[41 Pa.B. 4962]
[Saturday, September 17, 2011]
[Continued from previous Web Page]
CONTINUING EDUCATION (Editor's Note: Sections 40.67—40.69 are new and printed in regular type to enhance readability.)
§ 40.67. Continuing education for licensed physical therapist.
(a) Contact hour requirements. With the biennial renewal period beginning January 1, 2011, a licensed physical therapist shall satisfy the following continuing education requirements.
(1) During each biennial renewal period, a licensee shall complete qualifying continuing education equal to at least 30 contact hours of continuing physical therapy education.
(2) Except as permitted in § 40.20(c)(1) (relating to inactive status of physical therapist license), paragraph (4) or as directed by the Board, continuing education may satisfy the requirement in paragraph (1) only for the biennium during which it was completed. A contact hour of continuing education may not be used to satisfy the requirement in paragraph (1) for more than 1 biennium.
(3) Unless otherwise excused by the act or this subchapter, failure to complete the minimum required amount of continuing education during the applicable renewal period as required under section 7.2 of the act (63 P. S. § 1307.2) and this section will subject the licensee to disciplinary action under section 11(a)(6) of the act (63 P. S. § 1311(a)(6)) as provided in § 40.52(11) (relating to unprofessional conduct; physical therapists).
(4) The Board may, in individual cases involving physical disability or illness, or undue hardship, grant a waiver of the continuing education requirements or grant an extension of time to complete the requirements. A waiver or extension of time will not be granted unless a written request is submitted by the licensee; or in case of physical disability or illness, by a physician licensed in this Commonwealth or another state or territory of the United States or the District of Columbia and whose license is in good standing, or both. The necessary documentation shall be received by the Board no later than 90 days preceding the biennial renewal. If the physical disability or illness or undue hardship for which the waiver has been granted continues beyond the period of the waiver, the licensee shall reapply for an extension of the waiver. The Board may, as a condition of a waiver granted, require the licensee to make up all or part of the continuing education involved.
(b) Reporting completion of continuing education. Continuing education shall be reported and documented in the following manner.
(1) In general, proof of completion of a course or program of continuing education must consist of a certificate of completion issued by the course or program provider, including:
(i) The name of the participant.
(ii) The name of the provider.
(iii) The date or dates of the course or program.
(iv) The name of the course and any Board issued approval number of the course or program.
(v) The number of contact hours of continuing education or academic credit.
(2) A licensee shall retain proof of completion of continuing education for 5 years after completion of the continuing education or after the completion of the renewal period during which the continuing education was required or applied, whichever is later.
(3) The Board will audit licensees to verify compliance with continuing education requirements. A licensee shall fully respond to an audit notice within 30 days or other time period allowed in the notice.
(c) Credit for approved continuing education. Credit for continuing education will be determined in accordance with the following.
(1) Credit for continuing education will be granted only for courses or programs offered by providers preapproved under subsection (d)(1) or approved by the Board under subsection (d)(2).
(2) Unless limited by this section, continuing education credit may be earned in a course or program relating to any of the following:
(i) Subject matter falling within the definition of ''physical therapy'' in section 2 of the act (63 P. S. § 1302).
(ii) Subject matter that is part of training necessary to qualify one for licensure as a physical therapist or certification of authority to practice physical therapy without a referral.
(iii) Law or ethics applicable to the practice of physical therapy.
(iv) Subject matter that otherwise keeps the licensee apprised of advancements and new developments in the practice of the profession of physical therapy.
(3) Continuing education credit may not be earned in a course in office management or practice building.
(4) A licensee may not receive credit more than once in a given renewal period for repetition of courses or programs with substantially similar content and objectives.
(5) A licensee teaching a course or program of continuing education may receive the same credit that a licensee attending the course or program would receive and may also receive credit for time spent in preparation. Credit for time spent in preparation may not exceed the credit available for a licensee attending the course or program.
(d) Approval of continuing education courses and programs. Continuing education courses and programs may be approved in accordance with this subsection.
(1) Provided that the course or program otherwise meets the requirements in subsection (c)(2) and the provider issues to each attending licensee a certificate of completion record in accordance with subsection (b)(1), a course or program of continuing education from a provider preapproved under this paragraph is approved by the Board.
(i) The following providers are preapproved:
(A) APTA or its components.
(B) FSBPT and its jurisdictions.
(C) A physical therapy program accredited by CAPTE.
(ii) Any other provider seeking preapproved provider status shall:
(A) Apply to the Board on forms supplied by the Board
(B) Pay the required fee.
(C) Demonstrate that the provider is competent to provide continuing education to physical therapists without direct review by the Board.
(iii) The Board may terminate preapproved provider status if the provider, including the providers in subparagraph (i), is no longer able to demonstrate that it is competent to provide continuing education to physical therapists without direct review by the Board. The Board will audit preapproved providers to assure that the provider complies with the requirements in this paragraph and paragraph (3).
(iv) The Board will maintain a list of preapproved providers and make the list publicly available.
