What Does “Service Delivery” Entail?

Initial certification for both Board and Specialty Certification require a certain number of service delivery hours. Service delivery involves the provision of “services to an individual, group or population that includes the occupational therapy process of evaluation, intervention, and outcomes.”

In case you already read that in your handbook glossary and still have questions, let’s break it down…

First of all, your employment verification hours can be from either paid work or volunteer work. Your clients can be

• individuals receiving 1:1 OT services
• groups of persons receiving services, or
• populations

Some examples of service delivery with a population include:

• Serving as a consultant to make artistic programming at the local theater accessible to persons who may be in wheelchairs, have vision impairment, have a limiting psychiatric diagnosis, etc.
• Establishing transitional programs at a university for students on the autism spectrum who are starting college.
• Developing an aquatic therapy program for the local YMCA for persons with arthritis.

Service delivery may occur in any setting – clinics, homes, schools, work places, sports centers, etc. – and may involve research, consultation, and more. The key is that in all cases, you must be

• evaluating the client need
• establishing an intervention plan (delivery of intervention may be either direct or through others)
• and assessing the outcomes of your intervention

So whether it’s on the job in a clinic or through volunteer work in your community, when you bring your expertise as an OT practitioner to the table in an effort to influence quality of life, you’re probably “delivering service!”

Service delivery hours…are they really too much?

Would you go for a root canal with a dentist who hadn’t actually touched a patient in 5 years? If you were told you needed to see a medical specialist because your needs were beyond the capacity of your general practitioner, would it be enough for you to see someone who rarely dealt with your condition?

One of the foundations of the AOTA Board and Specialty Certifications is that they are considered to be practice certifications. That doesn’t mean that managers, researchers, and faculty can’t apply. It does mean, however, that all applicants need to have some actual service delivery hours in the area. What does that mean for certification candidates?

Let’s break it down using the assumption of 4 vacation weeks in a year and a 35 hour work week.

Specialty Certification

Specialty certification is valid for a period of 4 years. Applicants need to have 600 hours delivering services with clients in the specialty area. Given the above criteria for work hours and vacation, that breaks down to approximately 3 hours a week over 4 years – less than 2 days a month.

Board Certification

A minimum of 5 years as an OT is necessary to apply for Board Certification and BC is valid for 5 years. Applicants need 5,000 hours in the certification area, which can include anything from service delivery, to teaching, to management, to research, to consultation. Those hours can be met in 3 years working full time in the area; 4 years if you don’t work summers.

Of the 5,000 hours, 500 need to be delivering services with clients (individuals or groups). Those 500 hours break down to approximately 2 hours a week over 5 years.

Want to do it in less time?
Here’s what you need to meet the service delivery hour requirement…

Specialty Certification

4 years = 3 hours/week = 9% of caseload
3 years = 4 hours/week = 18% of caseload
2 years = 6 hrs 15 min/week = 27% of caseload
1 year = 12½ hours/week = 36% of caseload
6 mos. = 25 hours/week = 72% of caseload

Board Certification

5 years = 2 hours/week = 6% of caseload
4 years = 2½ hours/week = 12% of caseload
3 years = 3½ hours/week = 18% of caseload
2 years = 5 hours/week = 24% of caseload
1 year = 10½ hours/week = 30% of caseload
6 mos. = 21 hours/week = 60% of caseload

So what do you do if you don’t have the hours? Keep working on getting them! And use that time to develop a great portfolio that really highlights your achievements in meeting the competencies and indicators. Then, when you have your hours, all you have to do is click “Submit” and you’re on your way!

How much evidence is enough?

We sometimes get questions about how many pages of evidence an application should include. Your final page number will depend on

• the total number of activities you submit (remember a single activity may be used up to 4 times) and
• the different types of activities your application includes (a letter with a description and verification of volunteer service may be 1 page, whereas evidence for program evaluation may be 3 pages).

Reviewers really don’t want to see every little thing you’ve ever done (especially if it’s not relevant to the application at hand), and they don’t want to have to dig through a tomb to get to the heart of your application. Neither do they want to be left with questions because something is missing.

Applications with 35 pages of evidence have been approved, and applications with 200 pages of evidence have been approved.

To date, the average number of pages of evidence submitted with an application is 68.

Remember when you’re putting your evidence together to “communicate” with the reviewer by highlighting relevant information with arrows, circles, or actual highlighter. Including the indicator number(s) on each page is not required, but is always a welcome help.

Keep up the good work!

Maria Elena E. Louch, Professional Development Program Manager

Action Needed on Therapy Cap Exceptions Process!

If you see clients that receive Medicare benefits, you'll want to take a look at this Action Alert and make your voice heard by June 30!

Did someone say discount?

