2014 KPTA Summer Newsletter

Summer 2014

Upcoming Events: Kentucky Student Conclave Students can now register online for KPTA’s first Kentucky Student Conclave, being held September 1213 in Louisville. Students—be sure you are logged in to the KPTA website in order to receive the member rate. Click here to see the official conference brochure.

The event will bring all eight PT & PTA programs together under one roof for fun, education and leadership development.

The event will kick-off with an opening reception at 7:00p.m. on September 12 at the Crowne Plaza Louisville that includes an exhibit hall and student awards ceremony.

The highlight of the evening will be the presentation of the first-annual “David A. Pariser Exceptional Educator” award.

The award will be given to an outstanding PT or PTA prothat option will be available when you register. The followfessor, nominated by their students. ing awards will be presented at the reception: The program will continue on Saturday, September 13 at Donald H. Lange Lifetime Achievement Award Bellarmine University with topics on integrating technoloOutstanding Physical Therapist Service Award gy in the clinic, conquering student debt, implications of Outstanding Physical the Affordable Care Act and much more!

Therapist Assistant While this event is for PT & PTA students only, we are still Service Award 2 KPTA Member Named APTA accepting applications for sponsors.

Richard V. McDougall National Student of the Year “Fledgling” Award Fall FUNction!!!

2 CEU Update Outstanding Clinical 3 PTA Caucus Corner Educator Award At KPTA’s Fall FUNction – you’re the star! This year’s event

Inside…

is designed to surpass your expectations in education, information, networking and just plain fun. We’ll start the Fun with the 2nd Annual FUNction reception on Friday, September 26 at 7:00p.m. (EDT) at the Barrel House (903 Manchester Street, Lexington). ADVANCED REGISTRATION FOR THE RECEPTION IS REQUIRED. For members wishing to only attend the reception and not the full conference,

If you would like to nominate a colleague for an award, click here for criteria. The deadline for nominations has been extended to August 1. (continued page 11)

6 Medicare Myth 8. Sending Health Information via Email 8 Report to Congress on Self Referral 11 Practice Perspectives AND MUCH MORE!

MONTICELLO STUDENT NAMED APTA NATIONAL STUDENT OF THE YEAR A recent graduate of the Somerset Community College Physical Therapist Assistant Program has been named the recipient of the American Physical Therapy Association (APTA) National Physical Therapist Assistant Student of the Year Award for 2014. Briana Allen of Monticello received her award at the APTA NEXT Conference in Charlotte, North Carolina in June.

This is the eighth year in a row that a SCC student has won the award. SCC graduates who have won the award in the past include: Debbie Lasure of Stanford in 2013; Melissa Keith of Columbia in 2012; Erin Green of Danville in 2011; Valarie Cooper of Jamestown in 2010; Rod Edwards of Somerset in 2009; Bethany Gosser of Liberty in 2008; and Heather Tuel of Somerset in 2007.

The criteria for the award include academic and clinical performance, community service and contributions to the physical therapy profession. Her nomination was supported by faculty members Ron Meade, Steve Hammons, and Claudette Prather and by Jeff Parmelee, PT of Somerset.

Allen has been highly visible on SCC’s campus and in her community. She served as president of SCC’s Martial Arts Club and Physical Therapy Student Organization and was an active participant in SCC’s Student Government Association. She had also served the college as a student ambassador. She was the recipient of the prestigious John T. Smith Scholarship.

In addition, Allen volunteered for a number of community service projects and fundraisers, including volunteering to assist with free health screenings at the Kentucky Special Olympics, fundraising for the Foundation for Physical Therapy, and distributing information about organ and tissue donation.

She represented the college at the 2013 Kentucky Mountain Laurel Festival as the college’s queen candidate. In 2014, Allen received the APTA Academy of Geriatric Physical Therapy’s Outstanding Student Award in Las Vegas.

“Briana has just been a joy to have in the classroom and to know as a person,” states program director Ron Meade.