(2) A continuing education course or program offered by a provider not preapproved under paragraph (1) may be approved as provided in this paragraph.
(i) The provider shall apply at least 60 days prior to the date the continuing education course or program is scheduled to take place on forms provided by the Board and fully provide the information required on the application forms for the Board to fulfill its duties under this section. The application shall be submitted to the Board with payment of the fee as required under § 40.5 (relating to fees). A provider who is unable to submit the application at least 60 days prior to the date the course or program is given may request a waiver in writing setting forth the reasons why the 60-day requirement could not be met.
(ii) The provider shall apply for approval of each course or program of continuing education, which may include multiple presentations of the course or program at various locations and multiple offerings of the course or program. Unless approved by the Board, a significant change in content or use of instructors other than those described in the application for approval is a separate course or program for which Board approval is required.
(iii) The Board may deny approval of a course or program of continuing education when the provider has previously failed or is not currently able to comply with the provider responsibilities in paragraph (3) or the course or program does not qualify under subsection (c)(1). The Board may approve in part and deny in part an application for approval of a course or program. The Board may deny an application for approval that does not comply with the act or this chapter.
(iv) The Board may terminate its prior approval of a course or program of continuing education when the applicant made one or more false or misleading material statements on the application. The Board may also terminate in part or in whole its prior approval of a course or program when it is later determined that the Board has grounds to deny approval in accordance with this section. Termination of approval will not forfeit credit for a course or program completed prior to termination of approval.
(v) The Board will maintain a list of approved courses and programs in a form accessible to licensees and the public.
(vi) If the provider has not separately sought approval under this paragraph, a licensee attending the course or program may apply for approval of a course or program of continuing education in accordance with this paragraph. The licensee shall apply for approval prior to attending the course or program. The Board may waive the requirements in paragraph (3) when a licensee attending a course or program applies for approval.
(3) For each course or program of continuing education, the provider shall:
(i) Disclose in advance to prospective attendees the objectives, content, teaching method and the number of hours of continuing education credit approved by the Board.
(ii) Provide physical facilities adequate for the number of anticipated participants and the teaching methods to be used.
(iii) Provide accurate instructional materials.
(iv) Utilize qualified instructors who are knowledgeable in the subject matter.
(v) Evaluate the course or program through the use of questionnaires of the participants and instructors.
(vi) Issue a certificate of completion to each participant.
(vii) Retain attendance records, written outlines and a summary of evaluations for 5 years.
(e) Continuing competence. Continuing education is a structured process of education beyond professional entry-level education that is applicable to the practice of physical therapy and is designed or intended to support the continuous development of physical therapists and to maintain and enhance their professional competence. Accordingly, a licensed physical therapist may earn up to 15 contact hours of required continuing education in each biennial renewal period through continuing competence activities that do not otherwise qualify under this section if the activity is approved by the Board under § 40.68 (relating to continuing competence for licensed physical therapist).
§ 40.68. Continuing competence for licensed physical therapist.
(a) Requirements. A licensed physical therapist may satisfy in part the requirements in § 40.67 (relating to continuing education for licensed physical therapist) by completing continued competence activities approved by the Board as provided in this section. The Board will be guided by the following principles in applying this section:
(1) Continuing competence should be self-directed by the physical therapist.
(2) Evaluation or assessment of current competence is critical for the physical therapist. The results of an evaluation or assessment should be used by the physical therapist to select appropriate development activities.
(3) A physical therapist should have a wide variety of activities available to demonstrate his competence. There is not a single right way to demonstrate competence.
(b) Approval process. A licensee shall apply to the Board on forms provided by the Board and receive approval from the Board to earn continuing education credit for continuing competence activities. The continuing competence activity shall be fully documented, including certification as appropriate. In determining whether to approve a continuing competence activity and how much credit to award, the Board will be guided by the following standards:
(1) Content within the continuing competence activity must be relevant to the physical therapy profession and the designated audience.
(2) The continuing competence activity must foster the participant's learning and professional engagement through reflection, interaction, participation and contribution.
(3) The continuing competence activity must incorporate, reflect and promote the use of evidence-based practice (patient values, available evidence and clinician experience) or be based on the act or this chapter.
(4) Qualified individuals with appropriate subject matter expertise and credentials shall develop and, when applicable, conduct the continuing competence activity.
(5) The continuing competence activity must include behavioral objectives that encompass the content of the activity. The objectives must promote a high level of learning in one or more of the cognitive, psychomotor and affective domains.
(6) The design of the activity must support the achievement of the objectives.
(7) Each continuing competence activity must include objective methods to assess the participant's attainment of the specified activity outcomes.
(8) There must be mechanisms in place for ongoing review and evaluation of the quality and the effectiveness of the continuing competence activity. The activity shall be modified based on information gained from review and evaluation.
(9) The continuing competence provider shall furnish clear, complete information to potential learners about continuing competence activities regarding administrative details, activity specifics and content, biography of the activity deliverer/presenter and participant requirements.
(10) The continuing competence provider shall have established processes for developing, administering and documenting the continuing competence activity.
