CR 20-055 Rule Text

Illinois:

The Illinois Statutes provide an exception to practice without a license for the practice of physical therapy by a physical therapy student or a physical therapist assistant student under the on-site supervision of a licensed physical therapist. The physical therapist must be readily available for direct supervision and instruction to ensure the safety and welfare of the patient (225 ILCS 90/2).

Iowa:

The Iowa Statutes provide that students of physical therapy who practice physical therapy under the supervision of a licensed physical therapist in connection with the regular course of instruction at a school of physical therapy are not required to be licensed to practice physical therapy (Code of Iowa § 148A.3).

Michigan:

Rules of the Michigan Board of Physical Therapy provide for delegation of acts, tasks, or functions to and supervision of unlicensed persons, including students enrolled in accredited physical therapist or physical therapist assistant educational programs approved by the board. A physical therapist is required to provide "direct supervision" of students, which means the physical therapist is physically present and immediately available for direction and supervision when patients or clients are present at the time the act, task, or function is performed, and the physical therapist has direct contact with the patient or client during each visit (Mich Admin Code, R 338.7139).

Minnesota:

The Minnesota Statutes provide for the supervision of and delegation of tasks to student physical therapists and student physical therapist assistants (2019 Minnesota Statutes, Section 148.706).

A licensed physical therapist is required to provide on-site supervision of a student physical therapist. "On-site supervision" means the physical therapist is easily available for instruction to the student physical therapist. The physical therapist must have direct contact with the patient during at least every second treatment session by the student physical therapist. Telecommunications, except within the facility, does not meet the requirement of on-site supervision (2019 Minnesota Statutes, Section 148.65, Subd. 5.).

A student physical therapist assistant is required to be under the direct supervision of a physical therapist, or the direct supervision of a physical therapist and physical therapist assistant. "Direct supervision" means the physical therapist is physically present and immediately available to provide instruction to the student physical therapist assistant. (2019 Minnesota Statutes, Section 148.65, Subd. 6.).

Summary of factual data and analytical methodologies:

The proposed rules were developed by reviewing the Physical Therapy Examining Board’s rules relating to the supervision of physical therapist students and physical therapist assistant students to ensure the rules are consistent with current professional practices and applicable Wisconsin statutes.

Analysis and supporting documents used to determine effect on small business or in preparation of economic impact analysis:

The proposed rules were posted for a period of 14 days to solicit public comment on economic impact, including how the proposed rules may affect businesses, local government units, and individuals. No comments were received.

Fiscal Estimate and Economic Impact Analysis:

The Fiscal Estimate and Economic Impact Analysis document is attached.

Effect on small business:

These rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department’s Regulatory Review Coordinator, Dan Hereth, may be contacted by calling [phone].

Agency contact person:

Dale Kleven, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, Wisconsin 53708-8366; telephone [phone]; email at [e-mail].

Place where comments are to be submitted and deadline for submission:

Comments may be submitted to Dale Kleven, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, WI 53708-8366, or by email to [e-mail]. Comments must be received at or before the public hearing to be held at 8:30 a.m. on December 2, 2020, to be included in the record of rule-making proceedings.

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TEXT OF RULE

Section 1.   PT 1.02 (11c) to (11w) are created to read:

  PT 1.02 (11c) “Physical therapist” has the meaning given in s. 448.50 (3), Stats.

  (11g) “Physical therapist assistant” has the meaning given in s. 448.50 (3m), Stats.

  (11n) “Physical therapist assistant student” means a person enrolled in a physical therapist assistant educational program approved by the board who performs physical therapy procedures and related tasks consistent with the person’s education, training, and experience under the direct, immediate, on−premises supervision of a physical therapist or physical therapist assistant.

  (11r) “Physical therapist student” means a person enrolled in a physical therapist educational program approved by the board who performs physical therapy procedures and related tasks consistent with the person’s education, training, and experience under the direct, immediate, on−premises supervision of a physical therapist.

  (11w) “Student” means a physical therapist student or physical therapist assistant student.

