Problem Based Learning

Why isn’t RT better represented in public

policy and what can we do to improve our
representation in policy?
The Problem

● The problem at hand is that Recreation Therapy as a profession and

healthcare service is not getting sufficient representation in public policy.
○ The under representation in public policy can result in other therapies overshadowing
Recreation Therapy in public policy and getting more recognition whereas many people are
not aware of what Recreation Therapy is, the diagnoses it can serve, and the benefits
associated with it.
○ An example of this is Recreation Therapists serving schools because even though RT is included
on the IEP list of services the parent/guardian must be educated on the benefits and why it would
be appropriate for their student to request it in order for it to be provided (Hawkins, 2020).
Issues Surrounding
● Representation in….
○ Center for Medicare and Medicaid Services (CMS) in Inpatient Psychiatric Facilities (IPF),
Skilled Nursing Facilities (SNF), and Home & Community-Based Services
○ Individuals with Disabilities Education Act (IDEA) for Public schools
● The lack of representation presents issues in practice:
○ No representation in Inpatient Rehabilitation Facilities (IRF), gets covered through bed rates
○ Lack of federal funding to programs and equipment
○ Other therapies will be prioritized in client’s treatment
■ Inpatient rehabilitation “3-hour rule” (3 hours of therapy/day, 5 days/week)
■ “If the only activities prescribed for the patient are primarily diversional in nature, (i.e.,
to provide some social or recreational outlet for the patient), it would not be regarded
as treatment to improve the patient’s condition.” -policy 30.2.3
○ Advocating for RT/TR services to insurance companies and treatment teams
Solutions to the problem
● Arguing the problem in Congress
○ Write letters to members of Congress.
○ Call the Congress members.
○ Schedule a meeting with the Congress member. Lobby officials so as to get RT included in
the policies for all settings.
● Forums at physical rehabilitation agencies; behavioral health facilities; parks
& rec. departments; adapted sports facilities; long term care facilities;
hospitals; and schools.
○ Too many people do not know what RT is. At these forums RTs should explain the benefits
of RT treatment and the ways in which we can provide treatment.
○ Present relevant research
Solutions continued

● A statement between ATRA and The Joint Commission stating an

agreement to have RTs employed at their agencies.
○ The Joint Commission is an accreditation agency which evaluates and accredits more than
22,000 health care organizations and programs in the US (The Joint Commission, 2020). If
part of their accreditation standards included providing RT treatment, then that would
increase the number of agencies that would be required to have Recreation Therapists on
staff.
“Access to Inpatient Rehabilitation Act of 2021”
Passing that Bill
Step #1: Draft a bill

Step #2: Propose the idea to ATRA for sponsorship/Committee Action

Step #3: Introduce the bill to the House or Senate through the appropriate
congressional sponsor/ Vote

Step #4: Bill must be approved by both Chambers of Congress

Step #5: Presidential Action.

● If approved by President, the Office of Federal Register assigns the Public

Law a number and then it is officially a law
Plan: Pass a Law allowing RT to be a covered, optional service
within the Medicare Physical Rehabilitation Manual
● ATRA History: The last time ATRA sponsored a congressional bill for this
was in 2017.
● Why did this fall through?
○ Nobody (CTRSs in practice or otherwise) contacted the representatives!
● How do we solve the issue this time?
○ Send out an ATRA-wide email informing members of the bill, its purpose, and how to help
make it happen
○ Create an NCTRC pre-approved CEU workshop through ATRA (Advocacy & Legislative
Teams from ATRA)
■ ATRA Webinar: RT Policy and Practice Representation
■ Attendees receive CEU credits, a more in-depth analysis of the benefits of passing a
bill such as this, and are asked directly to contact the representatives
What will this do/How will this help?

● Directly improves representation in public policy

● It is important for health care professionals to see RT as an equal and “just-
as-necessary” form of service for patients.
● More acknowledgment and prevalence of RT in healthcare = more
understanding and representation
● TR treatments work but millions are not referred to this simply because it is
not included in their insurance and this legislation will stop limiting patient
options for quality healthcare.
References

Hawkins, B. (2020 Fall). Federal Public Policy & RT [Powerpoint]. Notes from a lecture on Federal Public Policy & RT in RTH 480
Seminar in Recreation Therapy at the University of North Carolina, Wilmington. Wilmington, NC.

Zero to Three. (2020). How a bill becomes law. Retrieved on October 11, 2020 from
https://www.zerotothree.org/resources/728-how-a-bill-becomes-a-law

American Therapeutic Recreation Association. (2020). Atra webinars. ATRA. Retrieved September 22, 2020 From
https://www.atra-online.com/page/ATRAWebinars

The Joint Commission. (2020). History of the joint commission. Retrieved on October 12, 2020 from
https://www.jointcommission.org/about-us/facts-about-the-joint-commission/history-of-the-joint-commission/