Orientation & Mobility (O&M) skill instruction helps an individual with low vision or blindness identify where they are in space and where they want to go (orientation). O&M skill instruction also equips an individual to carry out a plan to get where they want to go (mobility). O&M skills are taught only by a certified Orientation and Mobility Specialist.
O&M skills should begin to be developed in infancy starting with basic body awareness and movement continuing on into adulthood. The individual will learn skills that allow them to navigate the world efficiently, effectively and safely.
What skills are taught through O&M?
O&M skill training is individualized and may include:
The following Sensory Integration Techniques enhance sensory processing and promote adaptive responses to the environment:
Sensory Awareness includes gaining information about the world through hearing, touch, smell and proprioception.
Spatial Concepts incorporates the relationships that exist between objects in the environment and that objects exist even if not felt or heard.
Searching Skills to be able to locate items or places efficiently.
Independent Movement within an environment includes crawling, rolling, walking.
Sighted Guide Techniques in receiving assistance from another individual during travel.
Cane Skills incorporates various cane techniques to identify a clear path of travel.
Additional O&M skill instruction may include Self-Care and Home Management training. Those tasks may include activities of daily living (ADLs); lighting assessments as well as recommendation and instruction for effective use of assistive devices.
Where do O&M services take place?
O&M skill instruction is highly individualized and is intended to equip an individual with a skill set to be as independent as possible. Thus instruction may take place within the home setting, in the community, in public spaces; or if authorized on a student’s education plan, the instruction may take place in school. The O&M Specialist strongly encourages professionals involved with the individual to observe and learn the O&M skills and related language to support on-going use of learned skills.
What’s a primary goal of O&M?
A primary goal of O&M is to equip any individual with a visual impairment the ability to achieve independent movement to as great a degree as possible. Most individuals who have low vision or blindness are able to learn routes in familiar environments by utilizing various clues and landmarks to provide orientation. With O&M training any individual has the potential to travel independently.
How are O&M services paid for?
Effective July 1, 2013, Montana Medicaid will pay for Orientation & Mobility instruction for Medicaid eligible individuals’ age birth through twenty (20) who have low vision or blindness.
MILP is a contracted vendor with the VA, therefore any veteran who has vision loss from service and non-service related circumstances O&M services are paid for.
Any other adult O&M services can be provided through a fee for service arrangement directly with MILP.
How is an individual referred for O&M services?
Parents, legal guardians, early intervention family support specialists, medical providers, teachers, case managers, special education directors, Vision Outreach Consultants from Montana School for the Deaf & the Blind, or any service provider may provide a referral directly to MILP.
What is the reimbursement process for O&M services?
Birth to Three (3) Years
Children age birth to three are served under Medicaid's Early Periodic Screening, Diagnosis & Treatment (EPSDT) program. The referent or family member may contact MILP to provide O&M instruction. MILP will provide an agreement to establish a provision of services to be provided.
MILP bills Medicaid directly for O&M instruction.
School Age through Twenty (20) Years
Public School, Learning Co-operative:
If an eligible student has O&M services defined on their Individualized Education Plan (IEP), MILP may be considered by the school as a possible contracted provider.
MILP will supply a contract outlining the provision of O&M services which will meet the expectations outlined in the student’s IEP. Once the contract is signed by the appropriate school district representative, O&M services will begin.
MILP supplies the School with an invoice for the O&M service provided.
School pays MILP per the invoice received and contract agreement.
School bills Medicaid for the O&M instruction of Medicaid eligible students, using the appropriate codes and rates associated with the school provider type.
Summer Instruction: see below Community Instruction
The home school student’s family or legal guardian may contact MILP to arrange for O&M skill instruction. MILP will draft an agreement outlining the provision of services and payment arrangements. Once this agreement has been signed, O&M services will begin.
If the student is Medicaid eligible – MILP will bill Medicaid directly for O&M services.
If the student is not Medicaid eligible – MILP will bill the family/legal guardian the pre-determined fee for service amount.
The entire world is the classroom for an individual with visual impairment. O&M instruction may occur anywhere the student and family may go. For example the city park, mall, day camps, grocery store, ride the city bus, walk from home to the corner store or bus stop, etc. Coordination of community instruction takes place between the student’s family and the O&M Specialist.
MILP bills Medicaid directly.
EXCEPTION: If Community Instruction is part of school sponsored services such as a field trip – School will bill Medicaid just as if the services were provided “in” the school.
An eligible veteran may be referred to MILP for O&M instruction. MILP’s O&M Specialist makes arrangements with the veteran to provide services according to the authorization provided by the VA contract.
MILP bills the VA directly.
Adult 21+ Years
An individual 21 years or older with low vision or blindness may be referred to MILP for O&M instruction. MILP will provide an assessment if necessary and then an agreement to define the provision of services to be provided. The agreement will include a fee for service arrangement.
MILP bills the individual or family member/representative directly.
What about confidentiality?
All information obtained from the referral, assessment and provision of service delivery process is held in strict confidence. Information about the individual is important to the mutual planning for services. MILP employs a Certified Orientation & Mobility Specialist who adheres to a strict code of ethics. All individuals, and/or their representative, receiving services from MILP will be provided a copy of MILP’s Notice of Privacy Practices.
MILP is a not-for-profit agency governed by a consumer-controlled Board of Directors whose lives have been personally impacted by a disability. It is funded in part by the Rehabilitation Act of 1973 as amended in 1992 (Title VII- Independent Living Services), and the Montana Department of Public Health and Human Services (Disability Services Division). To obtain accessible formats of this website information contact MILP's Helena office at (406) 442-5755 or toll free at 1-800-735-6457.