OTS 46: School-Based Occupational Therapy in Rural America Feat. Billy Hatridge, OTR/L
- Jayson Davies
- Apr 5, 2020
- 49 min read
Updated: Jun 2
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Welcome to the show notes for Episode 46 of the OT Schoolhouse Podcast.
In this episode, Jayson hosts "The OT Dad", Billy Hatridge, to talk about what it is like to an education-based occupational therapist in the rural area of southwest Arkansas. Listen in as we share stories to help you not make the same mistakes we have.
This podcast does not qualify as a Professional Development Podcast. You can learn more about how to earn professional development credits through the OTSH Podcast for your OT/COTA renewal certification here!
Links to Show References:
Visit Billy's website TheOTDad.com to see what he is up to. Be sure to check out his videos where he provides some quick handwriting tips using the Handwriting Without Tears methods.
Learning Without Tears - Become a certified Handwriting Instructor through the Handwriting Without Tears program
Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs.
Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com
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Episode Transcript
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Amazing Narrator
Hello and welcome to the OT school house podcast, your source for school based occupational therapy, tips, interviews and professional development now to get the conversation started, here is your host. Jayson Davies class is officially in session.
Jayson Davies
Hey everyone, and welcome to episode 46 of the OT school house podcast. My name is Jayson Davies, and I am here to support you through everything that is going on, as much as I can. We're all working through this Coronavirus together, and we're going to get through this with teletherapy, with whatever we got to do right before we get started. I do want to say that I hope you, your family, your friends, everyone is safe. I hope you guys are healthy, and I hope everyone is surviving. All the time spent inside. I already binged watched Tiger King, of course, and watching Netflix on a pretty much nightly basis. It's my way to get out in a way other than walking my dog to the park every afternoon. So today we have on Billy Hatridge. He is an occupational therapist in Arkansas, so kind of in a more rural area, he was actually on the podcast in Episode 40 when we reviewed an article about hand strength and pencil grasp, as well as handwriting a little bit. And so he's actually coming back on to share a little more about what he does in Arkansas, in a rural area, how he manages his time, how he works with his assistants, how he completes evaluations, and then at the end, we're actually going to talk about how he's planning for distance learning. So stay tuned for that. It's going to be really good, but real quick, I want to give a quick shout out to purpose therapy box.com for sponsoring today's episode, they have some really cool shirts over there, such as their popular motivator shirt with a emphasized ot within the word motivator. So check it out at purpose therapy box.com use promo code ot schoolhouse all one word to get 10% off your T shirt. Order or use ot school house five to get $5 off their subscription box, which is brand new coming soon, and it's only available until April 13. So again, check that out at purpose therapy box.com and a special thank you to ally and Holly, the founders of purpose therapy box.com for being a sponsor of today's show. All right, let's jump into it again. Billy hat Ridge, we had such a good conversation right here, so you're not going to want to miss this really good stuff. So yeah, here he is, Billy hatridge, and I will catch you on the flip side. Hey Billy, welcome back to the OT school health podcast. How are you doing this morning? I'm doing great. Jayson, thanks for having me this morning. Yeah, no problem, man, it's great to have you back in episode 40. We had you on, and you and I discussed an article review. It was about handwriting and strength, right? Or no, that right?
Billy Hatridge
It was handwriting autism and hand strength versus, I think it was finger strength and kind of comparing the two. There we go. And so at that point, you gave us a little bit of a background about who you are and what you're doing. But how about you go ahead and refresh your memories about where you are and and what your ot practice looks like right now? Well, my name is Billy hattridge. I'm supervising occupational therapist for progressive therapy kids. We are a therapy company that contracts with school districts across the state of Arkansas, myself, and located in southwest Arkansas, and so we service the schools down in this area. Our team currently provides services, or my team personally, to nine school districts, and then my myself covers five of those districts, as far as supervising those therapy services. Wow. Okay, so you got a big area to cover that. I'm assuming it's geographically large. But you know one thing, the disclaimer on some of the school districts is some of them have five or six kids for the whole district. And so some of these districts aren't large districts, some are. But it's easy to have that amount of districts when you know you only have a few kids at some of those. So.
Jayson Davies
How much do you tie Do you spend? How much time do you spend driving just in a single day sometimes?
Billy Hatridge
in a single day? My longest travel is about four hours of driving on some of my days. Typically, I'm looking at about 15 hours a week on the road. Man, that's quite a bit of time to be listening to podcasts or thinking about other things or listening that. Podcast is pretty much it, especially up there the mountains of Arkansas. You don't have any phone signal. You can't make any kind of conference calls or anything, so you're just kind of along with the podcast and your thoughts. Just gotta make sure you download them before you lose service. There's no There's no streaming, for sure. That's funny.
Jayson Davies
Well, anyways, I'm really happy to have you back on here, because one of the things that I have really it's hit me a little bit, and I've learned the last few weeks, is that in California, things are so different. And as I've started this podcast, and I've started to. Reach out and talk to people that are outside of California, or even some people that I know that have moved out of California. They just tell me how different occupational therapy and the educational system and special education as a whole is. And so I'm excited to dive into that a little bit with you, but first we're gonna get into all that I want to last time you introduced yourself, you talked about how you were Handwriting Without Tears. Certified and certified autism specialist. Is that correct?
Billy Hatridge
Correct? Yes. So story on that autism is something that I've been really passionate about since I was about 13, and so within a year or two of me starting my career as an OT, I became a certified autism specialist through the International Board of continuing education standards. I think I left a word out there, but And so, and that's kind of an international certification, and it really focused on, you know, a lot of the ABA kind of therapies and a lot of the behavioral approaches to that, and my plan at the time was to become a specialist and just work with kids with autism in the schools. Right after I got that certification, our caseload, it just expanded, and we picked up more and more school districts, and I was kind of brought out of a specialized role into a supervising role, and so I wasn't able to utilize that as much on a daily basis. I was as I would have liked, but in the process of doing that, we got more and more handwriting referrals, more and more kids with handwriting issues, and so we had kids who were 504, they weren't receiving any special education services, but their handwriting was just so terrible that they were not able to perform well in school, so I switched gears and went towards the time it was Handwriting Without Tears. They hadn't made the switch to learning without tears yet, but went to all the classes. Had to drive all the way out to Dallas for those but and became certified with that, which actually proved to be a bigger benefit to me as a school based occupational therapist, since a lot of our schools look at us as the fine motor people.
Jayson Davies
Gotcha. Yeah, one of the my caseload right now is probably about 85 90% kids with autism and monseveer classrooms, and so I've been looking into some various just considering autism type of training and certification type of things. And I know there's so many out there. There's like, their own, there's colleges universities that will have, like, a one year track that you can do, and just like two or one or two classes a quarter, and it's just all focuses on autism. And then I saw the one that you talked about, and then I know there's also some of the teachers in my district that are autism certified, and it's like a very, very short, brief, like, online program. And so there's a bunch of them out there, but I just wanted to hear a little bit about what you how, how yours had been so interesting.
