accessibility program manager, Nicholas Horton

Accessibility Program Manager – Nicholas Horton

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This week’s spotlight is on Nicholas Horton, an OT who now serves as an Accessibility Program Manager for the Virginia Department of Health!


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What is your full name, title, and company name for your current, primary role?

Nicholas Horton – Accessibility Program Manager, Virginia Department of Health

What additional roles do you currently have?

On occasion, I provide UX/UI consultation at Boston University.

Where are you located?

Seattle, WA

Where did you go to OT school, and what year did you graduate?

MS at the University of Oklahoma, 2014, and I recently got my doctorate in Rehabilitation Science from Boston University in May of 2022.

What did you do when you first finished school, and for how long?

Assistive technology, ergonomics consulting and accessibility auditing, in conjunction with full or part-time clinical work for eight years.

In what setting(s) did you work, and what types of patients did you treat?

The clinical settings were mostly outpatient to conduct functional capacity evaluations, visual screenings, and ergonomic assessments. I worked primarily with working adults who had a temporary or permanent disability.

What did you enjoy about your early roles? What didn’t you enjoy?

I enjoyed working one on one with people with disabilities and gaining valuable insight to their lived experiences. I was fortunate enough to find unique opportunities in industrial and office workplaces where the fundamentals of OT could be applied.

To reiterate what many of my colleagues have said, I found the healthcare process frustrating. Arguing with insurance groups about denials, domain encroachment by other professions, administrative policy, stagnant wages, and the ever-increasing documentation wore me out.

When and why did you decide to do something non-clinical?

Before I finished OT clinicals, I knew I wanted to play a bigger role in either policy or systems improvement. The idea that universal (or inclusive) design could be applied to anything stuck with me, and since I had a bit of background in IT, the transition to digital accessibility felt natural.

What are you doing these days?

I am the Accessibility Program Manager for the Virginia Department of Health, within the offices of epidemiology and information management.

Our current focus is to ensure that the state COVID-19 data is accessible to individuals with disabilities, in addition to modernizing the state agencies’ website user interface (UI) for improved usability.

Overall, the program is facilitating statewide maturity on accessibility and expanding inter-agency cooperation through education and advocacy.

Are you still treating patients, or are you solely non-clinical?

I am a fully non-clinical OT, but continue to work with people with disabilities through user testing and other UX methodologies.

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How long have you been in your current role as an accessibility program manager?

Just over a year.

Did you get any special certifications to help you get into your current role?

Trusted Tester V5 certification (it’s free!)

Certified Data Professional – ICCP

How did you find your job?

A recruiter reached out to me after reviewing my LinkedIn profile, and I applied.

Did you do anything special to your resume and cover letter to land the job?

I made a habit of tailoring every resume to the relevance of the job I’m applying to, and I always include a custom and specific cover letter. 9/10 times this will at least land an interview. Thank you messages also help.

What was the interview like?

A quick phone screen by the recruiters, followed by a panel interview with the director and two senior IT managers.

How have people reacted to you leaving patient care?

My colleagues and friends have been very supportive and excited about the work I am doing. Many of my OT/PT friends have also expressed interest in learning more about bridging IT and clinical skills.

What’s a typical day or week in the life like for you as an accessibility program manager?

I work full-time from home, which is great, but since I live in Washington and work for Virginia, my days typically start at 5:00AM due to the time-zone difference.

Tasks are project-based and involve coordinating lots of different teams from within and outside the agency. There are daily meetings with various groups, mostly focused on organization and delegating tasks.

Otherwise, I am conducting information/data audits, planning remediation strategy, creating educational/training material, and preparing reports for presentation.

What are some of the rewards of your role? What are the biggest challenges?

Working in government is very rewarding. The effort I put into this program impacts a lot of people, and the bottom line is improving social policy on inclusion. I have a lot of freedom and trust with my team, and there are learning opportunities everywhere.

The challenges are associated with the sheer size of each governmental agency and the potential impact that individual decisions can have months or years down the road. Because of this, the approval process for implementing a plan can take a long time, which can then lead to work piling up fast.

How did your clinical background prepare you for this role? Which skills transferred?

Clinical practice taught me how to actively listen and understand what is personally meaningful to people who have lost (or never had) function.

My experience in problem-solving the barriers associated with disability using assistive technology and product/system improvements are a great fit for this role.

Roughly speaking, how are the hours and pay compared to patient care?

I get paid for the hours worked without pressure to either rush or work off the clock. I consistently work 40 hours/week and get paid 1.5x for any overtime.

My base salary is 50% higher than what I typically was paid as a clinician.

What type of person do you think would do well as an accessibility program manager?

A lot of therapists I know get intimidated by IT, but it’s not as hard as it seems. Being detail-oriented and well organized is a plus.

Anyone who is interested in UX, system or product design; and has an interest in inclusive social policy would do well as an accessibility program manager.

Does your organization hire PT, OT, or SLP professionals into non-clinical roles? If so, what type of roles?

The government hires people from all walks of life and from many different educational backgrounds. As far as I can tell, they are more interested in skills, experience, and education than previous titles, but that may differ by state, department, or agency.

To give an example, the director for the Virginia Department for the Deaf and Hard of Hearing (VDDHH) is an SLP.

Did you read any books, take any courses, or do anything special overall to get you where you are today?

I took some technical courses through DataCamp on Tableau, SQL, Power BI, and Python. These courses helped me understand the programs I am auditing and provide better feedback/recommendations to engineers on improvements.

What is a typical career path for someone in your role?

IT in general is very broad with ample career opportunities, and clinical skills can apply to many of them. I am very interested in data science and may eventually venture down that road, and/or continue expanding applications for accessibility.

What is next for you?

I hope to grow this program and play an even bigger role in digital accessibility standardization and adoption by both the public and private sectors.

What would you teach to today’s graduate students in your profession, if you had the opportunity?

The foundational theories and skills in OT have a much broader application than traditional roles, and it’s a real shame that the profession hasn’t embraced that. In school we were taught to think outside the box, but so many of us feel limited by the available career options.

I would teach graduate students that the apparent limitation is completely arbitrary, and encourage them to expand the scope of OT’s domain.

A little creativity in job searching can open a lot of doors.

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