(c) Credit. Credit for continuing competence activities may be awarded in accordance with this subsection. Credit will not be awarded for an activity that duplicates another continuing competence activity or continuing education for which credit is also awarded.
(1) For completion of a fellowship conferred by an organization credentialed by the APTA in a specialty area of the practice of physical therapy—10 contact hours for each full 12-month period of fellowship to be credited in the renewal cycle of completion of the fellowship.
(2) For completion of a residency program in physical therapy offered by an APTA credentialed organization—10 contact hours for each full 12-month period of clinical participation to be credited in the renewal cycle of completion of the residency program.
(3) For specialty certification or specialty recertification by the American Board of Physical Therapy Specialization or its successor organization—15 contact hours upon receipt of certification or recertification to be credited in the renewal cycle of certification or recertification.
(4) Taking the practice review tool of the FSBPT—5 contact hours; passing the practice review tool of the FSBPT—an additional 5 contact hours.
(5) Other activities evaluated and approved by the FSBPT—the number of continuing education units set by FSBPT with each continuing education unit worth 10 contact hours of credit.
(6) Becoming a Credentialed Clinical Instructor or a Credentialed Clinical Instructor Trainer as recognized by the APTA—1 contact hour for each hour of coursework required to receive the credential, not to exceed 15 contact hours, to be credited in the renewal cycle during which the credential was issued.
(7) Submission of a request to a funding agency for a research grant as a principal or coprincipal investigator—10 contact hours; award of the grant—an additional 10 contact hours.
(8) Service as a grants reviewer—1 contact hour for every 2 hours of review up to a maximum of 5 contact hours in a single renewal cycle.
(9) Authoring or editing a book dealing with a subject related to the practice of physical therapy—as determined by the Board, not to exceed 15 contact hours, to be awarded in the renewal cycle in which the book was published.
(10) Authoring or editing a chapter of a book dealing with a subject related to the practice of physical therapy—as determined by the Board, not to exceed 10 contact hours, to be awarded in the renewal cycle in which the book was published.
(11) Authoring a published peer-reviewed article relating to the practice of physical therapy—as determined by the Board, not to exceed 10 contact hours, to be awarded in the renewal cycle in which the article was published.
(12) Authoring a published non-peer-reviewed article relating to the practice of physical therapy—as determined by the Board, not to exceed 5 contact hours, to be awarded in the renewal cycle in which the article was published.
(13) Completing a professional self-assessment that is a process for the licensee to evaluate current professional practice ability, establish goals to improve those abilities, develop a plan to meet those goals and document that the objectives are being accomplished—as determined by the Board, not to exceed a total of 5 contact hours in a single renewal cycle.
(14) Participating in a National physical therapy or interdisciplinary (including physical therapy) organization as an officer or chair of a physical therapy services committee or physical therapy services task force member for at least 1 year—5 contact hours for each full year of participation.
(15) Participation in a State physical therapy or interdisciplinary (including physical therapy) organization as an officer or chair of a physical therapy services committee for at least 1 year—5 contact hours for each full year of participation.
(16) Participation in a local physical therapy or interdisciplinary (including physical therapy) organization as an officer or chair of a physical therapy services committee for at least 1 year—as determined by the Board not to exceed 5 contact hours in a single renewal cycle.
(17) Participation in a physical therapy professional organization committee involved with physical therapy services for at least 1 year—as determined by the Board not to exceed 5 contact hours in a single renewal cycle.
(18) Other continuing competence activities—as determined by the Board.
PROFESSIONAL LIABILITY INSURANCE § 40.69. Professional liability insurance.
(a) Professional liability insurance requirements. As required under section 9.1(b)(4) of the act (63 P. S. § 1309.1(b)(4)), a licensed physical therapist shall maintain professional liability insurance in the minimum amount of $1 million per occurrence or claims made as a condition of practicing as a physical therapist in this Commonwealth. Coverage may be provided through:
(1) A self-insurance plan that meets the standards and procedures established by the Insurance Department in 31 Pa. Code Chapter 243 (relating to medical malpractice and health-related self-insurance plans).
(2) Personally purchased professional liability insurance.
(3) Professional liability insurance, coverage provided by the licensee's employer.
(4) A similar type of coverage.
(b) Proof of professional liability insurance coverage. Proof of professional liability insurance coverage must include a certificate of insurance or copy of the declaration page from the insurance policy setting forth the effective date, expiration date and dollar amounts of coverage. A license that was issued in reliance upon a letter from the applicant's insurance carrier indicating that the applicant will be covered against professional liability effective upon the issuance of the applicant's license as permitted under section 9.1(b)(4)(iii.2) of the act will become inactive as a matter of law 30 days after issuance of the license if the licensee has not provided proof of professional liability insurance coverage and will remain inactive until the licensee provides proof of insurance coverage.
(c) Disciplinary action. Failure to maintain insurance coverage as required shall subject the licensee to disciplinary action under section 11(a)(6) of the act (63 P. S. § 1311(a)(6)) as provided in § 40.52(11) (relating to unprofessional conduct; physical therapists).
