By Stephanie Yamkovenko
If you work with Medicare patients, have a private practice, work in home health or hospice, or in any way have benefited from the expansion of occupational therapy in the past few decades, then you have Lindy Boggs to thank.
Representative Lindy Boggs died July 27 at her home. The 97-year-old former representative and ambassador was one of occupational therapy’s strongest advocates in Congress.
Boggs was born in New Roads, Louisiana, and married Hale Boggs who became a member of the House of Representatives and served for nearly 3 decades. After her husband’s death in 1972, Lindy Boggs ran in a special election for his seat in the House. She won the election and was reelected eight times, serving in the House from 1973 to 1991.
From left to right: Jim Garibaldi, former AOTA executive director; Representative Lindy Boggs; Mae Hightower-Van Damm, former AOTA president
Boggs was well known for her southern charm and grace, but she was also known as being able to get what she wanted (in a gracious manner, of course). She used those talents to help occupational therapy earn recognition and become an important part of Medicare.
“She really planted the flag for us and was the person who blazed the trail in terms of our Part B Medicare coverage,” says Fred Somers, AOTA’s executive director. “This of course led to all the growth that we’ve seen over the past 25 years for occupational therapy in a variety of settings.”
It all started with a relationship with members of the Louisiana Occupational Therapy Association. “They had a very close relationship with Representative Boggs,” says Susan Scott Lee, former director of AOTA’s Government and Legal Affairs and former AOTPAC Board Chair. “They knew we were in several initiatives to try to expand Medicare coverage of occupational therapy and so we began a dialogue with Representative Boggs then.”
In the 1980s, AOTA was working to expand coverage of occupational therapy, and Boggs became the champion of AOTA’s legislation in Congress. “She agreed to be the primary sponsor of that bill in the House,” says Lee. “She also took the lead rounding up other cosponsors.”
When the bill passed the House, Boggs continued to support it by finding sponsors and cosponsors in the Senate. “At the time, the senator from Louisiana headed up the Finance Committee, which is a committee in the Senate that approves this type of legislation, so she worked very closely on both sides to garner support for the bill,” says Lee.
The Omnibus Budget Reconciliation Act of 1986 expanded coverage of occupational therapy under Medicare. “It was ultimately the landmark legislation that expanded Part B coverage under Medicare for occupational therapy,” says Somers. “It really put us on the map as an autonomous profession.”
According to Somers, the legislation also led to AOTA’s recognition by the American Medical Association (AMA) and AOTA’s participation with AMA’s Current Procedural Terminology (CPT) panel and AMA’s Specialty Society Relative Value Scale Update Committee (RUC), which are both important for billing and coding.
Mae Hightower-Van Damm, past AOTA president with Representative Lindy Boggs
AOTA continued working with Boggs during her tenure in office on bills for hospice, outpatient rehabilitation facilities, and other issues. In 1980, she succeeded in getting occupational therapy’s right to "open a case" in Medicare home health expanded. However, the next year President Reagan, with the consent of Congress, turned back that and other changes to Medicare.
Boggs was such a strong advocate for the profession that AOTA’s Government and Legal Affairs established an award in her name in 1982, the Lindy Boggs Award. “We wanted to create an award for an AOTA member from the volunteer sector—which we called the grassroots therapists—who went out of their way or did extraordinary measures to lobby and gather support for legislation,” says Lee.
Boggs presented the inaugural award at the 62nd Annual Conference & Expo in 1982 to Susan Beth Young. When AOTA’s Annual Conference & Expo was in New Orleans, Louisiana, in 1990, Boggs also presented the award to Gladys Nobuko Masagatani. (See all Lindy Boggs award recipients here).
AOTA’s Vice President Amy Lamb, OTD, OTRL, FAOTA, received the Lindy Boggs award in 2011. “It was an honor to be recognized as a leader with similar characteristics,” says Lamb. “She is an excellent role model for women seeking to be authentic in their leadership wherever those paths may be.”
Boggs was more than an advocate for occupational therapy; she was also a close friend. “She was a very close friend of mine and of others in the profession,” says Lee. “She was always out there working for health care services and also for women’s issues.”
The story of how Boggs hand wrote an amendment to the Equal Credit Opportunity Act of 1974 to include protections based on gender and marital status (in addition to minorities) was cited in many of her obituaries. According to The Washington Post, she presented her amendment to the committee—saying the omission must have been an oversight—and it passed.
“At the time, and still today, the occupational therapy profession has a large percentage of women, so we really looked to her as something of a champion,” says Lee.
“Representative Boggs had a tremendous effect in helping us gain recognition as a vital rehabilitation service and also as an important part of the Medicare benefit in the outpatient area, in home health, and in hospice,” says Lee.
In her 1994 memoir, Washington Through a Purple Veil, Boggs summed up her approach nicely: “you played the Washington game with confidence and authority and graciousness.”
Stephanie Yamkovenko is AOTA’s Web editor.