American Physical Therapy Association House of Delegates. Post-House Packet

American Physical Therapy Association 2015 House of Delegates Post-House Packet June 19, 2015

**DRAFT LANGUAGE: NOT FINAL UNTIL HOUSE OF DELEGATES MINUTES ARE APPROVED** The Post-House Packet contains draft motion language that is current as of the close of the 2015 House. Final language will be reflected in the 2015 House minutes, which will be available by August 14, 2015. House positions and polices adopted or amended in June will be made available online by September. 1

RC 1-15 AMEND: BYLAWS OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION AND STANDING RULES OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION TO CHANGE THE LENGTH AND NUMBER OF TERMS FOR MEMBERS OF THE APTA BOARD OF DIRECTORS Required for Adoption: Previous Notice, 2/3 Vote DEFEATED Note: Triple asterisks () indicate language that is not being amended and therefore has not been included in order to make the document more concise. (Note: This is a motion with 2 conforming amendments - Parts A and B.) That Bylaws of the American Physical Therapy Association and Standing Rules of the American Physical Therapy Association be amended as follows to change the length and number of terms for members of the APTA Board of Directors. PART A That Bylaws of the American Physical Therapy Association, Article IX. Board of Directors, Section 4: Tenure, be amended by substitution: ARTICLE IX. BOARD OF DIRECTORS Section 4: Tenure A. The members of the Board of Directors shall be divided into 3 classes for the purposes of election, and the members of each class shall serve the term prescribed by these bylaws. which shall be equal in size or as nearly equal as possible. Each class will include one-third or approximately one-third of the members who are not officers, plus two officers. The Secretary and the Vice Speaker of the House of Delegates shall belong to the first class, which shall be elected in years that are multiples of 3. The Treasurer and the Speaker of the House of Delegates shall belong to the second class, which shall be elected the year after the first class. The President and the Vice President shall belong to the third class, which shall be elected the year after the second class. B. Members of the Board of Directors shall assume office at the close of the annual session of the House of Delegates at which they were elected. C. The term of office of each member of the Board of Directors shall be 3 4 years or until their successors are elected. D. No member shall serve more than 3 complete consecutive terms on the Board of Directors or more than 2 complete consecutive terms 1 complete term in the same office. E. A complete term for a member of the Board of Directors shall be defined as 3 4 years. F. Vacancies In the event that a position on the Board of Directors becomes vacant, the vacancy shall be filled in the manner prescribed in the standing rules. (Exceptions: President and Speaker of the House of Delegates.) Proviso: These changes shall affect any member elected at the 2016 annual session or later. 2

PART B That Standing Rules of the American Physical Therapy Association, 14. Vacancies: Officers and Directors, be amended by substitution: A. If a vacancy occurs within the first year of a 3 4-year term, the Nominating Committee shall select a candidate(s) for election at the next annual session of the House of Delegates; the elected person shall serve for the remaining 2 3 years of the term. B. If a vacancy occurs after the first year of a 3 4-year term, the vacancy shall be filled by appointment by the Board of Directors. C. Notwithstanding Standing Rule 13(B), if a vacancy occurs on the Board of Directors as a result of an election, a second election shall be required. The Nominating Committee shall prepare the slate for the second election, and additional nominations from the floor shall be in order. All candidates who were slated for any position on the Board of Directors and were not elected in the first election shall will be slated in the second election unless they have indicated otherwise. Candidates who were not elected for the Nominating Committee shall not be automatically slated but may be nominated from the floor. Proviso: These changes shall affect any member elected at the 2016 annual session or later. RC 2-15 AMEND: BYLAWS OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION TO CHANGE THE QUALIFICATIONS FOR PRESIDENT, VICE PRESIDENT, SECRETARY, AND TREASURER WITHDRAWN Please refer to Packet I for motion language. RC 3-15 AMEND: BYLAWS OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION TO GRANT COMPONENTS THE OPTION OF AMENDING THEIR BYLAWS TO PROVIDE A FULL VOTE FOR PHYSICAL THERAPIST ASSISTANT MEMBERS Required for Adoption: Previous Notice, 2/3 Vote PASSED Note: Triple asterisks () indicate language that is not being amended and therefore has not been included in order to make the document more concise. That Bylaws of the American Physical Therapy Association, Article IV. Membership, Section 2: Rights and Privileges of Members, B., (2), b., be amended by inserting the words unless the chapter or section allows such members 1 vote after the words one-half vote so that it would read: ARTICLE IV. MEMBERSHIP 3

