Beruflich Dokumente
Kultur Dokumente
The creators of this guidebook acknowledge and thank Paul Rao, PhD, and
Michelle Rives, MPH, who were the authors of the National Rehabilitation
Hospitals publication, A Consumer Guide for People with Stroke: Choosing a
Rehabilitation Program, on which this guidebook is largely based.
We would also like to thank the following individuals for their time and efforts in
reviewing this guidebook and providing valuable consumer feedback: Marcus Bell,
Bertha Joachin, and Robert Sevigny, in addition to all of the other reviewers for
their insightful comments, time, and energy.
Contents
INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
TERMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
RESOURCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Introduction
S
electing a high-quality medical reha-
bilitation program after you experi-
ence an injury or illness can be hard
to do. You want a rehabilitation program
that will give you the best possible care choose a high-quality rehabilitation pro-
and that takes into account your own cir- gram. It includes four major parts. Part 1
cumstances. For instance, you will want a describes medical rehabilitationwhat it
program that considers how well you get is, how it can help you, and the different
around, the type of transportation you use, rehabilitation professionals who will work
where you live, your level of family sup- with you. Part 2 discusses health insurance
port, and your insurance coverage. You plans so that you can understand what
also want a program that will help you to your plan will and will not cover. Part 3
become as independent as you can be in talks about the different types of rehabili-
your daily living. tation programs available to you, and Part
4 looks at ways that can help you find a
When it comes time to choose a rehabilita-
high-quality rehabilitation program to suit
tion program, where do you start? How
your needs.
can you tell which rehabilitation programs
offer high-quality services that will meet At the back of this guidebook, you will find
your needs, and which programs will not? a glossary of terms. When you are reading
through this guidebook and see a word in
Unfortunately, people often must decide
boldface type, you can find out its mean-
where to go for rehabilitation when they
ing in the terms section. You can also look
do not have the time to gather details
through the terms section first, to familiar-
about all available programs. Typically,
ize yourself with some of the words. You
decisions about which rehabilitation pro-
will see that next to each word is a page
gram to use are made when a person is
number where it appears in the text, if you
already in an acute care hospital. If some-
need further descriptions.
one has not talked with you or a family
member within the first few days after In addition, you will also find checklists to
being admitted to a hospital, ask to see a help you choose a high-quality rehabilita-
hospital social worker. The social worker tion program, as well as a listing of
can help you begin the process of choosing resources including organizations, Web
a rehabilitation program. sites, and phone numbers that might be
useful.
The goal of this guidebook is to help you to
After reading this guidebook, you should will be better prepared to choose a pro-
have a better understanding of how to find gram that meets your health care needs
a good quality medical rehabilitation pro- and helps you to be as independent as
gram. By becoming more informed, you possible.
Medical
Rehabilitation
CHOOSING A HIGH-QUALITY MEDICAL REHABILITATION PROGRAM
PART 1:
Medical
Rehabilitation
I
ts important to try to understand some to walk on a flat, indoor surface where
of the basic concepts about disability. there are no curbs or steps.
To begin with, how well you function
Performance is ones ability to do a cer-
depends on your health, where and how
tain task in a real-world setting that may
you live, and other individual factors.
have barriers, such as steps, uneven
Living with a disability means that your
ground, or bad weather. Although you
body might not be able to function fully. It
might have the capacity to walk, the envi-
also means that you might be limited in
ronment affects your real walking per-
doing some tasks or taking part in some
formance. It makes it harder for you to
activities.
function and plays a part in your disability.
Capacity and performance are two terms
that can help you understand how your WHAT IS MEDICAL REHABILITATION AND
functional ability relates to the concept HOW CAN IT HELP ME?
of disability. Capacity refers to ones abil- Treatment for disability or illness most
ity to do an activity in a barrier-free place. often begins with acute medical care.
