In The News

Student Corner: Pima Medical Institute Update

The Pima Medical Institute of Denver, SOTA students, have been busy hoeing and harvesting produce in a neighboring community garden, by the school. So far, SOTA and staff of the OTA program has donated roughly 45 pounds of produce to Pima students and faculty. Donations are handed out as frequently as every other Thursday. On September 24th SOTA organized an inservice by Handspring Prosthetics, Denver, to talk with OTA and PTA students on the holistic, specialized care in upper extremity prosthetic rehabilitation.

Submitted by Jessica Olah, OTAC PMI Student Representative


Next Year CO OT Practice Act needs passing

OTAC’s legislative efforts would not be nearly as successful if it weren’t for the financial support we receive from donations and membership fees. Our lobbyists work hard during session to protect our occupational therapy practice and values, and this would not be possible without our membership funds. Thank you, members, for supporting our occupational therapy practice in Colorado. Lastly, thank you to the Legislative Committee who worked hard to facilitate OTAC Capitol Hill Day, inform the efforts of our lobbyists, and advocate for OT practice. You are the gears that make our advocacy machine run. Thank you for your time, your ideas, and your motivation.

Next year, in addition to tracking bills that impact OT, OTAC’s efforts will be focused on getting the OT practice act passed. We will work with DORA and AOTA to ensure that our practice act is up to date and supports the most current occupational therapy practice, and then work with our lobbyists to navigate the legislative process of getting it passed.

If you have any interest in learning more about legislative committee or our efforts, please email [email protected]

Submitted by Bailey Johnson, MS, OTR/L, OTAC Board Chair for Public Policy


Medicare Home Health Flexibility Act

AOTA is advocating for passage of the Medicare Home Health Flexibility Act (H.R. 3127/S. 1725) which was reintroduced in both the House and Senate on June 6, 2019.

The act would fix a 30-year-old policy that causes unnecessary delays in health care delivery. Current Medicare regulations create an imbalance among the skilled therapy services. Even when occupational therapy is ordered in the plan of care, occupational therapists are not permitted to conduct the required initial visit under Medicare. Additionally, they are not allowed to complete the comprehensive assessment unless OT is the qualifying service, such as under Medicaid or when OT is the qualifying service on a “continuing need” basis. These bills would allow occupational therapists to open home health therapy cases under Medicare.

This legislation would specifically allow home health agencies the flexibility to use the most clinically appropriate skilled service to conduct the initial assessment visit and to complete the comprehensive assessments. This legislation would only affect cases where skilled nursing has not been ordered and would not alter in any way Medicare’s criteria for establishing eligibility for the home health benefit.

Along with AOTA, this legislation is supported by the National Association of Home Care and Hospice (NAHC), the American Physical Therapy Association (APTA), and the American Speech-Language-Hearing Association (ASHA).

Please contact your member of Congress and ask them to cosponsor or to AOTA’s Legislative Action Center to take action!

Submitted by Pam Dipasquale, MS, OTR/L, OTAC President. This article was taken from an email to all state association presidents from AOTA.


Student Corner: Taking An IADL To The Next Level

On April 19, 2019, occupational therapy students and practitioners celebrated a significant contribution in the gaming world of one occupational therapist who was at the forefront of creating an adaptive gaming controller for XBOX. Erin Muston-Firsch, MS, OTR/L, an occupational therapist at Craig Hospital in Denver, Colorado, helped a team at Microsoft to develop the first Xbox Adaptive Controller. She was approached by Microsoft because of her creation of the Adaptive Gaming Program at Craig Hospital. She was inspired to create the program after she was referred to a patient who had sustained a spinal cord injury. Prior to his injury he was an avid gamer, playing over ten hours per week. “In partnering with him to figure out how he could game, I realized how important gaming was to people and how it could help them return to a very valued occupation” said Muston-Firsch.

Microsoft had initially come up with the idea for an adaptive controller when they partnered with a nonprofit adaptive gaming organization, “Warfighter Engaged”, during their annual Hackathon. Warfighter Engaged supports injured veterans by creating custom built adaptive controllers for individuals. After Microsoft saw the need for this type of adaptive equipment to reach a broader population of gamers, they partnered with Muston-Firsch and Craig. The Microsoft team made many prototypes that were then tested in the hospital and then adapted and modified based on what was observed with clients. “It was great to see our patients give feedback as it was incredibly empowering for them to say that they influenced its design as well,” said Muston-Firsch. She also had the opportunity to attend Microsoft’s announcement of the controller where they shared the story of how the controller was developed. Muston-Firsch said, “It was pretty amazing to get to go to the Microsoft campus and see all the work that had been done to develop and test the controller.”
Gaming is not only a great recreational therapy for our spinal cord and brain injury patients but also an effective physical and occupational therapy practice. It can help patients increase their strength, dexterity, balance and more. “Research shows that patients have better outcomes when they are engaged with their therapy,” said Erin Muston-Firsch, an occupational therapist in the Assistive Technology Lab at Craig. “Mass repetition of movement is critical in neuro recovery, and gaming gives patients a really fun and measurable way to do that.”

