Exam #2- Profession of Physical Therapy – Flashcards
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Component
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Chapters at the state level, and sections, assemblies, and the newly formed American Council of Academic physical Therapy at the National Level are the components of the APTA.
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District
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District is the most LOCAL organizational unit in the structure of APTA(grass roots level) -Exist in highly populated states -Allow for easy access to meetings and input at the state(chapter) level.
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Chapter
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-State membership -In 2015, there was 51 chapters -Can assess dues(districts cannot) -Mechanism for members to participate at the state level and have proportionate representation at the national level via District Delegate. Maintains state wide legislation and regulations for physical therapy
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Section
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-Voluntary -Organized only at the NATIONAL level -Made of members with similar interests -Focus on special areas of practice(CSM) -Annual meeting Combined Sections Meeting, FEBRUARY=10,000 participants(San Antonio this year) -Special Interest Groups(SIGs) are common in sections -meetings provide eduataional and buisness sessions and product demos.
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Who does APTA represent?
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The Physical Therapy profession.
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What is National level?
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HOD, BOD, Committees/Task forces, Assemblies, Sections, PTA Caucus, American Council of Academic Physical Therapy, Staff
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What is State level?
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Chapters, Staff
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What is local level?
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Membership, Districts, Staff, students pay dues; graduation
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APTA Board of Directors - function, composition?
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6 officers and 9 directors Officers= President, Vice President, Secretary, Treasurer, Speaker of the HOD, Vice Speaker of the HOD -Duties, Carry out mandates and policies established by the HOD. -Manage the affairs of the APTA -Create ad hoc committees, standing committess, and task forces as needed -create ADVISORY GROUPS and councils to respond to unique service needs of APTA
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Combined Sections Meeting - what is it?
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Meeting provides a mechanism for educational and business sessions, and extensive product demonstrations in an exhibit hall. -Annual meeting Combined Sections Meeting, February=10,000 participants(San Antonio this year)
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House of Delegates - structure/function?
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Highest policy-making body of APTA -composed of voting and nonvoting delegates from each chapters -Formula creates body just over 400 members -Meet, June once a year - Create ad hoc committees, standing committees ,and task forces as needed
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House of Delegates -voting members/nonvoting members?
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-Voting delegates from all chapters -Nonvoting delegates(may speak and make motions): PTA caucus, Student Assembly, Board of Directors, Sections(Chapter 2 delegates, Section 1 delegate, PTA caucus 5 delegates, Student Assembly 2 delegates)
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PTA Caucus - structure/function?
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Created by the HOD in 2005 to serve as a representative body of PTAs. It consists of representatives from each of the chapters and the District of Columbia, as well as 5 delegates who sit at the HOD. *meet once a year preceding the HOD meeting, discuss issues pertinent to PTAs
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CAPTE, define and know what the abbreviation stands for?
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Commission on Accreditation in Physical Therapy Education. -Accredits PT and PTA education programs -Establishes standards for accreditation
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FSBPT, define and know what the abbreviation stands for?
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Federation of State Boards of Physical Therapy(Independent agency) -FSBPT exists to protect the public by promoting safe and competent physical therapy practice -Mechanisms, Develop maintain administer exams, -Model Practice Act
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ECPTOTE, define and know what the abbreviation stands for?
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Executive council of Physical Therapy and Occupational Therapy Examiners - is a State of Texas agency charged with protecting the health, safety, and welfare of the people of Texas by supporting the Board of PT Examiners and the Board of OT Examiners as they license and regulate qualified practitioners of physical therapy and occupational therapy and register facilities in which those services are provided.
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ABPTS, define and know what the abbreviation stands for?
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American Board of Physical Therapy Specialties -Provides a mechanism to recognize PTs with advanced knowledge and skills in an area of clinical specialization. *Examples-Cardiovascular and Pulmonary, Clinical Electrophysiology, Geriatrics, Neurology, Orthopaedics, Pediatrics, Sports, Women's Health
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Understand how the following terms are related: State Practice Act/statute/legislature?
