April Recap: National Advocacy Dinner

Name: Grace-Marie Vega, Class of 2019
Undergrad: Arizona State University
Hometown: Placentia, California
Fun Fact: One time, I drove a fire truck.

image1.JPGIf you were there on April 12, 2017, you hardly need me to recount the evening to you, but if you were not, here’s what you missed at this year’s Denver National Advocacy Dinner. First, allow me to set the scene. Room 210 of Claver hall, around dusk. As you walk into the room, you are immediately impressed by the free pizza AND La Croix. You look around and realize you are in the company of well-dressed professionals, esteemed professors, and the most promising physical therapy students in all of North America. You are here partially to avoid yet another night of diligent and thorough studying, but in a truer, more important sense, to get a handle on professional advocacy and how you as a student can become involved.

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The evening opened with an introduction from Dr. Ira Gorman. “Politics: you can’t ignore it, because it won’t ignore you!” And of course, he is right. Advocacy is inherently and perhaps lamentably inextricable from policy. Dr. Gorman went on to explain that in physical therapy, advocacy happens on different levels: at the level of the patient, the professional, the professional organization, and the healthcare environment as a whole. All of these levels are effected by legislation, and legislation can be effected by you. Dr. Gorman outlined political advocacy in a sequence of steps to follow.

First, you must arm yourself with knowledge. This can mean simply being aware of your professional organization, local government officials, and media you can utilize or connect with. The next step is research. This involves investigation of the issue you’re interested in, typically in the form of reading into the specifics and history of proposed legislation, and knowing a little about allies and opponents of that legislation. Then comes implementation. This means taking political action, possibly in the form of writing letters to or visiting elected officials, getting patient testimony, or connecting with legislative staff. The last step is reflection. Ultimately, healthcare reform will not happen by itself. It is up to you to be part of the creation of a system that best serves you and your patients. Your vote and your participation in democracy absolutely matters.

After Dr. Gorman’s talk, Dr. Hope Yasbin, Federal Affairs Liaison for the Colorado chapter of the APTA, talked to us about her own experiences in advocacy. Dr. Yasmin gave us the run down on a few of the biggest issues currently effecting our profession, including:

  • Repeal of the Medicare Therapy Cap: an arbitrary dollar amount limiting outpatient physical therapy and speech therapy coverage.
  • The PT Workforce Bill: which would incentivize PTs to build careers in underserved areas by offering loan forgiveness.
  • The SAFE PLAY Act: which sets up school districts with concussion education for young athletes.
  • The #ChoosePT campaign: an initiative to combat the prescription opioid epidemic.

If you would like more information on any of these topics, you might consider checking out the APTA action center webpage, and downloading the APTA Action app.

Following Dr. Yasmin was Regis’ own Ryan Tollis, a second year student and government affairs committee member. Ryan was chosen to attend this year’s Federal Advocacy Forum, a 2-day adventure/visit to Washington DC during which students, physical therapists, and lobbyists represent our profession and meet with elected officials. By Ryan’s account, it was a whirlwind of networking, briefing, and nonstop political action. Attending events like this is an awesome way to get involved, but there are other ways too.  You can:

To wrap up what was, by all accounts, a thoroughly informative and enjoyable evening, Dr. Cameron MacDonald reminded us that advocacy that best serves the public is when professionals in every field are practicing at the top of their scope. It is our right and duty to be bold in the development of our profession, and to take ownership of the skills we work hard to learn in order to offer the best service we can to our patients. In summation, physical therapy has grown to be what it is today due to the efforts of our professional organization, and the advocacy of many therapists before us. The future of our profession will depend on the work we do to advance it.

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By the end of the evening, you are very satisfied with the food (obviously), but even more so with yourself, for leaving as a more informed person than you were when you arrived. You tell yourself you will definitely be coming back next year, and you will be bringing all your friends.

Thanks to everyone who attended!

Special thanks to:

Speakers: Dr. Ira Gorman, Dr. Cameron MacDonald, and Dr. Hope Yasbin

Coordinators: Carol Passarelli and Ryan Tollis

Team: Kiki Anderton, Brianna Henggeler, Rachel Maass, Katie Ragle, Grace-Marie Vega

Funding: Dave Law and the Graduate Student Council, Dr. Mark Reinking and the Regis School of Physical Therapy

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APTA Tuesday: Interview with a Lobbyist

Learn more about the APTA and lobbying! Katie interviewed Michael Hurlbut, a lobbyist for the APTA.

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Michael Hurlbut, Senior Congressional Affairs Specialist

Michael’s Background

Michael Hurlbut worked for several years on Capital Hill before he came to us at the American Physical Therapy Association in 2009 as a full-time Congressional Affairs Specialist. He previously worked as a staff assistant/systems administrator for Representative Jerrold Nadler (New York’s 10th district which comprises NYC); he then worked for Representative Robert Ernest  Andrews (for New Jersey’s 1st district, including Camden, NJ) and as a legislative assistant and for Representative Louise Slaughter (New York’s 25th district). Michael has a background in sports medicine and was interested in healthcare and policy. So, when the job opened at the APTA, he felt it was a good fit for his interests and strengths.