“Without a doubt, if I owned a clinic, I would hire Briana. She is kind, hard-working and conscientious and we are so proud of her many accomplishments.”

Allen graduated from the SCC PTA Program in May. She is the daughter of Robert and Michelle Allen of Monticello and has a brother, Andre. She has worked for the physical therapy department at Wayne County Hospital in the past.

For more information about the SCC PTA Program, please contact the director of the program at ron.meade@kctcs.edu.

Briana Allen of Monticello is the American Physical Therapy Association’s National PTA Student of the Year for 2014. Briana received her award at the APTA NEXT 2014 Conference held in June.

CEU Update Did you know that ANY course you take that is produced, developed and offered by APTA or one of its’ components will count toward your Category 1 continued competency activities? Its true!

Even courses that are less than three hours in length will count as Category 1 as long as it is through APTA or one of its’ components. That means that KPTA members will get CEU credit for attending educational programming at our district meetings! APTA also offers FREE continuing education on its’ Learning Center! Click here for a listing of free CEU’s.

PTA Caucus Corner

By Chris Garland, PTA (chrisgarland221@gmail.com) The 2014 PTA Caucus Annual Meeting Minutes and House of Delegates Chris Garland, PTA, PTA Caucus Representative for the Kentucky Chapter participated in the 2014 PTA Caucus Annual Meeting and APTA’s House of Delegates. Forty-five PTA Caucus Representatives, 8 PTA Caucus Alternate Representatives, and 5 Delegates gathered in Charlotte June 7 and 8 for the PTA Caucus Annual Meeting.

PTA Caucus Nominating Committee conducted candidate interviews and elections. Those elected to serve included: David Harris (TN), Delegate; Crystal Morris (NC), Delegate; Jane Jackson (AZ) Alternate Delegate; and Nicole Volek (TX), Nominating Committee. The Chief Delegate also acknowledged outgoing officers, Paul Purdue (WA), Crystal Morris (NC), Jane Jackson (AZ), and Christina Wilson (AL) as well as those who had attained PTA Recognition.

The PTA Caucus voted down a motion to change voting privileges for the delegates in the PTA Caucus. The Caucus adopted a description of the PTA to be included in the approved updated version of the PTA Caucus Procedure Manual and used as needed pending approval of the Procedure Manual by the APTA House Officers via the “Approval Process for Component Bylaws.”

The PTA Caucus honored the Board members of the work group – Jennifer Green-Wilson, Chair, Shawne Soper, Lisa Saladin, and Sharon Dunn. Janet Bezner was also honored for her efforts on the work group and her support of PTA members during her tenure at APTA. From the House of Delegates: The official minutes of the House of Delegates are not yet available; please check the actual language for the following motions when the minutes are available. The House made the following decisions that impact work and governance in APTA for the PTA: · RC 2-12 was rescinded, so there was no reason to hear RC 3-14 or RC 4-14. The patient care delivery model will not change - PTAs will remain the only other physical therapy care provider in APTA positions and policies (at least for now). · RC 11-14 resulted in the House charging the Board (and staff) to create a plan to increase the value of PTA membership in APTA. From the March and April APTA Board of Directors Meetings: At the March APTA Board of Directors Meeting, the Board discussed RC 20-12 regarding the feasibility study for PTA education. The Board determined that there was insufficient information to make a decision and adopted the following motions aimed at gathering more data: · That APTA conduct an analysis of the work of the physical therapist assistant. · That mechanisms to identify and promote best practices in the work and relationships of the Physical Therapist (PT)/ Physical Therapist Assistant (PTA) Team in a variety of practice settings be identified and implemented in collaboration with the sections, American Council of Academic Physical Therapy (ACAPT), Commission on Accreditation in Physical Therapy Education (CAPTE), and PTA Caucus.

