Further Clarification on the PTA and joint mobilization debate

Physical Therapist Assistant rules
PTA rules that have been written are emergency rules and they don't go into effect until the PTA's become regulated in June. They were posted in March which allowed time for review and comment. 
 http://www.dora.state.co.us/physical-therapy/EmergencyRules_PTA.pdf.- click this link to read the actual rule
Joint Mobilization Debate
It is accurate that the Rule was written that joint mobilization is prohibited UNLESS the PT determines that the PTA meets certain criteria. APTA's position from the national House of Delegates is that PTA's should not be allowed to perform Joint Mobilization (any grades). Despite this position, there are inconsistencies across a variety of states.

  Current Rules in Colorado (have been in place for 7 years) do not prohibit PTA's from performing joint mobilizations. The rules are silent. (There is a Rule that specifically states that PT aides can not perform joint mobilization.) 

Update by Terra Wishon (2nd year CU PT Student)

Hello,
  A few bills are still being monitored for progress, please see Julie's last email. The board was established last year per last year's sunset act is still working on the wording of rules regarding PTA responsibilities. Currently in the rule, PTAs are not allowed to perform sharps debridement, triggerpoint dry needling, therapy on animals, or joint mobilizations. There is some wording in the rule that would allow a PTA to perform joint mobilizations, including grade V, if their supervising PT has determined that they are properly trained. In order to ensure patient safety and our right as a profession to perform grade V mobilizations, the GAC has recommended to the board that the wording be changed to simply PTAs can not do joint mobilizations. Grades of mobilization are not included in the rule, and the rules are not meant to very specifically spell out what PTAs are allowed to do so adding specifics about joint mobilizations does not seem to be an option. Other issues that are still being heavily discussed are continued competency and dilemma regarding recent graduates not being able to work for a few months until they are able to take the boards.
If you have any issues about current governmental affairs, please don't hesitate to contact us.
We will do our best to answer your questions or refer you to the correct people to talk to. Also please check the state advocacy page on the APTA website http://www.apta.org/StateIssues/ for more information (you do not have to be an APTA member to view this site). While you're there, click on the Take Action tab and document your activity for the Student Advocacy Challenge
LET US KNOW YOUR THOUGHTS??

Update by: Julie Engle (2nd year student from CU)- CO Government Affairs meeting 2/1/12

This is just a quick update from the Government Affairs Committee. We have been hard a work identifying bills pertinent to Physical therapy practice in the state of Colorado. Over 25 bills are being monitored as they move through the senate and the house.

News from the physical therapy board includes that new rules concerning PT assistants went into effect on March 1, 2012. One of these new rules states that PTA's can not do joint mobilization UNLESS the supervising PT feels that the PTA has had the proper experience and training. This includes all grades of mobilization (including grade V, thrust mobilization).

Small meetings are taking place between the acupuncture lobby and PT's who use dry needling. There has been reported progress from the perspective of the PT's in educating acupuncturists in how dry needling is different from their practice.

The board is also reviewing the continuing competency requirements in the state of Colorado. It sounds like there will be changes coming to these requirements sometime soon.

The Colorado APTA chapter recognized the University of Colorado PT program for hosting the second, annual Legislative Day at the state capitol on Feb. 28, 2012.  Check out the story on the CO APTA web page at https://webmail.ucdenver.edu/owa/redir.aspx?C=0eba34647cf34309868622c9444d8ce7&URL=http%3a%2f%2fwww.aptaco.org%2f

CU PT Legislative Day February 28,2012

It was a great turnout from the CU PT students at this year's legislative day! Over 40 students met at the capitol to speak with state legislators on what it means to be a physical therapist?  The afternoon began with guest speakers, followed by a tour of the capitol and meetings with our legislators. A highlight for our group was meeting with Senator Linda Newell.  A couple of us had met with her the year prior which made it nice to reconnect again this year.  She was so welcoming to our visit and most importantly we were able to educate her on direct access.   Check out more pictures and information at http://www.aptaco.org/!

