Service Delivery

  • When is a medical referral (or a new one) needed?

  • When do missed sessions need to be made up?

  • Are outside agencies, such as home health, allowed to provide their services within the school setting? Does it depend on whether the student is receiving school-based therapy services or not?

  • Should an OTR/COTA provide feeding therapy (oral-motor therapy for swallowing/chewing) in the school setting?

  • Are there guidelines for establishing reasonable caseloads for school-based therapists?

  • Our OTA's write daily notes each time they see a student. Question: Progress reports are due each 9 weeks; how should our progress on our goals be documented? 1. Do they need to say per .... OT in the 9 weeks progress report card even though this is not a daily note? 2. Do the OTA and OT need to sit down and write the 9 weeks progress report together and have both sign their name? 3 Can this communication of progress be completed without face to face contact, e. g., OTA writes note/OTR reviews?

  • What do OT and PT mean when they write "Integrated" services?

  • Can you please clarify school-based v. medical model?

  • Our therapists have posed the question of counting motor lab time as part of direct services time for our students. Do you have any guidance on this topic?

  • Teachers and administrators are asking the OT for weighted vests and other sensory items for students who are not receiving OT services; they want to take responsibility for the items. Should I issue these supplies to them?

  • Can OT provide service for a student who only has a Speech Impairment (SI) disability designation?

  • Can an OT provide services without a medical prescription or referral?

  • Can you help me explain the integrated service model to district staff and parents?

  • What is best practice for theraapy data collection in the school setting?

  • How long are medical referrals for school-based therapy services valid?

  • Can adaptive chairs be used with students for reasons other than to improve positioning? Our department is getting asked to recommend using adaptive chairs for students with autism, hyperactivity, etc. to assist with visual attention and focus. Can we recommend? Do we need a seating schedule? What schedule do you recommend? Also, where can we find more concrete written information on this issue to share with other school staff?

  • As a school-based therapist, must I provide stretching and range of motion for a student based on a physician's referral?

  • In reviewing the Electronic Signature Certification statement for SHARS billing, the OTs are questioning which of our services are considered "medically necessary" and how this is determined. Is handwriting or other classroom-based fine motor tasks ever considered "medically necessary?"