Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Health Care & Wellness Committee

HB 2160

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Background:

Physical Therapists.

Licensed physical therapists may perform a variety of services, including:

examining, evaluating, and testing individuals with mechanical, physiological, and developmental impairments, functional limitations in movement, and disability or other health and movement-related conditions;
alleviating impairments and functional limitations in movement;
training for, and the evaluation of, the function of a patient wearing an orthosis or prosthesis;
performing wound care services;
reducing the risk of injury, impairment, functional limitation, and disability related to movement; and
engaging in administration, consultation, education, and research.

To be licensed as a physical therapist, an applicant must:

have a baccalaureate degree in physical therapy from an institution of higher education or a baccalaureate degree from an institution of higher education and a certificate or advanced degree from an approved school of physical therapy;
be of good moral character; and
pass an examination.

A licensed physical therapist, may not use spinal manipulation or manipulative mobilization of the spine and its immediate articulations. A physical therapist may not advertise that he or she performs spinal manipulation or manipulative mobilization of the spine.

Chiropractors.

Chiropractic is a health care practice involving the diagnosis, analysis, care, and treatment of the vertebral subluxation complex and its effects, articular dysfunction, and musculoskeletal disorders, all for the restoration and maintenance of health and recognizing the recuperative powers of the body. To be licensed as a chiropractor, an applicant must:

graduate from an accredited chiropractic college;
show satisfactory evidence of a resident course of study of at least 4,000 hours of instruction;
be of good moral character; and

pass an examination.

Summary of Bill:

A physical therapist with at least one year of orthopedic practice experience may perform spinal manipulation and manipulative mobilization of the spine and its immediate articulations (spinal manipulation) if he or she:

is certified as an Orthopedic Certified Specialist by the American Board of Physical Therapy Specialists;
completes a fellowship in orthopedic manual physical therapy or a residency in orthopedic physical therapy accredited by the American Board of Physical Therapy Residency and Fellowship Education; or
completes both:
- one hundred fifty hours of education related to spinal manipulation covering differential diagnosis; didactic and practical training related to the indications, contraindications, assessment, and delivery of spinal manipulation; and imaging and laboratory training; and
- one year of practice under the direct supervision of a physical therapist authorized to perform spinal manipulation, which must be completed within one year of completing the educational requirements.

A physical therapist must develop a treatment plan for each patient for whom he or she performs spinal manipulation. If the scope or duration of treatment exceeds what is articulated in the plan, the physical therapist must discontinue treatment and refer the patient to a licensed physician, osteopathic physician, or chiropractor.

A physical therapist authorized to perform spinal manipulation may not:

have a practice in which spinal manipulation constitutes the majority of the services provided;
practice or utilize chiropractic manipulative therapy; or
delegate spinal manipulation.

A physical therapist authorized to perform spinal manipulation must complete at least 10 hours of Board of Physical Therapy-approved continuing education directly related to spinal manipulation per reporting period directly related. At least five hours of the training must be related to procedural technique and application of spinal manipulation.

If a physical therapist is performing spinal manipulation on a patient the physical therapist knows is being treated by more than one provider, the physical therapist must make reasonable efforts to coordinate patient care with the other providers.

A physical therapist may not advertise that he or she performs chiropractic adjustment, spinal adjustment, maintenance or wellness manipulation, or chiropractic care of any kind.

By November 15, 2019, the Board of Physical Therapy must report to the Legislature any disciplinary actions taken against physical therapists whose performance of spinal manipulation resulted in physical harm to a patient. Prior to finalizing the report, the Board of Physical Therapy must consult with the Chiropractic Quality Assurance Commission.