massachusetts occupational therapy practice act

Salaries were as follows: 10th percentile: $58,960 Occupational therapists who have a license to practice in Massachusetts can access fantastic jobs, a great quality of life and exciting opportunities for adventure. This is average compared to other occupational therapy licenses across the United States. hb```f``e`b``g@ ~3G9&lER{z;7 diiV f2sBCUHHa4 ]@,pg0 Occupational therapy is an evolving profession. Section 23O - Occupational Therapists or assistants; necessity for licensure; use of letters, abbreviations, etc. Criterion Child Enrichment 2. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. This bill was filed by Rep. Thomas Golden and Sen. Jason Lewis. Springfield affiliates with more than 300 fieldwork sites. Please count on me to continue to provide you with a bimonthly update. Jd^[[74m"X/Vk]V&b!xNy|ylC>_` 9 Students can search for accredited programs on the site of the American Occupational Therapy Association (AOTA). Administration of act by state board of healing arts. Occupational therapy services are included in this bill. MtUe3zHpIgyci|? A joint hearing was held on October 1, 2019. endstream endobj 40 0 obj <> endobj 41 0 obj <> endobj 42 0 obj <>stream hbbd``b`@ H0Hb&Fm %~ K The school offers a fully accredited OTD doctorate program. Names of past Presidents and Terms (at least past 10 years): 2022 - present - Michelle Savrann . The bill proposes to amend current law to include occupational therapist and occupational therapy assistant to the definition of qualified mental health provider in Massachusetts. While this is slightly less than the national mean, short-term travel therapy assignments typically offer up to 20% more than staff positions. hb``` f \h4w3Z^6F"._|Jx_9;o2 *y>wO>W'g9&g 4X{n,'V >CzGguDt|ze3:Ak $lK;]KT"\8>1ukD}Dq2[dWIP@z,`@V, A`a`wJDAx`jh*u@b.``hh`G` w@!P%. Secure websites use HTTPS certificate. Occupational Therapy Practitioners use everyday life activities (also known as: occupations) with clients of all ages to support occupational performance and participation. If you need assistance, please contact the Trial Court Law Libraries. Massachusetts occupational therapists help people participate and function in daily routines, work, and other life activities. But, we need help! Passing a bill in Massachusetts is hard, it is designed to be hard. Being an allied traveler, especially with Med Travelers, comes with a lot of amazing benefits. Submit your application to Med Travelers today. Nothing in this section shall be construed as authorizing an athletic trainer, occupational therapist, occupational therapy assistant, physical therapist, or physical therapist assistant to practice medicine or any other form or . 65-5403. endstream endobj startxref D'7[l8=O_|mZrQ>lc(Bx{4M= zYoEpdqg@[ 8e 01/27/2023. Refund Policy. If you need assistance, please contact the Trial Court Law Libraries. Massachusetts Occupational Therapy Salary Information. The Department has a 100-year history; it was once the Boston School of Occupational Therapy. They can also take the traditional path and enter as graduate students. Massachusetts occupational therapists averaged $87,160 in 2018. Occupational therapists help patients develop abilities such as motor, self-care, and organization and study skills. 4)Increased communication about MA Government Affairs. If so which ones? Regulations governing occupational therapists. %%EOF endstream endobj 91 0 obj <>stream hb```f``\ cBlXn30p`LqE[g_B_p#GG[#DCv30ls80Di~,p5 @X"Q "0 Licenses for occupational therapists are overseen by the Board of Allied Health Professionals. So with that said we need your help; the legislature does not like to pass new mandates and they think this is a new mandateI am trying to prove its not; I am hoping the information we gather from these questions will prove that. Some page levels are currently hidden. 