FUND 1 Exam CH 1-7 ADA

What is the practice act ?

definitions and requirements to practice in each state.

Physical Therapist

Professional practitioner of physical therapy services

Physical Therapist Assistant

only individual that assist the PT in practice

What is a physical therapy aid ?

do not require the clinical; decision making of the PT or the clinical problem living of the PTA.

what is Patients ?

individual who have conditions that require services to improve their function.

what is a client?

Individual who seeks physical therapy services to maintain health or a business that hires a PT for services.

Impacts of WW1 and Polio ? who was responsible for reconstruction aid ?

Mainly women of the profession/the division of special hospitals and physical reconstruction was created in 1917. Poliomyelitis affecting children.

What is the Vermont Plan ?

Developed to study the cause and effects of polio in children.

Post WW1 ?

Established American women’s physical therapeutic association in 1921.

Who was the first president post WW1 ? (Female)

Mary McMillan/first PT in the US. 1921

What are the 2 membership categories ?

Charter members- (reconstruction aid)

Active members- who had specific training in schools.

Impact Of WW2 and Polio ?

Due to need eight emergency 6 month courses were allowed in physical therapy to meet the demands ( discontinued in 1946)

Post WW2 Period ?

National organization renamed to (APTA) American physical therapy association.

when did the first 2 programs graduated in ? PTA programs

1969

APTA policy declared a PT needed a minimum of ?

Baccalaureate degree 1960.

what is the balanced budget act of 1997 ?

controlling costs in healthcare by limiting the type and number of services and the amounts reimbursed - Decreased applications bc of this

when was the first PTA Caucus meeting ?

2006 - expanded the role of PTA’s in Physical therapy.

What was the Beacon for the profession ?

APTA adopted the APTA vision statement for physical therapy 2020

Direct Access ?

approved in all 50 states in 2018 - don’t need to wait for doctor within 5 days. PT/PTA let Dr Knows.

How can someone provide primary care at entry point ?

referral by an individual’s MD or by direct Access.

Why someone must contentiously ask “WHY” ?

must be evidenced based research.

Code of ethics for the physical therapist ?

Knowing right from wrong

What is physical therapist scope of practice ?

What a PT/PTA do.

Education ?

Must be licensed in that state to practice

Systems review ?

when look at all systems of the body/could also include communication and cognitive abilities.

Test and Measures ?

Specific procedures are completed to determine the physical and functional status of the patient. ex- observation,manual techniques.

Evaluation ?

establishes findings based on examination and diagnoses prognosis and plan of care.

Diagnosis

PTA’s cannot make diagnosis

Prognosis who makes them and who dosen’t ?

Plan of care and Goals only written by PT/ PTA’s Don’t

Difference between discharge and discontinuation ?

Discharge is - goals and outcomes have been reached

Discontinuation is - BC no further progression towards goal can be made/PT believes no further intervention will improve patients status.

More then half of PTA’s hold a ?

Baccalaureate degree or higher

APTA gave birth to the PTA profession in ?

July 5th 1967

2 PTA programs graduated 15 students in ?

1969

What is the Balanced Budget Act of 1997 ?

Introduced the payment system under Medicare and restricted access to PT services caused a deadline in the job market.

Changes in evolution ?

Mandated reporter requirement

What is CAPTE/What they do?

CAPTE: Commission On Accreditation of physical therapy education. Only organization to recognized to accredit PT/PTA Programs.

CAPTE requires a minimum of blank weeks of full time clinical education ?

13 weeks

The licensure exam has how many questions ?

Contains 180 MC Questions.

Curriculum content state of Illinois requires how many hours every 2 years ?

20 HRS

Can PTA’s supervise Aide’s ?

YES

APTA states four interventions that should not be performed by a PTA what are they ?

• Spinal joint mobilization/manipulation

• Peripheral joint mobilization/Manipulation

• Dry Needling

• Sharp Debridement

What is TRICARE ?

Insurance for veterans

Degree of supervision: General supervision what is it ?

• PT not required to be on site but must be available by telecommunication for PTA’s.

Direct Supervision ?

• PT/PTA has to be directly present and available for supervision for PT/PTA’s students.

Direct personal supervision ?

• Physically present and immediately available to supervise tasks that relate to patients services - for a physical therapy aide.

For PTA students what is required

direct and personal supervision required

Goal for Laws, regulations and policies affecting the practice of physical therapy ?

• to ensure providers are competent and ensure that taxpayer dollars are being spent appropriately

Basic Principles

• Many of laws,regulations and policies that affect PT practice vary from state to state. If there is conflict between federal and state law - Federal law wins if there is conflict.

