Texas Association of Cardiovascular and Pulmonary Rehabilitation

1. A Message From Your New President We had a great turn-out for the “Rodeo, Ropin’ and Rehab: Deep in the Heart of Texas” conference in Dallas this year. I hope you all enjoyed it! It seems to get bigger and better each year. We received positive feed-back from the membership for the most part. I want you to know how important your comments are to the board. We want to you to express your opinions; be assured we take your comments into consideration as we plan for future conferences. Speaking of future conferences, plans are already underway for the TACVPR 2009 conference. The conference will be held at the Crowne Plaza in the Houston North Greenspoint area on April 3rd and 4th. The hotel has recently completed a $13 million renovation. It is an awesome facility and I think everyone will really enjoy the accommodations. Hope you’re planning to attend! We had two board members that chose not to re-run this year. A special thanks to Mary Hart and Kitty Collins for all their hard work. We appreciate both of you! Taking their places on the board are newcomers Erika Abmas and Tresa Anderson. The board depends on hard-working individuals who are willing to devote their time and energy to make things run smoothly. Julie Hartman, our out-going president, deserves special recognition for all her efforts in leading the board. She leaves big shoes for me to fill! I know that the only way that I will be able to do so is with the advice, care and support of the TACVPR board. The dog days of summer seem to have arrived. Stay cool and enjoy your summer! Marilyn Burwitz, RN TACVPR President Texas Association of Cardiovascular and Pulmonary Rehabilitation Do You Know Anyone Interested in Joining TACVPR? To join or renew your TACVPR membership, sign up online or download a printable membership application at www.tacvpr.org Annual dues are $40/person

2. Reimbursement Updates By: Twyla Selvidge, MS UPDATE ON OUR BILL: Cardiac and Pulmonary Rehabilitation Act of 2008 is still alive, but on life support at this time. Recent congressional action has not favored our efforts to get our bill passed as law. Our bill was attached to the large Medicare package HR 6331. Part of this package included a bill that would delay the 10.6% decrease in physician Medicare payments. On June 27, 2008 the House passed this bill. On the Senate side, they had their own similar bill, S 3101. The SenateDemocratic leadership decided to bring up HR 6331 for a vote (and not vote on S 3101). This action circumvented the need for a conference to address differences between the House and Senate versions. In order to bring the bill to a vote, a procedural vote from both Democrat and Republican senators was necessary to end debate and required 60 votes. Here’s how the voting went: All Democrats and 9 Republican Senators voted for cloture (limiting debate causing an immediate vote to be taken on the issue). BUT! This left the Democrats one vote shy of the 60 votes needed. Since parliamentary rules require that if a bill is to be reconsidered, the motion to reconsider must come from someone on the losing side. Senator Harry Reid, D, Nevada switched his vote so he could bring a motion to reconsider the bill at a later date. Because the vote failed, there will no action until after the Congressional 4th of July recess. Once the Senate returns, it has various options it could pursue. So, we once again wait for our bill to be passed. This last failure of our bill IS confusing and seems to surround political party issues. In the AACVPR’s own words, “many members are understandably a bit confused about what is transpiring in Congress, trying to decipher what it means and what happens next.” To make a long story short, the AACVPR stated in their last reimbursement update that they will keep their members apprised of legislative issues as they arise. I personally can’t wait for the update. The CPT code 93798 is used for both the technical piece (that’s you, the RN, EP, etc) and the professional piece (the physician). Since this 10.6% reduction in Medicare physician fee schedule will affect the professional side, physicians supervising Cardiac Rehab will be take a hit on the reimbursement for Cardiac Rehab. At the time of the writing of this article, the bill may have gone through legislation one more time. If so, hopefully it is good news! UPDATE! We received an updated email from the AACVPR on Friday, July 11th stating “Wednesday, July 9th was a monumental day for cardiac and pulmonary rehabilitation!” Both the House and the Senate voted in favor of HR 6331, the large Medicare bill that included our bill. The bill will be sent to the President who has indicated that he will veto this bill and send it back to Congress. However, both the House and the Senate Democratic leaderships are confident they could override such a veto. Per AACVPR, “there are a number of scenarios that could unfold as this bill travels to the White House and potentially back to Congress, but we remain confident that our provisions will remain intact as they are not controversial and do have strong bipartisan support. We are 99% of the way home, and as always, AACVPR will continue to keep you up to date on the progress of this bill as it unfolds. We have strong reason to believe all will be resolved prior to the August recess in a couple of weeks." UPDATE! UPDATE!Read all about it!: On July 15, 2008, Congress overrode President Bush’s veto! The Cardiac and Pulmonary Rehabilitation Act of 2008 is now law under the Social Security Act.