75th percentile: $101,440 To address an audience question, "non-compete" is against Massachusetts State law, as of October 1, 2019. Please send responses to the questions below by December 15, 2019 toSarahMcKinnonOT@gmail.com. Practice Act; License Verification; Legislative Links; Address Board of Allied Health Professionals 1000 Washington Street, Suite 710 Boston, MA 02118. . ROLE OF OCCUPATIONAL THERAPY IN THE SCHOOL SETTING 25 Related Services 25 OT 26 . endstream endobj 84 0 obj <> endobj 85 0 obj <> endobj 86 0 obj <>stream A lock icon ( Massachusetts has a lot going for it: innovative programs, top ranked schools, and a lot of job options. Please limit your input to 500 characters. We offer discounted continuing education, networking opportunities, advocacy, special interest groups, and a community of practitioners to help support and further your career! There are many phases to a bills life, as many of you experienced when you testified, that is the public phase. You skipped the table of contents section. As this bill sits in committee, there is no announcementof next steps by the committee for any votes followingour written and oral testimonies in July. Through the provision of skilled services and engagement in everyday activities, occupational therapy promotes physical health, mental health, and overall well-being by supporting occupational performance and engagement in meaningful activities. 4. To address an audience question, "non-compete" is against Massachusetts State law, as of October 1, 2019. The MAOT incorporation date-January 28, 1922. The cost of living is more expensive than the national index, largely due to housing. H|MN09,A2 !@%!nj{gz^KoV+(R,(0_? h7lW6yC1).yo, PTAs are skilled health care workers who provide services under the direction and 259 CMR 6.00: Physical therapy facilities. fcQ@zgF2J(*$mGIZy;Zu)#!'#[&{toLo}c28N7gh9 Please let us know how we can improve this page. Box 850543, Braintree, MA 02185 Email: info@maot.org, OT Service Guidelines for MA Public Schools, School, Pediatric, and Transition Planning SIG, COVID-19 Resources for Massachusetts Occupational Therapy Practitioners. ) or https:// means youve safely connected to the official website. Initial applications are processed by a third-party vendor and typically take two to four weeks. Section 23O - Occupational Therapists or assistants; necessity for licensure; use of letters, abbreviations, etc. of license, Section 23L - Practice of medicine or other form of healing, Section 23M - Rules & Regulations; record of proceedings; roster of licensees, Section 23M 1/2 - Practice Settings of licensees; regulations, Section 23N - Athletic Trainers; necessity of licensure. at any time to discuss MA Government Relations. How are OT/OTA services accessed now? Are OTs used by DMH or in any other state contracts? Massachusetts occupational therapists averaged $87,160 in 2018. We encourage you to perform your own Email: alliedhealth@mass.gov Phone: (617) 701-8605 Fax: (617) 727-9932. Please read below for an update on topics presented, and check out website links. In what settings is OT/OTA paid for for MHSU? The Massachusetts OT profession is predicted to increase by 16.2% across the 2016 to 2026 decade. Read through the resources on this page to see if an occupational therapy position in the Bay State is right for you. If you're concerned about affordability, look into travel OT jobs that provide perks such as furnished private accommodation or a housing allowance for the duration of your assignment. This bill was filed by Rep. Thomas Golden and Sen. Jason Lewis. This bill, which was filed by Sen. Michael Rush and Rep. Edward Coppinger, proposes increased scope of practice for athletic trainers beyond athletic injuries to include injury and illness. However, first and foremost, we must know the ins and outs of our State Practice Act. New England Baptist Hospital endstream endobj 88 0 obj <>stream 46 0 obj <>/Filter/FlateDecode/ID[<54BE0C99D248DAEA65C557984A00C7EF><7D643ACC61869A42AFA656DB0F4427F0>]/Index[39 16]/Info 38 0 R/Length 56/Prev 51335/Root 40 0 R/Size 55/Type/XRef/W[1 2 1]>>stream Thank you for your website feedback! profession. H.1000/S.550 An Act Relative to Mental Health Providers (Support). RDy endstream endobj 186 0 obj <> endobj 187 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/XObject<>>>/Rotate 0/Type/Page>> endobj 188 0 obj <>stream Standards for practice of telerehabilitation . Please contact me atinfo@maot.org, or more personally atSarahMcKinnonOT@gmail.com. The Model Occupational Therapy Practice Act has been updated to reflect the modern occupational therapy practice. %%EOF Some page levels are currently hidden. Both public and private? Ht=!SPj3OhMWp_cP1Pt6&n)lF7MQ2eOoqoQ69s}[5? Inpatient /Outpatient /Partial or Day programs? In 2019, many Massachusetts occupational therapists have come out in support of a bill that would make occupational therapists qualified mental health providers. hV[O9+~lUmBEmwaHLiHP2Tw. 0 For what services ? %PDF-1.5 % z1PV A3hwep JP+*j`*6V@A pBUw YVR2X-1B?HQD }Uac g'@2T'@,@ @,/? ) or https:// means youve safely connected to the official website. Among them are Medicare-certified home health services and therapy house calls. The emphasis is autism; the organization also serves other individuals with developmental issues. The board, in the manner hereinafter provided, shall administer the provisions of this act. Now What? Use this button to show and access all levels. 