For example, you might have the capacity This medical care usually is provided in an
acute care hospital before you begin Medical rehabilitation can help you to live
rehabilitation. Acute medical care seeks to as independently as possible with your dis-
stabilize your condition and lessen any ability. It helps to reduce the effects of any
further complications. Rehabilitation problems you may experience after your
begins after you are stable and your injury or illness. Rehabilitation uses a care-
doctors think you will have no more fully planned program to help you regain
complications. your ability to function on your own at
home, at work, and in the community. can make in your home to increase your
independence. These changes might
The rehabilitation process takes time and
include putting in ramps, changing door-
requires patience, motivation, and hard
knobs, widening doorways, and
work. To have a successful rehabilitation
moving furniture and rugs.
experience, you will need to relearn some
old skills, such as how to get around, While you are in a rehabilitation
and you will need to learn some program, you might feel limited
new skills as well. because you cant do
everything you did
The primary aim of
before your injury or ill-
medical rehabilitation is
ness. With persistence
for you to be able to do
and the help of family,
activities of daily liv-
friends, doctors, ther-
ing, such as eating, dress-
apists, nurses, and
ing, and bathing, so that you
other rehabilitation
can live as independently as
experts, you will be able to
possible. Rehabilitation works to
regain some of the functional
reduce the limitations you may experi-
ability you had before. You will also learn
ence with certain activities. For example, if
new ways to do tasks and take part in
you cannot walk on your own, physical
activities on your own.
therapy will help improve your balance
and muscle strength.
WHO WILL I WORK WITH
You might also be given assistive equip- DURING REHABILITATION?
ment. This would include items such as a During rehabilitation, you will most likely
cane, walker, brace, or wheelchair. All of work with several different rehabilitation
these will help to increase your independ- professionals. These professionals make up
ence. This equipment will also help you to your rehabilitation team. The members of
function better, get around on your own, your team will depend on your needs, your
and make your life easier. current insurance coverage, and the type of
Rehabilitation will also help you find ways rehabilitation program you choose.
to cope with the barriers of your physical Following is a list of some of the people that
environment. For example, you may learn you might work with; some of them might
how to go up and down ramps, get through be familiar to you. Regardless, full defini-
doors, and use public transportation. tions and descriptions of all of these profes-
sionals are included in the Terms section
You might also learn about changes you at the back of this guidebook.
Audiologist Prosthetist
Health
Insurance Plans
PART 2:
Health
Insurance Plans
T
he rehabilitation programs that you will also depend on whether you currently
can choose from will depend on, in have a private insurance plan or a public
part, what services your current insurance plan. Following, the differences
health insurance plan will cover. It is are described.
important to know and understand the
type of insurance coverage you have so WHAT ARE SOME DIFFERENT TYPES
youll know what type and amount of OF HEALTH INSURANCE PLANS?
rehabilitation services you can receive. For There are two general types of private
example, if you are a veteran, you might be health insurance plans, traditional insur-
eligible for rehabilitation services through ance plans and managed care plans, and
the Department of Veterans Affairs. two types of public plans, Medicare and
Medicaid. Over time, the differences
WHAT REHABILITATION PROGRAMS between these two types of plans have
AND SERVICES WILL MY HEALTH
become less and less clear. Today, many
INSURANCE COVER?
traditional plans have managed care fea-
When selecting a health insurance plan, tures. Many managed care plans also have
make sure to select a plan that covers features of traditional plans.
rehabilitation services, for the type of reha-
Traditional health insurance plans are
bilitation services you can choose will
sometimes referred to as fee-for-service
depend largely on the type of health insur-
plans. Usually, such plans only pay a por-
ance coverage you have. Your health
tion of your yearly health care expenses
insurance coverage can limit your choice
after you have paid a set amount of money
of rehabilitation services, providers, and
toward all the health care services you
facilities. It is important to understand
receive. This set amount of money (such
your health plan so you can make
as $250) is called the yearly deductible,
informed decisions about your care.
and you pay for this amount out of your
Keep in mind that all health insurance own pocket.
plans are not alike. They vary from state to
For example, your traditional health insur-
state and from person to person. Your
ance plan might pay for 80% of all your
plans coverage for rehabilitation services
health care expenses after you have paid
your yearly $250 deductible. After you type of managed care plan.
have paid the $250 out of pocket, you
With managed care plans, most of the fees
would only pay 20% of the cost of your
that you would pay for services you
next service. Your health plan would then
receive are fully covered. But each time
pay for the remaining 80% of the cost.
you use a service, you must pay a small
Traditional health plans generally offer co-payment amount instead, as opposed
more flexibility than managed care plans. to the actual fee for the health care serv-
With a traditional plan, you likely will have ice. This co-payment can range from $5 to
more choices in terms of where to go for $50 or more, depending on the service.
