SB305: Bill Text

Current law defines "physical therapy" as the branch or system of treating the sick that is limited to therapeutic exercises with or without assistive devices, and physical measures including heat, cold, air, water, light, sound, electricity, and massage. However, "physical therapy" does not include the use of roentgen rays and radium for any purpose, and the use of electricity for surgical purposes, including cauterization. This bill replaces the foregoing definition with one that defines "physical therapy" to mean any of the following:

1. Examining, evaluating, or testing individuals with mechanical, physiological, or developmental impairments, functional limitations relating to physical movement or mobility, disabilities, or other movement-related health conditions, in order to determine a diagnosis, prognosis, or plan of therapeutic intervention or to assess the ongoing effects of intervention.

2. Alleviating impairments or functional limitations by instructing patients or designing, implementing, or modifying therapeutic interventions.

3. Reducing the risk of injury, impairment, functional limitation, or disability, including by promoting or maintaining fitness, health, or quality of life in all age populations.

4. Engaging in administration, consultation, or research that is related to any activity described above.

Current law also requires an applicant for a physical therapist license to satisfy certain requirements, including education and examination requirements. In addition, different requirements apply, depending on whether or not the applicant graduated from a physical therapy school approved by the board. Under this bill, the board is allowed to promulgate rules that require an applicant who graduated from a foreign physical therapy school to satisfy additional requirements for demonstrating competence to practice physical therapy. However, as under current law, the board is not allowed to require an applicant to take an oral or English proficiency examination for the sole reason that the applicant graduated from a foreign physical therapy school, if the applicant satisfies the requirements under current law for an applicant who has not graduated from a school approved by the board.

Also under current law, with certain exceptions, a licensed physical therapist may practice physical therapy only upon the written referral of a physician, chiropractor, dentist, or podiatrist. This bill requires the board to promulgate rules establishing requirements that a physical therapist must satisfy if such a referral is made. The purpose of the rules is to ensure continuity of care. Also, the bill requires a physical therapist to refer a patient to an appropriate health care practitioner if the physical therapist has reasonable cause to believe that symptoms or conditions are present that require services that are beyond the scope of practice of physical therapy.

The bill also provides that a physical therapist is responsible for managing all aspects of the physical therapy care of each patient under his or her care. In addition, the bill requires a physical therapist to create and maintain a patient record for every patient that the physical therapist examines or treats.

Physical therapist assistants

Under current law, a "physical therapist assistant" is defined as a person who has graduated from a physical therapy assistant associate degree program approved by the American Physical Therapy Association. No license from the board is required for a physical therapist assistant to assist a physical therapist in practice, if the assistance is under the general supervision of the physical therapist. The board is required to promulgate rules that define what constitutes "general supervision."

This bill eliminates the above provisions and prohibits a person from representing that he or she is a physical therapist assistant unless he or she is licensed by the board. In addition, the bill provides that only a licensed physical therapist assistant may append to his or her name the letters "P. T. A."

To qualify for a physical therapy assistant license under the bill, a person must satisfy certain requirements, including graduating from a physical therapist assistant educational program that is accredited by an agency approved by the board. Also, the person must not have an arrest or conviction, the circumstances of which substantially relate to the activities of a physical therapist assistant. In addition, a person must pass an examination for demonstrating minimum competency in the technical application of physical therapy services.

A different examination requirement applies to certain persons who apply for a license before the bill goes into effect, which is 24 months after publication of the bill. Such a person may obtain a license if he or she passes an examination on state laws and administrative rules relating to physical therapy, instead of an examination on competency. Also, such a person must do the following: 1) submit letters of recommendation from two licensed physical therapists who have personal knowledge of the person's assistance of a physical therapist in practice; and 2) show that, during at least two years of the five-year period immediately preceding the publication of the bill, he or she was a physical therapist assistant, as defined under current law.

The bill also allows the board to grant a license to a person who is licensed as a physical therapist assistant in another jurisdiction of the United States. The board may waive the examination or graduation requirement, or both, for such a person. In addition, the board may promulgate rules that establish additional requirements that such a person must satisfy for a waiver.

The bill allows a licensed physical therapist assistant to assist in the practice of physical therapy only under the direct or general supervision of a physical therapist. The board is required to promulgate rules that define what constitutes "direct or general supervision." In addition, the bill allows the board to take disciplinary action, including suspending or revoking a license, if a physical therapist assistant engages in prohibited conduct.

