R10 Therapy News

Newsletter for School Based OTs and PTs in Region 10

March, 2020

“Life is nothing without a little chaos to make it interesting.” Amelia Atwater-Rhodes

Weekly OT PT Regional Office Hours/Chat

Beginning Tuesday April 7, 2020 Region 10 ESC will host office hours for Q & A, and discussion related to OT and PT services. All are welcome to join and share ideas and problem solve challenges. Here's how to join:

Join from PC, Mac, Linux, iOS or Android: https://Region10.zoom.us/j/186605511?pwd=R21tNFhlSlhsN1gxdHMxdlVWQU9HZz09

Password: 863912

If joining via telephone dial: 408-638-0968 or 646-876-9923 or 669-900-6833 and enter the meeting ID when prompted.

Meeting ID: 186 605 511

If you wish to join via an H.323 device please contact our Help Desk at (972) 348-1234 Opt. #1 for assistance.


Link to Q & A document from Regional meeting on March 30, 2020, weekly office hours and emailed questions. To be updated on regular basis as needed.

https://drive.google.com/open?id=17preX1nz59SUUFonVfZ5zeCrrZNcaxhY0-oNrOq4BfM


Link to the recording of Meeting On April 21, 2020 Access Password: 5G*88l69

https://Region10.zoom.us/rec/share/5dVHF5zx1UJOY5XJyEXhXYocANX5aaa81nQfrPNfy049GiTOXn1NRdJSc8nf1wh-


Link to the recording of meeting on April 14, 2020 password: m3*&*w6K

https://Region10.zoom.us/rec/share/5uxxK5-350JLS9Lm52_Vfp9mFJXraaa80CFK_qAFzksK-OysuV-mIGEu5EG51EsB?startTime=1586872355000


4/21/2020 Presentation:

https://drive.google.com/open?id=1vsw9LpeY40R60rtgdzOIw9FkGu2iODMdH2_avK0QBpg

SHARS Billable Services include Physical Therapy

See attached document from Fairbanks. It was posted April 9, 2020

https://drive.google.com/open?id=1nM9kLPQy6X5zzzbJEfW-N_1wiRFXAUfj


HHSC will allow reimbursement for SHARS services via telehealth for Physical therapy in addition to OT, ST, Audiology, counseling and physician services.


Informed consent must be obtained to bill Shars for all providers.

It's all going to be ok. Eventually.

In light of the current situation with the Covid-19 outbreak, all of us are having to adjust to a whole new world in education. No one really knows how long it will last and the situation seems to be changing day to day or hour to hour. Please take a deep breath, try to relax and know that you are not in this alone. Everyone across the state, the country and the world is dealing with the same issues. How are we going to take care of the students we serve, their families, ourselves and our families.


Region 10 ESC is here to help navigate through the chaos with you. While we do not have all the answers, we will pass on the most reliable and up to date information available. There is no need to try to solve this alone, we are a large region. Let's take advantage of networking between OTs and PTs across the region. I am also in contact with other therapists around the state. Social media and technology also allows networking across the country.


See link below and please share activities you find or develop. Let's help each other out. Our students, their families and teachers need our creativity and support more than ever.


"We can only do what we can do and you always do what is best for kids and this will be no different." Dr. April Estrada, PhD. Director of Special Populations, Region 10 ESC.

Region 10 OT and PT Activities to Share

This the link to a google folder I created to collect activities and ideas to share with others across the region. It is a live folder, so anyone can add documents. Please be careful as anyone can also edit or delete documents. If you find something you want to use, please make a copy and add it to your google drive. We will be adding to this over the next few weeks so check back often.


https://drive.google.com/open?id=1tV78wlqzLxv7fNV_3T5Qyb5Y1R_tSKRd


(Photo by bruce mars on Unsplash)

Resources for Fine and Gross Motor Activities

There are many, many resources available for fine and gross motor activities. Here are just a few:


National Center on Health, Physical Activity and Disability (NCHPAD)

well done videos - https://www.nchpad.org/Videos


Your Therapy source - free worksheets and activities

https://www.yourtherapysource.com/freestuff.html


The Measured Mom Activity List

https://www.themeasuredmom.com/indoor-gross-motor-activities/


The Inspired Treehouse Motor Activity List

https://theinspiredtreehouse.com/activities-index/



Facebook Page - Diane's Kids Diane is a OT in Fort Worth and has public group with lots of activities for home.