Billy Hatridge
All right, yeah, and I, B, C, C, E, S, E, S, I jumble it. And I'm sure there's somebody out there that's got it, and they're rolling their eyes, but they have several levels of the certification that I've got. And so they have, like, a autism certificate that is for like, OTs or paraprofessionals, and it's a lot quicker to pick up and get. And then they even have an advanced autism certified autism specialist, which is a, I think, 3842 hours of ABA training involved in that. And so it's a huge scale as far as all the different ones. And they have some mental health certification, some anxiety based ones. So they have a lot of really good options for people who want to be able to pick up these certifications at home or on their own time. It didn't require any kind of in person training for any of those certifications
Jayson Davies
All right and right now, with everyone sitting at home, you might have the time to do that. One last question before we move on, Handwriting Without Tears, certification, what did that look like? How many classes did that was that and what does that allow you to say or to do now that you are certified in handwriting.
Billy Hatridge
So the handwritten cut tiers, the way the certification worked when I got it. And I don't know if they changed it, since they switched over to the learning without tears, but you had to go to all of the in person workshops. So the pre K readiness workshop, the handwriting workshop, and then the handwriting evaluation workshop that covers their print tool. And then after you complete those required in person trainings, you have this packet that you do at home. And so you go through two example evaluations of kids handwriting. You write reports on those. You do an in person workshop with like a dozen people or so to kind of go over the handwriting factors curriculum. And then there's like 100 question tests that you take as a part of that to take on paper and send in. And so you do all that, and then you send all that in, and you wait, and you know, they'll give you that certification, which is technically what they call a level one certification, which I don't personally like, because they only have one level. They don't have a level two yet. And so sometimes, you know, so what's. Level two. Why do you only have level one? Well, that's the only level that they've got, but it allows you to advertise yourself as a handwriting specialist. It allows you to kind of advocate in the schools that you're not just an OT who works on handwriting. You are a on paper certified specialist. And I have found even in the school districts I've always worked in, that changed the way they listened to intervention ideas or adaptations you want to make in the classroom quite a bit when they know that you have that certification, and then allows you to to try to do a lot of people who have the certification do handwriting tutoring, or penmanship tutoring on the side, you know, just a cash kind of deal with parents who want to do that. So I've seen a lot of people who go full time into just internship tutoring in bigger cities and communities, and being that you're certified in Handwriting Without Tears, you can advertise that you are certified in that. And so I'm assuming that helps a little bit further. It does, yes, and I've actually been able to go into a lot of districts and work as kind of a liaison for handwriting thought tears. So they're adopting their curriculum the school wide. They're wanting to implement Handwriting Without Tears. They don't really want to send every teacher. They have to handwriting for tears workshops. So I get to kind of come in and go over the curriculum with the teachers and talk about the ins and outs of it and how it works in practice.
Jayson Davies
Cool. So for anyone out there interested in handwriting without tears or learning without tears, I think it's LW, tears.com. If I remember, right? So yeah, you can check that out. All right. So we're going to jump into some demographics background. You already kind of mentioned a little bit about your area, rural Arkansas, and four hours of driving. But how many schools specifically do you have? And you kind of started to talk about how some of them might be small, but go a little bit more into detail to what these schools look like.
Billy Hatridge
So we, like I said, as our team, which is myself, we have two other OTs, and then five OTs, and we cover nine school districts. And I think that has 17 different school buildings, as far as you count, up elementary schools, preschools, high schools, etc, and those are scattered across five counties that we serve some most actually this most of our schools. Our caseload is anywhere from five to 10 kids, so we kind of come in, we see them for a few hours, and then we we get out and go on to our next school district. We have a couple school districts that are much bigger we have two that make up probably just those two districts alone, 75% of our entire caseload, okay? And those are in bigger towns, you know. And I say bigger towns, we're talking about the population. About 6000 people is the biggest community that we serve. And at those we have a lot of kids, and we have a lot of kids from the both ends of that, that therapy spectrum that we serve really severe children to children who are just needing some of that fine motor help. And so typically, our com Our team works is our OTs are stationed at schools that are close to them. And so we look at the geographical need there for the school districts, and then the supervising OTs kind of cover whatever is closest to them travel wise, because a lot of these schools, you know, they're having to pay some travel time to get therapists out there. So we try to make that into account and make that they're getting therapists who are closer to home to help offset that cost.
Jayson Davies
Absolutely. And so how does travel impact your need for organization and planning? Quite a bit.
Billy Hatridge
Now, for a lot of my OTs on the team, or for almost all of our team, it's pretty straightforward. You know, they have a set schedule there at, you know, this elementary school Monday mornings from eight to 12, and they go to this elementary school that afternoon, and they kind of roll with that. And the kids have expected times that they go to therapy. The biggest factor is carrying our stuff with us. A few of our therapists have the benefit of being only at one school all week long, and so they have these wonderful little therapy rooms with, you know, board games and everything else. But a lot of us are working out of our cars, you know, and so whatever we can carry into the school with us is what we have with us to do therapy with. And so that's kind of one of the big factors there. For me. It's trying to make sure I'm hitting as many of the schools as I can in a given week, making sure that I'm sitting down with all of my OTs for an hour a week to kind of go over the caseload, go over what's happening, what kids are getting evaluated, and then talking with the special ed teachers and making those visits to make sure that our plan of care is still on track. And typically, my weights have a pretty set format, but with annual Well, we're in the middle of this COVID 19 lockdown, so I don't know what annual reviews are going to look like this year, but typically that's when everything gets hectic. So because we'll have a meeting, you know, in the morning over here, and then two counties over, two more meetings in the afternoon, and I've got to figure out whether I need to be at both, whether I need to send an OT a in call in, whether all they want is a piece of paper, and they're fine. So that gets kind of hectic, but typically, I'm able to get to all of my. Districts at least once a week, and so we work kind of on a weekly basis. Of our start reviews and stuff go.
Jayson Davies
Okay. So you started to talk a little bit about your annual reviews and whatnot. How does your How do the districts down there handle that? I've heard or I should? I'll just start by saying what we do. We have annual reviews throughout the entire year. A kid could have an annual review on the second day of school, or the second to last day of school, or anywhere in between. Is that similar for you? Or do they tend to group them all into a similar time frame? I'm
Billy Hatridge
going to be saying this a lot. I apologize, but it varies by our schools. Okay, that is probably one of the most frustrating things when you cover as many school districts as we do, because we have a few schools that pick up a child, they do an extension IEP to where the end of that the interview falls at the year, or they would all kind of sketch out to work that way. And then we have other districts, especially our smaller ones, who like what you say. It just happens throughout the year. So if the kid came in in December, the next December is when you do your annual review. And that that makes it a little more difficult for me to kind of plan our big district that I was talking about, the one that makes up easily half of our caseload. They do almost all of theirs in May. And so I know when those are expected. They know when to have me there. Those are the day come in and I sit in the conference room from eight to three, and we just do meeting after meeting after meeting. But some of our school districts that have these interviews throughout the year, February, November, whenever it might be, we often get forgotten as far as those supplemental therapy services, and they'll call me up say, Hey, I forgot we had this meeting the other day. We need, you know, a report or something to put in the file, because when they're only having one here, one there, it gets a lot easier to get about some of those other service providers when you're only seeing them an hour a week.