Subchapter C. PHYSICAL THERAPIST ASSISTANTS
GENERAL PROVISIONS § 40.152. Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
* * * * * Indirect supervision—Supervision of a physical therapist assistant by a licensed physical therapist that is not direct on-premises supervision, as authorized under section 9.1(c) of the act (63 P. S. § 1309.1(c)) and this subchapter, including § 40.173 (relating to supervision of physical therapist assistant by licensed physical therapist).
Physical therapist assistant—A person who has been [registered] certified in accordance with the act and this subchapter [and who provides patient-care services only in compliance with this chapter] to provide services as a physical therapist assistant.
Physical Therapist Assistant [Registration] Certification Examination—An examination adopted by the Board and administered in accordance with section 812.1 of The Administrative Code of 1929 (71 P. S. § 279.3(a)). The term also includes an examination administered by another state, territory or the District of Columbia if it is the same examination adopted by the Board.
Physical therapy independent private practice outpatient facility—
(i) A practice owned and operated by a licensee under the act, or by a licensee under the act and a healthcare practitioner, licensed by this Commonwealth, as permitted by law.
(ii) This term does not include a practice owned or affiliated with a hospital or healthcare system.
[REGISTRATION] CERTIFICATION § 40.161. [Registration of] Certification as physical therapist assistants; practice; exceptions.
(a) A person may not perform or hold himself out as being able to perform as a physical therapist assistant in this Commonwealth unless the person is [registered] certified by the Board under section 9.1 of the act (63 P. S. § 1309.1) and this subchapter or exempted under this section.
(b) A person or business entity may not use in connection with a business name or activity the words ''physical therapist assistant,'' the letters ''P.T.A.'' or similar words and related abbreviations to imply that physical therapist assistant services are being provided, unless the services are provided by a physical therapist assistant [registered] certified under the act and this subchapter.
* * * * * § 40.162. Application for [registration] certification.
(a) The applicant shall submit evidence satisfactory to the Board, on forms supplied by the Board, that the applicant has met the following criteria. The applicant:
(1) Satisfies either of the following age requirements:
(i) Is at least 20 years of age[, unless otherwise determined by the Board].
(ii) Is at least 18 years of age and the Board has determined that the candidate has proved the capability to accept and handle the responsibilities appurtenant to [registration] certification.
* * * * * (4) Has met the professional requirements for [registration] certification under § 40.163 (relating to requirements for [registration] certification).
(b) An applicant for [registration] certification issued by the Board shall apprise the Board of the following:
* * * * * (c) The reporting responsibilities enumerated in subsection (b) continue after the Board issues a [registration] certification. If, after the Board has issued a [registration] certification, one or more events listed under subsection (b)(1) and (2) occur, the [registrant] certified physical therapist assistant shall report that matter to the Board in writing on the biennial [reregistration] renewal application or within 90 days of its occurrence, whichever occurs sooner. The [registrant] certified physical therapist assistant shall report an event occurring under subsection (b)(3) within 30 days of occurrence.
§ 40.163. Requirements for [registration] certification.
(a) Under section 9.1(a) of the act (63 P. S. § 1309.1(a)), an applicant for [registration] certification by examination shall submit evidence of the following:
* * * * * (2) A passing grade on the physical therapist assistant [registration] certification examination.
(b) Under section 6(d.1) of the act (63 P. S. § 1306(d.1)), an applicant for reciprocal [registration] certification shall submit evidence of a valid license, certificate or registration as a physical therapist assistant issued by another state, territory or the District of Columbia, where the requirements for licensure, certification or registration were on the date of issuance substantially the same as those required by this Commonwealth, and which accords similar privileges to persons [registered] certified as physical therapist assistants in this Commonwealth.
§ 40.164. Physical therapist assistant [registration] certification examination.
(a) Application procedure. An applicant applying for [registration] certification by examination shall take the physical therapist assistant [registration] certification examination. The applicant who is taking the examination within this Commonwealth shall comply with the following:
* * * * * (Editor's Note: Sections 40.165 and 40.166 are new and printed in regular type to enhance readability.)
§ 40.165. Authorization to provide services as physical therapist assistant under indirect supervision.
(a) An applicant for a certificate of authority to provide services as a physical therapist assistant under indirect supervision by a licensed physical therapist shall submit to the Board on forms supplied by the Board a completed application, including all necessary supporting documents, and pay the fee in § 40.5 (relating to fees) for initial application for certification to provide services under indirect supervision.
(b) The Board will grant a certificate of authority as described in this section to an applicant who:
(1) Demonstrates that the applicant satisfies the requirements in §§ 40.161—40.164.
(2) Demonstrates that the applicant satisfies the requirements in section 9.1(c)(4) of the act (63 P. S. § 1309.1(c)(4)) for certification to provide services as a physical therapist assistant under indirect supervision of a licensed physical therapist by either verifying that the applicant:
(i) Has at least 2,000 hours of experience providing patient-related acts and services under the supervision of one or more licensed physical therapists, as verified by those physical therapists.
