New York Physical Therapy Association

CSM-Chicago

2012-02-13T07:49:00.002-05:00

Good Morning-
Returned from CSM yesterday and as always find myself more energized after a week with colleagues. Rumor has it that attendance was around 12,000 attendees which would shatter the old attendance record. Thank you to everyone who introduced themselves to me and engaged in conversation regarding the state of the Chapter. Participation comes in many forms and taking the time to share your thoughts, ideas and perspectives is very meaningnful.

I had the opportunity tho hear updates on APTA Governance Review process. The task force gave an oral report to the Board and is scheduled to give a full written report for their April meeting. Suggestions are significant and include the Board, Chapters, Sections, and House of Delegates. I also received an update regarding the use of support personnel. This too was an oral presentation to the board from the task force. I will continue to update you as I hear more.

In Good Health

Matthew Hyland
President NYPTA

CSM

2012-02-06T11:14:00.002-05:00

Hello everyone-
Congratulations to all of the Giants fans out there. I am presently packing to head to CSM in Chicago tomorrow and as always very excited about the upcoming week. I will be attending daylong leadership meetings on Wed and Thursday as well as the outstanding programming. If you see me there please take a moment and come say hi. Have a wonderful conference and I hope to see you there.

In Good Health

Matthew Hyland
President NYPTA

BOD Winter Board Meeting

2012-01-30T15:00:00.002-05:00

Hi all,
While at the Winter BOD meeting this past weekend I had the opportunity to watch the end of the Australian open. After almost 6 hours of tennis Novak Djokovic won a thrilling match. Afterwards while receiving his award at center court he thanked his team of supporters including his wife, his coach and his physio. Again, it is wonderful to see the impact we have world wide.

Our board meeting was very energetic with a wide variety of issues discussed and voted on. The Executive Committee made various appointments to committee's, approved a marketing campaign developed by our communications director and the PR committee, and further developed planning for our marketing firm at Lobby Day. The board disbanded the Research Task Force as they met their charge and is creating a new action task force to develope the research on outcomes and cost of funding the research. In addition motions were passed to fund the President and the Chair of APOL to Lobby Day and clarified the policy on reimbursment for Chapter Conference. We further discussed supporting a motion from New York regarding exercise at the HOD this year and identified ways in which we can utilize our website better to provide information.

If you have any questions regarding these meetings please do not hesitate to ask.
The minutes will be posted in the upcoming weeks.

In Good Health

Matthew Hyland
President NYPTA

High Copays

2012-01-12T10:22:00.002-05:00

Yesterday a meeting took place with myself, Chapter Staff, AIPT leadership, Chapter PR Chair and members of the APTA to discuss our battle against high copays. We have worked very hard to create awareness in our grassroots membership and think we have made significant progress. We have also worked very hard to try to have Assemblyman Morrelli (Chair of the Insurance committee) to see copays as a big issue for New Yorkers, and think we are making great progress there. Now we are working with APTA to increase our marketing efforts to the general public and employers organizations. We will be using mediums such as ads in movie theaters, social media, links through our homepage and pamphlets to advance our message. As we prepare for Lobby Day we are setting a strong plan to create as strong a message as possible. Thank you for all of your efforts.

In Good Health

Matthew Hyland

President NYPTA

Advisory Panel on Legislation

2012-01-04T22:23:00.002-05:00

I would like to take a moment and thank Mark Amir for his work over the past years as the Chair of APOL, his hard work and leadership have lead to many Chapter successes. Mark will be taking a position with the APTA and we wish him the best of luck as he continues to serve us. I am also very excited to announce and welcome our new chair Mike Mattia from Brooklyn/ Statan Island who I have no doubts will continue to lead us.

In Good Health

Matthew Hyland
President NYPTA

Happy Holidays

2011-12-29T10:17:00.002-05:00

Good Morning-
First I would like to thank the Catskill district for inviting me to join them at their meeting just prior to the Christmas Holiday. It was a pleasure to spend time and interact with the membership regarding some of the ongoing activities and planned direction of the Chapter.

On behalf of the Executive Committee,Chapter staff and entire Board of Directors I would like to wish everyone a happy holiday season.

Happy New Year,

In Good Health

Matthew Hyland
President NYPTA

Richard DiFabio, PT, PhD

2011-12-16T07:48:00.001-05:00

It is with sadness that we inform you of the death of Dr. Richard P. Di Fabio, PhD, PT. The following excerpt was sent from the Ortho Section.

In Good Health

Matthew Hyland
President NYPTA

Dr. Di Fabio passed away Friday Dec 9th after a prolonged and private battle with a progressive illness. “Dr. D” was on faculty at the University of Minnesota's Program in Physical Therapy for over 20 years, having previously served as Director at the University of Wisconsin, Madison. He was a graduate of the State University of New York (SUNY) – Syracuse, with a Bachelor’s degree in Physical Therapy and SUNY –Cortland with a Master’s in Health Education. He completed his PhD at the University of Iowa in 1982.

“Dr. D” was Editor-in-Chief of the Journal of Orthopaedic and Sports Physical Therapy from 1999-2001, and past member of the Editorial Board of the Physical Therapy Journal. He was known nationally and internationally for his research and scholarship. He was a recipient of the APTAs “Golden Pen Award” for scholarly writing, excellence in research awards from the Geriatric and Orthopaedic Sections of the American Physical Therapy Association, and “Fesler-Lampert Chair in Aging Studies” at the University of Minnesota from 2002-2003. His research was funded by the Minnesota Medical Foundation, NIDRR, and NIH.

Dr. Di Fabio’s legacy includes over 65 scientific manuscripts, 5 PhD graduates in Rehabilitation Science, and mentorship of 100s of professional physical therapy students. He had recently authored a text “Essentials of Rehabilitation Research” which is in final editing with FA Davis.

He was passionate about research and his research students, but even more so about his family, wife Betsy and two daughters, Danielle and Diana. His spirit will live on in his scientific contributions, and through his family.

Legislative Plan

2011-12-13T11:49:00.002-05:00

Hello-
the legislature has been quite quiet on the State level during the Holiday season. On the chapter level we continue to work on creating meaningful research to focus on cost and outcome as well as begin to set our legislative plan. At the forefront of our plan includes continued movement toward copays (which we are receiving wonderful support from APTA) and new legislation to eliminate the ability for self referral. I hope everyone is enjoying the Holiday's and I look forward to the new year together.

In Good Health

Matthew Hyland
President NYPTA

Executive Committee and Board Meeting

2011-11-30T11:09:00.002-05:00

Good Morning everyone,
On October 26th and 27th the Board held their Fall meeting. Preceeding the meeting was the Executive Committee meeting. The EC is currently reviewing proposals for a new marketing firm. In keeping with our new 365 day advocacy plan we are committed to chosing the firm that best meets our goals. With fiduciary responsibility of members money, we also do not want to make a hasty choice which we will be unhappy with moving forward. It is the hope of the EC that we have a plan in place by the end of the Winter Board meeting leaving plenty of time in preparation for Lobby Day 2012. The Chapter has satisfied its pledge to the "Foundation" and no further payments will be made at this time. A donation was approved to the Jayne Snyder Endowment Fund on behalf of the Chapter. As a standing item at EC meetings, appointments were made to standing committees and Rich Orsini was again appointed to represent the Chapter as our Federal Affairs Liaison for 2012. For the afternoon portion of the EC meeting the Finance Committee was present to hear a presentation by our new Financial Firm Wells Fargo. The EC and Board are very happy about this new relationship and have full confidence in the Finance Committee and our new Financial Advisors in managing the Chapters monies and reserves. Representatives from Wells Fargo also then later made a presentation to the entire board.

The Board meeting was Wednesday evening and all day Thursday. As customary the minutes from the previous board meeting were discussed and ultimately approved and can be found on the NYPTA website. The main goal of the Fall Board meeting is to discuss and ultimately approve a balanced budget for the following year. One of the main duties of the board is Fiduciary responsibility of Chapter and membership money. After a presentation by the Treasurer, who is also the chair of the Finance Committee, discussion regarding the budget ensued. In 2011 the Chapter established a new budget process to make the Chapter budget process more streamlined and easy to understand. While as with any change it was intially difficult, budget managers did a terrific job and ultimately the budget passed fairly quickly. I would like to thank the Treasurer, Finance Committee and all budget managers as well as the board for all of their hard work over the past months in preparation for this budget. An intial report was made to the Board from the Task force on research and further charges made to the task force and volunteers for the committee's pool were also accepted.

In addition to the EC and BOD meeting, there was a meeting of the Governance Review Task Force, the EC met with the CNC union reps and there was an AIPT and AASIG meeting. All in all a very busy couple of days of governance and leadership wrapped around a very successful conference. Thank you to all who attended the conference. Also thank you for the woderful work done by the Program Committee and Chapter Staff for making this happen and to the Practice Committee for hosting the Issues Forum.

If you have any quesions about any of the ongoing activities of the Chapter please do not hesitate to reach out to me.

In Good Health

Matthew Hyland
President NYPTA

Happy Thanksgiving

2011-11-27T10:59:00.003-05:00

It has been a little while since I have last posted as it has been very busy in my household with the Holiday. We have had 6 houseguests for the past 4 nights and turned Thanksgiving into a four day festival. With the house now quieter I would like to take a moment and on behalf of the Chapter Officers, Board and staff wish all of you a Happy Thanksgiving. Thank you so much for all that you do to help our profession "move forward."

In Good Health

Matthew Hyland
President NYPTA

Workers Comp in the Times Union

2011-11-12T08:27:00.002-05:00

Good Morning Everyone-
Below is a letter to the editor that was published in yesterdays Albany Times Union.

In Good Health

Matthew Hyland
President NYPTA

Quality of care a big part of reform

We couldnt agree more with Rick Karlin (When reform doesnt reform, Nov.7). Promising reform of the states cumbersome workerscompensation system has been derailed. New York has lost sight of the main goal returning workers to health and their jobs, effectively and efficiently.

The current race to push through new guidelines seriously compromises the quality of the care provided to injured workers. As experts in treating soft-tissue injuries, one of the most frequent workplace injuries, we are concerned the new guidelines fail to incorporate established, evidence-based practice patterns of physical therapy and focus more on cost than quality which, taken together, put workers health at risk.

It is time for meaningful workers compensation reform. New Yorkers deserve a workers compensation system with focus on the health and well-being of employees, with the ultimate goal being the right service by the right provider at the right time.

MATTHEW R. HYLAND

President New York Physical Therapy Association

UT article on Workers Comp

2011-11-09T08:29:00.003-05:00

Good Morning everyone-
Below is an article that appeared in yesterdays Albany Times Union. The NYPTA will be crafting a response today.

In good health
Matthew Hyland
President NYPTA

When reform doesn't reform
Littie improvement 3 years after workers' comp underwent change
By RICK KARLIN Capitol bureau
Published 11:55 p.m., Monday, November 7, 2011

ALBANY -- New York's workers' compensation system has long been criticized as slow, costly and unresponsive to the needs of employees and employers alike. More than three years after the latest dose of reform, things haven't markedly improved.

Reforming this creaking mechanism was one of the first priorities of former Gov. Eliot Spitzer, who in March 2007 met with labor and business leaders to announce a historic compromise. Going forward, injured workers would get more money, but only for a set period of time -- rather than for life, as had been the case in the past.

Both sides hailed the change as long overdue. "This is a major step toward reducing the cost of doing business in New York state," said Ken Adams, president of the state Business Council at the time. Adams now heads the Empire State Development Corp.

In the years since then, the reforms seem to have stumbled.

Critics, including lawyers on either side in workers' compensation matters, point to a backlog of at least 12,000 new cases since the reforms.

They place a good deal of blame on the politically appointed Workers' Compensation Board and its leadership.

"Businesses haven't seen any savings," said Peter J. Walsh of Walsh & Hacker, an Albany law firm that defends employers in compensation cases. "Gov. Spitzer promised this immediate relief, and we are nowhere close to that."

"It has not worked out the way that many people on both sides of the equation had expected it to work," agreed John Sciortino of Rochester's Segar & Sciortino, which represents injured workers.

The failure to reform the workers' compensation system is one of the many negative results of the legislative chaos that came in the wake of Spitzer's sudden resignation in March 2008. Critics say the board began to drift soon after and never recovered its bearings.

This lassitude doesn't mean that those who suffer workplace injuries don't get compensated. Instead, the slow pace of reform has meant that workers continue to collect payments through the same open-ended schedule that has existed for years.

That's costly to employers, who end up paying higher insurance premiums. For workers, it represents a form of legal limbo.

"They're kind of treading water," said Margaret Moree, director of federal affairs at the Business Council.

Workers' Compensation Board officials say that parties in many cases have been slow to come forward and seek rulings on the caps, or limits on how long injured workers can collect payments.

And there have been some caps: A report by the Department of Labor last December noted that of workers injured between the start of the reforms in March 2007 and June 30, 2009, 606 people have had their payments capped.

The 2007 overhaul focused on one of the most common forms of workplace injury, known as a permanent partial disability -- typically a soft-tissue injury to the knee or back, such as a torn ligament or slipped disc.

Such injuries, which can get better but may never heal completely, are suffered by a wide range of workers, including hospital aides, factory hands and construction workers.

One of the ideas behind the reforms was to provide some finality in such cases.

But workers' compensation judges haven't been ruling on the cases, in part because they haven't gotten guidelines from the Workers' Compensation Board, Moree said.

"We're four years plus from the reforms. The costs are mounting," said Moree, who added that compensation insurance rates also are rising for many businesses.

Just last week, the Workers' Compensation Board issued detailed guidelines on how compensation judges should rule on permanent partial disability cases.

But even that has angered lawyers, who note that the guidelines are scheduled to take effect Jan. 1 -- just two months after their release.

"Now we have a rollout of the new standards, which will affect the rights of thousands of workers, and we have been given very little time to comment on them," Sciortino said.

The 13-member board, the members of which are appointed by the governor and approved by the state Senate to seven-year terms, has been criticized as a nest of patronage appointees. It includes proteges of former Gov. George Pataki such as Richard Bell and Candace Finnegan, plus longtime Republican lawyer David Dudley. Another member, Francis Libous, is married to Senate Deputy Majority Leader Tom Libous, R-Binghamton.

On the Democratic side, the board includes Mark Higgins, the brother of Buffalo congressman Brian Higgins, and Frieda Foster-Tolbert, the widow of a top Democratic Assembly operative.

And although he's not a board member, Executive Director Jeffrey Fenster has political connections to powerful Brooklyn Democratic Assemblyman Vito Lopez.

Some say the board hasn't been avoiding work -- it's just that they're pushing on the wrong things.

"The Workers' Compensation Board ... has been involved in a number of initiatives in the past few years that, frankly, I think should have not been pursued," Sciortino said. For example, he said members have pushed, with little success, to institute digital recordings of hearings rather than use stenographers.

"They've been totally diverted," Walsh saod.

Now that the guidelines for compensation cases are in print, lawyers who represent injured workers or defend employers hope to move forward. But unless there is enough time for feedback, Sciortino fears future cases will drag on interminably.

"There will be abundant appeals. I'm almost certain of that," he said.

CMS Sets Cap at $1,880 in Final Physician Fee Schedule Rule

2011-11-07T13:53:00.001-05:00

Hello everyone-
This comes from CMS

In Good Health
Matthew Hyland
President NYPTA

On November 1, the Centers for Medicare and Medicaid Services (CMS) released the final physician fee schedule rule for Calendar Year (CY) 2012, which sets the therapy cap on outpatient services (except outpatient hospital departments) at $1,880beginning January 1, 2012 and updates payment rates for physicians, physical therapists, and other health care professionals for 2012. The therapy cap exceptions process will expire on December 31, 2011, unless Congress acts to extend it.
The final rule announces that there will be a 27.4% cut in Medicare payments for physicians, physical therapists, and other health care professionals based on the flawed sustainable growth rate formula (SGR). Congress must take action to prevent this cut by January 1, 2012. According to CMS, the Obama administration is “committed to fixing the SGR and ensuring these payment cuts do not take effect.” If the 27.4% cut does not go into effect, the aggregate impact of work relative value unit (RVU), practice expense RVU, and malpractice RVU change for 2012 on physical therapy payment is a positive 4%.

The CY 2012 final rule also modifies several physician incentive programs, including the Physician Quality Reporting System (PQRS). For 2012 the reporting period for PQRS will be based on a 12 month reporting time frame and the bonus payment amount will be .5%. In addition, CMS finalizes calendar year 2013 as the reporting period for the 2015 PQRS payment penalty.

In the final rule, CMS expands the potentially misvalued code initiative in an effort to ensure Medicare is paying accurately for services. CMS has targeted specific codes for review, including some CPT codes reported by physical therapists.
The final rule with comment period will appear in the November 28, 2011, Federal Register. APTA will post a detailed summary of the final rule later this week.

Medicare cap

2011-11-03T17:56:00.001-04:00

Good Evening-
This was sent out this week from APTA, it is very important and I think reposting here.

In Good Health

Matthew Hyland
President NPTA

Time is Running Out for Congressional Action to Extend the Therapy Cap
Exceptions Process

Only 60 days remain for Congress to take action on the therapy cap. It is
critical that Congress pass legislation before December 31, 2011 to extend
the therapy cap exceptions process and to avoid the scheduled 29.5% cut in
provider payments under the Medicare physician fee schedule.
There are several legislative vehicles that could be the home for the
therapy cap exceptions extension this year, including the imminent arrival
of the spending cuts package that the Joint Select Committee on Deficit
Reduction is crafting and measures that health writing committees in the
House and the Senate are currently pulling together. While APTA is working
tirelessly with congressional offices on the Hill to protect the profession
and our patients from these impending budget cuts, we need your help.
Help us reinforce our message by contacting your legislator today.
Message:

* Request that your Congressman sign onto the Therapy Cap Repeal
legislation (H.R. 1546). We are well on our way to reaching 150 cosponsors
and we need your help to drive up the numbers.
* Ask your member of Congress to contact their colleagues on the House
Ways and Means Committee, House Energy and Commerce Committee and the Senate
Finance Committee and express their support for working with APTA to resolve
the therapy caps once and for all. APTA has submitted proposals to these
health writing subcommittees that we believe will alleviate the pattern of
year to year extensions on the exceptions process. We need your member to
weigh in with the big health committees and encourage support for finding a
solution.

What You Can Do

* Send an email to your Members of Congress TODAY. For sample
letters and easy access to contacting your Members of Congress by electronic
means or download and print letters, utilize APTA’s Legislative Action
Center
7OP2W2tK9NxSuGyumfpBN%2flQI2qTN2SSJW000VZSYR64SMnRy> .
* Request your patients to contact Congress on this issue through
APTA’s Patient Action Center
. This site is
designed to educate patients on the issue and to provide easy access to form
emails and letters for them to contact Congress.
Keep Your Colleagues Informed – Request that your colleagues take action
through APTA’s Legislative Action Center
and sign up for
APTA’s Grassroots Network, PTeam
. PTeam will be the
main source of information for legislative updates and breaking news on the
effort to pass legislation to extend the therapy cap exceptions process and
avoid the 29.5% cut.

Patient testamonial regarding copays

2011-11-02T09:05:00.003-04:00

Andy Opett and Marcia Spoto have put together a video clip on the high co-pay issue. This is a patient in the Nazareth College clinic. It is a bit long, but she wanted to tell her story unscripted. It has already received over 200 hits on you-tube.
http://www.youtube.com/watch?v=b74Bgi40GRM

In Good Health

Matthew Hyland
President NYPTA

Autism bill

2011-11-01T14:40:00.002-04:00

Hi all-
Just got back from Chapter Conference including EC and BOD meeting. I will blog about that tomorrow, but this just came to me and thought it was worthwhile posting.

In Good Health

Matthew Hyland
President NYPTA

Governor Andrew M. Cuomo today signed a law that will require health insurance providers to offer coverage for the diagnosis and treatment of autism spectrum disorder.

The legislation will help families afford the expensive health care costs related to treating loved ones with autistic disorders. Under the new law, health insurance companies will be required to provide coverage for treatment of autism spectrum disorders, though coverage may be subject to deductibles, co-pays, and coinsurance consistent with those imposed on other benefits.

"This bill will help thousands of families across New York who struggle to obtain proper care for loved ones affected by autism spectrum disorder," Governor Cuomo said. "When it comes to autism, early diagnosis and treatment is essential, and it is inexcusable that financial constraints would stand in the way of a brighter future for those affected by this disorder. This bill opens the door to families seeking earlier treatment and better results. I thank Senator Fuschillo and Assemblyman Morelle for sponsoring this much-needed legislation."

Previously, state law only required that insurance coverage not exclude the diagnosis and treatment of autism disorder. While some health insurers provide limited coverage for ASD treatment, such as vitamins or occupational therapy, most do not offer coverage for treatments that are deemed not medically necessary. Families had little choice but to pay out-of-pocket for the necessary treatment, with costs sometimes more than $50,000 per year. Many families cannot afford to pay for treatment without a severe economic hardship and may have to forgo effective early treatment of ASD for their children.

With today's signing, New York is the twenty-ninth state to require health insurance coverage for conditions relating to autism spectrum disorder. As with other states, this legislation caps the cost of services per year. The law takes effect one year after its enactment on November 1, 2012 and applies to insurance policies issued or renewed after that date.

Autism spectrum disorders are a group of complex, pervasive developmental brain conditions that are often characterized by difficulties in social interaction, impairments in communication, and repetitive patterns of behavior. ASDs occur in approximately one in every 110 children in all racial, ethnic and social groups, and studies suggest that it is four times more likely to occur in boys than girls. Early detection of ASDs, when followed by the right interventions, can lead to better outcomes in functioning. In New York, approximately 30,000 individuals under the age of 19 have been identified with an ASD.

New York State offers a number of services and supports to individuals with ASD and other developmental disabilities, including the Department of Health's Early Intervention Program, preschool special education services and special education services for school children under the auspices of the State Education Department, and an "Autism Platform," provided by the Office for People with Developmental Disabilities that offers certain services and support for individuals with ASD, most of which are Medicaid-funded and provided in conjunction with an individualized service plan.

Senate Majority Leader Dean G. Skelos said, "Thousands of families throughout the state are facing critical choices between providing quality care for children and adults with autism or jeopardizing their finances. This bill will give them access to the tools that have been proven to make a difference in the life of an individual with autism. I thank Senator Fuschillo and Senator McDonald for their leadership, and commend the Governor for partnering with us to get this done."

Assembly Speaker Sheldon Silver said, "A government that steps up to ensure a brighter future for vulnerable children and adults – especially in difficult times such as these – is a government with its priorities in order. I thank the Governor for standing up for those afflicted with Autism Spectrum Disorders and for their families who are striving to give them the best care possible; and to my colleague, Assemblyman Joe Morelle, for his leadership and his tireless efforts to help make today possible."

Senator Charles J. Fuschillo, Jr. said, "Today is a great day for individuals with autism. For years, families have fought for access to treatment coverage for their loved ones. This new law will afford individuals with autism the opportunity to receive treatments and therapies they need without being forced to spend tens of thousands of dollars out of pocket every year. I thank Governor Cuomo for signing this law which will dramatically improve the lives of every New York family affected by autism."

Senator Roy J. McDonald said, "Autism is quickly erupting into epidemic levels with diagnosis rates climbing at an astonishing level, this is a mental health issue that is going to get much worse before it gets better and this legislation helps real people and their families. I want to thank Governor Cuomo for his leadership and support of this bill, along with my colleagues in the Senate and Assembly who sponsored this legislation."

Assemblyman Joseph Morelle said, "With Governor Cuomo's signature today, families will no longer have to decide between affording health care for one child or college education for another. New York has proven with this law that we remain a state that looks out for everyone, especially those who face hardship through no fault of their own. I thank the Governor for his leadership and attention to this issue, and I commend my colleagues in the legislature for passing this important bill."

