HF 3240

as introduced - 92nd Legislature (2021 - 2022) Posted on 03/14/2022 04:30pm

A bill for an act
relating to health occupations; modifying provisions governing the practice or
provision of physical therapy; amending Minnesota Statutes 2020, sections 148.65,
subdivisions 1, 5, 6; 148.706; 148.75; 148.76; repealing Minnesota Statutes 2020,
sections 148.65, subdivision 9; 148.77.

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

Section 1.

Minnesota Statutes 2020, section 148.65, subdivision 1, is amended to read:

Subdivision 1.

Physical therapy.

As used in sections 148.65 to 148.78 the term "physical
therapy" means the evaluation or treatment or both of any person by the employment of
physical measures and the use of therapeutic exercises and rehabilitative procedures, with
or without assistive devices, for the purpose of preventing, correcting, or alleviating a
physical or mental disability. Physical measures shall include but shall not be limited to
heat or cold, air, light, water, electricity new text begin , new text end and sound. Physical therapy includes evaluation new text begin ,
diagnosis new text end other than medical diagnosis, treatment planning, treatment, documentation,
performance of appropriate tests and measurement, interpretation of orders or referrals,
instruction, consultative services, deleted text begin and deleted text end supervision of supportive personnel new text begin , and prevention,
wellness, fitness, health promotion, and education in populations of all ages new text end . "Physical
therapy" does not include the practice of medicine as defined in section 147.081, or the
practice of chiropractic as defined in section 148.01.

Sec. 2.

Minnesota Statutes 2020, section 148.65, subdivision 5, is amended to read:

Subd. 5.

Student physical therapist.

"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. deleted text begin The
physical therapist shall have direct contact with the patient during at least every second
treatment session by the student physical therapist. deleted text end Telecommunications, except within the
facility, does not meet the requirement of on-site supervision.

Sec. 3.

Minnesota Statutes 2020, section 148.65, subdivision 6, is amended to read:

Subd. 6.

Student physical therapist assistant.

"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 deleted text begin direct deleted text end new text begin on-site new text end supervision of the physical therapist, or the deleted text begin direct deleted text end new text begin on-site new text end
supervision of the physical therapist and physical therapist assistant new text begin team new text end , performs physical
therapy interventions and assists with coordination, communication, documentation, and
patient-client-related instruction. deleted text begin "Direct deleted text end new text begin "On-site new text end supervision" means the physical therapist
new text begin or physical therapist assistant new text end is deleted text begin physically present and immediately deleted text end new text begin easily new text end available to
provide instruction to the student physical therapist assistant. new text begin Telecommunications, except
within the facility, does not meet the requirement of on-site supervision.
new text end

Sec. 4.

Minnesota Statutes 2020, section 148.706, is amended to read:

148.706 PHYSICAL THERAPIST ASSISTANTS, AIDES, AND STUDENTS.

Subdivision 1.

Supervision.

new text begin (a) new text end Every physical therapist who uses the services of a
physical therapist assistant or physical therapy 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 delegate deleted text end new text begin direct new text end duties to the physical
therapist assistant and assign tasks to the physical therapy aide in accordance with subdivision
2.

new text begin (b) A licensed physical therapist may supervise no more than two physical therapist
assistants at any time. A physical therapist supervising physical therapist assistants is not
required to be on site, but must be easily available by telecommunications.
new text end

new text begin (c) new text end 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. deleted text begin A licensed
physical therapist may supervise no more than two physical therapist assistants at any time. deleted text end new text begin
A physical therapist supervising a student physical therapist shall have direct contact with
the patient during at least every second treatment session by the student physical therapist.
A physical therapist or physical therapist assistant supervising a student physical therapist
assistant shall have direct contact with the patient during at least every second treatment
session by the student physical therapist assistant.
new text end

Subd. 2.

deleted text begin Delegation deleted text end new text begin Direction new text end of duties.

The physical therapist deleted text begin may delegate deleted text end new text begin is
authorized to direct new text end patient treatment procedures only to a physical therapist assistant who
has sufficient didactic and clinical preparation. The physical therapist may not deleted text begin delegate deleted text end new text begin
direct new text end the following activities to deleted text begin the deleted text end new text begin a new text end physical therapist assistant or to other supportive
personnel: new text begin initial new text end patient new text begin examination and new text end evaluation, deleted text begin treatment planning, initial treatment,
change of treatment, deleted text end new text begin development and modification of the plan of care, new text end and initial or final
documentation.

