Messages from APTA RI President regarding COVID 19

4.3.2020

 
 
March 31
We wanted to make you aware of the volunteer opportunities / databases as a health care provider during the COVID 19 crisis. Please consider adding your name to one of these.
 
For the State of RI: http://www.riresponds.org/
 
APTA is working with other organizations and members to connect volunteers with facilities that need physical therapy services.
Here is the site with more information: http://communities.apta.org/p/fo/st/thread=15337&source=6
 
March 30
Dear Colleagues,
 
We prepare for another week. Another week of being challenged personally and professionally.
 
As we unite, collaborate and work together, I think about the children we provide care to, that are now being home schooled. The people in pain who are now relying on telehealth or missing the positive atmosphere of an outpatient clinic. The elderly, quarantined in their homes, or nursing facilities. The sick, in hospitals that now look and feel very different. This list goes on but I am so encouraged when I hear the stories of the essential care we continue to provide our patients. It’s different and takes some creativity, but our profession is showing resilience, grit and strength. Thank you.
 
I have seen photos on Facebook of our colleagues in the hospital. Please know we are thinking of you, proud of you and here to help! Please do not hesitate to reach out.
 
At this time I would encourage and urge you all to continue to visit the APTA-RI website.
We have working hard to ensure the most up to date resources are available for ALL members and non members.
We have updated the RI Telehealth Billing Guide in this section:
 
 
Of course, please continue to visit. http://www.apta.org/
 
Thank you to everyone’s strength, work and words. I am lucky and honored to serve in my current roll in this challenging time.
 
Please feel free to reach out to me anytime.
 
Coming soon – APTA-RI newsletter. 
 
Stay Strong,
Michelle Collie PT, DPT, MS
President APTA RI
 

 
March 25
It’s hump day! Wednesday! – half way through another week! And I'm hearing from many of you…the stress, the panic….please breath and take one day at a time. 
Key notes for today;
 
We had an executive committee meeting last night and we have clinicians and students collaborating in all settings.
 
Today's MASSIVE shout out is to our students! YOU are our next generation. Watch and learn and help in anyway – your future is going to be amazing. I am so, so sorry to the URI graduating class. Your graduation has been cancelled BUT, I can assure you that we will celebrate every one of you soon. Be patient, be strong.
 
Our website chapter updates is the BEST place to go for the most up to date information!
(This link is updated daily. Includes free courses on Pulmonary Rehab and Acute Care setting): 
 
 
Click here for all the telehealth updates for billing!!!
This includes a link to the just in Neighborhood Health Plan
 
Please SHARE this message with anyone! Along with our website link. 
Most FAQ?
We are starting a section on the website for COVID 19 FAQs. Please help us with the answers to our daily question by replying to this email
 
What platform are people using for telehealth? 
 
Stay Strong,
Michelle Collie PT, DPT, MS
President APTA RI
 
 
March 23
Dear Colleagues, 
 
Monday – another day done! Congratulations!
 
As physical therapists now we are more essential than ever before. I am so proud of the work every single Physical Therapist and Assistant is doing. And students, we are working hard to make you proud!!!
Let’s continue to unite and collaborate and provide the best care to our community, no matter what setting we work in.
I spoke with a Physical Therapist who works in a SNF today. Like many, we discussed essential care and our professional responsibility. This is a challenging time and we must all support each other’s professional decisions as we keep our community safe.
 
We continue to work with other payers, our chapter lobbyist and a national PPS lobbyist and I will continue to provide updates.
 
Thank you for those who have stepped up to represent the different practice settings. We will be in touch very soon.
 
Reminder: APTA-RI Executive Committee Meeting is scheduled for March 24th at 7pm. I welcome input from members on what you need from APTA-RI.
Please feel free to share this message with non-members. They can also access it on our Facebook page.
 