Section 2: Rights and Privileges of Members B. Only members in certain categories have the following privileges (subject to restriction as otherwise provided in Association bylaws): (2) To vote. a. At House of Delegates meetings: Chapter delegates, 1 vote. b. At chapter or section meetings by members of the chapter or section: Physical Therapist, Retired Physical Therapist, and Life Physical Therapist, 1 vote; Physical Therapist Assistant, Retired Physical Therapist Assistant, and Life Physical Therapist Assistant, one-half vote unless the chapter or section allows such members 1 vote; except when chapter or section bylaws provide for a representative body. c. At assembly meetings: Members of the assembly, 1 vote. d. At committee meetings: Any member serving on the committee, 1 vote. RC 4-15 AMEND: BYLAWS OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION TO PROVIDE CHAPTERS THE OPTION OF AMENDING THEIR BYLAWS TO ENABLE PHYSICAL THERAPIST ASSISTANT MEMBERS TO SERVE AS CHAPTER DELEGATES PACKET II Required for Adoption: Previous Notice, 2/3 Vote DEFEATED Note: Triple asterisks () indicate language that is not being amended and therefore has not been included in order to make the document more concise. (Note: This is a motion with 2 conforming amendments Parts A and B.) That Bylaws of the American Physical Therapy Association and Standing Rules of the American Physical Therapy Association be amended as follows to provide chapters the option of amending their bylaws to enable physical therapist assistant members to serve as chapter delegates. PART A That Bylaws of the American Physical Therapy Association, Article IV. Membership, Section 2: Rights and Privileges of Members, B., (4), a., be amended by adding the words and, if permitted by chapter bylaws, Physical Therapist Assistant after the words Physical Therapist so that it would read: ARTICLE IV. MEMBERSHIP Section 2: Rights and Privileges of Members B. Only members in certain categories have the following privileges (subject to restriction as otherwise provided in Association bylaws): (4) To serve as a delegate to the House of Delegates. a. As chapter delegate: Physical Therapist and, if permitted by chapter bylaws, Physical Therapist Assistant. 4

b. As section delegate: Physical Therapist and Physical Therapist Assistant. c. As PTA Caucus delegate: Physical Therapist Assistant, subject to qualifications identified in Article VIII., Section 4., of these bylaws. d. As assembly delegate: Assembly member, subject to additional eligibility requirements in the assembly bylaws. PART B That Bylaws of the American Physical Therapy Association, Article VIII. House of Delegates, Section 3: Voting Delegates, A., (1), be amended by substitution: Section 3: Voting Delegates The voting delegates of the House of Delegates shall be the chapter delegates. A. Qualifications of Voting Delegates (1) Chapter delegates: Only Physical Therapist, and if permitted by chapter bylaws Physical Therapist Assistant, members may serve as chapter delegates. Only Physical Therapist and Physical Therapist Assistant members who have been Association members in good standing in any category of membership for no fewer than the 2 years immediately preceding the start of the House session may serve as chapter delegates. (2) Members of the Board of Directors may not serve as chapter delegates. (3) A delegate of any one component may not serve concurrently as a delegate of another component. RC 5-15 AMEND: BYLAWS OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION TO ALLOW SECTIONS TO VOTE IN THE HOUSE OF DELEGATES Required for Adoption: Previous Notice, 2/3 Vote DEFEATED Note: Triple asterisks () indicate language that is not being amended and therefore has not been included in order to make the document more concise. (Note: This is a motion with 11 conforming amendments - Parts A K.) PART A That Bylaws of the American Physical Therapy Association, Article IV. Membership, Section 2: Rights and Privileges of Members, B., (2), a., be amended by inserting the words and section after the word chapter so that it would read: Article IV. MEMBERSHIP Section 2: Rights and Privileges of Members 5

B. Only members in certain categories have the following privileges (subject to restriction as otherwise provided in Association bylaws): (2) To vote. a. At House of Delegates meetings: chapter and section delegates, 1 vote. b. At chapter or section meetings by members of the chapter or section: Physical Therapist, Retired Physical Therapist, and Life Physical Therapist, 1 vote; Physical Therapist Assistant, Retired Physical Therapist Assistant, and Life Physical Therapist Assistant, one-half vote; except when chapter or section bylaws provide for a representative body. c. At assembly meetings: Members of the assembly, 1 vote. d. At committee meetings: Any member serving on the committee, 1 vote. PART B That Bylaws of the American Physical Therapy Association, Article IV. Membership, Section 2: Rights and Privileges of Members, B., (4), b, be amended by striking out the words and Physical Therapist Assistant after the words Physical Therapist so that it would read: Article IV. MEMBERSHIP Section 2: Rights and Privileges of Members B. Only members in certain categories have the following privileges (subject to restriction as otherwise provided in Association bylaws): (4) To serve as a delegate to the House of Delegates. a. As chapter delegate: Physical Therapist. b. As section delegate: Physical Therapist and Physical Therapist Assistant. c. As PTA Caucus delegate: Physical Therapist Assistant, subject to qualifications identified in Article VIII., Section 4., of these bylaws. d. As assembly delegate: Assembly member, subject to additional eligibility requirements in the assembly bylaws. PART C That Bylaws of the American Physical Therapy Association, Article VII. Meetings, Section 3: Notice of Sessions, A. Annual Session, be amended by striking out the word chapter after the words to each so that it would read: ARTICLE VII. MEETINGS Section 3: Notice of Sessions A. Annual Session The time and place of the annual session shall be announced in the official journal of the Association, and notice shall be sent to each component president or chair and to each chapter chief delegate at least six weeks before the session is scheduled to convene. This notice may be made by mail or any telecommunications method including, but not limited to, fax and e-mail transmissions which must ensure the timely receipt of the notice and may ensure verifiable receipt of the notice by the intended recipients. 6

