BILL REQ. #: S-0634.2
| State of Washington | 60th Legislature | 2007 Regular Session |
Read first time 01/16/2007. Referred to Committee on Health & Long-Term Care.
AN ACT Relating to physical therapist assistants; amending RCW 18.74.010, 18.74.020, 18.74.030, 18.74.035, 18.74.040, 18.74.060, 18.74.070, 18.74.073, 18.74.090, 18.74.120, 18.74.130, 18.74.150, 18.74.160, and 18.74.170; and adding new sections to chapter 18.74 RCW.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1 RCW 18.74.010 and 2005 c 501 s 2 are each amended to read
as follows:
The definitions in this section apply throughout this chapter
unless the context clearly requires otherwise.
(1) "Board" means the board of physical therapy created by RCW
18.74.020.
(2) "Department" means the department of health.
(3) "Physical therapy" means the care and services provided by or
under the direction and supervision of a physical therapist licensed by
the state. The use of Roentgen rays and radium for diagnostic and
therapeutic purposes, the use of electricity for surgical purposes,
including cauterization, and the use of spinal manipulation, or
manipulative mobilization of the spine and its immediate articulations,
are not included under the term "physical therapy" as used in this
chapter.
(4) "Physical therapist" means a person who meets all the
requirements of this chapter and is licensed in this state to practice
physical therapy.
(5) "Secretary" means the secretary of health.
(6) Words importing the masculine gender may be applied to females.
(7) "Authorized health care practitioner" means and includes
licensed physicians, osteopathic physicians, chiropractors,
naturopaths, podiatric physicians and surgeons, dentists, and advanced
registered nurse practitioners: PROVIDED, HOWEVER, That nothing herein
shall be construed as altering the scope of practice of such
practitioners as defined in their respective licensure laws.
(8) "Practice of physical therapy" is based on movement science and
means:
(a) Examining, evaluating, and testing individuals with mechanical,
physiological, and developmental impairments, functional limitations in
movement, and disability or other health and movement-related
conditions in order to determine a diagnosis, prognosis, plan of
therapeutic intervention, and to assess and document the ongoing
effects of intervention;
(b) Alleviating impairments and functional limitations in movement
by designing, implementing, and modifying therapeutic interventions
that include therapeutic exercise; functional training related to
balance, posture, and movement to facilitate self-care and
reintegration into home, community, or work; manual therapy including
soft tissue and joint mobilization and manipulation; therapeutic
massage; assistive, adaptive, protective, and devices related to
postural control and mobility except as restricted by (c) of this
subsection; airway clearance techniques; physical agents or modalities;
mechanical and electrotherapeutic modalities; and patient-related
instruction;
(c) Training for, and the evaluation of, the function of a patient
wearing an orthosis or prosthesis as defined in RCW 18.200.010.
Physical therapists may provide those direct-formed and prefabricated
upper limb, knee, and ankle-foot orthoses, but not fracture orthoses
except those for hand, wrist, ankle, and foot fractures, and assistive
technology devices specified in RCW 18.200.010 as exemptions from the
defined scope of licensed orthotic and prosthetic services. It is the
intent of the legislature that the unregulated devices specified in RCW
18.200.010 are in the public domain to the extent that they may be
provided in common with individuals or other health providers, whether
unregulated or regulated under Title 18 RCW, without regard to any
scope of practice;
(d) Performing wound care services that ((is [are])) are limited to
sharp debridement, debridement with other agents, dry dressings, wet
dressings, topical agents including enzymes, hydrotherapy, electrical
stimulation, ultrasound, and other similar treatments. Physical
therapists may not delegate sharp debridement. A physical therapist
may perform wound care services only by referral from or after
consultation with an authorized health care practitioner;
(e) Reducing the risk of injury, impairment, functional limitation,
and disability related to movement, including the promotion and
maintenance of fitness, health, and quality of life in all age
populations; and
(f) Engaging in administration, consultation, education, and
research.
(9)(a) "Physical therapist assistant" means a person who ((has
successfully completed a board-approved physical therapist assistant
program)) meets all the requirements of this chapter and is licensed as
a physical therapist assistant and who performs physical therapy
procedures and related tasks that have been selected and delegated only
by the supervising physical therapist. However, a physical therapist
may not delegate sharp debridement to a physical therapist assistant.
(b) "Physical therapy aide" means a person who is involved in
direct physical therapy patient care who does not meet the definition
of a physical therapist or physical therapist assistant and receives
ongoing on-the-job training.