Dr. Nirav Shah, Commissioner of the Department of Health said, "Early detection of autism spectrum disorders, when followed by the right treatment programs, has been shown to lead to better functioning in patients, and will provide a more stable future for children and their families. I thank and commend Governor Cuomo and our Legislature for working together to enact legislation that will help families all across New York meet the challenges of autism spectrum disorders."

Courtney Burke, Commissioner of the Office for People with Developmental Disabilities said, "I cannot stress enough the importance of early diagnosis and treatment of autism spectrum disorders (ASDs). However, many families have had to forgo early intervention due to economic hardship. With the signing of this bill, caregivers can continue to advocate and support their child who has been diagnosed with autism, and not have to worry about the financial stress related to needed services. Today, the families of the 24,000 New York State citizens diagnosed with an ASD, whom OPWDD serves, join me in applauding Governor Cuomo and his decision to sign this vital bill."

John B. King, Jr., State Education Commissioner said, "The struggle with autism is hard enough for families. Those families shouldn't be forced to choose between a mountain of medical bills or delaying care for their children. And early and accurate diagnosis is vital for long-term, effective treatment. There are some things that are simply the right things to do. This new law is one of them. The Governor and the Legislature have taken a tremendous burden off the backs of thousands of New York parents with children suffering from autism spectrum disorder."

Bob Wright, Co-founder of Autism Speaks said, "Autism Speaks thanks Governor Cuomo for his wisdom and courage in standing by our families who struggle with autism. We commend the Governor's willingness to work with us and our champions, Assemblyman Joe Morelle and Senator Chuck Fuschillo, to craft one of the most powerful autism insurance reform bills in the nation. Today New York becomes the 29th state to enact reform, joining the growing majority of states that put families first."

Mark Roithmayr, President of Autism Speaks said, "Some New York families, already hit hard by the recession, are paying tens of thousands of dollars out-of-pocket each year to provide their children with the therapies they need and deserve. This critical legislation will not only right this wrong, but also save the taxpayers of this state an estimated $13 million in special education, Medicaid and social service costs in the next six years. This is a good day for all New Yorkers."

Paul A. Hamlin, MD, President, Medical Society of the State of New York said, "On behalf of the physician members of the Medical Society of the State of New York, the signing of this bill is a momentous event. The measure will expand health insurance coverage for the screening, diagnosis and treatment of autism spectrum disorders. Patients are often faced with significant gaps in treatments which may be needed over and above those provided pursuant to an individualized family, education, or service plan. We commend Governor Cuomo, Senator Fuschillo and Assemblyman Morelle for their foresight in championing this legislation which will expedite diagnosis and treatment by providing insurance parity for autism sufferers and result in better long-term health outcomes."

Patricia Schissel, LMSW, Executive Director of Asperger Syndrome and High Functioning Autism Association (AHA) said, "Today's signing lifts a great financial burden on families in New York who have to care for individuals with autism. By requiring health insurance companies to provide coverage for the diagnosis and treatment of autism, families can now more easily detect autism in individuals and begin needed treatment as soon as possible. I commend Governor Cuomo and Sponsors Senator Fuschillo and Assemblyman Morelle for their work in passing this legislation."

Elie Ward, Director of Policy & Advocacy, American Academy of Pediatrics, District II, NYS said, "Having a child diagnosed with autism can create enormous financial difficulties for families already struggling with the impacts of our current economy and compounds the emotional/social challenges of caring for a chronically ill child. Without the kind of health care coverage this legislation requires, these families are often left with no choice to but forgo treatments. As a result of this draconian choice, their children are left even further behind their peers and absorb more services going forward. By requiring health insurance companies to pay for the diagnosis and treatment of autism and autism spectrum disorders, Governor Cuomo is ensuring that the tens of thousands of affected children in New York are given access to proper care and a better chance to grow and develop to their full potential. The more than five thousand pediatricians across New York sincerely I thank Assemblyman Morelle and Senator Fuschillo and their many colleagues for getting this law passed in the legislature. And we thank Governor Cuomo for signing it."

Anita Altman, Deputy Managing Director for UJA-Federation of New York said, "For so long, families who are raising children with autism have been weighed down by backbreaking out-of-pocket costs for autism disorder treatments. And for those families who cannot afford treatment, their children are left with even more of a disadvantage academically and socially. Requiring health insurance providers to cover these costs will change the lives of these families, and I thank Governor Cuomo for signing this into law."

Katie Weisman, Secretary of the Autism Action Network said, "My family and I were so relieved when this bill finally passed in the legislature and could not be more excited that the Governor is signing it today. I would like to thank Senator Fuschillo, Assemblyman Morelle and all the advocates who worked on this piece of legislation. This law will acknowledge that autism is a medical condition and not just a psychiatric condition. I have seen first-hand how effective treatment can be. My children have grown leaps and bounds through both medical treatment and intensive educational support. It is important that all the individuals and families affected by autism be able to afford the care they so desperately need. We cannot pinch pennies over something as significant as improving long-term quality of life. This new law should smooth the road for those families whose loved-ones are affected by autism."

Susan Hyman, MD, Associate Professor of Pediatrics and Division Chief of Neurodevelopmental and Behavioral Pediatrics at Golisano Children's Hospital, University of Rochester Medical Center said, "In today's economy, having a child diagnosed with autism can be an enormous financial difficulty on already strained family budgets. Governor Cuomo is ensuring that proper medical and behavioral care will be reimbursed for the 1 in every 110 children and youth in New York with autism by requiring health insurance companies to pay for the diagnosis and treatment of this neurodevelopmental disorder. I would like to personally thank Assemblyman Morelle and Senator Fuschillo for getting this law passed in the legislature."

Stephen Sulkes, MD, Professor of Pediatrics at Golisano Children's Hospital and Director of the Strong Center for Developmental Disabilities, said, "Autism spectrum disorders have profound effects on the lives of thousands of New Yorkers, their friends and their family members. Today, Governor Cuomo's show of support for those impacted by ASDs proves the state government is on their side. I thank the Governor for signing this bill into law and working to minimize the challenges that result from ASDs by requiring health insurance providers to cover its treatment and diagnosis."

Paige Pierce, Executive Director of Families Together in New York State and President of the Board of the Autism Society of the Greater Capital Region said, "I congratulate New York on becoming the latest state to pass the Autism Bill requiring health insurance companies to provide coverage for treating people with Autism Spectrum Disorders. This Bill demonstrates an understanding of the importance of comprehensive and early care and treatment for our children. As a parent of a young man with ASD and the co-chair of the Timothy's Law Campaign, I know firsthand the challenges that families have faced in the past. I thank Governor Cuomo, Senator Fuschillo and Assemblyman Morelle for their progressive leadership and commitment to our children and families."

Jan Campito, Vice President of the Autism Society of the Greater Capital Region said, "Governor Cuomo has made the improvement of healthcare and its financial impact on New York and its constituents a priority since taking office. Today's signing is another example of his commitment to progressive health care for families with special needs. This new law is great news for our children and families who have had to make enormous sacrifices to afford the high costs of ASD treatments, and I commend the Governor, Senator Fuschillo and Assemblyman Morelle for their hard work."

Michael Smith, Chairman of the Foundation for Autism Information and Research, Inc. said, "This bill signing is a monumental achievement for the tens of thousands of New Yorkers directly affected by autism, and their families. Governor Cuomo, together with Senator Fuschillo and Assemblyman Morelle and the entire State Legislature, has ensured that heath care providers will fulfill their obligations and no longer demand that families suffer the burden of these expensive treatments and care. This bill is a positive step forward, but, much work remains to be done in addressing the overall hurdles to insurance coverage for families. The autism epidemic will continue to be a high priority in the State Legislature."

Sarah Milko, President of Upstate New York Families for Effective Autism Treatment said, "In today's economy, having a child diagnosed with autism can be an enormous financial difficulty on already strained family budgets. And if these families are left with no choice to but forgo treatments, their children are left even further behind their peers. By requiring health insurance companies to pay for the diagnosis and treatment of the disorder, Governor Cuomo is ensuring that the tens of thousands of affected children in New York are given proper care. I thank Assemblyman Morelle and Senator Fuschillo for getting this law passed in the Legislature."

PTAUNY

2011-10-20T13:56:00.002-04:00

I would like to extend a thank you to the PTAUNY leadership for inviting me to attend there annual conference in Batavia NY this past Tuesday. I had the opportunity to meet with leadership for almost two hours prior to the meeting to discuss some of the challenges in the outpatient arena in upstate as well as share some of the ongoing agenda of the Chapter. After we went to Gennessee Community College for the Annual Meeting. There I enjoyed a lengthy and indepth question and answer session during an exchange of ideas with members.

Tonight there is a conference call by the Advisory Panel on Legislation (APOL) to begin to establish the 2012 Legislative Agenda as part of 365 day advocacy. We have also extended an invitation to PTAUNY to designate a liaison to APOL so that we may keep close communication between the groups.

In Good Health

Matthew Hyland
President NYPTA

Press Release

2011-10-13T22:13:00.002-04:00

This was a release that was sent out yesterday and hit Twitter Accounts. The NYPTA views this as illegal and unethical and will take every measure neccessary to protect the profession of Physical Therapy and the practice act which we are held to.

In Good Health

Matthew Hyland
President NYPTA

press release

Oct. 12, 2011, 9:00 a.m. EDT

Chiropractor Announces Queens Physical Therapy Treatments Speed Injury Recovery
JAMAICA, NY, Oct 12, 2011 (MARKETWIRE via COMTEX) -- Dr. Lee's Spine Center in Jamaica, New York announced the incorporation of physical therapy into patient treatments. The rehabilitation and pain relief treatments include an initial diagnostic consultation followed by relief care that is designed to provide both immediate and long-term pain management. Depending on a patient's needs, a range of therapies is used to manage chronic pain and correct the underlying cause for this pain, including heat and ice therapy, spinal decompression, massage and corrective exercises.

Dr. James Lee, chiropractor and founder of Dr. Lee's Spine Center, announced the incorporation of physical therapy into his patient treatment plans. Each plan is tailored to a client's specific wellness needs and is designed to enhance pain relief and speed recovery.

"Our treatments are different from traditional medical care," said Dr. Lee. "We combine a range of therapies and customize each plan to meet a patient's individual wellness needs."

New patients receive an initial diagnostic consultation session. Dr. Lee evaluates the patient, determining the underlying cause for the pain or injury. For example, a herniated disc in the lower back may be responsible for radiating pain in the back, legs and buttocks, a condition known as sciatica.

"Many patients do not realize there are real options for treating chronic back pain and injuries," said Dr. Lee. "By precisely identifying the location of the nerve pain, we can create a treatment program to restore alignment to the musculoskeletal system for long-term relief and healing."

Dr. Lee uses a variety of physiotherapy techniques in his treatment plans as well. These techniques include heat therapy, ice therapy, corrective exercises, gentle movement under anesthesia and spinal decompression therapy.

"Our goal with every treatment is to restore a full range of movement to the body and providing long-lasting pain relief," said Dr. Lee. "To achieve this goal, we can't just cover up the pain with medication. Our treatments are designed to correct the underlying cause for pain and reduce the risk of future injury."

Physical therapy treatments help the body recover a full range of movement by strengthening the muscles and promoting internal healing. Soft tissue therapy, like massage, is a natural conservative treatment. According to Dr. Lee, massage enhances blood flow, which can help reduce inflammation and swelling. This may also relieve spasms and muscle pain by relaxing the soft tissues.

Dr. Lee also uses decompression treatments to correct a herniated or slipped disc and to relieve the underlying cause for pain in the lower back.

"Spinal decompression therapy is an important part of our overall rehabilitation plan," said Dr. Lee. "Each treatment session lasts between 20 and 35 minutes, and is essential in correcting nerve compression and restoring proper alignment to the spine. I frequently combine decompression treatments with other physiotherapy treatments like corrective exercises and heat or ice treatments."

Individuals in Queens and the surrounding communities who wish to learn more about Dr. Lee's rehabilitation treatment plans may do so by visiting the practice's website, http://dr-jameslee.com .

Prospective patients who would like to schedule an appointment with the chiropractor may do so by using the online appointment request form or by calling the center.

TU article on concussion law

2011-10-13T22:10:00.002-04:00

Below was an article published yesterday in the Albany Times Union. While I am disappointed PT was not included in the bill, that is another battle for another day. The legislation passed is definately in the best interest of our athletes and supported by the NYPTA

In Good Health

Matthew Hyland
President NYPTA

New law helps shield student athletes from brain injury
Athletes participating in school-sponsored sports gain protections
By CATHLEEN F. CROWLEY Staff writer
Published 12:05 a.m., Wednesday, October 12, 2011
Page 1 of 1

ALBANY -- A new law that protects student athletes' heads may help change some minds.

"It articulates a public policy that recognizes that concussion is not something benign, it is something that needs to be paid attention to," said Judy Avner, executive director of the Brain Injury Association of New York.

With the enactment of the Concussion Management and Awareness Act, Avner hopes people will stop dismissing it as a "bump on the head."

The law, which was signed by Gov. Andrew Cuomo last month, goes into effect in July 2012. The law applies to school-sponsored sports and activities but does not encompass recreational sports or private schools. Under the law:

An athlete who suffers a head injury or suspected concussion must be immediately removed from athletic activity. When it doubt, sit them out.

The athlete cannot return to play for at least 24 hours, and only after being evaluated and cleared by a doctor.

All school coaches, gym teachers, school nurses and athletic trainers must complete a course on concussions and traumatic brain injury.

More than 30 states have passed similar legislation, 20 of which did so in the past year.

A concussion is a type of brain injury caused by a bump, blow or jolt that moves the brain rapidly back and forth. Even mild bumps can be serious. The injury releases chemicals that make the brain even more sensitive to further injuries.

Each year, the nation's emergency departments treat an estimated 173,000 sports and recreation-related brain injuries, according to the Centers for Disease Control. The CDC has free online training videos for coaches and parents on handling concussions.

The shortcomings of the law, brain injury groups said, is that it overlooks recreational sports, does not require athletes to be evaluated by a doctor experienced in brain injury, and fails to mandate baseline testing of athletes.

But "It's an important first step," Avner said.

Reach Crowley at 454-5348 or ccrowley@timesunion.com.

New York Times Article

2011-10-12T09:29:00.004-04:00

I would like to thank everyone who forwarded me the link on the NY Times article published on October 1. Typically the window for an editorial is only about 48 hours with them, so we missed the window, however I do plan on addressing it in an upcoming blog post and Empire State Newsletter. Below is the article.

In Good Health

Matthew Hyland
President NYPTA

“When the nurse wants to be called doctor”
New York Times
October 1, 2011

NASHVILLE — With pain in her right ear, Sue Cassidy went to a clinic. The doctor, wearing a white lab coat with a stethoscope in one pocket, introduced herself.
“Hi. I’m Dr. Patti McCarver, and I’m your nurse,” she said. And with that, Dr. McCarver stuck a scope in Ms. Cassidy’s ear, noticed a buildup of fluid and prescribed an allergy medicine.

It was something that will become increasingly routine for patients: a someone who is not a physician using the title of doctor.

Dr. McCarver calls herself a doctor because she returned to school to earn a doctorate last year, one of thousands of nurses doing the same recently. Doctorates are popping up all over the health professions, and the result is a quiet battle over not only the title “doctor,” but also the money, power and prestige that often comes with it.

As more nurses, pharmacists and physical therapists claim this honorific, physicians are fighting back. For nurses, getting doctorates can help them land a top administrative job at a hospital, improve their standing at a university and win them more respect from colleagues and patients. But so far, the new degrees have not brought higher fees from insurers for seeing patients or greater authority from states to prescribe medicines.

Nursing leaders say that their push to have more nurses earn doctorates has nothing to do with their fight of several decades in state legislatures to give nurses more autonomy, money and prescriptive power.

But many physicians are suspicious and say that once tens of thousands of nurses have doctorates, they will invariably seek more prescribing authority and more money. Otherwise, they ask, what is the point?

Dr. Roland Goertz, the board chairman of the American Academy of Family Physicians, says that physicians are worried that losing control over “doctor,” a word that has defined their profession for centuries, will be followed by the loss of control over the profession itself. He said that patients could be confused about the roles of various health professionals who all call themselves doctors.

“There is real concern that the use of the word ‘doctor’ will not be clear to patients,” he said.

So physicians and their allies are pushing legislative efforts to restrict who gets to use the title of doctor. A bill proposed in the New York State Senate would bar nurses from advertising themselves as doctors, no matter their degree. A law proposed in Congress would bar people from misrepresenting their education or license to practice. And laws already in effect in Arizona, Delaware and other states forbid nurses, pharmacists and others to use the title “doctor” unless they immediately identify their profession.

The deeper battle is over who gets to treat patients first. Pharmacists, physical therapists and nurses largely play secondary roles to physicians, since patients tend to go to them only after a prescription, a referral or instructions from a physician. By requiring doctorates of new entrants, leaders of the pharmacy and physical therapy professions hope their members will be able to treat patients directly and thereby get a larger share of money spent on patient care.

As demand for health care services has grown, physicians have stopped serving as the sole gatekeepers for their patients’ entry into the system. So physicians must increasingly share their patients — not only with one another but also with other professions. Teamwork is the new mantra of medicine, and nurse practitioners and physician assistants (sometimes known as midlevels or physician extenders) have become increasingly important care providers, particularly in rural areas.

But while all physician organizations support the idea of teamwork, not all physicians are willing to surrender the traditional understanding that they should be the ones to lead the team. Their training is so extensive, physicians argue, that they alone should diagnose illnesses. Nurses respond that they are perfectly capable of recognizing a vast majority of patient problems, and they have the studies to prove it. The battle over the title “doctor” is in many ways a proxy for this larger struggle.

For patients, the struggle has brought an increasing array of professionals trained to deal with their day-to-day health woes, but also at times confusion over who is responsible for their care and what sort of training they have.

Six to eight years of collegiate and graduate education generally earn pharmacists, physical therapists and nurses the right to call themselves “doctors,” compared with nearly twice that many years of training for most physicians. For decades, a bachelor’s degree was all that was required to become a pharmacist. That changed in 2004 when a doctorate replaced the bachelor’s degree as the minimum needed to practice. Physical therapists once needed only bachelor’s degrees, too, but the profession will require doctorates of all students by 2015 — the same year that nursing leaders intend to require doctorates of all those becoming nurse practitioners.

Dr. Kathleen Potempa, dean of the University of Michigan School of Nursing and the president of the American Association of Colleges of Nursing, said that the profession’s new doctoral degree, called the doctor of nursing practice, was simply about remaining current. “Knowledge is exploding, and the doctor of nursing practice degree evolved out of a grass-roots recognition that we need to continuously improve our curriculum,” she said.

Last year, 153 nursing schools gave doctor of nursing practice degrees to 7,037 nurses, compared with four schools that gave the degrees to 170 nurses in 2004, when the association of nursing schools voted to embrace the new degree. In 2008, there were 375,794 nurses with master’s degrees and 28,369 with doctorates, according to a recent government survey.

Dr. Potempa said that nurses with master’s degrees were every bit as capable of treating patients as those with doctorates.

Nursing is filled with multiple specialties requiring varying levels of education, from a high school equivalency degree for nursing assistants to a master’s degree for nurse practitioners. Those wishing to become nurse anesthetists will soon be required to earn doctorates, but otherwise there are presently no practical or clinical differences between nurses who earn master’s degrees and those who get doctorates.

Nurse practitioners must generally graduate from college and take an additional 12 to 16 months of classes, which include months of treating patients for both mild and serious illnesses in clinics and hospitals under the watchful eyes of instructors. Those earning doctorates must generally take a further four semesters or 12 to 16 months of additional classes.

While instruction at each school varies, Dr. McCarver took classes in statistics, epidemiology and health care economics to earn her doctor of nursing practice degree. These additional classes, at Vanderbilt University, did not delve into how to treat specific illnesses, but taught Dr. McCarver the scientific and economic underpinnings of the care she was already providing and how they fit into the nation’s health care system. Studies have shown that nurses with master’s level training offer care in many primary care settings that is as good as and sometimes better than care given by physicians, who generally have far more extensive training. And patients often express higher satisfaction with care delivered by nurses, studies show. Physicians say they are better at recognizing rare problems, something studies have trouble measuring.

The benefits to patients of nurses receiving doctorates is unclear, since there is no evidence that nurses with doctoral degrees provide better care than those with master’s degrees do.

Given the proven effectiveness of nurses with master’s degrees, even some nursing leaders have asked why nurses should be required to get doctorates.
“If it ain’t broke, why fix it?” asked Dr. Afaf I. Meleis, dean of the University of Pennsylvania School of Nursing.

Some health care economists say the push for clinical doctorates across health professions could be misguided. They argue that anything requiring students to spend more time and money getting trained will invariably result in longer waits and increased costs for patients, because fewer students will meet the increased requirements and those who do will eventually demand higher compensation.

“Everyone’s talking about improving patients’ access to care, bending the cost curve and creating team-based care,” said Erin Fraher, an assistant professor of surgery and family medicine at the University of North Carolina School of Medicine. “Where’s the evidence that moving to doctorates in pharmacy, physical therapy and nursing achieves any of these?”

Depending on their area of specialty, nurse practitioners earn a median salary of $86,000 to $90,000 annually, according to the Medical Group Management Association — a bit less than half of what primary care physicians earn. Nurses with doctorates generally earn the same salaries as those with master’s degrees since insurers pay the same rates to both. Physician groups fear that the real reason behind the creation of the doctor of nursing practice degree is to persuade more state legislatures to grant nurses the right to treat patients without supervision from doctors.

Twenty-three states allow nurses to practice without a physician’s supervision or collaboration, and most are in the mountain West and northern New England, areas that have trouble attracting enough physicians. Nursing groups have lobbied for years to increase that number. “This degree is just another step toward independent practice,” said Louis J. Goodman, chief executive of the Texas Medical Association.
Not true, Dr. Potempa said — the new degree simply ensures that nurses stay competent. “It’s not like a group of us woke up one day to create a degree as a way to compete with another profession,” she said. “Nurses are very proud of the fact that they’re nurses, and if nurses had wanted to be doctors, they would have gone to medical school.”

HVD

2011-10-06T11:00:00.002-04:00

I would like to extend a thank you to the Hudson Valley District for inviting me to join them at there Fall Kickoff event last Friday night. It was a wonderful night with students and colleagues.

In Good Health

Matthew Hyland
President NYPTA

Great Media Coverage

2011-09-29T10:41:00.002-04:00

Good Morning-
In this mornings AM New York there is a speacial pull out on Physical Therapy! It is very pro the profession and the contributors NYPTA members. It is available around the City and also is an insert in the Daily News today- check it out. Below is the article I contributed on behalf of the Chapter.

In Good Health

Matthew Hyland
President NYPTA

Physical Therapy, Pg 2
Title: Moving for Change
Byline: Matthew Hyland, PT, PhD, MPA, CSCS, President of NYPTA

Intro: No matter what hurts, a physical therapist can help. But skyrocketing co-pays are prohibiting many from accessing the care they need – and discouraging new patients from seeking it out.

Chances are you’ve heard of physical therapists, but what you probably didn’t know is that physical therapy is a cost effective care that can improve your quality of life by helping you avoid surgery, unnecessary prescriptions and doctor visits, and prevent future injuries. The fact of the matter is physical therapy is one of the most effective services for a multitude of injuries and pains, but current health care reform and upsets with co-pays are making it difficult for people to access this care.

An Uphill Battle

New York is a “direct access” state, meaning you don’t need a doctor’s referral to see a PT. Most insurance plans provide coverage for physical therapy, but a recent trend of excessive co-pays has limited access for patients. The reality is insurance carriers set a “maximum allowable” for each visit. The co-pay is carved out of that visit and insurance pays the balance; that means you’re paying $40 and your insurance provider is shelling out $10.

Providers in New York consider physical therapists “specialists”, grouping them in with the likes of cardiologists and neurologists, but this has serious financial ramifications. Consider this: While a patient may visit their cardiologist a few times a year, seeing a PT for a back injury requires multiple visits every week. And at $40 per visit, that adds up pretty quickly.