PART D That Bylaws of the American Physical Therapy Association, Article VIII. House of Delegates, Section 3: Voting Delegates, be amended by substitution: ARTICLE VIII. HOUSE OF DELEGATES Section 3: Voting Delegates The voting delegates of the House of Delegates shall be the chapter and section delegates. A. Qualifications of Voting Delegates (1) Chapter and section delegates: Only Physical Therapist members may serve as chapter or section delegates. Only Physical Therapist members who have been Association members in good standing in any category of membership for no fewer than the 2 years immediately preceding the start of the House session may serve as chapter or section delegates. (2) Members of the Board of Directors may not serve as chapter or section delegates. (3) A delegate of any one component may not serve concurrently as a delegate of another component. B. Number of Voting Delegates The number of each section s delegates shall be determined according to the standing rules. The number of chapter delegates shall be based on, but not limited to, 400, which shall be apportioned among the chapters on the basis of the number of Physical Therapist, Retired Physical Therapist, Life Physical Therapist, Physical Therapist Assistant, Retired Physical Therapist Assistant, and Life Physical Therapist Assistant members in each chapter according to membership records in the Association headquarters and as described in the standing rules. a target number equal to 436 minus the number of section delegates. The number of each chapter s delegates shall be based on its member count as determined according to the standing rules. No chapter or section shall have fewer than 2 delegates. C. Selection of Voting Delegates Each chapter and section shall select the delegates who will represent it at the annual session. Each chapter and section shall designate 1 delegate as its chief delegate. D. Credentials Credentials shall be issued by the Association. Delegates shall register and file credentials before the first meeting of the House of Delegates and at such other times as designated by the Officers of the House of Delegates. E. Voting Body Each chapter voting delegate shall have 1 vote, except that if any of the delegates to which a chapter or section is entitled does not attend a meeting of the House of Delegates, the vote(s) may be transferred to the remaining member(s) of the delegation who are present in attendance. PART E That Bylaws of the American Physical Therapy Association, Article VIII. House of Delegates, Section 4: Nonvoting Delegates, be amended by substitution: ARTICLE VIII. HOUSE OF DELEGATES Section 4: Nonvoting Delegates The nonvoting delegates of the House of Delegates shall be the section delegates, PTA Caucus delegates, Student Assembly delegates, and the members of the Board of Directors. 7

A. Qualifications of Nonvoting Delegates (1) Section delegates: Only Physical Therapist and Physical Therapist Assistant members may serve as section delegates. Only Physical Therapist and Physical Therapist Assistant members who have been Association members in good standing in any category of membership for no fewer than the 2 years immediately preceding the start of the House session may serve as section delegates. (2 1)PTA Caucus delegates: Only Physical Therapist Assistant members who have been Association members in good standing for no fewer than 2 years immediately preceding the start of the House session may serve as PTA Caucus delegates. (3 2)Student Assembly delegates: Only Student Physical Therapist and Student Physical Therapist Assistant members who have been Association members in good standing for the 4 months immediately preceding the start of the House session may serve as Student Assembly delegates. For the purposes of this subparagraph (2), members who have converted under Article XI, Section 3, from Student Physical Therapist to Physical Therapist or from Student Physical Therapist Assistant to Physical Therapist Assistant shall be deemed members of the Student Assembly until the close of the House of Delegates meeting immediately following the date of graduation and shall be eligible to serve as Student Assembly delegates during that period. (4 3)Members of the Board of Directors may not serve as section or assembly delegates. (5 4)A section delegate or Student Assembly delegate may not serve concurrently as a delegate of another component. A PTA Caucus delegate may not serve concurrently as a section delegate. B. Number of Nonvoting Delegates (1) Section delegates: Each section shall be entitled to 1 delegate. (2 1) PTA Caucus delegates: The PTA Caucus shall be entitled to 5 delegates. (3 2)Student Assembly delegates: The Student Assembly shall be entitled to 2 delegates. C. Selection of Nonvoting Delegates Each section, t The PTA Caucus, and the Student Assembly shall select the delegate(s) who will represent it at the House session. D. Credentials Credentials shall be issued by the Association. Delegates shall register and file credentials before the first meeting of the House of Delegates and at such other times as designated by the Officers of the House of Delegates. E. Rights and privileges of nonvoting delegates Section delegates, PTA Caucus delegates, Student Assembly delegates, and members of the Board of Directors may speak, debate, and make and second motions. PART F That Bylaws of the American Physical Therapy Association, Article VIII. House of Delegates, Section 5: Conduct of Business, be amended by substitution: ARTICLE VIII. HOUSE OF DELEGATES Section 5: Conduct of Business A. Officers of the House of Delegates (1) The officers shall be the Speaker of the House of Delegates, the Vice Speaker of the House of Delegates, and the Secretary. (2) The officers shall be responsible for registering delegates, transferring voting privileges, preparing rules of order and an agenda for the consideration of the House of Delegates, recording and reporting the proceedings, appointing the Committee to Approve the Minutes, making appointments to the Reference Committee, conducting elections, making editorial changes to the 8

