HF 1918

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to health; modifying provisions relating to
physical therapists; providing penalties; amending
Minnesota Statutes 2004, sections 148.65, by adding
subdivisions; 148.706; 148.75; 148.7806; proposing
coding for new law in Minnesota Statutes, chapter 148;
repealing Minnesota Rules, part 5601.0100, subparts 3,
4.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2004, section 148.65, is
amended by adding a subdivision to read:

new text begin Subd. 3. new text end

new text begin Physical therapist assistant. new text end

new text begin "Physical
therapist assistant" means a graduate of a physical therapist
assistant educational program accredited by the Commission on
Accreditation in Physical Therapy Education (CAPTE) or a
recognized comparable national accrediting agency approved by
the board. The physical therapist assistant, under the
direction and supervision of the physical therapist, performs
physical therapy interventions and assists with coordination,
communication, and documentation; and patient-client-related
instruction. The physical therapist is not required to be
on-site except as required under Minnesota Rules, part
5601.1500, but must be easily available by telecommunications.
new text end

Sec. 2.

Minnesota Statutes 2004, section 148.65, is
amended by adding a subdivision to read:

new text begin Subd. 4. new text end

new text begin Physical therapy aide. new text end

new text begin "Physical therapy aide"
means a person, working under the direct supervision of a
physical therapist, who is not a physical therapist assistant as
defined in subdivision 3, who performs tasks as provided under
Minnesota Rules, part 5601.1400.
new text end

Sec. 3.

Minnesota Statutes 2004, section 148.65, is
amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Student physical therapist. new text end

new text begin "Student physical
therapist" means a person in a professional educational program,
approved by the board under section 148.705, who is satisfying
supervised clinical education requirements by performing
physical therapy under the on-site supervision of a licensed
physical therapist. "On-site supervision" means the physical
therapist is easily available for instruction to the student
physical therapist. The physical therapist shall 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.
new text end

Sec. 4.

Minnesota Statutes 2004, section 148.65, is
amended by adding a subdivision to read:

new text begin Subd. 6. new text end

new text begin Student physical therapist assistant. new text end

new text begin "Student
physical therapist assistant" means a person in a physical
therapist assistant educational program accredited by the
Commission on Accreditation in Physical Therapy Education
(CAPTE) or a recognized comparable national accrediting agency
approved by the board. The student physical therapist
assistant, under the direct supervision of the physical
therapist, or the direct supervision of the physical therapist
and physical therapist assistant, performs physical therapy
interventions and assists with coordination, communication,
documentation, and patient-client-related instruction. "Direct
supervision" means the physical therapist is physically present
and immediately available to provide instruction to the student
physical therapist assistant.
new text end

Sec. 5.

Minnesota Statutes 2004, section 148.65, is
amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Supportive personnel. new text end

new text begin "Supportive personnel"
means a physical therapist assistant, a physical therapy aide,
or an athletic trainer working under a physical
therapist-athletic trainer supervisory agreement as provided in
section 148.707.
new text end

Sec. 6.

Minnesota Statutes 2004, section 148.65, is
amended by adding a subdivision to read:

new text begin Subd. 8. new text end

new text begin Athletic trainer. new text end

new text begin "Athletic trainer" means a
person currently registered in good standing in Minnesota under
sections 148.7801 to 148.7815.
new text end

Sec. 7.

Minnesota Statutes 2004, section 148.706, is
amended to read:

148.706 SUPERVISION OF ASSISTANTS deleted text begin AND deleted text end new text begin , new text end AIDES new text begin , AND
STUDENTS new text end .

