National Association of Service Providers in Private Rehabilitation.
First, at the Fifth Annual NRA Conference on September 28, 1928 in Milwaukee, Wisconsin, a decision was made to relax the requirement that NRA members had to be employed by a state rehabilitation agency (Brabham, 1989). This decision enabled NRA to benefit from a broader employment membership base yielding a more diverse professional rehabilitation association capable of the significant growth realized since 1928. Since employment in a state agency was not a prerequisite for membership, it allowed private providers to become members of NRA.
Second, during the beginning of the explosive growth years of private sector rehabilitation in the 1970s, the need for a private sector division was considered, however, the consensus at NRA was that the existing National Rehabilitation Counseling Association (NRCA) already provided for private sector involvement. Therefore, an additional division was thought to be unnecessary at that time.
In 1986, the Colorado Rehabilitation Association (CRA) noted that over one-half of its 200 members were employed in private sector rehabilitation, and they were losing members to other professional association groups. A special interest group was therefore formed in October 1986 within CRA to address training needs and provide for communication of the numerous changes occurring in private sector work. The special interest group in Colorado was subsequently joined by Montana and Georgia in 1988 as well as Kansas in 1989 (Bosch, 1994).
While the special interest groups were being formed, NRA contacted CRA to determine if a private sector unit could be developed at the national level. NRA's interest was precipitated, in part, by numerous phone calls received from other states expressing interest in a private sector unit, along with input received from other national and local groups. As a result, what essentially started as a movement to develop a state special interest unit suddenly became the impetus for creating an entire new national division.
Subsequently, the NRA board voted unanimously to grant provisional status for NASPPR effective September 6, 1989. The private sector group, led by Ken Bosch of Colorado, was given two years to develop:
1. Constitution and Bylaws 2. National slate of officers 3. National membership criteria 4. A process to establish state chapters 5. Division brochure 6. Division newsletter 7. A process for optional training at the NRA Annual Conference.
With the foresight, diligence and leadership of Ken Bosch (Colorado), Carolyn Thompson (Illinois) and John Lui (New Hampshire), these steps were all achieved in just one year. The private sector unit was granted divisional status in 1990! Perhaps the only element of confusion from this expeditious development is that a few of the early state chapters of the original private sector unit found it necessary to redraft their Constitution and Bylaws since they were being suddenly transformed into state chapters of a newly formed NRA Division.
The purpose of NASPPR is quite accurately stated in Article
II of its Constitution: "It is the purpose of this Association to further develop, improve, and strengthen rehabilitation within the private sector. Implementation of this goal shall be accomplished by:
1. Promoting the highest quality of rehabilitation practices. 2. Upgrading of professional standards in the discipline of rehabilitation. 3. Helping to develop a specific body of knowledge in this field. 4. Encouraging and supporting professional training opportunities. 5. Providing a forum for discussion. 6. Encouraging and stimulating systematic, scientific research and enlightened inquiry. 7. Close communication with other professional groups dedicated to rehabilitation work" (NASPPR, 1994).
Perhaps one of the most important features of NASPPR is found in its membership criteria which are based on the PURPOSE and the recognition that rehabilitation case management is not the exclusive domain of vocational counselors since the rehabilitation process crosses the paths of a wide array of professional disciplines. As acknowledged by the Commission on Insurance Rehabilitation Specialists concerning their new CCM (Certified Case Manager) credential "Case management is not a profession in itself, but an area of practice within one's profession. Its underlying premise is that when an individual reaches the optimum level of wellness and functional capability possible, everyone benefits: the individuals being served, their support systems, the healthcare delivery systems, and the various reimbursement sources" (CIRSC, 1993).
Realizing the importance of these fundamental precepts even before they were so eloquently articulated by the CIRS commission, the NASPPR Division chose an inclusive membership philosophy. Membership includes rehabilitation counselors, rehabilitation nurses, placement specialists, physical therapists, occupational therapists, vocational evaluators, job developers, employers, speech pathologists, insurance adjustors, administrators, managers/supervisors, attorneys, physicians, educators, students, and anyone who has an interest in private sector rehabilitation. This inclusive membership philosophy was designed to enhance communication among the diverse members who participate in each client's rehabilitation process. To quote Article III of NASPPR's Constitution: "Membership in the Association shall be available to all profit and non-profit service providers and all others who are interested in enhancing the rehabilitation opportunities for persons with disabilities."