bylaws and standing rules, and performing other duties as determined by these bylaws or the standing rules. B. Quorum Delegates representing one-third of the chapters and sections, and numbering one-third of the total number of chapter votes that could be cast if all voting delegates from all chapters were present shall constitute a quorum. C. Voting (1) Voting on motions and resolutions in the House may be by voice, show of hands, standing, roll call, or use of electronic equipment. (2) If a decision must be made during the interval between annual sessions, a majority vote of the Board of Directors may determine that the chapter voting delegates be polled by mail. These delegates shall be those registered at the immediately preceding session of the House of Delegates. If the delegate is no longer a member of the chapter or section or holds membership in a category other than that held when the delegate registered at the immediately preceding session of the House of Delegates or for any other reason no longer meets the qualifications for delegate, an alternate delegate shall be named by that chapter or section. At least 50 percent of the ballots of the eligible delegates must be returned to validate the vote. (3) Election of officers, directors, and members of the Nominating Committee shall be by ballot or use of electronic equipment. Officers shall be elected by a majority of the votes cast. Directors and members of the Nominating Committee shall be elected by a plurality of the votes cast. If the vote fails to determine election, reballoting shall be conducted under procedures determined by the Officers of the House of Delegates. D. Memorials and Resolutions Only memorials or resolutions adopted by the House of Delegates can be issued validly in the name of the Association. PART G That Bylaws of the American Physical Therapy Association, Article XIV. Amendments be amended by substitution: ARTICLE XIV. AMENDMENTS These bylaws may be amended at the Annual Session of the House of Delegates in years ending in 0 and 5 by the affirmative vote of at least two-thirds of the chapter voting delegates present and voting, or at any special session of the House of Delegates or the Annual Session of the House of Delegates during years not ending in 0 or 5 by the consent to consider, without debate, of two-thirds of the chapter voting delegates present and voting and by the affirmative vote of at least two-thirds of the chapter voting delegates present and voting, providing the following: A. Any proposed amendment has been submitted in writing to the Association s headquarters by a date set by the Speaker of the House of Delegates, which shall be at least 4 months but no more than 5 months before the session of the House of Delegates. B. Copies of all proposed amendments have been printed in an Association publication or distributed to all Association members at least 2 months before the session of the House of Delegates. This distribution may be made by mail or any telecommunications method including, but not limited to, fax and e-mail transmissions, which must ensure the timely receipt of the notice and may ensure verifiable receipt of the notice by the intended recipients. Bylaw amendments pertaining to Article XI: Finance, Section 3: Dues, may be amended at any Annual 9

Session or special session of the House of Delegates by the affirmative vote of at least two-thirds of the chapter voting delegates present and voting, provided that the conditions of subparagraphs A and B above are satisfied. PART H That Standing Rules of the American Physical Therapy Association, 10. Delegate Credentials, be amended by substitution: 10. DELEGATE CREDENTIALS Component Delegates: Chapter or section delegate credentials shall be signed by the chapter or section president or the chapter or section chief delegate. The designation of chief delegate shall be indicated on the appropriate chapter or section credential. Section or aassembly delegate credentials shall be signed by the section or assembly president. PART I That Standing Rules of the American Physical Therapy Association, 11. Formula for Determining the Size of the House of Delegates, be amended by substitution: 11. FORMULA FOR DETERMINING THE SIZE OF THE HOUSE OF DELEGATES (1) Add the number of Physical Therapist, Retired Physical Therapist, and Life Physical Therapist members and one-half of the number of Physical Therapist Assistant, Retired Physical Therapist Assistant, and Life Physical Therapist Assistant members of the Association who are assigned to chapters as of June 30 of the year preceding the House of Delegates in which they will serve. (2) Divide the total found in Step 1 by 400. This shall be the apportionment number. (3) Divide the total number of Physical Therapist, Retired Physical Therapist, and Life Physical Therapist members and one-half of the number of Physical Therapist Assistant, Retired Physical Therapist Assistant, and Life Physical Therapist Assistant members for each chapter by the apportionment number. (4) Chapters shall be allowed one delegate for each whole number and one additional delegate for any remainder equaling or exceeding 50 percent of the apportionment number. (5) Any chapter that would be entitled to fewer than 2 delegates according to the above shall be allowed 2 delegates. (1) For each year the number of voting delegates in the House of Delegates shall be the sum of the section delegates and the chapter delegates, as determined in accordance with this Standing Rule. (2) For the purpose of determining the number of voting delegates to the House of Delegates for any year, the member count of each chapter shall be determined by adding the number of its Physical Therapist, Retired Physical Therapist, and Life Physical Therapist members and one-half of the number of its Physical Therapist Assistant, Retired Physical Therapist Assistant, and Life Physical Therapist Assistant members as of June 30 of the preceding year. (3) Each section shall be entitled to 2 delegates. (4) The chapter delegate target shall be the difference between 436 and the number of section delegates. (5) The number of delegates to which each chapter is entitled shall be determined as follows: (a) Add the member counts of all chapters and divide the sum by the chapter delegate target. This quotient shall be the chapter apportionment number. (b) For each chapter, divide its member count by the chapter apportionment number. The chapter shall be allowed the number of delegates obtained by rounding this quotient to the nearest 10

