• News New Blog Banner

  • APTA Helps Create New Grant Opportunities for PTs

    A new "mini grant" project aimed supporting implementation of a self-directed and group intervention program for adults living with arthritis is now accepting applications. The grants of at least $2,000 each are available to individual physical therapists (PTs) as well as APTA state chapters. APTA is a cosponsor of the program.

    The grants will be awarded to successful applicants who propose ways to implement the "Walk With Ease" (WWE) program either directly or in partnership with an external agency. Developed by the Arthritis Foundation, WWE is a community-based walking program based on group walking sessions and pre-walk discussions held multiple times per week. The initiative is a US Centers of Disease Control and Prevention (CDC)-recommended physical activity program.

    Grantees are expected to recruit at least 200 participants and work to ensure all participants complete 100% of the intervention by September 29, 2018, the end of the 3-month project period. Selected applicants can anticipate an average award of $2,000, although the number of awards is contingent on the availability of federal funds.

    Applications will be accepted and considered for funding on a rolling basis. Final applications must be received by Friday, July 27, 2018 at 11:59 pm ET and can be downloaded from the grant announcement webpage. Interested applicants must email the completed application to nmccoy@chronicdisease.org.

    APTA collaborated with the National Association of Chronic Disease Directors and the CDC's Division of Population Health Arthritis Program in the creation of the grants program.

    Innovative Collaborative Effort Between APTA, United Healthcare, and OptumLabs Could Introduce Important Changes to Pain Management Policies

    What would happen if payers encouraged patients with low back pain (LBP) to explore low-risk treatments such as physical therapy by waiving copays for initial sessions? Thanks to a collaboration between APTA and the nation’s largest private health insurer, we may find out.

    Through its work with APTA, United Healthcare is identifying 10 markets for a pilot program that would employ a variety of policy changes to its pain management program, including the elimination of cost-sharing for an initial physical therapist (PT) visit, easier appointment scheduling for patients, and stepped-up public and physician education efforts emphasizing the benefits of early referral to a PT for pain. If successful, the pilot could help to transform the payment landscape in ways recommended in a recent APTA white paper on addressing the opioid epidemic through better pain management policies.

    The pilot accelerates the practical application of findings from a joint study by APTA, United Healthcare, and OptumLabs on the potential impact of early physical therapy and other nonopioid strategies to address LBP. That study paid particular attention to cost and downstream utilization associated with early physical therapy for LBP.

    The study was one of the topics covered during the 2018 Rothstein Roundtable at the APTA NEXT Conference and Exposition (see video dispatch below). During the Rothstein discussion, David Elton, senior vice president of clinical programs for OptumHealth, characterized the study's findings as ones that "confirm what we've seen"—that "good things happen" when physical therapy is used early in an episode of LBP.

    While not yet finalized for publication—something that could happen as early as fall of this year—the study's results were convincing enough to cause the insurer to move quickly toward the creation of the pilot program.

    "The collaborative work between APTA, United Healthcare, and Optum is an innovative approach that brings providers and payers together to work on truly transforming the health care system in ways that make a difference to patients," said Carmen Elliott, MS, APTA vice president of payment and practice management. "We are excited about the publication of the joint study and pleased for the opportunity to make real-world changes to improve patient access."

    According to United Healthcare, APTA chapter leadership in the 10 markets under consideration will be contacted to schedule webinars that provide an overview of the pilot.

    OptumLabs and OptumHealth are businesses of Optum. Optum and UnitedHealthCare are benefits and services companies of UnitedHealth Group.

     

     

    NEXT 2018: Maley Lecture: Health Care Must Adopt a Biopsychosocial Model

    The health care system needs to evolve from a medical to a biopsychosocial model, asserted Robert Palisano, PT, ScD, FAPTA, in the 23rd Maley Lecture, delivered during NEXT 2018. "Healthy living is a societal and systems issue. The focus of the traditional medical model of health care is on the individual and acute conditions." The title of his lecture was "Lifecourse Health Development of Individuals With Chronic Health Conditions: Visualizing a Preferred Future."

    Palisano is associate dean for research at the College of Nursing & Health Professions at Drexel University.

