KNR 273: Credentialing

1. KNR 273:Credentialing

2. Credentialing • Process where by the competency of a professional is ensured as a provider of quality services • Defines minimum competence to practice • What is the difference between credentialing and accreditation?

3. Credentialing vs. Accreditation • Credentialing • Individual • NCB (CPRP) • NCTRC (CTRS) • If in community/SRA may need both CTRS and CPRP • Accreditation • Agency • COAPRT • CAAHEPCouncil on Accreditation of Allied Health Education ProgramsCARTE (adopted in 2010)

4. Quality in TR

5. Credentialing 3 types: • Registration • Certification • Licensure

6. Registration • The process by which qualified individuals are listed on an official roster maintained by a governmental or non-governmental agency • Could be state, national or professional organization • Can look at education & professional experience

7. Certification • A governmental or non-governmental agency grants recognition to an individual who has met certain predetermined qualifications set by a credentialing agency or association • Education & professional practice • Greater weight than registration • Restricts use of title, does not restrict practice • Title protection

8. Licensure • An agency of government grants permission to an individual to engage in a given occupation upon finding that applicant has attained the minimal degree of competency required to ensure that the public health, safety, and welfare will be reasonably well protected

9. Licensure • Strictest form of credentialing • Requires state government to enact legislation that defines the professional practice • Practice protection---illegal to practice if not licensed

10. Why is it important to have professional credentials?

11. Credentialing • Enables: the public (and gov't and 3rd party payers) to distinguish those who have attained some qualifying level of competency from those who have not • Provides: prestige, recognition and earning power

12. Credentialing • Increases the quality and accountability of services to the consumer • Increases credibility, respect, and professionalism • Increases the minimal qualifications of the professional • Increases the likelihood of providing uniform services based on consumer need • Encourages education and continuing education

13. Credentialing in TR • Registration • 1956: Council for the Advancement of Hospital Recreation created National Voluntary Registration Plan for Hospital Recreation Personnel • 1969: National Therapeutic Recreation Society created the NTRS Voluntary Registration Plan

14. Credentialing in TR • Certification---Certified Therapeutic Recreation Specialist (CTRS) • 1981: National Council for Therapeutic Recreation Certification (NCTRC) is established by NRPA • 1985: NCTRC is legally incorporated • 1988: NCTRC conducts initial Job Analysis Study • November 1990: 1st NCTRC exam administered • 1994: CTRS credential trademark is registered • 1997: 2nd Job Analysis Study completed • November 2001: 1st computer based exam is offered • 2007: 3rd Job Analysis Study completed • International Job Analysis of CTRS

15. International • CTRS working in 9 countries • Braham • Great Britain • Bermuda • Australia • Asia • 2009 Canadian Therapeutic Recreation Association = CTRS is preferred credential

16. Credentialing in TR • Licensure • Few states have licensure for TR • Utah (1974) • North Carolina (2005) • New Hampshire (2006) • Oklahoma (2009) • Georgia in the past, sunset law • Periodically TR has drives toward licensure • 7-8 states working on (including New York) • 7-8 thinking about starting (including Illinois) • CTRS exam = basis of licensure

17. Credentialing in TR • State Registration • Texas • California

18. NCTRC • National Council for Therapeutic Recreation Certification • Independent of NTRS and ATRA • Why? • Independence provides for a better relationship with regulatory groups like JCAHO and CARF • Doesn’t appear to be self serving

19. NCTRC - Mission • To protect the consumer of therapeutic recreation services by promoting the provision of quality therapeutic recreation services by NCTRC certificants

20. NCTRC - Purpose • To establish national (& international) evaluative standards for the certification and recertification of individuals who attest to the competencies of the therapeutic recreation profession • To grant recognition to individuals who voluntarily apply and meet established standards for certification in therapeutic recreation; and • To monitor adherence to the standards by the certified therapeutic recreation personnel.

21. General Requirements for CTRS • Education • Minimum: Bachelor-level degree • Experience • Documented field placement or work experience in TR • Examination • Successful completion of NCTRC exam

22. 2 Paths • Academic • Major in TR or recreation with option in TR • Accredited university or college • Not program

23. NCTRC Requirements (Effective 1/1/13) • Min. 18 semester hours with 15 in TR and the remainder in recreation • 5 courses and each course must be 3 hours • Must include: • Assessment • TR Process • Advancement of Profession • Not accepted: • Specific activity skill course for a specific population • Aquatics for People with Intellectual Disabilities • Camping for Special Populations

24. NCTRC Requirements (Effective 1/1/13) • 18 semester hours of supportive course work • Courses outside of department • Minimum of: • 3 in anatomy and physiology (1/2) • 3 in abnormal psychology • 3 in human growth & development across the lifespan • Remaining in content areas of social science and humanities • Medical terminology

25. NCTRC Requirements (Effective 1/1/13) • Internship • Minimum 14 consecutive weeks/560 hours • In TR services that use the TR process as defined by the current NCTRC Job Analysis • No less than 20 hours/week and no more than 45 hours/week • Must be at 1 agency • Keep log of hours & duties • Supervisor • Agency supervisor must be CTRS for 1 year before supervise intern • ISU says must be in field 2 years plus 1 year as CTRS • University supervisor must be CTRS • Online verification

26. Internship Cont. • Supervisor • Must be full time at agency (32 hours/week) • 50% of job duties must be in an established TR program in an agency • Must be 1 identified primary supervisor • Work consistently with student • Coordinates all secondary supervision • Oversees/signs off all evaluations and reports • Ensures exposure to all Job Analysis Task Areas • Signs field placement verification form

27. 2 Paths • Equivalency – work experience • Path A • Same courses plus 5 years full time in TR • Path B • Same courses plus 1 year full time under supervision of CTRS