Section 2.   PT 1.02 (14) is amended to read:

  PT 1.02 (14) “Unlicensed personnel” means a person other than a physical therapist, or physical therapist assistant, or student who performs patient related tasks consistent with the unlicensed personnel’s person’s education, training and expertise experience under the direct, immediate, on−premises supervision of the a physical therapist.

Section 3.   Chapter PT 5 (title) is amended to read:

CHAPTER PT 5

PHYSICAL THERAPIST ASSISTANTS, AND UNLICENSED PERSONNEL, AND STUDENTS

Section 4.   PT 5.001 is amended to read:

  PT 5.001 Authority and purpose. The rules in this chapter are adopted by the board pursuant to the authority delegated by ss. 15.08 (5) (b), 227.11 (2), 448.52 (1m) (c), and 448.56 (6), Stats., and govern the practice and supervision of physical therapist assistants and the supervision of unlicensed personnel, physical therapist students, and physical therapist assistant students.

Section 5.   PT 5.01 (1) is amended to read:

  PT 5.01 (1) A physical therapist assistant, as defined in s. 448.50 (3m), Stats., shall assist a physical therapist in the practice of physical therapy under the general supervision of a physical therapist licensed under s. 448.53 (1), Stats., or granted a physical therapist compact privilege by the board.

Section 6.   PT 5.02 (1) and (2) (intro.), (e), (g), and (h) are amended to read:

  PT 5.02 (1) A physical therapist licensed under s. 448.53 (1), Stats., or granted a physical therapist compact privilege by the board shall provide direct, immediate, on−premises supervision of unlicensed personnel at all times. A The physical therapist may not direct unlicensed personnel to perform tasks which that require the decision making decision-making or problem solving problem-solving skills of a physical therapist, including but not limited to patient examination, evaluation, diagnosis, or determination of therapeutic intervention.

  (2) (intro.) In providing direct, immediate, on−premises supervision, the physical therapist shall do all of the following:

  (e) Determine the competence of personnel to perform assigned tasks based upon his or her education, training, and experience.

  (g) Perform initial patient examination, evaluation, diagnosis, and prognosis, interpret referrals, develop and revise as appropriate a written patient treatment plan and program for each patient, and create and maintain a patient record for every patient the physical therapist treats.

  (h) Provide interpretation of objective tests, measurements, and other data in developing and revising a physical therapy diagnosis, assessment, and treatment plan.

Section 7.   PT 5.03 is created to read:

  PT 5.03 Supervision of physical therapist students and physical therapist assistant students.

  (1) Except as provided under sub. (2), a physical therapist licensed under s. 448.53 (1), Stats., or granted a physical therapist compact privilege by the board shall provide direct, immediate, on−premises supervision of a physical therapist student or physical therapist assistant student at all times.

  (2) (a) A physical therapist providing supervision of a physical therapist assistant student under sub. (1) may delegate that supervision to a physical therapist assistant. The delegating physical therapist shall, as required under s. PT 5.01, provide general supervision of the physical therapist assistant supervising the physical therapist assistant student.

  (b) A physical therapist assistant supervising a physical therapist assistant student under par. (a) shall provide face−to−face contact with the student, as necessary, and be physically present in the same building when a service is performed by the student.

  (3) A physical therapist supervising a physical therapist student or physical therapist assistant student under sub. (1) shall retain full professional responsibility for all of the following:

  (a) All physical therapy procedures and related tasks performed by the physical therapist student or physical therapist assistant student.

  (b) Delegation of treatment plans and programs to the physical therapist student or physical therapist assistant student in a manner consistent with the student’s education, training, and experience.

  (4) A physical therapist delegating supervision of a physical therapist assistant student to a physical therapist assistant under sub. (2) shall retain full professional responsibility for all of the following:

  (a) All physical therapy procedures and related tasks performed by the physical therapist assistant and by the physical therapist assistant student.

  (b) Delegation of treatment plans and programs to the physical therapist assistant student in a manner consistent with the student’s education, training, and experience.

Section 8.   Effective date. The rules adopted in this order shall take effect on the first day of the month following publication in the Wisconsin Administrative Register, pursuant to s. 227.22 (2) (intro.), Stats.

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