KNR 273:Credentialing

Credentialing

Process where by the competency of a professional is ensured as a provider of quality services

Defines minimum competence to practice

What is the difference between credentialing and accreditation?

Credentialing vs. Accreditation

Credentialing Individual

NCB (CPRP) NCTRC (CTRS)

If in community/SRA may need both CTRS and CPRP

Accreditation Agency

COAPRT CAAHEP

Council on Accreditation of Allied Health Education Programs

CARTE (adopted in 2010)

Quality in TR

Credentialing

3 types: Registration Certification Licensure

Registration

The process by which qualified individuals are listed on an official roster maintained by a governmental or non-governmental agency Could be state, national or professional

organization Can look at education & professional experience

Certification

A governmental or non-governmental agency grants recognition to an individual who has met certain predetermined qualifications set by a credentialing agency or association Education & professional practice Greater weight than registration Restricts use of title, does not restrict practice

Title protection

Licensure

An agency of government grants permission to an individual to engage in a given occupation upon finding that applicant has attained the minimal degree of competency required to ensure that the public health, safety, and welfare will be reasonably well protected

Licensure

Strictest form of credentialing Requires state government to enact

legislation that defines the professional practice

Practice protection---illegal to practice if not licensed

Why is it important to have professional credentials?

Credentialing

Enables: the public (and gov't and 3rd party payers) to distinguish those who have attained some qualifying level of competency from those who have not

Provides: prestige, recognition and earning power

Credentialing Increases the quality and accountability of

services to the consumer Increases credibility, respect, and professionalism Increases the minimal qualifications of the

professional Increases the likelihood of providing uniform

services based on consumer need Encourages education and continuing education

Credentialing in TR

Registration 1956: Council for the Advancement of Hospital

Recreation created National Voluntary Registration Plan for Hospital Recreation Personnel

1969: National Therapeutic Recreation Society created the NTRS Voluntary Registration Plan

Credentialing in TR

Certification---Certified Therapeutic Recreation Specialist (CTRS) 1981: National Council for Therapeutic Recreation

Certification (NCTRC) is established by NRPA 1985: NCTRC is legally incorporated 1988: NCTRC conducts initial Job Analysis Study November 1990: 1st NCTRC exam administered 1994: CTRS credential trademark is registered 1997: 2nd Job Analysis Study completed November 2001: 1st computer based exam is offered 2007: 3rd Job Analysis Study completed

International Job Analysis of CTRS

International

CTRS working in 9 countries Braham Great Britain Bermuda Australia Asia

2009 Canadian Therapeutic Recreation Association = CTRS is preferred credential

Credentialing in TR

Licensure Few states have licensure for TR

Utah (1974) North Carolina (2005) New Hampshire (2006) Oklahoma (2009) Georgia in the past, sunset law

Periodically TR has drives toward licensure 7-8 states working on (including New York) 7-8 thinking about starting (including Illinois) CTRS exam = basis of licensure

Credentialing in TR

State Registration Texas California

NCTRC

National Council for Therapeutic Recreation Certification

Independent of NTRS and ATRA Why?

Independence provides for a better relationship with regulatory groups like JCAHO and CARF

Doesn’t appear to be self serving

NCTRC - Mission

To protect the consumer of therapeutic recreation services by promoting the provision of quality therapeutic recreation services by NCTRC certificants

NCTRC - Purpose To establish national (& international) evaluative

standards for the certification and recertification of individuals who attest to the competencies of the therapeutic recreation profession

To grant recognition to individuals who voluntarily apply and meet established standards for certification in therapeutic recreation; and

To monitor adherence to the standards by the certified therapeutic recreation personnel.

General Requirements for CTRS

Education Minimum: Bachelor-level degree

Experience Documented field placement or work experience

in TR Examination

Successful completion of NCTRC exam

2 Paths

Academic Major in TR or recreation with option in TR

Accredited university or college Not program

NCTRC Requirements (Effective 1/1/13)

NCTRC Requirements (Effective 1/1/13)

• 18 semester hours of supportive course work

• Courses outside of department

• Minimum of:• 3 in anatomy and physiology (1/2)• 3 in abnormal psychology• 3 in human growth & development across the lifespan• Remaining in content areas of social science and humanities

• Medical terminology

NCTRC Requirements (Effective 1/1/13)

Internship Minimum 14 consecutive weeks/560 hours

In TR services that use the TR process as defined by the current NCTRC Job Analysis

No less than 20 hours/week and no more than 45 hours/week Must be at 1 agency Keep log of hours & duties

Supervisor Agency supervisor must be CTRS for 1 year before supervise intern

ISU says must be in field 2 years plus 1 year as CTRS

University supervisor must be CTRS Online verification

Internship Cont.

Supervisor Must be full time at agency (32 hours/week) 50% of job duties must be in an established TR

program in an agency Must be 1 identified primary supervisor

Work consistently with student Coordinates all secondary supervision Oversees/signs off all evaluations and reports Ensures exposure to all Job Analysis Task Areas Signs field placement verification form

2 Paths

Equivalency – work experience Path A

Same courses plus 5 years full time in TR Path B

Same courses plus 1 year full time under supervision of CTRS

Internship Cont.