Jayson Davies
Yeah, definitely. All right, so on top of that, you kind of alluded to, you know, last minute getting notifications for IEPs and whatnot like that. I've been there, done that. How are you able to take advantage of technology to lighten your travel needs. Or are you?
Billy Hatridge
We are a little bit especially right now, trying to figure out how to best utilize teletherapy. A lot of it is just calling in to those conferences. And usually the way it'll work is if it's at a school that I'm not driving to, or the school says, Hey, we really don't need you to drive two hours up here for this 30 minute meeting. If we can schedule it when my ot a is there, that's preferable, because then we have a person from the team who's there in person and can kind of relay that information, and then I'll make sure that I'm available to call in, you know, if we need to make any changes to the plan of care. And if that's not possible, then I call in, or I FaceTime in, depending on signal. And that's something else that's fun working in rural Arkansas is I have schools that I just have zero signal on my phone the entire time I'm there. And my wife loves it when I'm just unavailable for eight hours at a time because I'm down in a valley without single but I mean, that's something else that we have to factor into is saying I can't call in. Call in because I don't have signal when I'm at this particular school. So it depends on what's happening at the conference. Obviously, you know, for making a big change, and I try to really push and be there in person, but if it's, you know, run of the mill, we're meeting, we're kind of talking about general progress. We're not really changing a whole lot, then typically, the schools are fine with just having one member of our therapy team with us, ot PT, speech, and then, you know, the paper report to go over.
Jayson Davies
Okay, so you might submit a paper report, but the PT might be the one to kind of provide that paper report to the team, or something like that.
Billy Hatridge
Yeah, yeah. And that's happened quite a bit, especially for OTs covering for PTS, because our caseload tends to be a lot larger, and so the PT might only be at that school one hour a week, and isn't there on Tuesdays when having the meeting. So they'll send the report. And then the OT team, we're the ones who kind of understand how the bot two reads on that manual, or whatever, more so than maybe this bed teacher. So we kind of go over that, just to kind of break it down for those who can't speak the PT language a little bit. But.
Jayson Davies
So if the parent has any, I'm sorry, if the parent has any concerns, and you can just text up or call up the PT real quick, or if need be, or something like
Billy Hatridge
that. Yeah. And anytime we have any kind of meetings, and we know about ahead of time, we try to make sure supervising therapist that we're available to call at any at the drop of a hat, you know. So if you need somebody to come in and go over something or change something, part of the plan of care that we're available via phone.
Jayson Davies
All right, all right. So I want to jump into a little bit about caseload. Then, you mentioned earlier that you thought you're going to have more of a heavy caseload with students with autism, but it's kind of shifted into Handwriting Without Tears or kids with handwriting needs. Should say, What does your current caseload look like? Then you said you already talked about having several schools, but in terms of demographics and kids in different types of classrooms, what does that look like?
Billy Hatridge
Well, I'll tell you what I tell all my OT. Students that come through, I have what I call my rule of thirds, and that's something that's kind of been true since day one. About a third of the kids on our caseload, whether our caseload as a whole or individual schools, have some kind of prolonged, lifelong disability, you know, autism, Down syndrome, cerebral palsy. These are the kids that are in those special ed classrooms, those the ones getting all of the therapy services. Another third of our kids typically have some kind of developmental delay, and so these are kids who might be getting a, you know, special education just for math or reading, and then getting just a little bit of OT, maybe pt. And then about a third of our kids really probably wouldn't need any kind of services if their home lives were better. And this is one of the, actually one that might be growing and be breaking out of that third rule that I have, but Arkansas right now is the number one state for meth use in the country, and it is methamphetamines Okay, and especially in some of our rural towns and communities up in the mountains, that that number might be even higher. It is projected by our Department of Health for the state that upwards of 75% of all students will have some contact with methamphetamine before they turn 18, which is a staggering number. And so one of the things that we're seeing is kids who don't really have any kind of intellectual disability or or traditional disability that we might serve, but home life might be very difficult. We have a family that's moved in two weeks ago. They fostered a bunch of children who are found in a meth lab. And, you know, we're basically left their own devices. And so we have kids who are six, seven, you know, at six month old level, developmentally, and really trying to figure out how to combat that and how to serve those children who kind of have a very broad range of symptoms and needs that we need to address. And so that that's been the big change that we're trying to make is in reaching those people or those clients in school. You know, we're taught about how to address cerebral palsy, we're taught about how to address autism. For the most part, a lot of those traditional disabilities or diagnosis we might work with, but we're having bigger and bigger and bigger caseload of children who are just coming from rough family lives and are dealing with PTSD and anxiety issues and mental health issues and really trying to figure out how we as a team can better serve that population. I think I got off on a tangent there. I don't know if.
Jayson Davies
That, no, that's completely fine. I was gonna, I was gonna go with it and asking, I mean, you're not the first person I've heard that from surprising. I don't know if that's the prize at all, but has there been Have you had a chance to reach out and take any training specific to this area yet? And if so, I need to jump off.
Billy Hatridge
Well, we actually kind of as a team, started talking about this about three weeks ago. He said, Hey, we really need it. We really need to make sure that we're addressing this properly. We need to really send out, make some people. We're really trying to have our team, even though one ot a might be just at one district, but we're trying to make everybody a little specialized in different areas, whether it's low vision, autism, sensory, etc, so that we as a team can have kind of shared knowledge. But I think three days after we made the decision that we needed to focus on methamphetamine use and how we're going to deal with that, the COVID 19 issue came up, and so we're kind of stopped all of that for right now, and restricting gears towards teletherapy. And we're all scrambling to try to figure out how to how to do that. But at the same point, this is a good thing, because for the first time, we might have the option opportunity to get into our children's homes, even though it's digitally, you know, this is the first time we're seeing our kids in the home environment, and so that opens up a huge opportunity for us as occupational therapists to really observe the kid in the natural home environment, which something that you don't get to do in the school setting, and have that direct contact with families, you know, sit there with mom and dad, there at the computer, and talk to them in a way that you would be able to in the public school system.
Jayson Davies
Absolutely. And I definitely want to jump into that. I just want to kind of lump it all into one thing. We'll get there, because I know many people that are out there listening. That's what they want to hear as well. And so we'll definitely get to that point, thinking about, you know, before everything jumped off the walls and got crazy, did you have the opportunity you kind of talked talk about yourself in the supervisory role a little bit. Do you have the ability at this point to provide direct treatment, or is everything just about supervision for you?
Billy Hatridge
Now, there's quite a bit of direct treatment in my week. On my Tuesdays, I'm at, we actually have two satellite clinics that offer outpatient pediatric services in our area. And so on Tuesdays, I'm at one of those satellite clinics all day. And so I get to work on birth to 21 is kind of our our age range there, and it's about 50% of them are homeschool kids that. Would look like a typical, you know, school based provider, but over half is usually early intervention. And so that's a full day of treatment there. And then, when I make my school visits, if it's possible, I try to get in a treatment session with the kids, or look back through and if the kids missed a few times for, you know, sickness, illness, or if their ot had a conference and couldn't make it. I tried to make those sessions up, but most of it is sitting there redoing the charts while I observe the therapist doing or my OTs doing the treatment. But I would say, any given week I might get 12 to 15 hours of treatment.
