Project Description
Legislation at both state and federal levels profoundly shapes the practice and outreach of occupational therapy (OT), a profession uniquely equipped to address diverse needs across populations and settings, as well as the lives of client populations (American Occupational Therapy Association, 2023; Lencucha & Shikako-Thomas, 2019). Historical advancements such as the establishment of Medicare and Medicaid have significantly expanded accessibility to healthcare and rehabilitation services, highlighting the pivotal role of legislation in shaping OT practice and improving the well-being of client populations (Lencucha & Shikako-Thomas, 2019; AOTA, 2022). However, despite these advancements, challenges persist in navigating legislative landscapes and advocating effectively for the profession. In collaboration with the Ohio OT Association, this doctoral capstone project aims to enhance understanding and participation in state-level legislative advocacy among OT practitioners, educators, and students in Ohio to protect and propel the OT profession.
Area of Focus
Education & Advocacy
Area of Practice
Legislation & Ethics
Mission Statement
To educate occupational therapy professionals in legislative advocacy at a state level
Vision Statement
For occupational therapy professionals to be equipped with and utilize the advocacy tools for the enhanced service of marginalized and underrepresented persons, groups, and populations
About the Project Lead
Erika Eustaquio holds a Bachelor of Science in Public Health from Miami University, where she delved into the relationship between policies and individual, group, and population health.
Erika then continued on to a career as a case manager for individuals with developmental disabilities. This role provided insights into the impacts of rules and regulations of Medicaid and state agencies such as the Ohio Department of Developmental Disabilities & Ohio Department Of Job And Family Services on the health and safety of clients and families.
It was during her occupational therapy studies that Erika's passion for advocacy strengthened. In 2023, she took a significant step by joining her first Statehouse Day, where she passionately advocated for occupational therapy at the Indiana State Capitol. This experience deeply resonated with her, shedding light on the profound connection between legislation, occupational therapy practice, and the lives of client populations. This spark to promote positive change in her field led to the creation of this project.
project site
Ohio Occupational Therapy Association is a volunteer-driven professional organization committed to advancing the profession through advocacy and communication. OOTA works with lobbyists, legislators, and other professional associations to influence policy impacting Ohio's occupational therapy profession and client populations.
Key stakeholders
Thank you to the following individuals for their time, guidance, and support throughout the duration of this capstone experience!
- Cheryl Boop, MOT, OTR/L, BCP - OOTA Liasion for the Occupational Therapy Physical Therapy Athletic Training (OTPTAT) Board (expert mentor)
- Becky Finni, DHS, OTR/L, RAC-CT, FAOTA - OOTA President (site mentor)
- Christie Tuttle, MS, COTA/L - OOTA President-Elect (site mentor)
- Daniel Hurley - OOTA Lobbyist (consultant)
- Nathan Short, PhD, OTR/L, CHT, FAOTA (faculty mentor)
Project Design
The creation of this capstone project started with careful planning, focusing on understanding its importance and relevance. The project design process included the development of a formal needs assessment and literature review, providing a comprehensive understanding of the project's purpose and the existing context within the relevant field. Inquiries from relevant professionals were also obtained. This structured approach ensured that the project was grounded in evidence and informed by diverse perspectives, creating a foundation for impactful outcomes.
PROJECT OUTCOMES
1. Legislative Advocacy Toolkit
The project lead crafted a legislative advocacy toolkit with research-supported content to educate/support OT professionals with basic action steps for advocacy efforts and expand the scope of practice for serving all persons, groups, and populations. This toolkit encompasses subsections addressing advocacy basics, Ohio legislation basics, and an advocacy action guide. This student had to gain foundational knowledge and competence in state legislative processes to articulate information in a way that is understandable to the everyday OT advocate unfamiliar with legislation.
1A. Legislative Flowchart
The project lead created a simplified legislative flowchart to support OT professionals navigating legislation and advocacy efforts at the state level in Ohio. This convenient, easy-to-read, and visually engaging deliverable reflected the knowledge and understanding of the state legislative process gained through immersive in-person experiences at the Ohio Statehouse, consultations with lobbyist Danny Hurley, and online learning. This deliverable is also included within the legislative advocacy toolkit.
1B. Legislative Advocacy Action Guide
The project lead synthesized knowledge of legislative advocacy efforts obtained through direct advocacy experiences, online learning, shadowing opportunities, and consultation to design an advocacy action guide deliverable, which serves as a subsection of the legislative advocacy toolkit. This guide is made available for OT stakeholders seeking to become involved in legislative advocacy at the state level.
2. Continuing Education Course on Legislative Advocacy and Ethics
The project lead designed and delivered a continuing education webinar addressing legislative advocacy and ethics for occupational therapy advocates seeking to support the profession at the state level. OT practitioners have the opportunity to earn 1.5 contact hours upon attendance and successful completion of a quiz. Moreover, this webinar satisfies the ethics prerequisite for Ohio's licensure renewal for occupational therapists and occupational therapy assistants. This webinar was delivered twice and offered to both OOTA members and non-members.