The outcome? Patients stop treatment before they’re healed, or in some cases never start. But when the problem persists, they’re forced to seek out invasive and expensive interventions such surgery because insurance will cover that.

So what do we do?

Moving Forward

In an effort to remedy the situation, groups like the New York Physical Therapy Association have been lobbying on behalf of patients. There’s current a bill with the New York State Senate to bring an end to this practice of excessive copays and to ensure broad access to the full spectrum of physical therapy services. Change is on the way, but it may take a while before you feel the difference in your wallet.

In the meantime, riddle this: Regardless of co-pay, three major studies show that when a patient begins treatment with a PT at the first sign of injury, their overall healthcare costs are lower. No matter what happens on the Hill, the most important thing to remember is to listen to your body. If it hurts, don’t be afraid to see a physical therapist. You, and your wallet, will feel better.

Acute Care

2011-09-27T15:27:00.001-04:00

Hi everyone

This article first appeared in the September 2011 issue of H&HN magazine.

In Good Health

Matthew Hyland
President NYPTA

Fighting Tradition — Physical Therapy
By Geri Aston

Hospitals are bucking conventional wisdom that acute patients are too ill for PT, and integrating it into care earlier and more thoroughly

Economic and clinical forces are transforming the role of physical therapists in hospital inpatient and outpatient settings. These health professionals are seeing acute patients sooner, speeding their movement through the hospital, easing their transition to the next care setting, and working to keep them from coming back unnecessarily.

On the inpatient side, the trend is toward early physical therapy intervention for acute care patients, including those in the intensive care unit. Fueling the change is a growing body of evidence showing that getting these patients up and moving helps them to recover more quickly and decreases the chance that they'll have lingering weaknesses that can last for years, says Jim Smith, president of the American Physical Therapy Association's Acute Care Section.

Early PT also is good for the hospital bottom line because it reduces ICU lengths of stay and overall hospital LOS, experts say. Smith points to research, published in the August 2008 issue of Critical Care Medicine, by the Wake Forest University School of Medicine and North Carolina Baptist Hospital. The study found that use of a mobility protocol on acute respiratory failure patients shaved 1.4 days off their ICU stays and 3.3 days off their overall hospital LOS. The average cost per patient for those receiving the protocol was $41,142, compared with $44,302 for patients receiving usual care. Total direct inpatient costs, including mobility team members' salaries, were $504,789 lower for the group receiving the protocol.

Early intervention has the added benefit of increasing patient satisfaction, says Patric McQuade, director of the rehabilitation service line at North Shore–Long Island Jewish Health System. "The patients are very happy with how much therapy they're getting," he says. "That means they may choose the hospital again. That helps on the financial end."

However, physical therapy is underutilized in acute care at many hospitals. Several barriers contribute to the problem, including limited staff resources, says James Dunleavy, administrative director of rehabilitation services at Trinitas Regional Medical Center in Elizabeth, N.J. Perhaps the biggest obstacle is the conventional wisdom that acute care patients are too ill for active rehabilitation.

"The physician community has to be comfortable with this new way of looking at how to take care of these patients because they have been brought up under a very traditional model of leaving them in bed," Dunleavy says. "So we fight the tradition."

Because physician decision-making is so varied, Dunleavy is working to educate Trinitas doctors about when early PT is needed for acute care patients. "Some feel — understandably so — with the acute care problems of the patient, their musculoskeletal function is way down the list," he says. "I'm putting something together for our residents that explains to them what happens to the patient when they're acutely ill and lying in bed, and how the degeneration of the muscle system and the neuromuscular system can have a profound effect on other types of illnesses they might be treating."

He also plans to offer physicians a decision-making tool they can use to determine when acute care patients are ready for intervention. "It's a matter of getting those referrals more frequently and on more patients so we can have the positive impact," Dunleavy says.

Do You Know How I Can Help?
Having therapists participate in interdisciplinary rounds also helps get patients services sooner, notes Courtney Bryan, director of rehabilitative services at Houston Northwest Medical Center. It establishes routine communication with nurses and doctors and presents opportunities to suggest that a patient is ready for early mobilization.

To change the culture, especially in the ICU, physical therapists have to be a familiar face, says Smith, who is associate professor of physical therapy at Utica (N.Y.) College. ICU clinicians "need to know their patient is as safe with you as they are with any other member of the team," he says. "Once the therapist has shown their credibility, the dialogue changes from 'watch out for my patient' to 'when is a good time for you and me to mobilize the patient?' " However, physical therapists in some facilities don't go on rounds because of pressure on their productivity, Smith says.

Often, physical therapists' ability to provide early intervention for acute patients depends on the effectiveness of rehabilitation department leadership. "Those who can make the case to justify their staff have the people in place," Smith says. "Those who haven't been able to end up triaging patients — 'here's all the patients we have today and these are the ones we have to treat so they can get out the door.' " As a result, the priority list is shaved down to orthopedic surgical patients who can be discharged. ICU patients who could benefit from therapy, but for whom discharge wouldn't be affected, get pushed to the back burner.

In some facilities, physical therapists have created processes that help nurses and doctors think about therapy at the beginning of a patient's hospitalization. One example: Therapists developed a functional screen conducted as part of the initial nursing assessment on every patient so that patients in need of therapy are identified immediately.

At Houston Northwest Medical Center, the functional screen includes questions about mobility needs, activities of daily living and self-feeding, Bryan says. If a patient fails the screen, it triggers the nurse to talk to the physician about writing physical therapy orders.

Ideally, the assessment also should identify when a patient has pre-existing functional problems that would not benefit from therapy, Dunleavy says.

An emerging trend is PT order sets for certain patient types. North Shore–Long Island Jewish has sped access to physical therapy by using prepackaged order sets for patients having total joint replacement and those who've had a stroke. If a joint replacement patient has the operation on Monday, he or she automatically will be seen by a therapist on Tuesday, McQuade explains. The stroke patient order set includes an automatic assessment by the rehabilitation team. "It minimizes the time delay in getting the physician to write the order and then sending the order."

Which Patients Benefit?
The list of patients who are served by physical therapists has expanded over the past 10 years, Bryan notes. It includes patients with pneumonia, congestive heart failure and chronic obstructive pulmonary disease. For example, pneumonia patients are going to be deconditioned, which puts them at risk for falls. The patient isn't going to need a PT visit every day, but should be assessed by a physical therapist who can check his or her risk of falls and then work to correct any weaknesses.

As pressure to prevent readmissions grows, so does the importance of physical therapists' role, Bryan says. Not only do they provide care in the hospital, but they teach the patient and family about the disease process and disease management, prescribe home exercise programs, offer safety tips, and do anything else that might decrease the likelihood of an unnecessary readmission, she says.

Physical therapists are instrumental in helping to create a safe discharge plan, Bryan adds. They help determine the appropriate discharge destination for the patient. They go over the home environment with the patient and family to figure out what support and equipment the patient might need. "A lot of things the patient or the doctor doesn't think about are really important to us — mobility, feeding, positioning, prevention of falls, medications that make you dizzy," Bryan says.

Beyond the inpatient side of care, many hospitals are in the outpatient physical therapy business. This service line is getting renewed attention as hospitals prepare for the coming Medicare penalties for "excess" 30-day readmissions established under health reform, and as they evaluate whether they want to become accountable care organizations.

As is the case with inpatient care, the types of patients physical therapists can serve in the outpatient arena go beyond the orthopedic and stroke recovery realms that usually pop to mind. They include patients who have diabetes, lymphedema, vestibular disorders and those who need continuing wound care, Bryan notes.

The idea is that offering outpatient physical therapy as part of the hospital's care continuum helps to avoid readmissions and offers continuity to patients. When patients select the hospital's outpatient PT program, it has the added benefit of keeping that downstream revenue in the system, McQuade notes.

Meanwhile, hospital physical therapy directors are evaluating how an ACO model would affect delivery of physical therapy services as part of a larger episode of care. "It really puts the onus on the provider and the facility to provide the care as quickly and efficiently as possible," Dunleavy says. For example, for joint replacement patients, he's looking at how to create a seamless delivery structure from pre-op services, to surgery, to recovery, to outpatient rehab. "So there would be no delay," he says. "The barriers that make it difficult to follow through that way would not be there."

In communities where most physical therapists are in private practice, the push toward ACOs could create some new opportunities for partnership, Dunleavy says. "The guys in the private offices are talking to me because they're concerned that these ACO structures are going to lock them out of the patients." These practitioners might be interested in partnering with facilities or facility-based practices in some way.

A Place for PT in the ED
In the past few years, physical therapists at some hospitals have become a presence in another care setting — the emergency department. Two big reasons for the emerging trend are hospitals' desire to prevent avoidable admissions and the potential to improve ED efficiency.

One area in which therapists can have a big impact is handling patients with musculoskeletal complaints, says Anita Bemis-Dougherty, associate director of the American Physical Therapy Association 's department of practice. Some hospitals have a physical therapist in the ED full time who evaluates these patients, does physical exams, and determines whether they need to see the emergency physician or if their problems can be effecitvely managed on an outpatient basis. When it comes to patients who ultimately don't need emergency care, "you're keeping them out of the hospital, you're keeping them out of the ED, and you're making sure they get follow-up care."

Staffing the ED with a physical therapist can increase patient satisfaction, decrease wait times and ease emergency physicians' workloads, she adds.

North Shore–Long Island Jewish is exploring the creation of such a program for people arriving in the ED with back problems, McQuade says. "This is an opportunity for us to both prevent unnecessary hospitalizations and to potentially capture that patient for rehab down the line."

Hospitals considering this route must determine whether physical therapy services would be provided as part of the ED visit with no separate charge or billed as outpatient care. "My discussions first of all would be with administration — this is what an ED intervention program can do. This is what it will cost. What is the benefit?" says Bryan. "You might have ED patients who could not pay for physical therapy services, so are you offering them in a consultative role to the physician?"

North Shore–Long Island Jewish hasn't decided how it will handle billing,but is leaning toward not charging separately for PT, McQuade says. "If you can prevent an unnecessary admission, you minimize denials," he says. "Then if you can capture the downstream revenue, it's more than worth the investment." A financial analysis will be conducted to help make the final decision on how to bill.

Houston Northwest is utilizing physical therapists in caring not only for ED patients with musculoskeletal pain, but also patients who need wound care or who have poorly controlled chronic conditions, Bryan says. One example is diabetic patients. A lot of diabetics don't look at their feet everyday and wind up in the emergency department because they get wounds, she says. Many also have balance problems because they can't feel the bottom of their feet. Physical therapists in the ED address the problem, educate the patient and make sure they get proper follow-up care.

As in the acute care setting, physical therapists in the ED must make strong connections with the nurses and physicians to succeed, Bemis-Dougherty says. "They need to exhibit interprofessional collaboration and bring something valuable to the team. You can't just say, 'I can see everybody.'"

Geri Aston is an H&HN contributing editor.

--------------------------------------------------------------------------------

More Education, More Specialization
Recent advancements in physical therapists' education and training support their growing role in various hospital settings. In the past decade, physical therapy has shifted to a doctoral-level degree. The trend is driven, in part, by the growing complexity of care and state laws that give physical therapists varied levels of direct access to patients, says Jody Frost, American Physical Therapy Association director of academic/clinical education affairs.

Direct access means physical therapists must be able to determine which patients they can treat and which to refer right away, and they must have knowledge and skills in patient evaluation, diagnostics, radiology and imaging, oncology, pharmacology and evidence-based practice and prescription drugs. All of these subjects are part of the physical therapy doctorate curriculum, Frost says. Of the 212 accredited physical therapist programs, 207 are at the doctoral level, and the remaining five will be by 2015, as mandated by the Commission on Accreditation in Physical Therapy Education.

Physical therapists increasingly are seeking postdoctoral training via residency and fellowships that culminate in board certification to specialize in a particular area, Frost notes. Physical therapist residencies and board certification are available in cardiovascular and pulmonary, clinical electrophysiology, geriatrics, neurology, orthopedics, pediatrics, sports and women's health. Oncology and acute care physical therapy also are working toward recognition as specialties.

A growing number of hospital-based physical therapists are becoming specialists so they can focus on one area of hospital care and to better serve their patients, Frost says. Specialization typically doesn't lead to higher salaries, although in markets where a particular physical therapy specialty is in high demand, hospitals may offer bonuses or debt relief.

Therapists with specialty training are more common in larger hospitals where patient volume in the various clinical areas is high enough to warrant it, says Patric McQuade, director of the rehabilitation service line at North Shore–Long Island Jewish Health System. "If you have a large population of patients who are getting joint replacements, for instance, you really need somebody who can coordinate care, who can really start moving these patients, and who the physicians identify as experts."

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Concussion Legislation

2011-09-25T18:15:00.001-04:00

From the Gannett paper last week.

This is a very good first step in concussion legislation in our state.

In Good Health

Matthew Hyland
President NYPTA

Cuomo to sign legislation to protect student athletes

4:10 PM, Sep. 18, 2011 |

Written by

CARA MATTHEWS

ALBANY – Gov. Andrew Cuomo said he plans to sign a bill that will require students who may have suffered a concussion in a school sport or gym class to be sidelined for at least 24 hours.

The legislation will prevent students from returning to play until they have been without symptoms for at least one day and have been cleared by a physician. It also requires education and training for coaches, teachers and other school personnel on the symptoms and treatment of mild traumatic brain injuries.

“The guidelines that will be issued under this law will help enable student athletes who experience concussions get prompt treatment, helping avoid the future health problems that often accompany such injuries,” Cuomo said in a statement Sunday.

“By raising awareness to the risks of mild traumatic brain injuries we are protecting students across New York and ensuring that their health and safety is our top priority,” he added.

It is one of 126 bills the Senate and Assembly sent to the governor last week, and he has until Thursday to act on them. Cuomo spokesman Josh Vlasto has said the administration is reviewing the bills.

Others would require health-insurance coverage for oral chemotherapy, legalize low-level novelty fireworks like sparklers, and strengthen investigations of potential abuse or mistreatment at mental-hygiene facilities.

The concussion legislation, which will take effect July 1, seeks to end the practice of having children “play through” their injuries and to raise awareness about the potential harmful effects of head trauma. Concussion symptoms can include memory problems, difficulty concentrating, headaches, dizziness and vomiting.

The NFL, which has cracked down on helmet-to-helmet hits, is one of the organizations backing the bill. The league strengthened regulations on removing athletes who suffer concussions from the field.

Other groups that support it are the New York State Athletic Trainers’ Association and the New York State Public High School Athletic Association.

The legislation will require the state Education and Health departments to develop guidelines for recognizing and monitoring concussions, and protocols for removing students from play and clearing them to return. Those departments and local school districts will have to post information about concussions on their websites and on any consent forms for parents.

Many school districts have implemented concussion policies in recent years, according to the Public High School Athletic Association, which has assisted them.

Sen. Kemp Hannon, R-Suffolk County, and Assemblywoman Catherine Nolan, D-Queens, who sponsored the legislation, said in their memo on the bill that concussions could lead to permanent brain injury or even death if left untreated.

Dr. Jeffrey Bazarian, associate professor of emergency medicine, neurology and neurosurgery at the University of Rochester Medical Center, has said that if an athlete with a concussion gets hit again before recovering, the brain injury could be permanent.

The Brain Injury Association of New York State has said the bill is a good “first step” in recognizing the potential harm concussions can cause and raising public awareness.

Temporary Suspension of Provisions Relating to Payment of Fees for Duplicate State-Issued Documents

2011-09-21T23:11:00.002-04:00

Temporary Suspension of Provisions Relating to Payment of Fees for Duplicate State-Issued Documents

In response to the historic flooding and other conditions caused by Hurricane Irene and subsequent storms, Governor Cuomo issued Executive Order 21 on September 15, 2011temporarily suspending certain fees charged by the Education Department for replacement documents lost as a result of the disaster. Until further notice, the fees charged by the Education Department’s Division of Professional Licensing Services (DPLS) for issuing duplicate license parchments and registration certificates are suspended for the replacement of documents lost as a result of the disaster. Also suspended are the fees charged by the Professional Corporations unit, including fees for the certificate of authorization (COA) issued to professional engineering or land surveying services or for certification of other professional entities (e.g., professional corporation, professional limited liability corporation or professional limited liability partnership).

All requests for copies of any document or record on file with the Division of Professional Licensing Services or the Professional Corporations unit should indicate the document to be replaced was lost as a result of the disasters specified in Executive Order 21- for further information visit:
http://www.op.nysed.gov/news/executive-order-21.htm

In Good Health

Matthew Hyland
President NYPTA

Corporate Practice S 5524 FLANAGAN Same as A 8282 Glick

2011-09-14T09:11:00.005-04:00

It is with frustration and disappointment that bill (S 5524 FLANAGAN: Same as A 8282 Glick) has been sent to the Governor for signing. This bill allows for corporate entities to own physical therapy practice in the EI arena. It is the position of the NYPTA that corporate ownership of physical therapy should be illegal (and in fact is, other than this cutout legisation)and is bad for patient care.

We have met with the Govenor's office to convey our opposition to this bill, in fact NYPTA was the one group opposing the legislation this past year in the legislative process.

While the window is small it would be helpful if individual therapists weighed
expressing opposition to the bill to the Governors office ASAP. The full bill is below

In Good Health

Matthew Hyland
President NYPTA

S 5524 FLANAGAN Same as A 8282 Glick (MS)

State Education Department # 10

ON FILE: 06/01/11 Education Law

TITLE....Amends education law, creates waivers for certain institutions and repeals certain provisions of such law relating thereto

09/12/11 DELIVERED TO GOVERNOR

NEW YORK STATE SENATE

INTRODUCER'S MEMORANDUM IN SUPPORT

submitted in accordance with Senate Rule VI. Sec 1

BILL NUMBER: S5524

SPONSOR: FLANAGAN

TITLE OF BILL:

An act to amend the education law, in relation to special education

services, programs for preschool children with disabilities, waivers for

certain special education schools and early intervention agencies; and

to repeal certain provisions of such law relating thereto

PURPOSE OF THE BILL:

The purpose of the bill is to reconcile the provisions of Title VIII of

the Education Law that prohibit corporate practice of certain licensed

professions and the provisions of Education Law §4410 and other

provisions of Article 89 of the Education Law that contemplate that

special education schools and providers be organized to provide multi-

disciplinary evaluations and all related services recommended on the

student's individualized education program, regardless of the profession

involved. The bill would also clarify that the exemptions in the

professions of psychology and speech-language pathology and audiology

that allow elementary and secondary schools to employ school psychol-

ogists and teachers of the speech and hearing handicapped apply to

center-based preschool special education providers' services when

providing services on-site. The bill would similarly reconcile the

provisions of Title VIII of the Education Law that prohibit corporate

practice of certain licensed professions and the provisions of Title 2-A

of Article 25 of the Public Health Law that contemplate that early

intervention agencies be organized to provide the full range of early

intervention program services.

SUMMARY OF THE PROVISIONS OF THE BILL:

Section 1 would repeal §4410(6) relating to transition of children who

were in preschool programs pursuant to §236 of the Family Court Act

before July 1, 1989, and would add a new subdivision 6 to §4410 of

Education Law to resolve, in conjunction with sections 2 through 4 of

this bill, various conflicts between the provisions of §4410 on

preschool special education and the provisions of Title VIII of Educa-

tion Law on professional practice.

New §4410(6)(a) would provide that approved providers of preschool

special education that are operating pursuant to a waiver as special

education schools under new §6503-a of Education Law would be authorized

to employ licensed professionals or contract with licensees or entities

legally authorized to provide professional services in accordance with

§650.3-a. Without such waiver, employment or contracting for profes-

sional services in most licensed professions would conflict with

restrictions on corporate practice under Title VIII.

New §4410(6)(b) would clarify that an approved program may be formed as

a corporation, or as a limited liability company, and a group of appro-

priately licensed professionals may be formed as a professional service

limited liability company (PLLC) or a registered limited liability part-

nership (RLLP) and if so formed, may be authorized to provide special

education itinerant services or educational services, even though they

are entities ordinarily formed to provide professional services. In

addition, upon the grant of a waiver pursuant to section 6503-a of the

Education Law, such an entity would be authorized to contract with other

professionals or entities authorized to provide professional services

that the PLLC or RLLP would not be authorized to provide directly, where

such services are rendered for the purposes of conducting a multi-disci-

plinary evaluation or providing related services specified in the IEP of

a preschool child.

New §4410(6)(c) would clarify, without expanding, the current exemption

from the practice of speech-language pathology and audiology in Educa-

tion Law §8207(2) that applies to an approved 4410 provider that is a

center-based program, so they may employ a teacher of the speech and

hearing handicapped, for services rendered to students enrolled in such

center-based program. A center-based program is an approved §4410 school

that operates special education classes and/or special education classes

in an integrated facility-based setting. New §4410(6)(d) would similarly

clarify that the exemption from the practice of psychology in Education

Law §7605(1) would apply to an approved 4410 provider that is a center-

based program, so they may employ a school psychologist for services

rendered to students enrolled in such center-based program.

Section 2 would amend paragraphs band d of subdivision 9 of §4410 of

Education Law to require that a provider of special services or programs

that relies on formal written agreements or affiliations with appropri-

ately certified or licensed professionals, or agencies employing such

professionals, certify as part of the program approval application proc-

ess that it will apply for and obtain s waiver pursuant to §6503-a prior

to providing evaluation services or related services pursuant to such

written agreements or affiliations.

Section 3 would amend §4410(9-a)(a) of Education Law to require that a

group of appropriately licensed or certified professionals must be

formed as a PLLC, foreign PLLC, RLLP or New York foreign RLLP to be

eligible for approval as an evaluator on and after July 1, 2011. The

bill also would provide that the approval of any groups of licensed or

certified professionals that are in existence on July 1, 2011 and would

not be eligible for approval thereafter would terminate on July 1, 2013.

Section 4 would add a new §6503-b Education Law to provide for a waiver

of special education schools as corporate entities authorized to provide

a range of professional services relating to the evaluation of students

suspected of having a disability and the delivery of related services to

students with disabilities either through licensees employed by the

school or by contract with licensees or other authorized entities. New

§6503-a would also provide for the waiver of early intervention agencies

as corporate entities authorized to provide a range of professional

services relating to the early intervention program for infants and

toddlers with disabilities from birth to 2. In return, such special

education schools and early intervention agencies would become subject

to professional discipline in the same manner as professional corpo-

rations, PLLCs and other entities authorized to engage in the practice

of a profession. New §6503-a (1) would supply definitions of "special

education school," "early intervention agency," "early intervention

program services," "multidisciplinary evaluation" for both special

education schools and early intervention agencies, and "related

services." A "special education school" would include a §4410 approved

provider, approved private residential or non-residential school for the

education of students with disabilities (a "Chapter 853" school), and a

child care institution that operates a private school or an institution

for the deaf or blind ("4201 school") that conducts a multidisciplinary

evaluation or provides related services in one or more licensed

professions for which no exception from prohibitions against corporate

practice exists. New §6503-b(2) would prohibit special education schools

that are not operating under a waiver from employing licensed profes-

sionals or contracting with other entities to practice a profession

while conducting a multi-disciplinary evaluation or providing related

services to students with disabilities, unless an exception to the

corporate practice prohibition exists. "Early intervention agency" would

mean an agency as defined in title two-a of article twenty-five of the

public health law which is approved or is seeking approval to deliver

early intervention program multidisciplinary evaluations, service coor-

dination services and early intervention program services, and is

lawfully operated by a corporation, a limited liability company or a

professional services organization. "Early intervention program

services" would mean early intervention services as defined in subdivi-

sion seven of section twenty-five hundred forty-one of the public health

law that are provided under the early intervention program and author-

ized in an eligible child's individualized family services plan.