Jayson Davies
Okay, that's still a good amount to just satisfy your needs. Probably you're not just running around doing evaluations the entire time.
Billy Hatridge
Yeah, it is nice. Every once in a while I'll have to cover for an OT a who's out for, you know, whatever reason, and it's nice to turn off the supervisor brain for a minute and just get back into the treatment and kind of be reminded about why I got into this in the first place.
Jayson Davies
Yeah, no, no joke. I mean, I think it was on the last podcast that I did with Kate and Mary, and they're talking about how the occupational therapy assistants they get to have, they get the fun job. They get to work with kids all week long. And we have to do the we're the ones that drive around and do evaluation and go to the IEPs and have to do those parts.
Billy Hatridge
But that's the conversation I have with my parents quite a bit. You know, in the meetings, and I'll ask why I'm not the one providing therapy services, why it's, you know, Miss Brittany or miss Allie or whoever. And I explained to them like you want your the OTs treating your kid because they're the best at treatment, because that's all they do. And I'm a little jealous of how creative they get with their interventions and how many wonderful crafts and activities, because I'm usually doing more research on the diagnosis and the plan of cares and figuring out, you know, effect, evidence based practice. And they get to really have fun with those treatment things and look up stuff on Pinterest, and they just blow my mind. So my OTs about how creative they get with that stuff.
Jayson Davies
Yeah, no joke, there's a lot of good ones out there. All right. Well, we'll go, we'll continue on the OT a route. Actually, what does a case load look like for them?
Billy Hatridge
Then my OTs typically have anywhere from 20 to 30 kids on their caseload, and other than one or two, most of them are within a single district. And we've worked really hard over the last eight years to get to that point, because, like I said, when we have nine districts, and every district does it differently as far as how they do inter reviews, how they do billing, how they want to do documentation, it gets really hard to keep up with all of that, and so we really kind of prioritize having our OTs at one single district. It just really helps make sure things are it's easier for them to kind of understand the rules or the guidelines. So typically, our services are almost always individual, individual, pull out sessions. We've been really having a push this year for push in services. Our schools have kind of mentioned that some of the kids are missing more class time than they wouldn't like. And so we responded with, well, we can do push in. We can absolutely come into the classroom and work with them, and then the teacher is like, well, hang on, you know, if they need to get pulled out, they can. And so we've kind of been playing with that a little bit back and forth with the schools and figuring out, you know, what's appropriate for each kid. Not every kid needs to get push in services. Some of them really need that pulled out one on one time. It can't be a one size fits all, you know. So we're looking for system for therapy services and so, and as far as So, usually, my OTs, their work week is treatment. You know, they come to work and they just pull kid after kid after kid after kid and that they kind of treat all day. My more seasoned OTs are really good about consultation, or consultation and working with classroom teachers. And there are some that have been doing this longer than I have, that, you know, absolutely are great about taking a lead and saying, Hey, this teacher has some concerns about some other kids in the classroom. They have the knowledge to kind of help provide training, or, you know, any kind of accommodations for those children, and then if we need more, you know, then we get the referral for an OT evaluation, and I come in and kind of work with that kid. But a lot of times it's more of a classroom as a whole. It's what we see from a lot of teachers, is saying we have all these kids who can't write, all these kids who can't cut and so our OTs are great about stepping in and helping there.
Jayson Davies
That's great. Yeah, we actually, recently, Episode 42 was all about RTI, and that's kind of that process of teaching the teachers, using that knowledge translation to let them help. Because, I mean, let's be honest, there's what a school district population of OTs, if you want to call it that, or how many OTs they employ, is very, very little in comparison to how many teachers and paraprofessionals and and just other professionals, and we just can't better ourselves. Help that then to work with every single student on campus, obviously. And so that knowledge translation and helping the teachers so that they can help not only the kids that they have in their classroom now, but the kids that they have in their classroom next year and the year after that, and be able to just support all those students. It really helped. Yeah. Oh, absolutely, yeah. What about you? Are you able to get in and do like in services for teachers, or is it more kind of on that individual teacher saying they're having concerns and so you help that one teacher.
Billy Hatridge
I'll tell you. And this is something I encourage all school based OTs really, who have the opportunity to sit in the teacher's lunch and eat lunch my first several months of this job, I would be sitting over there in the therapy building or closet or whatever they happen to have us, you know, chowing down real quick and trying to get to my next one. But I found that when you go and you join in with the teachers, and you sit there and you start talking, they bring up these questions that they wouldn't bring up in a more formal environment, and you can really jump in there. And I've had absolutely most of my quote, unquote teacher trainings happen over lunch in the teachers lounge, as they ask about, you know, handwriting interventions and things I've had the opportunity at school district across the state, actually, as far away on the other side of the state as possible, contacted me last summer, and I got to go up there and do a handwriting workshop for their entire Co Op. And that was a really great opportunity to kind of get outside of my own school. And I've tried to push it a little bit on my school district that I served, saying that, hey, I can do this. I can do an in service for you guys. But they kind of look at it and say, hey, well, what about you're already here. You're already working with our teachers. You know, they can contact you at any point during the school year. So that's kind of the way it's been working. It's just the teachers know who I am. They know where I'm at, so when they have questions, they reach out to me. Yeah, and how long have you been in the schools that you're currently with? This will be the end of my seventh year. So this is my seventh school year.
Jayson Davies
So you've had some time to build some rapport, meet the teachers and see some new teachers come in and really get them to know who you are.
Billy Hatridge
Yes, yeah. And that's, I don't know if you this is the same way in California, but it's a really high turnover in special ed here in Arkansas. Yeah, I found and so a lot of times the kids might be on their third or fourth Special Ed teacher, and I'm still their OT, and so that really or they're still the same ot A and that makes us really good advocates for our students as well, because we know these kids. We've been with these I feel old because I have a kid who's getting ready to go into high school that was like in kindergarten when I first started seeing and I'm just not ready for that, but, but, yeah, no, it's great because we're with Sam. We're one of the few providers, educators, adults that these kids have consistency with over the years, and so that makes us really strong advocates when they switch schools and they go to upper elementary or middle school or high school.
Jayson Davies
Alright, sorry, I just got an idea while you're talking, but I want to first of all commend you on your your little tip about having lunch with the teachers, because that's a great tip, and that's one that I'm actually going to challenge my to challenge myself to do, because I am, I tend to be that, that ot that kind of hides in my room during lunch time, because, to be honest, part of the time is because I'm writing a report. And so I can kind of justify it that way, but I do see the benefits and what you're talking about having lunch with the teachers. And so I just want to, want to just go back to that in a second and say, Yeah, I do highly suggest that too, and I'm going to try and get better at that myself.
