STATES TAKING INITIATIVE ON OLMSTEAD - OPPORTUNITIES BECOMIMG ACCOMPLISHMENTS

As I drove home to Arkansas from the ATRA Annual in New Orleans, I had many professional issues to ponder. I was in the early stages of planning my presidency for ATRS and I was struggling to determine how to address some of our deficiencies as an organization. ATRS has had difficulty in the past with gaining involvement of a significant number of recreational therapists in the state and as a result, we have had difficulty gaining recognition in Arkansas as an organization that is striving to meet the needs of not only therapeutic recreation professionals, but also Arkansans in general.

I came away form New Orleans having learned of the Olmstead Act in particular and recognized an immense opportunity to impact the lives of all who live with disabilities as well as those who serve them on a daily basis. The Olmstead Act, though it has been in place for quite some time now, is just now reaching the stages of implementation in many states; Arkansas is no different. After taking in the information on Olmstead from ATRA and looking on the Internet for information on the implementation in Arkansas, I learned of the Arkansas Olmstead Coalition.

Governor Mike Huckabee. The task at hand was not only the implementation of Olmstead, but also the restructuring of the state's Medicaid program and the way Medicaid benefits will be provided. A similar committee or taskforce is likely already operating in most states and would probably encourage and welcome the participation of your chapter affiliate.

At the last meeting of Arkansas' GIST, five task-goal areas were defined and subcommittees were formed for each. Each of these goal areas represents opportunities for recreational therapy inclusion and recognition. The task-goals are as follows and the opportunities for recreational therapy are by no means 'all inclusive'.

1. Assessment, Accessibility, & Transition - This subcommittee will identify guidelines for determining the services for which Medicaid recipients qualify. Steps will be taken to ensure access to all services; and guidelines for transition from institutions to less restrictive environments, or vice versa, will be implemented.

Opportunities for Recreational Therapy: In this task-goal, recreational therapy can reasonably expect to be included in the services for which Medicaid recipients qualify. Through taking steps to ensure accessibility to available services, there is increased opportunity for recreational therapy jobs serving the Medicaid population. Also, recreational therapists can play a vital role in the transition of Medicaid recipients from one environment to another. Community reintegration is a huge aspect in the transition focus of this goal area and recreational therapists are thoroughly qualified to assist with training individuals for transition to the community.

2. Services & Supports - This subcommittee will focus on providing the same level of care (services and supports) to individuals in a variety of settings. Under Olmstead, Medicaid recipients will have the right to choose their own environment for which to receive services and supports, institution or a less restrictive environment depending upon the choice of the recipient or guardian.

Opportunities for Recreational Therapy: In this task-goal, recreational therapists will have an avenue to take in providing our services to Home Health recipients under Medicaid. In Arkansas, Medicaid recipients need not be homebound in order to receive Home Health benefits and services. Again, community reintegration services will help to improve the independence of individuals in their environments and can be reasonably expected to decrease the level of care Medicaid recipients require.

3. Financing Mechanisms - This subcommittee will be seeking federal grants and pursuing other avenues for funding to ensure that there is a method in place for recovering the costs of delivering all services and supports under Medicaid.

4. Opportunities for Recreational Therapy: In this task-goal, Medicaid should consider recreational therapy a covered service that is reimbursable. Job security for recreational therapists is a likely result of being a covered service. Again, there is a possibility for increased availability of jobs in the field of recreational therapy as progress is made to include recreational therapy as a viable option in the provision of healthcare services.

5. Staffing - This subcommittee will be focusing their efforts to determine ways to train and retain skilled caregivers and other healthcare providers at all levels of the continuum of care. In addition to provision of skilled healthcare providers, this subcommittee will be looking into ways to reimburse family members who become skilled in the care of their loved ones.

6. Opportunities for Recreational Therapy: In this task-goal, federal and/or state funding may be made available to provide continuing education for all skilled professionals, not excluding recreational therapists, to ensure that quality of care is not jeopardized for Medicaid recipients. The likelihood of inclusion of recreational therapists in staffing is good and recreational therapists will have an increased opportunity to work in diverse settings.

7. Public Awareness - This subcommittee will focus on disseminating information to the public, including current Medicaid recipients and potential recipients. It is one thing to offer a wide variety of supports and services, but if the individuals that need such supports and services are unaware of their benefits, the improvements made to the Medicaid structure will be insignificant.

Opportunities for Recreational Therapy: In this task-goal, recreational therapists and ATRA chapter affiliates have an opportunity to be recognized on a state level for their input into the restructuring. We all know that this is the kind of publicity that will do nothing but benefit your chapter and lead to other opportunities for advancing the profession.

As you can see, there are many opportunities for your chapter, your consumers, and yourself as a professional if you can get involved with Olmstead or other worthwhile causes in your state. In Arkansas, Olmstead is BIG! We have had considerable difficulty in finding the right contacts to move forward with Medicaid coverage of recreational therapy, yet our professionals continue to serve Medicaid recipients. Olmstead in itself has opened some doors for our influence in its implementation. The fact that it is being implemented with Medicaid opens other doors that will lead to even greater accomplishments.

I hope I have shed some light on some of the issues you might face with Olmstead. I also hope I have spurred an interest in doing more for your chapter, your state, and your profession. There comes a time when action must be taken in order to bring about a greater good. Many chapters have shown initiative on Olmstead and other issues, and as a result, opportunities are becoming accomplishments!

Kelly Parker
Arkansas Chapter