28. Internship Cont. • Job Analysis • Basis of internship • Basis of exam content • Basis of continuing education • Basis of ISU TR curriculum • MUST BE exposed to ALL of the job task areas in internship

29. 2007 Job Tasks (Practical Experience/Basis of Internship) • Job Task = TR Process • Professional roles & responsibilities • Assessment • Planning interventions/programs • Implementation • Evaluate outcomes • Documentation • Work with treatment/service teams • Organizing programs • Managing TR services • Public awareness/advocacy

30. 2007 Job Tasks (Professional Knowledge Domains - Theoretical Knowledge) • Basis of TR exam • Foundational knowledge (33%) • Practice of TR/RT (47%) • Organization of TR/RT service (13%) • Advancement of the profession (7%)

31. Foundational Knowledge Examples • Theories of play/rec/leisure • Diversity factors • Human growth/development • Theories of human behavior • Leisure thru lifespan • Leisure lifestyle • Health/human services • Societal attitudes • Legislation • Guidelines & standards • Cognition & related impairments • Anatomy, physiology • Senses & related impairments • Psychology & related impairments • Normalization & inclusion • Accessibility & barriers • Group interaction/leadership • Behavioral change

32. Practice of TR/RT Examples • Concepts of TR/RT • Models • Practice settings • Standards of practice • Code of ethics • Impact of impairment • Selection of assessment • Implementation of assessment • Behavior observation • Interview techniques • Functional testing • TR/RT assessments • Other sources of assessment data • Interpretation of assessment • Documentation • Activity analysis • Leisure education • Activity modifications • Modalities/interventions • Facilitation techniques

33. Organization of TR/RT Service Examples • Program design • Goal/behavior objectives • Progress notes • Evaluation • Quality improvement • Plan of operation • Personnel/volunteer supervision • Payment • Facility/equipment management • Budgeting

34. Advancement of Profession Examples • History • Accreditation standards • Professionalism • Certification • Advocacy • Legislation • Standards • Ethics • Public relations/marketing • Professional association • Continuing education

35. Accommodations for Examination • When submit application, include a separate letter describing • Candidate’s disability or special need • Adaptations being requested • Documentation from doctor that confirms disability and prescribes appropriate accommodations • (Disability Concerns) • If approved must contact Special Conditions Coordinator at the Prometric Candidate Services Contact Center at 1-800-967-1139 to schedule appointment for administration

36. Accommodations for Examination • Accommodations available are: • Reader • Marker/writer • Sign language interpreter for instructions • Separate room • Double test time • Extended time by 1.5

37. CTRS Examination • Must meet all eligibility requirements • Then pass a written, knowledge-based examination • Pass courses, qualify for test, pass test • Do ASAP because qualification standards can change and then would not be eligible to sit for examination • Offered 3 times a year (5 day period) • February 1 for May • July 1 for October • October 1 for January • New: Can take during internship ($25) • www.2test.com for locations • Prometric

38. CTRS Examination • Mastery testing • Some receive more questions • Starts with base test everyone takes • 90 questions / 86 minutes • Pass/fail/unclear • Testlets • 15 questions / 14 minutes • Maximum of 6 testlets • Get preliminary score of if not pass feedback on weak areas • Last 3 years, 66-75% passed

39. CTRS Examination • Cost • New application: $100 • Exam registration fee: $300 • Total: $400 • If do early = $425 • Certification good for 5 years • Annual maintenance fee ($80)

40. CTRS • Can’t say certification eligible until receive notification from NCTRC • Can’t use CTRS until receive official letter from NCTRC of passing

41. How Prepare for Exam? • STUDY • STUDY • STUDY

42. How Prepare for Exam? • Print/review current standards • Make sure all areas have been covered in internship • Go over requirements with supervisor • Complete practice application • Review texts & notes • Practice tests • NCTRC 50 sample questions ~$25 • Study guides (Stumbo & Folkerth) • Study groups / sessions • Flash cards (cost ~$50)

43. How maintain certification? • Annual Renewal • Form • Fee • Recertification to proved continuing professional competence • Form • Fee • Documentation • Keep: • Original documentation • Conference schedule • Hours • NCTRC areas • Audit process

44. Recertification • Must earn 100 credits to renew certification after 5 years • Points can be earned • Professional Experience (minimum of 480 hours over 5 years…could be volunteer) and • Continuing Education (50 hours) or • Reexamination (passing score on exam)

45. Recertification • Continuing education • Conferences, workshops • Publications • Presentations (c/b online) • Academic courses (take/audit) • Webinar/teleconference • Thesis or dissertation • Guest lecture • NCTRC test writing • No more than 25 credits from publications/presentations

46. Continuing Education • Points are measured according to the equivalency of an educational contact hour (60 minutes) • 1 contact hour = 0.1 CEU = 1 credit • Content of the experience must be linked with the knowledge areas of the NCTRC Job Analysis Study ** be careful because some things don’t count

47. How keep up with NCTRC changes? • NCTRC Newsletter • NCTRC Web site • Meetings at conferences • Professional journals/literature

48. Specialty Certification (2010) • Physical Medicine/Rehabilitation • Geriatrics • Developmental Disabilities • Behavioral Health • Community Inclusion Services • Valid 5 years • $100/$20 year

49. Specialty Certification Path A • CTRS active status • 5 years FT experience in area (1,000 hours) • 75 continuing education hours • Min of 3 professional certificate trainings • Each training must be min. of 6 CE hours • 2 professional references

50. Specialty Certification Path B • CTRS active status • Graduate degree in TR/RT • 9 graduate-level credit hours in specialty • 1 year FT experience in area • 2 professional references