CU PT Student Legislative Day is coming up!

The 2nd CU PT STUDENT LEGISLATIVE DAY will be February 28,2012.  Hurry up and sign up if you haven't already- there are only 5 more spots open!
Email Julie or Terra to reserve your spot!
Julie Engle-julia.engle@ucdenver.edu
Terra Wishon-terra.wishon@ucdenver.edu

Join other students who are just as passionate as you about our profession and our future! It will be a great day to come together and tell legislators why PT's are the practitioners of choice

New Physical Therapy Board Appointed by Gov. Hickenlooper

Colorado Gov. John Hickenlooper has announced the appointment of five physical therapists and two consumers to the new Board of Physical Therapy. Restoring the Board was the Chapter’s number one priority during the 2011 Sunset process. The legislation, SB11-169 formed the Board and authorized it to promulgate rules and regulations associated with the new PT Practice Act. The Board, which will begin its work on January 1^st, replaces the Physical Therapy Advisory Committee that has been in place for many years. Congratulations to the PTs who are all members of the APTA / Colorado Chapter:

Britt Smith, PT, DPT, private practice, Grand Junction – 2 year term

Carolyn Armstrong, PT, DPT, private practice, Nederland – 3 year term

Steve DiPaolo, PT, corporate practice, Lakewood – 3 year term

Ann Dinsmore, PT, hospital practice, Fort Collins – 4 year term

Tamara Struessel, PT, DPT, CU faculty, Denver – 4 year term

Marion Wells, public member – 4 years

Cindy Charlton, public member – 2 year term

Student Advocacy Challenge Winners!

(picture taken at 2011 National Student Conclave)

UNIVERSITY OF COLORADO- APTA STUDENT ADVOCACY CHALLENGE WINNERS!

This year the physical therapy students at the University of Colorado have worked very hard advocating for issues we felt were important. We have held various events in order to increase awareness and educate legislators on important issues regarding our profession. We hosted state legislators on campus, met with state lobbyists, held “lunch-and-learn” lectures and have been committed to writing letters to our legislators. The most exciting experience was the 1st annual CU PT student Legislative Day at the Colorado state capitol. On that day, thirty students from our DPT program met with legislators in small groups and spoke about important issues involving the sunset of our practice act.  We also had students attend the CO Government Affairs monthly meetings to remain up-to-date on important state legislation and relayed this information to the students.  All in all, this has been an exciting experience for all of us who participated.  It was a team effort that focused on advocating for the profession of physical therapy and support of Vision 2020.  We look forward to this year's challenge!

Update on H.R. 1426

Student Loan Repayment Bill- update
-The Physical Therapist Student Loan Repayment Eligibility Act - H.R. 1426, S. 975
-The NHSC loan repayment provides up to $30,000 in loan forgiveness per year for a minimum of two years of service in an underserved area.
Increased by 35 cosponsors since Hill Day (57 total currently)
Increased by 3 cosponsors since Hill Day (5 total currently)

218 votes are needed!

Student Advocacy Challenge

REMINDER!
The APTA Student Advocacy Challenge is coming to an end for this year! Report your activity so your school can get challenge points. Follow the link below and fill out your activity:
http://www.apta.org/StudentAdvocacy/
-click on report your advocacy activity
-fill out the challenge record sheet

This year's winner will be announced at National Student Conclave :)

The Physical Therapist Student Loan Repayment Eligibility Act of 2011 (HR 1426/S 975)

On September 1,2011 a group of students consisting of first, second and third year CU PT students (3rd year: Leslie Sanchez, Jennifer Keller, Dave Gerbarg, Jackie Kiernan, 2nd year: Julie Engle, Tracy Louk, 1st year: Erica Hylton) met with Andrea Autobee (Congresswoman Diana DeGette's Congressional Aid).  The meeting agenda included a 1 hour tour of physical therapy facilities on the Anshutz Medical Campus: Dr. Melanson lab, Dr. Stephens-Lapsly lab, physical therapy gait lab, and the physical therapy student teaching labs.  The tour was followed by a 1 hour conversation on the bill HR 1426.  We specifically asked for Congresswoman Diana DeGette to sign on and support HR 1426 while it is in her committee.  Currently, the only Colorado legislator to sign on and support our bill is Congressman Perlmutter.

