This time last year, the OT School House did not exist. It was still an idea brewing within conversations between Abby and I. We knew that we wanted to start a blog and we had an idea to start a podcast, but other than that, we had no idea how to get started.
We began to meet at Starbucks every Tuesday night and research how to build a website and what the cost would be as we knew we would not be making money off the blog anytime soon. We also looked into creating social media accounts which included taking pictures and videos we could share for the world to see. After all, what OT doesn't love to follow other OTs on Instagram and Facebook to see what free and inexpensive ideas they can use.
But before we started posting pictures onto social media, we knew we had to be careful about what we posted. Not only pictures but also the content we shared, whether it be our own, or another's popular post. The thing about having a website and media accounts that people follow closely is that you put yourself out on the line.
Just like almost every other OT out there, Abby and I are both nationally certified via NBCOT and licensed in the state of California. And as I am sure you are aware of, your state's practice act not only governs the skilled treatment you provide but also how you conduct yourself.
So naturally, as much as we wanted to build the OT School House, we also wanted to make sure that we were not putting our credentials at risk. So we made sure to look at the California practice act along with NBCOT, HIPAA, and FERPA regulations since we work in public schools.
Through that process, this is what we have found that we thought you may be interested in knowing.
NBCOT: Practice Standards
The NBCOT Practice Standards consists of 4 sections including 1) Practice Domains, 2) Code of Professional Conduct, 3) Supervision, and 4) Documentation.
We will dive into the Code of Conduct in just a second, but for school-based OTs I want to provide a quote from the standards here just in case you haven't revisited the NBCOT standards in awhile:
"The IDEA requires occupational therapists to:
1. Write a report of the evaluation the OT conducted;
2. Provide information and recommendations for students’
Individualized Education Program (IEP) plans;
3. Write service plans for students, considering: disability, medical
diagnosis, contraindications to therapy;
4. Help develop IEP goals and determine equipment and personnel/
assistance needed to meet therapy goals;
5. Prepare periodic status reports; and
6. Write a report when students discontinue therapy.
The law does not specify how long therapists must keep
documentation. The OTR or COTA should discuss the documentation
retention policy of their supervisor or employer."
This, as you can see, breaks down the required documentation for school-based OTs. It's amazing what you find when you are looking for something completely different. I underlined "Help develop IEP goals" because I think this proves that goals should be collaborative and not just "OT goals"
NBCOT: Code Of Conduct
NBCOT's code of conduct incorporates 9 principles that are completely understandable and justified. Principles such as not practicing while intoxicated and following state laws headline the code. Also included though is principle number 1 which states that we will provide accurate and timely information to NBCOT such as our certification registration every 3 years.
For the purpose of the OT School House, principle 8 was the one that popped out to me the most. Principle 8 states:
"Certificants shall not electronically post personal health information or anything, including photos, that may reveal a patient’s/client’s identity or personal or therapeutic relationship."
This, of course, was important because we knew we would be posting social media images. And this principle follows HIPAA guidelines in stating that we may not post identifying pictures. So next we looked at NBCOTs Practice Standards.
California Practice Act
State Occupational Therapy Practice Act
Now we couldn't go through every state's practice act for obvious reasons, but the California Practice Act is pretty thorough and is the one we must abide by. Although I won't go into detail because it is state specific, some key points shared in the practice act include:
- Ethical Guidelines
-Legal state definitions of "OT" "occupational therapist" "occupational therapy assistant" and more.
-Disciplinary actions should the board feel that ethical guidelines or other areas have been abused.
-Service delivery standards
Be sure to look up your state's practice act every now and then to update yourself on the happenings of OT in your state. In California, ours was amended just last month thanks to OTAC and several other key players.
HIPAA (Health Insurance Portability and Accountability Act of 1996)
Now, I'm sure just about every OT, if not every OT, has taken a workplace course on HIPAA. It tends to be one of those yearly online trainings that we all must take as a way to protect the school district, hospital, or wherever else from liability should protected information be released without consent.
In a nutshell, HIPAA exists to protect our clients' identity being connected with any one of the following related to that patient:
- a past, present or future physical or mental health or condition,
- the provision of health care to the individual, or
- the past, present, or future payment for the provision of health care to the individual,
This is directly related to the OT School House in the sense that you will not hear us on the podcast use a students name. If we use a name, you can rest assured that it is a pseudonym. It is too easy for someone listening to find out what schools I work at for me to even risk using a real name of a student. Likewise, you will not find any pictures on our website or social media pages that identify a student that we work with for the same reason.
And that brings us to...
FERPA (Family Educational Rights and Privacy Act)
Not all OTs are required to follow FERPA guidelines. This is specific to OTs and OTAs that work in public school systems and are required to protect student educational records. Where HIPAA prohibits OTs from sharing medical information on a student, FERPA prohibits the sharing of educational related material such as if a student is receiving special education services.
Some information, known as directory information (such as a student's name, grade, and phone number) can be shared for specified reasons such as use in a yearbook or when a district contracts with a photographer for class photos. With that said, at the individual level, we should not be sharing this information with just anyone.
Educational records can be maintained in any form, print, picture, audio, etc. So just about any form of documentation collected by an educational agency or representative of that agency that relates specifically to that child can be deemed as an educational record.
To me, FERPA is not as straightforward as HIPAA and I wish I better understood FERPA as it relates to special education. The way I try to follow FERPA as best I can is by following HIPAA guidelines for all educational information as I already do related to medical information.
Conclusions on our findings
As I said, the reason we set to look up all of this information is because we wanted to make sure we were not posting written, pictorial, or video information that would harm our students, you readers, or put ourselves at jeopardy. I forgot to mention earlier, but you should also check your employee handbook to see what your district policies are for posting pictures of work related material on your personal social media platforms.
This goes for any type of sharing or social media, be it at a conference, on Reddit, facebook pages or even "closed" groups, or Instagram (This is where I get the most worried by what I am seeing).
Through this process, we realized that if we followed HIPAA guidelines across the board in regards to sharing information, we (and you) should be okay. Of course, I am not a lawyer and I want to warn you that my limited research does not make me an expert in any of these guidelines. If you are worried that what you are posting or seeing on social media, you may want to reach out to your state's licensing board for more clarification.
So here is our list of 5 guidelines when it comes to posting on social media.
1. Do not use names! Neither student's name nor adult's names should be used to protect identity. You could get permission to use an adult's name, but I just try to stay clear of it.
2. No names, date of births, ID numbers, the name of a school, or any other identifiable info should be in your post.
3. No faces in pictures! We opt to go further and only take pictures of work samples.
4. Do not state what services a student may receive or for what condition.
5. Give credit when reposting. This one is not in the guidelines, but we hope it would be common sense. Whether sharing one of our photos or someone else's, please give them credit.