The bill also does each of the following: 1) makes current law regarding the preservation, destruction, and confidentiality of patient health care records applicable to records of a physical therapist assistant; 2) includes a physical therapist assistant as a heath care provider for the requirements under current law for powers of attorney for health care and for the prohibition under current law on discrimination related to acquired immunodeficiency syndrome; 3) requires a physical therapist assistant, like other professionals under current law, to make certain reports regarding abused or neglected children; 4) provides to physical therapist assistants the same protection from discipline under current law that is available to other health care providers who make certain reports regarding violations of law or clinical or ethical standards by health care facilities, health care providers, or employees of such facilities or providers; and 5) provides the same immunity that is available under current law to other health care professionals who make certain reports regarding violations of laws applicable to pharmacists or controlled substances.

Other changes

The bill also makes other changes, including each of the following:

1. The bill creates new grounds for disciplinary action by the board against physical therapists and physical therapist assistants, including engaging in sexual misconduct with a patient.

2. The bill allows the board to accept the voluntary surrender of a license when the board receives allegations of unprofessional conduct.

3. The bill requires the board to prepare an annual report on disciplinary action.

4. The bill requires the board to promulgate rules that do each of the following: a) establish a code of ethics for physical therapists and physical therapist assistants; b) establish procedures and requirements for filing complaints against physical therapists and physical therapist assistants; c) require the board to conduct periodic performance self-audits; and d) require a physical therapist or physical therapist assistant who applies to renew his or her license to demonstrate continued competence. Under current law, licenses must be renewed every two years.

5. Adds one physical therapist assistant member to the board. Under current law, the board has three physical therapist members and one public member.

For further information see the state fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

SB305, s. 1 Section 1. 15.406 (1) (am) of the statutes is created to read:

SB305,5,3 15.406 (1) (am) One physical therapist assistant licensed under subch. III of ch. 448.

SB305, s. 2 Section 2. 48.981 (2) of the statutes is amended to read:

SB305,6,7 48.981 (2) Persons required to report. A physician, coroner, medical examiner, nurse, dentist, chiropractor, optometrist, acupuncturist, other medical or mental health professional, social worker, marriage and family therapist, professional counselor, public assistance worker, including a financial and employment planner, as defined in s. 49.141 (1) (d), school teacher, administrator or counselor, mediator under s. 767.11, child care worker in a day care center or child caring institution, day care provider, alcohol or other drug abuse counselor, member of the treatment staff employed by or working under contract with a county department under s. 46.23, 51.42, or 51.437, physical therapist, physical therapist assistant, occupational therapist, dietitian, speech-language pathologist, audiologist, emergency medical technician, first responder or police or law enforcement officer having reasonable cause to suspect that a child seen in the course of professional duties has been abused or neglected or having reason to believe that a child seen in the course of professional duties has been threatened with abuse or neglect and that abuse or neglect of the child will occur shall, except as provided under sub. (2m), report as provided in sub. (3). A court-appointed special advocate having reasonable cause to suspect that a child seen in the course of the court-appointed special advocate's activities under s. 48.236 (3) has been abused or neglected or having reason to believe that a child seen in the course of those activities has been threatened with abuse and neglect and that abuse or neglect of the child will occur shall, except as provided in sub. (2m), report as provided in sub. (3). Any other person, including an attorney, having reason to suspect that a child has been abused or neglected or reason to believe that a child has been threatened with abuse or neglect and that abuse or neglect of the child will occur may make such a report. Any person, including an attorney, having reason to suspect that an unborn child has been abused or reason to believe that an unborn child is at substantial risk of abuse may report as provided in sub. (3). No person making a report under this subsection may be discharged from employment for so doing.

SB305, s. 3 Section 3. 146.81 (1) (dg) of the statutes is amended to read:

SB305,6,10 146.81 (1) (dg) A physical therapist or physical therapist assistant licensed under subch. III of ch. 448.

SB305, s. 4 Section 4. 146.997 (1) (d) 4. of the statutes is amended to read:

SB305,6,13 146.997 (1) (d) 4. A physician, podiatrist or, physical therapist, or physical therapist assistant licensed under ch. 448.

SB305, s. 5 Section 5. 155.01 (7) of the statutes is amended to read:

SB305,6,24 155.01 (7) "Health care provider" means a nurse licensed or permitted under ch. 441, a chiropractor licensed under ch. 446, a dentist licensed under ch. 447, a physician, physician assistant, podiatrist, physical therapist, physical therapist assistant, occupational therapist, or occupational therapy assistant licensed under ch. 448, a person practicing Christian Science treatment, an optometrist licensed under ch. 449, a psychologist licensed under ch. 455, a partnership thereof, a corporation or limited liability company thereof that provides health care services, an operational cooperative sickness care plan organized under ss. 185.981 to 185.985 that directly provides services through salaried employees in its own facility, or a home health agency, as defined in s. 50.49 (1) (a).

