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Over 13,000 Gather in Las Vegas for CSM

The APTA calls it a new record for the association's showcase conference

LAS VEGAS, NV -- The APTA announced Feb. 6 that attendance at the association's Combined Sections Meeting surpassed 11,000 registrants (therapists and students) plus an additional 2,000 exhibitors and other attendees for a total of over 13,000 in attendance in Las Vegas. The association's annual Combined Sections Meeting -- historically the largest conference for the association -- was held Feb. 3-6 at the Sands Convention Center on the Las Vegas Strip.

Here is a look at some key developments at the show.


J. Michael Bowers has been selected as its new chief executive officer, effective Feb. 28.

Bowers comes to APTA with recent experience as the CEO of the American Association for Marriage and Family Therapy (AAMFT). He worked at AAMFT in a variety of leadership positions for more than 25 years, developing expertise in many aspects of association management, including advocacy, governance, volunteer development, financial management, and member relations. While at AAMFT, he led the effort to achieve universal licensure for marriage and family therapists, and also improved the association's financial position by overseeing the purchase and full payment for a headquarters building.

"On behalf of the APTA Board of Directors, I am thrilled that Michael will be joining us as CEO, and I look forward to working with him," said APTA President Paul A. Rockar Jr, PT, DPT, MS. "Throughout his career, Michael has proven himself to be an innovative and visionary leader who cares deeply about members and staff. He also exhibits a passion for the types of quality of life issues that are so important to mission-based organizations like APTA and to the physical therapy profession."

Bowers will succeed Bonnie Polvinale, CMP, who has been serving as Interim CEO since June 2013.

"I couldn't be more excited or honored to join the staff of APTA in advancing physical therapy," Bowers said. "My commitment to members and the organization is to work collaboratively, with all my energy, to achieve outcomes that matter for patients and for the profession."

State-level Issues

A small but committed group of PTs gathered for "Physical Therapy Issues in the State Legislatures: Challenges and Opportunities to Making Vision 2020 a Reality," a session at the APTA's Combined Sections Meeting held Tuesday afternoon Feb. 4 in the Venetian Sands Expo Center in Las Vegas.

APTA Director of State Affairs Justin Elliott, well-known as a state legislative affairs guru and known for his "Jeopardy"-style presentations at APTA, brought attendees up to speed on legislative hot topics such as dry needling, direct access, title protection and the encroachment of other disciplines on PT treatments and scope.

Here is a brief rundown.

Medicaid expansion. Elliott's co-presenter Angela Chasteen, APTA's senior specialist of state affairs, relayed that the Supreme Court's decision on the Affordable Care Act was a game-changer for state Medicaid programs, essentially leaving it up to states to implement their own programs. As a result, 26 states have moved forward on expanding their Medicaid services, said Chasteen. And a state's government is not always a good predictor of how Medicaid will be implemented in that state.

Case in point is Arizona, where Republican Governor Jan Brewer has availed itself of federal dollars to expand the Medicaid program for its residents. This is good news for PTs working with patients covered by the program, Chasteen said.

"If it can happen in Arizona, there's a distinct possibility it can happen in most any state," Chasteen said. Florida and Pennsylvania are other big-population states that may be expanding their programs in 2014 or 2015.

Dry needling. Calling it "one of the hottest issues in terms of scope of practice issues in the states," Elliott outlined state-level efforts to bring dry needling under the scope of PT practice. Acupuncturists continue to battle the APTA on this issue -- cease and desist letters were received in Arizona, Indiana, and North Carolina, and lawsuits have been threatened in Washington and Wisconsin.

APTA's stance is that dry needling is a "shared intervention" and not owned by a particular discipline, and APTA will continue lobbying efforts to educate state legislatures in that regard. "2013 was a very busy year on the issue of dry needling," said Elliott. "2014 is going to be just as busy."

Athletic trainers. Currently regulated in 48 states, athletic trainers have in the last few years looked at their practice acts and have begun state-level legislative efforts to expand their practice scope language beyond sports medicine and athletic training services. An excerpt of NATA's profile of athletic trainers makes reference to the fact that in other countries, "athletic therapist" and "physiotherapist" are similar titles.

It becomes a matter of reimbursement. "They're looking for third-party payment," said Chasteen, adding that proposed bills in Vermont and Indiana would mandate payments for interventions that fall under the state's practice act for athletic trainers.

Direct access. All 50 states now allow PT evaluation without physician referral -- a "big milestone for the profession," according to Elliott. Now, the association turns its attention to an all-50-state policy for PT treatments -- Oklahoma and Michigan are the two remaining holdouts, but 2014 lobbying efforts are underway.

Eighteen states currently have unrestricted PT treatment, meaning no physician referral is required following a given timeline or number of treatments - what Elliott called the "gold standard" practice act. Another 18 plus the District of Columbia have direct access treatment with provisions, and 12 have "limited" direct access.

So though the 50-state milestone was reached, direct access is "still a priority for the association," said Elliott, adding that future efforts in this area will be directed toward federal (Medicare) direct access and tying quality of outcomes to physical therapy direct access.

"We're trying to pivot the conversation," he said.

Other legislative fronts include the South Carolina lawsuit regarding physician self-referral, rising PT co-pays, and encroachment of other disciplines including massage therapists, chiropractors and occupational therapists.

New Vision Statement

Last summer, the APTA House of Delegates approved the association's new vision statement: "Transforming society by optimizing movement to improve the human experience." The previous vision statement, Vision 2020, was reduced and distilled for better memorability and impact, said Tasha MacIlveen, DPT, CSCS, of Providence Health & Services in Oregon and a member of the vision statement task force.

However, this does not mean that the association's prior vision statement was inappropriate or ineffective, stressed William McGehee, PT, MHS, clinical assistant professor and director of clinical education at the University of Florida and a member of the vision statement task force.

The prior statement, which included association objectives such as professional autonomy, direct access, the doctorate of physical therapy degree, and evidence-based practice, was "clearly needed at the time it was passed," McGehee said. However, the association's House of Delegates felt a more concise statement was needed for the public and in 2011, charged the APTA with reviewing and revising Vision 2020 to reflect the profession's commitment to society beyond 2020.

"We are transformational change leaders," said McGehee, outlining the task force's challenge of keeping the statement clear and concise while reflecting the APTA's broad scope of initiatives and objectives.

Vision principles embedded within the larger statement include identity, quality, value, innovation, collaboration, consumer-centricity, access/equity and advocacy, outlined task force member Lisa Saladin, PT, PhD, professor and dean of the College of Health Professions at the Medical University of South Carolina in Charleston.

"How do I live out this vision?" asked APTA President Paul Rockar, DPT, at the conclusion of the session, imploring his audience to live the vision as they return to their workplaces. "I challenge you to go back and self-reflect."

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