March/April Update

Hi everyone,

Wow! What an exciting last few months we have had. ****WARNING**** this blog post is going to be lengthy, but hey - filled with the latest and greatest information for Texas PT and PTA students.

Where should we start?? Legislation of course - the stuff everyone is probably most excited (or secretly groaning about). House Bill 29 and Senate Bill 732. You might be asking yourself, what in the world is happening? Did we get direct access?

In short, the answer is 95% likely YES...with some stipulations. The language of the bill is as follows:

A physical therapist may treat a patient for an injury or condition for 10 consecutive business days without a referral if the PT:

• Has been licensed for at least one year (UGH we have to wait a whole YEAR after graduation for this to apply???)
• Is covered by professional liability insurance in the minimum amount required by board rule (Yea, yea the usual stuff...go on already)

AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND 

• A. i. Has a DPT from a program that is accredited in PT education (Yay! We will all have this) 
• OR
• A. ii. Has a DPT from an institution that is accredited by an agency or association recognized by the US secretary of education (Ok this is practically the same thing...)
• OR 
• B. Has completed at least 30 hours of continuing credits in differential diagnosis (wait...so my professor with 20+ years of experience can't have direct access under these pretenses...what the heck?!?)

A physical therapist may treat a patient for an injury or condition for 15 consecutive business days without a referral if the PT: 

• possesses a DPT as previously described above in A. i and A ii. 
• AND has completed a residency or fellowship (Wow..all that training for 5 more days of treatment...rad.) 

AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND AND 

• patient must sign a disclosure agreement in which the patient acknowledges that 
• PT is not a substitute for a medical diagnosis by a physician (Because we really need a MD to tell us a patient has LBP?!?!?!?!)
• PT is not based on radiological imaging (No, we take detailed history and do a thorough examination and don't rely on MRI for a crutch)
• a PT cannot diagnose illness or disease (Look we aren't trying to tell someone they have cancer...) 
• patient's health insurance may not include coverage for PT services (we have to sign a waiver now on this?!)

Seems as if the consensus is pretty split among Texas PTs, and DPT students.

• Pros: 
• Direct access is direct access. We can finally treat an injury without waiting weeks or maybe months! 
• 10 or 15 days could really do a patient good. That's up to 3 weeks of care!
• All PT students in Texas will now graduate with their DPT and will be allowed direct access in one year!
• Texas is finally in the game for providing adequate care for patients. 
• Cons:
• Is this the compromise that ends our fight toward unfettered treatment for good?
• Well...it's ONLY 10-15 days, can we really expect to get our patients fixed in that short amount of time?
• There aren't that many residency and fellowship trained individuals at all, none the less only in our state! 
• Is this only putting a bandaid on the wound for extra time to get treated? Especially if we have to send them back after 10-15 days?
• Is that disclosure agreement an undermining of our clinical judgment?

So folks - that being said, we have passed through the House and Senate and are just awaiting the Governor's signature. If passed, this law would go into effect on September 1st, 2019. Got an opinion? Email aptasa.coretx@gmail.com and we could feature YOU!

Alright! Moving on to the next topic. 

PT Olympics: A competition, a spectacle, a display of pure, raw, athletic talent. Boy oh boy was I impressed. Nearly every physical therapy school was represented at this event. A huge thank you to UTHSC-SA for putting on this event. Not only did it run completely smoothly, but there were no (documented) fights, and only a few minor cuts and bruises...a SUCCESS if you ask me. Not only did the competition go well, but the job fair was incredible. There were so many amazing vendors that discussed job opportunities, residency programs, and other continuing education opportunities. 

Now of course the most important part. ****Drum roll please***

3rd place: Incarnate Word

2nd place: UNTHSC-Ft. Worth, UTHSC-SA

And a big congratulations to our co-champions...