Every physical therapist who uses the services of deleted text begin an deleted text end new text begin a
physical therapist new text end assistant or new text begin physical therapy new text end aide for the
purpose of assisting in the practice of physical therapy is
responsible for functions performed by the assistant or aide
while engaged in such assistance. The physical therapist shall
deleted text begin permit the assistant or aide to perform only those functions
which the therapist is authorized by rule to delegate to a
physical therapist assistant or assign to a physical therapy
aide and shall provide supervision as specified deleted text end new text begin delegate duties
to the physical therapist assistant and assign tasks to the
physical therapy aide in accordance with Minnesota Rules, part
5601.1400 new text end . new text begin Physical therapists who instruct student physical
therapists and student physical therapist assistants are
responsible for the functions performed by the students and
shall supervise the students as provided under section 148.65,
subdivisions 5 and 6.
new text end

Sec. 8.

new text begin [148.707] SUPERVISION OF ATHLETIC TRAINERS.
new text end

new text begin Subdivision 1. new text end

new text begin Filing requirement. new text end

new text begin Physical therapists
who use athletic trainers pursuant to section 148.7806,
paragraph (e), shall file with the board a physical
therapist-athletic trainer supervisory agreement, prior to
provision of services by the athletic trainer. The board shall
notify the physical therapist, in writing, of receipt of the
supervisory agreement.
new text end

new text begin Subd. 2. new text end

new text begin Physical therapist-athletic trainer
agreement. new text end

new text begin (a) The supervising physical therapist, each
alternate supervising physical therapist, and the athletic
trainer must sign a supervisory agreement that specifies the
physical therapy tasks assigned to the athletic trainer and the
direct supervision by the physical therapist. The supervisory
agreement must contain:
new text end

new text begin (1) the name, address, telephone number, and license number
of record of the supervising physical therapist and any
alternate supervising physical therapist;
new text end

new text begin (2) the name, address, telephone number, and registration
number of record of the athletic trainer;
new text end

new text begin (3) a statement that the supervising physical therapist and
alternate supervising physical therapists assume full
responsibility for the physical therapy tasks performed by the
athletic trainer, and that the services provided by the athletic
trainer are customary to the practice of the supervising
physical therapist or alternate supervising physical therapist;
new text end

new text begin (4) documentation of the academic preparation and clinical
skills of the athletic trainer to perform the tasks assigned by
the supervising physical therapist and each alternate
supervising physical therapist, if the tasks assigned by the
alternate supervising physical therapist are different from the
tasks assigned by the supervising physical therapist. Evidence
of clinical skills must show activities by the athletic trainer
which have occurred within the year preceding the filing of the
supervisory agreement; and
new text end

new text begin (5) a description of each individual physical therapy task
assigned by the supervising physical therapist or the alternate
supervising physical therapist to the athletic trainer.
Physical therapy task assignment does not include examination,
evaluation, diagnosis, prognosis, initial treatment, change of
treatment, and initial or final documentation.
new text end

new text begin (b) The supervising physical therapist, alternate
supervising physical therapists, and the athletic trainer shall
review and update the supervisory agreement on an annual basis
from the date the board acknowledges receipt of the completed
supervisory agreement.
new text end

new text begin (c) The supervising physical therapist shall provide
written notification to the board within 30 days of a change of
name, address, or telephone number of the physical therapist,
alternate supervising physical therapists, or athletic trainer.
new text end

new text begin (d) Modification of tasks assigned by the supervising
physical therapist or alternate supervising physical therapist
to the athletic trainer must be submitted in writing by the
supervising physical therapist to the board at least 30 days
prior to the effective date of the modification, and meet the
requirements in paragraph (a).
new text end

new text begin Subd. 3. new text end

new text begin Informed consent. new text end

new text begin The supervising physical
therapist and alternate supervising physical therapist shall
document in the physical therapy record that the patient has
been informed by the physical therapist that an athletic trainer
is providing physical therapy tasks under direct supervision of
the physical therapist and alternate supervising physical
therapist.
new text end

new text begin Subd. 4. new text end

new text begin Documentation. new text end

new text begin The supervising physical
therapist and alternate supervising physical therapist shall
document in the physical therapy record for each treatment
session the name of the athletic trainer and all of the physical
therapy tasks performed by the athletic trainer.
new text end

new text begin Subd. 5. new text end

new text begin Patient list. new text end

new text begin The supervising physical
therapist and alternate supervising physical therapist shall
maintain a list of all patients seen by the athletic trainer
pursuant to section 148.7806, paragraph (e), for a period of two
years.
new text end

new text begin Subd. 6. new text end

new text begin Supervision. new text end

new text begin The supervising physical therapist
and alternate supervising physical therapist shall not supervise
more than one athletic trainer working under section 148.7806,
paragraph (e), at any given time. "Direct supervision" means
the supervising physical therapist or alternate supervising
physical therapist is physically present and immediately
available for instruction and assistance to the athletic
trainer. The supervising physical therapist or alternate
supervising physical therapist must observe the patient's status
before and after physical therapy tasks performed by the
athletic trainer. Telecommunications do not meet the
requirements of direct supervision.
new text end

