PT Role in the Opioid Crisis and Access to Rural Health Top APTA Federal Priorities

From March 31 to April 2, 300 physical therapists, physical therapist assistants and physical therapy students met in Washington, DC for the 2109 APTA Federal Affairs Forum (FAF). The advocacy objectives of the FAF are set by the APTA’s Public Policy Priorities. These policies are developed every two years in conjunction with each new Congress. During the first day of the forum we learned about these issues and general direction of Congress. It’s a lot more interesting hearing about it in this setting than to read about. (I’ll admit to being a news geek.) On the second day of the forum, we met with our Congressional delegates to educate them about how these impact the practice of physical therapy and more importantly, our patients.

This year the emphasis was on the role physical therapy in the opioid crisis  and rural health. There has been much national attention on the opioid crisis. APTA came out with the #Choose PT campaign about five years ago, so was well positioned to jump on the band wagon. The crisis is linked to the limited distribution of physical therapy in underserved rural areas.  One avenue of approach has been a reiteration of previous requests for the inclusion of PTs in the National Health Service Corps. There is also an effort to designate PTs as primary care providers in Federally Qualified Community Health Centers. These bills will open opportunities of PTs and PTAs in these settings.

The second day of “hill meetings” is probably the most exciting part of the forum. It sounds a bit daunting at first glance but becomes thrilling in the doing. This year I’m contracting at a rural health center (Waianae), involved in a pain/opiate management program, so I could speak first hand to the issues.  I met with staff at Senators Mazie Hirono’s and Brian Schatz’s, Representatives Tulsi Gabbard’s and Ed Case’s offices. Senator Hirono regularly and personally hosts a coffee and meet and talk story. Representative Case makes it a point to meet personally with visiting constituents. Hawaii’s Congressional delegates are genuinely friendly, generally informed of our issues and vote in favor of them. The discussions are usually to “put a face” on the issues and to thank them for their support. I’d taken this for granted until I spoke with members of the forum from other states where the legislators are not in agreement with the APTA positions. The efforts of those forum delegates are spent coaxing senators and representatives and their staff for suppor in an almost hostile setting. Hence, Hawaii has it easy and only gets sponsored to attend the forum on odd years, a cost saving measure on the part of APTA.

Over the course of the past 20 plus years, this was about my fifth opportunity to be a delegate to the FAF.  This is the first time for me that the Medicare cap was not one of the topics. The cap was removed with the last session of Congress. It, along with the elimination of Functional Limitation Reporting (FLRs), are victories to say the least. However, as with most legislative processes it comes at a cost. One of the concessions may be a lower payment differential for PTAs. APTA is opposed to this. Its implementation is scheduled for 2022. Details of these changes are in this issue of PT in Motion News. Stay tuned for more developments in this area and please lend your support when there are calls to action.

We are often caught up in our daily patient management duties to give much thought to the workings of federal institutions 5,000 miles away that might affect us. We may also feel that there is little we can do to affect change, thinking we’re at the mercy of government. We sometimes question why certain seemingly absurd rules exist and why someone doesn’t do something about them. I encourage anyone interested to step in and take a peek. It’s not as daunting or chaotic as it appears. I invariably come back from these meetings realizing someone (APTA) “has my back” and that we can and do make a difference. Feel free to contact me or APTA with questions.

My thanks to HAPTA for allowing me to serve in this capacity. It’s definitely a growth opportunity as well as a pleasure to visit my favorite city in the country. The cherry blossoms were in full bloom in the Tidal Basin.

Herb Yee
HAPTA Federal Affairs Liaison

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