DAR File No. 32706

Commerce, Occupational and Professional Licensing

R156-24a

Physical Therapist Practice Act Rules

NOTICE OF PROPOSED RULE

DAR File No.: 32706
Filed: 06/04/2009, 08:56
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

During the 2009 Legislative Session, S.B. 137 was passed which changed the Physical Therapist Practice Act from Title 58, Chapter 24a, to Title 58, Chapter 24b. Various additional amendments were also included in the statute. The amended statute now requires the Division to license physical therapist assistants. As a result of S.B. 137, various corresponding amendments need to be made in this rule. (DAR NOTE: S.B. 137 (2009) is found at Chapter 220, Laws of Utah 2009, and was effective 07/01/2009.)

Summary of the rule or change:

Throughout the rule, the term "rules" has been changed to "rule" where applicable and the entire rule is being renumbered from R156-24a to R156-24b. Throughout the rule various statute citations have been updated to reflect Title 58, Chapter 24b, and other statutory/regulatory citation corrections are also made. In Section R156-24b-102, updated wording with respect to "a recognized accreditation agency". Added definitions for "credential evaluation", "routine assistance", and "supportive personnel" and deleted the definition for "approved course work evaluation tool". In Section R156-24b-302a, amendments clarify requirements for applicants who are educated outside of the United States. In Section R156-24b-302b, added that the examination requirements also pertain to applicants for licensure as a physical therapist assistant. Section R156-24b-303b is being added to clarify continuing education requirements for licensees which the newly amended statute now requires. In Section R156-24b-502, the American Physical Therapy Association's (APTA) Code of Ethics is updated to the June 2000 edition and the APTA's Guide for Professional Conduct, dated January 2004, is also added to the section. Also added the following documents which are incorporated by reference for physical therapist assistants: APTA's Standards of Ethical Conduct for the Physical Therapist Assistant, dated June 2000, and APTA's Guide for Conduct of the Physical Therapist Assistant, dated February 2004. In Subsection R156-24b-503(1), amendments are made to limit the number of supportive personnel a licensed physical therapist can supervise but authorizes supervisors to request permission from the Board and Division to supervise additional personnel. Amendments in Subsection R156-24b-503(2) are made to provide that a physical therapist provide treatment to a patient at least every tenth treatment but no longer than 30 days from the day of the physical therapist's last treatment day, whichever is less. The remainder of the existing rule is being deleted as the provisions are covered in Title 58, Chapter 24b. Section R156-24a-601 with respect to animal physical therapy is also being deleted it is adequately covered in Section 58-24b-405.

State statutory or constitutional authorization for this rule:

Section 58-24b-101 and Subsections 58-1-106(1)(a) and 58-1-202(1)(a)

This rule or change incorporates by reference the following material:

Deletes the Federation of State Board of Physical Therapy (FSBPT) September 2000 publication entitled "A Course Work Evaluation Tool for Persons Who Received Their Physical Therapy Education Outside the United States"; updates the APTA Code of Ethics to the June 2000 edition; adds the APTA Guide for Professional Conduct, January 2004 edition; adds the APTA Standards of Ethical Conduct for the Physical Therapist Assistant, dated June 2000; and adds the APTA Guide for Conduct of the Physical Therapist Assistant, dated February 2004

Anticipated cost or savings to:

the state budget:

The Division will incur minimal costs of approximately $75 to print the rule and distribute it once the proposed amendments are made effective. Any costs incurred will be absorbed in the Division's current budget. Any additional costs to be incurred as a result of the Division now licensing physical therapy assistants were covered in the fiscal note which was completed for S.B. 137.

local governments:

The proposed amendments only apply to licensed physical therapy classifications and applicants for licensure in those classifications. As a result, the proposed amendments do not apply to local governments.

small businesses and persons other than businesses:

The proposed amendments only apply to licensed physical therapists and applicants for licensure as either a physical therapist or physical therapist assistant. Any cost or saving impact to either small businesses or persons other than businesses brought about by this rule change comes as a result of the changes to the statute under S.B. 137. The fiscal note prepared by the Division in response to S.B. 137 should be reviewed for information regarding the legislative bill's cost and saving impact and in turn any anticipated costs or savings with respect to this clarifying rule amendment filing.

Compliance costs for affected persons:

The proposed amendments only apply to licensed physical therapists and applicants for licensure as either a physical therapist or physical therapist assistant. Any cost or saving impact to affected persons brought about by this rule change comes as a result of the changes to the statute under S.B. 137. The fiscal note prepared by the Division in response to S.B. 137 should be reviewed for information regarding the legislative bill's cost and saving impact and in turn any anticipated costs or savings with respect to this clarifying rule amendment filing.

