15100671D
HOUSE BILL NO. 1457
Offered January 14, 2015
Prefiled December 30, 2014
A BILL to amend and reenact §§ 54.1-3482 and 54.1-3482.1
of the Code of Virginia, relating to direct access to physical therapy.
----------
Patron-- O'Bannon
----------
Committee Referral Pending
----------
Be it enacted by the General Assembly of Virginia:
1. That §§ 54.1-3482 and 54.1-3482.1 of the Code of
Virginia are amended and reenacted as follows:
§54.1-3482. Practice of physical therapy; certain experience
and referrals required; physical therapist assistants.
A. It shall be unlawful for a person to engage in the practice
of physical therapy except as a licensed physical therapist, upon the referral
and direction of a licensed doctor of medicine, osteopathy, chiropractic,
podiatry, or dental surgery, a licensed nurse practitioner as authorized practicing in accordance with his practice protocol agreement,
or a licensed physician assistant acting under the supervision of a licensed
physician, except as provided in this section.
B. A physical therapist who has completed
a doctor of physical therapy program approved by the Commission
on Accreditation of Physical Therapy Education or who has obtained
a certificate of authorization pursuant to §54.1-3482.1 may evaluate and treat
a patient for no more than 14 30
consecutive business days after an initial evaluation
without a referral under the following conditions: (i)
the patient is not receiving care from any
licensed doctor of medicine, osteopathy, chiropractic, podiatry, or dental
surgery, a licensed nurse practitioner practicing in accordance with his
practice agreement, or a
licensed physician assistant acting under the supervision of a licensed
physician for the symptoms giving rise to the presentation at the time of the
presentation to the physical therapist for physical therapy services or
(ii) the patient at
the time of presentation to a physical therapist for physical therapy services
is not being currently cared for, as attested to in writing by the patient, by is receiving care
from a licensed doctor of medicine, osteopathy, chiropractic, podiatry, or dental
surgery, a licensed nurse practitioner practicing in accordance with his
practice agreement, or a
licensed physician assistant acting under the supervision of a licensed
physician at the time of
his presentation to the physical therapist for the symptoms giving rise to the
presentation for physical therapy services and (a)
the patient identifies
a licensed doctor of medicine, osteopathy, chiropractic, podiatry, or dental surgery, a licensed nurse practitioner as authorized practicing
in accordance with his practice protocol agreement,
or a licensed physician assistant acting under the supervision of a licensed
physician for the symptoms
giving rise to the presentation; (ii) the patient
identifies a practitioner from whom the
patient intends to seek treatment if the condition for which he is seeking
treatment does not improve after evaluation and treatment by the physical
therapist during the 14-day period of
treatment; (iii) from whom he
is currently receiving care; (b)
the patient gives written consent for the physical therapist to release all
personal health information and treatment records to the identified
practitioner; and (iv) (c)
the physical therapist notifies the practitioner identified by the patient no
later than three 14
days after treatment commences and provides the practitioner with a copy of the
initial evaluation along with a copy of the patient history obtained by the
physical therapist. Evaluation and
treatment may not be initiated by a physical therapist if the patient does not
identify a licensed doctor of medicine, osteopathy, chiropractic, podiatry,
dental surgery, licensed nurse practitioner as authorized in his practice
protocol, or a licensed physician assistant acting under the supervision of a
licensed physician to manage the patient's condition. Treatment
for more than 14 30
consecutive business days after evaluation of such patient shall only be upon
the referral and direction of a licensed doctor of medicine, osteopathy,
chiropractic, podiatry, or dental
surgery, a licensed nurse practitioner as authorized practicing in accordance with his practice protocol
agreement, or a licensed physician assistant acting under
the supervision of a licensed physician. A physical therapist may contact the
practitioner identified by the patient at the end of the 14-day 30-day
period to determine if the practitioner will authorize additional physical
therapy services until such time as the patient can be seen by the
practitioner. A physical therapist shall not perform an initial evaluation of a
patient under this subsection if the physical therapist has performed an
initial evaluation of the patient under this subsection for
the same condition within the immediately preceding three months 60 days.
For the purposes of this subsection, business days
means Monday through Friday of each week excluding state holidays.