Sec. 9.

new text begin [148.735] CANCELLATION OF LICENSE IN GOOD
STANDING.
new text end

new text begin Subdivision 1. new text end

new text begin Board approval; reporting. new text end

new text begin A physical
therapist holding an active license to practice physical therapy
in the state may, upon approval of the board, be granted license
cancellation if the board is not investigating the person as a
result of a complaint or information received or if the board
has not begun disciplinary proceedings against the person. Such
action by the board shall be reported as a cancellation of a
license in good standing.
new text end

new text begin Subd. 2. new text end

new text begin Fees nonrefundable. new text end

new text begin A physical therapist who
receives board approval for license cancellation is not entitled
to a refund of any license fees paid for the licensure year in
which cancellation of the license occurred.
new text end

new text begin Subd. 3. new text end

new text begin New license after cancellation. new text end

new text begin If a physical
therapist who has been granted board approval for license
cancellation desires to resume the practice of physical therapy
in Minnesota, that physical therapist must obtain a new license
by applying for licensure and fulfilling the requirements then
in existence for obtaining an initial license to practice
physical therapy in Minnesota.
new text end

Sec. 10.

new text begin [148.736] CANCELLATION OF CREDENTIALS UNDER
DISCIPLINARY ORDER.
new text end

new text begin Subdivision 1. new text end

new text begin Board approval; reporting. new text end

new text begin A physical
therapist, whose right to practice is under suspension,
condition, limitation, qualification, or restriction by the
board may be granted cancellation of credentials by approval of
the board. Such action by the board shall be reported as
cancellation while under discipline. Credentials, for purposes
of this section, means board authorized documentation of the
privilege to practice physical therapy.
new text end

new text begin Subd. 2. new text end

new text begin Fees nonrefundable. new text end

new text begin A physical therapist who
receives board approval for credential cancellation is not
entitled to a refund of any fees paid for the credentialing year
in which cancellation of the credential occurred.
new text end

new text begin Subd. 3. new text end

new text begin New credential after cancellation. new text end

new text begin If a
physical therapist who has been granted board approval for
credential cancellation desires to resume the practice of
physical therapy in Minnesota, that physical therapist must
obtain a new credential by applying to the board and fulfilling
the requirements then in existence for obtaining an initial
credential to practice physical therapy in Minnesota.
new text end

Sec. 11.

new text begin [148.737] CANCELLATION OF LICENSE FOR
NONRENEWAL.
new text end

new text begin The Board of Physical Therapy shall not renew, reissue,
reinstate, or restore a license that has lapsed on or after
January 1, 2006, and has not been renewed within two annual
license renewal cycles starting January 1, 2008. A licensee
whose license is canceled for nonrenewal must obtain a new
license by applying for licensure and fulfilling all
requirements then in existence for an initial license to
practice physical therapy in Minnesota.
new text end

Sec. 12.

Minnesota Statutes 2004, section 148.75, is
amended to read:

148.75 LICENSES; DENIAL, SUSPENSION, REVOCATION.

(a) The state Board of Physical Therapy may refuse to grant
a license to any physical therapist, or may suspend or revoke
the license of any physical therapist for any of the following
grounds:

(1) using drugs or intoxicating liquors to an extent which
affects professional competence;

(2) conviction of a felony;

(3) conviction for violating any state or federal narcotic
law;

(4) obtaining a license or attempting to obtain a license
by fraud or deception;

(5) conduct unbecoming a person licensed as a physical
therapist or conduct detrimental to the best interests of the
public;

(6) gross negligence in the practice of physical therapy as
a physical therapist;