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule filing makes the rule for physical therapists consistent with recent statutory amendments. No fiscal impact to businesses is anticipated beyond that already considered by the Legislature in making the statutory amendments. The rule filing also removes unnecessary provisions and makes other technical corrections for which no fiscal impact is anticipated. Francine A. Giani, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Commerce
Occupational and Professional Licensing
HEBER M WELLS BLDG
160 E 300 S
SALT LAKE CITY UT 84111-2316

Direct questions regarding this rule to:

Rich Oborn at the above address, by phone at 801-530-6767, by FAX at 801-530-6511, or by Internet E-mail at roborn@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

07/31/2009

Interested persons may attend a public hearing regarding this rule:

7/07/2009 at 9:00 AM, Heber Wells Bldg, 160 E 300 S, Conference Room 474 (fourth floor), Salt Lake City, UT

This rule may become effective on:

08/07/2009

Authorized by:

Thad LeVar, Deputy Director

R156. Commerce, Occupational and Professional Licensing.

R156-24[a]b. Physical Therap[ist]y Practice Act Rule[s].

R156-24[a]b-101. Title.

[These rules are]This rule is known as the "Physical Therap[ist]y Practice Act Rule[s]".

 

R156-24[a]b-102. Definitions.

In addition to the definitions in Title 58, Chapters 1 and 24[a]b, as used in Title 58, Chapters 1 and 24[a]b or [these]this rule[s]:

(1) "[An accredited school of physical therapy]A recognized accreditation agency", as used in Subsections [58-24a-109(2)(b)]58-24b-302(1)(c) and (2)(c), means a college or university:

(a) accredited by CAPTE; or

(b) a foreign education program which is equivalent to a CAPTE accredited program as determined by FSBPT's Foreign Credentialing Commission on Physical Therapy.

(2) ["Approved course work evaluation tool", as used in Subsection R156-24a-302a(3), means the FSBPT's September 2000 revised publication entitled "A Course Work Evaluation Tool For Persons Who Received Their Physical Therapy Education Outside the United States", which is hereby adopted and incorporated by reference.]"Credential evaluation", as used in Subsections R156-24b-302a(2) and (3), means the appropriate Course Work Tool (CWT) adopted by the Federation of State Boards of Physical Therapy. The appropriate CWT means the CWT in place at the time the foreign educated physical therapist or physical therapist assistant graduated from the physical therapy program.

(3) "CAPTE" means Commission on Accreditation in Physical Therapy Education.

(4) "FSBPT" means the Federation of State Licensing Boards of Physical Therapy.

(5) "Joint mobilization", as used in Subsection [58-24a-104(2)(b)]58-24b-102(14)(d), means passive and active movements of the joints of a patient, including the spine, to increase the mobility of joint systems; but, does not include specific vertebral adjustment and manipulation of the articulation of the spine by those methods or techniques which are generally recognized as the classic practice of chiropractic.

(6) "Routine assistance", as used in Subsections 58-24b-102(10) and 58-24b-401(3)(b) means:

(a) engaging in assembly and disassembly, maintenance and transportation, preparation and all other operational activities relevant to equipment and accessories necessary for treatment; and

(b) providing only that type of elementary and direct patient care which the patient and family members could reasonably be expected to learn and perform.

(7) "Supportive personnel", as used in Subsection R156-24b-503(1), means a physical therapist assistant or a physical therapy aide and does not include a student in a physical therapist or physical therapist assistant program.

([6]8) "Unprofessional conduct" as defined in Title 58, Chapters 1 and 24[a]b, is further defined, in accordance with Subsection 58-1-203([5]1)(e), in Section R156-24[a]b-502.

 

R156-24[a]b-103. Authority - Purpose.

[These]This rule[s are] is adopted by the division under the authority of Subsection 58-1-106(1) to enable the division to administer Title 58, Chapter 24[a]b.

 

R156-24[a]b-104. Organization - Relationship to Rule R156-1.

The organization of this rule and its relationship to Rule R156-1 is as described in Section R156-1-107.

 

R156-24[a]b-302a. Qualifications for Licensure - Education Requirements.

(1) In accordance with Subsection [58-24a-109(2)(b)]58-24b-302(1)(c), the accredited school of physical therapy for a physical therapist shall be accredited by CAPTE at the time of graduation.

(2) In accordance with Subsection 58-24b-302(3), an applicant for licensure as a physical therapist who is educated outside the United States whose degree was not accredited by CAPTE shall document that the applicant's education is equal to a CAPTE accredited degree by submitting to the Division a credential evaluation from the Foreign Credentialing Commission on Physical Therapy. Only educational deficiencies in the humanities, social sciences and liberal arts may be corrected by completing college level credits in the deficient areas or by passing the College Level Examination Program (CLEP) demonstrating proficiency in the deficient areas.