Michael was kind enough to explain to me some of the logistics of what goes on in Washington and what it looks like on the ground. I appreciated this perspective; as a PT, this whole world is pretty foreign to me!

Some Definitions

Each congressman or congresswoman has a chief of staff and multiple staff members who listen to issues presented by either individual constituents or lobbyists that represent groups of citizens.  For example, the APTA would count as a group of constituents with similar interests. The staff team then updates their member of Congress on important issues and perspectives.

What does a lobbyist do?

The APTA currently employs three lobbyists, each of whom focuses on different issues within the field of physical therapy. Michael’s areas of specialty include post-acute care, self-referral, workers comp, and Veterans Affairs/armed services. He monitors everything relating to those issues–including bills that are being proposed, progress on relevant ongoing legislative actions, and upcoming meetings which will be held on issues pertaining to his areas of specialty (for example, the congressional committee on Veterans Affairs). In his day-to-day work, he performs research to better understand the issues, he finds data surrounding each of them, he attends hearings and talks to constituents, and he matches up each issue with the correct APTA staff member.

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Once he has all of his information, he prepares the APTA’s position on the topic. This could include creating a few talking points to be included in a conversation, or it could include a formal “Statement for the Record:” this is considered the formal stance of the APTA and must be approved by the APTA’s Executive Vice President for Public Affairs. He will set up meetings with members of the committee or other members of Congress to discuss the relevant issues.

Change in Legislation and Policy

Legislation can start in these committees and proceed out into the House or the Senate for a general vote if approved; legislation can also be proposed by the House or Senate Majority leader. Legislation with broad/bipartisan support in a committee may have a higher chance of being approved by Congress in general, but sometimes this is not the case.

Whether the bill starts in a committee or is proposed by the Majority Leader, Michael emphasizes that it is important to identify members of Congress who will be sympathetic to the issues that the APTA cares about. He notes that getting any bill through Congress is a slow process and it may take several congressional cycles to see any change. It is important to provide data, a convincing argument, and show a “grassroots” initiative–which, for us as PTs, would include individual practitioners and patients contacting our representatives and senators.  Change is typically incremental; as PTs, we can relate to that!  We are accustomed to slow, additive changes with a lot of our patients: even as patients make limited progress (or even have setbacks), we have to keep the bigger picture in mind and continue to work towards change.

Michael also points out that it is essential to recognize when it may be better to work directly with an agency (such as CMS for some of the Medicare/Medicaid issues).

How can we support legislative changes impacting our profession and our patients?

In addition to direct involvement with lawmakers (check in next week to read more about that!), we can support changes in legislation through continued APTA support with both membership dues and with donations to the PT-PAC (Physical Therapy Political Action Committee).katiepic3

PT-PAC pays for one of the Congressional Affairs Specialists (Michael or one of the other lobbyists) to attend the fundraising events for the re-election of members of Congress who have supported our initiatives in the past. Attending events is one of the most important ways to forge stronger contacts with members of Congress and their staff,  and it also increases interaction with other lobbyists who may support similar issues. APTA does not allocate PAC funds to individual candidates in hopes that they will support relevant issues. APTA member dues pay Michael’s and the other Congressional Affairs Specialists’ salaries, but the dues are not used for the PAC. So, when you pay your dues online to APTA, there’s a separate line item that asks you if you would like to donate to the PT-PAC.

The PT-PAC is among the top 10 political action committees of national health care organizations. If every APTA member donated $20, it would be the #1 healthcare PAC–that’s even bigger than the orthopedic surgeons’ organization!

If you are interested in further information or would like to donate to PT-PAC, click here.

Blogger: Katie Baratta

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My name is Katie Baratta, and I just graduated from Regis University’s School of Physical Therapy. I had the opportunity to spend two weeks at the APTA doing a student internship. I was able to talk to many different members of the APTA, attend the Federal Advocacy Forum, and learn so much about what the APTA has been doing to move our profession forward. I’ve written a series of posts about my experiences here at the Association.

Check in next Tuesday to learn more!

Regis University hosts the Denver National Advocacy Dinner

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The second annual National Advocacy Dinner was hosted at Regis University this past Wednesday, April 13, 2016. These dinners are going to be held all over the country between April 13th and May 4th, and are a great way to learn the top legislative issues affecting the PT profession. Furthermore, it’s a great (and easy) way to find out more ways that YOU can make a difference in furthering the profession. In case you missed the event at Regis and were wondering what topics we covered, read on for the recap!