All special education schools and early intervention agencies in exist-

ence on the effective date of new §6503-b would be deemed to be operat-

ing under a waiver for a period of time commencing on the effective date

(June 30, 2011) and ending on July 1, 2013, allowing them time to apply

for and obtain a waiver. New §6503-b(3) would contain the procedures for

obtaining a waiver, including an initial fee of $345, and provides where

the applicant simultaneously applies for approval as a special education

school and early intervention agency the total waiver fee will be $345.

New §6503-b(4) would provide for waiver renewal, with a triennial fee of

$260 and provides where the applicant simultaneously renews its waiver

as a special education school and early intervention agency, the total

waiver fee will be $260. New §6503-b(5) would require notification of a

change in location and new §6503-b(6) would authorize special education

schools and early intervention agencies operating under a waiver to

employ licensed professionals or contract with licensees or entities

legally authorized to practice the profession involved, solely for the

purpose of conducting a multi-disciplinary evaluation or providing

related services to students with disabilities. New §6503-b(7) would

make special education schools and early intervention agencies operating

under a waiver subject to the supervision of the Board of Regents and

the Department relating to professional practice, including professional

discipline.

Section 5 is the effective date.

STATEMENT IN SUPPORT OF THE BILL:

This bill would add a new Education Law §6503-b; and a new §4410(6) and

would amend §4410(9) and (9-a) to resolve a series of conflicts between

the provisions of Article 89 of Education Law, particularly §4410, as

well as the provisions of Title 2-A of Article 25 of the Public Health

Law relating to early intervention programs, and the provisions of Title

VIII of Education Law that prohibit licensed professionals from engaging

in corporate practice in most professions, particularly in an organiza-

tion with licensees from other professions. Education Law §6512 makes it

a Class E felony for an unlicensed person to practice a licensed profes-

sion or hold oneself out as being able to practice a licensed profes-

sion. With certain exceptions, such as speech-pathology and audiology,

corporate practice (practice of a profession by a corporation or other

corporate entity) is generally prohibited, particularly where multiple

professions are involved.

Education Law §4410 requires that multidisciplinary evaluations be

conducted by approved programs or groups of appropriately licensed

professionals associated with a public or private agency approved by the

Commissioner. It also gives the parent the right to select the approved

evaluator. However, §4410 is silent, as is the rest of Article 89 of the

Education Law, about how it relates to the ability of approved programs

to engage in corporate practice. A similar problem exists for early

intervention programs regulated by the Department of Health pursuant to

Title 2-A of Article 25 of the Public Health Law, where corporations are

conducting multi-disciplinary evaluations and providing early inter-

vention services to infants and toddlers with disabilities. In the

absence of specific language exempting such special education schools

and early intervention agencies from the prohibitions against corporate

professional practice, both the schools, agencies, and many licensees

are operating in conflict with the laws relating to professional prac-

tice and are at risk of prosecution, or in the case of the licensees, of

professional discipline.

It is imperative that action be taken to address this conflict in a way

that would preserve the ability of approved private schools, 4201

schools and approved preschool providers to continue to deliv.er related

services to students with disabilities and, where applicable, conduct

multi-disciplinary evaluations of students suspected of having a disa-

bility, and that would preserve the ability of early intervention agen-

cies to conduct multi-disciplinary evaluations and provide early inter-

vention services to infants and toddlers with disabilities. This bill

would accomplish that goal, while striking a balance that assures that

the policies underlying the laws regulating the licensed professions are

preserved. It would do so by authorizing special education schools and

early intervention agencies to employ licensed professionals or contract

for services from other licensees or entities to conduct multi-discipli-

nary evaluations or deliver related services to students enrolled in the

school, provided that the school or agency is operating pursuant to a

waiver under Education Law §6503-a and thereby becomes subject to super-

vision by the Regents and the Department under the law governing the

professions and professional discipline. This would provide protection

against unlawful practice of the professions, while allowing the special

education schools and early intervention agencies to continue to func-

tion without disruption. This bill would allow schools and early inter-

vention agencies to continue in their existing corporate form, provided

that they obtained a waiver under §6503-a.

New §4410(6) would also codify the Department's past interpretation of

Education Law §§8207(2) and 7605(1) that an approved center-based 4410

provider is a school indistinguishable from an elementary or secondary

school that is exempted from the practice of speech-language pathology

and audiology and psychology pursuant to those sections and is author-

ized to employ teachers of the speech and hearing handicapped and school

psychologists to deliver speech and language and psychological services,

respectively. Thus, this bill would maintain the status quo and allow

such providers to continue to deliver these services to students

enrolled in an approved center-based program without employing or

contracting with licensed psychologists or licensed speech-language

therapists, just as other approved center-based 4410 providers who serve

both preschool children and students with disabilities of school age are

clearly authorized to do under any reasonable interpretation of

§§8207(2) and 7605(1). If this issue is not clarified, the result could

be a disruption in services to preschool students with disabilities,

particularly where shortages of licensed professionals exist.

BUDGETARY IMPLICATIONS OF THE BILL:

This bill should not result in significant costs to the State or local

governments. The bill would require special education schools and early

intervention agencies obtaining a waiver under §6503-a to pay a fee of

$345 and a triennial re-registration fee of $260, which should defray

the costs of implementation of the waiver process.

PRIOR LEGISLATIVE HISTORY:

In 2010 a similar bill was introduced in the Senate as S.5954-D, which

passed the Senate and was referred to the Assembly Education Committee

and no further action was taken.

In 2009, a similar bill was introduced in the Senate as S.5954. S.5954

was referred to the Senate Rules Committee and no further action was

taken. An identical bill was introduced in the Assembly as A.8689-A, and

was referred to the Assembly Higher Education Committee and reported to

the Assembly Ways and Means Committee. No further action was taken.

In 2007, similar legislation was introduced in the Assembly as a portion

of A.8682, which was reported to the Assembly Education Committee and no

further action was taken.

EFFECTIVE DATE:

This act would take effect June 30, 2011. To ensure the protection of

the practice of professions, the effective date will provide the Depart-

ment of Health time to develop and adopt in regulations, criteria and

service delivery standards for approval and re-approval of early inter-

vention providers.

Education Bill

2011-09-06T11:21:00.003-04:00

Below is a summary written by Katherine Hurlihy that will appear in todays hotpoints and in the next newsletter.

In Good Health

Matthew Hyland
President NYPTA

A.2502-A (Canestrari)/S.3469-A (Oppenheimer) was signed into law by Governor Cuomo on August 17, 2011. As of August 17, 2012, this law will require applicants for physical therapy licensure to complete a master’s degree or higher in physical therapy (this law does not impact the validity of existing licenses and permits). Such standards reflect national accrediting standards, as well as the fact that the practice of physical therapy has advanced significantly since the establishment of the bachelor’s degree level. Indeed, all New York physical therapy educational programs are at the master’s degree or doctorate level. NYPTA has worked diligently on the adoption of this law since 2002, when it first began working with the State Physical Therapy Board to craft language to amend Article 136 of the Education law to require a post-baccalaureate degree.

This law will ensure that physical therapists from foreign jurisdictions no longer seek licensure in New York because of its bachelor’s degree threshold. New York was one of the only states, if not the only state, that accepted a bachelor’s degree for purposes of licensure. Not only did New York’s bachelor’s degree standard raise quality of care concerns, but the standard also disadvantaged graduates of doctoral degree programs and even foreign trained therapists, since foreign trained therapists experienced a high fail rate on the licensure exam, as the bachelor’s degree training left them ill-equipped to take the exam. Nearly every other state requires a master’s degree or doctorate. New York’s uniquely low educational requirement has impacted the quality of physical therapy care in other states, as foreign trained therapists obtain licensure in New York and subsequently seek reciprocity in other states that require higher academic credentials. This law enables New York to act as a leader in establishing educational and care standards rather than lagging behind the rest of the country. NYPTA is pleased that its advocacy efforts led to the successful enactment of this important piece of legislation for the profession.

Times Union Article

2011-09-06T07:41:00.002-04:00

Interesting Article last week in the Albany Times Union

In Good Health

Matthew Hyland
President NYPTA

September 1, 2011

Quiet Changes To New York Workers Comp Rules Leave Out Those With Chronic Pain
BY Celeste Katz

A little-noticed policy change at the state Workers' Compensation Board is jeopardizing insurance for thousands of workers and retirees with long-term medical problems.

Our Glenn Blain reports:

New treatment guidelines quietly enacted by the board late last year limit coverage to therapies that yield "functional improvement" in patients - leaving out people with chronic pain conditions, say labor leaders and caregivers.

"They basically tried to throw out all injured workers with chronic conditions," said Bruce Silber, president of the New York State Chiropractic Association, which has been lobbying lawmakers to intervene.

"They give them approximately two to three months to get better."
The board has applied the guidelines to new cases and existing patients in the system, including those who had been receiving treatment for years, Silber added.

"It's a travesty," said Jim Beamish, a retired Verizon worker from Massapequa Park, L.I., whose chiropractor dropped him after 13 years of treatment because of the new policy.

"They just make you feel like you are almost a criminal to try and get care," added Beamish, who still suffers neck pain from a 1998 fall.

Workers' Compensation Board officials and members of the state Business Council - which supported the changes - defended the new policy as an"evidence-based" system that ensures workers receive care quickly.

"In the past, there was no objective and consistent standard for determining whether the care was effective, which can lead to potential fraud, delay and mismanagement of the system," said board spokesman Brian Keegan.

Keegan said people denied coverage can appeal for a variance so long as they can show "objective evidence that a treatment medically benefits their patient."
Keegan said 78,178 variance requests have been filed, and more than two-thirds were approved.

Critics, including the powerful AFL-CIO, said the variance process is cumbersome and difficult to navigate.

"The agency now views itself asthe protector of insurers and employers," said Robert Grey, a lawyer who specializes in workers' compensation cases. "Clearly, someone thinks cutting off medical treatment will save money for employers and insurance companies."

Legislation that would have stopped the board from applying its new guidelines retroactively was approved by the Assembly this spring but stalled in the GOP-controlled Senate.

The bill faced stiff opposition from the Business Council.
"You just don't do something forever just because you feel like it," said the Business Council's Maggie Moree. "You have to have evidence."

Upstate Republican Sen. George Maziarz, the bill's sponsor, said he's pressing to have the Senate take up the measure at a yet-to-be-called session this fall - or in January.

"People are being denied care that is inexpensive and that I think helps them," Maziarz said.

Core Ambassador

2011-08-31T11:16:00.002-04:00

The National Student Assembly has a new program which each Chapter is assigned a "Core Ambassador" to their Component. Over the past year Jessica Thomas has filled that role for us here in New York. Jessica attended our Spring Board meeting as well as the DA. I would like to thank Jessica for her hard work and her being such a wonderful liaison to the Student Assembly. I would also like to welcome Ithaca College Student Katie Parrotte who is our new Core Ambassador. We look forward to working with her in the upcoming year.

In Good Health

Matthew Hyland
President NYPTA

WC- Guidelines CE

2011-08-30T11:19:00.001-04:00

Good morning- After extensive work our PT-specific training on the Medical Treatment Guidelines (neck only) will probably be going live on Monday. Once this is firm and in place keep an eye out for a member blast and information on the website. Our Low Back, shoulder and knee cases are in the works.

In Good Health

Matthew Hyland
President NYPTA

Meeting Aug 19th with APTA and AIPT

2011-08-23T08:47:00.002-04:00

On Friday August 19th Carmen Elliott and Justin Moore came to NY to meet with myself and the co-chairs of AIPT to discuss payment issues here in our Chapter AND to outline an action plan. As you know this has been a critical element to address for the present EC and Board. We are confident that the assistance of the APTA will only strengthen our position. I thank all those involved for their time and valuable insights. Below is a summery of the meeting.

In Good Health

Matthew Hyland
President NYPTA

Hello Matt et al,

The following is a summary of our meeting from Friday, August 19. Please let me know if anything is missing and I’ll be sure to include on the list.

NY Payment Strategy Meeting

Valhalla NY

Friday, August 19, 2011

Summary: On August 19, 2011, Carmen Elliott and Justin Moore met with leadership from the New York Chapter of APTA and from the Alliance for Independent Physical Therapists (AIPT) on payment issues. Primary to the meeting was to develop a coordinate national strategy on the issue of high copayments in physical therapists and other issues that shift the financial burden of care to the patient. Secondary to the meeting was a coordinated approach to diminishing and poor payment rates in Workers’ Compensation programs.

Action Items:

a) To investigate the potential for actuarial data analysis on the cost of physical therapist care and the impact on the insurance actuarial formulas from the research on downstream savings.

b) To provide the NY Chapter of APTA with sample legislation regarding copayments from around the country (Missouri)

c) To provide APTA an overview of the NY Workers Compensation Program (Jeff to provide resource paper).

d) To provide an analysis of the current NY legislation on copayments with suggestions for changes or amendments for the Chapter to consider if the legislation gains momentum.

e) To provide the chapter with a status on a resource tool kit or take action packet being developed by APTA state affairs

f) To provide a legal analysis of the current status of Workers’ Compensation payment to physical therapists in New York state and if there is any potential legal remedies to this issue.

g) To provide a national perspective on the state of payment under Workers’ Compensation nationally.

h) To connect the chapter with APTA communications and public relations staff for coordination and strategy.

i) To connect the chapter to Marc Goldstein for coordination and potential collaboration on health services research to advance payment initiatives. NY has a task force and funds to begin strategic investments in this area.

j) To provide the chapter with an issue summary and resources on diagnostic ultrasound.

Carmen Elliott, MS
Director, Payment Initiatives
American Physical Therapy Association
1111 N. Fairfax Street
Alexandria VA 22314
(703) 706-3171
(800) 999-2782 x3171
(703) 706-8567 FAX
carmenelliott@apta.org
www.apta.org

Education Bill

2011-08-20T15:23:00.002-04:00

Hi all-
it is with great excitement that I inform you our Education Bill was signed into law Thursday by Governor Cuomo. This is a major victory for the NYPTA and is evidence of how having the right message, working hard to inform legislators about that message and believing in ourselves can pay off. Thank you to everyone who helped get this accomplished from Mark Amir, Brian Lucey, Jim Dunleavy, the Chapter staff and all of you who attended Lobby Day, contacted your legislators or sent letters of support.

In Good Health

Matthew Hyland
President NYPTA

A2502A - Canestrari
Requires applicants to complete a master's degree or higher to obtain a license
in physical therapy
08/17/11 signed chap.410

PGA Championship

2011-08-16T08:41:00.002-04:00

While on vacation last week I had the opportunity to watch some of the PGA Championship. On Thursday, US Open Champion Rory McIlroy found his tee shot on the third hole resting up against a root in a clump of trees. He decided to try to hit the ball and while making contact with the ball he also hit the root square so hard that it bent the shaft of his club and injured his right wrist. He was clearly in pain and having trouble even swinging a club. The rules official assigned to the group immediately brought him an ice pack which he applied in between shots. The announcers, who were primarily former European tour pro's kept stating the Rory needed to ask for the "Physio" to come examine his wrist before he did permanent damage. Over the course of the next hour the term "Physio" was mentioned over a dozen times in terms of the medical management the announcers felt the player needed. The conversation included how important the "Physio's" were in prolonging their own playing career's and how Rory could be jeopardizing his career by not being evaluated by one on the course. Not once did the announcers discuss he should be evaluated by an MD or ATC, each and every time it was the "Physio." Eventually Rory did ask for medical consultation and indeed a Physical Therapist came out on the course and evaluated him on the spot, providing not only a diagnosis BUT also clearing him to continue play if he could tolerate the pain because in the opionion of the Physical Therapist he could do no further harm to the wrist.

This all played out over the next three hours including the Physical Therapist taping his wrist after a few more holes. Rory eventually finished the round, made the cut and played all four days with the Physical Therapist following him and administering treatment after and before each round. On Thursday alone in the four hours he was on the golf course I counted over two dozen references to the "Physio." It was a wonderful day to be a therapist, I felt proud of our profession and was surprised at the level of respect we have in the eyes of Europeans as a profession. The Physical Therapist who attended to Rory on the course did a wonderful job, asking all the right questions and appropriate system screening. This is what we should be aspiring too.

I also reflected some on the terms "Physiotherapist" versus "Physical Therapist." For some reason the term Physiotherapist seems so much more complete and encompassing of a medical profession versus an entity. It made me wonder if the term "Physical Therapist" is part of why we are often viewed as a commodity (see Jeff Hathaways article in the most recent Empire State Newsletter).

Anyway it was a wonderful day and I wanted to share the story with you for those of you who did not seee it.

In Good Health

Matthew Hyland
President NYPTA

Education Bill

2011-08-10T09:36:00.002-04:00

Good Morning all-
I have been informed that our education bill, which has passed both sides of the Legisature, has been sent to the Governors desk. At this time we are not aware of any opposition to our bill and are optimistically confident that it will pass. This is a wonderful day for the NYPTA- it is the second bill we have had pass the Legislature in the past year, and while the workers comp bill last year was vetoed by Governor Patterson, it is a sign that we are impacting change in our State. I will keep you informed as soon as I hear more.

In Good Health

Matthew Hyland
President NYPTA

2502-A Canestrari Same as S 3469-A OPPENHEIMER
Education Law
TITLE....Requires applicants to complete a master's degree or higher to obtain a license in physical therapy

S3469-A OPPENHEIMER Same as A 2502-A Canestrari
ON FILE: 05/09/11 Education Law
TITLE....Requires applicants to complete a master's degree or higher to obtain a license in physical therapy

Passing of Larry Steve

2011-08-04T12:29:00.002-04:00

I have just become aware of the passing of one of our longtime members and friends Larry Steve. Below is a copy of his obituary. Thank you to Larry for all of his years of hardwork and dedication to our profession and his patients.

In Good Health

Matthew Hyland
President NYPTA

Laurence M. Steve
January 25, 1934 – April 21, 2011

Physical Therapist & “Low-Grade Spy”

Laurence M. Steve, 77 of Mt. Vernon, NY, passed away April 21, 2011 at Calvary Hospital, Bronx, NY, ending a 15-month battle with pancreatic cancer.

Known to all as “Larry”, Mr. Steve was a respected Physical Therapist for nearly 50 years. Since 1986, he operated his own private practice at 2114 Williamsbridge Road in the Bronx. Prior to that, he was on the staff at Jacobi Hospital, taught anatomy at Albert Einstein College of Medicine and was a member of Ithaca College’s New York-based faculty for the school’s Physical Therapy program. In addition, he was an active member of the New York Physical Therapy Association and a passionate advocate for the profession. His dedication to his patients was legendary, helping scores of people regain their mobility and their quality of life.

Born on January 25, 1934 in Ithaca, NY, Larry was a 1951 graduate of Ithaca High School, where he was an all-around athlete participating in football, basketball, baseball and wrestling. In 1953, he joined the Army and was dispatched to Fort Dix, New Jersey, where he received training in radio operations using the old ‘Morse Code’ system. He served in Korea and Japan until early 1956 in an Army communications unit monitoring coded messages, often referring to himself as a “low-grade spy.” This work may have launched his life-long fascination with espionage books and spy movies.

After leaving the Army, Larry attended Ithaca College where he majored in physical therapy and sports medicine. One of his earliest jobs – and one of which he was most proud – was as an athletic trainer for the Cornell football team in the late 1950’s. In 1959 he married the former Phyllis “Marti” Quinn of Ithaca, NY and shortly thereafter moved to the Bronx and then to Nanuet, NY.

In addition to being an espionage buff, Larry was an avid music fan, enjoying classic jazz as well as soundtracks from Fellini movies and spaghetti westerns. Though he never learned to play an instrument, he owned and enjoyed three antique player pianos over the years. His often-eclectic interests included a collection of silent movies and classic sports cars along with an appreciation for art and architecture.

Larry was predeceased by his parents, Martin and Thelma Steve of Ovid, N.Y. and Port Charlotte, Florida, and his wife, Phyllis. He is survived by two sons, Marc of New York City and Jaime of Alexandria, VA, and his brothers, Ronald of Ovid, NY and Richard of Knoxville, TN.

A graveside service will be held on July 16, 2011, 11:00am at the Calvary Cemetery in Ithaca, NY.

Legislative Agenda

2011-07-30T09:18:00.002-04:00

Good Afternoon-
The 2011 Legislative Agenda page on our website has been updated this week to give specific bill numbers, bill sponsors and current status of bills. We hope that this keeps membership up-to-date on where our bills stand and serve as a tool for those who are meeting with legislators. Thank you to Kelly Garceau for updating the website. You can find the legislative agenda on the website under the legislation tab on the pull down menu and then "legislative agenda."

In Good Health

Matthew Hyland
President NYPTA

EC Meeting

2011-07-21T13:00:00.002-04:00

Good Morning-
The Executive Committee will be having their summer meeting this Saturday, July 23 in Rochester NY. Agenda items for the meeting include, the establishment of two task forces (one regarding the NYPTA research agenda and the second to review NYPTA Governance), selecting a Lobbying firm based on the received RFP's, Committee Appointments, a charge from the Finance Committee to review the Empire State Newsletter distribution, review of the student mini conclave and our Dirctors intern program. An ambitious agenda to be sure, but one that is all in the best interest of the Chapter. I will send an update next week after the meeting.

In Good Health

Matthew Hyland
President NYPTA

Physical Therapy Products Article

2011-07-19T14:18:00.004-04:00

I was recently interviewed by Stephen Noonoo the editor of Physical Therapy Products, below is his editors message for July 2011. While the phrase the bill is slated for passage is not exactly in the context I used it, I am excited and pleased by the progress we are making- and I do hope that sooner than later that phrase will be entirely true.

In Good Health

Matthew Hyland
President NYPTA

Issue Stories

Physical Therapy Products - July 2011

Editor's Message

The Grassroots Approach

by Stephen Noonoo

In last month's column on concussion safety ("Leveling the Playing Field," May/June 2011), I touched briefly on how PTs might consider educating lawmakers on the physical medicine profession's important role in society. But how exactly does that process work? Is it reasonable—or even efficacious—for a busy, full-time PT to call up their local representatives with their suggestions on how to improve their lot and that of their patients?

Absolutely, according to Justin Elliott, the American Physical Therapy Association's (APTA) director of state government affairs. Elliott spends most of his time promoting legislation important to the APTA at the state level—like strong practice acts or limits on physician-owned physical therapy—and he tells me that when it comes to getting this type of legislation passed, the industry needs all the help it can get. "The American Medical Association and their state societies have really focused on PTs as a threat, and what they see as infringement of the practice of medicine—and same with the orthopedic surgeons," he says. "So we have a number of very large and very intimidating opponents."

When it comes to stashing money in political action committees (PACs) or hiring the Beltway's best (read: priciest) lobbyists, the physical therapy industry can't hold a candle to state medical societies. "We will never be able to match them in terms of money," Elliott says. "We will never be able to match them in terms of number of lobbyists. And we'll never be able to match them in terms of state PAC donations—they out-raise us 10 to one."

To counteract this imbalance, PTs must out-hustle. That means better grassroots campaigns, more local media support, and bigger, more successful rally days at the state Capitol. It also means more support from every PT, regardless of how active they are in the state association or the local community. And yes, sidling up to local legislators can go a long way toward getting a bill out of committee. "There's a huge difference between writing a letter to a state senator you've never met before versus picking up the phone and calling a state senator who knows you by your first name," Elliott says.

Some state chapters—Elliott singles out Arizona—have seen tremendous success with their legislative efforts. Others, like Montana, face the very real challenges of distance and low membership numbers.

But even states with big chapters face obstacles when trying to push through meaningful legislation. Take New York, for example, whose association for the past 3 years has worked to push through a bill that would cap copays for patients at reasonable rates. After languishing in committee for several sessions, the bill is finally slated for passage. But it has been a long road so far. Once local reps were found to sponsor the bill, New York Physical Therapy Association President Matthew Hyland, PT, PhD, and others worked tirelessly to drum up support. "Once you have your sponsors, the grassroots plays a major role, because there are a lot of [factors] as to whether or not they let your bill see the light of the day on the floor," Hyland says.