(ii) Worked as a physical therapist assistant for at least 3 years between October 2, 2003, and October 2, 2008, the 5-year period immediately preceding the effective date of section 9.1(c)(4) of the act, and providing a detailed resume or other adequate documentation to corroborate the verification. Part-time work will be acceptable if it is at least equivalent to 3 years of full-time work.
(3) Otherwise complies with this subchapter.
§ 40.166. Temporary certificate to provide services as physical therapist assistant.
(a) An applicant for a temporary certificate to provide services as a physical therapist assistant under section 9.1(a.1) of the act (63 P. S. § 1309.1(a.1)) shall apply to the Board on forms provided by the Board including all necessary supporting documents and pay the fee in § 40.5 (relating to fees) for application for temporary certificate to provide services as a physical therapist assistant.
(b) The Board will grant a temporary certificate as described in this section to an applicant who:
(1) Demonstrates that the applicant satisfies the requirements in §§ 40.161—40.164 except the certification examination requirement in § 40.163(a)(2) (relating to requirements for certification).
(2) Has applied for certification to provide services as a physical therapist assistant in accordance with §§ 40.161—40.164 or § 40.165.
(3) Has not previously sat for the certification examination.
(4) Has not previously received a temporary certificate under this section.
(5) Otherwise complies with this subchapter.
(c) The Board may rescind a temporary certificate issued under this section if the Board determines that the certificate was issued based upon fraudulent information, such as the applicant's identity or educational, criminal, or professional or occupational licensure record.
(d) A temporary certificate issued under this section will expire upon the earlier of failing the certification examination or 6 months after issuance. A temporary certificate issued under this section will become void upon issuance of a certificate to provide services as a physical therapist assistant under §§ 40.161—40.165.
(e) A temporary certificate may not be renewed or extended beyond its expiration. The holder of a temporary certificate shall return the certificate to the Board within 10 days after its expiration.
(f) The holder of a temporary certificate may provide services as a physical therapist assistant only under the direct on-premises supervision of a licensed physical therapist.
SCOPE OF ACTIVITIES § 40.171. Functions of physical therapist assistants.
* * * * * (c) Patient care services performed by a physical therapist assistant under [direct on-premises] the supervision of a physical therapist shall be on the basis of not more than [two] three physical therapist assistants for a physical therapist. A student in a physical therapist assistant program is counted along with a physical therapist assistant in determining compliance with this restriction.
(d) The initial patient contact shall be made by a licensed physical therapist for evaluation of the patient and establishment of a plan of care.
(Editor's Note: The following section is new and printed in regular type to enhance readability.)
§ 40.173. Supervision of physical therapist assistant by licensed physical therapist.
(a) General rule. A physical therapist assistant may provide patient care services only under the supervision of a licensed physical therapist. Except as otherwise provided in the act or this subchapter, a physical therapist assistant may provide patient care services only under the direct on-premises supervision of a licensed physical therapist.
(b) Supervision generally. The required level of supervision depends upon the following factors:
(1) The performance of selected acts and services by the physical therapist assistant is the responsibility of the licensed physical therapist at all times.
(2) Supervision shall be based upon the following:
(i) The complexity and acuity of the patient's needs.
(ii) The proximity and accessibility of the licensed physical therapist to the certified physical therapist assistant.
(iii) The amount of supervision available in the event of an emergency or critical event.
(iv) The type of practice setting in which the service is provided.
(3) The supervising licensed physical therapist may determine and require that the physical therapist assistant provide services under greater supervision than would otherwise appear to be required under section 9.1(c)(3) of the act (63 P. S. § 1309.1(c)(3)) or this section, including requiring that the physical therapist assistant provide services under direct on-premises supervision.
(c) Practice setting. A physical therapist assistant holding a current certificate of authority to provide services under indirect supervision may do so in accordance with this section and section 9.1(c) of the act.
(1) When care is delivered to an individual in an acute care hospital, acute inpatient rehabilitation center, long-term acute care hospital setting or as otherwise required under Federal or State law or regulation, the physical therapist assistant shall be under the direct on-premises supervision of a licensed physical therapist.
(2) When care is provided to an individual in a preschool, primary school, secondary school or other similar educational setting, a licensed physical therapist shall make an onsite visit and examine the patient at least every four patient visits or every 30 days, whichever occurs first.
(3) When care is provided to an individual in an early intervention setting, a licensed physical therapist shall make an onsite visit and examine the patient at least every four patient visits or every 30 days, whichever occurs first.
(4) When care is provided to a patient in a physical therapy independent private practice outpatient facility, a licensed physical therapist shall provide direct on-premises supervision for a physical therapist assistant for at least 50% of the hours worked by the physical therapist assistant during the calendar week unless otherwise required under Federal law. The physical therapist shall be immediately available by telecommunication when not providing direct on-premises supervision.
