POST #5: JUNE 23, 2008

Q: One cannot stand in the way of evolution but the timing of its presentation in this time of recession and financial crises with an aging work force adds to stress and pressure. I noticed the presentation of electronic test taking and even that increased anxiety levels. (anonymous)

A: We realize that there are major changes in the industry with competitive bidding as well as other policy changes. The PSB is looking at our entire process to move forward in a logical, defensible direction. Those already certified will not be required to retake the test and will be transferred to the new certification at no cost.

The plans for computer-based testing are for the benefit of candidates also. Greater access to testing centers locally, availability of an exam on an as-needed basis, and results given at the end of the testing rather than a wait time of a few weeks are the advantages.

Q: Do not group the ATS and ATP into one category because our roles and educational background are not the same and that delineation was made for a reason. I do agree on the aspect of having specialty certifications as a way of showing that we are more knowledgeable in one or more areas. (anonymous)

A: We agree that the roles are different, and the educational background may be different, but there is a common defined scope of knowledge for both. Furthermore individuals change roles in the service delivery process throughout their careers. When certification makes the delineation between who does what, it is crossing the line into regulatory issues. The goal is to test competency in a knowledge base. The educational background, practice setting, employer requirements, funding source policy, and regulatory bodies will decide who will be paid for what service.

Q: My concern is that vendors will take on chairs that they cannot handle and confuse patients with their ATP certification. Patients may think they are specialists, when in fact they are not required to have the background that ATPs have to have to sit for the exam (anonymous).

A: The eligibility requirements between the current ATP and ATS differ in that a supplier may have a high school equivalency or higher, and any college degree is acceptable for either ATS or ATP given the right number of years of relevant work experience. The ATP that is a licensed therapist certainly has other qualifications and skills. We are not trying to equate an ATS to become what is currently thought of as an ATP. Perhaps this is also a good argument to call the certification something entirely different. What will decide roles and responsibilities is not the certification but rather the employer, funding sources, and regulatory bodies.

We have equal concern with anyone supplying AT equipment or services beyond their scope of competence. The RESNA Standards of Practice and Code of Ethics specifically outline the guidelines for ethical practice. Individual certified by RESNA agree to abide by these standards. The RESNA PSB has an established Complaints Review Committee to handle violations of these standards. It is the responsibility of all to report a known violation through the established Complaints Procedure. The PSB can not act on a breach of standards or ethical practice if no complaint is filed.

Q: I was pleased to see this effort and will support further credentialing into specialties (James Noland)

A: Thank you. As we move forward, we will continue to solicit input to guide the development of any advanced certifications or educational certificate programs. The development of future programs will be dictated by feasibility based on the level of interest, demand and financial resources.

Q: Does this mean RTSs not yet certified will have to take more than one exam? What type of "specialty certifications" do you envision?

And if the new baseline certification is called something other than ATS or ATP will RESNA work that out with Medicare since they require RTSs to be an ATS or ATP currently to provide equipment for Medicare? And will persons already certified ATS or ATP be grandfathered in with the new credential (anonymous)?

A: The RTS who is not yet certified would still take the one basic AT certification exam, whatever the new name. Right now, a seating and mobility specialty certification is planned to honor the commitment made many years ago to those wishing to further distinguish their AT specialty knowledge. Any future specialty certifications or educational certificate programs will be pursued to meet the need and demand. Alternate formats from a formal exam can be considered for these, as mentioned in the earlier post.

RESNA has already spoken with the DME MAC Medical directors regarding this proposed change, and they indicated that changing to a single certification would be in line with their intent also. RESNA will continue to maintain dialogue with CMS as well as many other stakeholders (Medicaid, state policy makers, etc.) to make sure any name changes are recognized and reflected in existing policy. Furthermore the PSB has engaged consultants to assist with the branding and promotion of the RESNA certifications. The goal is to increase the visibility and knowledge of the RESNA certification program and value of certification in the eyes of employers, funding sources, and the general public.

Q: I am wondering if this change will undermine the ATP that we already have. Specialty certifications often do. I am also not sure what weight this will really hold among the respective professions. I do have concerns with this (Gina Mirigliani, OTD, OTR/L, ATP).

A: Your ATP will still indicate that you have demonstrated competency in the specialty area of AT, but it will not imply what the certification enables you to do, as that is outside of the scope or intent of certification programs. Your other credentials (i.e. OT, PT, SLP, engineering, etc.) will indicate what you are able to do and who will pay you for your services. We have also contacted a number of stakeholders, such as CMS, NRRTS, AOTA, APTA, and ASHA to notify them of our proposed changes, to seek their input, and to involve them as we move forward with specialty certifications. We have had early indications of interest. We will continue the dialogues and work together where it is logical and where there is mutual interest.