Subd. 3.

deleted text begin Observation of deleted text end new text begin Collaboration with new text end physical therapist assistants.

When new text begin a
physical therapist directs new text end components of a patient's treatment deleted text begin are delegated deleted text end to a physical
therapist assistant, a physical therapist must deleted text begin provide on-site observation of the treatment
and documentation of its appropriateness at least every six treatment sessions. The physical
therapist is not required to be on site, but must be easily available by telecommunications. deleted text end new text begin :
new text end

new text begin (1) have a real-time, collaborative treatment session, that takes place in person or remotely
via telehealth, with the physical therapist assistant; and
new text end

new text begin (2) document the continued appropriateness of the plan of care at least every six treatment
sessions.
new text end

Subd. 4.

Observation of physical therapy aides.

The physical therapist must observe
the patient's status before and after the treatment administered by a physical therapy aide.
The physical therapy aide may perform tasks related to preparation of patient and equipment
for treatment, housekeeping, transportation, clerical duties, departmental maintenance, and
selected treatment procedures. The tasks must be performed under the direct supervision
of a physical therapist who is readily available for advice, instruction, or immediate
assistance.

Sec. 5.

Minnesota Statutes 2020, section 148.75, is amended to read:

148.75 DISCIPLINARY ACTION.

(a) The board may impose disciplinary action specified in paragraph (b) against an
applicant or licensee whom the board, by a preponderance of the evidence, determines:

(1) has violated a statute, rule, order, or agreement for corrective action that the board
issued or is otherwise authorized or empowered to enforce;

(2) is unable to practice physical therapy with reasonable skill and safety by reason of
any mental or physical illness or condition, including deterioration through the aging process
or loss of motor skills, or use of alcohol, drugs, narcotics, chemicals, or any other type of
material;

(3) has been convicted of or has pled guilty or nolo contendere to a felony or other crime,
an element of which is dishonesty or fraud, or has been shown to have engaged in acts or
practices tending to show that the applicant or licensee is incompetent or has engaged in
conduct reflecting adversely on the applicant's or licensee's ability or fitness to engage in
the practice of physical therapy;

(4) has been convicted of violating any state or federal narcotic law;

(5) has obtained or attempted to obtain a license or approval of continuing education
activities, or passed an examination, by fraud or deception;

(6) has engaged in unprofessional conduct or any other conduct which has the potential
for causing harm to the public, including any departure from or failure to conform to the
minimum standards of acceptable and prevailing practice without actual injury having to
be established;

(7) has engaged in gross negligence in the practice of physical therapy as a physical
therapist new text begin or in providing physical therapy as a physical therapist assistant new text end ;

deleted text begin (8) has treated human ailments by physical therapy after an initial 90-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, or the practice of advance
practice nursing as defined in section 148.171, subdivision 3, when orders or referrals are
made in and whose license is in collaboration with a physician, chiropractor, podiatrist, or
dentist, 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. The 90-day limitation of treatment by a physical
therapist without an order or referral does not apply to prevention, wellness, education, or
exercise;
deleted text end

deleted text begin (9) for a physical therapist licensed less than one year, has treated human ailments,
without referral, by physical therapy treatment without first having practiced one year in
collaboration with a physical therapist with more than one year of experience or under a
physician's orders or referrals as verified by the board's records;
deleted text end

deleted text begin (10) has failed to consult with the patient's licensed health care provider, or licensed
health care professional, 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";
deleted text end

deleted text begin (11) deleted text end new text begin (8) new text end has inappropriately deleted text begin delegated deleted text end new text begin directed components of a patient's treatment new text end to a
physical therapist assistant or inappropriately assigned tasks to an aide, or inadequately
supervised a student physical therapist, physical therapist assistant, student physical therapist
assistant, or a physical therapy aide;

deleted text begin (12) deleted text end new text begin (9) new text end has practiced 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;

deleted text begin (13) deleted text end new text begin (10) new text end has failed 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;

deleted text begin (14) deleted text end new text begin (11) new text end has divided fees with, or new text begin is new text end 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;