At the April APTA Board of Directors Meeting, the Board heard and discussed the report from the PTA Board Work Group and adopted the following motions: (continued page 5)

PTA Caucus Corner (continued) · That a bylaw amendment to provide eligibility for physical therapist assistant members to serve in non-officer positions on the Board of Directors (Board) be forwarded to the 2015 House of Delegates. · That a bylaw amendment to allow components the option to amend their bylaws to provide physical therapist assistant members a full vote at the component level be forwarded to the 2015 House of Delegates. · That bylaw amendments would establish physical therapist assistant membership eligibility to serve as a chapter delegate and continue to serve as a section delegate to the House of Delegates, at the discretion of each component, and would eliminate the Physical Therapist Assistant Caucus delegates by the year 2020 be forwarded to the 2015 House of Delegates. · That APTA policies related to the Physical Therapist Assistant Caucus be reviewed and revised to reflect the way in which the Physical Therapist Assistant Caucus currently operates. · That procedures be developed to encourage physical therapist assistant (PTA) members to join the volunteer interest pool and to facilitate the appointment of PTA members by the APTA Board of Directors and APTA staff to appropriate groups. · That data on the value of the physical therapist/physical therapist assistant team related to utilization and outcomes be collected via one or more of the following mechanisms in order to implement the most feasible approach to begin data collection in FY 2014: Explore access to existing/developing databases Determine resources required to collect data · That the physical therapist/physical therapist assistant team tool kit that describes the models of practice for physical therapist/physical therapist assistant teams and is a resource for members to communicate the role of the physical therapist assistant in physical therapist practice to payers be actively supported and promoted to APTA Components. · That a motion be prepared for the 2015 House of Delegates to consider the creation of a section-like component for physical therapist assistants and in the interim that the charge of the PTA Board Work Group be revised by the president to work towards advancing physical therapist assistant initiatives.

(Minutes available at: http://www.apta.org/BOD/Meetings/) As you can see, the PTA Caucus and APTA Board of Directors are working hard to change the culture of APTA to one of inclusiveness. They have done their part and now it is time for you – clinicians, faculty and students – to do yours by doing the following: 1. Join APTA. It is very difficult to convince APTA leadership that PTAs are invested in the profession when less than 8% of licensed PTAs are members of APTA. 2. Get active at the district and/or chapter (state) level of APTA. Go to meetings. Volunteer to help on committees. If you feel isolated, then take your PTA and/or PT friends with you to the next meeting so you won’t be alone!

3. Campaign and vote for chapter (state) delegates and leadership that value PTAs and will support this change in culture.

The members of the Affiliate Assembly, National Assembly, and PTA Caucus have provided innumerable hours and displayed the utmost professionalism to get to this point. Please be part of this evolution to a new and more inclusive role in APTA for PTAs.

PT/PTA Teamwork: Success Stories From the Field For almost 45 years, physical therapists (PTs) and physical therapist assistants (PTAs) have been working together to provide quality physical therapy services. Benefits of the PT/PTA team in physical therapy care include:

   

Extending the reach of the PT to improve access to physical therapy care Consistency of care where patients can expect to see at least one of their physical therapy "team" at each visit Opportunities for collaborative care that may result in increased efficiency and effectiveness Cost conscious care where both providers are able to work at the top of their license

Working as part of the PT/PTA Team is not only beneficial for the patient, it can be a rewarding partnership for the PT and PTA. Listen to these stories of how working PT/PTA teams provide excellent patient care and a gratifying work environment through respect and collaboration.

If you want to learn more about the PT/PTA Team, email us at PTA@apta.org.

Click the picture to watch Jenelle Lauchman and Joel Gersh discuss the PT/PTA Team. Visit here for more videos.

Medicare Myth There has been a longstanding myth that Medicare does not cover services to maintain or manage a beneficiary's current condition when no functional improvement is possible. The recent Jimmo vs Sebelius final settlement sought to dispel this fallacy and provide clarifications to safeguard against unfair denials by Medicare contractors for skilled therapy services that aid in maintaining a patient's current condition or to prevent or slow decline. For more information, please visit APTA’s website: http://www.apta.org/Payment/Medicare/CoverageIssues/SkilledMaintenance/.