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Statutes(Practice Act) statute= made by Legislatures(State or Congress) Federal Statute-Enacted by Congress, examples that affect PT, American with Disabilities Act(ADA) prohibits discrimination against person with disabilities. Created Medicare ; Medicaid,IDEA, HIPAA. -State Statutes, enacted at the state level by state -Regulation of the insurance industry, Health care funding for the poor(MCD),state health department requirments -State Practice Act-Legal foundation for the scope and protection of physical therapy practice legislatures, different from state to state.
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Understand how the following terms are related:Rules/regulations/Board of PT Examiners ?
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Regulations(Rules)= Government agencies(Board of PT Examiners) -Regulations: rules that governs operation of a government program. -Board rules PT support, Clarify, further define terms of statutes, set fourth procedures create by statute. -Example of federal agency/regulations: CMS(center for medicare and Medicaid services). Consequence for violating a CMS regulation, Fined or Jailed. -Example of State regulations, state Physical Therapy Board,Composition and function of board are determined by legislatures. May clarify scope of practice to government bodies, Advise PT ; PTA's on practice issues. Assist Licensing procedures and investigate rules violations and public complaints.
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Criminal vs. Civil law
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-Criminal, acts done in violation of duties that individuals owes to the community. Prosecution in a court of law. Consequences fines, probation, imprisonment. -Civil law, concerned with relationship among private citizen.Consequences fines or incarceration. PT providers may be named in civil lawsuits=Defamation, breach of contract, negligence, malpractice.
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negligence vs. malpractice
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Negligence, failure to act as a reasonably prudent person. To prove negligence, the patient would have to prove: Duty, Breach, Damages, Causation. Malpractice, Professional negligence, failure to do or avoid doing something that a member in good standing of a profession would have done, which causes subsequent injury to the patient.
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State vs. Federal laws that apply to physical therapy and example of each?
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Federal laws- enacted by congress; Federal statutes that affect PT- The Americans with disabilities act (ADA) prohibits discrimination against persons with disabilities; The Individuals with disabilities act (IDEA)- requires physical therapy ( and other services) be provided to students when needed; Social Security amendment of 1965 created medicare and Medicaid. The health Insurance portability and Accountability ACT (HIPPA)-Protectes privacy of patient information. The Patient Protection and Affordable Care Act of 2010- reduces the number of uninsured and underinsured Americans. Several other provisions. By 2014 individuals must purchase health insurance or pay a fine. Most common type of violation of Federal Statute FRAUD
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State vs. Federal laws that apply to physical therapy and example of each?
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State Laws- Enacted at the state level by state legislatures; State statures that affect Pt- Regulation of the insurance industry. Health care funding for the poor MCD. State health department requirements. State physical therapy practice act. Legal foundation for the scope and protection of physical therapy practice ACT. Insurance is a state issue different from state to state
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PT and PTA licensure - requirements to obtain and renew PT and PTA license (PT Practice Act)?
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A license is issued by the board; PT- an accredited physical therapy educational program; a program equivalent to CAPTE accredited program; at least 60 academic semester credits or the equivalent from an accredited institution of higher education. renewal every two years and continuing education and pay fee/due. if you wait a whole year you would have to take a reexamination, and comply with the requirements and procedures for obtaining an original license.
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PT and PTA licensure - requirements to obtain and renew PT and PTA license (PT Practice Act)?
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PTA, In addition to other requirements and qualifications established by the board, present evidence satisfactory to the board that the applicant has completed an accredited physical therapist assistant program or an accredited physical therapy educational program including courses in the anatomical , biological, and physical sciences and clinical procedures prescribed and approved by the board
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Practice Act and Rules related to PTA supervision?
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Supervised by a physical therapist in the practice of physical therapy -In physical therapy, ultimate responsibility for patient care ALWAYS remains with the PT. -PT may be held liable for a patient's injury even though he or she was not directly providing care. no caps for techs in texas
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Requirements to receive physical therapy in texas?
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Referral from doctor.
