By Stephanie Yamkovenko
Occupational therapy had an advocacy victory when it was included in new federal regulation as a mental health service that should be a part of quality community mental health. In late October, the Centers for Medicare & Medicaid Services (CMS) released their final conditions of participation for community mental health centers providing Medicare partial hospitalization services. The rule included occupational therapy as a service that must be available in these participating community mental health centers.
Nationwide, nearly 100 community health centers participate in Medicare partial hospitalization.
“Our understanding is that this could be bigger than just Medicare partial hospitalization,” says Heather Parsons, AOTA’s director of legislative advocacy. “It’s the first time in decades that the federal government has defined what quality community mental health should look like, and occupational therapy is included.”
Prior to the rule, there was limited federal guidance for community mental health centers participating in the Medicare partial hospitalization programs, and licensing requirements were left up to state regulations. Some states did not have regulations for these types of facilities in place, which the Office of the Inspector General concluded had resulted in some fraudulent practices. CMS decided to develop a core set of health and safety requirements for all community mental health centers receiving Medicare funding.
“It’s ultimately based on individualized client needs, but the rule says that community mental health centers should evaluate whether a client needs to receive occupational therapy,” says Parsons. “For community mental health centers to qualify to participate, they have to provide occupational therapy services.”
In fact, community mental health centers should be providing occupational therapy to all clients, not just Medicare beneficiaries. When the draft rule was first released, the American Occupational Therapy Association wrote a letter to CMS supporting the inclusion of occupational therapy.
“This is a victory because federal regulations now says that providing occupational therapy is what quality mental health looks like,” says Parsons. “As policymakers continue to define quality mental health, this rule could be the guideline that is used going forward.”
Do you work as an occupational therapy practitioner in a community mental health center? AOTA would like to hear from you—email AOTA’s Federal Affairs Division.
Stephanie Yamkovenko is AOTA’s Web editor.