Chapter 20 HPR 453 Houle 1980 included legal support as a distinct characteristic of a profession Skalko 1998 contends that the TR profession must work to influence public policy and healthcare regulation ID: 556514
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Slide1
Legislative and Regulatory Issues in Therapeutic Recreation
Chapter 20
HPR 453Slide2
Houle
(1980) included legal support as a distinct characteristic of a profession
Skalko
(1998) contends that the TR profession must work to influence public policy and healthcare regulation
Compton (1997) stated that if TR was to survive it must become more politically astuteSlide3
40 Year History
1966 – Creation of NRPA and NTRS
Early legislative effort reflected society’s to advance the condition of all persons
1970 – Legislative advocacy declared to be a priority for NTRS
1973 – Rehabilitation Act of 1973 – considered to be the “civil rights law for disabled persons” – contained references to recreation being an integral part of comprehensive rehabilitation Slide4
1975 –
Sen
Ted Kennedy
Education for all Handicapped Children Act
strongly supported by recreation and Phys Ed professionals
NTRS’ legislative efforts managed by a legislative committee and volunteer support
1984 – ATRA formed and public policy coordinated by Team appointed by the Pres
1993 – ATRA hires legislative counsel in DCSlide5
TR continues to depend heavily on Grassroots support
Consistent targets for TR legislative action have been
R
ehabilitation,
Education
N
ursing
H
ome
R
eformSlide6
Rehabilitation
Used to be viewed as vocational preparation and training
Rehabilitation Act of 1973
introduced “comprehensive rehabilitation”
Fullest possible participation in life, including living independently in the community
Congress then more receptive to considering the role of recreation in rehabilitation and independent livingSlide7
NTRS testimony influenced the US Senate to amend the law in 1978 to include “special recreation demonstration projects”
Intended to increase mobility and socialization of disabled persons through activities such as camping, sports and the arts
Amended again due to personal testimony
Extended and expanded the role of recreation in independent living and community integrationSlide8
TR personnel recognized as
bonafide
rehab personnel eligible for rehab training monies
Congress recognized TR as a means to reach desirable goals in the overall rehab processSlide9
Education
1975
- Education for All Handicapped Children Act
Mandated a free and appropriate education for all children with disabilities in a least restricted environment
Crafted so recreation would appear as a content area “related” to special education
If a child’s
eval
indicated a need their IEP would include assessment of leisure functioning, TR, Leisure Ed, or
rec
programs in the school or the community
Recreation was rarely found to be included in the IEP but recommended for after school programsSlide10
In 1991 the law was
retitled
to
Individuals with Disabilities Education Act
(IDEA) with the intent of TR transitioning a child from school into adult life (full inclusion)
TR still not fully utilized in schools but progress is being madeSlide11
Long-Term Care
OBRA regulations weakened nursing home requirements for activities and the staff who provided them
TR lobbying efforts eventually earned TR important recognition and respect
MDS 2.0 (1998) contained Section T to distinguish Recreation Therapy from Activity (
diversional
) services
MDS 3.0 – RT in Section along with other rehab
svcs
Slide12
Accessibility
Americans with Disabilities Act (1990) is one of the most significant pieces of legislation to impact access to recreation activities for people with disabilities
No specific provisions for TR but prohibits disability discrimination in employment,
govt
services, public accommodations, telecommunications, and certain other services, like insuranceSlide13
Legislative Process
3 fundamental processes related to introducing, passing and implementing law
Authorization
Appropriation
RegulationSlide14
Authorization
Law under which a program is established or continued (reauthorization) for a stated number of years (perhaps 5)
Specifies the aim and conduct and ceiling on the monies
Extensive lobbying by TR when laws such as Rehabilitation Act or IDEA have been up for reauthorization
Oral and written comments to change
statuatory
language (success and lack of on pg 330)Slide15
Appropriation
Means by which authorized programs are funded by Congress for that year
Funding may not include funding amounts in Authorization
Originates in House and followed by one in the Senate
When different compromised and taken back to the House
TR lobbying for special recreation funding has been successful due to providing for people with disabilitiesSlide16
Regulation
Organization, rules and procedures to distribute funds and monitor conduct of programs
Proposed regulatory changes are announced in
Federal Register
and public is invited to comment
In 1991 NIDRR was successful in securing funding for research projects such as
Benefits of Therapeutic Recreation: A Consensus View Slide17
ATRA Medicare Project
Regulatory language implies that RT is a covered service in skilled nursing, IP Rehab and IP Psych facilities
Beneficiaries often denied services due to inaccurate interpretations of fiscal intermediaries
H.R. 4248
Ensuring Medicare Access to Recreational Therapy Act of 2007
Bottom line - Requires
resources ($) and coordinated Grassroots efforts Slide18
Essentials for Legislative and Regulatory Action
Building and
M
aintaining Coalitions – Strength in numbers – consumers, providers, advocacy groups
Kennedy Foundation
President’s Committee on Employment of the Handicapped
National Easter Seals Society
National Rehabilitation Caucus
Coalition for Citizens with Disabilities
National Coalition for Nursing Home Reform
Alliance for Disability Sport and RecreationSlide19
1986 – NTRS, ATRA, the NCPERH formed the Legislative Coalition for Therapeutic Recreation
Unified Voice for lobbying efforts
Disbanded when ATRA hired
legislative counsel