whole number, except that each chapter shall be allowed at least 2 delegates. PART J That Standing Rules of the American Physical Therapy Association, 12. Mail Ballot, be amended by substitution: 12. MAIL BALLOT When the Board of Directors determines to conduct a mail ballot, according to Article VIII, Section 5., C., (2) of the bylaws, a ballot shall be prepared and distributed as follows: A. The question to be decided and appropriate supporting information shall be provided with the ballot. B. Instructions for completing and returning the ballot shall be printed on the ballot. C. The deadline for receipt of ballots at the Association's headquarters shall be printed on the ballot, and this deadline shall be no fewer than 30 days after the date mailed to the all voting delegates. D. An addressed envelope (to the Association's headquarters) and a plain envelope shall be included in the mailing. E. The ballots shall be mailed by first class mail to each chapter voting delegate. F. The voting delegate shall place the completed ballot in the plain envelope, place the plain envelope in the envelope addressed to the Association's headquarters, sign the outside envelope, and mail it to Association headquarters. G. The Officers of the House of Delegates shall be responsible for opening and counting the returned ballots and preparing a report of the results of the vote. PART K That Standing Rules of the American Physical Therapy Association, 20. Consent Calendar, D., be amended by striking out the word section, after the word chief, so that it would read: 20. CONSENT CALENDAR A. The officers of the House of Delegates shall prepare a list of recommended motions that are routine, standard, non-controversial, or self-explanatory and where general approval is anticipated, for placement on a consent calendar. B. The preliminary consent calendar will be distributed 3 weeks prior to the start of the first meeting of the House of Delegates. C. Prior to the first meeting of the House of Delegates motions may be removed from the consent calendar by the officers of the House of Delegates or at the request of 5 chief delegates. D. The revised consent calendar will be prepared by the officers of the House of Delegates for presentation to chief, section, and assembly delegates prior to the first meeting of the House of Delegates. E. Following the opening of the House of Delegates motions may be removed from the consent calendar by an affirmative vote of one-third of the voting body of the House of Delegates. F. If a motion is removed from the consent calendar, it shall be placed appropriately in the order of business previously assigned by the Speaker of the House and the chair of the Reference Committee. G. The consent calendar shall be presented for adoption in a single motion. Proviso: These amendments to the bylaws and standing rules shall take effect at the close of business of the 11

2015 House of Delegates. RC 6-15 AMEND: BYLAWS OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION TO GRANT LIFE MEMBERS THE PRIVILEGE OF SERVING AS DELEGATES TO THE HOUSE OF DELEGATES Required for Adoption: Previous Notice, 2/3 Vote DEFEATED Note: Triple asterisks () indicate language that is not being amended and therefore has not been included in order to make the document more concise. (Note: This is a motion with 3 conforming amendments - Parts A C.) That Bylaws of the American Physical Therapy Association be amended to grant Life Members the privilege to serve as delegates to the House of Delegates: PART A That Bylaws of the American Physical Therapy Association, Article IV. Membership, Section 2: Rights and Privileges of Members, B., (4), To serve as a delegate to the House of Delegates, be amended by substitution: ARTICLE IV. MEMBERSHIP Section 2: Rights and Privileges of Members B. Only members in certain categories have the following privileges (subject to restriction as otherwise provided in Association bylaws): (4) To serve as a delegate to the House of Delegates. a. As chapter delegate: Physical Therapist and Life Physical Therapist. b. As a section delegate: Physical Therapist and Life Physical Therapist, and Physical Therapist Assistant and Life Physical Therapist Assistant. c. As PTA Caucus delegate: Physical Therapist Assistant, subject to qualifications identified in Article VIII., Section 4., of these bylaws. d. As assembly delegate: Assembly member, subject to additional eligibility requirements in the assembly bylaws. PART B That Bylaws of the American Physical Therapy Association, Article VIII. House of Delegates, Section 3: Voting Delegates, A., (1), be amended by substitution: ARTICLE VIII. HOUSE OF DELEGATES Section 3: Voting Delegates 12

A. Qualifications of Voting Delegates (1) Chapter delegates: Only Physical Therapist and Life Physical Therapist members may serve as chapter delegates. Only Physical Therapist and Life Physical Therapist members who have been Association members in good standing in any category of membership for no fewer than the 2 years immediately preceding the start of the House session may serve as chapter delegates. PART C That Bylaws of the American Physical Therapy Association, Article VIII. House of Delegates, Section 4: Nonvoting Delegates, A., (1), be amended by substitution: Article VIII. House of Delegates Section 4: Nonvoting Delegates A. Qualifications of Nonvoting Delegates (1) Section delegates: Only Physical Therapist, Life Physical Therapist, Physical Therapist Assistant and Life Physical Therapist Assistant members may serve as section delegates. Only Physical Therapist, Life Physical Therapist, Physical Therapist Assistant, and Life Physical Therapist Assistant members who have been Association members in good standing in any category of membership for no fewer than the 2 years immediately preceding the start of the House session may serve as section delegates. RC 7-15 AMEND: BYLAWS OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION TO GRANT PHYSICAL THERAPIST ASSISTANT MEMBERS THE PRIVILEGE TO SERVE ON THE APTA BOARD OF DIRECTORS Required for Adoption: Previous Notice, 2/3 Vote DEFEATED Note: Triple asterisks () indicate language that is not being amended and therefore has not been included in order to make the document more concise. (Note: This is a motion with 2 conforming amendments - Parts A and B.) That Bylaws of the American Physical Therapy Association be amended as follows to grant Physical Therapist Assistant members the privilege to serve on the APTA Board of Directors: PART A That Bylaws of the American Physical Therapy Association, Article IV. Membership, Section 2: Rights and Privileges of Members, B., (3), a., be amended by adding the words ; Physical Therapist Assistant members may serve on the Board of Directors, but not as President, Vice President, Treasurer, Secretary, Speaker of the House of Delegates, or Vice Speaker of the House of Delegates after the words Physical Therapist so that it would read: ARTICLE IV. MEMBERSHIP 13

