March 18th, 2015 day at the hill.

This year is the first year that the PACT group went to Washington DC to support legislation that we had nothing to do with writing.  We were supporting the Medicare Telehealth Parity Act.  It is legislation written by the Telehealth group that includes Respiratory Therapy in the language.  It is one of several Telehealth bills in various stages of development, but the only one that specifically mentions Respiratory Therapy and Respiratory Therapists in the same bill. 

The bill if passed would add language to Medicare in a bill passed by congress recognizing Respiratory Therapy as a profession.  Although this may sound like a small thing, it is not because currently we are not recognized by CMS.  The bill has not yet been introduced into this session of congress, but was introduced last year late in the cycle.  It was well supported but never gained enough traction to get into the Senate. 

While in DC I had the opportunity to visit with the office staff of all of our elected officials and did get to speak personally with a couple of them.  As with years past the offices were supportive of our cause, and there was no real opposition to the legislation from any of the offices.  Unlike years past the staff members we spoke to and the members as that we spoke to as well were very familiar with the legislation and supported it. 

It was the first time that talked to our elected officials and did not get the feeling there was opposition from the other side.  This bill mentions other providers as well; it mentions PT, OT, Speech, Diabetes educators and others.  There groups also support this bill, and either have been or will be lobbying for it this year.  That aside our legislators not only knew I was coming, but they knew that this was a topic important to their constituents.  Every office I went into said something about the number of messages they had received from therapists in their district.  It was great to have this support.  All things considered it made the experience much different than in years past.  No longer did they wonder who we are or how our message could potentially impact their district.  They were well versed what I was talking about. 

They had good questions for me about how we could impact readmissions, and leaving every office I either had verbal support and a request to let them know when the bill was introduced, or a pledge to co-sponsor the legislation when it was introduced.  The message I was getting from Oregon continued during the debriefing that evening. 

I listened to other representatives from other states echo the same message. It didn’t matter if it was a red state or a blue one. They all had a similar experience.  The day after our official “day at the hill” I had the pleasure of meeting Senator Merkley with 2 therapists from Kaiser. I met Ben and Brian. They accompanied me to Thursday morning coffee with the Senator. There were a lot of people there to have coffee with the Senator, and our time with him was brief.  We did manage to get a picture with him and we had a couple of minutes to discuss the legislation with him.  He was also knowledgeable about it and wanted to know when it would be introduced into the Senate.  After the meeting with the Senator Ben and Brian went on a tour of the capital compliments of the Senator and his staff.  I would without a doubt consider this our most successful year in DC to date.  I am hopeful that this legislation will not only get reintroduced in to the House, but also the Senate and pass both.

Telehealth is nothing new, but the language of the proposed legislation adds reimbursement to areas not previously reimbursed, and adds specialty’s by name which include Respiratory Therapy.  Telemedicine although no longer a new idea, is becoming more and more commonplace, and in the near future will likely just be the way we make contact with medical professionals on a regular basis at least in the rural areas of the country.  The change will likely be slower in the metropolitan areas, but this to will likely change of the next few decades and we will log on for a routine visit to the doctor and not drive to the office or clinic to see them.

By Tony Garber, PACT

PACT report for June 6, 2014

PACT day at the hill was on April 1st this year. The weather was very nice, and the feel to the capitol was a bit different this year. The AARC assigned Rebecca Rudolph from the COPD foundation to help me with the meetings as I went to DC alone this year. We met with the office of each of our Representatives and Senators. The feel I am talking about is that each and every staff member that we spoke to was well informed about our bill this year. There was seemed to be a bipartisan understanding that we need to do something with the current healthcare system. Both sides have different opinions of what needs to be done, but the common theme is that it needs to be addressed, and both sides are well informed on the issues this year, and they took the time to listen to our presentation, and every office had good questions about what our proposed legislation HR 2619 would not only allow RT’s to do, but also how this legislation would reduce cost and deliver better care.