3. Legislative Awareness Survey
The project lead gathered legislative needs, interests, and state organizational inquiries from various regions throughout the state in preparation for specific engagements and presentations to share up-to-date information and resources for sustaining the Ohio Occupational Therapy Association’s impact on a state level. This was executed through a Google Forms survey.
4. Ohio Statehouse Experiences
To execute legislative advocacy in its most direct form, the project lead participated in experiences at the Ohio Statehouse in Columbus, with the collaboration of the Ohio OT Association and lobbyist Danny Hurley.
Statehouse Day
The project lead was involved in the outreach, coordination, and participation of OOTA's Statehouse Day. Alongside other occupational therapy peers, the project lead exercised her advocacy skills and engaged directly with legislators both within and outside her district, discussing the importance of skilled occupational therapy services and legislative initiatives that influence the profession and its client populations in Ohio. The project lead was able to meet with Senator George Lang, Senator Steve Huffman, Representative Monica Robb Blasdel, Representative Jean Schmidt, and the legislative staff of Representative Jennifer Gross. Other colleagues from other regions of Ohio were able to meet with legislators from their respective districts.
The primary legislative initiative advocated for was House Bill 141, The Copay Fairness Act. This initiative aims to prohibit health plans from charging higher copays for OT services than those for routine outpatient office visits, thereby reducing the financial burden on patients in need of these skilled services.
Shadowing Opportunities
To increase competency in the legislative processes, the project lead also shadowed Danny at the Statehouse prior to Statehouse/Advocacy Day. The project lead was able to sit in on hearings, ask questions, meet with legislators, share her capstone project, and also advocate for HB 141.
5 . OOTA & OTPTAT Licensure Board Meetings
Additional experiences that supplemented this capstone project included active participation in Ohio Occupational Therapy Association Board Meetings and bi-weekly legislative monitoring calls.
In addition, the project also included participation in Ohio Occupational Therapy Physical Therapy and Athletic Training (OTPTAT) Licensure Board meetings with Cheryl Boop, OOTA's OTPTAT liaison. This direct engagement provided the project lead with valuable insights into the licensure board's regulatory processes that are guided by state laws. These included establishing entry requirements, implementing administrative rules for efficient regulation, addressing complaints, enforcing disciplinary actions for breaches of the code of ethics, and overseeing licensee competence through mandatory continuing education.
6. Legislative Priority List with Evidence-Based Implications to OT
The project lead created a legislative priority list that aligns with the initiatives of the Ohio Occupational Therapy Association (as of Spring 2024), crafting a visually appealing document. This deliverable includes evidence-based implications regarding the impacts of the OT field and its client populations. This document is made available to individuals interested in supporting the profession at the state level.
7. DEI Advocacy Action Guide Collaboration
Empowering Inclusive Practice in Ohio
This project lead collaborated with Kaitlyn Deere, OTDS from Cleveland State University, on creating an advocacy action guide addressing Diversity, Equity, and Inclusion (DEI) for OT professionals in Ohio. This action guide serves as a tool for OT professionals to become more inclusive practitioners, fostering diversity and equity within their practice and community. With insights from both the project lead and Kaitlyn, the guide provides practical strategies and current legislation to navigate complex issues related to DEI.
8. Legislation and Advocacy Courses
The project lead completed the "Federal Process and Advocacy" course offered by the American Association of Collegiate Registrars and Admissions Officers (AACRAO), which comprehensively addresses both federal and state-level content. Additionally, a webinar titled "New Year, New Rules: 2024 Federal Policy and Advocacy Updates" provided by the American Occupational Therapy Association (AOTA) was completed as a supplementary experience to tie legislative knowledge to occupational therapy.
Future Directions
Erika Eustaquio aims to continue to make impacts within the occupational therapy profession beyond the daily practice level while prioritizing the needs of diverse client populations. For further inquiries or collaboration opportunities, please contact Erika at erikaeustaquio@gmail.com.
References
American Occupational Therapy Association. (2022). Policies supporting OT's role in shaping contexts and environments. https://www.aota.org/advocacy/everyday-advocacy/ots-role-in-shaping-contexts-and-environments
American Occupational Therapy Association. (2023). What is occupational therapy? https://www.aota.org/about/what-is-ot
Ohio Legislature. (2024). Legislative process. https://www.legislature.ohio.gov/publications/the-legislative-process
Lencucha, R., & Shikako-Thomas, K. (2019). Examining the intersection of policy and occupational therapy: A scoping review. Canadian Journal of Occupational Therapy, 86(3), 185–195. https://doi.org/10.1177/0008417419833183