    Lifecourse health development, a biopsychosocial model, previously had been applied to children and youth with cerebral palsy. Palisano extended the concept of lifecourse health development to adults with acquired chronic conditions such as spinal cord injury, traumatic brain injury, stroke, multiple sclerosis, Parkinson disease, and arthritis.

    He noted that APTA's Vision Statement for the Physical Therapy Profession—transforming society by optimizing movement to improve the human experience—served as the springboard for his presentation. Palisano defined "lifecourse" as a progression of socially defined events and roles in which a person engages. Health development, he said, occurs through person-to-environment and environment-to-person transactions that change over time. His preferred future, Palisano said, will be characterized by a person's physical, mental, and emotional well-being; participation in desired social roles throughout life; and achievement of personal goals.

    Using 2 case studies—a boy born with cerebral palsy and a woman who contracted polio at 16 months old—Palisano traced their successful transition from childhood to adulthood and identified experiences that contributed to their lifecourse.

    He said that the transition to adulthood for youth with disabilities has been described as "falling off a cliff" due to lack of preparation, limited support, lack of skills needed for adult roles, and disjointed adult services. He noted that a successful transition requires that timing "real-life" experiences and interventions coincide with the person's environment and readiness for change. "Unfortunately, implementation of comprehensive and coordinated health transition services and supports has not been widely achieved, and finding adult health care providers is often difficult," Palisano said.

    He noted that some laws, such as the Americans with Disabilities Act (ADA), can be of assistance. For example, the ADA defines "disabled but able to work" as an individual with a physical or mental impairment who is able to perform essential functions of a job with or without reasonable accommodations. Employers have a legal obligation to make reasonable worksite and workplace accommodations that are not an undue hardship. However, Palisano cited research that, during the hiring process, employers often have little guidance and are unaware of or do not comply with accommodations required by ADA and other laws.

    Further, he said, "Person-workplace transactions often are not timed or adapted to build capacity." Although assistive technologies "offer promise for improving work participation," access to appropriate assistive technologies and qualified providers and teams are "frequently limited."

    Addressing community living, Palisano said that key considerations are availability, accessibility, adaptability, and affordability. "Research indicates that young adults in supported living experience more variety in community activities and do preferred activities more frequently than do young adults living in group homes."

    Palisano summarized his theme: "The value proposition of lifecourse health development is healthy living. Healthy living involves managing, adjusting, and adapting to changes in health capacities and environments."

    To achieve the vision of a preferred future, Palisano said, "A system similar to the pediatric health system is recommended, whereby the health of adults with chronic conditions would be monitored by interprofessional teams, and a care coordinator would be available to coordinate services."

    He also called for physical therapy to occur in real life settings, also referred to as "natural environments. Research suggests that rehabilitation services in clinical settings do not optimize participation outcomes….Generalization of learning requires practice in different contexts, including open environments that are not predictable."

    Palisano concluded, "A preferred future that embodies lifecourse health development is ambitious, but not beyond the reach of a profession whose vision is to transform society and improve the human experience."

     

     

    2018 NEXT: Physical Therapy Can Play a Part in Addiction Treatment

    The power of physical therapy to help prevent people from starting opioid use has been well-documented, but work now being done by physical therapists (PTs) and physical therapist assistants (PTAs) is showing that the profession also has an important role to play in the lives of those recovering from addiction. And that role has everything to do with applying the knowledge and skills PTs and PTAs already possess.

    In their session "Beyond #ChoosePT: Physical Therapy and the Opioid Crisis," delivered at APTA's 2018 NEXT Conference and Exposition, presenters Mark Bishop, PT, PhD;Eric Chaconas, PT, PhD; and Ahmed Rashwan, PT, DPT, made an engaging, sometimes moving, case for why physical therapy shouldn't be thought of simply as a path for avoiding opioid addiction, but as an approach that can also help addicts achieve and maintain sobriety.

    Chaconas, an associate professor at the University of St Augustine, led the discussion framing addiction as a "cunning, baffling, powerful" disease that doesn't discriminate and should not be associated with a certain class of individuals. The addict's world is, in a way, frighteningly similar to the world of the non-addicted, he said, insofar as the addict is driven to act by cravings that are beyond her or his control. "It's no different from the craving you and I have to drink when we're thirsty or eat when we're hungry."