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Medicaid, Medicare Part A
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Hospital Insurance; 65 years or older persons with end stage renal disease and those who are disabled and entitled to social security benefits are covered; Provides mandatory coverage for inpatient hospital care, skilled nursing facility services , certain home health services and hospice care. It is financed by payroll taxes from workers and their employers and general federal revenues.
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Medicaid, Medicare Part B
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Supplementary Medical Insurance is a voluntary program. . Age 65 years or older persons with end stage renal disease and those who are disabled and entitled to social security benefits are covered. Medicare part B helps pay for physician services, outpatient hospital services , select home health services medical equipment and supplies an other health services including physical therapy. Medicare part B is funded from beneficiary premium payments, matched by general federal revenues.(older,renal)
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Medicaid, Medicare Part D
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This federal program decreases the costs of prescription drugs and provides more choices in health care coverage for Medicare beneficiaries.
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Medicare Advantage: Who is covered? What is covered? Where does funding come from (state vs. federal)
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-65 years old ; older, persons with end-stage renal disease, those who are disabled and entitled to social security benefits. -Inpatient hospital care, skilled nursing facility services, certain home health services, and hospice care. -Health insurance provided by Federal government.
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Retrospective payment vs. Prospective payment systems
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Retrospective payment, paid after health is provided, historically most common, Known as "fee-for-service" or indemnity plans, individual paid fee for health services provided similar to any other purchase of good or services VS PPS, prospective payment system was develop to contain costs, Fees and services covered set by insurance companies to control high costs of health care, health care choices now being influenced by insurance companies.
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MCOs (key features and differences related to consumer/patients and health care providers)?
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- Managed care organizations , institutions or groups who use the managed care principles.-Restrict access to services by limiting the types of, numbers of, or payment of services covered. *3 major types of MCOs=HMO, PPO, POS
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HMO (key features and differences related to consumer/patients and health care providers)?
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Health maintenance organization/prepaid insureance(loans;grants) -Staff model: providers employed by facility where services provided( all under one roof) kiaser contracted employee -Independent model: providers from group that contracts with HMO without operating the facilities where services provided; MORE COMMON than staff model.
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PPO (key features and differences related to consumer/patients and health care providers)?
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Preferred provider organization,"open managed care model" -Health insurer negotiates discounted fees with networks of Providers in return for guaranteeing a certain volume of patient, MOST COMMON form of MCO.
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POS (key features and differences related to consumer/patients and health care providers)?
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Point of service -Individual can seek in-network(cheaper) or out-of-network(more expensive) services. -Providers more flexibility of choice of provider
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DRG- define; what settings are they used in?; what type of payment system?
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-Diagnostic related groups, Part A medicare, Hospital paid for average cost of diagnosis regardless of actual cost for each patient. Setting-Hospitals Payment system-PPS(Prospective Payment system) fixed payment, *Hospital inpatients covered under Medicare part A.
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RUG- define; what settings are they used in?; what type of payment system?
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Resource utilization groups, Classifies residents into one of 53 resource utilization groups based on resources used to manage their condition. Setting- Skilled Nursing Facility Payment system-PPS(prospective payment system) *PT in SNF must report therapy minutes on a Minimum Data Set (MDS)
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MDS - define; what settings are they used in?; what type of payment system?
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Minimum Data Sheet,MDS is an assessment instrument used in the SNF PPS to classify residents into one of 53 resource utilization groups that categorize patients based on their levels of resources used.
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Co-pay
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*Every Visit, Flat dollar amounts a subscriber has to pay for specific health services at the time of service.
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coinsurance
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Expressed as a percentage, is a cost-sharing obligation under a health insurance policy. Example- Insurance 80%, You pay 20%
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Deductible
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Amount you pay before health insurer will pay for all or part of the remaining cost of the covered services.
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Premium
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Cost of the insurance, out of pocket. *what you pay or employer, or part of payment.