(7) treating human ailments by physical therapy after an
initial 30-day period of patient admittance to treatment has
lapsed, except by the order or referral of a person licensed in
this state in the practice of medicine as defined in section
147.081, the practice of chiropractic as defined in section
148.01, the practice of podiatry as defined in section 153.01,
or the practice of dentistry as defined in section 150A.05 and
whose license is in good standing; or when a previous diagnosis
exists indicating an ongoing condition warranting physical
therapy treatment, subject to periodic review defined by board
of physical therapy rule;

(8) treating human ailments, without referral, by physical
therapy treatment without first having practiced one year under
a physician's orders as verified by the board's records;

(9) failing to consult with the patient's health care
provider who prescribed the physical therapy treatment if the
treatment is altered by the physical therapist from the original
written order. The provision does not include written orders to
"evaluate and treat";

(10) treating human ailments other than by physical therapy
unless duly licensed or registered to do so under the laws of
this state;

(11) inappropriate delegation to a physical therapist
assistant or inappropriate task assignment to an aide or
inadequate supervision of deleted text begin either level of supportive personnel deleted text end new text begin a
student physical therapist, physical therapist assistant,
student physical therapist assistant, or a physical therapy
aide new text end ;

(12) practicing as a physical therapist performing medical
diagnosis, the practice of medicine as defined in section
147.081, or the practice of chiropractic as defined in section
148.01;

(13) failing to comply with a reasonable request to obtain
appropriate clearance for mental or physical conditions that
would interfere with the ability to practice physical therapy,
and that may be potentially harmful to patients;

(14) dividing fees with, or paying or promising to pay a
commission or part of the fee to, any person who contacts the
physical therapist for consultation or sends patients to the
physical therapist for treatment;

(15) engaging in an incentive payment arrangement, other
than that prohibited by clause (14), that tends to promote
physical therapy overuse, that allows the referring person or
person who controls the availability of physical therapy
services to a client to profit unreasonably as a result of
patient treatment;

(16) practicing physical therapy and failing to refer to a
licensed health care professional a patient whose medical
condition at the time of evaluation has been determined by the
physical therapist to be beyond the scope of practice of a
physical therapist; deleted text begin and
deleted text end

(17) failing to report to the board other licensed physical
therapists who violate this section new text begin ;
new text end

new text begin (18) practice of physical therapy under lapsed or
nonrenewed credentials;
new text end

new text begin (19) inappropriate task assignment or inadequate
supervision of an athletic trainer under section 148.7806,
paragraph (e);
new text end

new text begin (20) failure by a physical therapist to file a physical
therapist-athletic trainer supervisory agreement with the board
as required under section 148.707, subdivision 1; and
new text end

new text begin (21) failure by a physical therapist to comply with the
requirements under section 148.707, subdivisions 2 to 5 new text end .

(b) A license to practice as a physical therapist is
suspended if (1) a guardian of the physical therapist is
appointed by order of a court pursuant to sections 524.5-101 to
524.5-502, for reasons other than the minority of the physical
therapist; or (2) the physical therapist is committed by order
of a court pursuant to chapter 253B. The license remains
suspended until the physical therapist is restored to capacity
by a court and, upon petition by the physical therapist, the
suspension is terminated by the Board of Physical Therapy after
a hearing.

Sec. 13.

new text begin [148.754] EXAMINATION; ACCESS TO MEDICAL DATA.
new text end

new text begin (a) If the board has probable cause to believe that a
physical therapist comes under section 148.75, paragraph (a), it
may direct the physical therapist to submit to a mental or
physical examination. For the purpose of this paragraph, every
physical therapist is deemed to have consented to submit to a
mental or physical examination when directed in writing by the
board and further to have waived all objections to the
admissibility of the examining physicians' testimony or
examination reports on the ground that they constitute a
privileged communication. Failure of the physical therapist to
submit to an examination when directed constitutes an admission
of the allegations against the person, unless the failure was
due to circumstances beyond the person's control, in which case
a default and final order may be entered without the taking of
testimony or presentation of evidence. A physical therapist
affected under this paragraph shall, at reasonable intervals, be
given an opportunity to demonstrate that the person can resume
the competent practice of physical therapy with reasonable skill
and safety to the public.
new text end

new text begin (b) In any proceeding under paragraph (a), neither the
record of proceedings nor the orders entered by the board shall
be used against a physical therapist in any other proceeding.
new text end