Are you and your colleagues supporting each other on the development of your applications? Well, you’re in luck because AOTA offers a group discount on certification! Here’s the deal:

• You must be from the same work setting. This doesn’t mean you have to be working in the same facility, but you do need to be part of the same organization; for example, the same national long-term care company or the same school district.
• You must be applying at the same time. You may, however, be applying for different certifications.
• Payment for all applications must occur using a single payment method, i.e., 1 check or credit card payment to cover 5 people.

How much is the discount? Well, the more people applying, the greater the discount!

• 5–10 applicants = 10%
• 11–20 applicants = 20%
• 21+ applicants = 25%

Contact prodev@aota.org for more details specific to your group!

Maria Elena E. Louch
Professional Development Program Manager

Time to F.O.C.U.S.!

Here’s an approach you can try to help understand the competencies and indicators a bit more…F.O.C.U.S.!

In the presentations I’ve been doing at state conferences, people who have used the application manual and followed this process have shared that it has helped immensely. Take the application manual, a pen, highlighter, and make sure you have some time (meaning you have time to think critically about what you are reading and aren’t rushed). The F.O.C.U.S. approach is the following:

Frame the context of the competency and indicators by reading the client outcome.

• For each competency, read the competency, the client outcome(s), and the indicators for the competency. What is the real meaning of the competency? Possibly make some notes to yourself at the top of the page near the competency. Maybe you need to check out some of the references identified for that competency if things aren’t quite clicking for you.

Objectify thoughts by identifying key words.

• Go through the competency and indicators and highlight with a marker or underline “key” words in the competency. For example, “Engages client and relevant others in identification and prioritization of strengths and limitations to plan occupational therapy interventions for feeding, eating, and swallowing” is not just about prioritizing strengths and limitations for treatment planning. Key words here are that the specialist also “engages client and relevant others.” The client outcomes for this competency also speak to the client’s active participation in the process. Having a better understanding helps you start to organize your thoughts regarding the professional development activities you’ve been involved with that you can use to demonstrate your ability to address the competency.

Clarify key words by using the application glossary and Occupational Theapy Practice Framework.

• What words are confusing or possibly “new” to you? There is a glossary in each application handbook. “Relevant evidence” and “relevant others” are terms that are used in all the certifications extensively. Applicants would be doing themselves a disservice if they did not take a moment to check and see what the authors meant by these and other terms!

Unmask personal biases and put them aside so they don’t inappropriately influence your interpretation.

• We all have our own experiences, values, and preferences that we bring to every situation. Being able to recognize those and separate them in order to form an objective review of the competencies and indicators is important. Do you have biases about what clients can and can’t do based on your personal – not professional – experience that colors your view? Do you think you can’t learn anything from a fieldwork student? What are your biases?

Summarize & synthesize your interpretation of the competency by validating it against the indicators and client outcomes, and the indicator by validating it against the competency and client outcomes.

• Taking the time to make sure you clearly understand the competencies and indicators – and how they apply to your practice! – is an important first step in preparing a successful application. Once you’ve done all of the above, try to make sense of things relative to your work with clients. Once you’ve FOCUSed, then it’s easier to look at the Professional Development Activities List and determine what activities you’ve engaged in to best meet the indicators.

I think most of us do well if we have a goal and then set aside time regularly to work toward that goal. I’ve found in my discussions with people that working with someone toward certification is helpful and setting aside time to regularly go into your online application and work on writing the reflections to complete the process is helpful as well. Is there someone in your department who’d be interested in working on the application process with you as you go along? Someone form your state association? Or maybe just someone online! Whoever it is, make a plan to F.O.C.U.S.!

Christine Urish, PhD, OTR/L, BCMH

SAGE advice…at a discount!

Gero folks, have you been looking at the competencies and indicators for Board Certification and said to yourself, “I wish I could talk to someone about these?” Well guess what? We’ve got the next best thing: someone talking to you. Over 550 pages of talking can be found in the new Self-Paced Clinical Course (SPCC) Strategies to Advance Gerontology Excellence: Promoting Best Practice in Occupational Therapy, or SAGE for short.

Wait! Don’t run away peds and other folks, there’s something here for you too. Patience, patience…

The editors of SAGE were part of the panel that developed the competencies for Board Certification in Gerontology, and they have kindly structured the sections of SAGE around the gero competencies. How fabulous is that? What’s even more fabulous? You can get it at a discount!

In case you missed it, AOTA is offering 20% off many products and publications through June 15!

Whether you are working toward (or thinking about!) certification in any of the 8 areas offered by AOTA, now is the time to stock up on that professional development! Here’s how you can use it toward certification requirements:

• For continuing education like SPCCs and online courses it’s pretty easy. These are considered to be “Learning – Formal” according to the Professional Development Activity List in the certification handbook. You save your documentation that shows a minimum of 12 hours of participation (you’ll get a certificate after passing the exam) and print out and save the course description and learning objectives from the web site and you’re good to go as far as documentation needed for certification.
  