([2]3) In accordance with Subsection [58-24a-102(5)]58-24b-302(2), a physical therapist assistant shall complete one of the following CAPTE accredited physical therapy education programs:

(a) an associates, bachelors, or masters program; or

(b) [a foreign physical therapy education program approved by the division in collaboration with the board, which program is equivalent to a program set forth in Subsection R156-24a-302a(2)(a).

(3) In]in accordance with Section 58-1-302, an applicant for a license as a physical therapist assistant who has been licensed in a foreign country whose degree was not accredited by CAPTE shall document that [his]the applicant's education is [equal]substantially equivalent to a CAPTE accredited degree by submitting to the Division a credential evaluation from the Foreign Credentialing Commission on Physical Therapy[ which shall use the approved course work evaluation tool]. Only educational deficiencies in the humanities, social sciences and liberal arts may be corrected by completing college level credits in the deficient areas or by passing the College Level Examination Program (CLEP) demonstrating proficiency in the deficient areas.

 

R156-24[a]b-302b. Qualifications for Licensure - Examination Requirements.

(1) In accordance with Subsections [58-24a-109(2)(c)]58-24b-302(1)(e), (2)(e) and (3)(e), each applicant for licensure as a physical therapist or physical therapist assistant[, including endorsement applicants,] shall pass the FSBPT's National Physical Therapy Examination with a passing score as established by the FSBPT.

(2) In accordance with Section 58-1-309 and Subsections 58-24b-302(1)(d), (2)(d) and (3)(d), each applicant for licensure as a physical therapist or physical therapist assistant, including endorsement applicants, shall pass all questions on the open book, take home Utah Physical Therapy Law and Rule Examination.

(3) An applicant for licensure as a physical therapist or a physical therapist assistant must have completed the education requirements set forth in S[ubs]ection [R156-24a-302a(1) or (3)]R156-24b-302, or be enrolled in the final semester of a CAPTE accredited program, in order to be eligible to sit for the examination required for Utah licensure as set forth in Subsection [R156-24a-302b(1)(a)](1) above.

 

R156-24[a]b-303a. Renewal Cycle - Procedures.

(1) In accordance with Subsection 58-1-308(1), the renewal date for the two-year renewal cycle applicable to licensees under Title 58, Chapter 24[a]b is established by rule in Section R156-1-308a.

(2) Renewal procedures shall be in accordance with Section R156-1-308c.

 

R156-24b-303b. Continuing Education.

(1) In accordance with Subsection 58-24b-303(2), there is hereby established a continuing education requirement for all individuals licensed under Title 58, Chapter 24b as a physical therapist and a physical therapist assistant.

(2) During each two year period commencing on June 1 of each odd numbered year:

(a) a physical therapist shall be required to complete not less than 40 hours of continuing education directly related to the licensee's professional practice of which a minimum of six hours must be completed in ethics/law;

(b) a physical therapist assistant shall be required to complete not less than 20 hours of continuing education directly related to the licensee's professional practice of which a minimum of three hours must be completed in ethics/law.

(3) The required number of hours of continuing education for an individual who first becomes licensed during the two year period shall be decreased in a pro-rata amount equal to any part of that two year period preceding the date on which that individual first became licensed.

(4) Continuing education under this section shall:

(a) be relevant to the licensee's professional practice;

(b) be prepared and presented by individuals who are qualified by education, training and experience to provide physical therapy continuing education; and

(c) have a method of verification of attendance and completion.

(5) Credit for professional education shall be recognized in accordance with the following:

(a) unlimited hours shall be recognized for continuing education completed in blocks of time of not less than 50 minutes in formally established classroom courses, seminars, conferences or training sessions which meet the criteria listed in Subsection (4) above and which are approved by, or under sponsorship of:

(i) the American Physical Therapy Association;

(ii) the Utah Physical Therapy Association;

(iii) accredited universities or colleges; or

(iv) professional associations, societies and organizations representing a licensed profession whose program objectives relate to the practice of physical therapy;

(b) a maximum of ten hours per two year period may be recognized for teaching in a college or university and teaching continuing education courses in the field of physical therapy;

(c) a maximum of six hours per two year period may be recognized for clinical reading or in-service directly related to physical therapy practice; and

(d) a maximum of 12 hours per two year period may be recognized for internet or distance learning courses that include an examination and issuance of a completion certificate.