I have included our 1 page summary statement as to why Congresswoman DeGette should support our bill.
I encourage everyone to continue to write to your legislators and ask for their support!  You may include this 1 page summary with your letters (just don't forget to change the name ;)  Post any of your questions, comments or progress!

BELOW YOU CAN TRACK WHO HAS BEEN SUPPORTING OUR BILL:

H.R. 1426 Physical Therapist Student Loan Repayment Eligibility Act of 2011

Cosponsors Permalink: http://thomas.loc.gov/cgi-bin/bdquery/z?d112:H.R.1426:@@@P

S. 975 Physical Therapist Student Loan Repayment Eligibility Act of 2011

Cosponsors Permalink: http://thomas.loc.gov/cgi-bin/bdquery/z?d112:S.975:@@@P

 Link to 1 page summary handout: https://docs.google.com/document/d/14vgOtuPtg-YUkogH8CICHlLPw8IqqslO1PTqrtLjTYY/edit?hl=en_US#

Getting Started

The most important first step in getting started with physical therapy advocacy is identifying the individuals that represent you. You can find your Senator or Representative by district under "Colorado Legislative Links" or, if you are an APTA member, login to the Legislative Action Center. The Legislative Action Center shows your representatives based on the address associated with your membership. If you have a work, school or old address associated with your membership, these representatives may not be correct, so be sure to double check these are the individuals representing the district in which you currently live and vote.

Through the APTA website Advocacy & Governmental Affairs center you can receive updates regarding important issues facing our profession nationally and at your state level.

The easiest way to get involved as a student is to write your Senators and Representatives. Kyle Ridgeway PT, DPT, outlined detailed instructions on contacting your representative as part of a grassroots letter writing campaign with the American Academy of Orthopaedic Manual Therapists Student Special Interest Group in 2009. Below is an excerpt from Kyle's post, the full post can be found here.

APTA MEMBERS: FINDING/CONTACTING YOUR REPRESENTATIVE

If you are an APTA member you can send electronic correspondence by clicking on “Support Physical Therapy Provisions in Health Care Reform Legislation in Congress” in the APTA’s Legislative Action Center.

1. Click Here to sign into the Legislative Action Center directly:

2. Once signed in click the “Federal Issues” button on the top(A form letter will appear)

3. Under "Current Issues" Support Physical Therapy Provisions in Health Care Reform Legislation in Congress will be listed. Click "Take Action" (a form letter will appear)

3. Select whether you would like to send an e-mail or a letter
* E-mail: will be sent once you click submit
* Letter: Addressed letter will be ready to print after clicking submit

4. Please read over the letter. Add some personal information and insights to make the letter unique

* Whether you are a student or practicing therapist
* What you are interested in
* What patient populations you serve
* NOTE: You can also select a blank letter and enter information on your own
* Make sure to identify yourself as a constituent

5. SUBMIT! It is that easy!!
1. If you selected e-mail, it will be sent
2. If you selected letter, an addressed letter ready to print will appear


NON APTA MEMBERS

Finding Your Representatives

1. Click Here to find your representatives

2. Enter the zip code of where you are registered to VOTE.

Contacting

1. For each representative that appears click on their picture. This will take you to their profile.

2. Once in the representative’s profile click on the “contact” tab above their picture.

3. Please use the Washington DC Office address for all your representatives.

NOTE: Electronic Correspondence: If you would also like to send an electronic correspondence, click on the link for the representative’s WEBSITE and contact them from their website.

See the talking points and sample letter below… Add some personal insights to make your letter unique and send it onward!!


Coordinate your efforts with other students as important issues arise to remind your legislators to represent you and your profession when they vote.

