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Posted on 08-05-2016

We Reap What We Sow...Time For The 24-Visit Cap To Go

We reap what we sow, and sometimes it’s a good thing.  Last week we talked in the Corner a lot about making our own coincidences and magic.  That’s not dissimilar to this week’s theme.  More than a dozen years ago a few bad actors -  no not Keanu Reeves -  caused a lot of trouble for chiropractic.  Overutilization in the work comp system by a few, damaged the profession’s image mightily.

Sometimes we’re our own worst enemies in life and honest retrospection reveals our wounds were often self-inflicted.  I only bring this up because I am feeling optimistic this week that seeds we began sowing a year and half ago, may be bearing fruit soon.

Commission on Health and Safety and Workers Compensation (CHSWC) – Will The 24-Visit Cap Be A Thing Of The Past?

If you have a didactic memory, you’ll recall a Corner from over a year ago wherein I shared the results of a meeting Monica Miller, our contract lobbyist, and I had with some friends representing labor groups.  Our goal at that time was to ascertain if labor harbored similar concerns regarding the 24-visit cap.  Garnering labor’s support to remove the cap was and continues to be  a critical component of our strategy.

Fast forward to this week’s public meeting of the Commission on Health and Safety and Workers Compensation (CHSWC).  An item was added to the agenda titled, Preliminary Discussion on PT and Chiropractic Caps.”  This item was added as a result of the letter we requested Senator Jim Beall submit requesting the Commission study whether there remains any need to continue the cap.

The presentation by Dr. Ray Meister, Executive Medical Director at Division of Workers Compensation, featured the genesis of the cap and subsequent evolution of evidence based medicine as the guiding principal for determining appropriate care.  It was a fair and factual presentation. 

From our perspective what makes me optimistic is the questions and comments made after the presentation by the three Commissioners representing labor organizations.  They asked questions about the difference between functional improvement and pain.  A firefighter, for example, who experiences flare ups would need additional care to address pain issues.  Would not the functional improvement guidelines interfere with receiving that care?

Commissioners also cited other states that have utilization review but not caps on physical medicine have no over utilization issues.  They also expressed concern that the cap could restrict access to care and limits options.  They were clear that opioids were not an option worth considering.

Cris and Monica Testify On CCA’s Behalf

Monica and I testified during the public comment segment, which was immediately after the presentation and Commissioners’ Q&A segment.  I only mention this because ordinarily public comment is taken after all agenda items are completed.  Not sure if it was a simple courtesy extended solely to us, but it’s appreciated greatly nonetheless. 

Our testimony mirrored the Commissioners’ comments.  We did point out that a hard cap on any care is in direct conflict with current public policy that care be determined by evidence based medicine.  We also pointed that if you wear a gun on your hip and badge on your chest, you’re not permitted to use under the influence of opioids.

The net result of the day’s events is that the Commissioners’ requested data on the following:

  • How do current guidelines deal with the cap relative to flare ups?
  • How often is the cap in conflict with care provided using evidence based medicine?
  • How many injured workers are impacted by the cap?

The other, more subtle, result is that it is clear, at least to me, that labor would like to do away with the cap.  This week was an important step in right direction.

CCA-PAC Gets Serious For Upcoming General Election

Speaking of steps in the right direction, our PAC Trustees have signed off on implementing a very aggressive campaign program for this election cycle. CCA will be expending $400,000 on a short list of targeted races sure to make the biggest bang for our chiropractic buck!  I’d love to share more but as you know, we’re not the only folks who read the Corner and I wouldn’t want to give away too much of our strategy.  

Key Doctors Engaged In Local Candidate Endorsements

A big part of this year’s campaign effort is our local districts engaging in our process of determining which candidates will receive the coveted CCA endorsement.  I’d like to give a huge thank you to all our Key Doctors for working so hard to interview candidates and ferret out their views on chiropractic.  And of course I’d like to also thank Michelle Bancroft, who manages this grand undertaking for us. 

Michelle is also in the process of designing and producing the 2016 CCA Voter Guide.  Once the endorsement process is completed, we’ll be ready to get the Guide disseminated quickly due to Michelle’s project management magic.

Student Lobby Day

Another GA team project is our creating of a student-only lobby day.  We’ve been working with our distinguished college presidents and student leadership to provide an opportunity for students to come to Sacramento, meet with legislators and aides to tell their story of chiropractic. 

My experience is legislators love hearing from students their personal stories.  This effort will help educate legislators and aides about chiropractic and the student experience.  This personalization of chiropractic will build a great foundation for when the annual CCA Legislative Conference takes place and wherein we lobby on specific policies affecting the profession.

We’re currently contemplating a Tuesday in late January.  Still working out the details with our colleges.  That seems to be a good time in both our collegiate calendars, as well as, the legislative calendar.

Comment on Cris’ Corner!

Did you know you can now comment directly on the CornerJust look below for the comment box!

I encourage your feedback and questions. I look forward to hearing from you.

And that’s all the news that’s fit to print, and some that probably isn’t…for now.

©2016 California Chiropractic Association. All rights reserved. Please do not disseminate in part or whole without prior permission. Questions or permission to disseminate? Contact Cris Forsyth at cforsyth@calchiro.org.

charles shields dc said:

I feel confident that CCA is on the right course and is in good hands. For the first time in a long time I feel hopeful...

2016-08-05 14:29:14

Brian Porteous,DC said:

Professional, First Class Job ... Three Cheers for Chris and staff

2016-08-05 17:39:40

Claudette Satnick said:

Great job in the work comp arena! Is anything going on to influence the HMO reimbursements to reflect inflation, increases in overhead due to mandatory labor policies, increase in utilities etc?

2016-08-05 21:00:07

stephen barkalow said:

Nice to see action within the political arena. This profession is poised to be the major player in the physical medicine world not only in work comp but all aspects. To do that we need to leave behind the old model and move into the 21st century along with and ahead of the other professionals. Advanced training and thinking can and will help us move into the modern health care world. Increased scope of practice and better reimbursements for what we do.

2016-08-06 18:11:50

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