Tips for Sending Protected Health Information Via Email

By Elizabeth E. Hogue, Esq. The use of email pervades the healthcare world today. Without thinking, many providers send information all day, every day via email messages. Providers must take extra care, however, with the transmission of protected health information (PHI), as defined by the Health Insurance Portability Accountability Act (HIPAA).

First, providers should consider alternatives to the disclosure of PHI in email messages, such as: 

Telephone calls, instead of emails



Establishment of an extranet with encryption and limited access rights

formation via unencrypted message.

Here are additional potential problem areas that providers may encounter when they are sending PHI via email and how to handle them: 

Sending emails to multiple recipients that include PHI: providers should blind carbon copy (bcc) recipients, as opposed to listing them all in the "to" line

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Sending PHI to or from personal email accounts: providers should avoid both of these practices altogether

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Email addresses that "auto-fill": providers should carefully check addresses that auto-fill to make certain that they are correct

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Sending PHI on CDs, DVDs, or flash drives via overnight Finally, providers should develop a comprehensive policy delivery service and procedure that governs sending PHI via email. Staff It may also be unnecessary to refer to patients at all in members should be thoroughly trained regarding compliemail messages. If updated orders are received from a ance with this policy and procedure. physician, for example, a message could be sent alerting The stakes are high! The Office of Civil Rights and State staff to receipt of orders from Dr. X for a male patient.

Attorneys General, the enforcers of privacy rights, are in If it is necessary to refer to individual patients, providers enforcement mode! Special care with regard to this area should consider referring to patients by the initials of their is definitely needed now. first and last names, instead of using their full names.

Providers may also wish to implement encryption or secure email messaging in order to protect PHI in emails. If the recipient cannot support the use of encryption or secure messages, however, this option may not be viable.

If providers elect to use encryption, encryption programs must meet standards published by the National Institute of Standards and Technology (NIST). When providers use programs that meet these standards, they may avoid an obligation to report breaches because they fall within a safe harbor or exception to the obligation to report breaches.

It is important to note that unencrypted emails may always be sent to patients who are the subject of the PHI that is sent. Providers should tell patients that there is some risk of disclosure, but providers are not responsible for unauthorized access if patients still wish to receive in-

©2014 Elizabeth E. Hogue, Esq. All rights reserved.

Report to Congress on Self-Referral There has been a series of reports developed by the Government Accountably Office regarding self-referral for Medicare beneficiaries. The final report described total visits, total expenditures, and beneficiaries that receive services. After the report was published, a joint congressional statement included the following: “… Viewed collectively, the four GAO reports show substantial evidence that financial incentives, not patient needs, are driving some referral patterns …”

APTA’s “Integrity in Practice” Campaign seeks to eliminate the inappropriate utilization of physical therapy.

For more information, please visit APTA’s website: http:// www.apta.org/LegislativeIssues/SelfReferral/.

Practice Perspectives Guide to Physical Therapist Practice 3.0 Guide 3.0 will be released August 2014. It will be online only and is intended to provide a description of practice for academia and clinicians, with other resources addressing external communities. The elements of patient and client management are unchanged. ICF language is used throughout. There are category and language changes.

The practice patterns being archived will be used only for educational purposes. The catalogue of test and measures will be retired, as clinicians are directed toward PTNow for evidence-based practice. For more information, please visit APTA’s website: http://guidetoptpractice.apta.org/.

Physical Therapy Classification & Payment System APTA's goal is to reform payment for outpatient physical therapy services to improve quality of care, recognize and promote the clinical judgment of the physical therapist, and provide policymakers and payers with an accurate payment system that ensures the integrity of medically necessary services. APTA is working to develop a classification and payment system that is based on the clinical judgment of the physical therapist. Factors in payment will include the severity/complexity of the patient’s presentation with the added dimension of the required intensity/ complexity of the therapist’s clinical decision making and skill/expertise of techniques. For more information, please visit APTA’s website, http://www.apta.org/PTCPS/, or contact Carmen Elliott, carmenelliott@apta.org.

physical therapist practice in the ED. The resources include how to get started, billing and documentation, and resources on the benefits of physical therapist services in the ED. For more information, please visit APTA’s website: http://www.apta.org/EmergencyDepartment/.