    Efforts, such as APTA's #ChoosePT opioid awareness campaign, are crucial in helping to stop opioid dependence before it begins, Chaconas said, but there's much more work to be done for the millions whose lives have already been devastated by addiction. Once good place for PTs and PTAs to start: by working with addiction treatment programs.

    Bishop focused his portion of the presentation on the clinical "why" of the matter—specifically, why physical therapy is a profession uniquely suited to join the addiction treatment team. As Bishop explained, it's all about the brain and the ways in which addiction resembles many of the same brain processes as those associated with the experience of chronic pain.

    "If you're comfortable working with someone who's in chronic pain you have the skill set to work with someone struggling with addiction," Bishop said. "If you accept that chronic pain is a neurocognitive disorder, then be prepared to accept that addiction is, too."

    Bishop led the audience through a series of slides that not only explained the neural pathways taken by pain and the cravings experienced by an addict, but highlighted the ways in which dopamine response levels to drugs—which can sometimes be 500 times more powerful than the pleasure responses delivered by food or sex—can fuel addiction. The University of Florida professor also explained the chemical changes that take place when an individual experiences ongoing high stress levels, whether because of chronic pain or via the addiction cycle.

    So how is it that physical therapy can make a difference? Bishop said the PT's ability to help reduce stress and pain are key, but perhaps just as important is the PT's own belief in the power of her or his treatments, and the ability to engage in effective motivational interviewing that helps the patient develop an expectation of improvement.

    According to Bishop, studies have shown that patient faith in any treatment accounts for as much as 30% of the overall improvement experienced. In many ways, he said, the overall change patients experience "depends on what the patient thinks when they come in on day one." If the PT treating the patient with chronic pain can recognize and help to recalibrate those attitudes, improvement becomes that much more possible. "The good news is that those intervention strategies are the same for someone recovering from addiction," Bishop added.

    Rashwan was all about the "how" of the issue. As chief operations officer for Advanced Therapy and Wellness, Rashwan oversees a business that places PTs in addiction treatment centers as integral elements in the treatment process.

    Rashwan developed his business model partly after experiencing frustration with what he called the "hamster wheel" of outpatient physical therapy, and partly by accident. As he explained, one day at his clinic, he received a call from a treatment facility looking for PT services for a few of their patients. Rashwan was happy to take on the patients, but wondered how the facility had decided to call him. The facility staff explained that 2 other clinics had denied providing services after learning the patients were in active treatment for substance use disorder. That's all it took for Rashwan to begin thinking about how to make a difference.

    According to Rashwan, PTs in his company begin working with patients as soon as they've been medically stabilized and are placed in a residential or inpatient treatment setting. Treatments are designed to address any pain-related issues the patient might have, and puts a heavy emphasis on strength training. No modalities are used, and gear is limited to portable strength training equipment, foam rollers, and yoga mats. Keeping things simple and small helps the patient understand that she or he can easily continue the exercises at home, Rashwan explained.

    Rashwan echoed Bishop's emphasis on the importance of establishing a strong therapeutic alliance with each patient. Even among the most recalcitrant of patients, hearing a PT say "I want to know who you are, I want to know what makes you tick" can be a significant experience for someone whose addiction has led to estrangement from loved ones and societal rejection, Rashwan said.

    How to answer the question of whether physical therapy works in the addiction setting depends on who's asking, but the short answer in any case is "yes." Rashwan explained that as PTs and PTAs well know, physical therapy reduces pain and stress, and enhances a sense of wel-lbeing. But the program is also a win for the treatment facilities, which have decreased rates of patient actions "against medical advice" by 22%, increased length-of-stay rates by 15%, and seen improvements in relapse rates and in patient involvement in counseling sessions. And, Rashwan added, there's a business angle that shouldn't be ignored: facilities with a physical therapy program can advertise a more "holistic" approach to treatment, which can increase the patient census.

    Rashwan urged the audience to consider the power of physical therapy in addiction treatment.

    "We're helping people recover," Rashwan said. "We're working with the entire person, not just a diagnosis, and we're planting seeds in our patients. If we can save one life, we've done something important."

    2018 NEXT: PTs Offer Guidance on Developing Leadership Abilities

    A panel of 5 physical therapists (PTs) in various stages of their careers offered NEXT 2018 attendees their advice on how to become leaders and succeed professionally. The PTs were Carrie Cunningham, PT; Michael Gans, PT, DPT; Matthew DeBole, PT, DPT; Stephanie Weyrauch, PT, DPT, MSci; and Elizabeth Nixon, PT, DPT.

    Despite their varying levels of experience and their supporting anecdotes, their advice to those in attendance was similar.

    One agreed-upon observation is that leadership success is usually preceded by failures or setbacks. Cunningham, a board-certified clinical specialist in orthopaedic physical therapy who described herself as a mid-career PT, said, "Falling down is a part of life. I've learned from failures. Don't let fear stop you from the things you need to do to be a leader."

    Nixon, who graduated in 2016, admitted. "I had a lot of failures before I succeeded. For example, I interviewed at the University of North Carolina 3 times before I got in. I applied to get scholarships to attend professional meetings. But I kept losing out, so I paid to attend. I kept applying for scholarships, and I eventually got a few. If I'd given up the first time I'd gotten rejected, I wouldn't be standing here today."

    Many panelists cited positive experiences attending APTA programs, particularly as students. Matthew DeBole recalled, "I attended CSM in Chicago along with 3 other classmates. We were overwhelmed and in awe. There was a major program scheduled that everyone else went to. But I went to another session on leadership. I was super-curious and intrigued. By the time I got back home, I wanted all my classmates to attend the next meeting and even formed a Facebook group so we could attend CSM in San Diego the next year. I was motivated to run for a position on the Student Assembly Board of Directors and won. I was welcomed and helped. Others were open and very willing to help."

    Weyrauch said, "I attended NEXT in Charlotte. At a luncheon, I was seated next to some icons of the profession. And they talked to me—and all of us [with respect]."

    Many agreed on another aspect of academics: Getting the best grades isn't necessary to succeed as a PT or as a leader.

    For instance, Gans—now president of the Connecticut Chapter—admitted, "I wasn't the greatest student. My goal on graduation was to pass the Boards. Then I read Anthony DeLitto's McMillan lecture in PTJ. That alone got me to attend NEXT in 2010, where I heard Andrew Guccione's McMillan Lecture. That convinced me I needed to do more." Gans is a board-certified clinical specialist in orthopaedic physical therapy.

    Weyrauch advised the students in the audience: "Academics is important in physical therapist school, but you're going to have the biggest impact by doing some of those extra things you'll have the opportunity to do."

    Weyrauch presented 6 additional pieces of advice:

    • Be fearless and say "yes."
    • Understand your strengths and weaknesses.
    • Be open to and learn how to give feedback.
    • Network, network, network.
    • Develop expertise and competency
    • Be genuinely accountable and a good listener.

    The others on the panel agreed. Regarding feedback, Cunningham said, "Feedback is a great opportunity for growth."

    On networking, DeBole said: Try to connect with the right people and figure out the best way to go. Continue to connect with the people around you."

    The panel also had some advice for more experienced PTs. Gans said, "It only takes 1 person telling you to get involved. All it took was a single person to fuel my fire."

    Cunningham observed, "There are lots of opportunities in APTA. But you're all leaders in your day-to-day activities, in your own settings, and with your patients. Ask yourself: ‘How can I be better in the clinic every day?'"

    What's New at MoveForwardPT.com, Summer 2018

    APTA's consumer information website, MoveForwardPT.com, is a continually expanding resource where patients can learn about the many conditions and patient populations physical therapists (PTs) treat. The site includes everything from condition-based guides, podcasts, tip sheets, and videos, to the popular and "Find a PT" tool that allows patients to locate a member PT in their area. It's also home to APTA's national award-winning #ChoosePT opioid awareness campaign and toolkit.

    Bottom line: MoveForwardPT.com is always evolving, and a great resource for members to share with patients and others to help increase public understanding of all that the profession has to offer.

    Here are some recent additions to the site:

    Move Forward Radio podcasts

    Lifecycle of the Pediatric ACL Injury
    Neeraj Baheti, PT, DPT, is a board-certified clinical specialist in sports physical therapy and a board-certified clinical specialist in orthopaedic physical therapy. In this episode he discusses who is more predisposed to these injuries and what they can expect in terms of recovery.

    Bowel Health: What You Should Know
    Jenn Davia, PT, DPT, is a board-certified clinical specialist in women’s health and director of education for the Section on Women’s Health. In this episode, she takes on the topics of bowel health, including breaking bad habits, importance of proper positioning, and tips to achieve o bowel health.

    Tai Chi and Physical Therapy
    Kristi Hallisy, PT, DSc, board-certified orthopaedic clinical specialist, reveals how she incorporates tai chi into clinical practice and outlines how its vast benefits help herself and her patients.

    Once a Physical Therapist, a Young Woman Navigates New Life With Quadriplegia
    Elizabeth Forst, PT, DPT, was in her early 30s,working as a traveling physical therapist, when the simple act of diving into a pool changed her life forever.

    Washington Spirit’s Joanna Lohman Reflects on her “ACL Journey”
    The Washington Spirit midfielder reflects on the physical, mental, and emotional aspects of her rigorous ACL recovery.

    Combat Athletes and Physical Therapy
    Former amateur and professional combat athlete and current instructor Kirstin Schmidt discusses the injuries she endured during her career, and how physical therapy not only kept her fighting, but became 1 of her tools to staying healthy. Her physical therapist, Jessica Probst, PT, who participates in combat sports and treats combat athletes joins the episode.

    Tips

    5 Tips for Creating Good Habits While Toilet Training Your Child

    6 Sports for People with Parkinson Disease

    5 Exercises to Reduce Knee Pain

    What is Pitcher’s Elbow?

    Did You Know?

    New Research Shows: Physical Therapy First for Low Back Pain Curbs Opioid Prescriptions and Lowers Costs

    New and Updated Condition-Based Guides

    Cuboid Syndrome New

    Female Athlete Triad

    Hamstring Injuries

    Hyperkyphosis

    Multiple Sclerosis

    Osteoporosis

    Pain

    Snapping Hip Syndrome

    2018 NEXT: Making the Case for the PT and PTA Role in Disaster and Emergency Responses

    A panel of 4 physical therapists (PTs) with firsthand experience in responding to Hurricane Harvey, the Orlando Pulse mass shooting, the Great White concert fire, and other emergencies agree: PTs and physical therapist assistants (PTAs) have an important role to play in responding to these situations. The problem, they say, is that not everyone fully understands that role—including many PTs and PTAs.

    The panelists shared their perspectives at the APTA NEXT Conference and Exposition in Orlando, Florida, during a session that allowed each to tell their own story and share lessons learned. Though the details and circumstances differed, what emerged was a consensus thatfacilities and programs responding to emergencies often aren't prepared to put PTs and PTAs to best use, leaving therapists little choice but to take the reins wherever they can.

    Jessica West, PT, DPT, was thrust into emergency response when Hurricane Harvey devastated the Houston area in 2017. Just 2 years out of PT school, "I was truly going off my education," she said.

    She felt prepared to help, but unfortunately many in charge of the emergency response weren't prepared for her offer. "It was frustrating—they were relocating people to a conference center designed to hold 5,000 that was now holding 10,000 people," West said. "At the same time they were turning away therapists [who wanted to help]."

    When West was finally able to join providers onsite, she found a host of situations that were suited to responses from a PT—wound care, functional needs, basic screenings, and more. In her particular situation, West found that an obvious role for a PT would be to help temporary shelters better understand how to set up beds and other components in ways that account for the varying mobility needs of those being sheltered. "They should've had someone like me, like you, telling them how to set up a facility," West said.

    Erin Jones, PT, DPT, encountered a different situation when her hospital found itself taking in victims of the Pulse nightclub shooting that took place in Orlando in 2016. Although she didn't have much training in emergency management, she had experience in critical care—and, thankfully, her hospital had just finished a "massive" multifacility drill that tested responses to a campus shooter scenario.

    As did other panelists, Jones stressed the importance of drills of all kinds. "Prepare to know your role," Jones advised, adding that the preparation should include more than just a solid understanding of duties. Providers also need to prepare emotionally, particularly for the sudden, unexpected emergencies such as mass shootings. "These events can be emotionally draining," Jones said.

    As a PT with experience working with the Red Cross in Arizona, Gail Zitterkopf, PT, DPT, felt fairly well-versed in the workings of emergency response efforts. What she wasn't prepared for, after she moved to Texas, was being told when she showed up to join response efforts for Harvey to "go open up the Houston Astrodome" as a temporary shelter.

    Like West, Zitterkopf sees PTs and PTAs as eminently valuable components of an emergency response team. One example: the PT's understanding of the relationship between fatigue, body mechanics, and the potential for injuries. Victims of disaster need to be evaluated for their risk of experiencing further injury due to the impact of fatigue on their mobility, and that could be a crucial role for the PT, she said.

    Zitterkopf also echoed West's opinion that her PT training "well-prepared" her for a role in emergency response efforts. The problem is that the response system itself can be hamstrung by its own logistical inefficiencies—lack of coordination among multiple agencies, technical shortcomings, and provider transportation plans that don't always connect the provider with the closest facility. Then, of course, there are the even-more-basic things: "Often, volunteer registration websites do not provide PT or PTA options among its list of providers," she said.

    Jamie Dyson, PT, DPT, president of the APTA Florida Chapter, added to the discussion by describing his involvement in responding to natural disasters and other emergencies. Over the course of these events—not only responses to Florida hurricanes but also to victims of the Great White concert fire at a Rhode Island nightclub in 2003—Dyson said he has learned that "we have a lot of education that we need to do, both inward and outward."

    The challenge, according the Dyson, isn't just making the case to those in charge of emergency response programs—it's also about informing those within the physical therapy profession that they have a role to play and then getting them to take action.

    "Let's say someone wants to contact PTs to help in response to a disaster. That's great! But who do you call? We are not organized," Dyson said. "If we want to sit at the big table with health care, we have to put our big boy pants on and show what we can do."

    Panelists agreed that a directive adopted by the APTA House of Delegates just a day before their presentation could make a difference. The charge directs the association to work with other organizations and stakeholders to better define the role of PTs and PTAs in disaster relief and recovery, and to promote this role throughout the profession. "There's so much to learn about, and I'm really excited about what APTA will be able to do," West said.

    However, he added, with more disasters in the near future a near certainty, PTs and PTAs shouldn't wait for instructions from the association. "I want to encourage everyone to get out there and try," she said.

    2018 NEXT: 'You're Changing People's Lives' NEXT 2018 Attendees Told

    Professional beach volleyball player Gabrielle (Gabby) Reece told attendees at the opening event of NEXT 2018: "To serve others and help other people is a really important thing. You're changing people's lives."

    2018 - 06 - 28 - Gabby NEXT

    Although she didn't take up volleyball until 11th grade, Reece won an athletic scholarship to Florida State University, where she majored in communications and played volleyball. While there, she says, she developed sciatica. "They said I needed back surgery. That was a pretty serious situation. I went instead to a therapist and was able to play again" she said, explaining her growing appreciation of physical therapy. From that point, she continues, "I'd go to a physician and ask for physical therapy. That kept me going. Even then, I knew what a tool your craft is."

    Reece thanked her physical therapists (PTs) for the quality of attention and care she received. "I was always looked at as an individual person, not treated with a ‘cookie cutter' approach," she said. "In return, I was a very compliant patient because I knew their advice was designed specifically for me."

    As a professional volleyball player, Reece and her 4-person team took first place at the first-ever Beach Volleyball World Championships. She also competed domestically in the 1999-2000 Olympic Challenge Series. Reece was a contributing editor for Yahoo Health and has hosted "Insider Training" on the Fit TV/Discovery channel.

    A recent experience led her to offer the NEXT 2018 attendees another suggestion: "Two years ago, I finally had a knee replacement. I knew I had a lot of life left, so I was compliant. I forced the change, invited the change. You don't realize how powerful it is telling patients, ‘You'll get there.' That alone is powerful. Therapy got me back to my previous level."

    One action she didn't take, however, was using opioids for the pain. In addition to the danger of opioid medication, Reece explained, "I knew it would delay my recovery. The pain is there for a reason. The body is ready to figure out a way to health, and physical therapists help with that."

    2018 - 06 - 28 - Opening Sharon

    She also spoke about the importance of good nutrition and exercise, and offered this suggestion to people who might not regularly exercise or eat good food. "It's a lifestyle. I've created a system in which I can be successful. It's not about wanting to exercise every day," she said. Earlier in the evening, APTA President Sharon Dunn, PT, PhD, had spoken on the importance of building communities. Reece echoed this point when discussing a lifestyle to stay healthy, saying the key is "about finding your community."

    She concluded, "I'm inspired by you and take my hat off to you. It's a really honorable profession."

    Dunn, in her earlier remarks, also addressed the subject of change. She said, "There are so many opportunities in change…and I'm so excited where physical therapy fits in. It's the answer to a broken health care system. We're at a very pivotal point. We're thrilled with the alignment [of the many health care issues]. It's fun to be here right now."

    APTA 2018 House of Delegates Election Results Announced

    The following members were elected to APTA's Board of Directors and Nominating Committee on Monday, June 25, at the 2018 House of Delegates in Orlando, Florida.

    Sharon L. Dunn, PT, PhD, was reelected president.

    Matthew R. Hyland, PT, PhD, MPA, was elected vice president.

    Susan A. Appling, PT, DPT, PhD, Cindy Johnson Armstrong, PT, DPT, and Robert H. Rowe, PT, DPT, DMT, MHS, were reelected director.

    Dan Mills, PT, MPT, will serve the 2-year remainder of Hyland's unexpired term as director.

    Derek Fenwick, PT, MBA, was elected to the Nominating Committee.

    These terms become effective at the close of the House of Delegates on Wednesday.

    Multistate Practice Privileges to Become a Reality in 3 States

    It's on: 2 years after its launch as a concept, the Physical Therapy Licensure Compact (PTLC) is poised to become fully operational in 3 states, allowing physical therapists (PTs) and physical therapist assistants (PTAs) licensed in 1 of the states to obtain practice privileges in the other 2. The commission overseeing the compact system expects that over the coming months, the list of participating states will continue to grow as the 21 jurisdictions that have already signed on to the PTLC implement its provisions, and even more states adopt compact legislation. The compact was a project spearheaded by APTA and the Federation of State Boards of Physical Therapy (FSBPT).

    Beginning July 9, PTs and PTAs in Missouri, North Dakota, and Tennessee will be able to purchase the ability to legally practice in any or all of the 3 states. It's the first practical application of a concept that could revolutionize licensure mobility for the physical therapy profession by reducing the need for licensed PTs and PTAs to apply for separate licenses in additional states in which they want to practice. (Editor's note: for a more in-depth look at the system, check out this 2016 PT in Motion magazine article.)

    The road to becoming operational depended on meeting 2 important challenges: convincing state legislatures to change their licensing laws to allow for the compact system, and creating a centralized commission to oversee issuance—as well as denial and suspension—of compact privileges. To set up the Physical Therapy Compact Commission, a critical mass of 10 states needed to change their laws. That target was reached in April 2017, and the commission was established soon after. Its website offers information on the system and an online application for privileges.

    Rather than contacting individual licensing boards, PTs and PTAs must apply for privileges through the ptcompact.org website.

    Twenty-one states have adopted the compact language. In addition to the 3 states flipping the switch on July 9 are Arizona, Colorado, Iowa, Kentucky, Louisiana, Mississippi, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, Oklahoma, Oregon, South Carolina, Texas, Utah, Washington, and West Virginia. Compact legislation has been introduced in Pennsylvania and is expected to be introduced in more states during future legislative sessions. The Physical Therapy Compact Commission's website features a map that tracks the status of compact participation.

    The conceptualization of the compact system was a joint effort by APTA and FSBPT, but much of the advocacy for change had to be done by state chapters of APTA, said Angela Shuman, APTA director of state affairs.

    "The launch of the compact is an historic moment for the physical therapy profession, but it never could have happened without the dedication and hard work of the chapters and their members," Shuman said. "APTA is proud that this collaborative effort between APTA, FSBPT, and our state chapters have made this concept a reality. The gains we've made so far have created momentum that will help the program continue to grow."