rehabilitation, how much care you can
With managed care plans, you generally
receive, and which doctors you can
dont have to pay a yearly deductible
see. Some traditional plans dont
amount before the health insurance starts
limit the number of rehabilitation
to pay a percentage of your cost.
services
Instead, all of the cost of the
y o u
service is covered after
receive.
you pay the small
This is dif-
co-payment
ferent than
amount at each
managed
visit.
care plans,
which usually limit The downside of man-
the number of rehabilita- aged care plans is that your
tion visits that will be covered. choice of doctors and health care facilities
is limited. You often must choose from
Managed care plans are the other com-
only doctors who participate in the plan.
mon type of health insurance plans. With
Also, the plan may limit the amount of cer-
this type of plan, all health care services
tain health care services, such as rehabili-
are delivered at a reduced price to plan
tation services, you can receive.
members who agree to only get their
health care from certain doctors at certain Remember that not all health care plans
locations. With managed care plans, a are alike. Be sure to check with your health
doctor known as a primary care doctor plan provider before making any decisions
manages your care. You usually have to about your rehabilitation program. No
see your primary care doctor first, and matter what type of health insurance plan
then he or she can refer you to other you have, find out which services will be
providers you might need to see. A health covered and how many services you can
maintenance organization (HMO) is a receive.
tional and managed care insurance plans. health insurance coverage for low-income
For example, Medicare Part C, as it is com- people of any age. It also covers persons
monly referred to, includes Medicare with certain kinds of disabilities. In gener-
Managed Care plans (Medicare + Choice). al, Medicaid covers:
Introduced in 1997, Medicare Managed
Hospital care,
Care plans offer expanded benefits, for a
fee, through HMOs that contract with Doctors services,
Medicare. In 2004, Medicare + Choice was
Nursing home care,
replaced by Medicare Advantage.
Home health care,
Mecicare Part D is the new prescription
drug coverage, which becomes fully effec- Outpatient services, and
tive in 2006. This prescription drug benefit
Prescription drugs.
is optional and coverage, deductibles, co-
payments, and out-of-pocket costs will vary In some cases and depending on your
depending on both your personal income income, Medicaid can also help to pay for
and total prescription drug expenses. some of the Medicare expenses (such as
deductibles and co-payments) mentioned
Make sure to find out about coverage limi-
above.
tations under your Medicare plan, because
Medicare has rules about the services and Medicaid rules, eligibility, and coverage
treatments covered. For example, depend- differ from state to state. Make sure to
ing on your Medicare coverage, you may check with your state Medicaid office to
have to pay for a portion of the health care find out your states eligibility require-
services you receive. You also may have to ments and what rehabilitation services are
pay either a yearly deductible or co-pay- covered.
ments for certain services. To learn more about Medicare and
Medicaid, visit the federal Centers for
What does Medicaid cover? Medicare and Medicaid Services Web site
The state-run Medicaid program provides at: http://www.cms.gov.
Choosing a
Rehabilitation Program
PART 3:
Choosing a
Rehabilitation
Program
Now that you know what rehabilitation is, Subacute rehabilitation,
what it can do for you, and what your cur-
Day rehabilitation,
rent insurance plan may cover, the next
step is to understand the different types of Home care,
rehabilitation programs available.
Outpatient rehabilitation, and
The physical setting where these (TR). Other services may also be offered.
part in such a program, you must be able to therapy given in an acute rehabilitation
tolerate at least 3 hours of rehabilitation program. Subacute rehabilita-
therapy per day, at least 5 days a week. tion also requires that you are
in stable medical condition
Acute rehabilitation
and need continued medical
programs can be
care to avoid possible com-
found in freestand-
plications. For subacute
ing rehabilitation
rehabilitation, you must
hospitals. These
be able to tolerate 1 to 3
hospitals are dedi-
hours of therapy per day, 1
cated solely to
to 6 days per week.
rehabilitation. You
will also find acute Subacute rehabilitation is
rehabilitation pro- offered in many different
grams in acute settings, including:
care hospitals that have specialized reha-
Freestanding, subacute rehabilitation
bilitation units.
facilities that provide medical rehabilita-
Subacute rehabilitation programs often tion only;
provide therapy needed before or after you
Subacute rehabilitation units that are a
complete acute rehabilitation but before
part of general, acute care hospitals;
you go home. A fairly wide range of reha-
bilitation services, including PT, OT, SLT, Skilled nursing units that are a part of
and TR, is provided. Subacute rehabilita- general, acute care hospitals; and
tion is less intensive and generally lasts
Skilled nursing beds that are located in
longer than acute rehabilitation.
nursing homes.