C. After
completing a three-year period of active practice upon the referral and
direction of a licensed doctor of medicine, osteopathy, chiropractic, podiatry,
dental surgery, licensed nurse practitioner as authorized in his practice
protocol, or a licensed physician assistant acting under the supervision of a
licensed physician, a A
physical therapist who has not completed
a doctor of physical therapy program approved by the American Physical Therapy
Association or who has not obtained a certificate of authorization pursuant
to §54.1-3482.1 may conduct a one-time evaluation, that does not include
treatment, of a patient who does not meet the conditions established in
(i) through (iv) of
subsection B without the referral and direction of a
licensed doctor of medicine, osteopathy, chiropractic, podiatry, or dental surgery, a licensed nurse practitioner as authorized practicing
in accordance with his practice protocol agreement,
or a licensed physician assistant acting under the supervision of a licensed
physician; if appropriate, the physical therapist shall immediately refer such
patient to the appropriate practitioner.
D. Invasive procedures within the scope of practice of
physical therapy shall at all times be performed only under the referral and
direction of a licensed doctor of medicine, osteopathy, chiropractic, podiatry,
or dental surgery, a licensed nurse practitioner as authorized practicing
in accordance with his practice protocol agreement,
or a licensed physician assistant acting under the supervision of a licensed
physician.
E. It shall be unlawful for any licensed physical therapist to
fail to immediately refer any patient to a licensed doctor of medicine,
osteopathy, chiropractic, podiatry, or dental surgery, or a licensed nurse
practitioner as authorized practicing
in accordance with his practice protocol, whose agreement when
such patient's medical condition is determined, at the time
of evaluation or treatment, to be beyond the physical therapist's scope of
practice. Upon determining that the patient's medical condition is beyond the
scope of practice of a physical therapist, a physical therapist shall
immediately refer such patient to an appropriate practitioner.
F. Any person licensed as a physical therapist assistant shall
perform his duties only under the direction and control of a licensed physical
therapist.
G. However, a licensed physical therapist may provide, without
referral or supervision, physical therapy services to (i) a student athlete
participating in a school-sponsored athletic activity while such student is at
such activity in a public, private, or religious elementary, middle or high
school, or public or private institution of higher education when such services
are rendered by a licensed physical therapist who is certified as an athletic
trainer by the National Athletic Trainers' Association Board of Certification
or as a sports certified specialist by the American Board of Physical Therapy
Specialties; (ii) employees solely for the purpose of evaluation and
consultation related to workplace ergonomics; (iii) special education students
who, by virtue of their individualized education plans (IEPs), need physical
therapy services to fulfill the provisions of their IEPs; (iv) the public for
the purpose of wellness, fitness, and health screenings; (v) the public for the
purpose of health promotion and education; and (vi) the public for the purpose
of prevention of impairments, functional limitations, and disabilities.
§54.1-3482.1. Certain certification required.
A. The Board shall promulgate regulations establishing
criteria for certification of physical therapists to provide certain physical
therapy services pursuant to subsection B of §54.1-3482,
without referral from a licensed doctor of medicine, osteopathy, chiropractic,
podiatry, or dental
surgery, a licensed nurse practitioner as authorized practicing
in accordance with his practice protocol agreement,
or a licensed physician assistant acting under the supervision of a licensed
physician. The regulations shall include but not be limited to provisions for
(i) the promotion of patient safety; (ii) an application process for a one-time certification to
perform such procedures; and (iii)
minimum education, training, and experience requirements for certification to
perform such procedures; and (iv) continuing
education requirements relating to carrying out direct access duties under §
54.1-3482.
B. The minimum education, training, and experience
requirements for certification shall include evidence that the applicant has
successfully completed (i) a
doctor of physical therapy program approved by the American Physical Therapy
Association; (ii) a
transitional program in physical therapy as recognized by the Board; or (iii) (ii)
at least three years of active practice with evidence of continuing education
relating to carrying out direct access duties under §54.1-3482.
C. In promulgating minimum
education, training, and experience criteria, the Board shall consult with an
advisory committee comprised of three members selected by the Medical Society
of Virginia and three members selected by the Virginia Physical Therapy
Association. All members of the advisory committee shall be licensed by the
Board of Physical Therapy or the Board of Medicine and shall engage in clinical
practice. The committee shall have a duty to act collaboratively and in good
faith to recommend the education, training, and experience necessary to promote
patient safety. The advisory committee shall prepare a written report of its
recommendations and shall submit this report to the Board of Physical Therapy
and shall also submit its recommendations to the Board of Medicine for such
comments as may be deemed appropriate, prior to the promulgation of draft
regulations. The advisory committee may meet periodically to advise the Board
on the regulation of such procedures.
D. In promulgating
the regulations required by this section, the Board shall take due
consideration of the education, training, and experience requirements adopted
by the American Physical Therapy Association and the American Medical
Association.
|
