Realistic assessments of the present and dreams for the future can seem like mutually exclusive concepts, but the 2022 APTA House of Delegates managed to bridge that gap during its 78th session, which began online July 30 and concluded Aug. 14 and 15 at the APTA Leadership Congress.

In a series of actions that addressed both professional and societal issues, APTA's primary representative body largely used the here-and-now as a springboard to drive the profession forward.

[Note: This article was published before the official minutes of the House were formally adopted. Language quoted here may be different from final content of House positions, which will be posted on Oct. 14. The Post-House Packet, which includes draft language of motions adopted during the House will be available on Aug. 26.]

Special Addresses

The 2022 House of Delegates included the annual presidential address by Roger Herr, PT, MPA, and special remarks from U.S. Secretary of Health and Human Services Xavier Becerra.

President Herr’s address focused on the importance of foresight, inclusion, and willingness to change.

“Inclusive leadership isn't easy, but it's essential, and it starts with a commitment to each other,” Herr said. “When we surround ourselves with those who have the same experiences and perspectives, we are standing in a place as the world changes around us. Foresight isn't possible without accepting that progress doesn't happen without change.”

On the final day of the House, HHS Secretary Becerra encouraged the physical therapy profession to help tackle long COVID and to influence the challenging Medicare payment environment by committing to high-quality care.

Within the Profession

Several of the motions discussed by the 2022 House focused on how PTs, PTAs, and students can begin thinking — and doing things — differently on matters related to how the profession attends to its continued viability.

An affirmation of PT-PTA collaboration and the PTA’s role in the interprofessional services team. In a motion that revised APTA's position on the direction and supervision of PTAs, the House adopted changes that strengthen the concept of collaboration between the PT and the PTA, addressed basic concepts around the PT's supervision of the PTA, and clarified that the PTA could be included as part of the patient's or client's interprofessional services team. (RC 8-22, amended)

Support for equitable disability accommodations. The House voted to underscore APTA's commitment to inclusion by adopting a statement that supports "equitable processes to include individuals with disabilities entering and within the profession of physical therapy through reasonable accommodations across their careers." (RC-15)

A fresh look at methods for maintenance of licensure. The patchwork of continuing education and competency requirements, and the processes by which courses and providers get approval to be counted as acceptable CE, have been discussed within the profession for a while. A charge approved by the House could deepen that conversation by directing APTA to collaborate with interested parties to evaluate continuing competency requirements and develop recommendations "for a uniform evaluation process of educational and professional activities that could be implemented by components and jurisdictions." (RC 19-22)

An exploration of the feasibility to expand prescriptive authority within the PT scope of practice. The House voted to refer a motion to the APTA Board of Directors related to the feasibility of expanding prescriptive authority within physical therapist practice. (RC 17-22)

An exploration of new ways to share knowledge across the profession. Consistent with work already under way, the House voted for APTA to identify new opportunities for engagement, collaboration, and knowledge-sharing in physical therapist practice, beyond those currently provided within APTA’s component structure. (RC 18-22)

Societal Health

The House continued its focus on improving the health of society through an expanded role for physical therapy and continued emphasis on the importance of diversity, equity, and inclusion both inside and outside the profession.

More specificity around digital technologies in practice. With the use of digital health technology continuing to expand, the House adopted a statement that reinforces APTA's ongoing work in major related areas, including the importance of collaboration between the PT and patient to determine the optimal modes for any PT services, the PT's responsibility for "all aspects of patient/client management," the centrality of the therapeutic alliance, adherence to practice scope and requirements around use of assistive personnel, and compliance with local, state, and federal laws and regulations.

President Herr also referenced digital health in his address, saying “We must continue to hold the line that physical therapy involves PTs and PTAs, and we must prepare for digital health to be a fact of life, the predictable next step for a health system that always strives to support more people at less expense," echoing a position shared earlier in 2022 by way of a published statement. (RC-4, amended)

A stepped-up role for PTs in blood pressure management. House members adopted an official APTA position supporting the PT's and PTA’s roles in promoting research, education, practice, and policy in the nonpharmacologic management of blood pressure to enhance the health and well-being of society. (RC 9-22, amended)

Better access to physical therapy as part of prenatal and postpartum care. In a unanimous vote, House members approved a statement that articulates APTA's support for "access to physical therapist services in the prenatal and postpartum periods as the standard of care to improve health outcomes and prevent comorbidities and health disparities." The statement helps to underscore ongoing APTA work that has led to recent wins, including the introduction of legislation that would expand postpartum care under Medicaid. (RC 10-22)

An expansion of the PT's profile in wellness, health management, and disability determination. A position statement from 2017 that called for the recognition of PTs as qualified practitioners for making disability determinations was revised to include unrestricted access to PTs as entry-point practitioners for a broad range of services including activity participation, wellness, and health, as well as disability determinations. This includes the identification of cause or nature of the activity limitations and participation recommendations for accommodations, and other interventions that optimize functioning. (RC-11-22)

Increased direct-to-employer services provided by PTs — and an APTA effort to help make it happen. Physical therapist services provided through direct arrangements with employers have developed a strong track record, and now APTA has an official position that supports the association's continuing efforts in this area (RC-13-22), adopted by the House in a unanimous vote. In a related motion, the House charged APTA with developing "a coordinated approach to enable members to pursue direct-to-employer physical therapist services" that would help to highlight the association's longstanding support of PTs providing evaluative and preventive services directly to employers. (RC 12-22)

Improved access to physical therapy in Medicaid. The population of Medicaid and Children's Health Insurance Program beneficiaries is estimated at 88 million individuals, and access to PT services varies dramatically among the state-administered programs. The House voted to adopt a position statement that supports improved physical therapy access for this population as an area of focus for APTA, with the aim of making physical therapy a mandatory benefit in all Medicaid programs, "authorized without administrative delays and barriers at adequate levels to meet patient needs, and paid commensurate with other public and private payers." (RC 14-22)

A commitment to inclusivity of the LGBTQIA+ population. Consistent with past House motions that support APTA's efforts around diversity, equity, and inclusion, delegates adopted a statement that APTA is "committed to being an inclusive organization for individuals within lesbian, gay, bisexual, transgender, questioning, queer, intersex, and asexual populations, and individuals of other sexual orientations and gender identities." The statement also calls for commitment from APTA and its members to promote equity and inclusivity while also addressing policies and practices that perpetuate the exclusion of LGBTQIA+ people in our association, the profession, and society. (RC 16-22, amended)

Honorary Members

The House also recognized three champions of the profession with honorary membership in APTA. They are:

• Kent Culley, an attorney who played an instrumental role in establishing and defending the physical therapy profession within legal and regulatory frameworks across the country.
• Jesse Dean, an expert in biomechanical engineering and faculty member of the Medical University of South Carolina in the Division of Physical Therapy who has devoted his career to enhancing the knowledge of PTs.
• Marc Goldstein, a passionate advocate for physical therapy education and research (and former APTA staff member) who was instrumental in the transition to postbaccalaureate education for PTs and the recognition of physical therapy as an important area of research.

Elections

The in-person sessions of the House concluded work that began in July, when the House elected the association’s national leadership and Nominating Committee, for terms beginning in 2023.

Watch

APTA members can view recordings of the House of Delegates proceedings.