Billy Hatridge
And I'll build off that just for a moment, because it is a soapbox of mine, because a lot of our schools that we've picked up over the years, their prior service providers have been they get in, they sign real quick in the office, they pull the kids out, and then they leave, and they go On to the next school, and the principal never sees them. The superintendent never sees them. A lot of the general ed teachers never see them, and they don't know who they are. They don't know their names. They know kind of their face. But that might be it, and that's a really bad way to advocate for the profession, whether you're an OT PT, speech, anything, because we really need to be taking the time, even if we're not getting paid for that time, which a lot of OTs are paid by the treatment hour. It's still really important that you have those conversations, that you talk with the principal. Hey, how are things going? You know, kindergarten? Is there any issues? And allow yourself to know that you're not just a treater, that you can educate the teachers, you can educate the administrators, and you can't do that when we're just getting there, treating and leaving, and so communicating clearly with the team is important.
Jayson Davies
Yeah, absolutely. And I do often stay at IEPs for longer than I think some service providers do, because, I mean, like you're talking about, we don't get to see what's going on in the home, and a lot of times that IEP is the only communication that we get with a parent and sometimes also with the teachers who are busy, and likewise, the administrators that you're just talking about. I mean, you have that team in there, and you're really able to build rapport with everyone in those meetings. So I try to stay in IEPs as much as I can, especially if it's after school or before school. So yeah, all right, so we'll jump into supervision of COVID Just a little bit. What does that look like for you? I think you mentioned earlier, trying to spend about an hour with your CODAs a week, or maybe as a month, I can't remember.
Billy Hatridge
So with my OTs, that hour a week is face to face, sitting down with them and talking. About the caseload, I tend to spend an entire day with each ot a okay? And so try to find where they are, what schools are at, and kind of follow them along throughout their day, if that's possible. You know, there's always meetings happening somewhere. There's always more kids to be evaluated. But that tends to be my model, one hour of sitting down and kind of going through the caseload, and then quite a bit of sitting back with the charts in hand, kind of reviewing those while they treat and just kind of observing and answering any questions they might have during that time. And so typically, we have a pretty consistent supervision. Sometimes it strays a little bit, but for the most part, I see all the OTs every week, and we kind of go over the caseload and go over any kids that need to be evaluated, re evaluated, etc.
Jayson Davies
Gotcha. And in Arkansas, is there a limit on how many OTs you're allowed to supervise, or?
Billy Hatridge
According to the Arkansas State Medical Board, and they might have changed the last couple years, but the answer that I got several years ago was no that as long as you're able to keep up the requirements of the supervision, but Arkansas Medicaid, I think, caps out at five, four or five and so. And I'm not really sure how that works. If some schools build Medicaid and some schools don't, you know what that count works, but that, yeah, I'm supervising four right now. Okay, when you're under and I have had five at one time, but two of those for part time that are only working 1015, hours a week for us, and so that still kind of made one collective full time ot a but yeah, that's four or five tends to be kind of the max as far as Arkansas goes, especially when you're looking for Medicaid.
Jayson Davies
Gotcha so. So it sounded like you're kind of in the room with them. They might be treating a little a little bit while you're reviewing some files, and then you're able to spend some time with them, like after the school day ends, or something, spend some time going over those files with them, or any type of treatment plans.
Billy Hatridge
Yes, and that typically happens, you know, lunch breaks, especially some of our smaller districts. You know, we've got some schools where all of our kids are at either lunch or racist at the same time, yeah, because there's only two or three classrooms per grade, and so that's a good time to sit down and kind of go through that, or just go through that while they're working with the kid, depending on, you know, the level that kids able to perform.
Jayson Davies
So all right, and so I want to ask you a quick question, what's your process look like? About informing an OT a after you just had a meeting, so you just had an IEP for a student. What's your process for letting the OTA know what was discussed in that meeting or what they need to work on now that that meeting occurred.
Billy Hatridge
If I'm going to see them face to face before their treatment sessions begin, that tends to be when I do it, when we have that sit down meeting and say, Okay, here's a new kid. This is kind of what the deal is. A lot of times, my ot knows who that kid is long before I do, because it seemed that kid in the classroom, the teachers have brought up concerns long before we get the referral. And so by the time we actually have that placement conference, it's more like, Okay, we're good to go. You know, the teachers already kind of expressed some concerns to you as the OTA who's coming into the classroom, but if not, if you know they have to see them before I see them in person. The next time it's a phone call, usually of, you know, walk in through it. This is where they are. This is whose class they're in. These are some of the concerns. And then, you know, we'll send them the the daily documentation, the evaluation and stuff via email or whatever that system is, so.
Jayson Davies
Great. And so what about when you're planning for meetings? Like you said, most of your kids are being seen by a coda or an OT a so when you're about to go to an IEP for a student, do you make it a point to see that student before going to that meeting? Or do you heavily rely on the information from the OTA?
Billy Hatridge
I try really hard to at least, you know, see that kid face to face, come into the classroom say, hey, you know, I'm just really, I'm the OT, talk with the teacher, their general ed teacher and the special ed teacher both, just to get an idea as to is this a sensory issue we're dealing with, fine motor issue we're dealing with, what's the biggest concerns that you have as educators for this child? And then kind of relay that information on to my ot a sometimes that doesn't happen. Sometimes we get a kid that moves in from another district, they have ot on their IEP. They're good to go. We're having this meeting in two days. I'm not going to be anywhere near that district, and so we go in a little blind. But my OTs are amazing, and they're really great about kind of bracing for that and being able to jump in and then give me updates when I get there.
Jayson Davies
Yeah, cool. All right. So that kind of covers the supervision aspect, I think. Unless there's any part of it that that you think I missed about supervision, does that sound like we hit it most of the points, yeah, I think so. All right. The next part I wanted to jump into assessments. What, when do you assess? What do these look like? I guess. Let's talk about like you started to say, teachers will ask you for an initial assessment, right? So what does an initial assessment look like for you?
Billy Hatridge
Well, typically, well, there's kind of two models, two ways to go about this. The first is. Are more severe kids who come in, they're in the self contained or the full time special ed classroom, you know, they have that pronounced autism, cerebral palsy, downs, and it's kind of a, you kind of, know, going into this kid is a kid that's going to need ot services, and that evaluation looks a lot different if I have a kid who's kind of on the fence and they're saying, I think he might need ot he might not. I'm not real sure. The first thing I try to do is get collection of their classwork, because that's the biggest indicator of that kind of motor delay, yeah. And then I go through that, I talk with the teacher and see kind of what the issue is. Is it their written performance? Is it an attention issue? And then, you know, we get that consent to a test, and then I'll pull the kid out for about an hour, and I'll go through that formal evaluation process.
Jayson Davies
Okay? And then for your kids in the more mild to moderate classes, are you doing a full blown assessment for them, or is it more very, I guess, functional based.
