December 2025

• Client cracks his knuckles “hey! My muscles farted”
• Client while building: “I can do anything…except eat a banana”
• Email from a parent of a client with SM/phonological disorder: Btw on the way home she said she’s glad she’s learning her r’s so that her watch (voice text) understands when she says “fart”
• Client to OT: “Do you live here?”

• For any co-tx clients between speech and OT, therapists should be sharing general treatment plans before sessions as part of case management and collaborating at least 1x per month as part of case management in lieu of formal SOAP.  Documentation on Ensora can include things such as “met with SLP to discuss co-tx goals and plan for next few sessions.”-Reminder to be cc’ing therapists for shared clients on emails home as well as an easy way to keep each other in the loop
• For Kaiser clients, there is no change to our current progress report templates. In rare situations, Kaiser may request that a progress report be completed using their specific template—typically when they are initiating a re-evaluation for the client. If this occurs, Theresa will provide the required template well in advance of your progress report due date.

• Staff Schedule Updates
  • CC shifting office hours to Thursdays 12:45-1:45
  • Kayla Friday Schedule: In clinic 8 am to 12 pm, remotely 12 pm to 4 pm.

Updated Procedures During Remote Admin Hours

• Check-In:
  Kayla will check with all in-person staff before leaving the clinic to offer help with any on-site administrative tasks.
• Clear Family Communication:
  A sign will be posted directing families to call Kayla or Emily for any billing, scheduling, or general administrative questions during remote hours.
• Evaluation Reminder Calls:
  All Friday afternoon evaluation families will receive a phone call the day before, letting them know what to expect when they arrive (please wait in the waiting room; your therapist will greet you at your scheduled evaluation time).
• Secure Payment/Mail Drop Box:
  A locked drop box will be placed on Kayla’s desk for any payments or mail while she is working remotely.
• Late-arrival support for therapists: If a family is running late, therapists should text/call Emily or Kayla so admin can call the family to confirm their ETA.

PTO Flexibility Provision 

Flexibility Provision for Short-Term Caseload Fluctuations
To support normal and temporary caseload changes, full-time therapists will remain eligible for PTO as long as they maintain a minimum of 28 clinical hours per week.

• This 28–29 hour range is intended for short-term fluctuations only and does not replace the expectation that full-time therapists maintain 30+ clinical hours.
• When a therapist falls to 28–29 hours, Department Directors will support schedule adjustments and reserve the right to assign additional clients, groups, or school contracts to help the therapist return to 30+ clinical hours.

Safe AI Use

Little Hands permits the limited and responsible use of AI tools to improve efficiency in documentation and communication as long as all clinicians adhere to HIPAA and professional ethical standards (AOTA, ASHA).

Clinicians may use AI tools for:

• Drafting or improving non-clinical writing (emails, newsletters, parent education, handouts).
• Generating structure for reports.
• Rewording or summarizing fully de-identified clinical information.
• Brainstorming activity ideas or treatment approaches (non-client specific).
• Editing for clarity, grammar, or flow.

AI tools may support documentation but may NOT replace your clinical reasoning, decision-making, or interpretation of assessment results.

Clinicians may NOT:

• Input any protected health information (PHI), including:
  • Client names, initials, dates, specific ages, birthdates
  • School names, locations, addresses
  • Photos, videos, or audio
  • Detailed medical histories that could identify a client
• Enter raw standardized test scores for interpretation.
• Ask AI to interpret assessments (e.g., BOT-3, PDMS-2) or provide diagnostic conclusions.
• Copy/paste AI-generated content into evaluations without reviewing for accuracy.
• Use AI in a way that misrepresents authorship or replaces clinician judgment.

All staff must:

• Verify all AI-generated content for accuracy.
• Maintain clinical reasoning as the clinician’s work alone.
• Use only fully de-identified text when interacting with non-HIPAA-compliant tools.
• Avoid inputting proprietary test language from manuals.
• Follow AOTA, ASHA  ethical frameworks.
• Inform department directors if an AI tool is being used regularly to ensure quality review.

Recommended Workflow for AI-Assisted Documentation

• AI use does not need to be disclosed to families as long as the clinician is the true author.
• Leadership may audit evaluations for consistency, accuracy, and ethical use.
• Training will be provided annually and updated as best practices evolve.

Improper use of AI (e.g., entering protected health information, copying inaccurate content) may result in retraining or disciplinary action per clinic policy.

Policy will be reviewed every 12 months or when new professional guidelines emerge.