A subacute rehabilitation program
A skilled nursing facility (SNF) is one
includes 24-hour nursing care, and your
place you might receive subacute rehabili-
treatment plan is supervised by a rehabili-
tation. SNFs meet certain industry stan-
tation doctor. The rehabilitation doctor
dards and offer a higher level of nursing
also provides additional health care as
care than that offered by nursing homes.
needed. However, you will see the rehabil-
itation doctor less often than you would in Day rehabilitation, or day treatment,
an acute rehabilitation program. programs are like acute rehabilitation pro-
grams except that patients do not stay
Subacute rehabilitation is best for you if
overnight in a hospital. You can live at
you have a high level of disability but can-
home or in another community setting.
not tolerate the amount or intensity of
These programs offer many rehabilitation therapy). Additional nursing care is not
services, which are supervised by rehabili- provided. Typically, you receive outpatient
tation doctors. Nursing care and general rehabilitation therapy services 2 to 3 days
medical care are also offered as needed. per week.
If you are medically stable and dont need If you are in a medically stable condition
intensive nursing care or constant monitor- and are able to live in your own home
ing by a doctor, a day rehabilitation pro- without the risk of developing complica-
gram is best for you. These programs pro- tions, outpatient rehabilitation is best for
vide 3 to 5 hours of therapy per day, 3 to 5 you. Outpatient rehabilitation therapy
days per week. Day rehabilitation programs services are often given to continue treat-
can be independent freestanding programs, ment after more intensive acute or suba-
or part of rehabilitation hospitals. cute rehabilitation.
Home health care services allow you to Outpatient rehabilitation therapy services
receive rehabilitation treatment in your are provided in many different settings,
own home. Home health care would be including doctors offices, hospital-based
right for you if you are able to live at home outpatient units, hospital-owned outpa-
but are not able to travel to an outpatient tient centers, and other outpatient centers
facility if your health does not allow it, you that are not a part of hospitals.
live too far away, or you do not have trans-
A nursing home is another setting where
portation.
you might receive rehabilitation services.
With home health care services, rehabilita- Nursing homes are different from skilled
tion professionals travel to your home to nursing facilities because not all nursing
provide rehabilitation services and nursing homes provide rehabilitation services for
care. Services and care are provided as their residents.
often as your doctor prescribes them and
The kinds of rehabilitation services offered
your insurance allows. You typically
and the intensity of the rehabilitation treat-
receive 1 to 2 hours of therapy per day, 1 to
ment vary from one nursing home to
3 days per week.
another. Some nursing homes provide
Outpatient rehabilitation is provided if rehabilitation treatment 1 to 3 days per
you live at home and can travel to an out- week. Treatment can be a single rehabili-
patient facility. Outpatient rehabilitation tation therapy service, such as physical
can include a full range of therapy services therapy. It can also be offered as a coordi-
that make up a coordinated program of nated program of care that includes sever-
care. It can also include only one or two al different services.
services (such as physical or occupational
If you are medically stable but have special nently or for a period of time.
needs that require 24-hour nursing care, a
Nursing homes differ greatly in the care
nursing home is a good choice. You might
they provide, so it is very important to ask
want to consider a nursing home if you
many questions when you are choosing
need ongoing nursing care and cannot be
this type of care. Make sure to ask about
cared for safely at home, either perma-
the kinds of rehabilitation services that are skills, you could then get to the rehabilita-
offered, how often the services are provid- tion facility for outpatient care.
ed, and what types of rehabilitation profes-
Subacute rehabilitation can also be a
sionals provide care in the nursing home.
bridge between your discharge from an
acute care hospital and the beginning of
Will I need more than one
another rehabilitation program. Subacute
kind of program?
care might be helpful if you need time to
During the course of your rehabilitation, increase your endurance and tolerance for
you may need and receive care in more rehabilitation before starting another pro-
than one program or setting. Depending gram.
on how your medical condition and reha-
Moving from one treatment program or
bilitation needs change, you might be
setting to another is common. Doing so
moved to a different program or treatment
helps make sure that you receive the kind
setting. One program may serve as a
and amount of rehabilitation services you
bridge to another.
need, when you need them.
