Recreational Therapy Licensure in New JerseySherry Hurwitz, MA,

CTRS/LATRA/NCTRC Joint Task Force NJ

Representative

Kaylee McGuire, CTRS, CCLS

NJEPA-TRA Secretary & NJ Resident

Mary E. Maina, CTRS NJEPA-TRA NJ Member-at-Large, Legislative

Co-Chair

briley@nctrc.org

New Jersey/Eastern Pennsylvania Therapeutic Recreation Association

Fall 2013 Conference

Session Objectives• Understand the rationale for Recreational

Therapy Licensure in New Jersey• Understand the legislative process for

creating, introducing, and passing a licensure bill

• Understand how individuals apply for, receive & maintain licensure, and report violations

• Identify at least 3 ways to support the NJ Recreational Therapy Licensure Movement

Let’s take a walk down New Jersey’s

Recreational Therapy history,

shall we?

RT History in NJ• 1966: NTRS established, providing state chapters• 1981: NCTRC established a reliable, valid, and

standardized measurement of professional qualifications: the CTRS exam.

• 1984: ATRA established• 1988: NJEPA-TRA established as a local Chapter

of ATRA, Happy 25th Anniversary!!!• Discussion amongst key RT players regarding

licensure exploration but no formal committee nor record of exploration in NJEPA-TRA records

What is a Recreational

Therapy License, anyway?

Definitions• National Certification

• Certified Therapeutic Recreation Specialist (CTRS)• Regulated by NCTRC and recognized Nationally• Optional (Not Required to practice RT)• Good measure of clinical competency

• State Licensure• Regulated by your State Government • Not Optional (REQUIRED to practice RT)• Prevents harm to consumers: ensures that services are ONLY provided by professionals who demonstrate a standardized clinical competency

Definitions• Recreational Therapy:

• A treatment service designed to restore, remediate and rehabilitate a person’s level of functioning and independence in life activities, to promote health and wellness as well as reduce or eliminate the activity limitations and restrictions to participation in life situations caused by an illness or disabling condition.

- ATRA (July 2009)

• “Treatment Service” is further defined in the ATRA Standards of Practice as a structured, goal/outcome directed service. - ATRA SOP (Updated 2013)

• ATRA clearly states that Recreational Therapy is only provided by a Certified Therapeutic Recreation Specialist. (www.atra-online.com)

But, why is this Recreational

Therapy Licensure necessary?

Need for State Licensure

• According to the Bureau of Labor Statistics, there are 460 Recreational Therapists in New Jersey

• According to NCTRC, there are 323 CTRS’s in New Jersey

• Therefore, there are at least 137 unregulated and potentially unqualified practitioners working as Recreational Therapists in New Jersey

• Evidence of Abuse and Neglect gathered by the Joint Task Force of ATRA and NCTRC

Licensure of our NJ Peers

Practitioners with NJ Licenses• Occupational Therapists• Physical Therapists• Athletic Trainers• Massage/Bodywork Therapists

Other Related Practitioners • Art Therapists-their bill is being reviewed in

committee• Music Therapists do not have legislation pending• Dance/Movement Therapists are not pursuing

licensure • Activity Professionals are not pursuing licensure

How could a New Jersey

Recreational Therapy License

effect ME?

RT Licensure in 4 States

Licensure will Require 1) Recreational Therapists applying for Licensure are CTRS2) Maintain Licensure Dues, Standards, CEU’s, Ethics, etc.

RT Licensure in 4 States

• In Licensed states, if you practice Recreational Therapy you MUST apply for a license.

• Obtaining License: Submit an application to the state’s RT Advisory Council-Division of Consumer Affairs & pay an application fee.

• Maintain License: Maintain qualifications (CEU’s) and professional conduct as outlined in the rules of the law.

• Reporting Complaints/Violations: Reports are filed to the Advisory Council for investigation and possible legal repercussions (such as unlicensed practice, misconduct, incompetence, fraud, abuse, etc.)

Neighboring StatesNew York• Strong Licensure Committee made up of key state

players• Actively seeking Licensure for the past 7 years• Has a Licensure Bill actively going through legislationPennsylvania• Strong Licensure Committee made up of key state

players• Acquired a State Representative Sponsor, John Sabatina • Looking to compose a Licensure BillDelaware• Forming a Licensure Committee

NJ State Government

• 2 Houses in NJ: Senate & General Assembly• 40 Districts (Currently Democrats rule both Houses)

• Each District elects: • 1 Senator (4 yr term)-President of the Senate is leader• 2 General Assembly Members (2 yr term)-Speaker of the

Assembly

• 2-year Legislative Term • Unfinished business in year one moves to year 2• Unfinished business at end of year 2, expires

• Reference Committees: to review legislation, discuss merit, public comment at meetings

http://www.njleg.state.nj.us/legislativepub/our.asp

So how have we kick-started Recreational

Therapy Licensure in New Jersey?

Steps Towards Licensure

1. Form a NJ Licensure Committee2. Conduct a NJ Licensure Survey to gauge support and

interest of NJ Recreational Therapists3. Form alliances with Legislators to sponsor a Licensure

Bill4. Draft a Licensure Bill & associated Rules/Regulations5. Sponsors introduce the Licensure Bill to either House 6. Licensure Bill may be referred to a committee for further

review and editing7. Licensure Bill must pass a majority vote in both Houses8. NJ Governor has the final vote and may either

conditionally veto the act, veto absolutely, or sign and pass the act into law

http://www.njleg.state.nj.us/legislativepub/legprocess.asp

So Far in NJ…We are forming a NJ Licensure Committee

• NJEPA-TRA leading the efforts with their Legislative Committee members

• Key RT Players in New Jersey:• NJRPA Liaison for Recreational Therapy• Kean and Temple RT Professors and Students• Sherry Hurwitz volunteered as our NJ Liaison to the Joint Task

Force from NCTRC and ATRA• Looking for Seasoned and Motivated NJ RT

professionals from large NJ employers (Children’s Specialized Hospital, Genesis Healthcare, JFK, Kessler Rehabilitation, Voorhees Pediatric Facility, VA Hospitals, St. Barnabas, etc.)