3. 2008 TACVPR Conference Wrap Up By: Julie Hartman, MS, FAACVPR Rodeo, Ropin' & Rehab: Deep in the Heart of Texas Thank you to all who attended the TACVPR Conference on April 25th and 26th at the Doubletree Campbell Centre in Dallas. We had a great line up of speakers and were pleased to offer 8.25 continuing education credits, as well as, a unique opportunity to network with other Cardiac & Pulmonary Rehab professionals. We received a lot of great feedback from those of you who attended. Some of the comments were as follows: Great speakers especially keynote speakers were fascinating & inspiring Enjoyed the social- the view was great! Good opportunities to network This year’s conference was excellent! The hotel was good, small floors, fewer rooms/disruptions and comfortable rooms/beds. We love to hear the compliments, of course, but it also helps us to better serve you for next year by hearing what didn’t work well. Some of the comments on what could be improved were: Rooms were too cold Bathroom facilities should be more readily available Not enough chairs in some of the breakouts CD of presentations Overall, it was a successful event and we’re excited to have plans underway for the 2009 Conference. Mark your calendars for next year’s conference which will be held at the Crowne Plaza in the Houston North Greenspoint area on April 3rd and 4th. More information will be available as we get closer to the date. Congratulations to Karla Davila for winning the Vendor Card Drawing. She will receive a free 2009 TACVPR membership and 2009 TACVPR conference registration!!!!

4. Meet Your 2008-2009 TACVPR Board of Directors Marilyn Burwitz, RN President East Texas Medical Center Fairfield Julie Hartman, MS, CES, FAACVPR Immediate Past President THE HEART HOSPITAL Baylor Plano Dean Diersing, MS President Elect University Medical Center Health Point Fitness & Cardiac Rehab Twyla Selvidge, MS Treasurer East Texas Medical Center Nita Pack, RRT Secretary Charlton Methodist Hospital Lorri Lee, BS, RCEP Past President McKenna Memorial Hospital Poppy Patterson, RN Past President Hillcrest Health System Getterman Wellness Center Barbara Flato, MSN, RN-BC, FAACVPR CHRISTUS Spohn Cardiac Rehab Danielle Strauss, BSN,RN-BC, BS Baylor Jack and Jane Hamilton Heart and Vascular Hospital Erika Abmas, RRT Baylor University Medical Center Tresa Anderson, RRT Shannon Medical Center If you are interested in serving on the TACVPR Board of Directors, please contact Julie Hartman at julieob@baylorhealth.edu. Elections are held at the annual TACVPR conference.

5. Certification Corner By: Barbara Flato MSN, RN-BC, FAACVPR • “This certificate shall expire on August 31, 2009.” • Have you looked at your Program Certification Certificate lately? Does it say the same thing as mine? If so, then now is the time to begin compiling your documentation for the recertification process. We currently have 43 certified programs in Texas and are looking forward to adding a few more in August when the AACVPR Board of Directors bless the work of the Certification and Recertification Committees. If you are thinking of applying for Certification this year but have yet to begin getting your documentation together… IT’S TIME!!!! Although this year’s applications will not be up on the website until September, they are essentially unchanged from last year’s application. In a nutshell….. • Pull the application off the AACVPR website (www.aacvpr.org) • Read the application from start to finish • Work on the hardest Tabs first. • Competencies, Exercise Prescription, Outcomes, Care Plan) • Make it a group project. If you are a one man show… enlist family and friends!!! • Three tabs a month if you are trying to certify for the first time and two tabs a month if this is your recertification year. Starting today!!! • Feel free to contact the Texas committee members at the state or national level when preparing your application. These volunteers are happy to work with you to help you achieve AACVPR program certification or recertification. • Barbara Flato Poppy Patterson • barbara.flato@christushealth.orgppatterson@hillcrest.net • AACVPR Recertification Committee AACVPR Recertification Committee • Stacey Dramiga Laura Raymond • Stacey.dramiga@amedd.army.millaura.raymond@stdavids.com • AACVPR Recertification Committee AACVPR State Chairperson • Julie Hartman Erika Abmas • julieob@baylorhealth.eduErikaab@baylorhealth.edu • Texas Review Committee Texas Review Committee • Rhonda Leaverton • Rhonda_leaverton@mhhs.org • Texas Review Committee • We Are Here to Help!!

6. First Statewide COPD Summit Convenes in Austin TX By: Kitty Collins, RRT • On June 21st a group of over 100 Physicians, healthcare providers, patients and • caregivers attended the first COPD Summit at the Hyatt on Town Lake in Austin Texas. • The participants were all stakeholders in working towards creating a Statewide COPD • Coalition following in the steps of four other states that have successfully launched • statewide coalitions. After a full morning of lectures the participants split into four • working groups to discuss specific goals that would aid in implementing a statewide • action plan. The following objectives were identified. • Raise public awareness of COPD in Texas among the general population, at risk population, and policy makers. • Enhance the prevention of COPD, including promotion of smoking cessation activities that are integrated into healthcare, workplace, and government institutions in the aim to reduce the burden of the disease. • Increase COPD awareness among primary care healthcare workers and promote early detection and appropriate treatment of the disease • Provide a statewide network of resources for those living with COPD and their caregivers to improve their self-management skills in the aim to decrease the morbidity from this disease • Serve as a lobbying body on behalf patients with COPD regarding policies and legislations’ pertaining management issues such as reimbursement for medications, respiratory care and home medical equipment, pulmonary rehabilitation and others • Institute and increase surveillance programs for COPD through the Behavioral Risk Factor Surveillance System (BRFSS) and other data collection tools to obtain specific data about the morbidity and mortality of COPD in Texas • One thing that was recognized was in order for several of the objectives to be • successful the state should be broken down into at least four regions. Increasing COPD • awareness and enhancing education will need to be worked on at local levels and will need • the support of local agencies and media campaigns to have a campaign that meets the • objectives. The American Lung Association is looking for people that would like to be • involved and either help lead local initiatives or be part of a committee in each region. • They are looking for healthcare providers and patients/caregivers to help lead a • campaign with the guidance of the statewide coalition. One immediate goal is to have • statewide COPD awareness this November to coincide with World COPD Day on Nov. • 19th. Please spread the word and all interested may contact either Laura Chapman, • Regional Manager of American Lung Association at (512) 467-6753, • lchapman@breathehealthy.org, or Kitty Collins, RRT at (512) 324-8719, • kcollins@seton.org.