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Know how to apply Ethical standards for the PTA
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1. recognize and define the ethical issue.2. Reflect 3.Decide to do the right thing. 4. Implement, evaluate, reassess outcome. Standards 1-8 1.Respect the dignity and rights of all individuals. 2.Be trustworthy and compassionate in addressing the rights/needs of patients. 3.Make sound decisions in collaboration with PT and within boundaries of laws/regulations. 4.Demonstrate integrity in relationships with patients, families, colleagues, students, other HCPs, payers, employers, and the public. 5. Fulfill legal and ethical obligations 6. Enhance competence through lifelong acquisition and refinement of knowledge, skills, and abilities. 7. Support organizational behaviors and business practices that benefit patients/clients, and society. 8. Participate in efforts to meet the health needs of people locally, nationally, or globally.
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Balance Budget Act
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-Created an annual cap per beneficiary(patient) including speech-language pathology services for outpatient services. -In 2015, the cap was $1940 -Moratoriums came and went on the cap. *APTA continues to lobby against the cap because of its negative effect on patient care.
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Stages of the Continuum (of cultural competence)CULTURAL DESTRUCTIVENESS
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People are treated in a dehumanizing manner and denied services on purpose.
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Stages of the Continuum (of cultural competence):Cultural incapacity
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Health care system is unable to work with patients from other cultures effectively, and patients are treated with biases, paternalism, and stereotypes.
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Stages of the Continuum (of cultural competence) :Cultural blindness
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Health care system is based on a presumption that all people are the same and that biases do not exist. Services are ethnocentric and encourage assimilation.
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Stages of the Continuum (of cultural competence):Cultural precompetence
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Health care system is using appropriate response to cultural differences, weakness are acknowledged , and alternatives are sought.
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Stages of the Continuum (of cultural competence):Cultural Competence*
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Cultural differences are accepted and respected. There is continuous expansion of cultural knowledge, and resources and services are continuously adapted. There is constant vigilance regarding the dynamics of cultural differences.
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Stages of the Continuum (of cultural competence):Cultural proficiency*
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Cultural differences are highly regarded. The need for research on cultural differences is acknowledged , and new approaches are developed to promote culturally competent practice.
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Define each professional behavior and give examples, Critical thinking
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The ability to question logically, identify,generate, and evaluate elements of a logical argument. -Recognize and differentiate facts, appropriate or faulty inferences, and assumptions, and to distinguish relevant from irrelevant information. -The ability to appropriately analyze and critically evaluate scientific evidence to develop a logical argument.-The ability to identify and determine the impact of bias on the decision-making process. Example-
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Define each professional behavior and give examples, Communication
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Communicate effectively for varied audiences and purposes.
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Define each professional behavior and give examples, Problem Solving
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The ability to recognize ; define problems, analyze data, develop solutions, and analyze outcomes.
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Define each professional behavior and give examples, Interpersonal skills
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The ability to interact effectively with patients, family members, colleagues, doctors, nurses, insurance companies, and others in a culturally aware manner.
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Define each professional behavior and give examples, Responsibility
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To hold oneself accountable for the outcomes of personal and professional actions. To follow through on commitments that encompass the profession within the scope of work, community, and social responsibilities.
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Define each professional behavior and give examples, Professionalism
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To exhibit appropriate professional conduct and to represent the profession effectively while promoting growth and development of the physical therapy profession.
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Define each professional behavior and give examples, Use of constructive feedback
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The ability to seek out and identify high-quality sources of feedback, reflect on and integrate the feedback, and provide meaningful feedback to others. -ESPECIALLY when you are a student. Seek it out, internalize it, reflect on it, use it.
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Define each professional behavior and give examples, Effective use of time and resources
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The ability to manage time and resources effectively to obtain the maximum possible benefit. Time=$, Resources=$
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Define each professional behavior and give examples, Stress management
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Identify sources of stress. Develop HEALTHY coping mechanisms. Patient/family interaction, staff interaction=physicians,nurses, social workers.
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Define each professional behavior and give examples, Commitment to learning
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The ability to self direct. Know clinical weaknesses. Address weaknesses. Keep up with research and evidence based treatment.
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Define rapport
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Rapport means being able to adjust speech and body language appropriately for your audience. -3 types of rapport: Cultural, verbal, behavioral. -Got to speak their language -consider different types of patients construction worker with HS education Nun City mayor Middle school student
