UPDATE: Re: New Michigan PT Administrative Rules (11/29/10)

[Guest guest]

This goes to show you how difficult it is to write legislative language that is

not open for interpretation by the Department of the Attorney General, the

Michigan Athletic Trainers Society, or anyone else for that matter. I am unclear

as to why the MI PT Board did not just state that physical therapy may only be

provided by licensed physical therapists and licensed physical therapist

assistants and no one else. Would have been much clearer.

Rick Gawenda, PT

President

Gawenda Seminars & Consulting, Inc.

Subject: UPDATE: Re: New Michigan PT Administrative Rules

(11/29/10)

To: PTManager

Date: Friday, January 7, 2011, 2:46 PM

 

Memo from the AG's office (found on the MATS webpage) 12/27/10, from the

licensing and regulation division of the MDCH:

http://data.memberclicks.com/site/mats/AG_Memo_PT_-_AT_issue_R3387139.pdf

http://www.matsonline.org/

It is designated as a momorandum so I don't know what legal weight it carries.

Points out that (as many of us seemed to have feared) that licensed and

unlicensed is not clearly defined.

Points out that if you interpret the rules to apply only to PT's and PTA's, then

preventing delegation to unlicensed individuals does not apply to ATC's.

However if you do include ATC's, then they are not considered unlicensed.

Either way the rules are interpreted, they aren't limiting to licensed ATC's.

I also found it a little disturbing that they state that the MPTA's opinion goes

against the joint statement by the APTA and NATA from 2009.

It also states that it is " advice " not a formal opinion, so can anyone explain

what if any legal weight it carries?

> Mr. Nanzer, ATC's would not be allowed to provide physical therapy

> interventions. They would be able to perform tasks and acts delegated

> to them by

> a PT or PTA.

>

> Rick Gawenda, PT President Section on Health Policy & Administration

> APTA

> Supervisor

> Ingham Regional Medical Center

> SportsMed & Physical Therapy Center

>

>

>

>

>

>

[Guest guest]

As I stated a while back when this discussion came up, a licensed personnel

needs to be defined in the Rules/Act. It is assumptions that are not clearly

spelled out that cause all the problems. I once again recommend that the PT's

work hard with the MPTA to get the definition of a " licensed personnel " and

" unlicensed personnel " defined in the definitions for the act/rules.

His ruling (AG/AAG) is based on political gains, not what is

right/wrong/common-sense. Obviously he is getting paid more or has some type of

increased fear for loss of an election from the ATC association than he has from

the PT association. Especially if he states it is an opinion and not the " law " .

By being an opinion, it opens the discussion up and in addition he " recommends "

the MPTA stop the email blast. Sounds to me like he is not ordering it! Also

sounds to me like if the PTs there want the rule to mean " non-licensed is

defined as NOT a PT or PTA " , then you have to increase his fear of not being

elected.

I do have some questions when reading the AAG's opinion.

1. Why would the MPTA not define in the PT Act/Rules what a licensed person is?

And if an ATC can perform under a PT because they are licensed, then so can any

" licensed " person, i.e. massage therapist, hair stylist, or even your local bar

owner who has a license to sell liquor.

2. What is the concern by the PT's in Michigan if ATCs can perform " delegated

acts under a PT " ? Medicare still does not allow for it as only licensed

PTs/PTAs can perform physical therapy function. They are still " techs " under

Medicare guidelines for Part B and can't perform ANY delegated acts.

3. Private clinic owners/PTs " delegate " acts to unlicensed personnel all the

time. Perhaps they are the ones who wanted the email-blast to stop as it would

be interfering with their ability to make money? Why hire a PT/PTA if you can

hire an ATC or hair dresser for less money to perform " PT delegated tasks " .

Just a consideration.

Terry Stegman, PT, MS, Eng-Phy

Dallas, TX

>

> This was the fear; how the AG office would interpet the administrative rules.

According to the way I read the AG memo an AT would be able to continue to

practice under general supervision of a PT. Am I missing something here?

>

> , PT

[Guest guest]

Good post, Terry -

A good friend, mentor, and former employer of mine, Tom Carlson, PT was

previously a government economist. He used to tell us, " When you can't

figure out why something's happening, follow the money! " Sadly, Tom has

almost always been right!

Think about politicians, orthopedists, chiropractors, athletic trainers, PT

aides, and the practice act. PTs themselves are expensive, but the other

" extenders " are much less costly. If a provider can use that cheaper labor

and hold it out as being " physical therapy " , it can be pretty lucrative! In

the current Florida PT practice Act ( FL-486) , the Orthopods, Physiatrists,

and Chiros reserved to themselves the right to hire LPTAs directly and hold

out their services as being " physical therapy " .

Dick Hillyer, PT,DPT,MBA,MSM

_____

From: PTManager [mailto:PTManager ] On Behalf

Of TSTEGMAN2

Sent: Sunday, January 09, 2011 10:08 AM

To: PTManager

Subject: UPDATE: Re: New Michigan PT Administrative Rules

(11/29/10)

As I stated a while back when this discussion came up, a licensed personnel

needs to be defined in the Rules/Act. It is assumptions that are not clearly

spelled out that cause all the problems. I once again recommend that the

PT's work hard with the MPTA to get the definition of a " licensed personnel "

and " unlicensed personnel " defined in the definitions for the act/rules.

His ruling (AG/AAG) is based on political gains, not what is

right/wrong/common-sense. Obviously he is getting paid more or has some type

of increased fear for loss of an election from the ATC association than he

has from the PT association. Especially if he states it is an opinion and

not the " law " . By being an opinion, it opens the discussion up and in

addition he " recommends " the MPTA stop the email blast. Sounds to me like he

is not ordering it! Also sounds to me like if the PTs there want the rule to

mean " non-licensed is defined as NOT a PT or PTA " , then you have to increase

his fear of not being elected.

I do have some questions when reading the AAG's opinion.

1. Why would the MPTA not define in the PT Act/Rules what a licensed person

is? And if an ATC can perform under a PT because they are licensed, then so

can any " licensed " person, i.e. massage therapist, hair stylist, or even

your local bar owner who has a license to sell liquor.

2. What is the concern by the PT's in Michigan if ATCs can perform

" delegated acts under a PT " ? Medicare still does not allow for it as only

licensed PTs/PTAs can perform physical therapy function. They are still

" techs " under Medicare guidelines for Part B and can't perform ANY delegated

acts.

3. Private clinic owners/PTs " delegate " acts to unlicensed personnel all the

time. Perhaps they are the ones who wanted the email-blast to stop as it

would be interfering with their ability to make money? Why hire a PT/PTA if

you can hire an ATC or hair dresser for less money to perform " PT delegated

tasks " .

Just a consideration.

Terry Stegman, PT, MS, Eng-Phy

Dallas, TX

>

> This was the fear; how the AG office would interpet the administrative

rules. According to the way I read the AG memo an AT would be able to

continue to practice under general supervision of a PT. Am I missing

something here?

>

> , PT