Updated Resources and News:
 
 
For Private Practice PT’s: IMPACT magazine COVID-19 Special Issue (LOTS of great resources) 
 
 
 
ACT NOW to Protect IDEA During COVID-19. APTA Pediatrics is asking all members to contact your legislator immediately.
 
IDEA Rights May Be Waived by Congress as Part of COVID-19 Pending Stimulus Package. A Provision in the pending stimulus bill that would give the Secretary of Education authority to approve state waiver requests for any statutory and/or regulatory requirement of the Individuals with Disabilities Education Act (IDEA) for 1 year and extensions may also apply. Please visit the APTA Patient Action Center. ACTION MUST BE TAKEN NOW!
 
Members have received a direct email communication from APPT but EVERYONE needs to reach out to legislators by email on this issue to maintain appropriate services for the students we serve.
 
https://app3.vocusgr.com/WebPublish/Controller.aspx…
 
APTA updates  
 
PPS is now open for anyone and includes lots of small business, HR, business resources. https://ppsapta.org/physical-therapy-covid-19.cfm
 
 
 
Stay Strong,
Michelle Collie PT, DPT, MS
President APTA RI
 
 
 
March 21
Dear Colleagues, 
 
I truly hope everyone has had sometime this weekend to settle their nerves, exercise and get some sunshine. 
 
We have all had a week like no other. We all have our personal challenges and concerns as well as our professional dilemmas. 
 
Whether your practice setting is Homecare, Skilled Nursing, Pediatrics, or Outpatient. Or you are a researcher, professor, educator or student. I anticipate, like me, you have considered and debated; What is essential care? Is treating this patient breaking the ‘social distancing’ recommendations? Shouldn’t the APTA be providing stronger recommendations? Is me going to a patients home violating the social distancing recommendations? What should an outpatient or private practice do? And our students? – how do we support out next generation of professionals through this time?
 
I have spoken to many peers over this last week about these challenges. The fact is, no one speaks to this more eloquently than the APTA president Dr Sharon Dunn. I commend Sharon, admire, applaud and 100% support her statements. I urge you to spend today reading this letter 
 
In the next few days I hope to write a letter on behalf of APTA-RI to thank her for her position and support.
 
On Thursday Homeland Security provided guidance on essential services and Physical Therapy is listed. https://www.cisa.gov/publication/guidance-essential-critical-infrastructure-workforce
We are an essential service and we must remember this. But we must all consider that an essential service today, is very different to what it was 1 week ago. Today, outpatient and homecare services prevent MSK patients heading to their PCP or ER. Our PCP’s and ER’s do not want, or have the capacity to see these people. Today our essential services may be taking care of chronic pain patients, pediatrics, elderly patients – to keep them safe at home and away from the health care providers on the front lines, managing Covid-19.
 
To all of the physical therapists in the hospitals – I can only imagine how challenging it is to go to work each day. Thank you for serving and representing our profession and doing the best for patients, our community. PLEASE let us know what you need.
 
Private practices, academia etc – A request has been made for masks. Please, if you have any let me know. We can coordinate delivery to those in need.
 
Lets get to the updates. I am beyond ‘ecstatic’ to report that based on my conversations yesterday with BCBSRI, they are currently writing policy in line with the governors executive order. I have been verbally informed and expect written policy maybe Monday – definitely Wednesday. If you are providing any telehealth services, please document everything. The policy will be retroactive to when the governor placed her executive order. This is for homecare also. This includes videoconferencing and phone calls. Currently I believe we are the first group in the country to get this!!!
 
We are working with other payers, our chapter lobbyist and a national PPS lobbyist and the week ahead we will continue to advocate and pass on information.
 
I am grateful as having telehealth gives us a way to continue to provide care to our patients. No matter what! 
 
For those interested in telehealth – the National PPS Covid-19 advisory that I serve on is currently putting material together on this. However, if Rhode Island physical therapists would like additional information please let me know. We can quickly pull together educational material to support everyone.
I am happy, so happy that we have an option for managing and providing care to outpatient and home care patients, and everyone can stay safe.  
 