NASPPR is a recognized division of the National Rehabilitation Association and is incorporated as a 501(c)(6) tax exempt organization. Several state chapters of NASPPR have also opted for 501(c)(6) incorporation status. Other states (especially those states which had unaffiliated private sector associations and later joined NASPPR as a state chapter) have kept their original 501(c)(3) status. The benefit of 501(c)(6) is that "an organization that is exempted under section 501(c)(6) may permissibly engage in any amount of legislative activity germane to the common business interest of the organization's members."
As already implied, NASPPR is governed by a Constitution and Bylaws and each state chapter likewise has a similar Constitution and Bylaws (NASPPR, 1994). To aid in state chapter development, NASPPR has this available on a computer disk so any private sector state organization applying for state chapter status may do so by obtaining the disk and simply inserting the state's name. Each state may also make alterations to the standard Constitution and Bylaws; however, the final version must be approved by NASPPR before the state chapter is officially recognized. The NASPPR representative to the NRA board will serve as the correspondent between the state unit and the NASPPR board while the application is being reviewed.
The NASPPR board is comprised of: the immediate past president (one year), president (one year), president-elect (one year), secretary (one year), treasurer (two years), four board members at large (two years), and the NASPPR representative to the NRA board (three years). There is also a membership committee chair and a legislative committee chair. These positions may be held by existing board members as a collateral responsibility. Most state chapters have a similarly configured board, although some smaller populated states have combined board position responsibilities and opted for fewer board members.
At this writing, NASPPR's national structure is complimented by 13 state chapters with two additional states pending final approval. We are confident that additional state chapters will come into existence in future years.
Emerging Trends and The Future of NASPPR
We are all aware of the public laws in recent years such as Americans with Disabilities Act (ADA), Individuals with Disabilities Education Act (IDEA), and the Reauthorization of the Rehabilitation Act. Without a doubt, they will leave their footprints beyond the 21st century. Besides their tremendous impact on people with disabilities and social/public attitudes, the common philosophy of "choice" and "empowerment" will greatly affect the field of rehabilitation. In conjunction, the movement towards "public-private partnership" is evident in both federal and state programs such as Veterans Administration, Division of Vocational Rehabilitation, Social Security Administration, and Job Training Partnership Act and the proposed Re-employment Act and Social Security Reengineering Initiatives.
The arrival of these public laws will also assure that assistive technology will continue to be the growing field both in the public and private sector rehabilitation (Lui, 1993). Knowledge in the application of assistive technology in the rehabilitation process is essential. But, it is equally important to have the ability to foster relationships with specialized technology service providers and other professionals to identify possible solutions to functional needs (Langton, 1993). This "interdisciplinary technology team" will help to address the issues of "choice" and "empowerment" and successful outcome for the individuals with disabilities.
Whether or not national health-care reform will be passed as law, President Clinton's initiative has already put this issue in the forefront. There are already major changes in the health-care arena (Healthcare, 1994) and it is obvious that managed-care workers' compensation is the prevailing concept in solving ills in workers' compensation systems (Beane and Joseph, 1994). There are also development towards "integrating" workers' compensation programs with group health benefit programs (Juliff and Polakoff, 1994 and disability insurance programs (short-term and long-term) - so called 24-Hour Coverage." This totally redefines rehabilitation practitioners' relationships with payors, employers, employees, and the other professionals and providers in the care process of disabled workers, occupationally related or non-occupationally related.
These changes will provide ample opportunities for private rehabilitation firms and practitioners and will ensure the continuous growth of rehabilitation in the private sector. Its practitioners have diversified to include professionals in many disciplines to address the entire process of client care and rehabilitation. These developing trends further reinforce that the organization of a professional association such as NASPPR, its purpose and membership philosophy of inclusiveness is right and timely. NASPPR is well positioned to meet the challenges and demands of the future.
Beane, Reginald E. & Joseph, Larry N. (1994, May). Why Medical Cost Management Programs Make Good Business Sense. Risk Management, 48-51.