(5) When care is provided to a patient in an outpatient facility of a practice owned or affiliated with a hospital or healthcare system, a licensed physical therapist shall provide direct on-premises supervision for a physical therapist assistant for at least 50% of the hours worked by the physical therapist assistant during the calendar week unless otherwise required under Federal law. The physical therapist shall be immediately available by telecommunication if not providing direct on-premises supervision.
(6) For home health care, a licensed physical therapist shall make an onsite visit and actively participate in the treatment of the patient at least every seven patient visits or every 14 days, whichever occurs first. For purposes of this paragraph, active participation includes examination of the patient.
(7) For care provided in a long-term care nursing facility, skilled nursing facility or extended care facility, a licensed physical therapist shall make an onsite visit and actively participate in the treatment of the patient at least every seven patient visits or every 14 days, whichever occurs first. For purposes of this paragraph, active participation includes examination of the patient.
(d) Emergency situations. The emergency situation provisions in section 9.1(i) of the act apply to all current certified physical therapist assistants, whether or not authorized by the Board under section 9.1(c)(4) of the act and § 40.165 (relating to authorization to provide services as physical therapist assistant under indirect supervision) to provide services under supervision of a licensed physical therapist other than direct on-premises supervision.
DISCIPLINE § 40.181. Refusal, suspension or revocation of [registration] certification.
(a) Under section 9.1(f) of the act (63 P. S. § 1309.1(f)), the Board may refuse, suspend or revoke the [registration] certification of a person who has:
* * * * * (10) Provided services as a physical therapist assistant under indirect supervision without having a current certificate of authorization to practice under indirect supervision issued under § 40.165 (relating to authorization to provide services as physical therapist assistant under indirect supervision).
(11) Provided services as a physical therapist assistant under indirect supervision other than as authorized by section 9.1(c) of the act and § 40.173 (relating to supervision of physical therapist assistant by licensed physical therapist).
* * * * *
MAINTENANCE OF [REGISTRATION] CERTIFICATION § 40.191. Renewal of [registration] certification.
(a) A [registration] certification issued under this subchapter expires on December 31 of every [even numbered] even-numbered year unless renewed for the next biennium.
(b) Biennial renewal forms and other forms and literature to be distributed by the Board will be forwarded to the last mailing address given to the Board by the [registrant] certified physical therapist assistant. The [registrant] certified physical therapist assistant shall notify the Board in writing within 10 days after making an address change.
(c) To retain the right to engage in practice, the [registrant's registration] certified physical therapist assistant's certification shall be renewed by the [registrant] certified physical therapist assistant in the manner prescribed by the Board, and the required fee shall be paid by the [registrant] certified physical therapist assistant prior to the expiration of the next biennium. A certified physical therapist assistant applying for biennial license renewal shall:
(1) Complete and submit the renewal application, including payment of the biennial renewal fee in § 40.5 (relating to fees) for application for biennial renewal of physical therapist assistant certificate.
(2) Disclose any license to provide services as a physical therapist assistant in another state, territory, possession or country.
(3) Disclose any disciplinary action pending before the appropriate healthcare licensing authority in any other jurisdiction or taken since the most recent application for renewal, whether or not licensed, registered or certified to practice in that other jurisdiction.
(4) Disclose any pending criminal charges and any finding or verdict of guilt, admission of guilt, plea of nolo contendere or other criminal conviction since the most recent application for renewal.
(5) Verify that the certified physical therapist assistant has complied with the continuing education requirements mandated by section 9.1(j) of the act (63 P. S. § 1309.1(j)) during the biennial period immediately preceding the period for which renewal is sought in accordance with § 40.192 (relating to continuing education for certified physical therapist assistant).
(d) When a [registration] certification is renewed beyond December 31 of an [even numbered] even-numbered year, a [penalty] late fee of $5 for each month or part of a month that the [registrant] certified physical therapist assistant has engaged in practice beyond the renewal date will be charged, in addition to the renewal fee. Payment of a late fee does not preclude the Board from taking disciplinary action for providing services as a physical therapist assistant without a current certification.
(e) A [registrant] certified physical therapist assistant who does not intend to practice in this Commonwealth and who does not desire to renew the [registration] certification shall inform the Board in writing. Written confirmation of the Board's receipt of the request and notice that the [registration] certification has been classified as inactive will be forwarded to the [registrant] certified physical therapist assistant.
(f) The [registrant] certified physical therapist assistant who either fails to pay the biennial renewal fee or who notifies the Board of the desire not to renew the [registration] certification will not be sent biennial renewal forms for the following biennial renewal periods unless the [registrant] certified physical therapist assistant requests the Board, in writing, to reactivate the [registration] certification.
(g) [A registrant who is applying to return to active status is required to pay the current fees and submit a notarized affidavit stating the period of time during which the registrant was not engaged in practice in this Commonwealth.] To reactivate an inactive certification, the certified physical therapist assistant shall apply on forms supplied by the Board and answer the questions fully. The certified physical therapist assistant shall:
(1) Include the documentation required under § 40.192(b) for the immediately preceding biennium, which may be completed during the current biennium. Unless waived by the Board under § 40.192(a)(4), the Board will not reactivate a certificate until the required continuing education for the preceding biennium has been successfully completed.