(c) "Other assistive personnel" means other trained or educated
health care personnel, not defined in (a) or (b) of this subsection,
who perform specific designated tasks related to physical therapy under
the supervision of a physical therapist, including but not limited to
licensed massage practitioners, athletic trainers, and exercise
physiologists. At the direction of the supervising physical therapist,
and if properly credentialed and not prohibited by any other law, other
assistive personnel may be identified by the title specific to their
training or education.
(10) "Direct supervision" means the supervising physical therapist
must (a) be continuously on-site and present in the department or
facility where assistive personnel or holders of interim permits are
performing services; (b) be immediately available to assist the person
being supervised in the services being performed; and (c) maintain
continued involvement in appropriate aspects of each treatment session
in which a component of treatment is delegated to assistive personnel.
(11) "Sharp debridement" means the removal of devitalized tissue
from a wound with scissors, scalpel, and tweezers without anesthesia.
"Sharp debridement" does not mean surgical debridement. A physical
therapist may perform sharp debridement, to include the use of a
scalpel, only upon showing evidence of adequate education and training
as established by rule. Until the rules are established, but no later
than July 1, 2006, physical therapists licensed under this chapter who
perform sharp debridement as of July 24, 2005, shall submit to the
secretary an affidavit that includes evidence of adequate education and
training in sharp debridement, including the use of a scalpel.
Sec. 2 RCW 18.74.020 and 1991 c 3 s 174 are each amended to read
as follows:
The state board of physical therapy is hereby created. The board
shall consist of ((five)) six members who shall be appointed by the
governor. Of the initial appointments, two shall be appointed for a
term of two years, two for a term of three years, and one for a term of
four years. Thereafter, all appointments shall be for terms of four
years. Four members of the board shall be physical therapists licensed
under this chapter and residing in this state, shall have not less than
five years' experience in the practice of physical therapy, and shall
be actively engaged in practice within two years of appointment. One
member shall be a physical therapist assistant licensed under this
chapter and residing in this state, shall not have less than five
years' experience in the practice of physical therapy, and shall be
actively engaged in practice within two years of appointment. The
((fifth)) sixth member shall be appointed from the public at large,
shall have an interest in the rights of consumers of health services,
and shall not be or have been a member of any other licensing board, a
licensee of any health occupation board, an employee of any health
facility nor derive his or her primary livelihood from the provision of
health services at any level of responsibility. In the event that a
member of the board for any reason cannot complete his or her term of
office, another appointment shall be made by the governor in accordance
with the procedure stated ((above)) in this section to fill the
remainder of the term. No member may serve for more than two
successive four-year terms.
The secretary of health shall furnish such secretarial, clerical,
and other assistance as the board may require. Each member of the
board shall, in addition to travel expenses in accordance with RCW
43.03.050 and 43.03.060, be compensated in accordance with RCW
43.03.240.
Sec. 3 RCW 18.74.030 and 1983 c 116 s 6 are each amended to read
as follows:
(1) An applicant for a license as a physical therapist shall have
the following minimum qualifications:
(((1))) (a) Be of good moral character; and
(((2))) (b) Have obtained either (((a))) (i) a baccalaureate degree
in physical therapy from an institution of higher learning approved by
the board or (((b))) (ii) a baccalaureate degree from an institution of
higher learning and a certificate or advanced degree from a school of
physical therapy approved by the board.
(2) An applicant for a license as a physical therapist assistant
must have the following minimum qualifications:
(a) Be of good moral character; and
(b) Have successfully completed a board-approved physical therapist
assistant program.
(3) The applicant shall present proof of qualification to the board
in the manner and on the forms prescribed by ((it)) the board.
Sec. 4 RCW 18.74.035 and 1995 c 198 s 10 are each amended to read
as follows:
(1) All qualified applicants for a license as a physical therapist
shall be examined by the board at such time and place as the board may
determine. The board may approve an examination prepared or
administered by a private testing agency or association of licensing
authorities. The examination shall embrace the following subjects:
The applied sciences of anatomy, neuroanatomy, kinesiology, physiology,
pathology, psychology, physics; physical therapy, as defined in this
chapter, applied to medicine, neurology, orthopedics, pediatrics,
psychiatry, surgery; medical ethics; technical procedures in the
practice of physical therapy as defined in this chapter; and such other
subjects as the board may deem useful to test the applicant's fitness
to practice physical therapy, but not including the adjustment or
manipulation of the spine or use of a thrusting force as mobilization.
Examinations shall be held within the state at least once a year, at
such time and place as the board shall determine. An applicant who
fails an examination may apply for reexamination upon payment of a
reexamination fee determined by the secretary.
