Intro to Sunset

“If you’re not at the table, you’re on the menu.” 


By Jennifer Chuang, SPT

Texas Delegate to the APTA Student Assembly
TSPTA Liaison to the TPTA Government Affairs Committee

Why do we care?

Right now, the Physical Therapy Practice Act is in the process of being reviewed and many people don’t know much about it. The Sunset Review only takes place every 12 years (but was skipped 12 years ago due to budgetary reasons). This means decisions that are made in this legislative process can affect our ability to practice for the next 12-24 years.

Boundaries for the profession can be set or removed. For the best outcome, people need to be involved. So, I have researched and interviewed a handful of people and summed up the Sunset Review under a few questions with the goal of making it as easy as possible to help people be informed and get involved.

Physical Therapists, Physical Therapist Assistants and Students should care about this review because the process can shape how we practice. Physical Therapists are recognized as musculoskeletal experts yet consumers are restricted in Texas from access to physical therapy because current practice requires referral from a provider such as a physician, chiropractor, dentist, or nurse practitioner. Therefore, consumers of physical therapy services, should care about this review because the process can have implications on whom they can see, the evaluations and what types of treatment interventions they can receive.

What is the Sunset Review?

The Texas Sunset Act applies to about 130 state agencies including the Texas Board of Physical Therapy Examiners (TBPTE). Professional licensing and regulatory agencies are reviewed through the Sunset Advisory Commission (SAC). Put more plainly, it is the legislative process that all state agencies have to go through that determines if an agency is necessary for the public good and if business can be managed in a more effective and efficient way. Approximately 80% of the SAC recommendations become law. If you would like to read more some helpful links from the Sunset website are:

https://www.sunset.texas.gov/public/uploads/files/reports/Sunset%20in%20Texas_0.pdf

https://www.sunset.texas.gov/how-sunset-works

https://www.sunset.texas.gov/impact-sunset-reviews

What is the worst that could happen?

The SAC has the authority to shut down agencies deemed unnecessary, but the most recent SAC report had positive findings for physical therapy and recommended continuation of the ECPTOTE, TBPTE and TBOTE for the next 12 years. Some of the issues of greater concern are regarding the practice authority of Physical Therapists, which are at risk of being diminished. In the past, chiropractors have challenged whether physical therapists should have the authority to provide manual manipulation. Within the past few months alone, acupuncturists challenged whether dry needling was within the physical therapy scope of practice. As part of the current review, the SAC has recommended discontinuation of facility registration, which had originally been created to prevent fraud, abuse and improper physical therapy practices. A common saying often used when discussing the Sunset Review is, “If you’re not at the table, you’re on the menu.” If physical therapists don’t participate while being challenged then physical therapists will continue to need referrals to treat patients. In addition, physical therapists could lose current practices such as:

·      Evaluating without a prescription.

·      Supervising PTAs & Technicians.

·      Having the authority to perform treatment modalities and interventions such as dry needling and manual manipulations.

·      Experiencing a quality standardized continuing competency system. Sunset could require delegation of CCUs to an external organization staffed by people without the relevant education, training and clinical review. This change would ultimately compromise the quality of the courses provided.

What is the best that can happen?

The SAC aims to identify and improve any areas of weakness within an agency’s operations. It makes recommendations that are accomplished through changes in law and management directives. Many parts of the practice act are reviewed in the SAC Staff Report. The TPTA is aiming to keep, reinforce or expand current practice. Also, the profession has goals. The best that can happen is:

·      Sustainable existence of the Executive Council of Physical Therapy & Occupational Therapy Examiners.

·      Removal of the referral requirement, allowing for direct patient access to physical therapy services.

·      Physical Therapists continue to supervise PTAs and Aides without interruption.

·      Protection of the physical therapist scope of practice to include treatment modalities or interventions that are challenged.

·      Licensed physical therapists continuing to have influence over Continuing Competence approval process.

·      Continuous protection of the terms “physical therapy,” “physiotherapy,” “PT,” “MPT,” and “DPT” from being used as a generic term of services provided by people who are not licensed in physical therapy.

·      Participation in the Physical Therapy Licensure Compact that would allow all licensed physical therapists within compact member states to practice in the other compact member states with their original license.

What can we do?

Get informed

·      The first step for being involved is to understand what is going on. The Sunset website has a page specifically for the Texas Board of Physical Therapy Examiners with documents you can read and a link for Public Comments that you can read.

https://www.sunset.texas.gov/reviews-and-reports/agencies/texas-board-physical-therapy-examiners

·      The Texas Physical Therapy Association is a great source for information. On the top right side of the home page a tab labeled “Advocacy” leads to useful links. Emails from TPTA also are sent out to members and communicate important developments and information regarding participation.

www.tpta.org

·      Ask a TSPTA officer for more information or send questions. You can comment on this blog for more information or my TPSTA email account is tspta.ptdelegate@gmail.com. I will try to compile any questions people may have and share the information with everyone. Comments and emails are appreciated from anyone, including professionals, students and consumers.

Participate: Network/Spread the Word     #PTTransforms

·      Physical therapists, physical therapist assistants, and students must participate in the Sunset Review process in order for us to be successful. Participation includes networking with other PTs, PTAs, and students and spreading the word about what is happening.

·      Watch out for emails from the TPTA labeled “TPTA Member Call to Action.” Information and instructions are given for issues requiring immediate action as they arise.

·      Janet Bezner, Texas Chief Delegate, is currently in the process of identifying TPTA members who can serve as key contacts for every Texas legislator. Key Contacts establish a relationship with their legislator in the Texas House and Senate and educate the legislator on the specific issues related to sunset review as well as physical therapy in general. This process is critical now so that when the legislators vote during the legislative session in January – May 2017, the legislators can be contacted and asked for their support on legislation that is consistent with maintaining and enhancing physical therapist practice in Texas. If you are interested in becoming or learning more about Key Contacts please contact Janet Bezner at jb25@txstate.edu.

Donate    #TPTAPAC #Sunset2017

The TPTA Political Action Committee (PAC) needs money to be successful in the next Sunset review process. The TPTA PAC is aiming to raise $100,000 by September 1, 2016 and has already reached 1/3 of the goal. Now more than ever is the time to contribute to the PAC. Members and non-members of the TPTA can easily donate by the following link below to the TPTA website. Donations must come from individuals, not corporations or groups.

https://tpta.site-ym.com/donations/donate.asp?id=10168

Special thanks to the following people who took the time to speak to me, answer all of my questions regarding sunset and help me write this.

Brant Capps – Government Affairs Committee

Janet Bezner – Texas Chief Delegate

Don Haydon – TPTA Executive Director

Mark Milligan – Capital Area District Chair
Venita Lovelace-Chandler - Editorial Board Member of MoveForwardPT