Billy Hatridge
It's typically a full blown assessment for everybody. Now, some of our more are more profound kid OTs who can't participate in a formal standardized assessment. You know, you kind of write that up depending on what level of therapy or what level of participation they can do, and that varies case by case, obviously, but yeah, no, all of our kids go through a formal evaluation process. I'll pull them out of the classroom, we'll sit down, and we will at least attempt some of those standardized of those standardized testing that we do, even if I know that they might not be able to, I still try to get something on paper that I can put in their in their report, even if it's a scribble across the green VMI and that's all they're really giving me. That's still something that I can have to refer back to in years later. So.
Jayson Davies
Absolutely, do you have a few set assessments that you tend to use?
Billy Hatridge
Our go to? And I know it sounds old and traditional, but we still use the bot two and the VMI kind of as our go to. They're tried and true, and our company and our schools both are happy with them. That being said, the sensory processing measure, the sensory profile or two that we have in our toolkit. We use the real which is the role evaluation of activities of life. And it is a life skills questionnaire that can get filled out by the teacher or by the parent, and that goes through all of those ADLs. It goes through toileting, hygiene, money management, all those things. And so when our kids get ready for high school, we switch gears and work on life skills, and that's a really good questionnaire to give us a lot of information about what the plan of care needs to look like. And then the goal.
Jayson Davies
I don't know what it stands for either. I know of it, but I don't. I can't stand for either.
Billy Hatridge
But it's a fun one too, to kind of go through. But typically the issue I'm having the goal right now is that by the time they hit high school, when they get referred to OT they're usually pretty profound or pretty delayed, and the goal tends to give us first percentiles on almost every kid we test, because by the time they get referred to us at that age, you know, that's what you're seeing. But those and then we have the Peabody. We have the day see so our little ones.
Jayson Davies
Okay, and so do you feel like being at so many schools plays a role in what your evaluations look like? Or do you feel like even if you're at one school, your evaluations will look just the same?
Billy Hatridge
If I was trying to think if I wasn't a supervisor and I had just my own case treatment caseload, my evaluations would probably look a little different. If I had the same 30 kids, and those are the only 30 kids I was seeing, I could probably have a better idea as to what specific assessments each child needed, but that being said, I'd be worth them every single week, every single session, and so the evaluation isn't telling me as much as they do the way I do it right now. Because aside from what my OT is telling me, what I'm reading in the charts, the evaluation is one of the biggest data collection moments for us as a team. So, you know, it's one of those things. It's hard to say what it would do if things were differently, especially when it comes to the cost and figuring out, you know what, what's efficient, and not really having opportunity to try a lot of evaluations before we buy them. It's a little difficult too, but, you know, we're getting there. So.
Jayson Davies
Yeah, I just think that it absolutely plays a role. I mean, you can't take out that time and the environment and what is available to you, it plays a role in what your evaluation will ultimately look like. And so thought it might be a interesting to hear your point on it. So yeah, thank you. All right, I had one other question. I don't know this is going to be a fun one. Have you ever shown up to a school to see a kid, maybe for it's an evaluation or direct treatment, and it was like, the only kid that you needed to see at that school, and they weren't there.
Billy Hatridge
Yeah, yeah. All the time, all the time we have, okay, so the farthest school from my house is two hours away, and that's two hours of driving 60 miles an hour down, you know, state highway. And. And there's two kids there, and there's just two kids there. And so when we leave our school, we call up and say, Hey, are they there, you know, before we drive all the way out there, but usually we're 30 minutes to an hour closer. I mean, I'm not driving straight from my house to this school. Yeah, you hit another school on the way there. But I tell you, it seems like all the time, by the time I get over that they checked out. So and so has gone home, so and so sick, you know, and so that that's a little difficult to deal with, especially when you're kind of coming up on a timeline, and you're only there once a week, and they're sick, and then the next time you come there, oh, speech has them. And then, you know, okay, I've only got so many windows here to get this evaluation in, and that's, that's one of the big issues in dealing with is when the kids are out quite a bit, especially when it's flu season. I don't know how it is in California, but Arkansas, we've had school closings for the flu. We've had several districts close for an entire week because the flu just got that bad. And we've had that because.
Jayson Davies
Not because of Coronavirus, just because of the flu, the flu.
Billy Hatridge
For the last three years, we've had at least two or three districts every flu season have to close because the flu count just got that high. Wow. And so this whole COVID 19 issue, you know, we've braced that a little bit. We've had some school closings in the past for it, but, but, yeah, it's just, you know, that's been the biggest issue. It's just meeting those timelines on a kid who's not there or is unavailable quite a bit.
Jayson Davies
All right, you guys have actually had a little bit of experience with the school closure thing, then, yeah, this is like a brand new thing for us. We're, like, losing our minds over here.
Billy Hatridge
Well, it's a little different though, because, you know, in the past, they say, Hey, we're closing for five days. We're going to meet back. You know how long it's going to you know how long it's going to be, and those have been solid school closures. They didn't do AMI days, they just closed the week. So this is, this is new for us as well.
Jayson Davies
Gotcha Okay, so we're going to come back to that. I'm going to remember that phrase you used, ami. I just want to ask you two questions about organization, and then we will get into some Coronavirus stuff. How do you remain organized when you have so many kids, schools and even therapy assistants to keep track of what what tips or what tools do you use?
Billy Hatridge
My biggest tool for organization is my OTs. And I know that might be like a cop out, but when my OTs are organized, and I show up for those face to face meetings, and they have their list of like, okay, here's the kid that need to get evaluated, here's the kids that are coming up for reevaluation, it makes my job so much easier. And when it's set up like that, I'm able to turn off my mind for all my other schools and say, Okay, I'm here at Mena. I'm only thinking about MENA today, and I'm gonna barrel through this list of stuff that you've got. And then when I'm at, you know, cost ot river, or whatever my other districts are, then I can kind of focus in on that. I have, you know, my trunk of I have a company car, which helps tremendously, because I'm not in and out of my personal car and unloading everything, so I run for groceries. But you know, I've got, I've got a lot of files in there. I've got a lot of handouts in there. I have a tackle box that I use for my therapy materials, and so it's just a tackle box about from Walmart. It's got little individual compartments and boxes that you can put in there. And I've got a box for the bot, so all the little manipulatives of the bot are in one of these little tackle boxes that I just slide into my big kit. And that works really well. We use Slack as our communication platform for our team. We don't share any patient information across it, you know, for the HIPAA reasons, but that's been the biggest thing. Hey, you've got a meeting at so and so. You know, here's a couple of initials. I know who those those kids are at that district. We have channels for every school district, and that keeps us really on top of things, being able to communicate via that system versus just texting each other. And then we have an ongoing record just in Slack. When we make those phone calls through slack, when we make our messages through slack, we can keep track of when we had those conversations for the supervising requirements with the OTA logs.
Jayson Davies
Gotcha All right. Well, that actually answers my next question was, how do you use technology to just basically for scheduling and to help your organization? But it sounds like Slack is a tool that you guys use as far as technology goes.