deleted text begin (15) deleted text end new text begin (12) new text end has engaged in an incentive payment arrangement, other than that prohibited
by clause deleted text begin (14) deleted text end new text begin (11) new text end , 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;

deleted text begin (16) has failed to refer to a licensed health care professional a patient whose medical
condition has been determined by the physical therapist to be beyond the scope of practice
of a physical therapist;
deleted text end

deleted text begin (17) deleted text end new text begin (13) new text end has failed to report to the board other licensees who violate this section;

deleted text begin (18) deleted text end new text begin (14) new text end has engaged in the practice of physical therapy under lapsed or nonrenewed
credentials;

deleted text begin (19) deleted text end new text begin (15) new text end has had a license, certificate, charter, registration, privilege to take an
examination, or other similar authority denied, revoked, suspended, canceled, limited,
reprimanded, or otherwise disciplined, or not renewed for cause in any jurisdiction; or has
surrendered or voluntarily terminated a license or certificate during a board investigation
of a complaint, as part of a disciplinary order, or while under a disciplinary order;

deleted text begin (20) deleted text end new text begin (16) new text end has been subject to a corrective action or similar action in another jurisdiction
or by another regulatory authority; or

deleted text begin (21) deleted text end new text begin (17) new text end has failed to cooperate with an investigation of the board, including responding
fully and promptly to any question raised by or on behalf of the board relating to the subject
of the investigation, executing all releases requested by the board, providing copies of patient
records, as reasonably requested by the board to assist it in its investigation, and appearing
at conferences or hearings scheduled by the board or its staff.

(b) If grounds for disciplinary action exist under paragraph (a), the board may take one
or more of the following actions:

(1) deny the application for licensure;

(2) deny the renewal of the license;

(3) revoke the license;

(4) suspend the license;

(5) impose limitations or conditions on the licensee's practice of physical therapy,
including the: (i) limitation of scope of practice to designated field specialties; (ii) imposition
of retraining or rehabilitation requirements; (iii) requirement of practice under supervision;
or (iv) conditioning of continued practice on demonstration of knowledge or skills by
appropriate examination, monitoring, or other review of skill and competence;

(6) impose a civil penalty not to exceed $10,000 for each separate violation, the amount
of the civil penalty to be fixed so as to deprive the physical therapist of any economic
advantage gained by reason of the violation charged, to discourage similar violations, or to
reimburse the board for the cost of the investigation and proceeding including, but not
limited to, fees paid for services provided by the Office of Administrative Hearings, legal
and investigative services provided by the Office of the Attorney General, court reporters,
witnesses, reproduction of records, board members' per diem compensation, board staff
time, and travel costs and expenses incurred by board staff and board members;

(7) order the licensee to provide unremunerated service;

(8) censure or reprimand the licensee; or

(9) any other action as allowed by law and justified by the facts of the case.

(c) A license to practice as a physical therapist or physical therapist assistant is
automatically suspended if (1) a guardian of the licensee 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
licensee; or (2) the licensee is committed by order of a court pursuant to chapter 253B. The
license remains suspended until the licensee is restored to capacity by a court and, upon
petition by the licensee, the suspension is terminated by the Board of Physical Therapy after
a hearing.

Sec. 6.

Minnesota Statutes 2020, section 148.76, is amended to read:

148.76 PROHIBITED CONDUCT.

Subdivision 1.

Licensure required.

new text begin (a) new text end No person shall:

(1) provide physical therapy unless the person is licensed as a physical therapist or
physical therapist assistant under sections 148.65 to 148.78;

(2) use the title of physical therapist deleted text begin without a license as a physical therapist or use the
title physical therapist assistant without a license as a physical therapist assistant issued
under sections 148.65 to 148.78;
deleted text end

deleted text begin (3) deleted text end new text begin , new text end in any manner hold out as a physical therapist new text begin or as a provider of physical therapy new text end ,
or use in connection with the person's name the words or letters Physical Therapist, new text begin Doctor
of Physical Therapy, new text end Physiotherapist, Physical Therapy Technician, Registered Physical
Therapist, Licensed Physical Therapist, PT, new text begin DPT, new text end PTT, RPT, LPT, or any letters, words,
abbreviations or insignia indicating or implying that the person is a physical therapist,
without deleted text begin a license deleted text end new text begin being licensed new text end as a physical therapist deleted text begin issued deleted text end under sections 148.65 to
148.78 deleted text begin . To do so is a gross misdemeanor deleted text end ;