Bosch, Kenneth. Telephone interview with Lloyd Holt regarding the initial interest of the Colorado Rehabilitation Association to establish a private-sector unit and its ultimate succession to the NASPPR Division, September 13, 1994; documentable through meeting minutes and records maintained by Mr. Bosch and the Colorado Rehabilitation Association.
Brabham, Robert E. (former Executive Director, NRA). Personal letter to Kenneth Bosch dated 2/21/89, regarding history excerpted from a "forthcoming" NRA Reference Manual.
Brownfield, Bill. (1989, March). The President's Column. National Rehabilitation Association Newsletter, p. 3.
Commission on Certification of Insurance Rehabilitation Specialists [CIRSC] (1993). Philosophy of Case Management. (Initial brochure on Certification for Case Manager [CCM]). Rolling Meadow, IL: Author.
Juliff, Ronald J. & Polakoff, Phillip L. (1994, April). An Integrated Approach to Disability Management. Risk Management, 91-98.
Langton, Anthony J. (1993, Spring). Making more effective use of assistive technology in the vocational evaluation process. Vovational Evaluation and Work Adjustment Bulletin, 26(1), 13-19.
Lui, John W. (1993, October). Private Sector Rehabilitation: Insurance, Trends & Issues for the 21st Century. In L.G. Perlman & C.E. Hansen (eds), A Report on the 17th Mary E. Switzer Memorial Seminar (Switzer Monograph Mo. 17, pp. 47-53). Alexandria, VA: National Rehabilitation Association.
National Association of Service Providers in Private Rehabilitation [NASPPR], Constitution and Bylaws, 1994.
Runningen, John R. & Senko Elizabeth M. (1994, December). 1995 Health Care Industry Overview - Health Care Integration and the Balance of Power. Investment Focus, 9(12), 27-30.
Lloyd M. Holt is Coordinator of Patient and Public Information, Younker Rehabilitation Center, Iowa Methodist Medical Center, in Des Moines, Iowa (since 1988). After receiving a B.A. Degree in Psychology from Upsala College, East Orange, New Jersey, in 1968, he embarked on a rehabilitation oriented claim career with long term disability insurance carriers (1968-1974). He then occupied management and executive positions for two national private-sector rehabilitation case management firms in Chicago (1974-1983), as well as being an independent consultant in Pennsylvania (1983-1987). He is a charter member of the National Association of Rehabilitation Professionals in the Private Sector (NARPPS) from 1977-1989, and a member of NRA, NASPPR and NRAJPD since 1989. He was 1993 President of the NASPPR Division of NRA and was elected Board Member at Large for 1995-1996. An author of several articles on private-sector rehabilitation (case management and medical facility based), his most recent was published by NRA in the 1993 Mary E. Switzer Monogram concerning "The History of Private-Sector Rehabilitation".
John W. Lui, C.A.G.S. Northeastern University, 1980, M.S. University of Wisconsin Stout, 1975, B.S. University of Wisconsin Stout, 1974, MBA New Hampshire College, 1982. John is the President of Rehabilitation Consultants, Inc. (RCI), a Healthsource company. RCI and its affiliate, Vocational Assessment Center, were established in New Hampshire in 1976 and 1978 respectively. John is a Certified Rehabilitation Counselor and a Certified Insurance Rehabilitation Specialist. He is a current board and Executive Committee member of National Rehabilitation Association (NRA), the past president and current board member of National Association of Service Providers in Private Rehabilitation (NASPPR), the past president and current board member of the New Hampshire Chapter of NASPPR, and the past president and current board member of the New Hampshire Rehabilitation Association. In 1993, he was selected as a Mary E. Switzer Scholar and authored a paper on "Trends and Innovations in Private Sector Rehabilitation for the 21st Century" for the Mary E. Switzer Memorial Seminar and Switzer Monograph titled "Private Sector Rehabilitation: Insurance, Practitioners, Trends and Issues".. He is an adjunct professor of Assumption College's Master's Degree Program in Rehabilitation Counseling in Concord, N.H. He is a member and Executive Committee Member of the New Hampshire Rehabilitation Advisory Council, a Governor appointed position.