LRB-0750/4
MDK:kmg:pg
2001 - 2002 LEGISLATURE
October 31, 2001 - Introduced by Senators Burke, Darling, Erpenbach,
Grobschmidt, Hansen, Huelsman, Risser, Rosenzweig and Welch,
cosponsored by Representatives
Gard, Ward, Montgomery, Krawczyk,
Ainsworth, Berceau, Black, Carpenter, Hahn, Hoven, Huber, Huebsch,
Johnsrud, J. Lehman, Musser, Ott, Plale, Riley, Sykora and Townsend.
Referred to Committee on Health, Utilities, Veterans and Military Affairs.
SB305,1,11
1An Act to repeal 448.52 (3);
to renumber and amend 448.50 (4) and 448.54
2(2);
to amend 48.981 (2), 146.81 (1) (dg), 146.997 (1) (d) 4., 155.01 (7), 252.14
3(1) (ar) 4e., 448.51 (1), 448.51 (2) (a), 448.51 (2) (b), 448.52 (4), 448.54 (1), 448.54
4(3), 448.55 (2), 448.57 (2) (b), 448.57 (2) (e), 448.57 (2) (f), 448.57 (2) (g) and
5450.10 (3) (a) 5.; and
to create 15.406 (1) (am), 440.08 (2) (a) 57m., 448.50 (1m),
6448.50 (1r), 448.50 (3m), 448.50 (4) (a) to (d), 448.50 (5), 448.50 (6), 448.51 (1e),
7448.51 (1s), 448.527, 448.53 (1) (f), 448.535, 448.54 (2) (b), 448.55 (3), 448.56
8(1m), 448.56 (4), 448.56 (5), 448.56 (6), 448.565, 448.567, 448.57 (2) (am), 448.57
9(2) (bm), 448.57 (2) (fm), 448.57 (3), 448.57 (4) and 448.57 (5) of the statutes;
10relating to: licensing of physical therapists and physical therapist assistants
11and granting rule-making authority.
Analysis by the Legislative Reference Bureau
This bill makes certain changes to the regulation of physical therapists and
physical therapist assistants.
Physical therapists
Under current law, with certain exceptions, a person may not practice physical
therapy or designate that he or she is a physical therapist, unless the physical
therapists affiliated credentialing board (board) has granted the person a physical
therapist license. In addition, only a licensed physical therapist may use the title
"physical therapist," "physiotherapist," or "physical therapy technician," or append
to his or her name the letters "P. T.," "P. T. T.," or "R. P. T." Under this bill, the following
additional titles may only be used by a licensed physical therapist: registered
physical therapist; master of physical therapy; master of science in physical therapy;
or doctorate in physical therapy. In addition, only a licensed physical therapist may
append to his or her name the following additional letters: "M.P.T.," "M.S.P.T.," or
"D.P.T."
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
1Section
1. 15.406 (1) (am) of the statutes is created to read:
SB305,5,32
15.406
(1) (am) One physical therapist assistant licensed under subch. III of
3ch. 448.
SB305, s. 2
4Section
2. 48.981 (2) of the statutes is amended to read:
SB305,6,75
48.981
(2) Persons required to report. A physician, coroner, medical
6examiner, nurse, dentist, chiropractor, optometrist, acupuncturist, other medical or
7mental health professional, social worker, marriage and family therapist,
8professional counselor, public assistance worker, including a financial and
9employment planner, as defined in s. 49.141 (1) (d), school teacher, administrator or
10counselor, mediator under s. 767.11, child care worker in a day care center or child
11caring institution, day care provider, alcohol or other drug abuse counselor, member
12of the treatment staff employed by or working under contract with a county
13department under s. 46.23, 51.42
, or 51.437, physical therapist,
physical therapist
14assistant, occupational therapist, dietitian, speech-language pathologist,
15audiologist, emergency medical technician, first responder or police or law
16enforcement officer having reasonable cause to suspect that a child seen in the course
17of professional duties has been abused or neglected or having reason to believe that
18a child seen in the course of professional duties has been threatened with abuse or
19neglect and that abuse or neglect of the child will occur shall, except as provided
20under sub. (2m), report as provided in sub. (3). A court-appointed special advocate
21having reasonable cause to suspect that a child seen in the course of the
22court-appointed special advocate's activities under s. 48.236 (3) has been abused or
23neglected or having reason to believe that a child seen in the course of those activities
24has been threatened with abuse and neglect and that abuse or neglect of the child
25will occur shall, except as provided in sub. (2m), report as provided in sub. (3). Any
1other person, including an attorney, having reason to suspect that a child has been
2abused or neglected or reason to believe that a child has been threatened with abuse
3or neglect and that abuse or neglect of the child will occur may make such a report.
4Any person, including an attorney
, having reason to suspect that an unborn child has
5been abused or reason to believe that an unborn child is at substantial risk of abuse
6may report as provided in sub. (3). No person making a report under this subsection
7may be discharged from employment for so doing.
SB305, s. 3
8Section
3. 146.81 (1) (dg) of the statutes is amended to read:
SB305,6,109
146.81
(1) (dg) A physical therapist
or physical therapist assistant licensed
10under subch. III of ch. 448.
SB305, s. 4
11Section
4. 146.997 (1) (d) 4. of the statutes is amended to read:
SB305,6,1312
146.997
(1) (d) 4. A physician, podiatrist
or, physical therapist
, or physical
13therapist assistant licensed under ch. 448.