Billy Hatridge
It is. And, you know, speaking of technology, several years ago, I had this epiphany that I've got this almost $1,000 smartphone, I need to start using it. And so I made the decision, like, I'm going to start using Google Calendar, and I'm going to be a power user of this, of this phone, and I'm just going to go all in, and this doesn't make sense for me to carry this all day and not use it. And that lasted a few months, and I'm back to pen and paper. That's when I've got my paper notebook that I write my notes down in. It's accessible all the time. I don't have to wait till I have signal getting back up the mountain. But yeah, that's as far as technology and scheduling stuff. I'm still pencil paper on a lot of my stuff, a lot of my note keeping. We're still paper documentation for all of our daily notes. We still do that in paper, and our schools have mentioned trying to get us on some kind of digital platform, but I've seen our special ed teachers struggle with the computer systems for their IEPs paper notes there. I mean, even if there's no power in the school, you can still write your note. And so it's true.
Jayson Davies
All right, yeah, man, it's just crazy how things are. So. Friends. I mean, so different in our schools, our IEPs, many of our schools are projecting the IEP from the computer on the wall for the parent to see as we are writing it in. We don't pay paper IEPs don't exist there anymore, really. I mean, until they're printed out, the final copy is given to the parent. But, yeah, wow. All right.
Billy Hatridge
Well, we'll have, we'll have a paper copy at the meeting, and it says draft, you know, it's got the big watermark, draft, yeah, the parent through it, make those, those changes, and then everything gets compiled back up, and then back up to the parent within a day or two. Okay, yeah, that's not too far off then. All right, cool.
Jayson Davies
All right, let's dive into Coronavirus a little bit. I think this is something that you and I What's today's date? Today is March, 22 I believe 23rd 23rd it's I lose track because we're not in school anymore. It's a Monday. We in California have been quarantined for five days now, or one week, and this is We're in our second week of quarantine. Where are your schools at right now?
Billy Hatridge
So we're not we haven't had any official like lockdown measures across the state yet. It's still kind of social distancing. You know, you're still able to go out under, I don't know about California, but we haven't had any kind of curfew or mandated stay at home. Places stay at home, measures put in place. On the look at my calendar, we're on spring this is the first day of spring break. Technically, I'm losing track of my days. Also, last week, we were out all week, whatever date that was. You know, Arkansas schools closed on the can't do the math. I'm trying to pull up my calendar here. Look whatever date, the 14th. The 14th, it was a Saturday when ASA Hutchinson, our governor, came out and said, Hey, we need to close schools. Okay. And so the plan was at the time, we're going to be closed for two weeks, one week of school, spring break, come back on 31st Yeah. Asa Hutchinson made an announcement this past weekend. We're out to the 17th Okay, and so a lot of our schools are going to keep up with those AMI days and kind of move forward with that. And then some point, the next two weeks, we'll probably have an update, but until then, that's the plan.
Jayson Davies
All right. Yeah, we're that was a similar progression for us, except now we are out officially until May 1 gotcha, that's where we're at right now with talks that people seem to be under. The idea that it will go until the end of May even but we're not there yet, as far as officially on paper, AMI. What does AMI stand for? And what does that look like?
Billy Hatridge
So AMI is alternative method of instruction, and in the past, what a lot of our schools have done, and of course, nobody was ready for this, not to this scale, but what they've done is they've had, you know, big manila envelopes that's got printed classwork for the kids to do at home. And it wasn't an E school, it wasn't a digital learning it was just, here's this little handy packet of homework. Take it home and do it when we have a snow day or whatever, or flu days. I was talking about earlier with this, one of the issues that the schools are trying to figure out is a lot of our kids don't have access to the internet at home, or it's not good internet at home. Even me sitting here at my house, you know, we had trouble getting the Internet to work just for this call. And so the question is, if you've got kids who can't participate in learning, is it fair to your school population if only half of your kids can get online and do those, those e school things? And so our schools are really trying to figure out whether it's paper instruction, whether it's online, our company is trying to figure out the tele therapy part of it and how that will work and so, but that's what AMI is, typically, is when they call them AMI packet or an AMA diet, any of my day, it's those, those paper handouts and homework. Okay, it's in home.
Jayson Davies
So I think it was before we jumped on to this call you talked about your company with speech therapy has done a little bit of teletherapy, and you guys have a platform potentially. Can you tell us a little bit about where you're at in that whole process?
Billy Hatridge
Yes, so you know, we had an issue for several years now of providing speech therapy to some of our schools. That's one of the most underserved disciplines that we have at some of our area. And so I think about three years ago, progressive therapy kids had started providing speech therapy via telehealth or teletherapy. And so they usually have a pair of professional at the school with a laptop. They're bringing the kids, they sit them down, and then the kid interacts with that speech therapist over the computer. So we've been doing that for three years now, and so we've kind of been in the telehealth game a little bit, doing that, trying to figure out how to scale everything up, trying to figure out how OT and PT is going to work over the computer. You know, speech might be a little easier, but that's something that we're all kind of struggling with. I. Um, you know, the telemedicine as a whole has changed a lot over the last weekend or two, as people kind of try to loosen some of the restrictions and try to change the way it's getting paid for to help with that. And I think I'm speaking for everybody, but we're kind of just rolling with the punches right now and trying to figure out how that's going to look. You know, are we going to use Zoom. Are we going to use FaceTime? Are we going to use a more professional platform for this? Are we going to use telehealth? I think which is what we were using for Thera platform was what we were using for the speech therapy services. Say that again, I think it's Thera platform is the name of the what we're using for speech okay, I don't know if that would work for a company wide 17 plus therapist, but it also depends on the school district and what the school district wants to do, whether they want to go that route or not. You know, one of the things that we're hearing here in the state of Arkansas is the possibility of closing and then resuming school in the summer and going through the summer, and so if they close school, then the provision of therapy services via the IEP isn't take place, because the IPs are, you know, on hold until we come back to school. So.
Jayson Davies
Yes, yeah, so in California, I'll just give you an update what's going on right now. It's same type of conversation about teletherapy and equity as well, because, yeah, we do have kids that don't have devices, and currently, my wife's a fourth grade teacher in a school district I'm an OT so we're kind of going through the same thing, and both of our districts are trying to get computers to our kids, along with hot spot devices for those who may need that? It's my understanding that both of our districts truly underestimated how many kids were going to need these devices, because so many of them, or the families don't have a computer, they may have an iPad, but how much can you really do on an iPad? And most of them are relying on one smartphone for the entire family, and you obviously cannot. You just can't do work on a smartphone like that. Not acceptable. And so they grossly underestimated, from my understanding, how many Chromebook or whatever they're giving out they needed, as well as the device hot spots for the parent. So that's what they're working on now. We're on spring break too, just like you, and they're trying to get those devices out as fast as they can. And we're kind of in a similar spot, except we don't have, I think our district had a few speech therapists that were contracted for teletherapy, but that's a contract it's not like we have the platform in the district, right? And so we're, they're kind of playing around with zoom a little bit. It's my understanding that when we come back from spring break, or maybe the week, yeah, spring break, that we're going to have two weeks where it's called enrichment program versus distance learning enrichment is we're just going to be providing resources for parents, and so basically, we're just putting some resources up on the website for the first two weeks and saying, Hey, here's Handwriting Without Tears. They have free resources. Check it out and email us if you have questions. But after those two weeks, and now we're getting into, like, the middle of April, that's when we're gonna have to figure something out and start providing services through zoom or Google Hangouts, or whatever it might be called. So yeah, I think you're right. Everyone's just trying to figure it out. And so best of luck to you. Best of luck to me. Best of luck to everybody. I think, is where we're at right now. So yeah.