(6) A licensee shall be responsible for maintaining competent records of continuing education for a period of four years after the close of the two year period to which the records pertain. It is the responsibility of the licensee to maintain information with respect to continuing education to demonstrate it meets the requirements of this section.

 

R156-24[a]b-502. Unprofessional Conduct.

Unprofessional conduct includes:

(1) violating, as a physical therapist, any provision of the American Physical Therapy Association's Code of Ethics, last amended [January 1997]June 2000, which is hereby adopted and incorporated by reference;[ and]

(2) violating, as a physical therapist, any provision of the American Physical Therapy Association's Guide for Professional Conduct, last amended January 2004, which is hereby adopted and incorporated by reference;

([2]3) not providing supervision, as a physical therapist, as set forth in Section R156-24[a]b-503;

(4) violating, as a physical therapist assistant, any provision of the American Physical Therapy Association's Standards of Ethical Conduct for the Physical Therapist Assistant, last amended June 2000, which is hereby adopted and incorporated by reference; and

(5) violating, as a physical therapist assistant, any provision of the American Physical Therapy Association's Guide for Conduct of the Physical Therapist Assistant, last amended February 2004, which is hereby adopted and incorporated by reference.

 

R156-24[a]b-503. Physical Therapist Supervisory Authority and Responsibility.

In accordance with Section [58-24a-112]58-24b-404, [the supervisory responsibilities of a physical therapist include the following:]a physical therapist's supervision of a physical therapist assistant or a physical therapy aide shall meet the following conditions:

(1) a full-time equivalent physical therapist can supervise no more than three full-time equivalent supportive personnel unless approved by the board and Division; and

(2) a physical therapist shall provide treatment to a patient at least every tenth treatment day but no longer than 30 days from the day of the physical therapist's last treatment day, whichever is less.

[ (1) Adequate supervision requires at a minimum that a supervising physical therapist perform the following activities:

(a) designate or establish channels of written and oral communication;

(b) interpret available information concerning the individual under care;

(c) provide the initial evaluation;

(d) develop a plan of care, including short and long term goals;

(e) select and delegate appropriate tasks of the plan of care;

(f) assess competence of supportive personnel in the delegated tasks;

(g) identify and document precautions, special problems, contraindications, anticipated progress, and plans for reevaluation; and

(h) reevaluate, adjust plan care when necessary, perform final evaluation, and establish a follow-up plan.

(2) Supervision by a physical therapist of a physical therapist assistant shall include the following conditions:

(a) an initial visit shall be made by the physical therapist for evaluation of the patient and establishment of a plan of care; and

(b) supervision shall be on site by the physical therapist every sixth treatment but no longer than every 30 days from the time of the physical therapist's last evaluation or treatment.

(3) Duties delegated by a physical therapist to a physical therapist assistant may include:

(a) providing physical therapy services according to a plan of care established by the licensed physical therapist;

(b) adjusting a specific treatment procedure in accordance with changes in patient status only with prior evaluation and approval by the supervising physical therapist;

(c) responding to inquiries regarding patient status to appropriate parties within the plan of care established by a supervising physical therapist, but not interpreting data beyond the scope of his physical therapist assistant education; and

(d) referring inquires regarding patient prognosis to the supervising physical therapist.

(4) Duties delegated by a physical therapist to a physical therapist aide may include:

(a) engaging in assembly and disassembly, maintenance and transportation, preparation and all other operational activities relevant to equipment and accessories necessary for treatment; and

(b) providing only that type of elementary and direct patient care which the patient and family members could reasonably be expected to learn and perform.

(5) A physical therapist aide may not interpret referrals, perform evaluations or evaluate procedures, initiate or adjust treatment programs, assume responsibility for planning patient treatment care, perform debridement, topical medical application, or joint mobilization.

(6) Each physical therapist assistant and physical therapist aide shall clearly identify himself as a non-licensed person and shall not present or hold himself out in any way as a physical therapist.

 

R156-24a-601. Animal Physical Therapy.

In accordance with Subsection 58-28-8(12)(b), a physical therapist practicing animal massage must complete at least 100 hours of animal physical therapy training and education. The training shall consist of:

(1) completing 50 hours of on the job training under the supervision of a licensed veterinarian;

(2) completing a quadruped anatomy course; and

(3) completing the remaining hours in continuing education.]

 

KEY: licensing, physical therapy, physical therapist, physical therapist assistant

Date of Enactment or Last Substantive Amendment: [January 7, 2002]2009

Notice of Continuation: January 30, 2007

Authorizing, and Implemented or Interpreted Law: 58-24[a]b-101; 58-1-106(1)(a); 58-1-202(1)(a)