Upcoming Events (continued from cover) Danville-Area PT Pub Night The Danville area therapists will meet on August 19 at 7:00p.m. at Wilderness Trace Distillery, 445 Roy Arnold Boulevard. Attendees will be treated to a tour of the distillery, followed by a discussion on the latest opinions issued by the Kentucky State Board of Physical Therapy. Please RSVP by August 15 to kptaky@gmail.com as we need to provide a headcount to the distillery in advance.

Ron Barbato, PT, will facilitate the discussion at the Danville PT Pub Night. A member of the Kentucky State Board of Physical Therapy, Ron will discuss the latest opinions issued by the KBPT. Bring your questions and come ready for conversation !

Physical Therapist Practice in the Emergency Department Physical therapists are increasingly being asked to provide evaluation and management of patients in the emergency department (ED) setting. As part of the emergency department team, physical therapists have the opportunity to collaborate in the care of patients with a wide range of acute and chronic problems coming from the neuromusculoskeletal, cardiovascular/pulmonary, and integumentary systems. The physical therapist in the ED serves a critical role in screening for appropriateness of care, consultation with other practitioners, and in the direct care of patients. Based on a motion at the 2012 House, APTA has developed new resources on how to incorporate

Lexington-Area PT Pub Night The next Lexington area PT Pub Night will be August 21 at 7:00p.m. at Blue Stallion Brewing. Join your colleagues in a conversation on the issues affecting physical therapy. All PTs and PTAs welcome!

Please Support Our Valuable Partners

APTA Opposes United Healthcare’s Plan To Use Functional Limitation Reporting APTA is urging that UnitedHealthcare (UHC) stop its plan to implement Medicare outpatient therapy functional reporting code requirements in its Medicare Advantage plans.

UHC announced its decision to implement functional limitation reporting in their May bulletin (.pdf, p.46). The company plans to require G-codes and severity/complexity modifiers on contracted physical therapist (PT) claims with dates of service on or after August 1, 2014. Claims that do not include the appropriate G-code and modifiers will be rejected.

In its letter to UHC, APTA argues that the difficulties experienced by PTs during Medicare's changeover to the requirements, as well as limitations in data, make UHC's planned August 1 move ill-advised.

APTA has its own functional limitation reporting webpage that provides resources to help members meet this reporting requirement.

ICD-10 Resource Page If you’re feeling overwhelmed about ICD-10 implementation, be sure to checkout APTA’s ICD-10 Resource Page. The page contains great tips and links to webinars to help you prepare for the October 1, 2015 transition from ICD-9 to ICD-10. Also, be sure to fill out KPTA’s Payment Policy Survey so we can ensure your successful implementation.

Payment Policy Survey Please take a few minutes to complete our eightquestion Payment Policy Survey. Your responses will help us improve your member benefits by: 

Working with insurer’s to identify solutions to reimbursement problems.



Working with the Kentucky Department of Insurance to identify insurers who are not abiding

by Kentucky’s copay law.



Identifying what areas our members need support with reimbursement issues (i.e. ICD-10 implementation, Medicaid, Medicare, etc.).

PLEASE TAKE THE SURVEY TODAY!

September 26 7:00p.m.

The Barrel House 903 Manchester Street Lexington Watch you email for an invitation to the reception. Advanced registration IS required.

A celebration of YOU! If you need accommodations, we suggest one of the following venues: Holiday Inn Express (http://www.visitlex.com/listings/Holiday-Inn-Express-Hotel-Suites-Downtown/6193/) Hilton Lexington Downtown (http://www.visitlex.com/listings/Hilton-Lexington-Downtown/5891/) Hyatt Regency Lexington (http://www.visitlex.com/listings/Hyatt-Regency-Lexington/6178/)

KPTA received the 2014 “Innovative Component Award� from APTA for collaborating with other healthcare providers to positively affect payment policy, advocacy and inter-professional networking.