Section 2: Rights and Privileges of Members B. Only members in certain categories have the following privileges (subject to restriction as otherwise provided in Association bylaws): (3) To hold office. a. For the Association: Physical Therapist; Physical Therapist Assistant members may serve on the Board of Directors, but not as President, Vice President, Treasurer, Secretary, Speaker of the House of Delegates, or Vice Speaker of the House of Delegates. PART B That Bylaws of the American Physical Therapy Association, Article IX. Board of Directors, Section 2: Qualifications, be amended by substitution so that it would read: ARTICLE IX. BOARD OF DIRECTORS Section 2: Qualifications Only Physical Therapist or Physical Therapist Assistant members of the Association can are eligible to serve, except that only Physical Therapist members are eligible to serve as President, Vice President, Treasurer, Secretary, Speaker of the House of Delegates, or Vice Speaker of the House of Delegates. and they Members are not eligible to serve if unless they have: A. Been Physical Therapist or Physical Therapist Assistant members in good standing for at least 5 years immediately preceding their election or appointment, and B. Consented to serve. RC 8-15 DELIVERY OF VALUE-BASED PHYSICAL THERAPIST SERVICES PACKET II PASSED (Note: This is a motion with 2 conforming amendments - Parts A and B.) That the following position be adopted: PART A DELIVERY OF VALUE-BASED PHYSICAL THERAPIST SERVICES Physical therapists are health professionals who transform society by optimizing movement to improve the human experience. As such, it is the position of the American Physical Therapy Association (APTA) that physical therapists embrace and are accountable for best practice standards to provide high quality services that promote value, and that all individuals have access to physical therapist services. Achieving these goals requires a value-based system for the delivery of physical therapist services the 14

principles of access, quality, and accountability, each grounded in a patient- and client-centered approach to delivery. PRINCIPLE I. ACCESS TO PHYSICAL THERAPIST SERVICES A. REDUCING BARRIERS TO PHYSICAL THERAPIST SERVICES 1. As an essential health benefit, APTA supports the inclusion of physical therapist services in all appropriate health care policies, including, but not limited to: a. Insurance policies by third-party payers and state, federal, or any other regulatory agencies; b. Title XIX of the Social Security Act (the Medicaid program) at the state and federal levels; and c. State and federal workers compensation programs. 2. APTA supports cost-sharing legislation, regulations, and policies that prevent cost-shifting by insurance carriers and intermediaries. APTA opposes cost-shifting models that result in patient/client copayment or coinsurance obligations that equal or exceed the rate paid by the carrier or intermediary for physical therapist services. 3. APTA supports state and federal legislation that requires payers to develop and use consistent terminology regarding coverage of physical therapist services. 4. APTA supports the inclusion of physical therapist services in all appropriate telehealth policies, regulations, and legislation by third-party payers and state, federal, and any other regulatory agencies. 5. APTA supports initiatives to promote a value-based system for physical therapist services that utilizes evidence, best practice, and outcomes for meeting the needs of individuals and the public. B. RELATIONSHIPS WITH OTHER HEALTH PROVIDERS 1. APTA supports collaborative, collegial practice relationships between physical therapists and other health providers that promote access to and integration of physical therapists services in the health services delivery continuum. 2. APTA opposes legal restrictions and relationships with other health providers that hinder the ability of physical therapists to use their clinical judgment and skills in relation to patient and client services, and that limit access to physical therapist services. PRINCIPLE II. QUALITY OF PHYSICAL THERAPIST SERVICES A. MEDICALLY NECESSARY PHYSICAL THERAPIST SERVICES The medical necessity of physical therapist services is determined by a licensed physical therapist based on the results of the physical therapist's evaluation. Medically necessary physical therapist services improve, maintain, or slow the decline of the current level of function, or prevent, minimize, slow the progression of, or eliminate impairments of body functions and structures, activity limitations, or participation restrictions. B. PAYMENT REFORM FOR PHYSICAL THERAPIST SERVICES APTA supports efforts to reform payment for physical therapist services. Payment reform should: 1. Reflect efforts to tie payment to health outcomes, performance, and quality; 2. Recognize and reward the value of physical therapist services based on the clinical reasoning and decision-making of the physical therapist; 3. Recognize physical therapists role in prevention; 4. Reduce unnecessary and unwarranted regulations that add cost, reduce efficiency, and do not improve clinical outcomes; 5. Integrate physical therapist services into various models of service delivery, while separately identifying and reporting these services; 6. Be transparent and accountable to patients and clients, payers, and policy makers; 15