What are law’s

• Set of rules used to govern people’s behavior

What is a statute ?

Type of law enacted/establishes by the legislative dept. of government. Created by legislators at the federal or state level.

Federal statutes ? what is it and examples ?

Apply to all citizens across state lines. Examples- ADA,HIPPA,Social security amendment of 1965,Patient protection and affordable care act of 2010.

ADA

• Requires goods and services available to the public be made accessible to persons with disabilities.

Social security amendment of 1965

• contains the Medicare program

HIPPA

Requires all health care providers to keep patients info confidential

Patient protection and affordable care act of 2010

• worked to reduce the number of uninsured and under-insured non elderly Americans.

What are state Statutes ?

• States are permitted to regulate education professional licensing and insurance.

State Statutes Examples

• single most important statute is the state phystical therapy ptactice act

• Will cover - identification of tasks

• supervisory requirements

• education requirements

• continuing education

• direct access - (legal in all 50 states)

Compact Act ?

• Agreement between states which allows PT’s and PTA’s living and working in their home state to work in other states without going thru the full licensing process.

What is a regulation ?

Serves to regulate industries and government benefit programs such as Medicare and Medicaid.

Federal Regulation

• CMS- is responsible for regulating of the Medicare and medicaid and children’s insurance programs .

State Regulation

• functions advise legislatures to clarify the scope of practice

Professional misconduct ?

Actions by licensed pros that demostrates an inability to meet professional standards and preform duties EXAMPLES: are fraud, sexual abuse and patient abandonment.

Common Law

• A law that has been created by court decisions written by judges and handed down

Criminal Law

• Crimes committed against society and the state prosecutes these actions on behalf of the public.

Civil Law

• One citizen brings a lawsuit against another to seek compensation for injuries recieved.

Parts of Medicare - Part A

• Hospital Insurance - provides mandatory coverage for inpatient hospital care

Part B - Supplementary medical insurance -

• Voluntary program for those entiltled to part A. Pays for physcian services and medical equipment and supplies.

PART D

Mainly for drugs

Medicare advantage

• Approved by Medicare but offered by private insurance companies.

MediCaid

• insurance for low-income adults and children and pregnancies funded by state and government.

Waste vs abuse vs fraud

Waste- most common risk management

Abuse - involves payments for items or services when their is no legal entitlement to the payment.

Fraud- billing for services that were not furnished.

3 major types of MCO ?

• (HMO’s)- Health maintenance organization

• (PPO’s) - Preferred provider organization

• (POS) - point of service

retrospective methodology

• Known as fee for service

prospective methodology

• Various methods of paying health care providers and organizations in which payments are established in advance

• Per diem: .

• Pregnegotiated per day flat or fixed fee

Medicare threshold

• Annual threshold amount. Apply a KX modifier after threshold is met. Require’s therapist to track their patients’s progress toward the annual threshold each year.

(CPT) codes Current procedural terminology

• used for outpatient physical therapy settings.

MDS- Minimum data set

• used in snf to report rehab minutes/ Model that focuses on unique characteristics needs and goals of each patient.

Intrapersonal communication

• Conscious and subconscious self talk we employ to make sense of our experiences

Interpersonal communication

• interacting with others in an authentic way thru verbal and nonverbal forms of expression.

Cultural rapport

• use of dress and greeting appropriate to the setting

verbal rapport

• use the same or similar descriptive phrases and conversational content as the person your are speaking to.

Behavbioral rapport

• mirroring and matching the posture and body movements of the person you are speaking to.

Implicit bias

• attitudes or stereotypes that affect our understanding actions and decisions in an unconscious manner.

Altruism

• the act of putting the welfare of others before your own.

Cultural competence

• set of attitudes and policies that promote positive interactions between cultures.

5 titles within the ADA title 1 employment

• employment requires employers to provide reasonable accomadations. Undue hardship: significssntly difficult or expensive accomdations.

TITLE 2

• Public services and transportation

title 3

• public accommodations - requires businesses to communicate effectively with customers with vision hearing and speech disabilities.

title 4

telecommunications- requires closed captions

title 5

• Other provisions provide a list of certain conditions that are not considered disabilities.

Specific requirements - doorways

• minimum 32 inches width

turning radius

60 inches width

Hallway clearance

• 36 inches width

Bathrooms - sink

not less then 29 inch height

Toilet - grab bars

Grab bars should be 1-1/4 - 1-1/2 inches in diameter.

Hotels - parking space

• Approximately 2% of total rooms must be accessible

• 96 inches width.