SB305, s. 6 Section 6. 252.14 (1) (ar) 4e. of the statutes is amended to read:

SB305,7,2 252.14 (1) (ar) 4e. A physical therapist or physical therapist assistant licensed under subch. III of ch. 448.

SB305, s. 7 Section 7. 440.08 (2) (a) 57m. of the statutes is created to read:

SB305,7,5 440.08 (2) (a) 57m. Physical therapist assistant: November 1 of each odd-numbered year; $44.

SB305, s. 8 Section 8. 448.50 (1m) of the statutes is created to read:

SB305,7,7 448.50 (1m) "Business entity" has the meaning given in s. 452.01 (3j).

SB305, s. 9 Section 9. 448.50 (1r) of the statutes is created to read:

SB305,7,11 448.50 (1r) "Diagnosis" means the result of an evaluation of a condition or impairment by neuromusculoskeletal examination or study of its symptoms for the purpose of a therapeutic intervention.

SB305, s. 10 Section 10. 448.50 (3m) of the statutes is created to read:

SB305,7,15 448.50 (3m) "Physical therapist assistant" means an individual who holds a license as a physical therapist assistant granted by the affiliated credentialing board.

SB305, s. 11 Section 11. 448.50 (4) of the statutes is renumbered 448.50 (4) (intro.) and amended to read:

SB305,7,23 448.50 (4) (intro.) "Physical therapy" means that branch or system of treating the sick which is limited to therapeutic exercises with or without assistive devices, and physical measures including heat and cold, air, water, light, sound, electricity and massage; and physical testing and evaluation. The use of roentgen rays and radium for any purpose, and the use of electricity for surgical purposes including cauterization, are not part of physical therapy. any of the following:

SB305, s. 12 Section 12. 448.50 (4) (a) to (d) of the statutes are created to read:

SB305,8,7 448.50 (4) (a) Examining, evaluating, or testing individuals with mechanical, physiological, or developmental impairments, functional limitations related to physical movement and mobility, disabilities, or other movement-related health conditions, in order to determine a diagnosis, prognosis, or plan of therapeutic intervention or to assess the ongoing effects of intervention. In this paragraph, "testing" means using standardized methods or techniques for gathering data about a patient.

SB305,8,9 (b) Alleviating impairments or functional limitations by instructing patients or designing, implementing, or modifying therapeutic interventions.

SB305,8,12 (c) Reducing the risk of injury, impairment, functional limitation, or disability, including by promoting or maintaining fitness, health, or quality of life in all age populations.

SB305,8,14 (d) Engaging in administration, consultation, or research that is related to any activity specified in pars. (a) to (c).

SB305, s. 13 Section 13. 448.50 (5) of the statutes is created to read:

SB305,8,16 448.50 (5) "Sexual misconduct with a patient" means any of the following:

SB305,8,18 (a) Engaging in or soliciting a consensual or nonconsensual sexual relationship with a patient.

SB305,8,20 (b) Making sexual advances toward, requesting sexual favors from, or engaging in other verbal conduct or physical contact of a sexual nature with a patient.

SB305,8,22 (c) Intentionally viewing a completely or partially disrobed patient during the course of treatment if the viewing is not related to diagnosis or treatment.

SB305, s. 14 Section 14. 448.50 (6) of the statutes is created to read:

SB305,9,3 448.50 (6) "Therapeutic intervention" means the purposeful and skilled interaction between a physical therapist, patient, and, if appropriate, individuals involved in the patient's care, using physical therapy procedures or techniques that are intended to produce changes in the patient's condition and that are consistent with diagnosis and prognosis.

SB305, s. 15 Section 15. 448.51 (1) of the statutes is amended to read:

SB305,9,11 448.51 (1) Except as provided in s. 448.52, no person may practice physical therapy or designate himself or herself as a physical therapist or use or assume the title "physical therapist" or "physiotherapist" or "physical therapy technician" or append to the person's name the letters "P.T.", "P.T.T." or "R.P.T." or any other title, letters or designation which represents or may tend to represent the person as a physical therapist unless the person is licensed as a physical therapist under this subchapter.