(2) Pay the current renewal fee and the reactivation application fee in § 40.5.
(3) Verify that the certified physical therapist assistant did not provide services as a physical therapist assistant in this Commonwealth while the certification was inactive.
(h) A certified physical therapist assistant who does not make the verification of subsection (g)(3) shall also pay prior biennial renewal fees and late fees as required under this subsection. Unless previously paid, the certified physical therapist assistant shall pay the renewal fee for each biennial renewal period after the certificate became inactive and during which the certified physical therapist assistant provided services as a physical therapist assistant in this Commonwealth. The certified physical therapist assistant shall also pay a late fee of $5 per month or part of month from the first date the certified physical therapist assistant provided services as a physical therapist assistant in this Commonwealth after the certificate became inactive until the date the certified physical therapist assistant files a fully-completed reactivation application. The applicant for [registration] certification renewal will not be assessed a fee or penalty for preceding biennial periods in which the applicant did not [engage in practice] provide services as a physical therapist assistant in this Commonwealth. Payment of a late fee does not preclude the Board from taking disciplinary action for providing services as a physical therapist assistant without a current certification.
(i) If other conditions of the act and this chapter have been met, active status will be restored upon payment of fees [and penalties] which have accrued.
(j) A certified physical therapist assistant who has not renewed the certification may not provide services as a physical therapist assistant in this Commonwealth until the certification has been renewed or reactivated. A certified physical therapist assistant who provides services as a physical therapist assistant in this Commonwealth after the certification has expired and before it has been renewed or reactivated is subject to disciplinary action under section 9.1(d) and (f) of the act, as set forth in § 40.181(a)(6) (relating to refusal, suspension or revocation of certification). A [registrant] certified physical therapist assistant who has engaged in practice during a period in which the [registrant] certified physical therapist assistant's certification was not [registered] active may be subject to criminal prosecution under section 12 of the act (63 P. S. § 1312).
(Editor's Note: Sections 40.192 and 40.193 are new and printed in regular type to enhance readability.)
§ 40.192. Continuing education for certified physical therapist assistant.
(a) Contact hour requirements. With the biennial renewal period beginning January 1, 2011, a certified physical therapist assistant shall satisfy the following continuing education requirements.
(1) During each biennial renewal period, a certified physical therapist assistant shall complete qualifying continuing education equal to at least 30 contact hours of continuing physical therapy education, including at least 4 contact hours in identifying and responding to emergency health conditions.
(2) Except as permitted in § 40.191(g)(1) (relating to renewal of certification), paragraph (4) or as directed by the Board, continuing education may satisfy the requirement in paragraph (1) only for the biennium during which it was completed. A contact hour of continuing education may not be used to satisfy the requirement in paragraph (1) for more than 1 biennium.
(3) Unless otherwise excused by the act or this subchapter, failure to complete the minimum required amount of continuing education during the applicable renewal period as required under section 9.1(j) of the act (63 P. S. § 1309.1(j)) and this section will subject the certified physical therapist assistant to disciplinary action under section 9.1(f) of the act as provided in § 40.181(6) (relating to refusal, suspension or revocation of certification).
(4) The Board may, in individual cases involving physical disability or illness, or undue hardship, grant a waiver of the continuing education requirements or grant an extension of time to complete the requirements. A waiver or extension of time will not be granted unless a written request is submitted by the certified physical therapist assistant; or in case of physical disability or illness, by a physician licensed in this Commonwealth or another state or territory of the United States or the District of Columbia and whose license is in good standing, or both. The necessary documentation shall be received by the Board no later than 90 days preceding the biennial renewal. If the physical disability or illness or undue hardship for which the waiver has been granted continues beyond the period of the waiver, the certified physical therapist assistant shall reapply for an extension of the waiver. The Board may, as a condition of a waiver granted, require the certified physical therapist assistant to make up all or part of the continuing education involved.
(b) Reporting completion of continuing education. Continuing education shall be reported and documented in the following manner.
(1) In general, proof of completion of a course or program of continuing education must consist of a certificate of completion issued by the course or program provider, including:
(i) The name of the participant.
(ii) The name of the provider.
(iii) The date or dates of the course or program.
(iv) The name and any Board issued approval number of the course or program.
(v) The number of contact hours of continuing education or academic credit.
(2) A certified physical therapist assistant shall retain proof of completion of continuing education for 5 years after completion of the continuing education or after the completion of the renewal period during which the continuing education was required or applied, whichever is later.
(3) The Board will audit certified physical therapist assistants to verify compliance with continuing education requirements. A certified physical therapist assistant shall fully respond to an audit notice within 30 days or other time period allowed in the notice.
(c) Credit for approved continuing education. Credit for continuing education will be determined in accordance with the following.
(1) Credit for continuing education will be granted only for courses or programs offered by providers preapproved under subsection (d)(1) or approved by the Board under subsection (d)(2).