(2) All qualified applicants for a license as a physical therapist
assistant must be examined by the board at such a time and place as the
board may determine. The board may approve an examination prepared or
administered by a private testing agency or association of licensing
authorities.
Sec. 5 RCW 18.74.040 and 1991 c 3 s 177 are each amended to read
as follows:
(1) The secretary ((of health)) shall license as a physical
therapist, and shall furnish a license to, each applicant who
successfully passes the examination for licensure as a physical
therapist.
(2) The secretary shall license as a physical therapist assistant,
and shall furnish a license to, each applicant who successfully passes
the examination for licensure as a physical therapist assistant.
Sec. 6 RCW 18.74.060 and 1996 c 191 s 60 are each amended to read
as follows:
Upon the recommendation of the board, the secretary shall license
as a physical therapist or physical therapist assistant and shall
furnish a license to any person who is a physical therapist or physical
therapist assistant registered, certified, or licensed under the laws
of another state or territory, or the District of Columbia, if the
qualifications for such registration, certification, or license
required of the applicant were substantially equal to the requirements
under this chapter. At the time of making application, the applicant
shall comply with administrative procedures, administrative
requirements, and fees established pursuant to RCW 43.70.250 and
43.70.280.
NEW SECTION. Sec. 7 A new section is added to chapter 18.74 RCW
to read as follows:
The board shall waive the examination and grant a license to a
person who meets the commonly accepted standards for practicing as a
physical therapist assistant, as adopted by rule. Persons eligible for
licensure as a physical therapist assistant under this section must
apply for a license within one year of the effective date of this
section.
Sec. 8 RCW 18.74.070 and 1996 c 191 s 61 are each amended to read
as follows:
Every licensed physical therapist and physical therapist assistant
shall apply to the secretary for a renewal of the license and pay to
the state treasurer a fee determined by the secretary as provided in
RCW 43.70.250 and 43.70.280.
Sec. 9 RCW 18.74.073 and 1998 c 143 s 1 are each amended to read
as follows:
Any physical therapist or physical therapist assistant licensed
under this chapter not practicing physical therapy or providing
services may place his or her license in an inactive status. The board
shall prescribe requirements for maintaining an inactive status and
converting from an inactive or active status. The secretary may
establish fees for alterations in license status.
Sec. 10 RCW 18.74.090 and 1991 c 3 s 181 are each amended to read
as follows:
(1) A person who is not licensed with the secretary of health as a
physical therapist under the requirements of this chapter shall not
represent him or herself as being so licensed and shall not use in
connection with his or her name the words or letters "P.T.", "R.P.T.",
"L.P.T.", "physical therapy", "physiotherapy", "physical therapist" or
"physiotherapist", or any other letters, words, signs, numbers, or
insignia indicating or implying that he or she is a physical therapist.
No person may practice physical therapy without first having a valid
license. Nothing in this chapter prohibits any person licensed in this
state under any other act from engaging in the practice for which he or
she is licensed. It shall be the duty of the prosecuting attorney of
each county to prosecute all cases involving a violation of this
chapter arising within his or her county. The attorney general may
assist in such prosecution and shall appear at all hearings when
requested to do so by the board.
(2) No person may use the title "physical therapist assistant," the
letters "PTA," or any other words, abbreviations, or insignia in
connection with his or her name to indicate or imply, directly or
indirectly, that he or she is a physical therapist assistant without
being licensed in accordance with this chapter as a physical therapist
assistant.
Sec. 11 RCW 18.74.120 and 1991 c 3 s 183 are each amended to read
as follows:
The secretary of health shall keep a record of proceedings under
this chapter and a register of all persons licensed under it. The
register shall show the name of every living licensed physical
therapist and physical therapist assistant, his or her last known place
of residence, and the date and number of his or her license as a
physical therapist or physical therapist assistant.
Sec. 12 RCW 18.74.130 and 1983 c 116 s 22 are each amended to
read as follows:
This chapter does not prohibit or regulate:
(1) The practice of physical therapy by students enrolled in
approved schools as may be incidental to their course of study so long
as such activities do not go beyond the scope of practice defined by
this chapter.
(2) Auxiliary services provided by physical therapy aides carrying
out duties necessary for the support of physical therapy including
those duties which involve minor physical therapy services when
performed under the direct supervision of licensed physical therapists
or physical therapist assistants so long as such activities do not go
beyond the scope of practice defined by this chapter.
(3) The practice of physical therapy by licensed or registered
physical therapists of other states or countries while appearing as
clinicians of bona fide educational seminars sponsored by physical
therapy, medical, or other healing art professional associations so
long as such activities do not go beyond the scope of practice defined
by this chapter.