Thank you for those who have stepped up to represent the different practice settings. We will be in touch very soon.
 
Reminder: A APTA-RI Executive Committee Meeting is scheduled for March 24th at 7pm. I welcome input from members on what you need from APTA-RI.
Please feel free to share this message with non-members. They can also access it on our Facebook page.
 
Updated Resources and News:
APTA updates 
Furnishing and Billing E-visits. 
PPS is now open for anyone and includes lots of small business, HR, business resources. 
 
Stay Strong,
Michelle Collie PT, DPT, MS
President APTA RI 
 
 
March 19
Today’s Questions/Comments;
(please feel free to send any questions. I apologize if I am unable to personally get back to you, but will answer all questions in this email as appropriate)
 
We play a crucial role in rehospitalization - our patients have been cancelling us and I only expect that to continue as cases continue to grow. With telehealth, we can play a crucial role in keeping our sick patients home
 
SO GREAT – to hear from providers in different settings! Thank you!
 
Today an official letter was sent to payers on behalf of APTA-RI. We have created a Covid-19 Telehealth Task Force. We will work together to strategically manage communication with payers in advocating for Physical Therapy in all settings. Many have acknowledged our letter. I spoke to the CMO at BCBSRI today with details about telehealth and how essential this is for the safety of our patients, us and our communities. We are advocating for getting reimbursed the same rate, for the same codes we already use. Including evaluations. This is very different to what CMS is allowing.
 
Introducing our task force!
Lisa DeCoste and Yvonne Swanson from Performance PT. Both Board members plus Yvonne chairs payment committee.
Jason Harvey from Elite. Past president.
Don Levine and Mike Pappas – OPT and Pappas. Current board members. 
Jeff Taylor-Lobbyist for APTA RI.
 
WE NEED HELP! To advocate for homecare, skilled nursing, pediatrics and more! I am looking for a person from each practice setting to represent their setting.
  1. Telehealth in these settings.
  2. And to communicate with APTA-RI what you need, want or expect from APTA-RI.
 
I joined the presidents from MA, CT and NH today to discuss member’s needs. We are collaborating and gathering information on your needs, so please continue to send questions. We are meeting early next week to determine what we do next to help our members and our profession. Some kind of virtual town hall meeting is being proposed, soon.
 
An APTA-RI Executive Committee Meeting is scheduled for March 24th at 7pm. I welcome input from members on what you need from APTA-RI.
Please feel free to share this message with non-members. They can also access it on our Facebook page.
 
Updated Resources and News:
APTA updates  
 
 
I continue to be on a daily call, serving on the Covid-19 Advisory Board so we continue to get the most up to date information from the leaders at APTA. 
 
 
If there is information, or questions you have, please continue to reach out to myself or any member of the APTA RI board of directors.
 
Stay Strong,
Michelle Collie PT, DPT, MS
President APTA RI
 
 
March 18
Dear Colleagues, 
Please note the updates for today.
Please excuse my ‘typos’!
 
Today’s Question:
***please feel free to send any questions. I apologize if I am unable to personally get back to you, but will answer all questions in this email as appropriate
 
As many people exponentially turn to Healthsource RI, and the Governor and BC are working closely to help, can APTA-RI get BC Direct to reimburse at the same rate as the other products versus their current reduced rate?”
 
At this time every person is working in a crises mode. Patients, providers AND payers. No one knows yet what the financial ramifications are of this pandemic. Therefore APTA-RI will not be advocating for increased reimbursement at this time. We will reassess in the coming weeks. Access to safe care is what we are focused on. Telehealth is one solution to this. 
A reminder for those in private practice, there are updated resources specific to Covid-19 on the PPS site www.ppsapta.org.
 