7. Whole Person Wellness By: Tresa Anderson, RRT There are many things that fall under Whole Person Wellness. We must realize that health is more than having a body that works properly. It includes physical, emotional, social, spiritual, and intellectual dimensions as well as occupational and vocational dimensions. Health involves all of you – your mind and emotions, your connection with other people, your sense of hope, and your satisfaction with work, as well as your body. One should have hobbies/ interests/activities which bring you pleasure outside your work or studies. You should be comfortable with the direction of your future plans. Can you accurately assess your strengths and weaknesses? Are you doing what you want to do with your life? These dimensions encourage goal setting for one’s personal enrichment. Vocation wellness is linked to the creation of a positive attitude about personal and professional efficacy (the belief in one’s ability to successfully perform desired task), and personal choice. These concepts change the focus from what we can’t do to what we can do. When you assess these areas you may find that the things you thought were so important are not what are the most important to you in your life, and make changes accordingly. In future issues we will discuss the social, spiritual, intellectual, physical, and emotional dimensions of Whole Person Wellness. If you have information you would like to share on this topic feel free to email me at tresaanderson@shannonhealth.org. TACVPR Members Only Section Have you had the chance to check out the “Members Only” section of the TACVPR website? If you answered “no” to this question, take a minute to log on to www.tacvpr.org to see what it has to offer. You can access TACVPR newsletters, the Texas Program Directory and more! For log-in questions, please e-mail Dean Diersing at mdiersing@teamumc.com.

8. TACVPR Recruit–A–Pal (RAP) Program What is the RAP Program? The Recruit–A–Pal program was initiated in time for the conference in 2007. This program starts on January 1st each year and continues to the start of TACVPR annual conference. For each new person you recruit to join the TACVPR or to attend the conference you earn points. You may also earn points for an approved poster presentation. (A new person is someone who was not a member over the past year nor attended the previous conference). The Point System: 1 point: Each new member recruited between Jan 1st and the conference 2 points: Each new person brought to conference 1 point: An approved poster presentation The AWARDS: 5 points: Earns a free membership for a year 7 points: Earns a free conference fee for the following year IMPORTANT: Make sure to have your name filled in the “RAP Program Referral” section as the referring person on the membership form and the conference registration form. CONGRATULATIONS TO THE FOLLOWING RAP (Refer-A-Pall) WINNERS FOR 2008 The following have won a free 2009 Conference Registration: JoAnn Wilson (2) with 18 points Tresa Anderson with 10 points Dean Diersing with 8 points Nita Pack with 8 points The following have won a free 2009 Free Membership: Janie Harrison with 6 points

9. North Texas Association of Cardiovascular & Pulmonary Rehabilitation SUMMER CONFERENCE Please Join Us For FUN, FOOD AND CNEs WHEN: Saturday, August 2, 2008 WHERE: Patterson Medical Building 405 South Nolen Dr., Suite 200, Southlake, TX 76092 SCHEDULE OF EVENTS: 8:30-9:00 Continental Breakfast 9:00-10:00 A Comprehensive Approach to Diabetic Patients In the Cardiac Rehab Setting, Dr. Amit Khera 10:15-11:15 Identifying Postural and Musculoskeletal Abnormalities in Cardiac Rehab Patients, Susan Beckham, PhD 11:15-12:05 Practicum: Susan Beckham, PhD Learn to perform tests to recognize Musculoskeletal Abnormalities Learn to perform and teach appropriate exercises 12:15-1:30 Lunch and short Business Meeting Seating is limited, so please RSVP as soon as possible to Lauren Jones at 214-590-8236 (fax 214-590-8339) lnjone@parknet.pmh.org or Ellen Bracy at 214-857-0119 This class has been approved for 3.0 CNE contact hours IN OTHER NEWS… JOB OPENING Full Time Cardiac Rehab Nurse at Baylor Jack and Jane Hamilton Heart and Vascular Hospital in Dallas, TX. For more information call Danielle Strauss at 214-820-3050 or email at daniells@baylorhealth.edu Is Your AACVPR Membership Up to Date? AACVPR membership dues expired June 30th – Don’t forget to renew! Membership fees: $185 Member/Associate Member; $75 Student Go to www.aacvpr.org to join or renew your membership.