• You want to buy a textbook, which doesn’t come with a certificate? Never fear! The category “Learning – Self-Directed (Independent)” is for you! Just make sure to establish your personal learning objectives for reading the book, track the number of hours you spend with it/them (you need a total of 12), and write up a brief critical analysis.

Now that you are armed with this information (not to mention a great discount!), here are some ideas of products to consider for each of the certification areas:

BOARD CERTIFICATION

Gerontology

• Strategies to Advance Gerontology Excellence (SPCC)
• Strategies to Advance Gerontology Excellence (Book)

Mental Health

• Cognition and Occupation Across the Life Span: Models for Intervention in Occupational Therapy, 2nd Edition (Book)
• Supported Education for Adults and Adolescents With Psychiatric Disabilities: Occupational Therapy’s Role (CE Article)

Pediatrics

• Collaborating For Student Success: A Guide For School-Based Occupational Therapy (SPCC)
• Collaborating for Student Success: A Guide for School-Based Occupational Therapy (Book)

Physical Rehab

• Neurorehabilitation Self-Paced Clinical Course Series: Core Concepts in Neurorehabilitation (SPCC)
• Living With Illness or Disability: 10 Lessons of Acceptance, Understanding, and Perseverance (Book)

SPECIALTY CERTIFICATION

Driving and Community Mobility

• Driver Rehabilitation Across Age and Disability: An Occupational Therapy Guide (Book with CD-ROM)
• Non-Driver Rehabilitation Specialists: Community Mobility Across the Life Span (Conference Session Webcast)

Environmental Modification

• Home Modifications: Occupational Therapy Practice Guidelines (Publication)
• Occupational Therapy and Dementia Care: The Home Environmental Skill-Building Program for Individuals and Families (Book with CD-ROM)

Feeding, Eating, and Swallowing

• Dysphagia Care for Adults (SPCC)
• Introduction to Evaluation and Treatment of Children with Eating and Feeding Disorders (Online Course)

Low Vision

• Low Vision: Occupational Therapy Evaluation and Intervention with Older Adults (SPCC)
• Functional Visual Behavior in Adults: An Occupational Therapy Guide to Evaluation and Treatment Options, 2nd Edition (Book)

See you at the bookstore!

June 11, 2008 is Coming!

Hey, June applicants, are you getting nervous? Don't! You've been working hard on what I’m sure is a great application! As you’re giving everything the final once-over, make sure

• you have all the required evidence for your activities as identified in the Professional Development Activity List
• the page numbers in your application and your scanned evidence match( (it’s always the obvious things that trip us up, isn’t it!)
• you have made a clear connection between your activities and the indicators to which you’ve assigned them
• you proof your narratives for grammar and typos (best foot forward!) and have asked someone else to read them and give you feedback. It doesn't have to be another OT...a significant other, sibling, or friend will do!

For last minute questions and reassurances, don’t forget to take advantage of one of the remaining Q&A sessions on either Tuesday, June 3 at 4:00 EDT or Thursday, June 5 at 1:00 EDT. Sign up online!

Maria Elena E. Louch, Professional Development Program Manager

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I Can’t Figure Out the Points!

Helpful hint regarding points: Stop thinking about them!

Yes, there are numbers assigned to the competencies, the indicators, and the professional development activities. What would our world be like without numbers! While we can explain what they mean, the probability is that they won’t ultimately matter if you approach the application correctly. Here’s what I mean…

If you select your 1 best activity for each indicator in each competency, it is highly likely that when you are done assigning activities to every indicator (without even having thought about points) you will have reached your total point requirement. If you actually don’t have enough points, then you can go back and pick your 2nd best activity for 1 or 2 (whatever it takes) indicators in the competency where you are short.

That’s it…don’t think any more about it!

Okay, realizing that there are still some folks out there who need to understand the nitty-gritty, here you go…

• Each competency has been weighted in relationship to the other competencies, which is ultimately translated to the total number of required points for that competency. All competencies combined equal 100 points.
• Likewise, within each competency all the indicators have been weighted relative to each other. So indicators may be worth .5, 1, 1.5, or 2. The total value of all indicators within any given competency is 10.
• When you assign a professional development activity to an indicator, the points that you receive for that activity (let’s say the 2 points you get for a “Case Study” being applied to a Knowledge indicator) are multiplied times the value of the indicator. If the indicator was valued at .5 points, you would get 1 point. If the indicator is valued at 2 points, you would get 4 points.
• There is no minimum point requirement for each indicator, only a total point requirement for each competency. As long as you have 1 activity for each indicator, you are fine, regardless of how many points you have attributed to that particular indicator.

Don’t let the numbers be the focus of how you approach the application, though. That method can really prevent you from putting your best application forward! The best applications represent a thoughtful appraisal and reflection on the activities that best represent how the applicant met the requirements of a particular indicator – regardless of how many points were assigned!

Maria Elena E. Louch, Professional Development Program Manager