For example, home health care can be
Keep in mind that there is no right way to
used as a bridge between the acute care
progress through rehabilitation. Each per-
hospital and an outpatient rehabilitation
son has different needs that are met by dif-
program. During home care, you might
ferent kinds of rehabilitation at various
learn certain skills, such as how to man-
points in time.
age stairs in front of your home and how to
get in and out of a car. After learning those
Quality and
Rehabilitation
Its also a good idea to try to find out about a rehabilitation program, you can compare
the quality of rehabilitation services when the quality and services of different pro-
you choose where to go for rehabilitation. grams to help you decide how well they
The following section will help you to fig- meet your own needs. One way to do this
ure out what to look for in a high-quality is to compare different rehabilitation hos-
rehabilitation program. It also describes pitals. For example, U.S. News & World
some of the ways to measure quality. With Report magazine publishes yearly ratings
can buy. For instance, if you want to buy a itation outcomes. In general, the outcome
new television set, you can read Consumer of an event is the end result of that event.
For example, the outcome of an event
such as a football game would be the final rehabilitation outcomes such as these, you
score. The score reflects the fact that one can compare services and programs and
team did better than the other. decide which one is best for you.
WHAT ARE SOME WAYS QUALITY IS home and to their communities when
MEASURED AT THE INDIVIDUAL LEVEL? they leave the program, and
The percentage of patients who return Your level of functioning will probably be
measured through what is called the FIM, home and community, and patient satis-
or Functional Independence Measure. The faction, you can get an idea of how good a
FIM is a measurement tool with 18 items rehabilitation programs services are (See
that look at how well you do certain activ- More About Outcomes box).
ities while in acute inpatient rehabilitation.
(See More about the FIM box). WHAT ARE SOME WAYS
QUALITY IS MEASURED AT THE
Return to community. Another outcome to ORGANIZATIONAL LEVEL?
consider is the percentage of individuals
The measures described above will help
who return to their communities (rather than
you learn about the quality of care provid-
to nursing homes, for example) after inpa-
ed to individuals who have been in a reha-
tient rehabilitation. This would mean that
bilitation program. They will help to
they are functioning well enough on their
answer questions such as: Do inpatients
own to not need assistance with daily living.
have functional improvements? Are they
Satisfaction. Patients and their family able to go home after rehabilitation? Are
members satisfaction is another outcome they satisfied with their care?
to think about. Many rehabilitation facili-
All of those are important questions to ask.
ties and programs ask inpatients to fill out
But there are also many other ways to look
a satisfaction survey and to rate their care.
at quality on a broader, more general level
By asking about FIM scores, return to as well. For example, you can ask about:
MEASURING OUTCOMES
tion. Some facilities provide a wide range JCAHO is the Joint Commission on
of rehabilitation services for conditions, Accreditation of Healthcare Organizations.
such as stroke rehabilitation, brain injury, It is an independent, non-profit organiza-
multiple sclerosis, and hip replacement. tion that looks at how well health care
Others programs may offer expert care in providers meet quality and performance
only one area, such as hand or spinal cord standards. JCAHO looks at the quality of
injury rehabilitation. the staff and equipment, as well as the
organizations success in treating patients.
It is important to find out which rehabilita-
An organization, hospital, or program is
tion programs provide the specialized care
accredited only if these standards are met.
you need. If one is not available in your
area, you might want to consider going to CARF, the Rehabilitation Accreditation
another area or state for rehabilitation. Commission, is another independent, non-
profit group that helps to ensure high-quality
Accreditation status. Another way to find
care and the best possible outcomes. CARFs
out about the general quality of a rehabili-
Health Care Division only reviews and
tation program, organization, or facility is
accredits medical rehabilitation services and
to look at its accreditation status.
programs. These services and programs may
Accreditation is like a seal of approval
be offered in an inpatient hospital, an outpa-
given to hospitals and both health care
tient clinic, or in a workplace or other com-
facilities. Accredited organizations and
munity setting. CARF accreditation means
programs meet high standards of excel-
that the services that a program provides
lence in service and quality.
meet high standards of quality.
Two accrediting groups you may hear of
If you know how to look at quality and out-
are JCAHO and CARF. If a rehabilitation
comes at both the individual and organiza-
facility, program, or health care organiza-
tional levels, you will be better prepared to
tion is accredited by both of these organi-
choose a high-quality rehabilitation facility
zations, you can feel confident that it will
or program that will best meet your needs.
provide high-quality care. (See More about
Part 3 of this guidebook offers more advice
JCAHO and CARF Accreditation box).
for choosing a rehabilitation program.