(4) The practice of physical therapists and physical therapist
assistants in the armed services or employed by any other branch of the
federal government.
Sec. 13 RCW 18.74.150 and 2005 c 501 s 4 are each amended to read
as follows:
(1) It is unlawful for any person to practice or in any manner hold
himself or herself out to practice physical therapy or designate
himself or herself as a physical therapist or physical therapist
assistant, unless he or she is licensed in accordance with this
chapter.
(2) This chapter does not restrict persons licensed under any other
law of this state from engaging in the profession or practice for which
they are licensed, if they are not representing themselves to be
physical therapists, physical therapy assistants, or providers of
physical therapy.
(3) The following persons are exempt from licensure as physical
therapists under this chapter when engaged in the following activities:
(a) A person who is pursuing a course of study leading to a degree
as a physical therapist in an approved professional education program
and is satisfying supervised clinical education requirements related to
his or her physical therapy education while under direct supervision of
a licensed physical therapist;
(b) A physical therapist while practicing in the United States
armed services, United States public health service, or veterans
administration as based on requirements under federal regulations for
state licensure of health care providers; and
(c) A physical therapist licensed in another United States
jurisdiction, or a foreign-educated physical therapist credentialed in
another country, performing physical therapy as part of teaching or
participating in an educational seminar of no more than sixty days in
a calendar year.
(4) The following persons are exempt from licensure as physical
therapist assistants under this chapter when engaged in the following
activities:
(a) A person who is pursuing a course of study leading to a degree
as a physical therapist assistant in an approved professional education
program and is satisfying supervised clinical education requirements
related to his or her physical therapist assistant education while
under direct supervision of a licensed physical therapist;
(b) A physical therapist assistant while practicing in the United
States armed services, United States public health service, or veterans
administration as based on requirements under federal regulations for
state licensure of health care providers; and
(c) A physical therapist assistant licensed in another United
States jurisdiction, or a foreign-educated physical therapist assistant
credentialed in another country, or a physical therapist assistant who
is teaching or participating in an educational seminar of no more than
sixty days in a calendar year.
Sec. 14 RCW 18.74.160 and 2005 c 501 s 5 are each amended to read
as follows:
(1) A physical therapist licensed under this chapter is fully
authorized to practice physical therapy as defined in this chapter.
(2) A physical therapist shall refer persons under his or her care
to appropriate health care practitioners if the physical therapist has
reasonable cause to believe symptoms or conditions are present that
require services beyond the scope of practice under this chapter or
when physical therapy is contraindicated.
(3) Physical therapists and physical therapist assistants shall
adhere to the recognized standards of ethics of the physical therapy
profession and as further established by rule.
(4) A physical therapist may perform electroneuromyographic
examinations for the purpose of testing neuromuscular function only by
referral from an authorized health care practitioner identified in RCW
18.74.010(7) and only upon demonstration of further education and
training in electroneuromyographic examinations as established by rule.
Within two years after July 1, 2005, the secretary shall waive the
requirement for further education and training for those physical
therapists licensed under this chapter who perform
electroneuromyographic examinations.
(5) A physical therapist licensed under this chapter may purchase,
store, and administer medications such as hydrocortisone, fluocinonide,
topical anesthetics, silver sulfadiazine, lidocaine, magnesium sulfate,
zinc oxide, and other similar medications, and may administer such
other drugs or medications as prescribed by an authorized health care
practitioner for the practice of physical therapy. A pharmacist who
dispenses such drugs to a licensed physical therapist is not liable for
any adverse reactions caused by any method of use by the physical
therapist.
Sec. 15 RCW 18.74.170 and 2005 c 501 s 6 are each amended to read
as follows:
(1) Physical therapists are responsible for patient care given by
assistive personnel under their supervision. A physical therapist may
delegate to assistive personnel and supervise selected acts, tasks, or
procedures that fall within the scope of physical therapy practice but
do not exceed the education or training of the assistive personnel.
(2) Nothing in this chapter may be construed to prohibit other
licensed health care providers from using the services of physical
therapist assistants, as long as the title "physical therapist
assistant" is not used in violation of RCW 18.74.090, physical
therapist aides, or other assistive personnel as long as the licensed
health care provider is responsible for the activities of such
assistants, aides, and other personnel and provides appropriate
supervision.
NEW SECTION. Sec. 16 A new section is added to chapter 18.74 RCW
to read as follows:
A physical therapist is professionally and legally responsible for
patient care given by supportive personnel under his or her
supervision. If a physical therapist fails to adequately supervise
patient care given by supportive personnel, the board may take
disciplinary action against the physical therapist.