7. Promote the use of evidence-based physical therapy; 8. Reduce fraud, abuse, and waste within the health service delivery system; and 9. Use standardized language and data sets across the health service delivery system. C. USE OF DATA TO IMPROVE THE QUALITY OF PHYSICAL THERAPIST SERVICES 1. APTA supports meaningful and standardized data collection by physical therapists through the adoption of interoperable electronic health record (EHR) systems in all practice settings that can advance patient care, improve quality, and demonstrate the value of physical therapist services to patients, payers, policy-makers and the provider community. 2. APTA supports the collection and tracking of data to improve the quality of physical therapist services. The functionality of data collection systems should allow analyses that: a. Identify clinical practice patterns; b. Promote adherence to clinical practice guidelines; c. Guide payment policies; d. Support quality improvement initiatives; and e. Promote health services research on delivery, utilization and outcomes to further establish the value of physical therapist services. 3. APTA supports and promotes participation in quality assurance and quality improvement activities that are incorporated into physical therapist services. D. PATIENT- AND CLIENT-CENTERED PHYSICAL THERAPIST SERVICES APTA supports patient- and client-centered health services delivery. As such, physical therapist services include patients and clients goals. Physical therapists engage patients, clients, families, and caregivers in dialog to determine desired outcomes, while maximizing patient and client satisfaction. Physical therapists coordinate with other health professionals as needed to ensure continuity throughout episodes of care. PRINCIPLE III. ACCOUNTABILITY FOR PHYSICAL THERAPIST SERVICES A. PERFORMANCE OF PHYSICAL THERAPIST SERVICES 1. The patient/client management elements of examination, evaluation, diagnosis, and prognosis should be represented and paid as physical therapist services only when they are performed by a physical therapist. 2. The patient/client management element of intervention should be represented and paid as physical therapist services only when performed by a physical therapist or, for selected interventions, by a physical therapist assistant under the direction and supervision of a physical therapist. 3. Notwithstanding the foregoing, when physical therapist students and physical therapist assistant students perform elements of patient/client management as a part of their clinical education within a program accredited by, or developing programs recognized by, the Commission on Accreditation in Physical Therapy Education, these elements of patient/client management should be represented and paid as physical therapist services. B. REASONABLE FEES FOR PHYSICAL THERAPIST SERVICES 1. APTA supports charging reasonable fees for physical therapist services. APTA encourages physical therapists to: a. Be knowledgeable of practice or institutional fee schedules, contractual relationships and payment methodologies used in relation to physical therapist services. b. Participate in establishing practice or institutional fee schedules/contractual relationships and attempt to ensure that providers, agencies, or other employers adopt physical therapy fee schedules and contractual relationships that are reasonable and encourage access to necessary services. 16

c. Seek guidance from the Code of Ethics for the Physical Therapist and Guide for Professional Conduct, applicable state law, and other institutional or payer policies if any question or disagreement arises regarding professional fees. 2. APTA opposes any acts by physical therapists or physical therapist assistants that place financial interest above the welfare of patients and clients, including but not limited to: a. Over or underutilization of services for institutional or personal gain; and b. Participating in services that are linked in any way to the financial gain of the referral source. C. PEER REVIEW OF PHYSICAL THERAPIST SERVICES 1. APTA supports peer review of physical therapist services only when provided by a physical therapist who possesses an active license without sanctions to practice physical therapy. Peer review shall be based on APTA s Standards of Practice for Physical Therapy, the Guide to Physical Therapist Practice, additional APTA documents supporting evidence-based literature, state practice acts, and other jurisdictional state and federal laws relevant to physical therapist services. 2. APTA supports that peer review policies and procedures should be clearly outlined in all provider contracts or manuals. 3. APTA opposes conducting a peer review without proper notice to providers before conducting the review. APTA strongly encourages payers to provide training to providers before implementing a peer review policy. D. LIABILITY REFORM FOR PHYSICAL THERAPIST SERVICES APTA supports comprehensive liability reform that puts patient and client safety first while working to reduce preventable injuries and improve communication between physical therapists, other health providers, and their patients and clients. To achieve these goals, protections must be put in place for physical therapists and their patients and clients. Such protections include: 1. Access to personnel and funding for patients and clients to pursue legitimate claims; 2. Fair and timely compensation for injuries to patients and clients; 3. Reasonable caps on non-economic damages; 4. Reduction of liability premiums for physical therapists; and 5. Mechanisms to protect the health service delivery system from repeat malpractice offenders and frivolous lawsuits. E. INTEGRITY OF PHYSICAL THERAPIST SERVICES 1. APTA supports the identification and mitigation of fraud, abuse, and waste in physical therapist services. Within the profession, physical therapists and physical therapists assistants are obligated to: a. Understand compliance by being aware and staying up-to-date on applicable laws, regulations, and policies; b. Take action to prevent and report suspected fraud, abuse, and waste; and c. Provide and bill for services legally and ethically and exercise sound clinical judgment. 2. APTA supports efforts by payers to prevent fraud, abuse and waste. APTA expects payers to provide notice to providers when new fraud, abuse and waste policies and regulations are implemented and to work with providers to ensure such policies and regulations are applied properly. 3. APTA supports best practices in business arrangements and professional relationships in connection with physical therapist practice, including the following: Integrity: Business arrangements and professional relationships are free of avoidable conflicts of interest and comply with all APTA positions, standards, guidelines, policies, and procedures. Equity: Physical therapist ownership is proportional to investment and shared risk. Incentive: Physical therapists are compensated based on the value, quality, and complexity of their services. Decision-making: Physical therapists are responsible for and control all clinical decision-making and patient/client management relating to physical therapist services. This responsibility cannot be subjugated by the employer or other health providers, nor is it delegated to other personnel. 17

