Transcript Heather Parsons Director of Federal Advocacy Tim Casey Director of Federal Affairs S Tips for the Day S Wear comfortable shoes.

Heather Parsons
Director of Federal Advocacy
Tim Casey
Director of Federal Affairs
S
Tips for the Day
S Wear comfortable shoes. You may be doing a lot of walking!
S Be prepared to go through metal detectors and security lines.
S The schedule is unpredictable. You may have to wait through no
fault of the Member of Congress or their staff.
S Keep the contact information for the offices your are visiting with
you. Should you be delayed, call the office and let them know.
S If in a large group – identify speakers for your group
Things that May Surprise You
S Youthful Staffers
S Meeting Location
S Meeting space is limited
S Nontraditional locations (hallway, cafeteria)
S Meeting Length
S 15-20 minutes
S Important to be clear and concise
Meeting Pointers
S Introductions
S Introduce yourself – your training/practice program
S Provide quick overview of OT
S Key Legislative Issues
S Choose 2-3 issues to discuss, you will not be able to cover all four
S Conclusion
S Thank them for their time
S Ask them what would be the best way to follow up with them
Meeting Pointers
S Avoid medical jargon or acronyms
S Congressional staff have multiple responsibilities
S Familiarity with our issues may vary
S Be an honest broker
S Your credibility is EVERYTHING
S It’s okay if you don’t know the answer; Tell them you will get
back to them; Relay the question to AOTA staff and we will be
sure to get back to them.
Meeting Pointers
S Advocacy Packets
S Serve as a framework for your meetings
S Hand staff the information from the packets
S Discuss the issues included
S Packets Include
S “One-pagers” on each of the issues to be discussed
S A Fact sheet and brochure about OT
S Information on “OT as part of the Health Care Solution”
Meeting Pointers
S Be respectful of the staffers time
S Offer yourself as a resource
S Leave your packet with the staff
S Ask when and how to follow up with them
S Ask them for business card for follow up
What else is going on?
Environment on Capitol Hill
S Government Shutdown on October 1st???
S Funding for the Federal Government needs to renewed by
September 30th or the government will shut down
S What is the fight about?
S Fight over spending levels
S Fight over funding Obamacare
S Fight over raising the debt ceiling (or the ability to borrow
money to pay debts)
Medicare Outpatient
Rehabilitation Therapy Cap
S Therapy Caps… brought to you by the Balanced Budget Act
of 1997
S Congress acts to avoid harmful policy
Moratorium
Exceptions process
State of Play on the Cap
S Fiscal Cliff Deal
S Extended the Medicare therapy cap exceptions process until
December 31, 2013.
S The automatic exceptions process applies when patients
reach the $1,900 threshold
S The manual medical review process continued at the $3,700
threshold.
S Increased Multiple Procedure Payment Reductions
Medicare Access to
Rehabilitation Services Act
HR 713/ S 367
The Medicare Access to Rehabilitation Services Act - Repeals Medicare’s outpatient
rehabilitation therapy cap.
Enjoys strong bipartisan support
S Senate Champions: Senator Ben Cardin (D-MD) & Senator Susan Collins (R-ME) - 24 CoSponsors
S House Champions: Congressman Jim Gerlach (R-PA) and Xavier Becerra (D-CA) - 127 CoSponsors
Hurdles to Passage
S $$$
S Continuing concern about overutilization of therapy services
Reforming the Medicare Physician
Fee Schedule and Repealing
Sustainable Growth Rate
S NOT sustainable and has to be fixed every year.
S Historically the CAP is fixed at the same time as the SGR.
S Momentum for long term solution strong
S Address Caps in any legislation reforming the Medicare
Physician Fee Schedule
House E&C Committee Passed
Medicare Payment Reform
The legislation passed unanimously out of Committee
The bill has four elements we must pay attention to:
S
Payment for quality/outcomes
S
Payment for efficiency of services
S
Payment for quality improvement (including adopting evidence-based practices)
S
Alternative Payment Models (i.e. Non-Fee for Service Models such as Medical Homes
and ACOs)
S
Even if this bill isn’t signed into law it is clear: this is the direction of health care
Supporting Rehabilitation
Research
S National Center on Medical Rehabilitation Research
(NCMRR)
S Blue Ribbon Panel convened in 2011
S Panel issued Recommendations in December 2012
S NIH considering the recommendations and its authority to
implement them independently
Support Rehabilitation
Improvement Act of 2013 (S.
