Brief Description: Modifying the scope of care provided by physical therapists.

Sponsors: By House Committee on Health Care (originally sponsored by Representatives Morrell, Orcutt, Cody, McDonald, Green, Campbell, Clibborn, Schindler, Kagi, Woods, Hunt, Miloscia, Linville, Lantz, Moeller, Williams, Wallace and Kenney).

House Committee on Health Care
Senate Committee on Health & Long-Term Care

Background:

Physical therapists conduct tests to measure the strength, range of motion, balance and coordination, muscle performance, and motor function of patients with movement or mobility problems due to injury or disease. With this information they develop treatment plans and perform services for patients to restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities.

Physical therapists work in several different settings including hospitals, private offices, clinics, public schools, nursing homes, and rehabilitation centers. Some physical therapists specialize in certain areas such as pediatrics, geriatrics, orthopedics, sports medicine, neurology, and cardiopulmonary physical therapy.

In Washington, physical therapists are regulated by the Department of Health and the Board of Physical Therapy.

Summary:

Practice of Physical Therapy

The general and non-specific description of the practice of physical therapy as applying to any bodily or mental condition is replaced with more specific parameters referencing the practice's basis in movement science and functional limitations in movement.

The range of physical therapist activities, including treatment of bodily or mental conditions by (1) the use of heat, cold, air, light, water, electricity, sound, massage, and therapeutic exercise and (2) the performance of tests and measurements of neuromuscular function, are replaced with more specific activities. Permissible activities are redefined to include:       

• examining patients to determine proper diagnoses and plans for therapeutic interventions;
• designing and implementing therapeutic interventions, functional training, manual therapy, therapeutic massage, postural control devices, airway clearance techniques, physical agents or modalities, mechanical and electrotherapeutic modalities, and patient-related instruction;
• training and evaluating the function of people wearing orthotic or prosthetic devices;
• performing wound care services;
• reducing the risk of injury, impairment, functional limitations, and disability; and
• engaging in consultation, education, and research.

Medications

Physical therapists may purchase, store, and administer medications such as topical anesthetics, hydrocortisone, fluocinonide, silvadine, lidocaine, zinc oxide, and other similar medications. Physical therapists may administer other drugs and medications as prescribed by an authorized health care provider.

Referral and Additional Training Requirements

When a physical therapist believes that a person has symptoms or conditions that are beyond the scope of practice of a physical therapist or that physical therapy is contraindicated, he or she must refer the person to an appropriate health care practitioner.

The requirement that physical therapists only provide treatment using certain orthoses upon referral or consultation by an authorized health care practitioner is removed.

A physical therapist may only perform electroneuromyographic examinations upon completion of additional training and education and referral from an authorized health care provider. Wound care services may only be performed upon referral from an authorized health care provider. Wound care services that involve sharp debridement may only be performed by physical therapists who have obtained adequate education and training.

Assistive Personnel

Three categories of assistive personnel are defined: "physical therapist assistants;" "physical therapy aides;" and "other assistive personnel." They may assist a licensed physical therapist with delegated or supervised tasks or procedures that are within the practice of physical therapy according to their level of training. Other licensed health care providers may use such assistants, aides, and personnel in their practices.

Matters Related to Licensure

The practice of physical therapy without a license is prohibited. Licensing requirements do not apply to: (1) people satisfying supervised clinical education requirements as part of a physical therapist education program; (2) physical therapists practicing in the military, United States Public Health Service, or Veteran's Administration; or (3) physical therapists credentialed out-of-state who are teaching or participating in an educational seminar.

Votes on Final Passage:

House   88   9
Senate   40   9   (Senate amended)
House   94   1   (House concurred)

Effective: July 24, 2005