The PT Compact is no longer just a dream of travelers – it’s happening! Washington State’s Governor just signed the PT compact into law making Washington the 10th state to adopt the compact. Before you go on reading this, take a look at the current status of states working on adopting the compact: https://www.fsbpt.org/FreeResources/PhysicalTherapyLicensureCompact.aspx
The compact needed 10 states to go live. The compact commission will now be formed which will develop and maintain the specific rules and regulations for the compact. With 10 states having adopted the compact, it is now a reality – but, there’s another 8 states currently considering the compact in their legislatures. I assume licensure reciprocity between compact states will be a reality sometime during 2018 – only a guess. I also suspect that by that time, we will be somewhere in the neighborhood of 25 to 30 states participating in the compact. If the states that aren’t yet talking about the compact haven’t realized it yet, they are going to be at a big disadvantage for recruiting PTs to their states. This will be especially true in states with less PTs graduating from programs than the public demand for PT; There are very few states that are able to supply their full PT workforce independently. If your state is not pursuing the compact yet, get on it! States not involved with the compact are going to be losing PTs to compact states that allow licenses to be easily transported across state lines.
I’m psyched. I first started letters to FSBPT in March of 2010 suggesting improved reciprocity between states. Later that year, in October, FSBPT leadership charged their Board of Directors with researching the development of an interstate licensure compact – coincidence? I’d like to think not (so I can take credit for the whole thing), but I guess we’ll never know the full truth. Although, Rachel Jermann reached out to me this week with a quote from Lucy Blair’s 1971 McMillan Lecture, “Several recent studies have contained challenges that licensure and registration on a state basis are barriers to the movement of personnel from state to state and are handicapping adequate distribution.” …I guess we’re all about 45 years late to the party.
As I have pushed for the compact to be pursued here in Colorado, I have learned a lot about the legislative process. Here in Colorado, the compact legislation was introduced to the house of representatives in January. In Colorado, a bill can be introduced to either chamber of the state congress (House or Senate). Once it passes one chamber of congress, it then progresses to the next. Most states have a similar system. Depending upon the content of the bill, it is required to be reviewed by particular committees in each chamber. I got the chance to testify before the “Health, Insurance, and Environment Committee”. I have long looked forward to doing this kind of work, but lacked the passion for any one particular topic. The compact gets my juices pumping – it hits close to home with travel therapy and I feel like I’m very well versed in the topic of interstate PT licensure. Describing my experiences with licensure in travel PT to the committee of 11 state representative was both very rewarding and extremely terrifying. I was well prepared, which got me through, but I became very, very nervous while testifying despite all the very nice things said about PT by the Representatives on the committee. We can’t forget that our profession touches many peoples’ lives, including politicians. I suspect with repetition in testifying my nervousness will subside, I hope I get the chance to continue this kind of work in the future.
There were a couple other PTs testifying that opened my eyes to the PTs and patients outside of the traveling world that will benefit from the interstate compact:
- Military families who move often without warning would benefit greatly from improved licensure portability.
- PTs entering telehealth are running into licensure issues because: Are they practicing physical therapy where the PT is located? Or where the patient is located? The answer to this question is unclear at this time.
- Newly graduating PT students who are at school out of their home state and are unsure of where they will practice – stay and practice where they are in school or return to their home state? These students would be helped by being able to more freely take their license between states.
- And, of course, let’s not forget all of the employers and, most importantly, the patients who would benefit from having easier access to PTs, especially in rural communities where PT recruitment can be difficult and on state borders where an available PT may live just a few miles away but be limited by the lack of state reciprocity. (see other letters of endorsement from other businesses, consumer advocates, and policy organizations)
So what are the arguments against the PT compact?
Apparently there aren’t many, since the compact is bulldozing its way across the country. It just makes good sense that in this time of internet and air travel that PTs and PTAs should be allowed to transport their licenses across state lines more easily – I think state legislators see that practicality. It is easy for them to see that increased license portability is good for therapist, patient, and business alike.
But, there are a few legislators that do vote against the compact. Let’s entertain for just a minute that there might be significant opposition to the compact (which there is not). I can think of two reasons passing the licensure compact might be opposed:
- The 10th Amendment to the Constitution protects states’ rights to govern licensure within their borders. There could be a perceived loss of individual state control through the compact. Although, the way the compact is set-up allows a state to repeal the compact legislation at anytime to return to their individual governance of PT licensure. Also, this is the way driver’s licenses work – a driver’s license interstate compact is what allows you to drive across state borders. Compacts are nothing new.
- Cost. There can be some costs with implementing the compact. It requires fairly strict licensing standards – background check, finger printing, etc which can cause cost to the state or increase the cost of being licensed. Some states are simply absorbing this cost through increased licensure fees. The way I see it, the compact would remove a host of administrative burdens which, in turn, would increase efficiency and recoup cost from the current antiquated, cumbersome process.
I’m so excited about the compact. It’s a system I have pictured for many years and believe it will tear down one of the great barriers travel PTs and PTAs face. I foresee the states that are involved in the compact will become prime-targets for travelers while the non-compact states may struggle to find the temporary and permanent help they need. So, get your state in. I don’t care if it’s your home state, the state you are working in, or the state you are at school in. Start talking about it to people in your state that can create legislation and make it happen.
I’m excited to have been a part of the process here in Colorado but would like to do more. For now, I’ll do everything I can to keep moving the PT compact forward and make sure it passes here – we’re getting close. Working on this topic that I care about and know deeply is a great first step to being more involved in PT legislation. State legislatures are ultimately the gate-keeper for a patient’s ability to access our full scope of practice in each state. We need to continue to demonstrate to them the commonsense quality and cost-effectiveness of the services that Physical Therapists provide across the country.