25th percentile: $72,380 Learn more about us Boston University is tied for top rated program in the nation. This bill is in committee and a hearing has not been scheduled. Section 23P - Physical therapists and assistants; necessity for licensure; use of . Those at the high end 90th percentile earned approximately twice what those at the low end 10th percentile did. Our services are provided for clients who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. ; fees, Section 23F - Athletic Trainers; qualifications, Section 23G - Occupational therapists; qualifications, Section 23H - Occupational therapy assistant; qualifications, Section 23I - Physical Therapist Qualifcations, Section 23J - PT Assistants; Qualifications, Section 23K - Revocation, suspension, etc. By clicking "SUBMIT" I agree to receive emails, automated text messages and phone calls (including calls that contain prerecorded content) from and on behalf of {{site_name}}, its parent, AMN Healthcare, and affiliates. Physical therapy facilities ; 259 CMR 7.00: Continuing competence . Please do not include personal or contact information. The Developmental Medicine Center at Boston Childrens supports children through age 17 who have a range of conditions. 323, 3; July 1. Section: 326-C:1 Definitions. The Rehab and Nursing Center at Everett. Representative Assembly. %%EOF 83 0 obj <> endobj members while developing and preserving occupational therapy as a If not then it needs to be addressed there and if so why is legislation needed? The feedback will only be used for improving the website. Please let us know how we can improve this page. The following were among the organizations and businesses seeking occupational therapists in Massachusetts in 2019: Lanessa Extended Care Our recruiters place allied health professionals throughout the country and are ready to help you line up a rewarding OT position in Massachusetts or another destination of your choice. If you're keen to learn more, our staffing specialists are happy to share their expertise and help you build your OT career in Massachusetts. endstream endobj startxref Work may take place in the educational sector as well as the healthcare one. The Physical Therapy Practice Act is comprised of Chapter 112 of the MA General Laws, Sections 23A - 23Q. Please include Medicare and MassHealth in this response. This page is located more than 3 levels deep within a topic. They are a slow and deliberative body which is frustrating, I understand. The state as a whole had a location quotient of 1.54 as compared to a national norm of 1.00. Thank you for your website feedback! Occupational therapists may utilize therapeutic modalities for which they have had appropriate training. We will use this information to improve this page. AnAct Relative to Mental Health Providers, H.1000/S.550, is currently in the Joint Committee for Financial Services, chaired bySen. James WelchandRep. James Murphy. To meet a portion of your licensure renewal or continuing competence/continuing education requirements, you may elect to take the jurisprudence exam if it is available in the jurisdiction in which you practice physical therapy. Applicants for a license in occupational therapy must submit all of their information, as indicated in these instructions, directly to PCS. COVID-19 Resources for Massachusetts Occupational Therapy Practitioners. >p hX6)pF4Ab&H|P,E0)@3, q~\V1l(b?4Y68c(b[*Q?Fa8#F0,Oqo#>g!$@0 dhllD}dctD4'SS>318]'zvgl,!kwV+OS2zOgLpC`I8G,-nT>Zl~dezyI,LlB8pssb\j ) H.3483/S.1338 An Act Relative to Athletic Training (Opposed). Faculty members have diverse research interests; one operates the REACH Lab (Research on Ethics, Aging, and Community Health). Mass.gov is a registered service mark of the Commonwealth of Massachusetts. )Y2,ynFd. Please limit your input to 500 characters. Is it included in a bundled payment or day rate? Based on feedback from a membership survey and discussions at the 2018 MAOT annual conference, one bill, An Act Relative to Mental Health Providers (HR1000/S550), was filed by Sen. Nick Collins and Rep. Natalie Higgins. The following are among Massachusetts diverse employers: The Koomar Center has a focus on sensory integration. What might be a surprise to people is the legislature is not a proactive body. Htn0wFltH;x:TQJJ6'!