After decisively passing legislation to expand New Yorkers' access to physical therapy, a state lawmaker said Tuesday that work continues to expand the scope of practice for a variety of state-licensed medical professionals to address an ongoing staffing crisis.
Assemblymembers passed a bill in the final days of session to allow physical therapy assistants to work under general supervision, or permitting physical therapists to oversee a PT assistant's treatment and care plan without having to be physically present.
"During COVID, we had physical therapy assistants who were ready, willing and able to work and they couldn't, and so we had patients that had to be either be canceled or go unseen simply just because we didn't have somebody there to directly supervise — to be in-house while that physical therapy assistant was working," American Physical Therapy Association N.Y. President Michael Tisbe said.
Tisbe said if Gov. Kathy Hochul signs the bill into law, it would help fill in widening care gaps in smaller PT clinics or poor or rural areas, and continue care for New Yorkers who need rehabilitation.
A federal change enacted in January allows PT assistants to practice under general supervision when treating Medicare patients. The change is expected to save $271 million in Medicare costs over the next decade, according to a 2022 report by Dobson & Davanzo.
"They also had done studies checking to see if efficacy, if treatments changed, if there was any danger or risk to the public, and they didn't find any," Tisbe said.
The off-site supervision of PT assistants is permitted in 49 other states. Hochul will review the legislation once it's sent to her desk before the end of the year.
Senate Higher Education Committee Chair Toby Ann Stavisky sponsored the bill and said the change is needed to improve access to physical therapy treatment in health care deserts upstate.
The bipartisan proposal passed without opposition — something Stavisky said is a step toward advancing other proposals to expand the scope of practice, or legal boundaries, for medical professionals such as nurses, physicians and physicians assistants.
"Without a doubt, it's a problem, not just for physical therapy, but for nurses and all areas of the health care professions," the senator told Spectrum News 1 on Tuesday.
Stavisky said she hopes bipartisan support for the legislation will bolster ongoing conversations with the state Department of Education she expects later this year as lawmakers mull proposals to expand the scope of practice for certain health workers and boost a suffering workforce.
Legislation has been proposed to expand the scope of practice for physician assistants, nurse practitioners and physical therapists, but hasn't cleared the Legislature.
A bill cleared the Legislature this session allowing podiatrists to perform total ankle replacements after demonstrating the required training and experience.
Many medical groups have fought the proposals and raised concerns about a reduced quality of care, but Stavisky said lawmakers must decide to address the fallout from making changes, or the larger consequences of inaction as New Yorkers' proximity to critical health care services dwindles outside New York City.
"There are bills like this which require some time in the oven before they're ready to serve," Stavisky said.
The senator said she expects to continue work this year, and the Legislature could vote to modernize the legal boundaries for health professionals in the state in the next year or two.