htm • To Learn More about the Legislative Process, visit: http://www.senate.gov/reference/resources/pdf/legprocessflowchart.pdf • To Learn More about HR4755, go to: • Government Tracking/Overview: https://www.govtrack.us/congress/bills/113/hr4755 • Congress site: https://www.congress.gov/bill/113th-congress/house-bill/4755 • Advocacy Group: http://www.striveonline.org/component/content/article/102-strive • MTRA: http://www.michigantra.com/page-1861984 • ATRA: https://www.atra-online.com/policy/federal-public-policy