In terms of national legislature, the Federal update was presented by Regis’s own Ira Gorman:

  1. Medicare Access to Rehabilitation Services Act of 2015 (“Repeal of the Medicare Cap”)

This bill would eliminate the cap on therapy services for those patients with Medicare. For those of you who are unfamiliar with this idea, as PTs, we only get $1960/year for therapy services. But wait—that’s shared with Speech Language Pathology Therapists too! This would help patients with complex cases (ie. TBI, CVA, hip fractures/replacements, etc.) get more of the services they really need. Check this bill out: HR 775/ S 539

  1. Physical Therapist Workforce and Patient Access Act of 2015 (Loan Repayment)

THIS IS IMPORTANT FOR STUDENTS! In other words, this bill is all about student loan forgiveness. Currently, PTs are not a part of the National Health Service Core, and therefore cannot earn the loan forgiveness that many other health professionals can. With the passing of this bill, PTs would be granted access to the plan when they worked in rural and/or medically underserved areas. This could mean up to $30,000 in two years. As an extra benefit, it’s been shown that when health professionals work in these areas, they tend to lay down roots and stay. This helps to improve communities by keeping quality health care in the area. Check this bill out: HR 2342/ S 1426

  1. Prevent Interruptions in Physical Therapy Act (Locum Tenes)

This bill was explained as a “technical fix,” in which PTs will have an easier time working with Medicare when a staff goes on a leave of absence (ie. Maternity, travel, etc.). Currently, clinics cannot bring temp PTs in unless they are Medicare certified at the specific clinic. Overall, this is a logistical nightmare when you only need a temp for a week or two. Check this bull out: HR 556/ S 313

 Gorman emphasized these three, but also hit on three more important bills. The Safe Play Act would allow PTs medical decision-making abilities in return-to-sport for youth athletes; this bill also promotes safety in youth athletics (with provisions about concussions, heat stroke, and sudden cardiac arrests). Next, the Medicare Opt Out bill is a physician bill that PTs joined in order to work with patients who may have their own private insurance and do not always want to follow through with sole Medicare payment. The bill would allow providers to avoid billing to Medicare and, instead, just bill the patient’s private insurance. The NIH Bill would help fund more rehabilitation research and create a larger focus on rehabilitation topics. Finally, the Telehealth bill would be one step closer for PTs to have a compact license (i.e. One license would allow a PT to practice in any state). Currently PT’s have to have a license for any state their patients may reside in. For example, if your clinic was near state boarders—say, in Colorado but close to Wyoming—you would have to have a license for both Colorado and Wyoming to treat the residents of Wyoming coming to your clinic. The telehealth component plays in when treating patients in other states via an alternative form of communication. (Check out these bills: HR 829/ S436, HR 1650/ S 1849, HR 1631/ S 800, and HR 2948 respectively)

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The other top speaker at the dinner was Colorado State Senator, Irene Aguilar, MD. She presented on a state issue regarding the insurance plan Colorado Care (Amendment 69). This measure will be on the ballot in November 2016 and will improve health insurance coverage in the state by creating a single-payer system. Colorado Care would be resident owned, non-governmental healthcare for any Colorado resident. Individuals could still purchase their own private insurance similar to supplemental Medicare, but would still pay for Colorado Care. Premiums would be collected from residents and employers based on income, effectively reducing costs through the elimination of third party administrative costs. However, this means a 7% tax for employers, a 3% tax for employees, and a combine 10% tax for the self employed in order to cover the budget, which is estimated at $25 billion. (Read more at http://coloradocareyes.co/ and http://www.npr.org/sections/health-shots/2015/12/19/458688605/coloradans-will-put-single-payer-health-care-to-a-vote.)

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 Now what? Well, as an incoming student, current student, new grad, or current practitioner, it is important to start spreading awareness. The easiest way to do this is check out the APTA take action center (http://www.apta.org/TakeAction/). As a member of APTA, you get access to support any of the current issues with easy, pre-made letters to send to your Congressmen. This is helpful because research shows that Representatives want to know you’re knowledgeable about the bills you’re asking them to support. Heads up, though—they want: to have a constituent reason for your stance on the bill, the specific legislation cited, the bill number, the impact of the bill, and your full name and address.

If you’re looking for a little more action, join PT-PAC (political action committee) or donate money in their name for a more focused contribution. There’s even an app for that! Search APTA Action.

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Upcoming Advocacy Events:

June 8-11, 2016                 NEXT Conference (Nashville, TN)

Oct 27-29, 2016                 National Student Conclave (Miami, FL)

Feb 15-18, 2017                 Combine Sections Meeting (San Antonio, TX)

Spring 2017                           Federal Advocacy Forum (Washington, DC)

 Important Links:

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Keep an eye out for our student spotlight on Cindi Rauert, Regis DPT Class of 2017, who spearheaded this event as the SPT Delegate on the Student Assembly Board of Directors.

Blogger: Sarah Campbell, Class of 2017