SB305, s. 16 Section 16. 448.51 (1e) of the statutes is created to read:

SB305,9,20 448.51 (1e) No person may designate himself or herself as a physical therapist or use or assume the title "physical therapist," "physiotherapist," "physical therapy technician," "licensed physical therapist," "registered physical therapist," "master of physical therapy," "master of science in physical therapy," or "doctorate in physical therapy," or append to the person's name the letters "P.T.," "P.T.T.," "L.P.T.," "R.P.T.," "M.P.T.," "M.S.P.T.," or "D.P.T.," or any other title, letters, or designation which represents or may tend to represent the person as a physical therapist, unless the person is licensed as a physical therapist under this subchapter.

SB305, s. 17 Section 17. 448.51 (1s) of the statutes is created to read:

SB305,9,24 448.51 (1s) No person may designate himself or herself as a physical therapist assistant, use or assume the title "physical therapist assistant," or append to the person's name the letters "P.T.A." or any other title, letters, or designation that represents or may tend to represent the person as a physical therapist assistant unless the person is licensed as a physical therapist assistant under this subchapter.

SB305, s. 18 Section 18. 448.51 (2) (a) of the statutes is amended to read:

SB305,10,7 448.51 (2) (a) In this subsection, "advertisement" includes advertisements that appear on outdoor signs, in print or electronic media, and in material mailed to a person other than a patient, client, or prospective patient or client who has requested the material.

SB305, s. 19 Section 19. 448.51 (2) (b) of the statutes is amended to read:

SB305,10,11 448.51 (2) (b) Except as provided in par. (c), no person may claim to render physical therapy or physiotherapy services unless the person is licensed as a physical therapist under this subchapter.

SB305, s. 20 Section 20. 448.52 (3) of the statutes is repealed.

SB305, s. 21 Section 21. 448.52 (4) of the statutes is amended to read:

SB305,10,17 448.52 (4) A physical therapy student practicing assisting a physical therapist in the practice of physical therapy or a physical therapist assistant student assisting a physical therapist in performing physical therapy procedures and related tasks, if the assistance is within the scope of the student's education or training.

SB305, s. 22 Section 22. 448.527 of the statutes is created to read:

SB305,10,21 448.527 Code of ethics. The affiliated credentialing board shall promulgate rules establishing a code of ethics governing the professional conduct of physical therapists and physical therapist assistants.

SB305, s. 23 Section 23. 448.53 (1) (f) of the statutes is created to read:

SB305,11,2 448.53 (1) (f) If the person was educated at a physical therapy school that is not in the United States, the person satisfies any additional requirements for demonstrating competence to practice physical therapy that the affiliated credentialing board may establish by rule.

SB305, s. 24 Section 24. 448.535 of the statutes is created to read:

SB305,11,6 448.535 Licensure of physical therapist assistants. (1) The affiliated credentialing board shall grant a license as a physical therapist assistant to a person who does all of the following:

SB305,11,8 (a) Submits an application for the license to the department on a form provided by the department.

SB305,11,9 (b) Pays the fee specified in s. 440.05 (1).

SB305,11,12 (c) Subject to ss. 111.321, 111.322, and 111.335, submits evidence satisfactory to the affiliated credentialing board that the applicant does not have an arrest or conviction record.

SB305,11,15 (d) Submits evidence satisfactory to the affiliated credentialing board that the applicant is a graduate of a physical therapist assistant educational program accredited by an agency that is approved by the affiliated credentialing board.

SB305,11,16 (e) Passes an examination under s. 448.54.

SB305,11,23 (2) The affiliated credentialing board may waive a requirement under sub. (1) (d) or (e), or both, for an applicant who establishes to the satisfaction of the affiliated credentialing board that he or she is licensed as a physical therapist assistant by another licensing jurisdiction in the United States. The affiliated credentialing board shall promulgate rules for granting a waiver under this subsection. The rules may require an applicant to satisfy additional requirements as a condition for granting a waiver.

SB305, s. 25 Section 25. 448.54 (1) of the statutes is amended to read:

SB305,12,4 448.54 (1) The affiliated credentialing board shall conduct or arrange for examinations for physical therapist and physical therapist assistant licensure at least semiannually and at times and places determined by the affiliated credentialing board.

SB305, s. 26 Section 26. 448.54 (2) of the statutes is renumbered 448.54 (2) (a) and amended to read:

SB305,12,10 448.54 (2) (a) Except as provided in sub. (3), examinations for physical therapist licensure shall consist of written or oral tests, or both, requiring applicants to demonstrate minimum competency in subjects substantially related to the practice of physical therapy.