PART B That the following positions be rescinded: Insurance Benefits for Physical Therapy Services (HOD P06-02-25-05) Physical Therapy as a Mandated Service under Medicaid (HOD P06-03-21-17) Transparency Requirements for Contractual Agreements between Patients/Clients, Payers and Intermediaries (HOD P06-11-11-09) Health Care Liability Reform (HOD P06-04-28-24) Professional Practice Relationships (HOD P06-02-24-47) Quality Assurance and Performance Improvement (HOD P06-98-13-13) Support of Electronic Health Record in Physical Therapy (HOD P06-08-13-11) Reimbursement for Physical Therapy Services (HOD P06-01-12-15) Professional Fees for Physical Therapy Services (HOD P06-00-22-34) Financial Considerations in Practice (HOD P06-99-13-17) Peer Review of Physical Therapy Services (HOD P06-04-16-15) Reimbursement Policies (Federal and State) Affecting Physical Therapy Services (HOD P06-00- 31-09) Methods for Investigating Fraud and Abuse (HOD P06-00-31-10) Guidelines: Principles of Professionalism Guiding Physical Therapist Business Relationships (HOD G06-10-12-10) Reference: 1. Porter ME. What is Value in Health Care? NEJM 363.26, 2477-81, Dec 2010. RC 9-15 ADOPT: MEDICALLY NECESSARY PHYSICAL THERAPIST SERVICES WITHDRAWN Please refer to Packet II for motion language. RC 10-15 RESCIND: HEALTH CARE COVERAGE FOR ALL AMERICANS (HOD P06-05-18-27) PASSED That Health Care Coverage For All Americans (HOD P06-05-18-27) be rescinded. 18

RC 11-15 ADOPT: HEALTH PRIORITIES FOR POPULATIONS AND INDIVIDUALS PASSED That the following position be adopted: HEALTH PRIORITIES FOR POPULATIONS AND INDIVIDUALS That the following population health priorities guide the American Physical Therapy Association (APTA) work in the areas of prevention, wellness, fitness, health promotion, and management of disease and disability. Physical therapists can positively impact these areas and, where opportunity exists, can improve the health status of populations and individuals. Physical therapists also can help prevent secondary health conditions commonly associated with many chronic diseases and disabilities. The population health priorities identified to most relate to physical therapist practice in primary and secondary prevention and in disease management are: I. Active living 1 A. Physical inactivity is a risk factor that contributes to onset and progression of diseases and conditions in individuals of all ages, including diabetes, heart disease, pulmonary disease, obesity, metabolic syndrome, psychosocial health, stroke, certain cancers, and certain musculoskeletal conditions. B. Physical therapists have unique opportunities with the following populations identified by the US National Prevention Strategy (USNPS): 1. Aging individuals and populations (risk of falls, more individuals living longer with chronic diseases and conditions, impact of reduced physical fitness on quality of life) 2. Individuals and populations of all ages with health disparities 3. Individuals and populations of all ages with chronic conditions, disabilities, and diseases that impact their ability to remain independent and physically active II. Injury prevention 1 A. Reducing injury improves physical and emotional health. Injury can be prevented by making homes, communities, schools, and worksites safer and by implementing community-based prevention policies and programs. B. Physical therapists have unique opportunities in the following areas of injury prevention identified by USNPS: 1. Falls prevention 2. Workplace injury prevention 3. Community-based injury prevention III. Secondary prevention in chronic disease and disability management A. Reducing or preventing health conditions that accompany many chronic diseases and disabilities helps to improve physical and emotional health and optimize individuals participation in society. Secondary conditions and their risk factors can be identified and ameliorated through screening and recognition. B. Priorities for physical therapists in secondary prevention in chronic disease and disability management include: 1. Diseases and disabilities that impair an individual s body function or structure 2. Diseases and disabilities that limit an individual s activity 3. Diseases and disabilities that restrict an individual s participation in society 19

4. Diseases and disabilities that require modification of environmental factors to allow for full participation in society Physical therapists provide education, behavioral strategies, patient advocacy, referral opportunities, and identification of supportive resources after screening for the following additional USNPS 1 health priorities: A. Stress management B. Smoking cessation C. Sleep health D. Nutrition optimization E. Weight management F. Alcohol moderation and substance-free living G. Violence-free living H. Adherence to health care recommendations REFERENCES 1. US Department of Health and Human Services. National Prevention Strategy. http://www.surgeongeneral.gov/initiatives/prevention/strategy/index.html. Accessed 03/11/15. RC 12-15 ADOPT: THE ROLE OF THE PHYSICAL THERAPIST IN DIET AND NUTRITION PASSED THE ROLE OF THE PHYSICAL THERAPIST IN DIET AND NUTRITION Diet and nutrition are key components of primary, secondary, and tertiary prevention of many conditions managed by physical therapists. It is the role of the physical therapist to screen for and provide information on diet and nutritional issues to patients, clients, and the community within the scope of physical therapist practice. This includes appropriate referrals to nutrition and dietary medical professionals when the required advice and education lie outside the education level of the physical therapist. RC 13-15 ADOPT: THE ASSOCIATION S ROLE IN ADVOCACY FOR PREVENTION, WELLNESS, FITNESS, AND HEALTH PROMOTION, AND FOR MANAGEMENT OF DISEASE AND DISABILITY PASSED THE ASSOCIATION S ROLE IN ADVOCACY FOR PREVENTION, WELLNESS, FITNESS, AND HEALTH PROMOTION, AND FOR MANAGEMENT OF DISEASE AND DISABILITY The American Physical Therapy Association (APTA) advocates for prevention, wellness, fitness, and health promotion, and for management of disease and disability. Advocacy includes but is not limited to scientific, educational, regulatory, and legislative activities that 20