The good news from all of this is that every office was supportive of the legislation, and we were told by 3 offices that they would look it over and consider co-sponsoring the bill. To date Oregon has 1 co-sponsor and that is Representative Peter Defazio. We also received very positive comments from both Senators offices, but due to Sen. Wyden’s current position as the Senate Finance Chair, and another piece of legislation that he introduced into the Senate prior to taking this position he could not sponsor a Senate bill, but support is very likely if we can get one introduced. If you have not read his proposal it is called the “Better care lower cost act” and would be a good companion bill for our legislation. The brought about a conversations with Dr. Ron Kline a physician fellow in Wydens office about the structure of healthcare in Oregon. We spoke specifically about the possibilities of using the CCO’s and ACO’s to meet some of the upcoming goals of the ACA. There is a good possibility that at least in Oregon there will be incentives to get professions like RT working with patients outside the hospital to keep patients out of the ED. It will be interesting to see how this unfolds in our state. We have already seen CMS reimburse for CHF as a primary diagnosis for Cardiac Rehabilitation this year. I am hoping it is not the last move they make to increase reimbursement for preventative care.

PACT update 2011.

What a difference a year makes.   April Venes an myself made the trek to Washington DC this year.  April was taking the place of Joe Dwan, at least she did so as well as anyone could.  Joe you were missed by all in DC as this was the first year that there was a PACT meeting in DC without Joe.  Last year it was Norm who I filled in for, and that was the first without both Norm and Joe.  So with my limited experience and a new partner we headed off to DC to meet with our representatives.  We both were a little unsure of what to expect as we attended the Monday evening brief.  We had both gone over a mountain of paperwork, although April was on top if it all as she prepared extra paperwork with her advanced spreadsheet skills.  It worked out well as she was the task master, and I the time keeper.  After the brief was over we headed out to dinner and discussed our plan for the next day.  We had a detailed list of who, when and where.  All was organized and we just needed to come up with that pesky last piece the dreaded sales pitch.  How to put all this information into a brief summery to engage them.  While at dinner we received our first monkey wrench into the works.  One of our appointments needed to reschedule due to a conflict it was 8 pm and well you just roll with it.  We reset the appointment for an hour earlier and it was done.  Not 2 minutes later we received another call and that time didn’t work for them either.  A little more fine tuning and we had our schedule set again.  It looked like we would just adjust our lunch back a little and all would work out great.  The next morning we headed to the hill and we were off and running literally we were running.  Unlike the year before when Joe and I had put so much into it just to see one office after another look run down and beaten up basically just wanting to be professionally polite and listen to our spiel and get on their way.  This had a much different feel right from the start.  We were greeted by new staff and a new enthusiasm.  Office after office spoke with us for 20 to 30 minutes and some even more.   We found ourselves leaving one office and rushing to another only to find the same results.  The staff had good questions, they were interested, engaged and even curious as to why this had not already passed.  If it weren’t for a little help from the Alpha-1 foundation giving us a ride we may have been late for an appointment, but as luck had it we make it just in the nick of time.  With 3 down and it was now noon we followed a staffer down to what we thought was going to be a quick bite to eat, but with about 20 to go to the next appointment and the lines looking like we were standing in a Wal-Mart checkout on line on Black Friday we opted for a drink and to move on to the next appointment.  it was a good thing to we made it just in the nick of time.  This the staff was running a little late, and they were very nice and said we are running just a little behind.  They apologized and soon we were greeted by the only Oregon representative to actually sit down with us this trip.  It was Rep. Greg Walden.  He took the time to sit with us and made us feel like we were family and time was not an issue.  What a nice surprise.  He sat with us and spoke about the Medicare part B respiratory iniative and before we knew it 30 minutes were gone and it was time to move on.  He gladly took pictures with us and then apologized as he had to go he was late for his next meeting.  His senior healthcare advisor spent about another 15 minutes with us and there went lunch.  It was sure a good thing that April had brought a little chocolate we may not have made it thru the day if she hadn’t, at least I may not have.  I shudder to think of what could have happened, the grumpy side of me may have reared its ugly head, so I thank April for rescuing me.  The next 3 appointments were all 30 minutes apart and we literally ran from one to the next as staff wanted to talk to 20 plus minutes in each office.  What a difference a year makes.  I finally asked one of the staffers what it was like last year.  We were there just a few days before the vote on healthcare reform.  His answer was October to March was a really long month last year, yeah I got Christmas off though, but other than that we pretty much worked straight thru.  It is finally over and I must say a sincere thank you to all who helped us out.  In particular I would like to thank Joe Dwan for all the hard work he did before we went back.  Thank you Joe, you were missed and greatly appreciated.  I would also like to thank April Venes for filling in for Joe as not many could have.  You had a very large pair of shoes to fill, and you didn’t look like a clown, not even once.  You filled in like you had been doing it for years.  I was impressed how quickly you caught on and how all of our meetings went smooth from start to finish.  I would also like to thank each member of the OSRC BOD for being involved and making sure we are well represented in Washington DC.  Thank you all for your time and service, and thank you for the support you gave us on our journey to the capital.

