Assigned to HEALTH                                                                                          FOR CAUCUS & FLOOR ACTION

ARIZONA STATE SENATE

Forty-seventh Legislature, Second Regular Session

AMENDED

FACT SHEET FOR H.B. 2643

physical therapist assistants

Purpose

            Extends the scope of practice for a physical therapist assistant (PTA) to include practice under the general supervision of a licensed physical therapist (PT), outlines temporary general supervision guidelines and expands the Board of Physical Therapy (Board).

Background

            The Board currently consists of five members who are residents of the state, appointed by the Governor and serve staggered four-year terms.  Three of the members are PTs who posses unrestricted licenses and have been practicing in the state for at least five years prior to their appointment.  The final two members are public members who are not affiliated with and do not have financial interest in any health care profession.  Board members are eligible for reimbursement to cover necessary expenses for attending Board meetings or for representing the Board in an official Board activity.  H.B. 2643 adds one PT and one PTA to the Board’s membership.

            The practice of physical therapy involves examining, evaluating and testing people who have mechanical, physiological and developmental impairments, functional limitations and disabilities or other health and movement related conditions.  It also includes alleviating impairments and functional limitations by managing, designing, implementing and modifying therapeutic interventions by using various techniques defined in statute.  PTs are licensed by the Board and are responsible for determining a diagnosis, a prognosis and a plan of therapeutic intervention and assessing the ongoing effects of intervention. 

            A PTA is a person certified by the Board who performs physical therapy related tasks.  A PTA is selected and delegated tasks by a supervising PT, and currently must function under the on-site supervision of a licensed PT.  Statute defines on-site supervision as when a supervising physical therapist is on site and present in the facility or on the campus where a PTA is performing services, is immediately available to assist the PTA in the services being performed and maintains continued involvement in appropriate aspects of each treatment session in which a component of treatment is delegated.

            The Senate Health and House of Representatives Health Committee of Reference (COR) held a sunrise hearing in November regarding a proposed increase in the scope of practice for PTAs to include general supervision in a home health care setting.  General supervision allows PTAs to perform routinely designated tasks in a home health setting with a PT available via telecommunications for consultation.  PTAs may not initiate care, make the initial patient visit unsupervised or make any changes to the plan of care or discharge patients, and are required to have any chart notation signed off by the supervising PT. 

            Arizona, Maryland, New Jersey and Pennsylvania allow direct supervision of PTAs, however do not allow general supervision.  The remaining 46 states allow some form of direct or general supervision, some more permissive than others.

            The Board estimates the total cost of implementing the changes made in H.B. 2643 will be $87,641 in FY 2006-2007 and $56,181 each following year.  In addition, the Board reports that it will need a new ¾ FTE to carry out the new provisions.

Provisions

1. Defines general supervision as supervision by a PT who is on call and readily available via telecommunications when a PTA is providing treatment interventions.

2. Increases Board PT membership from three to four.

3. Adds a certified PTA who has been practicing in the state for at least five years to the Board membership.

4. Expands the PTA scope of practice to include performing selected interventions under the general supervision of a PT.

5. Requires the Board to adopt rules to prescribe requirements for the supervision of PTAs and assistive personnel.

6. Applies the following requirements to PTs, PTAs and assistive personnel until the Board adopts its own rules:

a) PTAs must be within 50 miles of the supervising PT while providing treatment.

b) PTAs must document evidence of general supervision.

c) PTAs must have at least 2,000 hours of experience working under on-site supervision in order to work under general supervision.

d) PTs may not supervise more than three assistive personnel at a time, one of whom is a PTA.

e) PTs may not provide general supervision for more than two PTAs at a time.

f) supervising PTs have the authority to use assistive personnel based on a patient’s acuity and treatment plan.

7. Makes technical and conforming changes.

8. Becomes effective on the general effective date.

Amendments Adopted by Committee

· Changes the type of supervised experience PTAs must have completed from direct to on-site, which is defined in statute.

House Action Senate Action

HEALTH        2/8/06     DPA     8-0-0-1                    HEALTH        3/20/06     DPA     5-2-0

3^rd Read           3/2/06                  55-2-3-0

Prepared by Senate Research

March 27, 2006

BKL/AH/jas