First posted in June, 2013
Where are we, and where do we want to go?
By Patty Arnold, Gene Bourquin, Lynn Gautreaux, Rod Haneline, John Higgins,
Elga Joffee, Okono Okono, Craig Phillips, and Dona Sauerburger
Our O&M profession is at a critical crossroads, and we have to push hard to get it to the next level.
However, the O&M profession has no organization which has the authority to speak or act on its own behalf without getting approval from others outside the profession. The largest organization dedicated to O&M, the O&M Division of AER, is in a structure which requires AER International Board oversight and approval authority over every decision it makes. This structure has impeded actions which O&M professionals decided were needed, as explained in this paper.
Thus we are proposing to establish an O&M professional association which will have the autonomy and structure to speak and act on behalf of O&M professionals. This Professional Association could either be established as an autonomous affiliate within AER or as a separate organization.
We need your input and your ideas as to how to set up the Professional Association.
SUMMARY OF THIS PAPER:
What is a Professional Association and what can it do?
Professional Associations "represent the interest of the professional practitioners" (Harvey, Mason, and Ward, 1995). Joining a Professional Association may be "the best way to ensure your profession's future," as eloquently expressed by Cheryl Crow (2012).
What do Professional Associations do?
The needs of different professions vary, so the purposes of their PAs also vary.
Some of the goals of various PAs include:
What can Professional Associations accomplish?
Professional Associations not only can provide resources and support to its members, they can energize them and help focus their efforts to strengthen and promote their profession.
One example is the American Occupational Therapy Association (AOTA), which will celebrate its 100th birthday in 2017.
Over the last century, AOTA has done many things to strengthen its profession.
Should O&M have a Professional Association?
For example, AOTA was alert for changes and trends that needed to be addressed to ensure the future of the profession. Thus they were aware that when the Balanced Budget Act of 1997 resulted in fewer health care dollars, other professions (such as nurses, physical therapists and speech/language pathologists) began expanding into the OT scope of practice. AOTA took action and worked hard to establish their scope of practice in legislation, including state practice acts. This scope of practice also serves to protect consumers by defining what OT practitioners have the education and skills to provide.
AOTA also addressed the problems that resulted from inadequate name recognition. For example, they created an evidence database to give their members a tool to quickly demonstrate their effectiveness, and worked hard to promote name recognition through effective public education and marketing programs. The winner of their 2011 student video contest, "Promoting Occupational Therapy" by Cheryl Crow, is inspirational and could serve as a model for promoting O&M.
While AOTA has been working hard to secure the future of its profession, the O&M profession has been left behind:
That means that referral sources and consumers who could benefit from the services often know nothing about it.
O&M is not recognized as a reimbursable service by Medicare, insurance companies, and other funding sources.
so nothing can prevent unqualified professionals from being compensated for providing it.
We have given a lot of thought to how this can be accomplished.
The rest of this paper will consider how O&M can have its own Professional Association (PA). We will first consider whether AER's O&M Division can serve as a PA, and then address several options for setting up an O&M PA.
Can AER's O&M Division function as a Professional Association?
AER's bylaws state that the purpose of the O&M Division and other divisions is to provide forums to
What options exist to have an autonomous O&M Professional Association?
Are there consequences for not being able to make our own decisions?
Below, we provide some examples of the result of not being able to make decisions for ourselves:
Does an O&M Professional Association (PA) need to be autonomous?
Earlier this year, the O&M Division decided it was important to send the new chair of its Environmental Access Committee (EAC) to advocate and raise awareness at the Transportation Research Board in Washington, DC.
However, even though AER's Board had approved enough funds for the O&M Division to cover all her expenses and allowed the Division to pay for her registration fee, it did not allow the Division to use any of those funds to pay for her travel.
As a result, even though the Division had enough funds to pay for her hotel and transportation, the only way that the O&M Division's EAC chair could advocate on behalf of the O&M profession was to pay for those expenses herself.
The O&M Division was not allowed to have its own conference until 2003. The reason given was that an O&M conference might draw too many people away from AER's biennial conferences.
After the very successful 2003 O&M Division Conference, the AER Board rejected requests to have another one until 10 years later. We know the O&M Division conference in New Orleans this December will be another huge success, but an autonomous O&M Professional Association would have O&M conferences more often than once every decade.
At the O&M Division business meeting in 2002, our members developed a statement to support O&M specialists who were being required to blindfold all their students and another statement supporting O&M specialists who were being required to teach O&M in groups or teach only on campus. The O&M Division members voted unanimously to forward both of these statements to AER for consideration as resolutions.
However, AER's Resolutions Committee rejected them. The reason given was that the resolutions might alienate some of AER's rehabilitation members (details).
About 15 years ago, AER worked on a bill that would provide Medicare reimbursement for services of several blindness professionals, including O&M. It was determined that some of the more serious opposition to this bill could be overcome if the bill was revised to reimburse O&M services but not include all the blindness professionals.
After several days of serious consideration, AER's Board decided to have all the blindness professions stand together and risk the ensuing opposition to the bill. It may be that standing together with other professionals would be in the best interest of the O&M profession, but this decision should have been made by an organization speaking on behalf of the O&M profession.
We believe that the only way to ensure that a profession can advance in the direction it thinks is best is to have a PA that is fully autonomous.