So Far in NJ…We are Polling NJ Recreational Therapists• Survey began this fall (Still open till 10/31)• Sent out via Email Blast, Facebook, and NJEPA-TRA

newsletter• Over 120 respondents to date• Majority are supportive but not willing to volunteer• Many responses have common misconceptions

about Licensure

Latest Survey Results

• Are you currently a Certified Therapeutic Recreation Specialist (CTRS) & work in New Jersey?• YES, 81%• Not now but have in the past, 6.5%• No, 7.4%

• What best describes the RT setting you work in?• Long term care/skilled nursing facility/assisted

living/dementia care/residential care/personal care, 33.3%• PM&R, 17.6%• Psychiatric hospital/chemical dependency, 13.9%

Latest Survey Results

• Do you support RT Licensure in NJ?• Yes, 79.6%• No, 3.7%• Not sure, 16.7% (Needs education)

• I support the concept that only individuals who are Certified Therapeutic Recreation Specialists (CTRS) should be eligible for Recreational Therapy licensure:• YES, 97.2%• No, 2.8%

Latest Survey Results

• I am willing to help campaign/volunteer:• Yes, 30.6%• No, 69.4% (NEED TO EDUCATE & RECRUIT)

Summary:There is enough positive support for

starting the NJ Recreational Therapy Licensure process but we need volunteers to join the NJ Licensure Committee and to educate NJ Recreational Therapists regarding facts of licensure.

What else needs to happen for Recreational

Therapy Licensure in New Jersey?

Form Legislative Alliances

• Do you or anyone close to you have Political Connections?

• Does your facility have Political Connections or Influence?

• Who has supported our clientele in past issues?• Find out who represents you in the NJ Government

• Senators : 1 for each of the 40 Districts • Assembly Members: 2 for each of the 40 Districts (80)• http://www.njleg.state.nj.us/members/legsearch.asp • They are here to serve us, so we need to put them to work!

Drafting a Licensure Act

• Use of other State RT Laws • Review of other NJ Health Professional Licensing

laws(Scopes of practice may overlap among disciplines)

• Defines terms and general scope of practice• Rules and Regulations sets standards for:

• Education• Experience/training• Exam• Continuing education• Conduct• Recreational Therapy Advisory Council-Division of

Consumer Affairs• May contain rules regarding Assessment and

Documentation

Educate New Jersey RTs

• Joint Task Force Website coming soon!

• NJEPA-TRA to get the word out there:• Hold sessions at conferences• Provide Information on Website, Email Blasts,

Newsletters, Facebook, LinkedIn, etc.• Share your handout from today’s session!

• Tell a co-worker, friend, colleague, classmate, etc.!

Educate our NJ Peers

• Reached out to Debbie Hommel, NJ State Rep for NCCAP

• Reaching out to other Professional Colleagues (OT, PT, SLP, MT, Art, Massage, etc.)

• Collaborating with NJPRA through Dina Trunzo• Talk with your co-workers from other

disciplines and your supervisors to get the word out there and build alliances!

Improve your RT Practice

• Are your clients receiving quality services?• Make sure you are effectively providing RT

services• Use the APIE process• Track your outcomes• Clinical observation & appraisal• Review the Revised ATRA Standards of Practice

• Your QUALIFIED services provide direct appraisal of RECREATIONAL THERAPY so Share your Successes!

Common Questions• Is Licensure about getting reimbursement for

services?• No. Licensure is about protecting consumers. Licensure however may provide an avenue in which stakeholders may pay attention to licensed, qualified providers.

• Do professionals have to pay for their license?• Yes. There are fees associated with applying and maintaining your license that all licensed professionals are expected to pay.

Common Questions• Is licensure sought to increase respect towards

professionals?• No. Licensure is sought to protect consumers by mandating the use of qualified provider. Professional respect may be an indirect outcome of licensure due to licensed professionals providing quality services.

• Will I have to take an exam to become a Licensed Recreational Therapist in New Jersey?• Most RT Licensure laws require passing a competency exam; current RT Licensure laws accept the NCTRC exam.

Common Questions• Do Licensed Recreational Therapists have to

work a certain number of hours per week?• No. A license only qualifies you to practice

Recreational Therapy-it is a credential.

• Why do we need a License if we are a CTRS?• A CTRS is the benchmark credential in our

field, however there is no STATE LAW or REGULATION that requires a qualified professional to provide “Recreational Therapy”.

Common Questions• Is Licensure designed to protect my job, take jobs from

other fields, and increase jobs for other RT’s?• Absolutely not. Licensure is to protect the consumer. Recreational Therapy Licensure mandates that anyone providing “Recreational Therapy” is the most qualified provider of those services-they must meet the standards outlined in the law.

• If the RT Licensure Act is passed into law, will obtaining a license be optional if I work as a Recreational Therapist?• No. Anyone providing Recreational Therapy services are REQUIRED to hold a license if mandated by state law.

Common Questions• Are we only seeking licensure in New Jersey

because NCTRC and ATRA are forcing us to?• NCTRC and ATRA are not forcing any state to do anything. NCTRC and ATRA have created a joint task force to support any state that expresses an interest in pursuing licensure. Individual states must collaborate with each other to provide support/guidance and to insure reciprocity amongst laws and regulations.

Any More Questions?