HB2643 - 472R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 32-2001, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2001. Definitions

In this chapter, unless the context otherwise requires:

1. "Assistive personnel" includes physical therapist assistants and physical therapy aides and other assistive personnel who are trained or educated health care providers and who are not physical therapist assistants or physical therapy aides but who perform specific designated tasks related to physical therapy under the supervision of a physical therapist. At the discretion 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. This paragraph does not apply to personnel assisting other health care professionals licensed pursuant to this title in the performance of delegable treatment responsibilities within their scope of practice.

2. "Board" means the board of physical therapy.

3. "General supervision" means that the supervising physical therapist is on call and is readily available via telecommunications when the physical therapist assistant is providing treatment interventions.

3. 4. "Interim permit" means a permit issued by the board that allows a person to practice as a physical therapist in this state or to work as a physical therapist assistant for a specific period of time and under conditions prescribed by the board before that person is issued a license or certificate.

4. 5. "Manual therapy techniques" means a broad group of passive interventions in which physical therapists use their hands to administer skilled movements designed to modulate pain, increase joint range of motion, reduce or eliminate soft tissue swelling, inflammation, or restriction, induce relaxation, improve contractile and noncontractile tissue extensibility, and improve pulmonary function. These interventions involve a variety of techniques, such as the application of graded forces.

5. 6. "On‑site supervision" means that the supervising physical therapist is on site and is present in the facility or on the campus where assistive personnel or a holder of an interim permit is performing services, is immediately available to assist the person being supervised in the services being performed and maintains continued involvement in appropriate aspects of each treatment session in which a component of treatment is delegated.

6. 7. "Physical therapist" means a person who is licensed pursuant to this chapter.

7. 8. "Physical therapist assistant" means a person who meets the requirements of this chapter for certification and who performs physical therapy procedures and related tasks that have been selected and delegated by the supervising physical therapist.

8. 9. "Physical therapy" means the care and services provided by or under the direction and supervision of a physical therapist who is licensed pursuant to this chapter.

9. 10. "Physical therapy aide" means a person who is trained under the direction of a physical therapist and who performs designated and supervised routine physical therapy tasks.

10. 11. "Practice of physical therapy" means:

(a) Examining, evaluating and testing persons who have mechanical, physiological and developmental impairments, functional limitations and disabilities or other health and movement related conditions in order to determine a diagnosis, a prognosis and a plan of therapeutic intervention and to assess the ongoing effects of intervention.

(b) Alleviating impairments and functional limitations by managing, designing, implementing and modifying therapeutic interventions including:

(i) Therapeutic exercise.

(ii) Functional training in self‑care and in home, community or work reintegration.

(iii) Manual therapy techniques.

(iv) Therapeutic massage.

(v) Assistive and adaptive orthotic, prosthetic, protective and supportive devices and equipment.

(vi) Pulmonary hygiene.

(vii) Debridement and wound care.

(viii) Physical agents or modalities.

(ix) Mechanical and electrotherapeutic modalities.

(x) Patient related instruction.

(c) Reducing the risk of injury, impairments, functional limitations and disability by means that include promoting and maintaining a person's fitness, health and quality of life.

(d) Engaging in administration, consultation, education and research.

11. 12. "Restricted certificate" means a certificate on which the board has placed any restrictions as the result of a disciplinary action.

12. 13. "Restricted license" means a license on which the board places 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 a patient to whom the licensee may provide services. END_STATUTE

Sec. 2. Section 32-2002, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2002. Board of physical therapy; appointment; qualifications

A. The board of physical therapy is established consisting of five members appointed by the governor pursuant to section 38‑211. Three four members shall be physical therapists who are residents of this state, possess an unrestricted license to practice physical therapy in this state and have been practicing in this state for at least five years before their appointment. One member shall be a physical therapist assistant who is a resident of this state, possesses an unrestricted certificate issued pursuant to this chapter and has been performing selected interventions in this state for at least five years before the person's appointment. The governor shall also appoint two public members who are residents of this state and who are not affiliated with, and do not have a financial interest in, any health care profession but who have an interest in consumer rights.

B. Board members serve staggered four year terms. Board members shall not serve for more than two successive four year terms or for more than ten consecutive years. By approval of a majority of the board, a member's service may extend at the completion of a four year term until a new member is appointed or the current member is reappointed.

C. If requested by the board the governor may remove a board member for misconduct, incompetence or neglect of duty.

D. Board members are eligible for reimbursement of expenses pursuant to title 38, chapter 4, article 2 to cover necessary expenses for attending each board meeting or for representing the board in an official board approved activity.

E. A board member who acts within the scope of board duties, without malice and in the reasonable belief that the person's action is warranted by law is immune from civil liability. END_STATUTE

Sec. 3. Section 32-2043, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2043. Supervision; patient care management

A. A physical therapist is responsible for patient care given by assistive personnel under the physical therapist's 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 that do not exceed the education or training of the assistive personnel.

B. A physical therapist assistant shall function under the on‑site supervision of a licensed physical therapist and as prescribed by board rules.

B. A physical therapist assistant certified pursuant to this chapter may perform selected interventions under the general supervision of a physical therapist licensed pursuant to this chapter.

C. A physical therapy aide and other assistive personnel shall perform designated routine tasks only under the on‑site supervision of a licensed physical therapist who is present in the facility.

D. A licensed physical therapist must provide on‑site supervision of an interim permit holder.

E. A physical therapist student and a physical therapist assistant student must practice under the on‑site supervision of a licensed physical therapist.

F. A physical therapist is responsible for managing all aspects of the physical therapy care of each patient. A physical therapist must provide:

1. The initial evaluation of and documentation for a patient.

2. Periodic reevaluation of and documentation of for a patient.

3. The documented discharge of a patient, including the response to therapeutic intervention at the time of discharge.

G. A physical therapist must verify the qualifications of physical therapist assistants and other assistive personnel under the physical therapist's direction and supervision.

H. For each patient on each date of service, a physical therapist must provide and document all of the therapeutic intervention that requires the expertise of a physical therapist and must determine the use of physical therapist assistants and other assistive personnel to ensure the delivery of care that is safe, effective and efficient. Documentation for each date of service must be as prescribed by the board by rule.

I. A physical therapist assistant must document care provided but may do so without the co‑signature of the supervising physical therapist if the physical therapist complies with the requirements of subsections G and H.

J. A physical therapist's responsibility for patient care management includes accurate documentation and billing of the services provided. END_STATUTE

Sec. 4. Supervision of physical therapist assistants and assistive personnel; rules; interim requirements

The board shall adopt rules to prescribe requirements relating to the supervision of physical therapist assistants and assistive personnel. Until these rules are adopted the following requirements apply:

1. A physical therapist assistant must be within fifty miles of the supervising physical therapist if the physical therapist assistant is providing treatment interventions off site.

2. A physical therapist assistant must document evidence of general supervision for each visit, including evidence of the supervisory physical therapist of record.

3. To be able to perform under the general supervision of a physical therapist, a physical therapist assistant must possess evidence of at least two thousand hours of experience of working with patients under on-site supervision.

4. A physical therapist must concurrently supervise not more than three assistive personnel, at least one of whom is a physical therapist assistant. When performing treatment interventions under general supervision, a physical therapist may supervise not more than two physical therapist assistants at any one time.

5. A patient who is receiving physical therapy services by qualified personnel who are performing treatment interventions under general supervision must be seen by the supervising physical therapist of record at least once every six visits or fourteen calendar days, whichever occurs first.

6. The supervising physical therapist retains the right to determine the use of assistive personnel based on the physical therapist's determination of a patient's acuity and treatment plan.