Any PA decision that requires approval from another board, be it setting policy or declaring a position or spending money or taking an action, is a decision that may be denied, which may open the door for roadblocks or even sabotage the efforts of the PA to achieve its goals.
Since AER's O&M Division can make none of these decisions without getting approval from AER's Board, it cannot serve as a Professional Association.
And there can be potentially serious consequences of having the O&M PA efforts thwarted in this manner.
For example, one of the comments from our survey was "At the agency where I work, mobility instructors have been asked to work with more than one student at a time. This is extremely disturbing, and it is clear that the decision was made for fiscal reasons, not with the student or mobility instructor in mind."
He went on to say, "My sole reason to consider joining forces to form a PA is to protect the mobility instructor from ill-conceived decisions based on fiscal constraints."
But we can't ensure that the O&M PA will be able address his concerns unless it is fully autonomous. We saw what happened in 2002, when the O&M Division developed a statement supporting O&M specialists whose agency requires them to teach more than one student at a time. As we explained, the AER's Resolutions Committee rejected it because it might alienate some of AER's rehabilitation members.
If a subgroup of AER members can have that much influence over AER's consideration of core-value O&M issues, it's easy to imagine what will happen when the interests or goals of the O&M profession are in conflict with those of individual AER board members.
Requiring AER board approval for any PA decisions or actions means that the direction and focus of the O&M profession can be directly affected by others outside of the profession.
We can't allow that to happen. We therefore conclude that in order to promote, support, and strengthen our profession, we need a Professional Association that can make its own decisions about
We can think of two options for having an O&M Professional Association (PA):
Option #1: Have a Professional Association separate from any umbrella or coalition organization
A Professional Association (PA) can easily be established on its own.
In the beginning, it could be managed without an office, as the American Council of the Blind and the Association of Travel Instructors and many other organizations did when they were first established. Checks would be processed, membership records kept and a website maintained by part-time staff working from their home.
Option #2: Have Professional Associations within AER
As more people join and/or there is income from sales, conferences, and continuing education, the O&M PA could develop financial stability, expand, offer scholarships, etc. and eventually establish an office.
AER currently has two categories of affiliated organizations -- Divisions, and Chapters:
Considerations for the O&M Professional Association (PA):
These new AER affiliates would have to be autonomous in order to function effectively as Professional Associations,
as we already explained.
This autonomy would have to be codified in AER's bylaws to ensure that it endures.
How could this be administered?
That is, the AER bylaws would have to specify that the PAs can make decisions that do not require the approval of AER's Board or staff to:
Once AER's bylaws are revised, AER's Board could form Professional Associations (PAs) whenever there are enough members who want to establish one for their profession.
People could join the PAs by being a member of AER and then pay their PA dues, as they do now for Divisions.
When a PA is created, it might replace the corresponding Division. However, most AER Divisions do not represent any particular profession and would continue to function as interest groups, just as they do now.
The Professional Associations (PAs) would manage their own affairs, similar to what the AER Chapters do except that the PAs would determine their own dues and how to collect them. They would reimburse AER for the use of their staff and resources for anything that the PAs did not handle themselves.
There has already been a precedent for this kind of operation, which existed when AER was first established:
Comparing the two options for the O&M PA:
If this is not possible, the only option for having an O&M PA is to establish it separate from AER.
When looking at the accomplishments of PAs and task forces, we found that small groups of people who are energized, focused on the goals and knowledgeable about how to work the "system" can often advocate more effectively and accomplish more than organizations that are several times larger, or that are part of a coalition that doesn't share exactly the same interests.
Professional liability insurance is available through other organizations such as the Council of Exceptional Children (CEC) and of course it can also be purchased individually through private companies.
Meanwhile, there has been a great deal of concern about whether the Forrest T. Jones' professional liability insurance policy covers what O&M specialists do (for more information, you can click here). AER started looking into this concern more than a year ago, but has not yet been able to ascertain what the policy actually covers and where it applies.
We are considering this issue seriously. We have included several questions in the survey to gauge how important professional liability insurance is to O&M specialists as a membership benefit, and we will use this information when making our decision about the best option for setting up an O&M PA.
If our PA is established within AER, GDMIs could either be part of our PA, or have their own PA within AER. If our PA is established separate from AER, GDMIs could be one of our PA's special interest groups. However, because GDMI is a profession, not a subspecialty of O&M, their group would be given a portion of their members' dues, as well as autonomy for decisions about spending those funds, developing position papers, having conferences, etc.
What do YOU prefer?
We are asking YOU to help decide whether the O&M Professional Association should be established within AER or separately, and what concerns we should address when setting it up.
Plan for establishing the O&M PA
So if you are an O&M specialist and you care about your profession, please let your voice be heard and complete our survey.
To enable you to speculate about which option might be best, the survey includes a hypothetical amount for dues. We based this on a tentative calculation of budget and membership for each PA (if you want more details, you can click here).
We will leave the survey open for your input until September 30, 2013, and then post the results on this website.
If you have any questions, suggestions, or concerns you want to share with us, or if you want to get involved with planning the historic establishment of the first Professional Association for O&M, we would be delighted to hear from you!
You can contact us by emailing OandM.PA@gmail.com. Thank you for your consideration.
Please don't miss this opportunity to let your voice be heard and
guide our direction in this auspicious moment in the history of O&M!
The survey will be open until September 30, 2013.