/Z [ (`4*m^(5ctoa72Jdf*uGypO&X9o%TX&IeCh6()N%NBhSs5:jHD*m|gj+Au]5N~ ~`Zz`4B*Z0BFd`CIu$Tue;.iWVu/7ClCJv839,$Nbdjq\G ;2#d$(sdjX6+ x L Occupational therapists in Massachusetts earn an annual mean wage that's very close to the national average. Occupational therapists in Massachusetts earn an average annual salary of $85,760, according to the Bureau of Labor Statistics. trainer, occupational therapist, occupational therapy assistant, physical therapist, or physical therapist assistant to practice medicine or any other form or method of healing not specified in said section." MGLA ch 112 23L (LexisNexis 2005) Non-Physical Therapist Practice Acts and Regulations understanding of, occupational therapy. An official website of the Commonwealth of Massachusetts, This page, 259 CMR 3.00: Occupational therapists, is, for 259 CMR 3.00: Occupational therapists. Written testimony by MAOT was provided in favor of this bill. A .mass.gov website belongs to an official government organization in Massachusetts. we write about. 106 0 obj <>stream Those at the high end 90th percentile earned approximately twice what those at the low end 10th percentile did. Let us know if you have any questions about OT state boards licensing. profession to the public and promoting better access to, and The greater Boston area had the 5th highest employment levels of any metropolitan area in the nation. Our site does not feature every educational option available on the market. Section 23L Practice of medicine or other form of healing Section 23L. In this case, the program will take 2 1/2 years. See privacy policy or cookie policy for more details. I understand these messages will be to the email or phone number provided, and will be about employment opportunities, positions in which Ive been placed, and my employment with AMN companies. The school lists potential faculty mentors by area of interest: children and youth, productive aging, health and wellness, and mental health. South Bay Community Services ABPT COVID-19 Statement to Practitioners ALASKA 12 AAC 54.530. 259 CMR 5.00: Physical therapists ; 259 CMR 6.00: Physical therapy facilities ; 259 CMR 7.00: Continuing competence ; Regulation Regulation 259 CMR 5 . 90th percentile: $117,860. Mary Immaculate Health Care Services offers a continuum of support services, including a short term rehabilitation program termed Remarkable Recoveries for individuals preparing to return home after a major illness, injury, or surgery. %PDF-1.6 % Physical Therapy Board Listings. Puddingstone Place also serves multiple age groups. J/5kB;XD889/{q^knZ6Gk`-`l4m[ Boston University students have the option of pursuing a combined OTD/PhD. Occupational therapy in this unit may include stroke recovery, cognitive safety screening, community reintegration, and re-learning of ADLs (Activities of Daily Living). If so which payerscover it; which ones do not? Career Center. An applicant for licensure as an occupational therapy assistant shall: (a) successfully completed an accredited occupational therapy assistant educational program approved by the board, (b) successfully completed a minimum of two months of supervised field work, (c) successfully passed an examination conducted by the board for . Here is a link to more informationif you are aware of this topic and would like some information. The licensing examination is the National Board for Certification in Occupational Therapy, or NBCOT. $`T&. Massachusetts serves up a bit of everything: bustling cities and laid-back college towns, iconic getaways in Cape Cod and Nantucket, rich historic and cultural attractions and plenty of natural wilderness. https://www.salemnews.com/news/local_news/autism-developmental-disabilities-center-opens-in-danvers/article_0253a4a2-2087-56c7-8b9f-183b9b259d1a.html, https://www.mass.gov/allied-health-professionals-licensing. endstream endobj 89 0 obj <>stream All ethical and scope of practice guidelines apply to telehealth practice the same as face-to-face practice. The Massachusetts Board of Allied Health Professionals has authorized Professional Credential Services (PCS) to process all of its applications for licensure for occupational therapy. ?=4 cmTD)9 !