Hyland and his fellow association members started an awareness campaign from the ground up, using social media to spread the word, and found patients to talk up the bill's merits with lawmakers. They also hired a PR firm, held a press conference, attended town hall meetings, and even polled patients as to why they stopped attending physical therapy to prove cost was an issue.

No one single donation, or one particular therapist, made it all happen. Instead, a collaborative effort between PTs, lawmakers, and patients came together to build an unstoppable momentum. Small steps will make a big difference, which makes being the underdogs a lot less daunting.

Letter to the Governor

2011-07-14T15:33:00.002-04:00

I am very excited to announce that NYPTA membership hit an alltime high in June of this year with over 5,700 members. This is an achievement which strengthens our position as an association. Presently NYS is the second largest Chapter behind only California, has more PT and PTA programs then any other Chapter and is strong in its membership and values. For all members, please try to continue to spread the word about the value of membership to non-members, the next goal is 6,000!

Please find below a letter which we just sent to the Governors office. What a tremendous accomplishment to have one of our bills that we drafted and have been lobbying for pass both sides of the legislature and sent to the Governor.

In Good Health

Matthew Hyland
President NYPTA

July 13, 2011

Ms. Mylan Denerstein, Esq.
Counsel to the Governor
Executive Chamber
State Capitol
Albany, NY 12224

Re: A. 2502-A (Canestrari) – AN ACT to amend the education law, in relation to the practice of physical therapy

Dear Ms. Denerstein:

On behalf of the New York Physical Therapy Association, Inc. (“NYPTA”), which represents the interests of 5,500 physical therapists, physical therapist assistants and physical therapy students in New York, we write to respectfully request the Governor’s approval of the above-referenced legislation, which would update the statutory educational requirement for physical therapy licensure to be consistent with current accrediting standards.

This legislation would require applicants for physical therapy licensure to complete a master’s degree or higher in physical therapy. NYPTA understands that New York is one of the only states, if not the only state, that accepts a bachelor’s degree for purposes of licensure. Nearly every other state requires a master’s or doctoral degree. Such standards reflect national accrediting standards and that the practice of physical therapy has advanced significantly since the establishment of the bachelor’s degree requirement. Indeed, all New York physical therapy educational programs are at the master’s or doctorate degree level, as is the case in the rest of the country.

With a lower educational requirement unique to New York, physical therapists from foreign jurisdictions seek licensure in New York. As a result, the current bachelor’s degree requirement adversely impacts the quality of physical therapy care in New York. It also diminishes the value of licenses of New York trained physical therapists. Finally, New York’s uniquely low educational requirement also impacts the quality of physical therapy care in other states as foreign trained therapists obtain licensure in New York and subsequently seek reciprocity in other states that require higher academic credentials. New York should act as a leader in establishing educational and care standards rather than lagging behind the rest of the country. A. 2502-A would address the inconsistency of New York’s educational requirements with the rest of the country.

On behalf of the New York Physical Therapy Association, we thank you for the opportunity to comment on A. 2502-A (Canestrari), and respectfully request the Governor’s approval of A. 2502-A.

Very truly yours,

MATTHEW R. HYLAND, PT, PhD, MPA
President

2011-07-11T11:03:00.002-04:00

An important movement of our association has been to create alliances with interested partners. One example of this is with regard to the newly created NYS medical indeminty fund. Please find a letter below which was sent to the Governors office and signed by myself and the presidents of NYSSLHA and NYSOTA

In good health

Matthew Hyland
President NYPTA

The New York State Speech-Language-Hearing Association, The New York Physical Therapy Association and The New York State Occupational Therapy Association, representing nearly 55,000 licensed professionals across New York State, are concerned that the creation of the NYS Medical Indemnity Fund through Title 4 of the 2011-12 Budget will result in severely limiting access to services for infants that have suffered injury due to medical malpractice.

Reimbursement Impact
Basing the reimbursement rate for health care providers on Medicaid rates will severely limit access to therapy providers. Many private providers do not participate in Medicaid because of the poor reimbursement rates. Although physicians diagnosing the infants will receive 100% of their usual and customary rate, the professionals that will provide the care for the child, potentially for the rest of their lives, will receive about 20% of their usual and customary rate.

We believe this will limit access to Article 28 facilities, essentially eliminating the option for private, home-care for these developmentally disabled infants. It does not appear that the new legislation compensates for transportation costs, putting an undue burden on these families.

In addition, requiring health insurance to be the first payor for health care for a victim of medical malpractice may, in fact, encourage more health plans to drop or decrease coverage for therapy services for all customers. Or, at the very least, encourage insurers to increase premiums to cover the cost of the medical malpractice.

While the Medical Indemnity Fund is reimbursing at Medicaid rates, it is unclear if another set of regulations, processes and documentation will be created for the providers of care under the Medical Indemnity Fund. Multiple processes could be challenging to the organizations that must provide the documentation for payment.

Integration with Other Programs
Given the length of time it may take to determine eligibility for inclusion in the Medical Indemnity Fund, many of these children will receive services through the Early Intervention Program and the Committee on Preschool Special Education (CPSE) and Committee on Special Education (CSE) in the interim. Currently, Medicaid reimburses the state and municipalities at the Early Intervention rates, not Medicaid rates. If the Medical Indemnity Fund will reimburse the state and municipalities at a lower rate, will they absorb the difference in rate, or will they have the authority to retroactively collect this payment from the providers? If they have the authority to retroactively collect overpayments, this will result in fewer providers willing to provide therapy for these children and could lead to fewer Early Intervention providers for all children. What provider would be willing to take the chance that they may have to pay back revenue that was earned several years ago? We oppose any regulation that would allow the states or municipality or school district to retroactively collect payments made to providers who provided care for these children.

Professional Independence
The legislation indicates case managers will be assigned to manage the care of these individuals across their lifetime. We are concerned that these case managers may not have the appropriate background to oversee the needs of these fragile infants. We recommend that case managers have a background in therapeutic care to ensure the special needs of this unique population are understood by the case managers.

It is unknown if the case manager will determine the frequency/duration of therapy requirements or if it will be the diagnosing physician or if there will be a multi-disciplinary evaluation after a doctor’s diagnosis. We recommend that multi-disciplinary evaluations be completed to ensure that a licensed professional is recommending therapy requirements for these children. It is critical that the licensed professionals be allowed to use their professional judgment while treating this vulnerable population. We also recommend that licensed professionals be reimbursed at 100% of the usual and customary rate for the multi-disciplinary evaluations to ensure access to timely evaluations for these children.

We have serious concerns that the funding of this program will be inadequate to provide quality care for these individuals. One child’s care could easily cost millions of dollars, offsetting the fees collected. The purpose of the program will be seriously compromised and the proposed benefit of lower medical malpractice premiums will not be realized.

We recognize the need to address out-of-control medical malpractice premiums, but we do not believe it should be at the expense of the innocent victims of errors made at birth.

Sincerely

Michael Bergen Matthew Hyland Izel Obermeyer
NYSSLHA President NYPTA President NYSOTA President

2011-07-11T09:42:00.002-04:00

I hope everyone had a wonderful weekend. We had long enjoyed a strong relationship with the NYS Board and have no doubt that will change. Congratulations to Mr. Lentivech and welcome.

In good health

Matthew Hyland
President NYPTA

Doug Lentivech Appointed as the Deputy Commissioner for the Professions
On Tuesday, June 21, 2011, the Board of Regents unanimously voted to appoint Doug Lentivech as the Deputy Commissioner for the Professions. The Commissioner recognized Doug’s service to the Office of the Professions, and his commitment to the important work of the office in overseeing licensed professionals.

Doug has served in the Office of the Professions since 1994. During his tenure as Assistant Counsel, he has provided legal counsel on a variety of areas impacting each of the 48 professions as well as on complex practice/professional business organization issues. In addition to his legal responsibilities, in 2006, he was appointed by the Board or Regents as Executive Secretary for the NYS Board for Chiropractic.

In 2008, he was also named Executive Secretary for the NYS Boards for Respiratory Therapy, Speech Language Pathology/Audiology, Occupational Therapy and Acupuncture.Congratulations to Doug on his new role with the Office of the Professions.

Congratulations also to Valerie Grey who, as Chief Operating Officer, served as Acting Deputy Commissioner since the retirement of Frank Muñoz earlier this year. Valerie has been appointed Executive Deputy Commissioner by the Board of Regents, and we look forward to her continued close ties with the Office of the Professions.

FSBPT

2011-07-07T12:48:00.000-04:00

FSBPT Practice Analysis Survey Open to all Practicing PTs and PTAs

In late April, the Federation mailed out surveys to a random sample of about 18,000 PTs and PTAs to gather information which will be used to update the National Physical Therapy Exam (NPTE). FSBPT has now opened the survey to practicing PTs or PTAs who were not part of the initial sample.

The goal of this project, called a practice analysis, is to update the content outline for the PT and PTA examinations so that they continue to test knowledge currently required for safe and effective patient care by entry-level practitioners.

You can access the survey using the link https://www.humrro.org/apps/fsbpt/, which is also located in the shortcuts section of FSBPT's website (www.fsbpt.org). The surveys will close on July 8, 2011.

In good health

Matthew Hyland
President NYPTA

Website

2011-07-07T12:42:00.002-04:00

First I would like to take a moment and wish everyone a Happy Fourth of July, I hope that you enjoyed a long weekend with friends and family. Our new website went live on July 1st and looks fantastic. I would like to thank our communications director Bibiana Braun and the website redesign task force Nate Mosher, Andrew Bartlett, John Rabbia and Jeremy Crow for their dedication and hardwork, the outcome is definately something to be proud of. I would also like to thank the Executive Committee for having the foresight to approve the financial resources required to make this project possible. The new website represents our Chapter well to members and visitors alike. Also you can now register online for our Chapter Annual Conference October 28-29 in Rye Brook. I hope to see you there.

In good health

Matthew Hyland
President NYPTA

Website

2011-06-24T10:16:00.002-04:00

Hi everyone-
I am very excited to announce that we are planning on launching our new Chapter website July 1st! Thank you to Bibiana Braun and the entire Website redesign task force for there extensive efforts. The address will remain unchanged, www.nypta.org

In good health

Matthew Hyland
President NYPTA

Interesting Article in Buffalo News

2011-06-23T15:33:00.002-04:00

Good Afternoon-
Below is an interesting article that appeared in yesterdays Buffalo News.

In Good Health

Matthew Hyland
President NYPTA

State lawmakers weigh changes to Workers’ Comp guidelines
By Matt Glynn

NEWS BUSINESS REPORTER

Updated: June 22, 2011, 7:10 AM

State lawmakers are considering altering workers’ compensation guidelines adopted last year that injured workers complain have resulted in reduced or denied medical treatment.

The debate centers on medical treatment guidelines for injured workers that the Workers’ Compensation Board adopted on Dec. 1, 2010.

Advocates for injured workers claim those guidelines should not apply retroactively to workers whose cases predate last Dec. 1, sometimes by years. They say the guidelines are interfering with care and causing confusion among health care providers.

But supporters of the guidelines say there ought to be a uniform standard of medical care for all cases in the system. And they say the guidelines help medical professionals identify whether the care patients receive is of good quality and is actually helping them restore function.

Legislation proposed in the State Senate and Assembly would tweak the guidelines so that they apply only to cases from Dec. 1, 2010 onward. State Sen. George Maziarz, R-Newfane, sponsored the Senate legislation. The Assembly version, sponsored by Assemblyman Keith Wright, D-Harlem, passed the Assembly on Monday.

Groups such as the New York Workers’ Compensation Alliance have opposed the medical treatment guidelines. “Carriers have denied treatment and medication in numerous cases, which has resulted in a flood of variance requests,” said Robert Grey, the Alliance’s chairman, in a letter to the Workers’ Compensation board’s chairman.

The Alliance argues that the guidelines are illegal, contending they violate sections of the workers’ compensation law.

Maziarz’s office received complaints from some constituents who had been receiving chiropractic care for workers’ compensation-related issues, but were impacted by the changes implemented last December, said Adam Tabelski, a spokesman for Maziarz.

The Business Council of New York State is among the opponents of the legislation. The group argues the Workers’ Compensation board’s guidelines should apply to every case, and that their adoption was a significant part of workers’ compensation reform in 2007.

“The legislation seeks to set two different standards of care for injured workers,” said Margaret Moree, director of federal affairs for the Business Council.

Moree said the guidelines do not preclude a medical professional from seeking to extend treatment for a patient if that treatment is showing progress. And she said costs are not the only issue.

“This was as much about ensuring people were getting quality care consistent with medical evidence,” she said.

The fate of the legislation was uncertain on Tuesday, as the State Legislature’s session was winding down. While the bill passed the Assembly, it was unclear if it would reach the Senate floor for a vote.

Recent Speech at NYU

2011-06-18T10:44:00.002-04:00

Below is a speech I recently delivered at NYU- Happy Fathers Day to all of our PT Dads out there!

In Good Health

Matthew Hyland
President NYPTA

I headed down to National Harbor in DC Saturday night for a leadership kickoff reception to launch the 67th House of Delegates prior to Annual Conference. I attended the House Sunday through Wednesday, joined 1,000 PT/PTA/PT students at a rally in the Mall Thursday morning in 105 degree heat- a day I will never forget- and joined over 40 New Yorkers that day in meeting with Legislators in effort to make meaningful change. I then jumped in my car- which I have put over 50,000 miles on in 13 months since being elected to serve as your Chapter President and drove to Albany to meet with our Lobbyist Friday night to discuss the progress of our State Legislative agenda- then spent all of Saturday in the Chapter office with the Finance committee outlining a balanced budget for the Chapter for 2012. So. . . coming here tonight only 30 miles from my home to spend an evening with a group of energetic therapists is a joy. So again thank you for having me.

It is hard to believe that a year has passed since last year’s Delegate Assembly- no matter how prepared one thinks they may be for a new challenge- I am not sure I could have ever realized or been prepared for how amazing the opportunity to serve this Chapter as President could ever be. After bumbling my way through my oath of office last year- the responsibilities ahead hit immediately. When the new executive committee sat down together at the close of last year’s DA we outlined a general plan for what we hoped to accomplish and tasks that needed immediate attention.

Discussed at that first meeting was a need to become more present as a board and an executive committee. To give the Chapter a face so to speak, to tear down improperly perceived barriers from the grassroots toward leadership- to try to answer the question “what does the NYPTA do for me.”

Tonight I come to you to discuss the many victories we have achieved in the past year. I realize they are not financially based necessarily, but that is only one area of practice- and before going any further I want to let you know that I too am a private practitioner and if I could snap my fingers and make the wc issues go away, increase reimbursement and remove the many restrictions to our provision of care, trust me I would do it, but it is not that simple.

I said publically that I intended on visiting each District and as many of our educational institutions as possible in the first 18 months of office- and I am proud to say that I have been to seven of our districts, 9 educational institutions, and attended meetings of both the Academic Administrators SIG and AIPT discussing the activities of our Chapter, our new Strategic Plan and the need for participation.

During these travels I am moved and encouraged by the level of participation by membership as well as the many new faces that have shown a willingness to serve and become involved. When reading district reports and talking to Chairs and Directors I understand the frustration of holding business meetings with only 4-8 people in attendance. But at the same time, membership is at an all-time high, last year’s lobby day had record attendance and Chapter and District CE events have been tremendously well attended. Maybe we just need to refocus as to what TODAYS benchmark of success should be in our Chapter.

Mandatory Continuing Education, while only about 20 months into inception has created many opportunities for the Chapter. Many Districts are using Man Con Ed as a vehicle to increase participation in meetings as well as providing a wonderful member benefit. One of the discussed initiatives is that if a member were to take their 36 CE Hours through the Chapter and Districts that the savings versus a non-member or versus the significantly higher cost with an outside vendor that their membership would almost pay for itself. We are not there yet, but it is possible. The Program Committee lead by chair JJ Mowder has worked very hard to arrange for high level programming at Chapter events, specifically our Chapter Conference, which will be help this year in Rye Brook October 27, 28- and I encourage each and every one of you to attend- I also know that they are also working very hard already for the 2012 conference in Rochester.

We have also made great strides in upgrading our IT capabilities. Based on the recommendations of our Communications Director, Bibiana Braun, the Executive Committee approved a proposal to purchase new software for the Chapter’s website to provide for enhanced website capabilities and more robust electronic communications and support, including video-conferencing and CEH tracking. A website redesign task force was created to oversee the development and implementation of the new website, which we anticipate launching this coming July. Please go to the website frequently for all Chapter updates.

Other new Technology initiatives has been social media- we now use twitter, facebook and have a Presidents blog- and with any technology there is potential negative undesirable consequences- but with the hard work of our Media Director and the PR committee (Tracy Sawyer, Jennifer Zaleskie and Nate Moser) our tweeting remains current, with the help of Dave Sofer our facebook is professional and reflective of the message we are trying to send and I continue in the effort to produce a meaningful message on the Presidents Blog.

Other successes over that past year include our Directors Liaison initiative, Directors intern program and new budgeting plan. The Directors Liaison initiative was created to give committee’s more voice and representation at each Board meeting. A Chapter Director, who is a voting member of the Board, has been assigned to each Committee. Directors were asked to rank which Committee they were most interested in representing and the Staff and EC paired them to best meet the desires of the Directors. This helps assure that Committees have more Board and EC information for their conference calls and electronic dialogue as well as a represented voice at Board Meetings which they may not be funded or are unable to attend.

The Directors Intern Program is a very exciting new initiative which is presently a Pilot Program cosponsored by the Chapter and the AASIG. The program allows each academic PT and PTA program in the state- 32 in all- to send one student, fully funded to attend a Chapter Board Meeting. The student is paired with a Board Member Mentor and along with their mentor receives materials in advance, attends discussion group and is able to contribute to the Board meeting. Upon completion of the meeting the student is asked to complete a survey regarding their experience. To date we had 16 students come through the program and we hope this initiative is one that other Chapters consider in some form moving forward to help foster leadership and participation by our student members as they transition into our great profession.

In 2010 the Finance Committee underwent a new budget process in order to more likely assure a balanced budget for the upcoming year, and also to ensure that the Chapter is funding activities that are consistent with the new Strategic Plan. In 2011 and moving forward Budget managers are required to submit a budget for their Districts or Committees with a plan for the upcoming year of how they will use that money AND in what way that plan helps achieve the Strategic Plan. This new process will allow the EC, the Board and the Finance Committee to more appropriately track dollars being spent and assure members’ money is being used in the best way possible to advance the Chapter. In fact as an example of Chapter Governance and how it relates to Chapter activities: at this year’s Delegate Assembly- which is the highest policy making group in the Chapter- elected delegates were asked to rank items on the Strategic Plan in order of importance. It is not a surprise that in the top 9 three had to do with educating the consumer, three with reimbursement and 3 legislative in nature. The Finance Committee heard this loud and clear and made some difficult decisions on how to allocate funds for 2012.

We have launched a new year round advocacy plan which is kicking off immediately- part of this plan includes the hiring of Empire Public Relations to help us advance our goals. As we enter a new two year legislative cycle with a new Governor, new Attorney General and many new Legislators- it is critical that we make new friends and get our message through clearly and succinctly. At the forefront of this year’s legislative plan are the high copays bill, PTA’s being reimbursed under WC, a WC mandatory fee increase and an education bill. We had over 300 members attend this year’s Lobby Day and the media coverage for our Copay bill has been unprecedented. I was interviewed by 7 print media outlets, 3 TV stations and 2 radio stations. To date our story has been picked up by the AP and run in over 27 outlets Nationally, the Daily News, the Albany Times Union- including a follow up to the editor and newsweek. Our fight in Albany to address the issue of high copays, or what they really are “All pays” has garnered National attention, our message is being heard and we are making a difference. The fight is far from over, but we are starting to draw even in the race.

While the landscape of NYS government is unstable to say the least in the face of a 10 billion dollar deficit, we will continue to work hard to make meaningful change to improve the landscape of practice and prevent infringement or negative influence upon us. As an example of this the NYPTA in conjunction with many allies was able to minimize the drastic negative proposed cuts and arbitrary caps in EI and Medicaid programs. We played a role in getting the projected 10% EI cut reduced to 5% and the 20 visit coupled PT/OT/ST cap under Medicaid separated to each service and not including children with developmental disabilities. Not fully the outcomes we had hoped, but meaningful change to say the least.

We continue to work very hard to improve the landscape of care under workers compensation. The changes that were implemented in 2010 dramatically limit access to our services and the quality of care provided. These issues were identified by NYPTA leadership over two years ago. Despite our recommendations at the time, the WC board implemented these new guidelines and many of the foreseen issues are coming to fruition. The downside is that the guidelines remain in place to date and there has been little change. The good news is that we have had numerous formal meetings with the Board over the past year and our concerns are being heard. In addition we have formed an alliance counsel that includes The chapter, our special interest group AIPT, PTAUNY and the Counsel of Phyisotherapy to proactively work together to form one message and one voice. As a group we have also had multiple meetings with the Board and are working to improve access, change the variance process, increase reimbursement and alter the guidelines to move from a cookbook approach to a proactive evidence based model that represents good physical therapy.

We continue to try to stress to the Board that continuing to have physicians determine the physical therapy guidelines dramatically decreases the quality of care and the access to our critical profession. It is no more appropriate to have physicians set guidelines for the doctorally trained profession of physical therapy for which they do not have a degree- as it is for us to make surgical recommendations for which we don’t have a degree. Our hope is that the WC board will open there eyes and realize that the current guidelines dramatically lack any of the current evidence based practice that identify appropriate physical therapy intervention and invite us to help fix a system that is not an improvement to the old, rather just rearranging the furniture on the Titanic. Meaningful change will not come until the system invites those to the table that practice in the areas they are trying to govern.

We have four bills right now we have introduced in Albany, our high copays bill, allowing PTA’s to be a covered entity under workers compensation, an education bill and a workers compensation review of the fee schedule. I talked about the successful positive movement of our copay bill, a bill which has everything to do with access and shows Albany to be what it is, a political arena whose interests are not always aligned with those of the constituents in which they serve.

I want to address the education bill for a moment. Not a sexy piece of legislation to say the least. NY is the only state that presently allows a candidate to sit for licensure with a bachelor’s degree- yet the minimum degree at present in the US is a Masters with a move toward the Doctorate. Yet we let individuals sit for licensure with a bachelor’s. We introduced legislation that requires a minimum of a Masters to sit for licensure. That bill has passed the assembly floor and just today passed the Senate as well. This is a significant victory for the association and we anticipate Governor Cuomo signing the bill in the upcoming weeks

Now the WC fee schedule bill. In 2010 we introduced legislation that forced the WC board to look at WC rates at a minimum of every two years with a report in writing. Why did we need that bill, because the last time WC raised there rates in NY was in 1996! The last time the WC board even assessed rates was more than a decade ago. Our bill passed both sides of the legislature last year and went to the Governor’s desk, don’t take that lightly, we the NYPTA got a bill passed due to grassroots and leadership efforts and landed it on the Governor’s desk. The day he was to make a decision on it, ironically the workers compensation board gave a 30% increase to every provider billing under E and M codes and asked the Governor not to sign the bill. He promptly vetoed the bill and a raise was given to all WC providers EXCEPT PT. So we did a great job getting raises for physicians in NY State, we did that for them. Yet they continue to battle us on our workers compensation bills. It’s time to tear down these barriers of protecting our areas of practice and start advocating for increased access to our patients, increased quality and continuity for our patients, and increased reimbursement for the skilled services we provide, not waste our time and efforts battling each other.

We have again introduced this bill to the Legislature in 2011 and hope to move it forward as last year and hope that the Medical society and orthopedic society of New York will jump on board and support us this year, respecting the profession of physical therapy and the place it has in the new health care arena.

