SB104 By Senator McClendon RFD Healthcare Rd 1 04-FEB-20

SYNOPSIS: Under existing law, physical therapy may only be performed based on a referral from a licensed physician, dentist, chiropractor, physician assistant, or certified registered nurse practitioner, except in limited, enumerated circumstances that allow a licensed physical therapist to perform an initial evaluation or consultation of a screening nature without a referral.

This bill would eliminate the requirement that a licensed physical therapist may only perform physical therapy, except in limited circumstances, based on a referral from a licensed health care practitioner.

A BILL TO BE ENTITLED AN ACT

Relating to physical therapy; to amend Sections 34-24-191, 34-24-210.1, and 34-24-217, Code of Alabama 1975; to remove the prohibition against practicing physical therapy without a referral from a licensed health care practitioner.

BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:Section 1. Sections 34-24-191, 34-24-210.1, and 34-24-217, Code of Alabama 1975, are amended to read as follows:

§34-24-191.

"(a) For the purposes of this article, the following words and phrases shall have the meanings respectively ascribed by this section:

"(1) BOARD. The Board of Physical Therapy established by Section 34-24-192.

"(2) FOREIGN EDUCATED PHYSICAL THERAPIST. A person trained or educated in the practice of physical therapy outside of the United States or any of its territorial possessions.

"(3) IMPAIRED. The inability of a physical therapy licensee to practice physical therapy with reasonable skill and safety to patients by reason of illness, inebriation, excessive use of drugs, narcotics, alcohol, chemicals, or other substances, or as a result of any physical or mental condition.

"(4) PHYSICAL THERAPY. The treatment of a human being by the use of exercise, massage, heat, cold, water, radiant energy, electricity, or sound for the purpose of correcting or alleviating any physical or mental condition or preventing the development of any physical or mental disability, or the performance of neuromuscular-skeletal tests and measurements to determine the existence and extent of body malfunction.; provided, that physical therapy shall be practiced only upon the referral of a physician licensed to practice medicine or surgery, a dentist licensed to practice dentistry, a licensed chiropractor, a licensed assistant to a physician acting pursuant to a valid supervisory agreement, or a licensed certified registered nurse practitioner in a collaborative practice agreement with a licensed physician, except as otherwise provided in this chapter. Physical therapy does not include radiology or electrosurgery.

"(5) PHYSICAL THERAPIST. A person who practices physical therapy.

"(6) PHYSICAL THERAPY LICENSEE. A physical therapist or physical therapist assistant who is licensed under this article.

"(7) PHYSIOTHERAPIST. Synonymous with the term "physical therapist," and the term shall be used to identify only those persons licensed under this article. The physical therapist may use the letters "P.T." or "R.P.T." in connection with his or her name or place of business to denote his or her registration hereunder.

"(8) PHYSICAL THERAPIST ASSISTANT. A person who assists in the practice of physical therapy and whose activities require an understanding of physical therapy but do not require professional or advanced training in the anatomical, biological, and physical sciences involved in the practice of physical therapy. The physical therapist assistant shall practice only under the direction of a licensed physical therapist.

"(9) PHYSICAL THERAPY AIDE. A person trained under the direction of a physical therapist who performs designated and supervised routine tasks related to physical therapy services.

"(10) RESTRICTED LICENSE.

"a. For a physical therapist, a license on which the board has placed restrictions or conditions, or both, as to the scope of practice, place of practice, supervision of practice, duration of licensed status, or type or condition of patient to whom the physical therapist may provide services.

"b. For a physical therapist assistant, a license on which the board has placed any restriction.

"(b) Words importing the masculine gender shall include the feminine.

§34-24-210.1.

"(a) Without prescription or referral, a licensed physical therapist may perform an initial evaluation or consultation of a screening nature to determine the need for physical therapy and may perform the physical therapy. and other services provided in subdivisions (1) to (5), inclusive, of subsection (b). Implementation of physical therapy shall otherwise be based on the referral of a person licensed to practice medicine, surgery, dentistry, chiropractic, licensed assistant to a physician acting pursuant to a valid supervising agreement, or a licensed certified registered nurse practitioner in a valid collaborative practice agreement with a licensed physician.

"(b) The physical therapy and other services referred to in subsection (a), which may be performed without prescription or referral, include and are limited to the following:

"(1) To a child with a diagnosed developmental disability pursuant to the plan of care for the child.

"(2) To a patient of a home health care agency pursuant to the plan of care for the patient.

"(3) To a patient in a nursing home pursuant to the plan of care for the patient.

"(4) Related to conditioning or to providing education or activities in a wellness setting for the purpose of injury prevention, reduction of stress, or promotion of fitness.

"(5) To an individual for a previously diagnosed condition or conditions for which physical therapy services are appropriate after informing the health care provider rendering the diagnosis. The diagnosis shall have been made within the immediately preceding 90 days. The physical therapist shall provide the health care provider who rendered the diagnosis with a plan of care for physical therapy services within the first 15 days of physical therapy intervention.

§34-24-217.

"(a) The board shall refuse to issue a license to any person and, after notice and hearing in accordance with its regulations and rules, shall suspend or revoke the license of any person who has:

"(1) Practiced physical therapy other than upon the referral of a physician licensed to practice medicine or surgery, a dentist licensed to practice dentistry, a licensed chiropractor, a licensed assistant to a physician acting pursuant to a valid supervisory agreement, or a licensed certified registered nurse practitioner in a valid collaborative practice agreement with a licensed physician, except as provided in Section 34-24-210.1, or practiced as a physical therapist assistant other than under the direction of a licensed physical therapist;

"(2) Used drugs or intoxicating liquors to an extent which affects his or her professional competency;

"(3) Been convicted of a felony or of a crime involving moral turpitude;

"(4) Obtained or attempted to obtain a license by fraud or deception;

"(5) Been grossly negligent in the practice of physical therapy or in acting as a physical therapist assistant;

"(6) Been adjudged mentally incompetent by a court of competent jurisdiction;

"(7) Been guilty of conduct unbecoming a person licensed as a physical therapist or licensed as a physical therapist assistant or of conduct detrimental to the best interest of the public;

"(8) Been convicted of violating any state or federal narcotic law;

"(9) Treated or undertaken to treat human ailments otherwise than by physical therapy as defined in this article;

"(10) Advertised unethically according to standards as set by the board; or

"(11) Failed or refused to obey any lawful order or regulation of the board.

"(b) For purposes of this article and notwithstanding any other provision of this article or any rules or regulations adopted by the board, any person licensed under this article who has a bona fide employment or independent contract with a physician, a physician group, or an entity with which a physician has a legal compensation arrangement, including fair market value wages, compensation, benefits, or rents for services or property provided, or in which a physician has a legal financial interest, including any direct or indirect ownership or investment interest, shall not be deemed to be engaged in conduct unbecoming a person licensed under this article, or to be engaged in conduct detrimental to the best interest of the public, or to be in violation of any other provision of this article by virtue of any of the above relationships, and shall not be subject to licensure denial, suspension, revocation, or any other disciplinary action or penalty under this article: (1) by virtue of such employment or contract, or (2) by virtue of the provision of physical therapy services pursuant to a referral from the employing or contracting physician, or from a physician with a legal compensation arrangement with or a legal financial interest in the employing or contracting physician group."

Section 2. This act shall become effective on the first day of the third month following its passage and approval by the Governor, or its otherwise becoming law.

Physical Therapists

Health Care

Physical Therapy, Board of

Code Amended