Photo by Gabriel Baranski on Unsplash

Buggy and Buddy.com - free printable scavenger hunts and more.

https://buggyandbuddy.com/free-printables/


Parent videos and free downloads:

https://makesociallearningstick.com/keep-calm-and-structure-on-how-to-manage-emotions-and-build-structure-at-home-during-covid-19/


Handwriting Without Tears offered free to parents thru July 2020

https://www.lwtears.com/programs/distance-learning


Ready Bodies Learning Minds has posted a video and suggestion page for Virtual/Home Motor lab for students who have already been taught motor lab activities at home.

https://readybodieslearningminds.com/create-a-virtual-motor-lab/


Youtube Channel - PE with Joe (Joe Wicks)

Daily PE class at home.


Tips on Providing Telehealth for PT

https://drive.google.com/open?id=16o_ejd9YlHUXD7-frcJ2h2HgUdBkAUvg


Youtube: StorylineOnline - Books being read by various celebrities. Student can listen in various positions.

Laura Harris NBC5 Facebook live on Thursdays to Read kids books.


Planesandballoons.com - Free printaable worksheets


Lakeshore Learning has made available over 1000 free printables, videos and more. NEW

https://www.lakeshorelearning.com/resources/free-resources?ref=hpH2


Youtube: Cosmic Kids Yoga


Youtube: Pediatric Physical Therapy Exercises - exercises and videos on how to teach developmental and mobility skills (mostly younger kids)


Pink Oatmeal - movement breaks

https://www.pinkoatmeal.com/


Seakfreaks has posted a list of free or mostly add free resources: NEW April 9, 2020

http://seekfreaks.com


Free printables

https://www.toolstogrowot.com/


Brain Breaks - Move and Freeze Added April 20, 2020

https://www.youtube.com/watch?v=388Q44ReOWE


Balloon Activities - Added April 20, 2020

https://youtu.be/OvnkgOXuEps


Animal Walk Video - Added April 20, 2020

https://www.youtube.com/watch?v=hOKm8l-Vx78&feature=youtu.be


Sidewalk Chalk Course - Added April 20, 2020

https://www.youtube.com/watch?v=GTPCaqxECi0&feature=youtu.be


Action Words - Added April 20, 2020

https://www.youtube.com/watch?v=GTPCaqxECi0&feature=youtu.be

“In the middle of difficulty lies opportunity.” Albert Einstein

The Big Picture Thoughts


The following thoughts are generated from various documents and meetings. Districts should be in contact with their attorneys for specific guidance. The most important thing is to communicate with your administrators and follow the directives from your LEA on the decisions have been made at the local level.


  • If an LEA closes its schools and does not provide any educational services to the general student population, then an LEA would not be required to provide services to students with disabilities during that same period of time.
  • Once instruction resumes, the LEA must make every effort to provide special education and related services to the child in accordance with the child’s individualized education program (IEP) or, for students entitled to FAPE under Section 504, consistent with a plan developed to meet the requirements of Section 504.
  • It is important to know what instruction is being offered to the general education, so commensurate instruction and services can be offered to students with disabilities.
  • It is important to follow your districts instructions/policy and procedures in regards to how services will be provided under these circumstances.
  • Providing PT or OT in Texas via Telehealth is legal. See Practice Acts/Rules cited later in this newsletter.
  • It is important to communicate well with parents, teachers and administrators.
  • It is important to document all sessions, communication and attempts at communication during this period.
  • Special Education personnel will need to determine if each student can be provided FAPE according to the current IEP while the school buildings are closed - either by virtual instruction, sending home activities or in some other format.
  • If not, IEP and services may need to be amended by the ARD committee for a temporary period of time.
  • If FAPE cannot be provided in a virtual environment, then do the best possible services/instruction and know compensatory services may be needed.
  • FAPE is considered making overall progress, not necessarily meeting each IEP objective or service minutes.
  • ARDs can be held virtually, consent and timelines still apply.
  • Evaluation timelines also apply, complete as much of the evaluation as possible virtually and amendment/addendum may have to be added later when their educational demands/location change from home to school building.
  • When activities or "assignments" are sent home, include some type of data tracking. Will need some way to track progress and follow up virtually as well (phone, tablet or computer).
  • Work with your teachers so parents are not overwhelmed with the volume of information and activities going home, keep it simple.
  • Providing something is better than nothing.
  • Matching services minute by minutes is not expected, do what the student needs to make progress and prevent regression.

