“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:
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.
·
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.
·
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.
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