Click here for our Governors Executive Order that was released today. I am working with our lobbyist Jeff Taylor to craft an official letter to all local payers for clarification on their updated policies and procedures on reimbursing physical therapy for telehealth. An official letter will be sent early tomorrow morning from myself on behalf of APTA-RI.
ANY updates/changes in policies, I will share immediately to our website.
 
An Executive Committee Meeting is being scheduled for March 24th at 7pm. I welcome input from members on what you need from APTA-RI.
 
I especially would like to hear from people NOT in private practice. What do you need from APTA-RI in this crises.  
 
Please feel free to share this message with non-members. They can also access it on our Facebook page.
 
Updated Resources and News:
 
 
***CMS has released information on covering e-visits. Note – this is NOT telehealth! I am on a daily noon call as part of the Covid-19 Advisory Board so we are getting the most up to date information from the leaders at APTA. I am waiting to hear more from our local carrier.
 
If there is information, or questions you have, please continue to reach out to myself or any member of the APTA RI board of directors.
Stay Strong,
Michelle Collie PT, DPT, MS
President APTA RI
March 17
Dear Colleagues, 
 
This feels like a diary that documents how our lives, our professions are changing faster than anyone could ever have imagined.
Following are the updates for March 19 th , 2020. 
Please continue to share this email with colleagues. Now is the time when we need to collaborate and work together like never before.  
 
I have been in contact with our Governor. There may be opportunities for us to provide help to elders or childcare. As an organization this may be a wonderful opportunity for us to collaborate and give back to our community in a time of need.
The health and safety of our community continues to be of the utmost importance.
At this time, because we are health care providers there has been no requirement or recommendation for physical therapy practices to close. Of course we must all follow CDC and the states recommendations.
 
Questions;
 What is the APTA-RI position on if practices should be open .”
This is an ethical question that the APTA-RI cannot answer – as there is no right answer. We must respect everyone is struggling with this. 
The private practice section of the APTA is currently releasing a significant amount of information to support private practices. I would encourage private practices to access this at  www.ppsapta.org . This will soon include, how to make decisions like this.
 
Updated Resources and News:
Click here for an updated statement from the APTA  http://www.apta.org/Coronavirus/Statement/
 
Potentially good news; CMS Moves to Allow Digital Communications for PTs. 
 
I have been in touch with our local carrier and he will contact me as soon as he has clarification.
I continue to be in touch with local payers – no policies have changed as of this moment!
 
I am working with our lobbyists at Mayforth group on new advocacy efforts. The Massachusetts governor and health care commissioner have released documents regarding telehealth that we are utilizing to encourage changes in RI.
Let’s continue to be a source of valid information for our patients and our communities. Please act in accordance with CDC guidelines to provide the safest environment for your patients and your staff.
 
For our students, here is the statement from CAPTE
 
If there is information, or questions you have, please feel free to reach out to myself or any member of the APTA RI board of directors.
 
Best of health to all,
 
Michelle Collie PT, DPT, MS
President APTA RI
March 16
Dear Colleagues, 
 
The challenges and concerns of this unprecedented time continue. In an attempt to help, even just a little, I will send daily updates on resources and what our association is doing. Please share this email with colleagues. Now is the time when we need to collaborate and work together like never before.  
The health and safety of our community continues to be of the utmost importance.
 
Today I spoke to the Health Care Commissioner, the governors office, the Department of Health and our Medicare Administrative Contractor. I have also been in touch with all local payers.
 
At this time, because we are health care providers there has been no requirement or recommendation for physical therapy practices to close. Of course we must all follow CDC and the states recommendations.
 
Click here for more information.  http://www.apta.org/Coronavirus/
 
Currently no payer has changed their policies with regard to reimbursing for Telehealth services. We will continue to advocate.
 
 
Please reach out to our legislators through the APTA Action Center
 
This is a strange time and I do hope we can all lean on each other for professional support, so we can ultimately better serve our community. It is important that we continue to be a source of valid information for our patients and our communities. Please act in accordance with CDC guidelines to provide the safest environment for your patients and your staff.
 