=4 dmTD'1D We will use this information to improve this page. The Occupational Therapy Code of Ethics was last updated and adopted by the American Occupational Therapy Association's (AOTA's) Representative Assembly (RA) in 2020. The capstone project pairs doctoral students with faculty mentors, they carry out a project related to clinical practice, advocacy, research, and/ or education. Please limit your input to 500 characters. H.991/S.621 An Act Advancing and Expanding Access to Telemedicine Services (Support). MAOT serves the interests of its members by representing the If you can picture yourself living and working in the Bay State, tell us about your ideal job so we can help you get there. Htn013&R/T4 L18~q=L"Q' The Tufts University-Boston program is ranked 6th in the nation. This compact would allow for reciprocity for OT professionals to practice across state lines. Is this allowed in your licensure? Occupational therapists ; 259 CMR 4.00: Athletic trainers . Hebrew SeniorLife also provides a continuum of services for the elderly and others with serious health conditions. Therapists are able to provide evaluation and intervention for adults as well as pediatric populations. Please use the links below for navigation. 2)Mental Health Legislation Written Feedback (WE NEED YOUR HELP). A lock icon . The As licensed professionals, it is our responsibility to know the rules and regulations required of us in the setting we practice in. Referral? Over a dozen MAOT members presented oral testimony and 18 MAOT member provided written testimony in support of this bill. Please remove any contact information or personal data from your feedback. hbbd``b`:$ $D I= >&3012ic`$ Lahey Health System It typically takes between six and eight weeks to receive your occupational therapy license in Massachusetts. 95 0 obj <>/Filter/FlateDecode/ID[<7EEF56180128CC4BAD553DFABE8941D9>]/Index[83 24]/Info 82 0 R/Length 69/Prev 125605/Root 84 0 R/Size 107/Type/XRef/W[1 2 1]>>stream Boston Childrens has special programs for Down Syndrome and Williams Syndrome. AddressBoard of Allied Health Professionals1000 Washington Street, Suite 710Boston, MA 02118, ContactEmail: alliedhealth@mass.govPhone: (617) 701-8605Fax: (617) 727-9932. You Asked Experts Answered 2020 Archive, You Asked Experts Answered 2019 Archive, One-on-One PDPM Training Session for Individual Members. Box 850543, Braintree, MA 02185 Email: info@maot.org Powered by Wild Apricot Membership Software ), I will send an email by the 1st of every other month with any MA government relations issues, as well as solicit your feedback and personal experiences at this time. Given the concern for infringement on occupational therapy practice, MAOT has prepared a written statement opposing this bill. SNF Medicare Part A Proposed Rule Changes for October 1st 2023, Medicare Part B Final Rule for 1/1/23: Guide for SNF Therapy. This proposed change will allow clients with mental health and/or substance abuse diagnoses to further expand services available to them to achieve functional, independent, and meaningful lives. 0 H.991/S.621 An Act Advancing and Expanding Access to Telemedicine Services (Support) This bill encompasses expansion of telemedicine services to populations with Massachusetts. hS[O0+q{|I*J* <CAtlus c&a Mass.gov is a registered service mark of the Commonwealth of Massachusetts. Top-requested sites to log in to services provided by the state, Regulations governing physical therapists. A lock . It was the subject of an article in the Salem News (https://www.salemnews.com/news/local_news/autism-developmental-disabilities-center-opens-in-danvers/article_0253a4a2-2087-56c7-8b9f-183b9b259d1a.html). independent research before making any education decisions. Please do not include personal or contact information. The feedback will only be used for improving the website. A .mass.gov website belongs to an official government organization in Massachusetts. The Model Practice Act is meant to help . A prospective OT must apply to the Massachusetts Board of Allied Health Professionals for a license. Physical Therapy Practice Acts By State. New Hampshire Statutes Table of Contents 326-C: OCCUPATIONAL THERAPISTS. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. 