new text begin (c) In addition to ordering a physical or mental
examination, the board may, notwithstanding section 13.384,
144.651, or any other law limiting access to medical or other
health data, obtain medical data and health records relating to
a physical therapist or applicant without the person's or
applicant's consent if the board has probable cause to believe
that a physical therapist comes under paragraph (a). The
medical data may be requested from a provider, as defined in
section 144.335, subdivision 1, paragraph (b), an insurance
company, or a government agency, including the Department of
Human Services. A provider, insurance company, or government
agency shall comply with any written request of the board under
this paragraph and is not liable in any action for damages for
releasing the data requested by the board if the data are
released pursuant to a written request under this paragraph,
unless the information is false and the provider giving the
information knew, or had reason to believe, the information was
false. Information obtained under this paragraph is classified
as private under sections 13.01 to 13.87.
new text end

Sec. 14.

new text begin [148.755] TEMPORARY SUSPENSION OF LICENSE.
new text end

new text begin In addition to any other remedy provided by law, the board
may, without a hearing, temporarily suspend the license of a
physical therapist if the board finds that the physical
therapist has violated a statute or rule which the board is
empowered to enforce and continued practice by the physical
therapist would create a serious risk of harm to the public.
The suspension shall take effect upon written notice to the
physical therapist, specifying the statute or rule violated.
The suspension shall remain in effect until the board issues a
final order in the matter after a hearing. At the time it
issues the suspension notice, the board shall schedule a
disciplinary hearing to be held pursuant to the Administrative
Procedure Act, chapter 14. The physical therapist shall be
provided with at least 20 days' notice of any hearing held
pursuant to this section. The hearing shall be scheduled to
begin no later than 30 days after the issuance of the suspension
order.
new text end

Sec. 15.

Minnesota Statutes 2004, section 148.7806, is
amended to read:

148.7806 ATHLETIC TRAINING.

Athletic training by a registered athletic trainer under
section 148.7808 includes the activities described in paragraphs
(a) to (e).

(a) An athletic trainer shall:

(1) prevent, recognize, and evaluate athletic injuries;

(2) give emergency care and first aid;

(3) manage and treat athletic injuries; and

(4) rehabilitate and physically recondition athletic
injuries.

The athletic trainer may use modalities such as cold, heat,
light, sound, electricity, exercise, and mechanical devices for
treatment and rehabilitation of athletic injuries to athletes in
the primary employment site.

(b) The primary physician shall establish evaluation and
treatment protocols to be used by the athletic trainer. The
primary physician shall record the protocols on a form
prescribed by the board. The protocol form must be updated
yearly at the athletic trainer's registration renewal time and
kept on file by the athletic trainer.

(c) At the primary employment site, except in a corporate
setting, an athletic trainer may evaluate and treat an athlete
for an athletic injury not previously diagnosed for not more
than 30 days, or a period of time as designated by the primary
physician on the protocol form, from the date of the initial
evaluation and treatment. Preventative care after resolution of
the injury is not considered treatment. This paragraph does not
apply to a person who is referred for treatment by a person
licensed in this state to practice medicine as defined in
section 147.081, to practice chiropractic as defined in section
148.01, to practice podiatry as defined in section 153.01, or to
practice dentistry as defined in section 150A.05 and whose
license is in good standing.

(d) An athletic trainer may:

(1) organize and administer an athletic training program
including, but not limited to, educating and counseling
athletes;

(2) monitor the signs, symptoms, general behavior, and
general physical response of an athlete to treatment and
rehabilitation including, but not limited to, whether the signs,
symptoms, reactions, behavior, or general response show abnormal
characteristics; and

(3) make suggestions to the primary physician or other
treating provider for a modification in the treatment and
rehabilitation of an injured athlete based on the indicators in
clause (2).

(e) In a clinical, corporate, and physical therapy setting,
when the service provided is, or is represented as being,
physical therapy, an athletic trainer may work only under the
direct supervision new text begin as defined in section 148.707 new text end of a physical
therapist as defined in section 148.65.

Sec. 16. new text begin REPEALER.
new text end

new text begin Minnesota Rules, part 5601.0100, subparts 3 and 4, are
repealed.
new text end