If there is information, or questions you have, please feel free to reach out to myself or any member of the APTA RI board of directors. We plan to have additional resources available within the next few days. 
Best of health to all,
 
Michelle Collie PT, DPT, MS
President APTA RI
Please follow us on our social media for updates
FB          @rhodeislandapta
Twitter    @riapta1
 

 
March 15
Dear Colleagues, 
 
Whether you are a physical therapist or assistant, student or seasoned clinician, work in academia, a hospital, or a private practice it is a strange and concerning time for everyone. As health care providers we are being faced with many challenges and questions; Should we be treating patients? How can I protect myself and my patients? How will my practice survive? Can I provide telehealth services? 
 
Of course the health and safety of our community is of the utmost importance. APTARI is working diligently to gather and provide information for our community, including expanding access to care while protecting our members and our community. 
 
All APTA RI events and meetings are being postponed or moved to a virtual format through to the end of April 15th. This date may be extended as we monitor the situation. The Building Balance Series is postponed to the Fall.
Given the questions and needs of colleagues, we are working to provide resources for members.
 
APTA has an excellent article on standard precautions. Click here  http://www.apta.org/Blogs/PTTransforms/2020/3/10/CoronaBestPractices/?_zs=e9xDc1&_zl=RRRb6).
 
Additional APTA resources can be found here. (http://www.apta.org/Coronavirus/)
 
Additional Resources:
 
Centers for Disease Control and Prevention<https://www.cdc.gov/>
 
 
Healthcare Professionals: Frequently Asked Questions and Answers<https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html>
 
Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease (COVID-19)<https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html>
 
Steps Healthcare Facilities Can Take Now to Prepare for Coronavirus Disease 2019 (COVID-19)<https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/steps-to-prepare.html>
 
 
Occupational Safety and Health Administration <https://www.osha.gov/SLTC/covid-19/controlprevention.html#health> 
 
The latest guidance documents issued by CMS related to COVID 19 following President Trump’s declaration on Fridays of a national emergency:
 
Emergency Declaration Provider Fact Sheet:
 
Press Release from CMS on National Emergency:
 
Additional Emergency and Disaster-Related Policies and Procedures That May Be Implemented Only With a § 1135 Waiver:
 
CMS has issued revised Guidance for Infection Control and Prevention of COVID-19 in Nursing Homes, including revised guidance for visitation:
 
Note on telehealth: it would appear that despite the remarks from the President on Friday on expanding the use of telehealth, the declaration will not provide for a waiver to expand authorized health care professionals to deliver services via telehealth under Medicare. APTA will continue to press Congress to include legislative language that waives the current restrictions on PTs and other health care providers from delivering services via telehealth under Medicare to assist with the current COVID 19 situation.
 
As of today, although PT’s in RI are able to provide telehealth services, however insurance companies are not covering this benefit. APTA RI has reached out to local payers in attempts to facilitate or expedite telehealth as a reimbursable service for physical therapy. We are working on resources that will be available soon.
 
APTA-RI has reached out to our local Medicare carrier requesting changing their policy for payment for telehealth.
 
We have reached out to the RI Health Care Commissioner to request expanding the telemedicine reimbursement requirement announced on 3/14/2020 be expanded to physical therapy services. 
 
This is a strange time and I do hope we can all lean on each other for professional support, so we can ultimately better serve our community. It is important that we continue to be a source of valid information for our patients and our communities. Please act in accordance with CDC guidelines to provide the safest environment for your patients and your staff.
 
If there is information, or questions you have, please feel free to reach out to myself or any member of the APTA RI board of directors. We plan to have additional resources available within the next few days. 
Best of health to all,
 
Michelle Collie PT, DPT, MS
President APTA RI
 


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Building Balance lecture series postponed until the Fall
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