50th percentile: $87,940 Z An official website of the Commonwealth of Massachusetts, This page, 259 CMR 5.00: Physical therapists, is. Please use the links below for navigation. hbbd``b`e@QH 9 tHD$+H#H#F Occupational therapist council established; appointment of members; compensation. G f PhysicalTherapyPracticeAct.org. Occupational therapy services are included in this bill. Share sensitive information only on official, secure websites. With regard to location quotient, two of the top 10 metropolitan areas in the nation were in Massachusetts: the Leominster-Gardner metropolitan area and the New Bedford metropolitan area. Based on member feedback, the lobbyist and MAOT leadershipwill not hold a gatheringin the middle of MA on 12/11; rather,we will solicit written feedback to assist us. Z))8L8AU:}l. %7>2yU=\O]l;-BxL6VUJ_[T 3. Its answering questions, its legal research, its correcting misinformation. Box 850543, Braintree, MA 02185 Email: info@maot.org, OT Service Guidelines for MA Public Schools, School, Pediatric, and Transition Planning SIG, COVID-19 Resources for Massachusetts Occupational Therapy Practitioners. HealthCarePathway.com 2009-2023 All Rights Reserved. Guidelines for Provision of Occupational Therapy Services in Massachusetts Public Schools CONTENTS . In September 2019, AOTA and NBCOT announced a four-year collaboration to create an interstate licensure compact for the OT profession. The following words as used in sections twenty-three A to twenty-three P, inclusive, unless the context otherwise requires, shall have the following meanings:. 5. Section 23C: Athletic trainers, occupational therapists or physical therapists or assistants; practice upon filing of license application Section 23C. This bill encompasses expansion of telemedicine services to populations with Massachusetts. Membership in MAOT is an investment in yourself and our profession. Massachusetts Physical Therapy Practice Act. You skipped the table of contents section. 54 0 obj <>stream If you need assistance, please contact the Trial Court Law Libraries. Currently, the following states offer jurisprudence exams for continuing competence credit: California; Florida; Nebraska OT/OTA services are currently reimbursed by payers. 39 0 obj <> endobj The New OSA is HERE for 10/1/23! 185 0 obj <> endobj The programmatic accreditor, the Accreditation Council for Occupational Therapy Education, is under the AOTA banner. Many listings are from partners who compensate us, which may influence which programs They evaluate patients, create treatment plans, and implement them or support their implementation. Spending for the services of PTs in private practice (PTPP) represented 15 percent of this total. MAOT provides a professional network for its Prospective OTs earn degrees at the graduate level. Why cant a referral be given for MHSU through the same procedure now? *:z \6iS"sCOpix17+F%fd0z/6GxKt>gF#ggY_%:W tV-0kF1|#KlUL]g08?Odb5a_[KFz dDF0>vnEQ5QmII7(p}\/PJ&q7|i-'*WDO)$[e[]VWxiZ+yebY>fev>Zxbo \Zp\LGE!{` ,`0zX]P"eeIHn 4Z\m,gIwte|^ =NeAgX0TP{4.Uu3u~uQ@r42D&6AKsn236hc1afyXdfX3zYxWWm wRei,u T;\6lN+\?Zj3 -Yoww6+z2l0-;UovD+;'S@@ zN6 M)U\p-bso#X/^Gn@n_.Rr{wV- b& Section 23B - Examination; application for Licensure; Fees; renewal, Section 23C - Practice upon filing of license application, 23D - Licensing of persons registered in other states, territories, etc. Or is it reimbursed to the individual provider. Its boring and hard and has no guarantees. Section: 326-C:2 Evaluation and Treatment Authorization. Section 23P - Physical therapists and assistants; necessity for licensure; use of letters, abbreviations, etc. The OT after a healthcare professionals name stands for occupational therapist; it means the person is part of a highly valued and growing profession. 1. Advertising & Careers. If so how is that happening in the contract or program design with a rate built in. Is OT/OTA currently being reimbursed for MHSU services by any payers? Are you ready to embrace an exciting travel occupational therapy job? The Physical Therapy Practice Act is comprised of Chapter 112 of the MA General Laws, Sections 23A - 23Q. The bill was referred to the committee of Financial Services and a hearing was held on July 9, 2019. A representative from MAOT attends most of the monthly Board of Allied Health meetings and reports back to MAOT membership. The scope of practice is intended to include patients, in addition to athletes, and encompass patients within community settings outside of athletic environments. Is this possibly a parity violation issue that the med surg side of a policy pay for OT/OTA but the MHSU does not? Treatment plans include activities that help people recover or develop skills across areas, including sensory-integrative, neuromuscular, and cognitive. This page is located more than 3 levels deep within a topic. 195 0 obj <>/Filter/FlateDecode/ID[<2A924ABC6F8E2B4361A4D6CFBCCE29E0>]/Index[185 22]/Info 184 0 R/Length 67/Prev 390660/Root 186 0 R/Size 207/Type/XRef/W[1 2 1]>>stream
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