Why the emphasis on Workers Compensation in New York State- a good question to be sure, as we have many issues in the reimbursement arena. However, we continue to work hard on workers compensation. The reason is simple. Insurers look at two things when setting fee schedules, State WC rates and Medicare rates, and the harsh reality is that we are the lowest reimbursed workers compensation state in the US- Which makes us not surprisingly the lowest overall reimbursed State in the Nation. If we can alter WC rates it will change the landscape of reimbursement in our State. If you are not in private practice this applies to you as well. It is very foreseeable that in all areas of practice that they will lower themselves to the floor. It is foreseeable that EI will continue to get slashed until they get to $55 per visit, that there will be $50 copays for homecare visits and that acute care reimbursement patterns will change. It all rests in Workers Compensation and we will continue to pound that area until meaningful change is met.

Here is the thing- while we have not achieved victory in the legislative or reimbursement arena’s yet, we are getting closer and making progress. And while we may not have the financal resources to compete economically in the battle against the medical society or insurance industry, we do have two major things on our side- a passionate membership and to be frank- we are right. We have the right message; others are trying to prevent what is right for health care and those who are trying to access it in their own best financial interest, but eventually what is good and just will win out. And our message is what is good and just.

I started tonight talking about the fact I had just returned from the House of Delegates and Annual Conference. On Thursday I had the privilege of joining over 1,000 PT/PTA/ PT students at a rally on the mall lawn. The purpose of that day was to move three National Bills that the APTA supports. The first was permanently removing the arbitrary Medicare cap that limits access to physical therapy. The cap was a byproduct of the 1997 balanced budget act and had no basis behind it. The reality is, and it is hard to understand how it cannot be as obvious to politicians, other providers and carriers that PT accounts for under 2% of the money paid out by Medicare, yet they continue to cut and cap it. The reality is that if a patient gets to the right service at the right time by the right provider- further more expensive interventions such as medications, injections and surgery can often be avoided. The second bill is concussion legislation that has been introduced in the House and is supported by the NFL and NCAA, and the third bill has to do with loan forgiveness for physical therapy students who would be willing to work in underserved urban and rural areas nationally.

The gap between what we have and what we don’t have with regard to health care in this country and in our profession is enormous. It is estimated that 35% of what we do in medicine has no value- in other words it moves money within the system with no health value to the patient! Said differently IT IS WASTED!
The Association of American Medical Colleges estimates that with Health Care reform that by the year 2025 there will be a shortage of up to 150,000 physicians in the US- This will impact the already strained triad of cost, quality and access that continues to threaten our healthcare system today.
It is time that physical therapists at the grassroots begin to look at their practice patterns and make changes. The status quo will not succeed in the upcoming years. The idea of healthcare reform is going to create sweeping change and with change inevitable comes conflict!

What is interesting is that every organ in the body has a specialist- Kidney doctor, liver doctor, heart doctor, lung doctor, etc. Nobody is a muscle doctor- you would think the physiatrist would carry that banner- but they don’t. So muscles are the orphan organ, they have no parent. In this world of reform it is time that physical therapy advocates and rightly takes their place as the Nations Healthcare Experts on the Neuro-Musculo-Skeletal system. That we achieve unfettered direct access and be appropriately reimbursed for the highly skilled services we provide- anything less is unacceptable. A dramatic paradigm shift is in the making, and you are a part of it. “The right service, at the right time, by the right provider.”

Being elected to serve you and the over 5,500 members of the NYPTA is an incredible honor and a job that I take with the utmost seriousness. But one of the great frustrations is that while membership is at an all-time high here in NY- it still represents less than half of the PT’s in our State.
Passivity and apathy will not get the job done. We need action! Now is NOT the time to sit on the sidelines and complain while waiting for someone else to do the job. YOU must help do the job.

This years house the delegates tackeled such issues as governance, alternative payment systems on how we should be reimbursed, concussion management, Vision 2020 and the provision of care by support personel.

We have had a very busy year to say the least- We continue to undergo a governance review process on a Chapter Level concomitant with National, work closely with our State Board in areas of practice and continuing education, strive to improve mentorship and create a streamlined, approachable, exciting Chapter that is a model for Governance. We have much to do, but I believe we have a great team to get the job done.

I thank you again for having me here tonight, New York is an awesome Chapter, we are the second largest in the Nation. New York has many leaders who are shaping our profession. There are three section Presidents who call New York home including Tim Tyler who is here for our panel discussion tonight. In fact everyone sitting on the panel tonight is serving the association or the Chapter in some leadership position. So it is an honor to be a panel member with them and I look forward to answering your questions. For those of you who know me you know I love quotes. One of my favorites comes from Alice in Wonderland. It was an exchange between Alice and the Cheshire cat.

Alice: “excuse me sir could you please tell me which way I ought to go.”
Cat: “That depends a great deal on where you want to get to.”
Alice: “I don’t much care where.”
Cat: “Then it doesn’t matter which way you go.”

We here in NY, on the section level and component level know where we ought to go, and we are asking you to be an active part of it.

Thank you-

More Copay Press

2011-06-12T11:23:00.003-04:00

This was just published in the Daily News! We are making progress

In Good Health

Matthew Hyland
President NYPTA

Physical therapy patients sore over high cost of co-pays, doctors pushing for laws to help

BY Kathleen Lucadamo
DAILY NEWS STAFF WRITER

Physical therapists are pushing for a state law that would reduce the high co-pays they say are forcing some patients to skip treatments.

Even people with insurance have to pay up to $50 a session - nearly the full cost of a visit - and some regimens can call for three a week.

"These people are paying monthly premiums to have a benefit when in reality they are paying 100% of the visit," said Matt Hyland, president of the New York Physical Therapist Association.

The law, which was re-introduced last month after failing to get a vote last year, would cap PT co-pays at 20% of the cost of care.

The association estimates that would bring the patient's portion of the bill closer to $10 a session.

Queens patient Dino Trivlis, 60, said such a measure would have saved him a bundle.

In April, a doctor ordered him to go for physical therapy three times a week for a muscle tear in his shoulder. A $50 co-pay meant he would have been shelling out $600 a month - on top of the $1,132 premium he pays for Oxford Health Care.

"I go twice a week," Trivlis said. "I'm retired and on a fixed income. I can't do it."

His therapist, Rich Orsini of Access Therapy in Brooklyn, said the treatments only cost $55, so the insurance company paid just $5 a visit while Trivlis bore the rest of the cost.

"People say I just can't afford to come multiple times a week. What can you do?" said Orsini.

Insurance companies define physical therapy as a speciality that comes with a higher co-pay.

Therapists say if insurance companies paid more for PT, they would save money in the end, since the treatments are cheaper than painkillers or surgery.

"It's ridiculous," said Peggy Soumakis, 42, of Gravesend, Brooklyn, who pays $40 a visit for knee pain and cut back to one session a week after her co-pay jumped.

"I just financially can't," she said. "It's physical pain versus financial pain."

2 Chapter Members Recognized

2011-06-12T11:09:00.002-04:00

I would like to congratulate Michael Pagliarulo and Dale Avers for receiving the prestigious Lucy Blair service award at this years Annual Conference. I am proud to say that I know both Michael and Dale personally and they are wonderful people, mentors and advocates for our great profession and our Chapter. Please take a moment to read the information below including what the Lucy Blair award is and then information about Michael and Dale.

In Good Health

Matthew Hyland
President NYPTA

History

In 1969, the Lucy Blair Service Award was established to honor the contributions of Lucy Blair,who served the American Physical Therapy Association from 1950-1969 as Poliomyelitis Consultant, Chief of Professional Services, Associate Director, and Executive Director. She wasalso a recipient of the Mary McMillan Lecture Award. In 1969, the first Lucy Blair Service Award was presented to Ms. Blair at APTA’s Annual Conference in San Francisco, California. Lucy Blair (deceased 1985) received her physical therapy education at Harvard Medical School and joined the Association in 1930. Before joining the staff of APTA, Ms. Blair served as a physical therapist with the Visiting Nurse Associations of Boston and Milwaukee, with the Wisconsin Bureau of Handicapped Children, the U.S. Navy (during World War II), and the Joint Orthopedic Nursing Advisory Service in New York City.

During the poliomyelitis epidemic in the early 1950s, Ms. Blair personally directed the role of the Association and the profession in evaluating the efficacy of gamma globulin and, later, the poliomyelitis vaccine. Ms. Blair had personal contact with several hundred physical therapists in forty states and three Canadian provinces, which strengthened the quality of physical therapy services nationwide. What endeared Lucy Blair most to so many people were her personal qualities: "unswerving dedication, self-sacrifice without limit, an infectious enthusiasm, strong
personal and professional values, a sharp wit and sense of humor, and a genuine interest and concern for every individual she met." Based on these enduring qualities of Lucy Blair, each recipient of this award will be given a pin with three stones that represent her dedication,devotion, and outstanding service to the American Physical Therapy Association.

Purpose
To acknowledge and honor physical therapist members of the Association whose contributions to the Association as a whole, at both the Association level and the component level, like those of Lucy Blair, have been of exceptional value.

Dale Avers, PT, DPT, PhD

APTA is pleased to recognize Dale Avers' contributions to the profession with the Lucy Blair Service Award.
Dale Avers, PT, DPT, PhD, has made contributions of exceptional value to the association as a whole and the Section on Geriatrics in particular.
Avers is director and associate professor of the Transitional Doctor of Physical Therapy Program, SUNY Upstate Medical University in Syracuse, NY. Previously she was a clinician with VanBeveren & Yankowitz Physical Therapy, and graduate program director and associate professor of the Doctor of Science program in geriatrics at Rocky Mountain University of Health Professions. She earned a PhD from Indiana University, DPT from Rocky Mountain University of Health Professions, and MSEd and BHS from the University of Kentucky.

Avers served almost continuously on the Section on Geriatrics' board of directors from 1981 to 2000 in a variety of leadership roles. Under her leadership, the section formalized its strategic planning process, grew by more than 1,000 members, established a full-time executive office, founded the Geriatric Fund, and established special interest groups to better meet the clinical practice interests and needs of members. Between 2004 and 2008, Avers co-chaired the Exercise Task Force that developed an evidence-based foundation for entry-level professional PT students, Physical Therapists as Exercise Experts with Aging Adults Curriculum Guidelines, a publication that was distributed to all PT professional education programs. She is active in the Retooling for an Aging America Taskforce, which develops surveys to assess the entry-level preparedness of both physical therapist and physical therapist assistant students to work with older adults.

A member of APTA since 1978, Avers' involvement in the association has been significant and continuous. On the national level, she was co-chair of the Council of Component Presidents, chair of the Committee on Sections, and a candidate for director. She served as president of the Section on Geriatrics twice, as well as director, vice-chair, secretary, nominating secretary, on the Clinical Residency Task Force, Falls Initiative Steering Committee, and the Retooling for an Aging America Task Force. Other sections that have benefited from her involvement include Administrative, Private Practice, Orthopaedic, Sports, and the Section on Education. She has held leadership positions in the New York, California, Indiana, and Kentucky chapters as well. Avers has been recognized with the President's Award for Excellence in Teaching from Upstate Medical University; the Section on Geriatrics' Distinguished Educator award, Dissertation of the Year from the School of Education at Indiana University, and the Anna Tracey Memorial Award, recognizing producers of a communications medium that enhances the image of the elderly.

Acknowledgment
This award is only possible through the support, encouragement, and love from many friends and colleagues who have cared enough to coach and mentor me. Working with them has been a joy, as is serving this fantastic profession. The Section on Geriatrics holds a special place in my heart, for they have served as a vehicle for my passion for older adults. The past 10 years have been the best, however, because of the unwavering support and caring from my physical therapist husband, partner, and love of my live, Patrick VanBeveren.

Michael Anthony Pagliarulo, PT, MA, EdD, BA, BS
APTA is proud to recognize Michael Anthony Pagliarulo's many contributions to his profession and the association with the Lucy Blair Service Award.
Michael Anthony Pagliarulo, PT, MA, EdD, BA, BS, has shaped the lives of countless physical therapists and PTAs as an educator and advocate for the profession.
Associated since 1980 with the Department of Physical Therapy at Ithaca College, Pagliarulo has held the roles of curriculum coordinator and academic coordinator of clinical education, assistant professor, associate professor, assistant director, and chair, and is currently professor. He was a lecturer at the University of California, San Francisco, and California State University, and a laboratory instructor at Cerritos College of Downey, California. Pagliarulo received an EdD from Syracuse University, MA in physical therapy from the University of Southern California, and BA and biology and BS in physical therapy from the State University of New York at Buffalo.

Colleagues consider Pagliarulo's career to have been dedicated to service. As an instructor, he has tirelessly advanced new concepts, theories, and knowledge for the benefit of not only students, but also faculty, patients, administrators, and policymakers whose decisions affect the path of physical therapist education. Though his active membership in the Section on Education, he has shaped the profession and helped develop high education standards of physical therapy. In his academic roles, he has promoted the importance of being a member of a professional association through words but also by example. His diverse roles in the New York Chapter have ranged from leadership to technology to governance, strategic planning, and member participation.

Pagliarulo has been involved with APTA since 1969, and has served on the Health Policy and Administration and Education sections, as well as a member of the Academic Administrators Special Interest Group of the Education Section. He has been appointed to several committees within APTA and currently serves on the Reference Committee and Steering Committee for the Education Leadership Institute. With the New York Chapter, he is currently on the Task Force on Governance and in the past has served as Speaker of the Assembly, on the Executive Committee, and the Task Force on Strategic Planning, Task Force on Annual Business Meeting, and Technology Task Force, to name just a few. He was involved with the California Chapter as well. Over the course of his career, his accomplishments have been recognized with a host of awards, including the Dorothy E. Baethke-Eleanor J. Carlin Award for Teaching Excellence, the New York Chapter's Normal Chadwick and Dr Marilyn Moffat Distinguished Service Award, and the Outstanding Service Award.

Acknowledgement
My thanks begin with my parents, Anthony and Louise, who taught me the value of a strong work ethic and service to others; my wife, Tricia, for her generosity to others and encouraging me to do my best while maintaining balance in my life; and my 3 children, Michael, David, and Elisa, who taught me to appreciate new and different perspectives. Thanks to visionaries and mentors Helen Hislop and Marilyn Moffat, with whom I had the privilege of working and who showed me the importance of taking bold steps; to my long-standing friendships in California and NY at the district and Chapter levels; my colleagues and students at Ithaca College over three decades; and certainly those who wrote in support of this award: Jim Dunleavy, Marti Ferretti, Meredith Harris, Marilyn Moffat, and Patrick VanBeveren. I have learned and received far more than I have given.

Capital Hill Day

2011-06-12T11:02:00.002-04:00

On Thursday June 9th over 1,000 physical therapists, physical therapy assistants and physical therapy students attended a rally outside the Captial Building in Washington DC to advocate for our Profession. I am proud to say that we had over 40 New Yorkers there advocating with our legislators on a grassroots level to address the Medicare Cap, Protecting student athletes from concussions and the Physical therapist student loan repayment program. A special thank you to Rich Orsini who is our Federal Government Affairs Liaison who helped shepard the New York Delegation to where were supposed to be- great job Rich! I am already aware of one legislator, Congresswoman Nita Lowey who has signed on as a cosponsor to HR 1546 which is a bill to remove the medicare cap all together due to our efforts. Thank you to everyone who took the time to attend the rally and Capital Hill day, getting to spend time with you advocating for the right cause in 105 degree heat is something I will never forget. Keep and eye out for pictures on the homepage in the upcoming weeks.

In Good Health

Matthew Hyland
President NYPTA

EI- Article in TU

2011-06-07T07:34:00.002-04:00

Good Morning- the article below was published yesterday in the Albany Times Union

Tots suffer as therapy cut
State reduces support for speech, other early intervention programs; eligibility rules changed

By CATHLEEN F. CROWLEY Staff writer
Published 12:01 a.m., Monday, June 6, 2011

ALBANY -- Alexzander Hayden spoke like any other toddler until a few months after his second birthday.

"Out of the blue, his speech started disappearing," said his mother, Hollie Hayden, who lives in Latham. "He would scream and throw a cup at the refrigerator instead of giving me the cup and telling me he wanted something to drink."

Alexzander was evaluated and qualified for "early intervention" services that helped him start talking again.

Therapists who treat infants and toddlers with speech, behavioral and physical problems say fewer children like Alexzander will get services due to state budget cuts.

Since 1993, the state has provided therapy to children from birth to age 3 who have developmental delays or physical disabilities. The idea is that early intervention can help children catch up to their peers before they reach kindergarten.

About 75,000 children, including 4,000 on the autism spectrum, receive services annually though the state's $700 million early intervention services.

But professionals who provide the therapy say children will be turned away because changes in eligibility rules, and the loss of therapists who are leaving the program because of the low pay.

The state cut a total of $23 million from the program in 2010 and 2011. Therapists saw a 10 percent pay cut in 2010 and a 5 percent cut this year, and are facing additional reductions this month. Therapists are paid less than they made in 1993, said Leslie Grubler, a speech therapists who founded United New York Early Prevention Providers, a 1,500-member group that represents agencies, therapists and providers.

The new payment rates released last week by the state Department of Health pay agencies in the Capital Region $62 for a home visit, but therapists -- who are usually subcontractors -- receive less than that. The payment includes mileage and travel time for a therapist to get to a client's house.

Grubler recently surveyed the therapists in her group about the impact of the cuts.

"Seventy-five percent said they would have no choice but to leave early intervention because they have to make a living, they have to pay their bills," she said.

A spokesman for DOH said the cuts to the program and restructuring of how agencies are paid will save money, encourage efficiency and incentivize therapists to spend more time with children because agencies will be paid by 15-minute increments rather than per visit.

Six programs have advised the state that they are eliminating their early intervention services, including agencies in Wyoming and Genesee counties, but the state has found other providers for the children, said Jeffrey R. Gordon, spokesman for the department.

"Our main concern is ensuring that there are enough therapists to provide services to the children who need it," Gordon said. "At this point, we've seen no impact on availability of services for children, and that's our No.1 priority."

In the Capital Region, Helping Hands in Clifton Park -- one of Saratoga County's largest providers -- is eliminating its early intervention services. Early Start in Ballston Spa is reducing the size of the team it sends to evaluate a child from three therapists to two.

"It will be a struggle to see if we can stay in business," said Kim Slocum, owner of Early Start, which she runs out of her home.

Slocum and other providers said many of groups affected by the cutbacks are small, women-owned businesses like hers. Her staff of four therapists conducts 350 child evaluations for Saratoga County each year.

Helping Hands' management decided to eliminate the program because of the impending cuts. The school will continue to treat children age 3 to 5 years old because the funding mechanism for those children is more stable.

"I think there will be more families looking for early intervention services than there are providers," said Patti Crisafulli, coordinator of early intervention at Helping Hands.

Both Crisafulli and Slocum believe that children who need services will end up being treated later, which may not be as effective.

"The earlier you begin, the better the outcomes," Crisafulli said. "For young children, the brain is very malleable. When you work with children at a younger age, you can make a great impression on the way they think and learn."

Therapists visited the Capitol on Wednesday to lobby legislators to restore their pay rates to the pre-2010 level.

Crisafulli said, "I think the cost to society is we are going to save money up front, but we're going to spend more in the end."

In Good Health

Matthew Hyland
President NYPTA

Elections

2011-06-07T06:29:00.002-04:00

Good Morning-
The results of Elections for National Office are official and as follows:

Treasurer: Elmer Platz

Speaker: Shawn Soper

Director (3 elected): Kathy Mairella, Jennifer Green Wilson, Dave Pariser

Nomminating Commitee (2 elected): Babette Sanders, Ben Braxley

We in the NY Chapter look forward to working with these individuals.

In Good Health

Matthew Hyland

President NYPTA

More Press

2011-06-07T06:27:00.003-04:00

The media from our Lobby Day continues to create very positive press for us. On May 22 the Albany Times Union Published a story regarding our copays issue. In response I wrote a letter to the editor to further clarify some of the issues. That letter was printed this past week. Please find the letter below.

In Good Health

Matthew Hyland
President NYPTA

The May 22 story, "Getting physical therapy co-pay cap in shape," highlights outrageously excessive insurance co-pays.

These co-pays have put necessary treatment out of reach for many New Yorkers who already are paying ever-increasing insurance premiums. A New York Physical Therapy Association poll found that 71 percent of New Yorkers would be more likely to receive all necessary physical therapy care if insurance co-pays were lower.

But the real problem is that high co-pays are limiting necessary physical therapy, resulting in unnecessary surgery. A 2008 Fritz study shows adherence to prescribed physical therapy lowers overall patient costs.

Most patients are paying nearly the entire cost of physical therapy treatment out-of-pocket and in some extreme cases are paying up to 150 percent. These are unfair "all-pays," not fair "co-pays."

That is why we support the Cahill/DeFrancisco bills that fairly limit the co-pay to 20 percent of the cost. It's a rare win-win for patients, taxpayers and the health care system.

MATTHEW R. HYLAND, PT, Ph.D

President

New York Physical Therapy Association

Greetings from the House of Delegates

2011-06-06T15:22:00.003-04:00

Hi all-
I had hoped to send daily updates regarding the ongoing activities at the House, but unfortunately there is very limited internet access, so I will go in lengthier spurts with more information. First let me assure you that your elected Delegates are working very hard to represent the membership in New York as well as advance the profession, you should be very proud of your colleagues who are here representing us.

Saturday night was a leadership reception with the opportunity to speak informally to other Chapter Presidents, Chief Delegates and elected officials. I was suprised at the National recognition of our copay bill and the interest from other Chapters. In addition I have been in discussions with other Northeast Presidents considering legal action against third party intermediaries who prevent access to needed care and who violate the newly passed "essential benefit" bill which requires insurers to cover the service of Physical Therapy. To me, when a copay is equal to or in excess of the maximum allowable, it is no longer a covered benefit and therefore violates "essential benefit." I will let you know more as these talks become more firm and a plan is developed.

Sunday I participated in the Leadership Developement workshop and rest assured topics such as high copays is high on the agenda of the APTA. Our governing body is going through a very exciting Governance Review process, as are we on the Chapter level, and are working hard to improve structure and process to create better outcomes. The board has also in their March meeting prioritized the Strategic Plan and 5 of the top 8 initiatives are payment and reimbursement based. Additionally, the APTA is working hard to develope a unique forward thinking alternative payment system for Physical Therapy services. Lastly the Medicare Direct Access pilot program in rural areas has the potential to change the landscape of access, quality and cost in the CMS system. I mention many of these initiatives so that you are aware of a few of the critical, exciting and innovative things our association is doing for us as members.

Tonight we hold elections for the offices of Treasurer, Speaker of the House, two spots on the Nominating Committee and 3 spots on the Board of Directors. There has been tremendous dialogue and rapid well thought out and negotiated changes to many of the motions we will be debating and voting on tomorrow and Wednesday. I will surely keep you abreast of the ongoing activities.

Thank you as always for your participation, your membership and your support

In Good Health

Matthew Hyland
President NYPTA

House of Delegates

2011-06-03T16:37:00.002-04:00

As I prepare to head off to the House of Delegates I have been contemplating "how are we doing." And superficially it is easy to be frustrated, reimbursement continues to decline, costs continue to escalate and from a political standpoint we have not seen any victories of late. But as I look deeper I see so much progress- we have gotten so much press out of Lobby Day this year it has been tremendous. Our bills have been gaining traction in Albany and are making progress. We were invited to a meeting with the Department of Health, Department of Insurance and representatives from the Governors office regarding medical malpractice: a meeting in the past we would never have been invited too. Membership is at an alltime high, participation is growing, and our voice is being heard. I am as optomistic as ever that major changes are on the way, and I am excited to be a part of it. I will keep you posted on house activities and hope to see some of you down at National Harbor.

In Good Health

Matthew Hyland
President NYPTA

More Media Coverage

2011-05-31T08:55:00.002-04:00

I hope everyone had a wonderful Memorial Day weekend. The media coverage of our Lobby Day continues to be very strong. Below is an article which was run last Sunday in the Albany Times Union.