deleted text begin (4) deleted text end new text begin (3) use the title of physical therapist assistant, new text end in any manner hold out as a physical
therapist assistant, or use in connection with the person's name the words or letters Physical
Therapist Assistant, P.T.A., or any letters, words, abbreviations, or insignia indicating or
implying that the person is a physical therapist assistant, without deleted text begin a license deleted text end new text begin being licensed new text end
as a physical therapist assistant under sections 148.65 to 148.78 deleted text begin . To do so is a gross
misdemeanor deleted text end ; or

deleted text begin (5) deleted text end new text begin (4) new text end employ fraud or deception in applying for or securing a license as a physical
therapist or physical therapist assistant.

new text begin (b) No person, business entity, or an employee, agent, or representative of a business
entity shall use in connection with that person's name or with the activity of the business,
the words physical therapy or physiotherapy or any other words, abbreviations, or insignia
indicating or implying, directly or indirectly, that physical therapy is provided or supplied,
unless the services are provided by or under the direction and supervision of a person licensed
as a physical therapist under sections 148.65 to 148.78. No person or business entity shall
advertise or otherwise promote another person as being a physical therapist or physiotherapist
unless the person who is advertised or promoted is licensed as a physical therapist under
sections 148.65 to 148.78. A person or business entity that offers, provides, or bills any
other person for services shall not characterize the services as physical therapy or
physiotherapy unless the services are provided by or under the direction and supervision of
a person licensed as a physical therapist under sections 148.65 to 148.78.
new text end

new text begin (c) new text end Nothing in sections 148.65 to 148.78 prohibits a person licensed or registered in this
state under another law from carrying out the therapy or practice for which the person is
duly licensed or registered.

Subd. 2.

deleted text begin Prohibitions deleted text end new text begin Prohibition new text end .

deleted text begin (a) deleted text end No physical therapist may deleted text begin :
deleted text end

deleted text begin (1) treat human ailments by physical therapy after an initial 90-day period of patient
admittance to treatment has lapsed, except by the order or referral of a person licensed in
this state to practice 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, the practice
of dentistry as defined in section 150A.05, or the practice of advanced practice nursing as
defined in section 62A.15, subdivision 3a, when orders or referrals are made in collaboration
with a physician, chiropractor, podiatrist, or dentist, 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.
The 90-day limitation of treatment by a physical therapist without an order or referral does
not apply to prevention, wellness, education, or exercise;
deleted text end

deleted text begin (2) use any chiropractic manipulative technique whose end is the chiropractic adjustment
of an abnormal articulation of the body; and
deleted text end

deleted text begin (3) deleted text end treat human ailments other than by physical therapy unless duly licensed or registered
to do so under the laws of this state.

deleted text begin (b) No physical therapist licensed less than one year may treat human ailments, without
referral, by physical therapy treatment without first having practiced one year in collaboration
with a physical therapist with more than one year of experience or under a physician's orders
or referrals as verified by the board's records.
deleted text end

new text begin Subd. 3. new text end

new text begin Violations. new text end

new text begin (a) A person or business entity that violates this section is guilty
of a gross misdemeanor.
new text end

new text begin (b) The board may impose a civil penalty, not to exceed $10,000 for each separate
violation, against any person or business entity that violates subdivision 1. In addition, the
board may seek an injunction against conduct that violates subdivision 1 in any court of
competent jurisdiction. For purposes of this paragraph, in seeking an injunction, the board
need only show that the defendant violated subdivision 1 to establish irreparable injury or
a likelihood of a continuation of the violation.
new text end

Sec. 7. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2020, sections 148.65, subdivision 9; and 148.77, new text end new text begin are repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: 22-05581

148.65 DEFINITIONS.

Subd. 9.

Licensed health care professional or licensed health care provider.

"Licensed health care professional" or "licensed health care provider" means a person licensed in good standing in Minnesota to practice medicine, osteopathic medicine, chiropractic, podiatry, dentistry, or advanced practice nursing.

148.77 VIOLATIONS.

Any person violating the provisions of section 148.76 is guilty of a gross misdemeanor.