Physical medicine and rehabilitation states are the public payers of health
(PM&R): A medical specialty dedicated insurance programs such as Medicare
to diagnosing, treating, and preventing and Medicaid.
disability, and to improving patients
Quality (p.17): How well health care
functional ability, quality of life, and
services meet the unique needs of each
independence.
individual patient. Quality can be deter-
Physical therapy (p.5): Therapy that mined by asking, for example: Is the
restores and maximizes movement and patient satisfied with the health care
function. A physical therapist (PT) services? Is the health care organization
will evaluate how well you control responsive to each patients needs? Are
movement and your physical function- staff members qualified in their fields?
ing. He or she will do tests to see how Is the organization accredited?
much mobility, strength, and range of
Rehabilitation (also see medical rehabil-
motion you have. Your PT will then
itation) (p.3): Treatment received as part
design a treatment program to restore
of a program to enhance functional abil-
and maximize your movement and
ity following disease, illness, or injury.
function based on the test results.
Rehabilitation services can include, but
Primary care doctor (p.8): In a man- are not limited to, medical care, nursing
aged care plan, this is the doctor that care, physical therapy, occupational
manages your care. He or she can also therapy, speech-language therapy,
refer you to medical specialists or other therapeutic recreation, vocational
providers for additional health care that rehabilitation, counseling, and other
you may need. activities prescribed to increase a
patients independence and functional
Private payer (p.9): A non-governmental
abilities.
entity that pays for your health
insurance plan. Private payers typically Rehabilitation case manager: A health
are employers. care professional who makes sure that a
person receives needed services after a
Prothetist: A professional who helps
rehabilitation stay. A rehabilitation case
make, fit, and repair adaptive devices,
manager coordinates care across health
such as artificial limbs (prostheses).
care providers and facilities, and also
Public payer (p.9): The federal makes sure that all aspects of your
government or state that pays for treatment comply with the rules of your
a persons health insurance plan. insurance coverage.
The federal government and individual
Quality Checklists
QUALITY CHECKLIST: MEETING YOUR PERSONAL NEEDS
Following are more examples of questions for you to ask as you look for a high-quality
rehabilitation program. These questions relate to what you personally want in a
rehabilitation program. These questions should be considered carefully, depending
on your personal needs.
Yes No
Are the visiting hours convenient for your family and friends?
Does the program ask patients and family members how satisfied
they are with the services and care they received?
What percentage of people with your condition return to their homes after
being discharged (as opposed to being discharged to a nursing home)? ______ %
Yes No
Does the program have a system for checking both the clinical
progress of its patients and its own internal quality?
Yes No
Does the program have a relationship with other programs that offer
rehabilitation services you may need at a later point in time (such as
subacute care, day treatment, outpatient treatment, or home care)?
Does the program use a team approach, where the doctor, therapists,
and other rehabilitation professionals work together and meet at regular
intervals to talk about your progress?
Does the program look at the progress of each patient by measuring his
or her functional ability and level of independence in doing daily activities?
RESOURCES
CHOOSING A HIGH-QUALITY MEDICAL REHABILITATION PROGRAM
AoA is the federal focal point and advocate American Occupational Therapy
agency for older persons and their con- Association (AOTA)
cerns. It supports state and local commu- http://www.aota.org/
nity-based services, including home-deliv- 301-652-2682
ered meals, in-home assistance for elderly TTY: 800-377-8555
persons, transportation services, and
AOTA is a professional organization for
employment help.
occupational therapy professionals. Its
Web site provides consumers with general
information about occupational therapy;
tip sheets about health and disability
issues, conditions, and daily living;
resource listings; and a searchable directo-
ry of occupational therapy specialists.
ASHA provides callers with referrals to CMS is the federal government agency
certified speech-language pathologists responsible for the Medicare and Medicaid
and audiologists throughout the country. health insurance programs. CMS offers
The association also helps consumers to information about Medicare and Medicaid
find therapists who are bilingual or have coverage.
special skills.
