Hawaii's Commitment to Occupational Therapy
By Ashley Opp Hofmann
“This is my third go-around,” says Occupational Therapy Association of Hawaii (OTAH) President Virginia Tully, OTR, referring to her third term as president. After serving two 4-year terms in the 1970s, she’s closing in on the end of her current 6-year term, adding up to 14 years of service. Embodying a long-term commitment to the members of OTAH and to the profession within the state, Tully has addressed many issues important to Hawaii’s practitioners, particularly during her most recent term.
Doing Smarter Business
First, Tully worked to tighten up OTAH’s operations. “We are a very small organization. We had to revise how we do business as far as taxes, our political action, and our bylaws. We had to become more businesslike,” Tully says. OTAH hired a certified public accountant and a bookkeeper, and got the bookkeeping properly squared away.
At an Affiliated State Association Presidents (ASAP) meeting, some presidents discussed revising their state association’s bylaws, which inspired Tully to look into Hawaii’s laws for nonprofit organizations. OTAH engaged the services of an attorney and updated its bylaws, which now requires all voting to be conducted at a general membership meeting, including election, and bylaws changes. OTAH’s Board meeting quorum and voting process was also revised.
Improving Occupational Therapy Statewide
OTAH recently fended off new rules that would limit workers’ compensation. Hawaii followed California and its Official Disability Guidelines, which would cap the number of visits based on diagnoses and services, including occupational therapy. Among other stakeholders, OTAH representatives attended a community hearing at which OTAH opposed the decision. “Somehow, the legislature got wind of the opposition by the consumers and providers and passed a ruling that prevented the director of labor and industrial relations from making any changes without the permission of the legislature,” Tully says, “So all of that effort to change workers’ compensation was cancelled.” OTAH continues to closely monitor legislative bills to ensure that the Association has enough time to address any proposals that affect occupational therapy services within the workers’ compensation benefits.
Also under Tully’s tenure, Blue Cross Blue Shield (BCBS), a major health insurance company in Hawaii, began reimbursing for occupational therapy services. A task force within BCBS made up of occupational therapists, physical therapists, and speech-language pathologists helped the organization determine what services BCBS would cover within its preferred provider organization system. “We helped [BCBS] write the guidelines of what services we provided by sitting down with them and explaining different scenarios—why this diagnosis would require occupational therapy and why this one wouldn’t.” says Tully. The task group still works with BCBS to work out any problem areas, and as Tully points out, “We now have a resource in them.”
Tully is particularly proud of how OTAH listens to members’ concerns. The way in which OTAH has addressed continuing education (CE) in the state demonstrates this commitment to Hawaiian practitioners. “For many of our members it’s expensive to travel to the mainland to attend conferences or educational seminars, especially with airfares increasing. So we try to offer education locally and focus on what the members want and bring the mainland speakers to Hawaii.” To accomplish member-centered CE, OTAH distributes a form at its annual conference, asking what topics members want covered. OTAH’s conference committee pays very close attention to members’ highest priorities, and secures speakers and sessions that fit what members want and need.
Facing OT Shortages
Although most states are experiencing a workforce shortage of occupational therapy practitioners, this shortage tremendously affects Hawaii. “It’s really a challenge to bring occupational therapists here to work. There are no [occupational therapy] schools in Hawaii, so even those who are born and raised here go to the mainland for school. Some of them return, but some decide to stay there because cost of living is cheaper,” Tully says.
The University of Hawaii has an occupational therapy assistant program, which was placed on hold due to lack of students in 2007 and didn’t accept new students. However, OTAH and community supports explained why the program is needed, providing data from AOTA and asking community employers to explain their need for occupational therapy assistants. After a 1-year moratorium, the occupational therapy assistant program will reopen in September 2008.
Tully knows exactly what she likes best about serving as president: “I like working with the different people within the organization and learning about occupational therapy practice throughout the state. But I also get to meet with people across the nation as well, and share ideas and listen to what they are doing.” Tully says.
Now for the big question: Would she agree to another 6-year term? She laughs. “I’ll continue to support the organization as needed.”