Memorial Day Monday, May 27th, was also the last day (sine die) of the 86th Texas Legislative Session. Symmetry is excited to report that amidst a flurry of last-minute law-making, both the Texas House of Representatives and the Texas Senate have passed and signed House Bill 29 – a measure that will enable easier access to physical therapy by Texas healthcare consumers. On May 28th, the final bill was sent to the Governor’s desk. Governor Abbot now has until June 16th to either sign or veto all of the legislation that arrives at his office. If he neither signs nor vetoes a bill, it will automatically go into effect on September 1st. House Bill 29 was one of 2827 pieces of legislation that were completed by this year’s Legislature. Considering that there were almost 11,000 bills introduced (10,854, to be precise), this is really quite remarkable!
Before explaining more about what House Bill 29 says and how we anticipate that it will work, we would like to extend a heartfelt THANK YOU to each of you that has participated with us during this Session to push this legislation towards the finish line. Each of your stories and opinions and voices has been so helpful! A huge THANK YOU also goes out to State Representative Ina Minjarez of San Antonio, who championed the Bill and worked throughout the Session to ensure that it continued to move forward through the law making process. House Bill 29 ultimately passed unanimously on the House Floor! (We’ve dropped thank-you notes electronically to our local House Representatives, letting them know that we appreciate their work on this issue. If you would like to do the same, it’s likely that your communication would be well-received.)
As is often the case during the crafting of legislation, House Bill 29 evolved throughout this Session and has ultimately been passed with compromise. The final draft of the bill is not what was initially put forward, and the Bill proposed this session was already a compromise from what was originally proposed several Legislatures ago. If you are interested in an expanded history of how support for and opposition to the concept of allowing patients to directly access their physical therapist for musculoskeletal health care services has waxed and waned over the years, feel free to ask. For now, however, the short version of our conclusions is that House Bill 29 looks likely to become the 1st step in Texas in a good direction for health care consumers.
The provisions of House Bill 29 are essentially as follows:
Provided that Governor Abbot signs the bill, beginning on September 1st, 2019 –
- Patients will be able to choose to see a Physical Therapist without a referral / prescription for 10 or 15 business days. (How many days are available for each case will depend on the specific post-graduate degree training of each individual therapist.)
- Patients choosing to see a Physical Therapist without a referral will sign a disclosure stating that they understand that physical therapists do not make “medical diagnoses” of illness or disease.
Between now and September 1st, the Texas Physical Therapy Association and the Texas Board of Physical Therapy Examiners will be more specifically communicating recommendations for the interpretation of these new guidelines. Already, many questions and “what-if” scenarios have arisen and will need to be worked through. Presumably, future Legislative Sessions will also address appropriate modifications to this measure, as it becomes more evident how the new process is working for health care consumers. For now, the bottom line is that improving the ease of access to physical therapy will have a positive impact on community health, even though the direct access interval is currently short-term. Here are a couple of examples:
- When HB 29 goes into effect, a patient having a flare-up in back pain after working in the yard on the weekend will be able to choose to see a physical therapist for hands-on treatment and pain management as soon as they wish. Often, mechanical pain episodes such as this will respond and resolve within several treatments during a short period of time, particularly if the problem is addressed quickly. It is typical that the wait time to see a physical therapist is less than 2-3 business days. Being able to access care quickly will hopefully result in less missed-work or missed-recreational activity due to joint and muscle pain.
- Patients with known chronic health issues will be able to periodically check in with their physical therapist for maintenance care and/or “tune-up” treatments. Are you having neck or back pain associated with your progressing pregnancy? Is your knee arthritis acting up because of a recent long car trip? Is your endurance down after a recent cancer treatment? Fewer barriers will exist to patients seeking physical therapy treatment in each of these situations.
- Patients with injuries that are likely to ultimately require complicated care will be able to get a physical therapist’s advice about how to manage their condition until further imaging or surgical consult is possible. Wait times are often 2-4 weeks for orthopedic injury specialists. If you’ve significantly injured a joint or muscle and are having difficulty moving around and participating in normal activities, it will be possible for you to seek guidance from your physical therapist about how to use a sling or crutches or a brace or how to revise your desk set-up or your bedroom to help you to function in this interim period. Caring appropriately for an acute injury can smooth the path of longer-term care by limiting compensations in movement that can create unrelated pain and/or allow additional mechanical issues to develop. Decreasing the wait time between injury and assessment by a health care provider will help to streamline this process.
- Well-care and preventative care for the musculoskeletal system will be more readily available. Consumers will be able to choose to see their physical therapist periodically for general assessments or check-ups to help keep their bodies in optimal working condition. Strong, mobile joints and muscles are a powerful tool in the management and prevention of health issues such as heart disease, diabetes, depression, and dementia. Once this bill takes effect, being able to access a physical therapist for advice and activity recommendations BEFORE a significant problem compromises daily function will save both individuals and the community in time and health care costs.
Symmetry will be actively participating in the process of better determining how the provisions of House Bill 29 will work moving forward into the Fall. Further information will be forthcoming as this process moves forward. Thanks again to all of you who have been interested in and/or participated along with us during this Legislative Session!