State Victory! Virginia Passes Occupational Therapy Licensure Legislation
By Ashley Opp Hofmann
On March 2, 2008, Virginia Governor Tim Kaine signed licensure legislation for occupational therapy assistants. Licensure raises the professional status of occupational therapy assistants, alleviates some liability of the occupational therapists supervising them, and requires continuing education.
Making the Decision
Occupational therapy assistant licensure has been a long time coming in Virginia. The commonwealth’s occupational therapists received licensure in 1997. A few years later, the Virginia Occupational Therapy Association (VOTA) started working on licensure of occupational therapy assistants, but a study conducted by the Virginia Department of Health Professions (DHP) at VOTA’s request recommended against licensure due to a lack of evidence that its absence threatened clients’ well-being. Despite this setback, in 2005 VOTA successfully lobbied the General Assembly for title protection for occupational therapy assistants to ensure that only certified occupational therapy assistants could use this title.
However, there was still no scope of practice protection. In 2006, VOTA began petitioning the DHP for new regulations to increase the oversight of occupational therapy assistants. This effort was unsuccessful, so VOTA decided to pursue occupational therapy assistant licensure. VOTA discussed the issue with the American Occupational Therapy Association (AOTA), and additional discussions with the Occupational Therapy Advisory Board to the Virginia Board of Medicine and the Virginia DHP helped to develop the language for occupational therapy assistant licensure.
The timing was good. In 2006, Democrats had retaken the state senate, and they historically had shown less resistance to regulation than the Republicans. Based on the recommendation of lobbyist Alexander Macaulay, VOTA hired a legislative consultant, Rebecca Bowers-Lanier, to assist in taking the bill through the proper steps, which was, as VOTA President Grace L. Williams, MEd, OTRL, ATP, puts it, “one of the best recommendations he could have made for us. We didn’t have contacts in the house or senate. Our grassroots abilities needed to be organized and directed. Becky took a lot of pressure off the VOTA Board and justified the extra expense,” she says. “State associations are not rich. We don’t have a lot of money to spend, so deciding to stick our neck out financially was a bit of a risk, but it has paid off.”
By November, VOTA had a copy of its bill at Richmond’s legislative services for approval as well as sponsors: Senator Edd Houck and House Delegate John O’Bannon. When the bill entered committee, VOTA notified practitioners living in the areas that the committee members represented, and urged them to ask the members for their support. “Committee members were being educated even before they actually sat down to discuss it,” Williams points out.
The bill passed unanimously in committee, on the house floor, and in the senate. On March 2, Governor Tim Kaine signed the legislation, which will go into effect on June 1, 2008.
Why is Licensure Important?
Without licensure, occupational therapy assistants are not regulated and have no continuing educational requirement. VOTA leaders were concerned because occupational therapy assistants could not be held legally accountable for their actions, which added an extra burden of liability to the supervising occupational therapist.
More importantly, however, is the status that comes with having professional expectations. “I have had occupational therapy assistants say to me, ‘This is a great idea. It’s going to make me feel more like a professional,’” Williams says. She also notes that occupational therapy assistant state membership increased as VOTA has pursued licensure.
“AOTA is an important partner of the state association. They know what is happening in other states that can help us make decisions and they have given us support and feedback,” Williams says. “AOTA has been there for us through this entire effort.”
The legislation will go into effect on June 1, 2008. Virginia is the 44th state to achieve licensure for occupational therapy assistants.
The Path to Licensure
Although every state is different, there’s no need for state associations to reinvent the wheel when it comes to pursuing licensure. Here’s how VOTA did it:
In 2007, President Williams and legislative chairperson Michele Stoll, BS, OTA, CMT, worked with lobbyist Alexander Macaulay and his colleague, Gerry Milsky, to draft legislation. AOTA reviewed it, and VOTA’s lobbyists obtained further input from the VOTA Board, some members of which are occupational therapy assistants.
In August, Williams took the legislation and political process to the VOTA Board. “I presented the financial and time commitments it would require and said, ‘Because of the time and money, do we want to take this on as an organization?’” Williams says. “At our August meeting, we decided. Yes, we would do this.”
In September 2007, legislative consultant Rebecca Bowers-Lanier met with the lobbyists and presidents of stakeholder groups, such as the associations for home care, physical therapists, speech–language pathologists, and the Virginia Medical Association, to determine their level of support.
Then in October they met with the senators and delegates to find sponsors for the legislation. Bowers-Lanier also put together a grassroots guide, while Williams and her team sent out a questionnaire to former and current VOTA members to see how many would support grassroots efforts—60% indicated they would actively do so. Williams made cold calls to occupational therapy assistants—members and nonmembers—and urged them to support licensure. VOTA also posted an easily accessible fact sheet, and Bowers-Lanier continually sent e-mail blasts informing supporters of what they could do at particular points in the process.
In December, VOTA asked supporters to make personal visits with their representatives, a move that proved very successful. “From what our consultant heard at committees and on the floor, everyone knew what occupational therapy was and everyone had had some kind of contact through e-mail, phone calls, letters, or visits from occupational therapy practitioners,” Williams says. In February, VOTA hosted its tenth Legislative Day, and more than 60 graduate students met with their state representatives to discuss issues such as licensure.
The grassroots support by occupational therapy practitioners in Virginia paid off, and the bill became law on March 2, 2008.
Ashley Opp Hofmann is AOTA’s senior staff writer.