Guidance documents concerning Convid-19

Guidance and recommendations from Centers for Disease Control and state and local authorities seem to be changing daily or sometimes even hourly. The following is a list of several documents that may provide useful information. Please check frequently for updates. Each LEA's administration is in contact with TEA and therefore should be your first resource for providing services in your district. Region 10 Education Service Center is open and available as a resource as well. There is a lot of information being posted in various places. This is not an all inclusive list, just a place to start.


TEA Guidance Document on OT and PT. Posted 4/16/2020

https://tea.texas.gov/sites/default/files/COVID-19%20SPED%20Task%20Force%20OT-PT%20Guidance%20_April%2016.pdf


Region 10 ESC Teaching and Learning At-Home Learning Page:

https://sites.google.com/region10.org/r10-remote-learning-resources/home


Region 10 ESC Digital Learning: Live and Recorded sessions on various digital technology.

https://sites.google.com/region10.org/region10webinarseries/home


Region 10 ESC Special Populations At-Home Learning page:

https://sites.google.com/region10.org/specialpopulationshomelearning/home


Here is a link to the Newsletter shared with Special Education Directors across Region 10. It will be updated as information becomes available. https://www.smore.com/y6de4


Updated Q & A from TEA (April 7)

https://tea.texas.gov/sites/default/files/covid19_special_ed_qa_updated_april_7.pdf


TEA Supporting Students with Complex Needs (LID) _ Posted April 9, 2020

https://tea.texas.gov/sites/default/files/COVID-19%20Support%20for%20Students%20with%20Complex%20Needs_April%209_Final.pdf


At Home Resources for Students with Disabilities TEA Posted April 9, 2020

https://tea.texas.gov/sites/default/files/covid-19_-_at_home_learning_resources_april_7.pdf


Progress Monitoring from TEA posted April 14, 2020

https://tea.texas.gov/sites/default/files/covid-19_progress_monitoring_checklist_april_14.pdf


US Department of Ed/IDEA

https://sites.ed.gov/idea/idea-files/q-and-a-providing-services-to-children-with-disabilities-during-the-coronavirus-disease-2019-outbreak/


APTA:

http://www.apta.org/PTinMotion/News/2020/03/17/CoronavirusUpdateMarch17/


Academy of Pediatric PT: School based services page NEW

https://sites.google.com/view/sbptcovid-19perspectives/home?authuser=0


Texas PT Board added Telehealth FAQ document: NEW

https://www.ptot.texas.gov/idl/7F9C31AC-EAD1-6635-405A-448E602C640A


AOTA:

https://www.aota.org/Publications-News/AOTANews/2020/coronavirus-resources.aspx?promo_name=coronavirus&promo_creative=Advocacy-Policy&promo_position=hero


TxSpot is adding resources so check back often:

https://www.txspot.org/SitePages/Resources.aspx


Information regarding HIPPA

https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html


FERPA considerations:

https://tea.texas.gov/sites/default/files/covid-19_privacy_and_ferpa_considerations_for_virtual_instruction_april_2.pdf


CDC:

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-schools.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fspecific-groups%2Fguidance-for-schools.html


Medicaid/SHARS:

https://nam02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.tmhp.com%2FManuals_PDF%2FTMPPM%2FTMPPM_Living_Manual_Current%2F2_Telecommunication_Srvs.pdf&data=02%7C01%7CLois.Goodin%40region10.org%7C6b9fc007d22e4b30e0c808d7d010ba20%7C31049577a6864b2d9222b60ccb42a5fc%7C0%7C0%7C637206642560862962&sdata=ZVHjHt7q5i8vbsAXbL5rxxbPPHZBhPzhNnv6%2BBG5GZo%3D&reserved=0


Recommended hours of homeschooling per grade: Posted 4/14/2020

https://www.popsugar.com/family/homeschool-hours-by-grade-chart-47384958

(Photo by Roman Kraft on Unsplash)

“When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.”Mr. Rogers

Telehealth information

Here is link to a powerpoint presentation put together by Jean Polichino, OTR, MS, FAOTA for the Texas school based conference on June 7, 2018.


https://drive.google.com/open?id=1phe5XKNWZCe9r1yRawwpCeBVK59p6Wnj


Please note that some of the information slide 13 has been updated. PTA are now allowed to provide services via Telehealth. See below. There is much more information about Telehealth on the APTA and AOTA webistes.