SB305, s. 5
14Section
5. 155.01 (7) of the statutes is amended to read:
SB305,6,2415
155.01
(7) "Health care provider" means a nurse licensed or permitted under
16ch. 441, a chiropractor licensed under ch. 446, a dentist licensed under ch. 447, a
17physician, physician assistant, podiatrist, physical therapist,
physical therapist
18assistant, occupational therapist
, or occupational therapy assistant licensed under
19ch. 448, a person practicing Christian Science treatment, an optometrist licensed
20under ch. 449, a psychologist licensed under ch. 455, a partnership thereof, a
21corporation or limited liability company thereof that provides health care services,
22an operational cooperative sickness care plan organized under ss. 185.981 to 185.985
23that directly provides services through salaried employees in its own facility, or a
24home health agency, as defined in s. 50.49 (1) (a).
SB305, s. 6
25Section
6. 252.14 (1) (ar) 4e. of the statutes is amended to read:
SB305,7,2
1252.14
(1) (ar) 4e. A physical therapist
or physical therapist assistant licensed
2under subch. III of ch. 448.
SB305, s. 7
3Section
7. 440.08 (2) (a) 57m. of the statutes is created to read:
SB305,7,54
440.08
(2) (a) 57m. Physical therapist assistant: November 1 of each
5odd-numbered year; $44.
SB305, s. 8
6Section
8. 448.50 (1m) of the statutes is created to read:
SB305,7,77
448.50
(1m) "Business entity" has the meaning given in s. 452.01 (3j).
SB305, s. 9
8Section
9. 448.50 (1r) of the statutes is created to read:
SB305,7,119
448.50
(1r) "Diagnosis" means the result of an evaluation of a condition or
10impairment by neuromusculoskeletal examination or study of its symptoms for the
11purpose of a therapeutic intervention.
SB305, s. 10
12Section
10. 448.50 (3m) of the statutes is created to read:
SB305,7,1513
448.50
(3m) "Physical therapist assistant" means an individual who holds a
14license as a physical therapist assistant granted by the affiliated credentialing
15board.
SB305, s. 11
16Section
11. 448.50 (4) of the statutes is renumbered 448.50 (4) (intro.) and
17amended to read:
SB305,7,2318
448.50
(4) (intro.) "Physical therapy" means
that branch or system of treating
19the sick which is limited to therapeutic exercises with or without assistive devices,
20and physical measures including heat and cold, air, water, light, sound, electricity
21and massage; and physical testing and evaluation. The use of roentgen rays and
22radium for any purpose, and the use of electricity for surgical purposes including
23cauterization, are not part of physical therapy. any of the following:
SB305, s. 12
24Section
12. 448.50 (4) (a) to (d) of the statutes are created to read:
SB305,8,7
1448.50
(4) (a) Examining, evaluating, or testing individuals with mechanical,
2physiological, or developmental impairments, functional limitations related to
3physical movement and mobility, disabilities, or other movement-related health
4conditions, in order to determine a diagnosis, prognosis, or plan of therapeutic
5intervention or to assess the ongoing effects of intervention. In this paragraph,
6"testing" means using standardized methods or techniques for gathering data about
7a patient.
SB305,8,98
(b) Alleviating impairments or functional limitations by instructing patients
9or designing, implementing, or modifying therapeutic interventions.
SB305,8,1210
(c) Reducing the risk of injury, impairment, functional limitation, or disability,
11including by promoting or maintaining fitness, health, or quality of life in all age
12populations.
SB305,8,1413
(d) Engaging in administration, consultation, or research that is related to any
14activity specified in pars. (a) to (c).
SB305, s. 13
15Section
13. 448.50 (5) of the statutes is created to read:
SB305,8,1616
448.50
(5) "Sexual misconduct with a patient" means any of the following:
SB305,8,1817
(a) Engaging in or soliciting a consensual or nonconsensual sexual relationship
18with a patient.
SB305,8,2019
(b) Making sexual advances toward, requesting sexual favors from, or engaging
20in other verbal conduct or physical contact of a sexual nature with a patient.
SB305,8,2221
(c) Intentionally viewing a completely or partially disrobed patient during the
22course of treatment if the viewing is not related to diagnosis or treatment.
SB305, s. 14
23Section
14. 448.50 (6) of the statutes is created to read:
SB305,9,324
448.50
(6) "Therapeutic intervention" means the purposeful and skilled
25interaction between a physical therapist, patient, and, if appropriate, individuals
1involved in the patient's care, using physical therapy procedures or techniques that
2are intended to produce changes in the patient's condition and that are consistent
3with diagnosis and prognosis.
SB305, s. 15
4Section
15. 448.51 (1) of the statutes is amended to read:
SB305,9,115
448.51
(1) Except as provided in s. 448.52, no person may practice physical
6therapy
or designate himself or herself as a physical therapist or use or assume the
7title "physical therapist" or "physiotherapist" or "physical therapy technician" or
8append to the person's name the letters "P.T.", "P.T.T." or "R.P.T." or any other title,
9letters or designation which represents or may tend to represent the person as a
10physical therapist unless the person is licensed
as a physical therapist under this
11subchapter.
SB305, s. 16
12Section
16. 448.51 (1e) of the statutes is created to read: