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  • New Michigan Law Means All 51 US Jurisdictions Allow Direct Access to PTs

    The people of Michigan are better off—and the physical therapy profession has reached an important milestone—now that legislation has been signed into law allowing allow patients in Michigan to go directly to a physical therapist (PT) for evaluation and treatment without a physician’s referral. The legislative victory now means that all 50 states and the District of Columbia allow for some form of direct access to PTs for evaluation and treatment.

    SB 690, signed into law by Gov Rick Snyder, was sponsored by Sen John Moolenaar and promoted by the Michigan Chapter of APTA (MPTA). The new law creates the option for patients to see a PT without a referral or prescription from a physician for up to 21 days or 10 treatment visits, and will also allow patients to see a PT directly for injury prevention and fitness promotion, with no time or visit limit. SB 690 also strengthens the profession by specifying that only licensed PTs may use the term “doctor of physical therapy” in connection with their services. A similar bill was sponsored in the Michigan House of Representatives by Rep Margaret O’Brien.

    The passage of this legislation is the culmination of many years of hard-fought effort on the part of MPTA that at times faced significant opposition.

    “The goal of direct access to physical therapy in Michigan has been 34 years in the making,” said MPTA President Sue Talley, PT, DPT, C/NDT, in a news release. “This achievement would not have been possible without the commitment of multiple MPTA presidents, legislative chairs, the grass roots efforts of our members and patients, and Sen Moolenaar and Rep O’Brien."

    “This is a significant milestone for the people of Michigan and for the physical therapy profession,” said Paul A. Rockar Jr, PT, DPT, MS, president of APTA. “APTA has long advocated for improved patient access to physical therapists, and I applaud Michigan’s achievement in making this policy a reality.”

    The milestone of achieving some form of direct access to treatment in all 51 US jurisdictions comes on the heels of achieving direct access to evaluation throughout the US in 2013. While notable in its own right, the achievement sets the stage for association efforts to improve access in some states that have more restrictive direct access laws that "are not based on evidence or on the best interests of the patient,” according to Rockar.

    The new Michigan law will take effect January 1, 2015. APTA provided a direct access grant to the Michigan Chapter to support its efforts on SB 690.

    2014 - Michigan Direct Access Signing 
    Gov Rick Snyder signs SB 690, making Michigan the 51st jurisdiction
    to allow some form of direct access to PTs.

    2015 NEXT Proposal Deadline July 14

    Who's NEXT? How about you?

    APTA members have until July 14 to submit proposals for sessions at the 2015 NEXT Conference and Exposition, set for June 3–6 at National Harbor, Maryland, near Washington DC.

    Detailed information on how to submit proposals is available at the NEXT submission site. Proposals are being requested for 90-minute education sessions and daylong preconference courses, and the association welcomes content focused on effectiveness of care, patient and client-centered management across the lifespan, professional excellence, and value and accountability.

    For the 2015 conference, APTA is particularly interested in topics related to health policy, innovative collaborative care, interprofessional education, prevention and wellness, research, and women's health.

    APTA Comments on SNF, IRF, IPPS Proposed Rules Now Available

    Skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and prospective payment systems for acute and long-term care are the subjects of newly available APTA comments on proposed rules from the Centers for Medicare and Medicaid Services (CMS).

    In the SNF letter (.pdf), APTA commends the agency for its work to create an alternative therapy payment methodology and encourages the inclusion of a standardized assessment tool as well as a universal therapy payment model across all postacute care settings. APTA also thanks CMS for its proposal to ease SNF assessment requirements and urges the agency to provide educational resources to providers on how the change will apply to all SNF assessments.

    APTA's letter on IRFs (.pdf) urges CMS not to adopt proposals that would change the 60% rule presumptive compliance list, specifically the deletion of amputation and prosthetic status codes. Most notably, the association strongly recommends that CMS halt finalization of policies to implement a definition and IRF Patient Assessment Instrument (IRF-PAI) reporting requirement for group therapy. As an alternative, APTA recommends that CMS collect data regarding the delivery of therapy in the IRF setting.

    A separate APTA letter on inpatient prospective payment systems and long-term care hospitals (.pdf) includes several recommendations regarding the 2-midnight admission criteria, short stays, and observation status. Specifically, APTA recommends that any therapy services provided as inpatient or observation stay be exempted from outpatient therapy requirements such as functional limitation reporting and the therapy cap. In addition, APTA supports the changes made to the hospital readmission reduction program and makes suggestions to improve the long term care hospital quality reporting program.

    CMS will consider all comments submitted and issue final rules for these settings around August 1, 2014.

    A Map to Everywhere: PT in Motion Looks at Patient and Client Advocacy

    For physical therapists (PTs) and physical therapist assistants (PTAs), patient and client advocacy is all over the map.

    And that's a good thing.

    The July issue of PT in Motion, APTA's monthly member magazine, takes a look at how the sometimes-nebulous concept of advocacy takes shape in the real world of physical therapy. Through a series of short interviews with PTs from across the country, readers find out how PTs are engaging with patients and clients to educate, empower, protect, and fight for the care they deserve.

    What emerges are advocacy efforts that the article describes as "encompassing clinical environments, classrooms, the halls of government, offices of third-party payers, and entire communities." And although the actual approaches vary among the PTs interviewed, the efforts are rooted in a shared commitment to living out an ethical imperative that goes beyond simply doing a job.

    In the article. Nicole Volek, PTA, BA, describes her own work in community education and goes on to characterize the challenge of advocacy in general. "PTAs and PTs aren't just PTAs and PTs," she says. "We're social workers, in a very real sense. To advocate effectively for patients and clients, we've got to be all kinds of people beneath our PTA and PT hats."

    Hardcopy versions of PT in Motion are mailed to all members who have not opted out; digital versions are available online ahead of print to members.