Practice Act intro

The 2010 sunset review of physical therapist regulation from DORA is currently available. This document can also be found in under "Physical Therapy links"

This draft will be submitted to the Senate Health and Human Services Committee (HHS). There will be a public hearing where the HHS will recommend continued licensor or termination. Licensor can be recommended to continue for up to 15 years.

In January our practice act will be submitted to the senate. There will be a public hearing before the HHS where the CO chapter of the APTA, DORA and others will be present (likely chiropractors, acupuncturists, etc.): this is the 1st reading. After this the bill can be amended or killed. The bill then goes to 2nd reading, at which time there is a debate with the full senate. At the 3rd reading there is typically not a debate, and our practice act will be voted on. This process is then repeated in the House of Representatives. After the bill has gone through both houses, the Governor (John Hickenlooper) can sign or veto the bill, or permit it to become law without signing it.

Summary of Meeting with Renee Peters

On October 21^st, Renee Peters took the time to meet with a couple of us from the UCD PT program to share her experiences and offer advice as we prepare for the upcoming Sunsetting of our practice act.


Renee had the opportunity to travel to Washington DC last spring and participate in the APTA Federal Advocacy Forum & Capital Hill Day. She recommends Ellen Caruso and Betsy Murray as our best resources to stay updated on current issues and to advise us on the best ways to take action. When meeting with legislators, Renee's advice is to be clear and succinct, and personalize the message: be memorable. Nearly everyone has an experience with PT - either personally or through family. Use legislators experiences to demonstrate why the bill you are asking them to support is important. Perhaps the most important consideration when meeting with legislators is to make it clear that what you are fighting for will serve the public: legislators aren't concerned with turf wars—make a clear link to public protection.


In preparation for future events, we discussed brainstorming clear and concise answers to common questions such as “what is a PT” and “why is it a DPT?” that engulf the full scope of PT practice, from pediatrics to geriatrics, in a few short sentences. In the near future, we plan to contact the Regis PT program to combine our efforts as a community of student PT advocates.

Community Advisors

Below are several members of our physical therapy community (in alphabetical order) who are active in governmental affairs and advocacy efforts. These individuals have offered their wisdom and guidance to support student physical therapy advocates, and may be contacted by the methods provided.

Jennifer (Jen) Hide PT, DPT, ATC, CMT

Biography
Jen graduated from the University of Colorado Denver Doctor of Physical Therapy porgram in 2007. In 2000 she earned her Bachelor of Fine Arts degree in Human Performance and Sport with minors in Computer Management Systems and Nutrition from Metropolitan State College of Denver with a focus in Athletic Training and graduated from the Cottonwood Scool of Massage Therapy. She is a licensed Physical Therapist, a Certified Athletic Trainer and a Certified Massage Therapist. As a student Jen was secretary of the Student Special Interest Group from 2005-2006 and President from 2006-2007. From 2005-2007 she also acted as the Students Liason for her DPT class.

Jen is currently a member of the Society for Neuroscience and is very active in the Colorado American Physical Therapy Association (APTA). In the CO APTA she currently holds the position of Delegate-at-Large, Co-Chairs the Mentoring Committee and Governmental Affairs Committee, holds membership in the Sunset Task Force and the Research Committee and is the Historian for the Section of Neurology. From 2008-2010 she held the position of Director-at-Large for the CO APTA.

Advice for new advocates

• Get involved in any way you possibly can. Volunteers are always needed at the state level.
• Networking is key! Always introduce yourself to PTs and PTAs that you are around. Don't be shy. PTs are a great group.
• Keep in contact with your classmates and faculty. They are great resources to utilize in the future.
• Find a mentor through the new Mentoring Committee to help further your knowledge base and continue to grow.