1st place: Army Baylor, Texas State 

Federal Advocacy Forum: 

So as most of you know, March 31st-April 2nd students and clinicians across the nation went to Capitol Hill to talk with legislators about issues facing our profession. This year the APTA public policy priorities are as follows:

More Movement Better Health 

         Our nation is dealing with the consequences of so many chronic debilitating conditions/diseases that decrease independence and increase reliance on opioids. PTs and PTAs can efficiently utilize financial resources to empower patients to achieve good health. We need to stop focusing on treating the problem, and start focusing on fixing it! By working with congressman and the administration, here's how they propose we do it: 

1. Population Health: APTA urges Congress and the Administration to enact policies to empower people to live healthy and independent lives 
1. No limits on people with pre-existing conditions
2. Support programs that increase/educate on the importance of physical activity and exercise
3. Support finding for prevention and wellness services such as falls prevention in insurance programs 
4. Support funding for public health initiatives that increase health literacy
5. Increase funding for the Individuals with Disabilities Education Act (IDEA)
6. Preserve and protect services provided by Medicaid 
7. Advance efforts to create and sustain healthy communities and promote use of active transportation 
8. Advance policies to increase knowledge to primary care services providers about non-pharmacological interventions for those with pain  
2. Patient Choice and Access: APTA urges Congress and the Administration to improve patient outcomes by eliminating barriers to health care services. 
1. Expand the definition of primary care services providers to include PTs 
2. Expand opportunities in public programs for direct access to PT services
3. Expand coverage and payment for rehabilitation services delivered via digital health and telehealth 
4. Eliminate/Reduce out-of-pocket costs for non-pharmacological services
5. Increase health provider workforce in rural and medically underserved areas by adding PTs to federal student loan repayment programs 
6. Secure regulations to implement the National Defense Authorization Act of 2017 that established PTA as an authorized TRICARE provider. 
7. Advance policies to ameliorate the payment differential for PTAs to ensure access to essential services 
8. Increase transparency to patients regarding costs of health care services and conflicts of interest in the delivery of health care services
9. Advance policies to ensure that financial incentives for patients, providers, and payers align and incorporate the true costs of appropriate services necessary for patients to achieve their desired outcomes. 
3. Value Based Care and Practice: APTA urges Congress and the Administration to improve patient outcomes by supporting efforts to increase efficiencies in the delivery of health services that reduce administrative burdens to providers and ensure transparency to patients.  
1. Support demonstration projects to validate alternative payment models in public and commercial insurance that increase administrative efficiency, effective patient outcomes, and collaboration among health care providers including PTs
2. Advance policies that reduce administrative burden in Medicare, Medicare Advantage, and commercial insurance 
3. Enact legislation to allow PTs to opt out of Medicare and privately contract with Medicare beneficiaries 
4. Research and Innovation: APTA urges Congress and the Administration to prioritize research and clinical innovation to increase access to appropriate value-based health care services. 
1. Increase funding for rehabilitation research across federal agencies including the National Institutes of Health, the Department of Defense, the Department of Education, the Department of Veterans Affairs, and the Centers for Disease Control and Prevention
2. Ensure parity for the PT profession with physicians and hospitals regarding the use, certification, and interoperability of electronic health records
3. Support use of PT Outcomes Registry in both public commercial payment programs to drive the delivery of quality, effective, and efficient rehabilitation services. 

A HUGE congratulations to our two TSPTA Federal Advocacy Forum scholarship winners: Emily Campbell from UT Medical Branch-Galveston and Christina Martinez from UT Southwestern. Way to go ladies, and thank you to all that went and rallied on our behalf this year. Your work and support of the profession does not go unnoticed. 

Last but not least: National Advocacy Dinners

What an incredible year for NADs in Texas. Our first one took place in Dallas, TX at TWU Dallas on April 24th courtesy of contributions by TWU and UT Southwestern students. Approximately 150 people were in attendance!! Their keynote speakers were Representative Colin Allred of District 32 and Linda John who both discussed ways students and clinicians can get involved right now in advocacy. This event was free to all, and an incredible night of learning, and passion for physical therapy. 

In Houston, TX TWU Houston hosted their third annual NAD on May 9th, courtesy of contributions by TWU, HCC, and UTMB students. Their evening kicked off with a great keynote by Lex Freiden about persistency with advocacy. Way to go everyone! #PTAdvocacy matters INDEED. 

Well that about wraps it up for March, and April. Look out for another blog at the end of summer as we get ready for elections for new officer positions for the TSPTA board. If you have any interest in running for the Core Ambassador position and creating your very own blog posts like this, email me at aptasa.coretx@gmail.com. 

Thanks everyone,

Julie Christeen Chrisman or JC to keep it simple...signing off!