Letter from the Legislative Committee

Vermont Occupational Therapy Association

Date: October 31, 2024

Dear VOTA Members,

As we close October and look toward the challenging months ahead, we are writing to you as both your Legislative Committee and as fellow practitioners navigating these uncertain times. This moment asks much of us—as occupational therapists, as community members, and as advocates for those we serve.

Today feels scary. Many individuals and families in our community are facing real fears about their futures. As October ends, we're witnessing the culmination of federal policy decisions that will continue to deeply affect our clients, their families, our neighbors, and us. The impacts are not abstract—they are landing in our treatment rooms, our schools, our community centers, and our homes.

Some of these decisions will be amplified as Vermont steps in to partially cover SNAP and LIHEAP benefits with state funds—a stopgap that reveals both our state's commitment and the precariousness of the safety net. We're seeing forced decisions about who can access medical care (stigmatizing and endangering many people in our community), systems of power exerting their lens over all others, continued human rights atrocities, and an ongoing climate of fear about safety and future. These forces pull us in many directions at once.

At times, we are paralyzed by the pull. The weight of what we're witnessing can feel immobilizing. But as occupational therapists, we understand something fundamental—that meaningful occupation, participation, and agency are not luxuries. They are human rights. They are the foundation of health, dignity, and community.

This is why we are asking everyone to join us in mobilizing to be voices for our clients, our neighbors, and ourselves. Advocacy is not separate from our practice; it is integral to it. When we fight for equitable access to services, when we show up at public meetings, when we speak truth about the barriers our clients face—we are practicing occupational therapy.

Here are upcoming opportunities to make your voice heard. These meetings shape the policies that directly impact our clients' access to services, educational supports, and healthcare:

School Redistricting Subcommittee Meetings: Task Force

Agency of Education Meetings: The Commission on the Future of Public Education in Vermont 

Special Education Advisory Council 

Green Mountain Care Board Sessions: Board Meeting Information & Materials | Green Mountain Care Board

Center on Budget and Policy: Opioid Settlement Advisory Committee | Vermont Department of Health

Blueprint for Health :Vermont Steering Committee for Comprehensive Primary Health Care

Please do not feel like you need to attend everything. Choose one meeting. Bring a colleague. Listen first, then speak when you are ready. Your clinical expertise matters in these spaces.

Vermont-Specific Resources: Agency of Education

School Choice with Act 73

Vermont food and heating assistance uncertainty with the Federal Government Shut down

National Advocacy Resources: Medicaid Cuts Would Reduce Access to Health Care for Entire Communities | Center on Budget and Policy Priorities

FAQ about Occupational Therapy & the Government Shutdown | AOTA

Our profession was founded on the belief that occupation is a human right and a determinant of health. This moment is calling us to live those values and use our voices to advocate. Your voice—whether at a legislative hearing, a school board meeting, or in conversation - carries the weight of your clinical knowledge and your commitment to human dignity.

Thank you for the work you do every day. We can move forward together.

In solidarity and service,

The Legislative Committee

Vermont Occupational Therapy Association

For questions about advocacy opportunities or to connect with other members engaged in legislative work, please contact hannah.bloom@vermontot.org

Home Health

Thanks to advocacy from AOTA and other representatives of Occupational Therapy and Home Health; CMS has included the permanent provision beginning Jan 1, 2022 for Occupational Therapists performing initial assessments and comprehensive assessments in Medicare Home Health therapy cases.  During the early months of the pandemic, Occupational Therapy was given this provision under the CMS COVID Waiver 1135, in order to facilitate access to needed Home Health services for seniors.  This permanent move rightly recognizes Occupational Therapists as integral members of the home health team.

The HH PPS proposed rule is scheduled to be published in the Federal Register on July 7, 2021, and comments are due to CMS by August 27, 2021. AOTA staff is analyzing additional provisions of the proposed rule and will submit written comments. Read the CMS Fact Sheet for an overview of the proposed rule.  FACTSHEET