Contact Information
jhide@comcast.net
(303)810-3821

Mary Jane Rapport, PT, DPT, PhD

Biography
Mary Jane Rapport, PT, DPT, PhD is a Professor in the School of Medicine, Department of Physical Medicine and Rehabilitation and the Department of Pediatrics, at the University of Colorado where she is the Assistant Director of the Physical Therapy Program. Dr. Rapport has extensive experience in clinical practice and as academic faculty, a productive record of publications, and has been involved with many grant funded projects. She has been actively involved in physical therapy and in promoting pediatric physical therapy through the American Physical Therapy Association (APTA), serving on numerous committees and task forces as well as in a variety of leadership roles in the Section on Pediatrics.

Advice for new advocates
Don’t give up. Learning and action both take time. Stick with your passions and beliefs, and keep plugging away. The more you know, the more you will want to know. That’s a good thing, because the more you know, the more you will believe and feel the need to act.

Contact Information
maryjane.rapport@ucdenver.edu

Kyle Ridgeway PT, DPT

Biography
Dr. Kyle Ridgeway PT, DPT graduated from University of Colorado Denver in 2010 with his Doctor of Physical Therapy (DPT) degree. He graduated from Pomona College (Claremont, CA) in 2007 with a bachelor of arts in neuroscience. At Pomona College, Kyle was a varsity football player.

While in school Kyle was involved in a variety of activities, including serving as the co-coordinator of the UC Denver Marquette Challenge Team. The Marquette Challenge is grassroots fundraising competition between physical therapy students that raises money for the Foundation for Physical Therapy. The UC Denver Team placed 3rd and 2nd respectively out of over 60 participating schools raising over $25,000 total for the Foundation.

Kyle was also the national social chair for the American Academy of Orthopaedic Manual Physical Therapist’s (AAOMPT) Student Special Interest Group (sSIG). His blog posts examining research, advocacy, language, and physical therapy related issues received local and national attention from students, physical therapists, and faculty.

Further, he served on the Capitol Hill Day committee for AAOMPT, recruited students to attend Capitol Hill Day 2009 in Washington, DC, and organized a grass roots letter writing campaign through the sSIG blog. He has met with members of congress at the state and national level in both Washington, DC and Washington State. In October 2009 as a part of the AAOMPT National Conference in Washington, DC he spoke with members of Congress regarding physical therapy. In early 2010, he participated in a Legislative Action Day in Washington State, advocating alongside 700 PT’s and PT supporters for the passage of legislation allowing PT’s to provide thrust manipulation of the spine. He spoke with members of the state legislator regarding thrust manipulation and physical therapy.

In 2010 Kyle had the honor of receiving the Pauline Cerassoli Academic and Clinical Excellence Award from the Colorado Chapter of the American Physical Therapy Association as Physical Therapy Student of the Year. During graduation he received the Outstanding Doctor of Physical Therapy Student Award from the University of Colorado Denver Physical Therapy Program.

Dr. Kyle Ridgeway has a broad array of professional and personal interests. He currently practices in 3 settings/locations: Acute Inpatient (University of Colorado Hospital), Private Outpatient Orthopaedics and Sports (Panther Physical Therapy), and Long Term Acute Care (Colorado Long Term Acute Care Hospital). He is interested in blogging as well as leveraging technology to improve clinical care, efficiency, communication, and access to scientific research. He loves the mountains and enjoys mountain biking, skiing, and golfing in his free time.

Advice for new advocates

• Know your audience
• Know your message 
• Speak clearly and concisely 
• You are the expert
• Be confident
• Believe in yourself and physical therapy
  

Contact Information
Kyle.J.Ridgeway@gmail.com
425.870.3808

Tami Struessel PT, DPT, OCS, MTC

Biography
Tami is a Professor in the Doctor of Physical Therapy program at the University of Colorado Denver Anschutz Medical Campus and a clinician in Denver, CO specializing in Orthopedics. Her full biography can be found on the program website.

Advice for new advocates
Never underestimate the impact individual contact can make in the advocacy process for healthcare issues in general, and physical therapy issues in particular. In addition, a great way to get started in advocacy for the profession is to join the Colorado Chapter Governmental Affairs Committee.

Contact Information
Tami.Struessel@UCDenver.edu (preferred contact)

303-724-9140 (Alternative)