Reporter's notebook: The ATP/SMS conundrum

YARMOUTH, Maine - It hinges on a bill passing in Congress and, even then, it's years away from being implemented, but what could an “ATP-plus” designation look like?

“It's anybody's guess right now,” said Weesie Walker, executive director of NRRTS. “We're not rushing into anything; we want to get it right.”

A bill to create a separate benefit for complex rehab requires CMS to establish an additional designation for providing complex rehab technology—above and beyond the ATP—within a year, and to implement it within two years.

Though the bill hasn't been passed, a group of stakeholders that includes NRRTS, NCART and RESNA has been proactive, meeting regularly to discuss what the designation could look like.

“We're not kicking it down the road,” said Charlie Raphael, director of certification and education for RESNA. “We're meeting monthly.”

CMS began requiring that providers have an ATP on staff to provide certain CRT in 2008, but stakeholders have long argued that the certification is too generalized.

“CMS adopted it because it was the only thing out there, and it's taken a life of its own,” Walker said.

Since then, RESNA has launched the SMS to demonstrate competency specifically in seating, positioning and mobility, but stakeholders argue it doesn't cover key areas like funding.

“It's a fine line,” Raphael said. “Do we take the SMS and dig deeper? That's difficult, because we want it to global and (funding issues aren't necessarily global).”

The specifics still need to be worked out, but what stakeholders can agree on: the need for an “ATP-plus.”

“It's exciting to think RTSs will have recognition as a supplier, not as an assistive technology professional,” Walker said. “Having their own designation is important when you look at the clinical setting and the consumer understanding what their role is.”