1027)
Introduced by Senators Mark Kirk (R-IL) and Tim Johnson (D-SD)
The bill would seek to:
S Enhance Coordination
S Establish rehabilitation research priorities
S Require feasibility report for all recommendation
Advancing Rehab Research without Authorizing new funding
Seeking Co-Sponsors in Senate and original Sponsors in the House
Ongoing Challenges for OT in
Mental Health
S Behavioral Health Specific Education
S Behavioral Health Specific Fieldwork
S Low Reimbursement Rates
S State Scope of Practice Barriers
S Lack of Public, Policy Maker Awareness and
Education on OT’s role
Current Hill Environment and Mental
Health
• Recent mass shootings have brought the serious issue of
severe, persistent mental illness into the national
spotlight.
• There is a new dialogue about the ways in which we as a
country we are falling short on early diagnosis and
adequate treatment for people with mental illness.
• Members of Congress who never thought about mental
illness are now trying to find solutions – big and small.
OT in Mental Health Act –
HR 1067
S Introduced by Rep. Paul Tonko (D-NY) in the House.
S This bill amends the National Health Service Corp to include
Occupational Therapists under the definition of “behavioral and
mental health professional” for the purposes of loan forgiveness.
S OT fills an important niche in prevention of mental illness and
promotion of mental health.
S The percentage of the workforce entering mental health has
declined.
OT in Mental Health Act – HR
1067
The bill will expand the number of OTs practicing mental health –
and therefore the overall number of mental health providers in two
ways:
S Because of loan forgiveness, more new therapists will choose to
enter jobs focused on mental illness, that traditionally pay less.
S States often use federal statute when defining state reimbursement
policies. Expansion of the definition = expanded opportunities in
states that currently do not reimburse OT for mental health
services.
Talking Point Tips
1)
Only 3% of OTs work in mental health. This not a dramatic expansion of
the loan program.
2)
Other groups listed in the definition are either supportive or neutral of our
efforts – (see letter from the Mental Health Liaison Group).
3)
Use vignettes to make your point! Use school based examples or
community based ones if possible. This is a great way to sell the profession!
4)
We would like more cosponsors of the bill in the House.
5)
We are seeking a Senate sponsor and hope to have one soon. Seek support
for a bill “should it be introduced” or find out if the office would be
interested in introducing a bill.
Mental Health Liaison Group
letter of support
S
The other professions currently eligible for loan forgiveness as mental and
behavioral health professionals either openly support our inclusion or
have agreed to remain silent.
S
This support is very rare, but other professions understand the unique role
of OT in helping people with mental illness.
Education Funding Sequestration
S Sequestration was a series of automatic spending cuts that were
put into place in 2013 after Congress was unable to reach an
agreement on how to reduce the federal deficit by $1.2 trillion.
S
Under sequestration both Title I (general education) and
IDEA funding was cut by 5.1% for 2013.
S There is a strong likelihood that these cuts will continue into 2014,
with the possibility that they could be increased another 2.1%.
(Total cut of 7.2% from 2012 to 2014).
Education Funding Issues: Cuts to
IDEA
S The effect of these cuts on occupational therapy
will vary from state to state, school district to
school district:
S Has the state or district planned for these cuts already?
S What is the local and state economy like? Has the
housing market (and tax base) begun to rebound?
S How committed is your district to Special Education and
related services like occupational therapy – is it a
priority?
Education Funding Issues: Cuts to
IDEA
S Cuts are going to happen IDEA services including occupational
therapy, are required by law.
S We are advocating that Congress role back cuts to education.
S In your discussion you should:
S Discuss the value of your work with individual students
and the school as a whole;
S Discuss the importance of special education services for
student’s with disabilities.
Taking your message to
Capitol Hill
S Make it personal
S YOU are Occupational Therapy’s best advocate
S Connect with your legislators
S Where did you train?
S Where do you practice?
S Why did you become an occupational therapy practicioner?
S Convey the link between policy and your patients
S You are their constituents
Do your Homework
S Take 15 minutes to learn a little bit about the offices you are
visiting.
S Use the Legislative Action Center to do some research
1. Are they already a cosponsor of the legislation? Then thank
2.
them!
Visit their website to see if they highlight issues that can be
related back to occupational therapy or to establish common
ground.
S Using a Smartphone? Download the “Congress” app from the
Sunlight Foundation.
Most Importantly…
S YOU are the EXPERT
S Convey your passion for OT
S Express your concerns
S Have FUN!