Billy Hatridge
And it's, and, you know, we're in a good place right now. My wife's an accountant. She usually works from home. She works for an IT network company who is booming right now. Oh, there you go, everything. And so I've had a good, good chance of being a stay at home dad for the last couple days. My two year old, and she's trying to get back to work a little bit. So that's been, it's been nice for her to kind of have that opportunity to go back to work, and they're able to give her more hours while I sit here, tell them my thumbs waiting on spring break, get back and see kind of what happens there, and how my supervision rule works. Yes, you know how our notes work, because all of our charts are still locked up at the schools. And, you know, can we go and get those? I need to send out all that stuff again and have our therapist work from home. It's, yeah, it's gonna be interesting, for sure, figuring out how this moves forward.
Jayson Davies
Yeah, and the speech therapist I work with at my school sites, or two of them, she's a contracted speech therapist. She's her own contractor, and she has employees, I think one other SLP, and a few slippers. And, well, basically, at this point, the district's kind of saying, well, we don't have a need for your slippers right now. And so I don't know. Are you in a similar situation where the districts may or may not be paying you at this point or your company because there's no school.
Billy Hatridge
I haven't heard that yet. So far, all of our districts have been pretty on the ball about saying, Yeah, whatever y'all can provide, we want to provide that to our kids. Now, what that's going to look like in a few weeks, what that's going to look like when we try teletherapy and it doesn't work as well, if you think it does, or if it does, if I work great. It might work great. And I'll open up a lot of opportunities. I feel like this COVID 19 situation is going to change healthcare forever. Absolutely, it's going to change the way we interact with the doctors or therapists. Is going to change the way we interact with so we have to teletherapy moving forward. We don't have to just serve schools that are geographically close. You know, if it's effective, and the question is going to be, how effective is it?
Jayson Davies
But yeah, and I think everyone, if you're not already aware of it, a ot A is working on trying to get licensure. I don't know what exactly they're calling it, but they're trying to basically make licensure easier, or like a universal license, so that way, and it's basically for telehealth. Because right now, if you want to practice telehealth in your state and Texas, you have to have a license in your state and Texas in order to see that get in Texas right. But they're trying to make it kind of a universal license to where you just need one. So a lot of things are happening to support telehealth, and we shall see what happens, I guess.
Billy Hatridge
So yeah, and that's going to change, you know, quite a bit on the supervision, because our supervision guidelines are Arkansas State Medical Board who has our state licensure, you know? And so if it's a national licensure, and every state, it kind of has to meet the same guidelines, you know, what will that supervision look like for our OTs? You know? What would that supervision look like, as far as how often you have to do it.
Jayson Davies
I forgot to ask you that question, what does that look like?
Billy Hatridge
Super so under the Arkansas State medical boards guidelines, you have to meet face to face for an hour for every 40 treatment hours that the OTA generates, which in the schools is typically like 25 hours a week, yeah, realistically speaking. And so by meeting with them face to face, every face to face, every week, I'm more than covering that, yeah, catch it up a week after you meet with each meet with each patient once every 30 days, and then you sign all the OT a documentation within 30 days of that service.
Jayson Davies
Wow. You know how nice it is to have that very specific guidance, because not every state has that. I mean, in California, I it kind of says the OT is responsible to provide guidance as necessary or as they feel necessary based on the experience of the OT or something like that. It's very broad. It's very general, and it kind of leads a lot for interpretations, especially when you're trying to tell your district that you're overworked because they don't understand that. Yeah, you do need to see your OTs once a week, and you do need to be seeing the clients of the OT, or the caseload of the OT, a you need to be seeing those kids, and they don't.
Billy Hatridge
That's one of the big things we've had across the state too, is the interpretation of that line. Meet with each client every 30 days, some ot school OTs or school OTs. Take that as I'm going to have a therapy session with each kid every single month. Others take that as I'm going to walk into the special ed classroom, look across the room, make facing, you know, eye contact with everybody. Check my box and move on. And that was my supervision for the month. You know, I'm trying my best to figure out, you know, the middle line there of observing them in the classroom, observing them at lunch, observing them with a therapist, treating them myself. But, yeah, that's the issue with guidelines. Is there's so much interpretation, whether you're talking about Medicaid or state guidelines, supervision guidelines, and I think there's a reason they make it vague so that you can kind of work work it to make what works best for your system.
Jayson Davies
Yeah, cool, man. Well, I want to wrap this up. We've been going on for about an hour already. Time flew by. Thank you, man, for coming on. I think we hit so many awesome topics. I mean, from Coronavirus that we had no expectations to address this a week ago to all the things that we did intend to address, and I think we nailed them. It's going to be super helpful for everyone. Do you want to give out any information? If anyone would like to contact you, or you have a website, I don't know what you want to share.
Billy Hatridge
Yeah, so I've got a website. It's the OT dad.com it's kind of more of a blog and kind of personal insight, but there's some resources there as well. I'm the OT dad on Facebook, Instagram, we got a Pinterest that's not as a bit as I'd like it to be, but yeah, the OT Dad, you can usually find me you know, I'm more than willing to help families during this time or other educators who are kind of struggling with this. I've really tried to reach out to my parents and say, anytime you have any questions while you're home with your kids and they're not getting these services. On time. This might be the first time a parent sees their kids handwriting, then suddenly it's a lot of questions. Oh, man. And so I think it's really important for all of us. I don't know when this is episodes going out, but just to make ourselves available to parents who are struggling or to other therapists, because this is new for everybody. And so if anybody has any questions or has any thoughts on school based OT or other OTs are working in rural areas who have issues. I am more than happy to help any way I can.
Jayson Davies
Great man. Well, thank you, Billy. I appreciate you coming on and we'll stay in touch and see you next time.
Billy Hatridge
Thank you, Jayson for having me.
Jayson Davies
All right. And that wraps up episode number 46 of the OT school house podcast. Thank you again. So much to Billy hattridge for coming on and sharing what things are like down in Arkansas. You know, sometimes I feel like in California, things are just so much different that it's nice to talk to people outside of outside of California and see what ot looks like out there. This was an especially nice phone call Billy. Billy and I kind of joked how nice it is just to have a conversation, or real, a real conversation with an adult, sometimes outside of the house. And you know, we're in quarantine. And so I hope this podcast can act as a way for you all to just step aside a little bit from reality and what's going on. So appreciate you listening, and I hope you found this as a very beneficial podcast for your practice. Let us know what you thought about this podcast. Leave me a comment down in the Apple podcast app if that's where you're listening, but yeah, otherwise, we will see you next time on the OT school house podcast. Take care. Bye. Bye.
Amazing Narrator
Thank you for listening to the OT school house podcast for more ways to help you and your students succeed right now. Head on over to otschoolhouse.com Until next time class is dismissed.
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