In Good Health

Matthew Hyland
President NYPTA

Getting physical therapy co-pay cap in shape
Published 12:01 a.m., Sunday, May 22, 2011

Read more: http://www.timesunion.com/default/article/Getting-physical-therapy-co-pay-cap-in-shape-1390259.php#ixzz1Na0ocrV1

ALBANY -- Physical therapists are back at the State House trying to get legislation that would outlaw high co-pays. A legislative effort died in 2010 -- the bill never got to a vote -- but the therapists are trying again this year.

Matthew Hyland, president of the New York Physical Theraphy Association, called New York the birthplace of the $50 co-pay, a distinction of which he is not proud. In some areas of western New York, Hyland said the co-pay is higher than the actual cost of the therapy.

Physical therapists lobbied lawmakers Tuesday for legislation that would cap co-pays at 20 percent of the cost of the care. The association said the high co-pays make physical therapy unaffordable for some New Yorkers. The legislation to cap co-pay amounts is sponsored by Sen. John DeFrancisco, R-Syracuse, and Assemblyman Kevin A. Cahill, D-Kingston.

Co-pays for physical therapy have more than doubled in the past decade, said Thomas J. Flynn of Mercer Health & Benefits, a Rochester-based firm that counsels companies on insurance benefits. In the early 2000s, patients paid $5 to $10 a visit, but the average co-pay in New York is now $35. Physical therapy fees can add up because most patients go to therapy several times a week.

Insurance companies use co-pays to remind consumers of the financial cost of a service, but Hyland said the fees discourage people from going to physical therapy. Skipping physical therapy may lead to more health care costs because a patient may not fully recover from surgery or an injury.

Kentucky recently passed a cap on physical therapy co-pays that was based on the legislation introduced in New York, and Missouri is also considering a cap.

-- Cathleen F. Crowley

2011-05-21T06:59:00.002-04:00

Good Morning-
I am thrilled to announce that we have had tremendous media follow-up on our Lobby Day. Below you will find an AP story that was released yesterday. Despite the reporter angling two concepts a little off: "doctor ordered physical therapy" and "but its priced too high," the overall message is solid. We have been assured those two points will be corrected Monday.

The story has been picked up by at least 20 media sources so far from Seattle to Albany including CNBC, CBS, Newsday, Times Hearald Review and Albany Times Union just to name a few. As with any online story, readers have the right to comment on the story, and the comments from readers has largely been very pro PT!

Thank you again for all the efforts to keep our message on point

In Good Health

Matthew Hyland
President NYPTA

NY Physical Therapists Seek Break In Co-Pays
May 20, 2011 | Associated Press Print Free Newsletter
Copyright: (c) 2011 The Associated Press. All rights reserved.
Source: Associated Press
Wordcount: 93

ALBANY, N.Y. -- The New York Physical Therapy Association says the health insurance industry hasn't caught up with the explosion in doctor-ordered physical therapy.

The group now lobbying the Legislature says physical therapy can dramatically speed relief and recovery for patients, but it's priced too high.

The association says physical therapy still carries a co-pay of a medical specialty.

A normal course of physical therapy can be as much as $480 and keep many New Yorkers from getting the care.

The group has several bills with strong sponsors in the Senate and Assembly.

Lobby Day

2011-05-18T10:01:00.002-04:00

Hi all- Lobby Day was a huge success yesterday, we had almost 300 individuals representing the NYPTA. I had the opportunity to speak to over dozen media outlets: print, tv, radio to move our message. Please find below a message sent out by the Chair of our Advisory Panel on Legislation- I would like to echo his sentiments and thank him for al of his hard work as well.

In Good Health

Matthew Hyland
President NYPTA

WOW. What a great Lobby Day / 2011. We have had many one on one interactions with our legislators and there was tremendous feedback and positive response regarding our legislative issues. Many legislators were supportive of our bills.
NONE of this would have been possible without the efforts of the legislative Liaisons, office staff and most importantly - participants.
I can't thank you enough and I can't express, in words alone, how energizing the event was.
We also had a significant amount of Press release as well as several PT's and NYPTA leadership were interviewed by the press.
Kelly, Leslie, Pam, Bibiana and Linda - outstanding job as always.
Doreen - thanks for the webinar.
Lori Monson - Thank you for the talking points.
Jeff and Dimitri - Thank you for the leadership.
Brian - great to have your input and insight through the years.
Debra - what a great gathering of PTA students to help in advocacy.
Last but certainly not least - Matt Hyland - We certainly appreciate the terrific leadership and energy you bring to the association. You are a great role model for emerging leaders in the field.
I am certainly forgetting many more people involved but the point is that all of these contributions, and many more, helped in making Lobby Day 2011 as successful as we envisioned.
Looking forward to 2012 - BUT, BUT, BUT - Please stay tuned for Lobby Day follow ups once we digest the event and review our feedback forms. There is more fun to be had between now and then - locally.
Best to all,

Mark Amir, PT, DPT, DipMDT

Response to high high copay letter

2011-05-16T16:41:00.002-04:00

Please find on the nypta.org homepage a link to the response NYPTA received from APTA regarding our high copay concerns. Hope to see you tomorrow at lobby day.

In Good Health

Matthew Hyland
President NYPTA

One more bill

2011-05-14T07:53:00.002-04:00

I apologize, I fogot to include the information on the Workers Compensation fee increase bill:

This is the bill that we passed through both the Senate and the Assembly last year, a feat to be sure, but was unfortunately vetoed by the then Governor Patterson.

Workers Compensation A7356 Canestrari/ S5090 Griffo
Require WC Chair Review Fee schedule Biannually

Assembly bill and memo of supportThe other workers comp bill is to require the WC chairperson review the fee schedule every 2 years - the fees have not been changed since 1996 - 15 years.

In Good Health

Matthew Hyland
President NYPTA

Lobby Day Bill Information

2011-05-12T09:43:00.000-04:00

Below you will find our bill information for Lobby Day- I hope to see many of you there.

NYPTA 2011 Legislative Issues

High Co-Pays(Assembly BillA0187 Sponsor/Cahill, Senate Bill 4870/DeFrancisco)(now in Insurance Committee)
High co-pays and the treatment of practicing therapists as “specialists” has a significant impact on access to needed physical therapy. A patient with a high co-pay must pay a disproportionate share of the cost- as much as 95% of the total fee for service. Patients must spend as much as $600 for one month of PT while their insurer is responsible for only $24-$120 of the monthly cost.
NYPTA seeks passage of legislation to limit co-payments to no more than 20 percent of the reimbursement paid to the physical therapist.

Workers Compensation (Assembly Bill A7308/Canestrari, Senate Bill S5005/Griffo) (now in Labor Committee)
NYPTA seeks passage of legislation that brings Worker’s Compensation laws up to date with New York’s physical therapy practice laws. The legislation allows WC payment for PT services provided by a licensed Physical Therapy Assistant.

Increase Educational Requirements (A2502/Canestrari, S3469/Oppenheimer)
NYPTA seeks legislation to raise the educational requirements for licensure toan advanced post-baccalaureate degree. Currently, New York is one of the few if not the only state that requires only a baccalaureate degree. Baccalaureate degrees are no longer offered in physical therapy schools.

Early Intervention Cuts and Corporate Practice of the Profession for Purposes of EI
NYPTA is opposed to the State’s enacted cuts and limitations to the early intervention program.
Additionally,NYPTA will continue to oppose attempts to allow for the corporate practice of the profession. For-profit business corporation providers of early intervention services have sought the passage of legislation which would allow their practice of the profession for purposes of early intervention services, threatening the survival of independent physical therapy practitioners.

In Good Health

Matthew Hyland
President NYPTA

Lobby Day

2011-05-10T09:42:00.002-04:00

Good Morning all-

Lobby Day is fast approaching- it is next Tuesday May 17th! To date we have 226 people registered, an impressive number to be sure, however last year we set a record with almost 400. I challenge each and every one of you to try to carve the day out and join your colleagues and leadership in Alban to make a difference.

I look forward to seeing you all there.

In Good Health

Matthew Hyland
President NYPTA

Happy Mothers Day

2011-05-08T15:20:00.003-04:00

To all of the Mothers in our membership and staff-
We have such a wonderful profession- while we hold dear to our core documents, are proud of our History and strive to embrace the changing health care environment, enduring traits that are the heart of what we do are nurture, encourage and support our patients. Wonderful attributes to be sure- happy Mothers Day to all of you- thank you for all you do for our profession.

While I take this blog very seriously and try to keep it very professional, I would like to take a moment and wish a special Happy Mothers Day to my Mother Kathie, while not a PT I know she follows this blog regularly. I love you Mom- thank you for your unwaivering support.

In Good Health

Matthew Hyland
President NYPTA

Awards

2011-05-07T10:23:00.002-04:00

I would like to congratulate all those who received awards last weekend at the Delegate Assembly:

DR. MARILYN MOFFAT DISTINGUISHED SERVICE AWARD- Dr. Stacey Zeigler.

OUTSTANDING SERVICE TO DISTRICT
Jeremy Crow, Greater New York District
Colleen Lamb, Long Island District
Theresa Kolodziej, Western District

Certificates of Appreciation
CHAPTER DIRECTORS
Jennifer Bunao, Southern Tier
Jill Dungey, Central
Robert Fleming, Eastern
Corey Simon, Western

DISTRICT CHAIRS
Steve Young, Central Co-Chair

COMMITTEES
Colleen Backus, Leadership
Sherry Backus, Research Co-Chair
Jennifer Bunao, Judicial & Practice
Robert Byrnes, Nominating
Peter Droste, Federal Affairs Liaison
Cathy Hil,l Advisory Panel on Reimbursement
Christine McNamara, Program
Scott Minor, Research Co-Chair
Alice Pena, Finance

TASK FORCE ON SIG GOVERNANCE
Jill Dungey
Melanie Gillar
Jeff Hathaway
Gary Krasilovsky
Jake McPherson
William O'Keefe

Thank you to each and everyone for your committed service to the Association

In Good Health

Matthew Hyland
President NYPTA

Elections

2011-04-30T15:59:00.002-04:00

I would like to congratulate Scott Minor (Treasurer), Jeremy Crow (Secretary), Lynn Rivers (Chief Delegate)on their reelections and Stacey Ziegler (Nominating Committee) on election as officers to the NYPTA today at the Delegate Assembly.

In Good Health

Matthew Hyland
President NYPTA

2011-04-30T08:48:00.003-04:00

Good Morning-
It is a very busy weekend here for our Chapter. On Thursday our Executive Committee met to discuss ongoing activities of the Chapter. While many issues were discussed at the forfront was Leadership, Mentorship, Lobbying, Public Relations and the use of Technology in the Chapter. Thursday night and Friday was the NYPTA Board Meeting-issues discussed included Chapter Bylaws, Budgeting, Social Media, Lobby Day and year round advocacy.

Today is a very busy day- as I write the 2011 Delegate Assembly (DA) is underway. The Delegate Assembly which, as you know, has the power to determine Chapter policies, including amending and repealing bylaws, approved changes in the bylaws to the roles and responsibilities of the offices. We Look forward to a full day of Governance for our Chapter to continue to meet the needs of the Chapter. Below is the State of the Chapter Address which I just presented to the DA.

In Good Health

Matthew Hyland
President NYPTA

STATE OF THE CHAPTER
2011
APRIL 30, 2011

Before getting started on behalf of the Chapter and the entire Delegate Assembly I would like to welcome Dianne Jewell here today. Dianne is our APTA Board Liaison and has been a key supporter of ours and point person for communication between the Chapter and National.

Also, Leslie and the entire staff thank everyone for getting your annual reports in on time. I am told this is the first time in 18 years this has happened. And I know that if you can do the same for your budgets Scott and the entire finance committee would be thrilled.

It is hard to believe that a year has passed since last year’s Delegate Assembly- no matter how prepared one thinks they may be for a new challenge- I am not sure I could have ever realized or been prepared for how amazing the opportunity to serve this Chapter as President could ever be. After bumbling my way through my oath of office last year- the responsibilities ahead hit immediately. When the new executive committee sat down together at the close of last year’s DA we outlined a general plan for what we hoped to accomplish and tasks that needed immediate attention.

At the top of that list- with the election of Jenny Collins to Vice President was to appoint a Secretary. We sought out names from many individuals and created an extensive and solid list of candidates. We discussed each at length in the subsequent weeks and narrowed the list to a handful. It was important to us that we find an individual with a fresh perspective, one who could help reach the newer generation of incoming new graduates, who was capable of not being overwhelmed by the responsibility, was comfortable speaking their mind but at the same time support decisions and someone whose passion for the profession and Chapter would only grow with this opportunity. With that in mind we narrowed our list to three and interviewed them. And while I have no doubts that all three would have served this Chapter passionately- I could not be more thrilled than with the dedication and professionalism that Dr. Jeremy Crowe has served us.

Also discussed at that first meeting was a need to become more present as a board and an executive committee. To give the Chapter a face so to speak, to tear down improperly perceived barriers from the grassroots toward leadership- to try to answer the question “what does the NYPTA do for me.”
I said publically that I intended on visiting each District and as many of our educational institutions as possible in the first 18 months of office- and I am proud to say that I have been to seven of our districts, 9 educational institutions, and attended meetings of both the Academic Administrators SIG and AIPT discussing the activities of our Chapter, our new Strategic Plan and the need for participation.

During these travels I am moved and encouraged by the level of participation by membership as well as the many new faces that have shown a willingness to serve and become involved. When reading district reports and talking to Chairs and Directors I understand the frustration of holding business meetings with only 4-8 people in attendance. But at the same time, membership is at an all-time high, last year’s lobby day had record attendance and Chapter and District CE events have been tremendously well attended. Maybe we just need to refocus as to what TODAYS benchmark of success should be in our Chapter.

Mandatory Continuing Education, while only about 20 months into inception has created many opportunities for the Chapter. Many Districts are using Man Con Ed as a vehicle to increase participation in meetings as well as providing a wonderful member benefit. One of the discussed initiatives is that if a member were to take their 36 CE Hours through the Chapter and Districts, that the savings versus a non-member or versus the significantly higher cost with an outside vendor that their membership would almost pay for itself. We are not there yet, but it is possible. The Program Committee lead by chair JJ Mowder has worked very hard to arrange for high level programming at Chapter events, specifically our Chapter Conference, which will be help this year in Rye Brook October 27, 28- and I encourage each and every one of you to attend- I also know that they are also working very hard already for the 2012 conference in Rochester.

We have also made great strides in upgrading our IT capabilities. Based on the recommendations of our Communications Director, Bibiana Braun, the Executive Committee approved a proposal to purchase new software for the Chapter’s website to provide for enhanced website capabilities and more robust electronic communications and support, including video-conferencing and CEH tracking. A website redesign task force was created to oversee the development and implementation of the new website, which we anticipate launching this coming July. Please go to the website frequently for all Chapter updates.

Other new Technology initiatives has been social media- we now use twitter, facebook and have a Presidents blog- and with any technology there is potential negative undesirable consequences- but with the hard work of our Media Director and the PR committee (Tracy Sawyer, Jennifer Zaleskie and Nate Moser) our tweeting remains current, with the help of Dave Sofer our facebook is professional and reflective of the message we are trying to send and I continue in the effort to produce a meaningful message on the Presidents Blog.

Other successes over that past year include our Directors Liaison initiative, Directors intern program and new budgeting plan. The Directors Liaison initiative was created to give committee’s more voice and representation at each Board meeting. A Chapter Director, who is a voting member of the Board, has been assigned to each Committee. Directors were asked to rank which Committee they were most interested in representing and the Staff and EC paired them to best meet the desires of the Directors. This helps assure that Committees have more Board and EC information for their conference calls and electronic dialogue as well as a represented voice at Board Meetings which they may not be funded or are unable to attend.

The Directors Intern Program is a very exciting new initiative which is presently a Pilot Program cosponsored by the Chapter and the AASIG. The program allows each academic PT and PTA program in the state- 32 in all- to send one student, fully funded to attend a Chapter Board Meeting. The student is paired with a Board Member Mentor and along with their mentor receives materials in advance, attends discussion group and is able to contribute to the Board meeting. Upon completion of the meeting the student is asked to complete a survey regarding their experience. To date we had 16 students come through the program and we hope this initiative is one that other Chapters consider in some form moving forward to help foster leadership and participation by our student members as they transition into our great profession. In addition I would like to welcome Jessica Thomas who is here today. Jessica, a University of Buffalo student, and is our Chapters Student Ambassador to the National Student Assembly- welcome Jessica (clap).

In 2010 the Finance Committee underwent a new budget process in order to more likely assure a balanced budget for the upcoming year, and also to ensure that the Chapter is funding activities that are consistent with the new Strategic Plan. In 2011 and moving forward Budget managers are required to submit a budget for their Districts or Committees with a plan for the upcoming year of how they will use that money AND in what way that plan helps achieve the Strategic Plan. This new process will allow the EC, the Board and the Finance Committee to more appropriately track dollars being spent and assure members money is being used in the best way possible to advance the Chapter.

We have launched a new year round advocacy plan which is kicking off immediately- part of this plan includes the hiring of Empire Public Relations to help us advance our goals. As we enter a new two year legislative cycle with a new Governor, new Attorney General and many new Legislators- it is critical that we make new friends and get our message through clearly and succinctly. At the forefront of this year’s legislative plan are the high copays bill, PTA’s being reimbursed under WC, a WC mandatory fee increase and an education bill.

While the landscape of NYS government is unstable to say the least in the face of a 10 billion dollar deficit, we will continue to work hard to make meaningful change to improve the landscape of practice and prevent infringement or negative influence upon us. As an example of this the NYPTA in conjunction with many allies was able to minimize the drastic negative proposed cuts and arbitrary caps in EI and Medicaid programs. We played a role in getting the projected 10% EI cut reduced to 5% and the 20 visit coupled PT/OT/ST cap under Medicaid separated to each service and not including children with developmental disabilities. Not fully the outcomes we had hoped, but meaningful change to say the least.

We continue to work very hard to improve the landscape of care under workers compensation. The changes that were implemented in 2010 dramatically limit access to our services and the quality of care provided. These issues were identified by Jim Dunleavy, Kathy Anastasiou, APOR and the EC over two years ago. Despite our recommendations at the time, the WC board implemented these new guidelines and many of the foreseen issues are coming to fruition. The downside is that the guidelines remain in place to date and there has been little change. The good news is that we have had numerous formal meetings with the Board over the past year and our concerns are being heard. In addition we have formed an alliance counsel that includes The chapter, our special interest group AIPT, PTAUNY and the Counsel of Phyisotherapy to proactively work together to form one message and one voice. As a group we have also had multiple meetings with the Board and are working to improve access, change the variance process, increase reimbursement and alter the guidelines to move from a cookbook approach to a proactive evidence based model that represents good physical therapy.

Just prior to leaving for Albany this week I was notified by the APTA that National Government Service has ruled in favor of not changing the longstanding policy of PT's getting reimbursed for EMG testing.

The APTA will be issuing a formal statement in the upcoming weeks- However, I wanted to let you know the good news since this is a day of victory for our profession- in collaboration with the APTA, the Section for Clinical Electrophysiology, NYPTA Leadership, AIPT and all of you we were able to organize and prevent further restrictions and limited access on our ability to practice and to our patients.

This victory sets an example on how we can work together to achieve great success.

We have had a very busy year to say the least- We continue to undergo a governance review process on a Chapter Level concomitant with National, work closely with our State Board in areas of practice and continuing education, strive to improve mentorship and create a streamlined, approachable, exciting Chapter that is a model for Governance. I would like to thank the Chapter Staff, the EC- our outgoing member at large Kathy Birnbaum, our incoming member at large Joel Van Slyke- who also just received the APTA emerging leader award yesterda, the Board and you the DA for all you have done to make our profession and especially this Chapter so great. We have much to do, but I believe we have a great team to get the job done.

Thank you-

High Copays Bill

2011-04-28T09:00:00.002-04:00

Good Morning-
Good news out of Albany yesterday- our High Copays Bill has been introduced in the Senate. Our bill is still in the Assembly, but with a change in the majority in the Senate we wanted to have it reintroduced by a Republican. Information is below. Be aware we will be slightly changing the language from 20% to "that of an office visit." Keep an eye out for more information as we get closer to Lobby Day.

Bill Information:

S 4870 DEFRANCISCO Same as A 187 Cahill (MS)

TITLE....No policy of group accident, group health or group accident and health shall impose copayments in excess of 20 percent of total reimbursement to the provider of care

04/27/11 REFERRED TO INSURANCE

A187 Cahill (MS) Same as S 4870 DEFRANCISCO

TITLE....No policy of group accident, group health or group accident and health shall impose copayments in excess of 20 percent of total reimbursement to the provider of care

01/05/11 referred to insurance

In Good Health

Matthew Hyland
President NYPTA

NGS RULES ON THE PROFESSIONAL COMPONENT FOR PTs PERFORMING EMGs

2011-04-26T11:49:00.003-04:00

I have been notified by the APTA that NGS has ruled in favor of not changing the longstanding policy of PT's getting reimbursed for both the PC and TC of the testing. NGS plans to put out a revised policy at the beginning of May.

I anticipate the APTA will be issuing a formal statement in the upcoming weeks- However, I wanted to let you know the good news since in the past I asked you to take action to stop the detrimental proposed change.

This is a day of victory for our profession- I would like to personally thank APTA, the Section for Clinical Electrophysiology, ACE, NYPTA, our legal consultant specialists and all of you for stepping up, getting organized and making this happen.

This victory sets an example on how we can work together to achieve great success.

In Good Health

Matthew Hyland
President NYPTA

Thank you's

2011-04-26T07:45:00.002-04:00

I would like to take a moment and than Dr. Pagliarulo's Current Issues class at Ithaca College for inviting me to participate in their discussion two weeks age about Vision 2020- the students were prepared and engaged.

I would also like to thank the Faculty and students at New York Medical College for inviting me to give the Keynote Address at their research day. I was tremendously impressed with the level of research and dedication.

With the future of physical therapy resting in the hands of students such as those that I have spent time with in the past few months. I have no doubt things are looking bright.

In Good Health

Matthew Hyland
President NYPTA

From APTA

2011-04-20T12:52:00.001-04:00

The following was sent from APTA home office:

1099 Repeal Signed into Law

On April 14, 2011 President Obama signed the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011 (H.R. 4) into law. The act repeals the IRS Form 1099 reporting requirement that was set to go into place in 2012. Enacted as part of the Patient Protection and Affordable Care Act passed by Congress in March 2010, the Form 1099 requirements would have forced all businesses to issue a Form 1099 to vendors from whom they buy goods totaling $600 or more annually.

APTA advocated for the repeal of the 1099 requirement and was quoted by the House Ways and Means Committee on the effect the requirement would have on physical therapy practitioners and business owners.

On April 5, the Senate voted 87 to 12 to repeal the requirement. The House adopted the measure on February 2 by a vote of 314 to 112.

In Good Health

Matthew Hyland
President NYPTA

Albany Blog Posting

2011-04-13T13:54:00.000-04:00

Top Silver Aide Fuleihan Departing

Dean Fuleihan, a 33-year veteran of the Assembly who has served as Sheldon Silver’s right-hand man – if not an outright extension of his brain – for the entire duration of his speakership (which started in 1994), is departing his post at the end of the month, multiple sources confirm.

A formal announcement will be made by the speaker at the Assembly Democrats’ closed-door conference later today. Fuleihan is not leaving for another job. But he’s also not retiring and is considering a number of options, I’m told.

He’ll likely keep his hand in government, but is not yet sure about his next move.

Silver will also be announcing internal shuffling to fill the considerable gap that Fuleihan will leave behind. The new team – and there will be more than one person stepping up to take over Fuleihan’s duties – will include the elevation of Matt Howard, who has helped Fuleihan with budget negotiations over the past decade.