Tony T. Garberg.


PACT – Political Action Team

OSRC’s PACT, in conjunction with the AARC Political Action Team, is working to promote, protect, and support Respiratory Care as a profession in the political arena. To see your state and national PACT teams at work please view the following PACT updates. By being a member of the AARC and OSRC you support these efforts.
Do you want to Make A Difference for Your Patients in Oregon?

Breaking News: Oregon RT’s in DC
40 to 50 helicopters in the air, motorcades with big limos and attached flags, followed by ominous big, black SUVs was the scene in Washington DC on March 9th. Marching protestors in hospital gowns, complete with signs, protested in favor of healthcare reform, as noted by the picture in both the USA Today and the Oregonian. Healthcare advocacy ads “clog airwaves” according to USA Today (3/10/10, 5A). And health care workers clogged the sidewalks around the Senate and House offices. The chest physicians, alziemers groups, lab techs, rehab folks, homecare companies, all were tromping the halls of Congress promoting their issues.

Heatlhcare Reform was literally in the air, on our recent PACT trip to DC, where over 100 RT’s from Alaska to Florida, Oregon to Maine and states in-between. Tony Garber, RT manager at Hermiston’s Good Samaritan Hospital and OSRC Eastern Director, participated in the seven meetings with the Oregon Congressional Delegation. We also had Jerry Killian, an Alpha One patient from Oregon provide the patient perspective on the difficulty of daily living with COPD, home oxygen and the lung transplant process. Jerry’s story was passionate and powerful, eliciting a strong response from the legislative aides in our meetings.

As I said at the Feb OSRC Conference, RN’s, PT’s, OT’s, Speech Pathologists, Radiology, MRI, Ultrasound, EEG, you name them, they are reimbursed by Medicare for services provided outside of the hospital. Respiratory Therapists are the only ancillary group that is not reimbursed for services outside the hospital. So our trip to Washington, DC is to gain reimbursement for RT’s, which will improve access, care and cost to our asthma and COPD patients. We want to revise the Medicare statue to add recognition of respiratory therapy services as a separate Medicare Part B benefit to permit qualified RT’s to provide respiratory therapy services under the general supervision of a physician.

The second issue we brought to Congress was to have the bills (S343 & HR 1077), described above, reviewed by the Congressional Business Office, who will determine how much this will cost Medicare.

Our third issue is to improve research funding for COPD. As you know, COPD is the #4 killer in America, but will become #3 by 2020. Research funds are pitiful, compared to cardiac, diabetes, AIDS, and other top diseases.

We also discuss home oxygen equipment issues and Jerry described what it’s like to live with the ‘green leash’.

OUR FEW RT’S NEED TO MAKE SOME NOISE! Write to your Oregon Congressmen Today!
It takes 5 minutes, when you use, Capital Connection, type in your zip code. Use the letter already there or create your own. Help us advocate for our asthma and COPD patients!
Healthcare Reform has passed and President Obama has signed this historic legislation. RT’s tried to include our legislation into HCR but were unsuccessful thus far. For a brief description of what HCR is see

Joe Dwan, MS, RRT
PACT CoChair

Contact #’s for Oregon Congressional Delegation
Wyden 202 224 5244. Senate Bill S 343
Merkley 202 224 3753. Senate Bill S 343
Walden 202 225 6730. House Bill HR 1077
Wu 202 225 0855. HR 1077
DeFazio 202 225 6416 HR 1077
Blumenauer 202 225 4811. HR 1077
Schrader 202 225 5711 HR 1077

PACT Information
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