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The State Compact Storm: What Hurricane Harvey Taught Us About Interstate Licensure

September 25, 2017 • Other • Heidi Jannenga

The aftermath of September 2017 will not soon be forgotten. Early on in the month, Hurricane Harvey slammed into Houston and left massive, widespread destruction in its path. Irma followed quickly thereafter, wreaking havoc in the Caribbean and Florida. Now, Maria has left Puerto Rico devastated in its wake. At the same time, wildfires ravaged the Pacific Northwest. And while WebPT is located in landlocked Phoenix, Arizona, we’ve certainly felt the reverberation of Harvey’s and Irma’s impact, even in the middle of the desert. There are WebPT Members in all 50 states, and many have been affected by the devastation resulting from these events.

As anyone who works with us knows, our Members aren’t just customers, they’re family, and families look out for each other. We knew we had to do something in response to these storms, and because giving back is one of our company’s core values, the solution was clear. To that end, we developed the Rehab Therapists Give Back crowdfund. Our goal is lofty, but simple: we want to raise $1 million to assist those affected by the recent natural disasters. There’s more to come on this, so stay tuned.

But, donations aren’t the only avenue to helping those in need, and it seems that the Centers for Medicare and Medicaid Services agree. In fact, CMS recently announced it would waive provider screening requirements for those practitioners in affected areas, allowing providers in Louisiana and Texas to enroll in the federal health programs and receive temporary Medicare billing privileges. CMS is also granting exceptions under certain Medicare quality reporting and value-based purchasing programs to hospitals, acute care organizations, and other inpatient facilities. But, if you’re a PT in an outpatient practice outside of the affected states, there’s no clear path to using your education and license to offer assistance. That is, of course, unless the Federation of State Boards of Physical Therapy (FSBPT) moves forward with the interstate licensure compact for physical therapists.

How would interstate licensure help PTs?

Let’s be frank: these storms won’t be the last to hit our country. Even as I write this, Hurricane Maria batters the Caribbean and barrels toward the East Coast. That’s one of the reasons why interstate licensure is so crucial. This is an opportunity for us as PTs to rise to our potential by reaching out to our colleagues, and their patients, who are in desperate need.

And an interstate compact wouldn’t just be beneficial in times of crisis; the positive impact would extend well beyond disaster relief. Here’s how:


Right now, PT is a stationary field in an increasingly mobile society. If you’re licensed in one state, you’re still expected to jump through hoops in order to obtain your license in another state. If you’re a PT practicing near state lines, then I don’t have to tell you how frustrating this can be. Cross-state licensure recognition would allow therapy practice flexibility without forcing therapists to spend the time, or the money, to get a separate license.

We’ve seen this work in other professions. Both nurses and physicians have introduced their own interstate licensure compacts, and they’ve been met with marked success. By implementing a compact of our own, PTs could ensure the access and delivery of effective, quality health care to patients in all areas.


We’re at a pivotal point in our industry with regard to telehealth accessibility and delivery. With providers everywhere looking for ways to better serve patients in this age of mobility, the telehealth debate has taken center stage. To date, PTs have had a difficult relationship with telehealth, especially in terms of reimbursement. But with initiatives such as the Medicare Telehealth Parity Act and the CONNECT for Health Act currently sitting before Congress, the possibility of telehealth becoming the norm for PTs is within our reach. However, the rise of telehealth brings to light new reimbursement issues for services provided across state lines via phone or video conference. With the compact, however, the process for obtaining reimbursement for out-of-state services wouldn’t be nearly as complicated.

According to the FSBPT, the compact could go into effect as early as 2018. Currently, however, only 14 states are members of the compact. So, until all 50 states are on board, PTs must find ways to support each other. Here are some ways you can help providers in need:

  • Even if you can’t give much, every dollar counts. Take up a collection in your practice and make a donation to a philanthropic organization or fundraiser like Rehab Therapists Give Back.
  • If your state is participating in the interstate compact, think critically, and go vote. If your state has rejected participation, make your voice heard.
  • Talk to your legislators about telehealth. Stay informed on upcoming initiatives in our industry. There’s a lot going on right now, but ultimately, we got into this profession to help people, and there are many in need at this moment.


The physical therapy profession is on the precipice of major change, and in order to continue moving forward, it’s imperative that PTs rally and stand together as a united force. We must keep up with, or even stay ahead of, the times. And in order to do that, we must reach our hands across state lines to support providers, and, subsequently, patients, in need. To that end, I urge every physical therapist to take ownership of the future of our profession: lobby your state PT boards to join the federal licensure compact, get out and talk to your legislators about voting “yes” on the telehealth measures and ensuring those laws include PTs as eligible providers. We have the opportunity to lead the healthcare pack in terms of practice mobility. After all, if we aren’t supporting each other, then who is?



About the Author

Heidi Jannenga PT, DPT, ATC/L is the president and co-founder of WebPT, the leading practice management solution for physical, occupational, and speech therapists. Heidi leads WebPT’s product vision, company culture, and branding efforts, while advocating for the physical therapy profession on a national scale. She co-founded WebPT after recognizing the need for a more sophisticated industry-specific EMR platform and has since guided the company through exponential growth, while garnering national recognition. Heidi brings with her more than 15 years of experience as a physical therapist and multi-clinic site director as well as a passion for healthcare innovation, entrepreneurship, and leadership.

An active member of the sports and private practice sections of the APTA, Heidi advocates for independent rehab therapy businesses, speaks as a subject-matter expert at industry conferences and events, and participates in local and national technology, entrepreneurship, and women-in-leadership seminars. In 2014, Heidi was appointed to the PT-PAC Board of Trustees. She also serves as a mentor to physical therapy students and local entrepreneurs and leverages her platform to promote the importance of diversity, company culture, and overall business acumen for private practice rehab therapy professionals.

Heidi was a collegiate basketball player at the University of California, Davis, and remains a lifelong fan of the Aggies. She graduated with a bachelor’s degree in biological sciences and exercise physiology, went on to earn her master’s degree in physical therapy at the Institute of Physical Therapy in St. Augustine, Florida, and obtained her doctorate of physical therapy through Evidence in Motion. When she’s not enjoying time with her daughter Ava, Heidi is perfecting her Spanish, practicing yoga, or hiking one of her favorite Phoenix trails.

Heidi Jannenga

Heidi Jannenga, PT, DPT, ATC, is the co-founder and Chief Clinical Officer of WebPT, the leading practice management solution for physical, occupational, and speech therapists. Heidi advises on WebPT’s product vision, company culture, branding efforts and internal operations, while advocating for the rehab therapy profession on a national and international scale. She’s an APTA member,...

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