This groundbreaking controller was released in May of 2018 after a four-year process of creation and revision with a Microsoft team. The controller was promoted in Super Bowl LIII commercial this past February.

Submitted by Heidi Kunugi, OTS, Creighton-Regis Student Representative, OTAS. Vetted by Erin Muston-Firsch, MS, OTR/L.


Student Corner: Sex and Sexuality in OT: An OTA Student’s Perspective

I was 24 years old when I received a common surgery to alleviate symptoms caused by a varicose vein in my pelvic region. The surgery was a success by the standards of the urologist who performed it, and I was left with only a small scar about an inch above my genitals. “Nothing a former high school wrestling star can’t handle,” I told myself. Confidence had never been an issue for me. That was until the little scar left behind became the bane of my existence. It burned. I felt like it was on fire at times. The sensation was on the opposite end of the spectrum from the pleasure I typically felt from that region of my body. To make things worse, the pain was unbearable during sex because of the pressure and rubbing on the scar. I returned to the urologist for my post-op check-up about a month later. I immediately expressed my concerns about the pain I felt. I was distraught, confused, and angry. She looked at me and said, “Some people heal differently, just give it time.” Before I knew it, I was driving back home with nothing more than a painful scar of shame and embarrassment in my pants. The demons in my head laughed. Would I ever be able to perform sexually the same way? Will my fiancé want to be with me if the sex isn’t as good? Oh my god, sex will never be the same! The physical pain lasted for months, but eventually subsided. The effect of the experience on my psyche lasted far longer, and is still something that I think about every time I see that little scar.

I share this with you today because I know my story of pain, insecurity, and change related to sex and sexuality do not stand alone. Thanks to Janice Hinds, MS, OTR/L, BCMH and her leadership group at the latest OTAC Conference, I was able to speak about the topic of sex and sexuality as an area personal interest to a room filled with students, professors, and occupational therapy practitioners. That day I announced my goal of advocating for occupational therapy as a primary tool to those who have an acquired disability that affects their sex life and would benefit from the holistic approach we as a profession take to health and wellness.

If something such as a small incision to the pelvic region can have great effects to sexual activity, what are the consequences of a CVA, SCI, amputation, catheter bag, etc.? I have been taught that a solid OT intervention incorporates what is important and enjoyable to a patient. We discuss bathing, care for pets, leisure participation, and so much more. As important and enjoyable these things are to me, and I imagine most others, sex is even more enjoyable. Let’s go as far as saying it is the most enjoyable. Sexual activity, conveniently listed as one of the primary ADL categories in the Occupational Therapy Practice Framework, is defined as, “engaging in activities that result in sexual satisfaction and/or meet relational or reproductive needs” (AOTA, 2016). Satisfaction is a very important word in that definition. The act of having sex is not enough. Leaving a patient to figure it out on their own is not the way. We as occupational therapist have the duty to discuss sex and sexuality with our patients, as long as we have permission. “Exclusion of sex and sexuality within the rehabilitative process has serious consequences for clients and occupational therapy practice as a whole” (Rose & Hughes, 2018). We would not leave a patient who has post-CVA sensory loss in the kitchen to start chopping, grating, and boiling without help and professional intervention. At the same time, we should not leave this patient to explore sexual function and how they now feel about their sexuality completely to their own device.

The idea of speaking about something so personal and intimate with another person is scary. Not only for the patient, but for the OT practitioner as well. Thoughts of doubt may enter your mind. What do I know about helping someone in the realm of sex and sexuality? You know more than you may think. We have the tools. “Sexual concerns often can be addressed through positioning, tool adaptation, energy conservation principles, and other forms of intervention already familiar to most practitioners” (Rose & Hughes, 2018).

Challenge yourself and the OT community to create a sex positive environment. Be open and honest with your fellow practitioners, patients, and anyone who is interested in the topic. The more we discuss how OT can benefit patients in the realm of sex and sexuality due to a change in their life, the more we will learn and the more people we will help.

*Submitted by Nicholas T. Moceri, OTAS. Vetted by Pima Medical Institute, OTA Instructor, Amber Sand, BS, COTA/L*

American Occupational Therapy Association. (2016). The reference manual of the official documents of the American Occupational Therapy Association, Inc. (21st ed.). Bethesda, MD: Author.

Rose, N., & Hughes, C. (2018). Addressing sex in occupational therapy: A coconstructed autoethnography. The American Journal of Occupational Therapy, 72(3), 1-6. doi:

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