Job Analysis Basis of internship Basis of exam content Basis of continuing education Basis of ISU TR curriculum

MUST BE exposed to ALL of the job task areas in internship

2007 Job Tasks (Practical Experience/Basis of Internship)

Job Task = TR Process

Professional roles & responsibilities Assessment Planning interventions/programs Implementation Evaluate outcomes Documentation Work with treatment/service teams Organizing programs Managing TR services Public awareness/advocacy

2007 Job Tasks (Professional Knowledge Domains - Theoretical Knowledge)

Basis of TR exam

Foundational knowledge (33%)

Practice of TR/RT (47%)

Organization of TR/RT service (13%)

Advancement of the profession (7%)

Foundational Knowledge Examples Theories of play/rec/leisure Diversity factors Human growth/development Theories of human behavior Leisure thru lifespan Leisure lifestyle Health/human services Societal attitudes Legislation Guidelines & standards

Cognition & related impairments

Anatomy, physiology Senses & related impairments Psychology & related

impairments Normalization & inclusion Accessibility & barriers Group interaction/leadership Behavioral change

Practice of TR/RT Examples Concepts of TR/RT Models Practice settings Standards of practice Code of ethics Impact of impairment Selection of assessment Implementation of assessment Behavior observation Interview techniques Functional testing

TR/RT assessments Other sources of assessment

data Interpretation of assessment Documentation Activity analysis Leisure education Activity modifications Modalities/interventions Facilitation techniques

Organization of TR/RT Service Examples

Program design Goal/behavior

objectives Progress notes Evaluation Quality improvement

Plan of operation Personnel/volunteer

supervision Payment Facility/equipment

management Budgeting

Advancement of Profession Examples

History Accreditation

standards Professionalism Certification Advocacy Legislation

Standards Ethics Public

relations/marketing Professional

association Continuing education

Accommodations for Examination

When submit application, include a separate letter describing Candidate’s disability or special need Adaptations being requested Documentation from doctor that confirms disability and

prescribes appropriate accommodations (Disability Concerns)

If approved must contact Special Conditions Coordinator at the Prometric Candidate Services Contact Center at 1-800-967-1139 to schedule appointment for administration

Accommodations for Examination

Accommodations available are: Reader Marker/writer Sign language interpreter for instructions Separate room Double test time Extended time by 1.5

CTRS Examination Must meet all eligibility requirements Then pass a written, knowledge-based examination

Pass courses, qualify for test, pass test Do ASAP because qualification standards can change and

then would not be eligible to sit for examination Offered 3 times a year (5 day period)

February 1 for May July 1 for October October 1 for January

New: Can take during internship ($25) www.2test.com for locations

Prometric

CTRS Examination

Mastery testing Some receive more questions Starts with base test everyone takes

90 questions / 86 minutes Pass/fail/unclear Testlets

15 questions / 14 minutes Maximum of 6 testlets

Get preliminary score of if not pass feedback on weak areas

Last 3 years, 66-75% passed

CTRS Examination

Cost New application: $100 Exam registration fee: $300 Total: $400

If do early = $425

Certification good for 5 years Annual maintenance fee ($80)

CTRS

Can’t say certification eligible until receive notification from NCTRC

Can’t use CTRS until receive official letter from NCTRC of passing

How Prepare for Exam?

STUDY

STUDY

STUDY

How Prepare for Exam?

Print/review current standards Make sure all areas have been covered in internship Go over requirements with supervisor Complete practice application

Review texts & notes Practice tests

NCTRC 50 sample questions ~$25

Study guides (Stumbo & Folkerth) Study groups / sessions Flash cards (cost ~$50)

How maintain certification?

Annual Renewal Form Fee

Recertification to proved continuing professional competence Form Fee Documentation

Keep: Original documentation Conference schedule Hours NCTRC areas

Audit process

Recertification

Must earn 100 credits to renew certification after 5 years

Points can be earned Professional Experience (minimum of 480 hours over 5

years…could be volunteer) and Continuing Education (50 hours) or Reexamination (passing score on exam)

Recertification

Continuing education Conferences, workshops Publications Presentations (c/b online) Academic courses

(take/audit) Webinar/teleconference Thesis or dissertation Guest lecture NCTRC test writing

No more than 25 credits from publications/presentations

Continuing Education Points are measured according to the

equivalency of an educational contact hour (60 minutes)

1 contact hour = 0.1 CEU = 1 credit Content of the experience must be linked

with the knowledge areas of the NCTRC Job Analysis Study ** be careful because some things don’t count

How keep up with NCTRC changes?

NCTRC Newsletter NCTRC Web site Meetings at conferences Professional journals/literature

Specialty Certification (2010)

Physical Medicine/Rehabilitation Geriatrics Developmental Disabilities Behavioral Health Community Inclusion Services

Valid 5 years $100/$20 year

Specialty Certification Path A

CTRS active status 5 years FT experience in area (1,000 hours) 75 continuing education hours

Min of 3 professional certificate trainings Each training must be min. of 6 CE hours

2 professional references

Specialty Certification Path B

CTRS active status Graduate degree in TR/RT 9 graduate-level credit hours in specialty 1 year FT experience in area 2 professional references

Why don’t people seek out continuing education opportunities? Cost Work constraints Lack of benefits Family constraints Disengagement