CARF, the Rehabilitation
American Therapeutic Recreation Accreditation Commission
Association (ATRA) http://www.carf.org
http://www.atra-tr.org/atra.htm 520-325-1044, voice and TTY
703-683-9420
CARF is an independent, not-for-profit
The American Therapeutic Recreation organization that reviews and accredits
Association (ATRA) is the largest, national rehabilitation facilities to help ensure high-
membership organization representing quality care and the best possible out-
the interests and needs of recreational comes. CARFs Web site includes a list of
therapists. accredited rehabilitation programs that
can be searched by state and program
type. Click on the Search for a Provider
link from the home page.
Arizona Georgia
http://www.de.state.az.us/rsa/ http://www.vocrehabga.org/
default.asp 404-232-3910
602-542-3332 TTY: 404-232-3911
TTY: 602-542-6049
Hawaii
Arkansas http://www.state.hi.us/dhs/
http://www.arsinfo.net/index.html 808-692-7722
501-296-1600
Idaho
TTY: 501-296-1669
http://www2.state.id.us/idvr/
California 208-334-3390
http://www.rehab.cahwnet.gov/
Illinois
916-263-8981
http://www.dhs.state.il.us/ors/
TTY: 916-263-7477
800-843-6154
Colorado TTY: 800-447-6404
http://www.cdhs.state.co.us/ods/dvr/
Indiana
ods_dvr1.html
http://www.state.in.us/fssa/
303-866-4150
servicedisabl/
Connecticut 317-232-1252
http://www.brs.state.ct.us/index.html
Iowa
800-537-2549
http://www.dvrs.state.ia.us/
TTY: 860-424-4839
515-281-4211 (voice and TTY)
Delaware
Kansas
http://www.delawareworks.com/
http://www.srskansas.org/rehab/
divisions/dvr/welcome.htm
index.htm
302-761-8275
888-369-4777
TTY: 302-761-6611
Relay: 800-766-3777
District of Columbia
Kentucky
http://dhs.dc.gov/info/rehabservices.
http://www.glasgowbarren.com/
shtm
glas_acc/vrehab/pages/reachus.htm
202-442-8400
502-651-5147
TTY: 202-442-8600
Louisiana
Florida
http://www.dss.state.la.us/offlrs/index.
http://www.rehabworks.org/
htm
800-451-4327 (voice and TTY)
800-737-2958
Maine Nebraska
http://www.state.me.us/rehab/ http://www.vocrehab.state.ne.us/
800-698-4440 402-471-3644
TTY: 888-755-0023
Nevada
Maryland http://detr.state.nv.us/rehab/index.htm
http://www.dors.state.md.us/ 775-684-4040
888-554-0334 TTY: 775-684-8400
Oklahoma Vermont
http://www.okrehab.org/ http://www.vocrehabvermont.org/
800-845-8476 866-VRWORKS (866-879-6757) (voice
and TTY)
Oregon
http://www.dhs.state.or.us/disabilities/ Virginia
503-945-5944 http://www.vadrs.org/
TTY: 503-947-5330 800-552-5019 (voice and TTY)
Pennsylvania Washington
800-442-6351 http://www1.dshs.wa.gov/dvr/
http://www.dli.state.pa.us/landi/cwp/ 800-637-5627 (voice and TTY)
view.asp?a=195&Q=68442&landiRNav
West Virginia
radC6865=|&landiRNavradC1381=|
http://www.wvdrs.org/
TTY: 800-233-3008
800-642-8207
Rhode Island
Wisconsin
http://www.ors.state.ri.us/
http://www.dwd.state.wi.us/dvr/
401-421-7005
800-442-3477
TTY: 401-421-7016
TTY: 888-877-5939
South Carolina
Wyoming
http://www.scvrd.net/scvrinfo.htm
http://dwsweb.state.wy.us/vr.asp
803-896-6500
307-777-7389
South Dakota
http://www.state.sd.us/dhs/drs/
United Cerebral Palsy (UCP)
605-773-3195
http://www.ucp.org/
Tennessee 800-872-5827
http://www.state.tn.us/humanserv/ TTY: 202-973-7197
VRServices.html
The United Cerebral Palsy is the leading
615-313-4714 (voice and TTY)
source of information for individuals with
Texas cerebral palsy. They advocate for the
http://www.rehab.state.tx.us/index.html rights of persons with disabilities and
800-628-5115 strive to advance the independence and
productivity of people with disabilities.
Utah
http://www.usor.utah.gov
800-473-7530