I can’t really overstate the significance of this. The news will undoubtedly send shockwaves through the Capitol. (Actually, that has already started as word of Fuleihan’s imminent last day is starting to leak out).

For as long as I have covered Albany, there was Dean and there was Shelly. The concept of the Assembly majority without Fuleihan is going to take some getting used to.

Fuleihan started working for the Assembly back in 1978 under then-Speaker Stanley Steingut. Fueled on endless cups of coffee and the ability to function at high levels on very little sleep, he has been the Assembly Democrats’ point man in every budget negotiation I can remember, and I’ve been covering the Capitol on and off since about 2000.

Fuleihan has remained a constant in Silver’s inner circle even as other high-profile members departed (Pat Lynch, communications director) or were felled by scandal (Michael Boxley, counsel). But he has been talking about leaving for several years – at least since the 2008 elections when Silver faced – and handily won – his first primary challenges in two decades.

Silver and Fuleihan have been quietly laying the groundwork for this for some time now, insiders say. That’s part of the reason why the speaker brought in former state Supreme Court Justice Jim Yates (who was appointed a Court of Claims Judge by then-Gov. Mario Cuomo in 1992) to serve as his counsel at the start of this year.

Fuleihan agreed to stay on through this budget battle to help the speaker navigate the twin challenges of a fiscal crisis and an uber-aggressive new governor. Now that the budget has been passed – on-time for the first time in five years – he has held up his end of the bargain.

This departure will undoubtedly reignite speculation about Silver’s own tenure. He is longest-serving member of the Capitol’s power trio, although he has not yet hit the longest-serving speaker in history mark.

Sources insist Silver will not be following Fuleihan out the door any time soon, despite the fact that he appears to have lost some clout in the Cuomo Capitol. Silver loyalists remind anyone who suggests the speaker’s time in power might be winding down that he is waiting game master. Further complicating matters is the fact that he has no clear successor.

Letter to APTA

2011-04-13T13:43:00.003-04:00

I recently sent a letter (below) to APTA President Scott Ward, CEO John Barnes and the entire Board of Directors. I am pleased to say that they were very supportive and today Kelly Garceau (NYPTA Reimbursement Coordinator) and I had a conference call with members of the APTA office including Justin Elliott (Direcor of State Government Affairs), Angela Chasteen (Associate Director of State Government Affairs and Carmen Elliott (Director, Payment Initiatives)to discuss the letter and our concerns. They assured us that the APTA is aware of the copay issues that are becoming a National crisis and that an action pack is being created and should be available by years end. In addition Virginia has made a motion for this years House of Delegates directing the APTA to develope further initiates to help address this growing problem. We have been assured that we will receive a letter in writing from the APTA in the upcoming weeks, and when it arrives I will share it with you.

In Good Health

Matthew Hyland
President NYPTA

Scott and John,

I would like to thank you for the exciting programming at CSM- while my energy level typically runs quite high, I am always even more excited every time I leave a National event with my Colleagues. I am also very impressed at the wonderful job the Staff and the Board does with the many volunteer leaders in keeping our organization and profession so strong.

I am writing to you both to verbalize a growing concern that started initially here in our Chapter but seems to be spreading aggressively across the Country based on conversations at the Presidents Meetings. As you know two years back the NYPTA introduced a high copay bill to our legislature here in NY. The driving issue which stimulated this move was the dramatic cost shifting from the carriers to the patients. As you are aware NY is one of the lowest reimbursed States in the US for physical therapy services. This in large part is due to the fact that we are one of the lowest if not the lowest reimbursed Workers Comp States. This has allowed the commercial insurers to come into our State and set their rates within percentages of WC and justify it. This has created significant issues unto itself in our Chapter- but over the past few years there has been a growing trend to lump physical therapists into the “specialist” copay category.

As a profession we strive to be recognized as specialists, leaders in the Neuromusculoskeletal arena; but by categorizing us as such in the copay is not intent the term specialist. The specialist copay was originally meant to be an all-encompassing one-time payment to a professional for a course of care. If someone went to the orthopedist, they are charged the specialists copay the first consult, but any additional follow-ups do not have any copay. Same thing with Obstetrics, the mother sees her doctor during the pregnancy and is charged the specialist copay for the first visit, but then subsequent visits do not have a co-pay. What insurance carriers here in NY have done is categorize us as specialists, although not reimburse us as such, and then charge the patient the specialist co-pay each and every visit.

The copay issue here in NY has genuinely gotten out of hand to the point it is greatly limiting access to care. It is now the norm not the exception that copays account for 60-90% of the maximum allowable on a visit. In fact we have many instances where the copay is $50 on a $55 maximum allowable- meaning the patient is paying $50 per visit while the insurer is only picking up $5 per visit. Ironically the insurer still regulates he visits by requiring certain paperwork to be filled out to obtain authorization for the additional $5. The greatest injustice here is that we have identified one carrier whose copay is actually in excess of the maximum allowable charge for the visit, meaning the PT is breaking the law no matter how they bill the patient. If they accept the copay in full then they have charged more then the maximum allowable, and if they accept only the maximum allowable, they have waived part of the copay.

These are the issues we have been facing here in NY- and which lead to us introducing our high copay bill two years ago. Jim Dunleavy made a presentation at the 2010 State Government Affairs Forum in Portland about our bill. After conversations in New Orleans with other Chapter Presidents I now recognizing that the trend that started here in NY is becoming an issue across the Nation. I am aware that Kentucky, Missouri and Ohio have either introduced or about to introduce copay legislation in their own states. I am writing to you to ask that the APTA begin to assess the issue on a more National scale and gather information as to which Chapters are looking to introduce legislation. I am also wondering if whether in your conversations with the Wellpoints and United Healthcares you have addressed the impact that hi co-pays and specialist category assignment for PT has adversely affected access; and in some instances not providing any coverage or an illusionary benefit for which the subscriber though they had purchased coverage.

I thank you for all the hard work and time you give to our Association and Profession and I look forward to hearing from you.

In Good Health

Matthew Hyland, PT, PhD, MPA, CSCS
President
New York Physical Therapy Association

Senate Passes 1099 Repeal

2011-04-12T08:18:00.001-04:00

From APTA:

The Senate voted 87-12 to repeal a much-hated tax provision in the health care law on Tuesday, which required businesses to file 1099 tax forms for purchases over $600. APTA advocated for the repeal of the 1099 requirement and was quoted by the House Ways and Means Committee on the effect the requirement would have on physical therapy practitioners and business owners.

Democrats and Republicans agreed the requirement would be too burdensome for businesses but it took nearly 10 months for them to agree on the pay for to cover the $22 billion cost of repealing 1099.

Next Steps: The bill will now be sent to President Obama for signature. The president does not like how Congress covered the cost of the 1099 repeal, but he has not threatened to veto the bill.

In Good Health

Matthew Hyland
President NYPTA

EI and Medicaid Letters to Legislators

2011-04-06T11:29:00.002-04:00

I would like to thank all of you who took the time to open the blast email and click the link to forward letters to your legislators regarding the Medicaid and EI issues.
To date membership has forwarded 602 letters regarding Medicaid and 663 letters regarding Early Intervention. Thank you for your participation and advocacy efforts.

In Good Health

Matthew Hyland
President NYPTA

Scope of practice and CEH's

2011-04-05T14:41:00.002-04:00

I received an email today from a member asking about licensed professionals taking continuing education in topic areas outside of their scope of practice. I forwarded the email to the State Board and here is the response- found it interesting and thought I would share it.

Response:New York State licensed occupational therapists are not required to take continuing education, so there are no approved (or disapproved) courses for them and no regulation.

Physical therapists often take courses that are outside the scope of practice - dry needling being one of them. They will not count toward the mandatory CE necessary for registration, but there is nothing that prohibits a PT from taking these courses as long as they are not practicing dry needling when taking the course (or after taking the course).

Many of the continuing education providers are national organizations that provide CE to New York and many other states. While certain functions may not be within the scope of practitioners in New York, they may be in other states. We have no authority to regulate or control who takes these courses unless there is a continuing education requirement for that profession.

Claudia

In Good Health

Matthew Hyland

President NYPTA

Long Island

2011-04-04T10:03:00.002-04:00

I had the pleasure of visiting the Long Island District yesterday during their Spring Mini-Conference. It was a wonderful day of programming and fellowship with over 70 participants. Included in the day was a 30 minute business meeting to discuss District activities, Lobby Day and Chapter initiatives. Thank you to District Leadership including Colleen and Bill for inviting me to join you.

In Good Health

Matthew Hyland
President NYPTA

EI

2011-03-31T10:40:00.002-04:00

Sometimes when things happen it is difficult to determine whether it should be viewed as a victory or defeat. That is how I am feeling right now regarding the EI cuts that are going into effect tomorrow April 1, 2011. The proposed cuts were 10%, and the NYPTA in association with other allies fought bitterly and aggressively to prevent those cuts from happening. Our voice and our arguements were heard and change was made to a 5% cut. While this is much better then the proposed 10%, it is still disappointing and another example of Legislators impacting quality and access to care with arbitrary cuts. I am happy that we were able to impact change with our Lobbying, but disappointed it did not result in no cuts. Below is the language in the bill that was passed today.

49 § 4. Notwithstanding any contrary provision of law, rates established
50 pursuant to section 69-4.30 of Title 10 of the New York Codes, Rules and
51 Regulations for approved services rendered on and after April 1, 2011
52 shall be reduced by five percent.

In Good Health

Matthew Hyland
President NYPTA

Medicaid

2011-03-28T12:12:00.002-04:00

The following is an excerpt written by Claudia Alexander from the State Board of Physical Therapy. The entire article will be posted in the next Empire State Newsletter. Please be assured the NYPTA in collaboration with the APTA and the NYS Board of Physical therapy are working very hard to get this interpretation changed.

“CMS would expect providers to be graduates of physical therapy programs accredited by CAPTE (Commission on Accreditation in Physical Therapy Education) and if applicable, licensed by the State. Equivalency rulings are not valid for physical therapist qualifications."

This interpretation has left almost all of the foreign educated physical therapists licensed in New York State unable to provide treatment and be reimbursed by Medicaid. There are only three foreign programs accredited by CAPTE, one in Scotland and two in Canada. This leaves the vast majority of the foreign educated New York State licensed physical therapists unqualified.

Subsequently, the Department of Health wrote again to CMS in October 2010 and the American Physical Therapy Association (APTA) wrote in November 2010 to urge a change in interpretation. So far, there has not been a response.

While we have been working with the Department of Health to encourage a chance in interpretation, none has been forthcoming. As a matter of fact, CMS has not responded to recent requests. The result is that many physical therapists have lost their jobs because they cannot bill for Medicaid services.

In Good Health

Matthew Hyland
President NYPTA

Letter to the Editor of NY Times

2011-03-28T12:11:00.001-04:00

To the Editor:

RE "Medicaid and the N.Y. Budget: Sensible Cuts, and Little Political Flak" (editorial, March 12):

Sensible Medicaid reforms and cost-savings initiatives are critical to health care reform but not at the expense of access to quality care. We agree with your editorial that the narrowly tailored reduction to limit physical, occupational and speech therapy visits to 20 in a 12-month period is far too limiting in most cases, not just for those badly injured or disabled.

We also agree that increased Medicaid co-pays for physical therapy will discourage people from seeking necessary care. In fact, out-of-control co-pays for all physical therapy visits, which often exceed the reimbursement rate, have already done just that.
Finally, we agree that all health care patient advocates need a stronger voice at both the Medicaid and health care reform tables. We will continue lending our voice to improving the standard of health for people of all ages and advancing the benefits of physical therapy and the interests of physical therapy professionals throughout New York State.

Matthew R. Hyland, PT, PhD, MPA, CSCS
President
New York Physical Therapy Association

Medicaid and EI updates

2011-03-25T07:11:00.002-04:00

With regard to the proposed Medicaid cuts the Assembly is working to modify the therapy cap and I believe it will be modified to allow a prior authorization for visits in excess of 20 and it will exempt a host of additional populations. While not ideal, it is a significant improvement from the proposed system.

The EI rate cut is still in the mix and both houses are working to reject it but I’m less optimistic that we’ll get a modification- but we will continue to work hard to do such.

In Good Health

Matthew Hyland
President NYPTA

Updates

2011-03-24T11:12:00.002-04:00

I hope everyone is enjoying the beginnings of Spring, here in Valhalla we have celebrated with two days of snow. I have been receiving many emails from members over the past two weeks regarding the critical Medicaid issues and EI issues, these coupled with the WC issues create busy times. Be assured we are working hard on all three fronts. You should have received this week a blast email with direct links to your legislators to oppose both the EI and Medicaid status quo. It is critical that you take the two minutes to read the email and click the two links. This little effort will go a long way in making needed change. In addition I sent a letter to the editor of the NY Times in response to last weeks article on the Governors Medicaid proposed cuts. Lastly I had a meeting last week with the WC Board to highlight three concerns: reimbursement, the variance process and the lack of evidence in the new guidelines.

Myself, the Board and Chapter office will continue to work tirelessly to make change, we need you help though: keep the emails coming and be active. Read the email blasts, read the hotpoints, check the blog regularly, and go to the homepage. We need to stay informed to make change.

In Good Health

Matthew Hyland
President NYPTA

EI

2011-03-16T15:07:00.002-04:00

It has been a very busy week in the Chapter. Our EI task force had a meeting yesterday with the DOH in conjunction with one of our allies the OTA. While I await a full report you can find letters that the Chapter has generated in last Mondays Hotpoints. The letters will also be posted on the homepage in the next week.

In Good Health

Matthew Hyland
President NYPTA

Lobby Day Continued

2011-03-16T15:04:00.002-04:00

After day long meetings with the State Board, our Public Relations Firm and Lobbiest we are refining our Lobby Day Agenda to potentially include legislation to dramatically alter the Workers Compensation Variance process. Stay tuned for more information.

In Good Health

Matthew Hyland
President NYPTA

Small Victories

2011-03-15T15:29:00.002-04:00

In October 2010 The State Board for Physical Therapy made a determination that CPR is not considered continuing education and therefore no CEH's toward licensure renewal attained. The NYPTA sent letters of opposition to this ruling and asked that the Board reconsider. I am happy to announce that the Board has changed their position on CPR and will award 2 credits per licensure cycle for anyone who completes a American Heart Association or Red Cross Certification that includes AED instruction. We are pleased that the Board heard our concerns and reassessed their position.

In Good Health

Matthew Hyland
President NYPTA

Lobby Day

2011-03-12T15:42:00.003-05:00

We have had multiple meetings in the past few weeks regarding Lobby Day. The NYPTA intends on introducing bills to allow Direct Access under Workers Compensation, allow PTA's to treat under Workers Compensation, reintroduce our high copay bill, support our quality assurance bill, and introduce an education bill. In addition we are working with the State Board to have Dry Needling and suture removal allowed under our practice act. Finally we intend on assessing the idea of Faculty practice and may introduce a bill later this year on the topic. Please keep an eye out for future information and please make every effort to attend Lobby Day.

In good health

Matthew Hyland
President NYPTA

Future Of Physical Therapy Symposium

2011-03-12T15:37:00.003-05:00

I had the distinct opportunity to attend a very forward thinking, innovative symposium last weekend in Atlanta Georgia with other leaders in our Profession. Practitioners, Educators, Administrators, Elected Officials and more gathered to exchange thoughts and ideas of where we need to be moving forward in healthcare reform. Morning programming consisted of presentations and the afternoon small group breakout sessions. Many of our concerns here in NY are not unique and with allies in other states, and innovative leadership, in time I have no doubt that we will continue to become a stronger force in the healthcare team for our patients, and in Washington as well Politically.

I look forward to coninuing to serve you and thank you all for you efforts in helping our Profession to "Mover Forward."

In Good Health

Matthew Hyland
President NYPTA

Copays and State Board

2011-03-03T17:07:00.002-05:00

The State Board of Physical Therapy will be meeting tomorrow and agenda items include mandatory continuing education- what counts toward CE hours. Additionally, I sent a letter today to John Barnes, Scott Ward and the entire APTA Board of Directors outlining our concerns about high copays. The letter will be posted early next week to the webpage. I am off to Atlanta to the "Exploring the Future of Physical Therapy Symposium" I look forward to keeping you up to date.

In Good Health

Matthew Hyland
President NYPTA

Workers Comp

2011-03-02T11:14:00.002-05:00

We have submitted our fourth workers compensation case study for approval from the WC Board. We have also recieved approval from the Program Committee to offer CE in the area of Workers Compensation with the case studies- more information to follow on this.

In Good Health

Matthew Hyland
NYPTA President

Case Studies

2011-02-25T11:10:00.002-05:00

The NYPTA has submitted 3 case studies to the workers compensation board to be used for training purposes in interpreting the new guidelines. As we are now in month 3 of the guidelines the NYPTA continues to work hard to make meaningful change.

In Good Health

Matthew Hyland
President NYPTA

CSM

2011-02-13T11:39:00.002-05:00

I have just returned home from Combined Sections in New Orleans- what a wonderful week of programming, business and comraderie. There were many exciting moments and one thing that I took away from this week is how wonderful the members of our Chapter are. During the Presidents Luncheon on Wednesday the Chapter was recognized for receiving two APTA grants in 2010 in the areas of reimbursement and marketing- these were achieved due to the hard work by the PR committee and Bibiana and Kelly at the Chapter office.

I had the opportunity to spend time with a few New Yorkers serving in Leadership positions Nationally including Jim Smith (President of the acute care section), and Tim Tyler (President of the Sports section). In addition I met with leadership across all components to have open and productive dialogue on how other states are addressing their issues of insurace cuts, workers compensation, high copays, etc. Lastly I had extensive conversation with the APTA staff regarding the areas of dry needling and EMG's in an effort to put into place a Chapter plan to address these areas of practice.

Lastly I would like to recognize our immediate past President Jim Dunleavy. Jim was the co-founder of the acute care section in the early 90's and served as its first President for five years. Jim was recognized Thursday night and had the honor of being invited to present the first "Annual Acute Care Lecture." This award is the Acute Care Sections version of the Mary McMillan Lecture done annually at National. Congratulations to Jim and thank you for all you have done for us.

I leave New Orleans with excitement and passion to continue to serve all of you and help to lead this great Chater in the upcoming years. Thank you to all of you who took the time to seek me out and introduce yourself to me, it was a pleasure.

In Good Health

Matthew Hyland
President NYPTA

Webinar

2011-02-07T20:00:00.005-05:00

I would like to thank Dave Autin from the Workers Compensation Board and Kelly Garceau from Chapter office for giving their time tonight to present to us. The Chapter continues to have significant issues with the existing guidelines and is working very hard to creat meaningful change that will benefit all existing parties: patient, provider and payor. This type of meaningul and significant change will create a system that allows therapists to provide high quality services as they deem appropriate and be reimbursed accordingly thus alleviating the strain on the existing cost-quality-access triad. In the interim we strive to make an impact to losten some of the extensive regulations on the new guidelines as implemented.

I would like to thank the leadership and membership of AIPT, PTAUNY and the Counsel of Physiotherapy for their committment to "One Mission One Voice!" I have arrived in NO for CSM and hope to see many of you here.

In Good Health

Matthew Hyland
President NYPTA

Winter Board Meeting

2011-01-31T08:36:00.002-05:00

Have returned from our Winter Board meeting in Albany. I would like to thank the Chapter Staff for all of their hard work organizing the meeting as well as your elected officials for their committments and contributions this weekend. Of significance the Board approved the 2011 Legislative Agenda. The Board also voted to approve a significant upgrade to the NYPTA webhost which should improve our technology and ability to communicate with members. I wish you all well.

In Good Health

Matthew Hyland
President NYPTA

BOD Meeting

2011-01-28T08:40:00.003-05:00

Have arrived safely in Troy for this weekends Executive Committee and Board Meeting- I look forward to a very productive two days of discussion and stewardship. I thank you for the opportunity to serve you and will post upon conclusion.

In Good Health

Matthew Hyland
President NYPTA

PTAUNY and Workers Compensation

2011-01-21T09:22:00.002-05:00

This past Tuesday, Kelly Garceau and I had the opportunity to meet with over 60 members of PTAUNY regarding workers compensation and ongoing Chapter activities. Over the past week between travels to Albany and Buffalo we have had the opportunity to have town hall type meetings with over 160 members. This kind of dialogue helps us move toward one mission and one unified voice.

As a reminder the Chapter will be hosting a Workers Compensation Webinar on Monday February 7th. It is FREE to members. You may sign up on the Chapter website right on the homepage at www.nypta.org

In good health

Matthew Hyland
President NYPTA

Eastern District

2011-01-12T10:31:00.002-05:00

I would like to thank the leadership of Eastern District for hosting a meeting with Dave Austin from the Workers Compensation Board this past Monday. The turnout was tremendous- roughly 100 individuals, and well represented from all over the Chapter as I met individuals from Brooklyn/Staton Island, Hudson Valley, Catskill, and Central Districts who were in attendance. The dialogue was meaningful and the unity evident. I respect the difficulties that the private practitioner is experiencing right now, and I assure you that your Chapter Leadership is working very hard to make meaningful change.

In Good Health

Matthew Hyland
President NYPTA

Happy New Year

2011-01-03T06:57:00.000-05:00

To all the Members of the NYPTA, on behalf of the Executive Committee, the Board of Directors and Chapter Staff I would like to thank you for your committment to our profession and wish you all a very happy and healthy New Year.

In Good Health

Matthew Hyland
President NYPTA

Happy Holiday

2010-12-28T08:53:00.002-05:00

I would like to take a moment during this busy season to wish everyone a very merry and happy Holiday. I appreciate all the work that you do, and I hope you enjoy family and friends during this speacial time of year.

In good health

Matthew Hyland
President NYPTA

Workers Compensation

2010-12-20T22:24:00.002-05:00

For those of you who have been following this blog- I appreciate it. The NYPTA in conjunction with numerous allies have been working aggressively and tirelessly to make change to the Workers Compensation Guidelines and reimbursement patterns. Recently an unprescedented meeting between leadership of the NYPTA, AIPT, PTAUNY, the Council, and APOL took place in Queens to create a PAC to address our issues together. I am excited and optimistic about the change that this group with your support can create.

In good health

Matthew Hyland
President NYPTA

Congratulations to Ithaca College

2010-12-12T12:00:00.001-05:00

Ithaca College PT Students Receive APTA Student Advocacy Challenge Award. Graduate students in the PT program at Ithaca College participated in a national Student Advocacy Challenge sponsored by the American Physical Therapy Association (APTA). This first-ever event involved points for certain legislative activities to advocate for the profession and patients who benefit from these services.

Last May, 39 of these students went to Albany to participate in Lobby Day conducted by the NYPTA. This included meetings with local legislators to advocate for two bills that impact the practice of PT. Additional students wrote letters to their state legislators for similar purposes. Students across the country who conducted similar activities completed and submitted forms to verify their actions and receive points for their academic program. Ithaca College was announced as the winner at the National Student Conclave on October 29th.

Congratulations to the students and faculty at Ithaca College! Thank you for your partcipation and support of our Chapter and Profession.

In Good Health

Matthew Hyland
President NYPTA

Workers Compensation

2010-12-06T11:02:00.002-05:00

December is here and with it brings the new workers compensation guidelines. The NYPTA has worked aggressively to make changes to the implemented guidelines and is on record as opposing them in there current form. However, in the best interest of our members we will be publishing them in PDF format as created by the Workers Compensation Board in the next few days- please keep an eye out for them. The NYPTA will continue to actively work to make changes to these guidelines which restrict access to our services, while continuing to not address the unacceptable reimbursement provided.

In Good Health

Matthew Hyland
President NYPTA

Happy Thanksgiving

2010-11-29T11:06:00.003-05:00

On behalf of the Executive Committee, the Board of Directors and the NYPTA office staff I would like to wish everyone a Happy Thanksgiving. Thank you all for your efforts to "Move Forward" our profession

In Good Health

Matthew Hyland
President NYPTA