What Does The Practice Act and Rules Say About Virtual PT?

As schools across the United States adjust to virtual instruction as a result of the Convid-19 Pandemic, where does that leave OT and PT related services? Telehealth is not included in the Practice Act/Rules in all states. However, over the past couple of years is has been addressed in the Practice Act and Rules for both OT and PT in Texas.


PT Rules:

§322.5. Telehealth (a) When used in the rules of the Texas Board of Physical Therapy Examiners, telehealth is the use of telecommunications or information technology to provide physical therapy services to a patient who is physically located at a site in Texas other than the site where the physical therapist or physical therapist assistant is located, whether or not in Texas. (b) Physical therapy telehealth services must be provided by a physical therapist or physical therapist assistant under the supervision of the physical therapist who possesses a current: (1) unrestricted Texas license; or (2) Compact Privilege to practice in Texas. (c)The provision of physical therapy services via telehealth requires synchronous audiovisual or audio interaction between the physical therapist or physical therapist assistant and the patient/client, which may be accompanied by the use of asynchronous store and forward technology. (d) Standard of Care. A physical therapist or physical therapist assistant that provides telehealth services: (1) is subject to the same standard of care that would apply to the provision of the same physical therapy service in an in-person setting; and (2) the physical therapist is responsible for determining whether an evaluation or intervention may be conducted via telehealth or must be conducted in an in-person setting. (e) Informed Consent. A physical therapist that provides telehealth services must obtain and maintain the informed consent of the patient, or of another individual authorized to make health care treatment decisions for the patient, prior to the provision of telehealth services. (f) Confidentiality. A physical therapist or physical therapist assistant that provides telehealth services must ensure that the privacy and confidentiality of the patient's medical information is maintained during and following the provision of telehealth services, including compliance with HIPAA regulations and other federal and state law. (g) The failure of a physical therapist or physical therapist assistant to comply with this section shall constitute detrimental practice and could subject the licensee to disciplinary action by the Board. (h) Telehealth is a mode for providing one-on-one physical therapy services to a patient/client and is not a means for supervision of physical therapy aides. Source Note: The provisions of this §322.5 adopted to be effective November 11, 2018, 43 TexReg 7353; amended to be effective March 1, 2020, 45 TexReg 899.

OT Practice Act and Rules

The OT Rules does not include a separate section on Telehealth, however it is embedded throughout the Rules.


Definitions: (39) Telehealth--A mode of service delivery for the provision of occupational therapy services delivered by an occupational therapy practitioner to a client at a different physical location using telecommunications or information technology. Telehealth refers only to the practice of occupational therapy by occupational therapy practitioners who are licensed by this Board with clients who are located in Texas at the time of the provision of occupational therapy services. Also may be known as other terms including but not limited to telepractice, telecare, telerehabilitation, and e-health services.


Evaluation: (4) The occupational therapist must have contact with the client during the evaluation via telehealth using synchronous audiovisual technology or in person. Other Texas Board of Occupational Therapy Examiners December 2019 37 telecommunications or information technology may be used to aid in the evaluation but may not be the primary means of contact or communication.


Plan of Care: (7) Except where otherwise restricted by rule, the occupational therapy practitioner is responsible for determining whether any aspect of the intervention session may be conducted via telehealth or must be conducted in person.

(8) The occupational therapy practitioners must have contact with the client during the intervention session via telehealth using synchronous audiovisual technology or in person. Other telecommunications or information technology may be used to aid in the intervention session but may not be the primary means of contact or communication.

(9) Devices that are in sustained skin contact with the client (including but not limited to wheelchair positioning devices, splints, hot/cold packs, or therapeutic tape) require the on-site and attending presence of the occupational therapy practitioner for any initial applications. The occupational therapy practitioner is responsible for determining the need to be on-site and attending for subsequent applications or modifications.

Do not let anyone tell you it cannot be done. No challenge can match the heart and fight and spirit of America. We will not fail. Our country will thrive and prosper again. Donald Trump

Kidnetic Games : May 16, 2020 Has been cancelled

Archives of past 2019-2020 Newsletter

An archive document with links to previous newsletters and topics has been created. It is posted on the Region 10 OT PT Google Site. Here's the link to the document.


http://bit.ly/OTPTNewsletter

The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy. Martin Luther King, Jr.

Resources for School Based OTs and PTs

"Our lives begin to end the day we becomes silent about things that matter." Dr Martin Luther King Jr.