Pictured from left: KPTA Executive Director, Lisa Volz; APTA President, Paul Rockar, PT, DPT, MS; and KPTA President, Michael Muscarella, PT, DPT, LDE.

KPTA Members Shine at APTA’s NEXT 2014 Andrea Behrman, PhD, PT, FAPTA accepts the John HP Maley Lecture Award from APTA President, Paul Rockar, PT, DPT. Dr. Behrman is Director of the Pediatric NeuroRecovery Program and co-Director of the Reeve Foundation NeuroRecovery Network with a mission of infusing standardized evidence and activity-based therapies into clinical practice across clinical sites in the U.S. and Canada.

Dr Behrman will be a featured presenter at this year’s Kentucky Student Conclave.

KPTA Member, Terry Brown, PT, DPT, COMPT was a participant in this year’s Oxford Debate. Held June 13, the debate could easily have been retitled "Oxford: The Musical." Teams from both sides included song parodies to argue their side of the debate's topic, which was whether or not evidencedriven manual therapy improves patient outcomes. Terry participated on the "pro" team, arguing that evidence-driven manual therapy does not necessarily improve patient outcomes.

While the moderator, Charles Ciccone, PT, PhD, FAPTA, declared the "pro" team the winners based on each member's presentation and audience response, it wasn't clear which, if any, side of the issue emerged on top content-wise. Perhaps opponents Dunn and Seif joining each other on stage in matching Wonder Woman outfits was indicative of a sense that there is room for both camps: tools such as clinical prediction rules, combined with the physical therapist's clinical judgment and reasoning, provide for better outcomes than either approach alone.

The playful atmosphere was, as a participant described it afterward, like watching a kid's cartoon salted with some adult references: not only was it a lot of fun, but if you understood the issue, you got the messages, too. " (Continued next page)

KPTA Members Shine at APTA’s NEXT 2014 (continued) Sarah Beth Martin, SPT, PhD received the Mary McMillan Scholarship Award. The intent of the award is to recognize those students who exhibit superior scholastic ability and potential for future professional contribution. Congratulations, Sarah!

Are You Getting the Attention You Deserve?

If you enjoyed this edition of KPTA’s Newsletter, consider advertising in our next edition. Our newsletter is e-mailed to over 1,300 PTs, PTAs and students throughout the Commonwealth and is archived on our website, www.kpta.org. Our rates are: 1/4 page ad (approximately 3 1/2" x 4 3/4") $50.00 1/2 page ad (approximately 7 1/2" x 4 3/4") $95.00 Full page ad (approximately 7 1/2" x 10")

$175.00

Contact the KPTA office to make arrangements for your facility to be featured in our next edition, and get the attention you deserve!

Discount Benefit Program for APTA Members APTA members are eligible to apply for a full range of costsaving and value-added products and services.

Got questions? Members are invited to contact APTA's Member Services Department for assistance whenever questions or concerns arise regarding risk management or member benefits. Reach us at 800/999-2782, ext 3146, or at insfinsvcs@apta.org. We look forward to serving you.

APTA Online Mall Receive cash back for online purchases at your favorite stores through the APTA Online Mall, powered by Azigo!

Car Rental Program APTA members save money when you rent a car from partnering companies.

PT Clinician App for APTA Members A personalized mobile app solution to streamline communication with patients by giving them a unique and convenient way to interact with their physical therapist outside the clinic.

Office Depot Discount Program APTA members can save up to 80% on all in store and online purchases on eligible office and school supplies from Office Depot.

Getting the Most From Your Membership APTA provides a variety of benefits for their members.

Browse here to ensure you’re getting the most from your membership.

Learn about the value of membership from our members! Membership matters!