(2) Unless limited by this section, continuing education credit may be earned in a course or program relating to any of the following:
(i) Subject matter falling within the definition of ''physical therapy'' in section 2 of the act (63 P. S. § 1302).
(ii) Law or ethics applicable to the practice of physical therapy.
(iii) Subject matter that otherwise keeps the certified physical therapist assistant apprised of advancements and new developments in the practice of the profession of physical therapy.
(3) Continuing education credit may not be earned in a course in office management or practice building.
(4) A certified physical therapist assistant may not receive credit more than once in a given renewal period for repetition of courses or programs with substantially similar content and objectives.
(5) A certified physical therapist assistant teaching a course or conducting a program of continuing education may receive the same credit that a certified physical therapist assistant attending the course or program would receive and may also receive credit for time spent in preparation. Credit for time spent in preparation may not exceed the credit available for a certified physical therapist assistant attending the course or program.
(d) Approval of continuing education courses. Continuing education courses or programs may be approved in accordance with this subsection.
(1) Provided that the course or program otherwise meets the requirements in subsection (c)(2) and the course or program provider issues to each attending certified physical therapist assistant a certificate of completion record in accordance with subsection (b)(1), a course or program of continuing education from a provider preapproved under this paragraph is approved by the Board.
(i) The following providers are preapproved:
(A) APTA or its components.
(B) FSBPT and its jurisdictions.
(C) A physical therapy program accredited by CAPTE.
(D) The American Heart Association and the American Red Cross and their component organizations for purposes of providing continuing education in identifying and responding to emergency health conditions as required under subsection (a)(1).
(ii) Any other provider seeking preapproved provider status shall:
(A) Apply to the Board on forms supplied by the Board.
(B) Pay the required fee.
(C) Demonstrate that the provider is competent to provide continuing education to physical therapist assistants without direct review by the Board.
(iii) The Board may terminate its prior approval of a course or program of continuing education when the applicant made one or more false or misleading material statements on the application. The Board may also terminate in part or in whole its prior approval of a course or program when it is later determined that the Board has grounds to deny approval in accordance with this section. Termination of approval will not forfeit credit for a course or program completed prior to termination of approval.
(iv) The Board will maintain a list of preapproved providers and make the list publicly available.
(2) A continuing education course or program offered by a provider not preapproved under paragraph (1) may be approved as provided in this paragraph.
(i) The provider shall apply at least 60 days in prior to the date the continuing education course or program is scheduled to take place on forms provided by the Board and fully provide the information required on the application forms for the Board to fulfill its duties under this section. The application shall be submitted to the Board with payment of the fee as required under § 40.5 (related to fees). A provider who is unable to submit the application at least 60 days prior to the date the course or program is given may request a waiver in writing setting forth the reasons why the 60-day requirement could not be met.
(ii) The provider shall apply for approval of each course or program of continuing education, which may include multiple presentations of the course or program at various locations and multiple offerings of the course or program. Unless approved by the Board, a significant change in content or use of an instructor or instructors other than those described in the application for approval is a separate course or program for which Board approval is required.
(iii) The Board may deny approval of a course or program of continuing education when the provider has previously failed or is not currently able to comply with the provider responsibilities in paragraph (3) or the course or program does not qualify under subsection (c)(1). The Board may approve in part and deny in part an application for approval of a course or program. The Board may deny an application for approval that does not comply with the act or this chapter.
(iv) The Board may terminate its prior approval of a course or program of continuing education when the applicant made one or more false or misleading material statements on the application. The Board may also terminate in part or in whole its prior approval of a course or program when it is later determined that the Board has grounds to deny approval in accordance with this section. Termination of approval will not forfeit credit for a course or program completed prior to termination of approval.
(v) The Board will maintain a list of approved courses and programs in a form accessible to certified physical therapist assistants and the public.
(vi) If the provider has not separately sought approval under this paragraph, a certified physical therapist assistant attending the course or program may apply for approval of a course or program of continuing education in accordance with this paragraph. The certified physical therapist assistant shall apply for approval prior to attending the course or program. The Board may waive the requirements in paragraph (3) when a certified physical therapist assistant attending a course or program applies for approval.
(3) For each course or program of continuing education, the provider shall:
(i) Disclose in advance to prospective attendees the objectives, content, teaching method and the number of hours of continuing education credit approved by the Board.
(ii) Provide physical facilities adequate for the number of anticipated participants and the teaching methods to be used.
(iii) Provide accurate instructional materials.
(iv) Utilize qualified instructors who are knowledgeable in the subject matter.
(v) Evaluate the course or program through the use of questionnaires of the participants and instructors.
(vi) Issue a certificate of completion to each participant.
(vii) Retain attendance records, written outlines and a summary of evaluations for 5 years.
(e) Continuing competence. Continuing education is a structured process of education beyond professional entry-level education that is applicable to the practice of physical therapy and is designed or intended to support the continuous development of physical therapist assistants and to maintain and enhance their professional competence. Accordingly, a certified physical therapist assistant may earn up to 15 contact hours of required continuing education in each biennial renewal period through continuing competence activities that do not otherwise qualify under this section if the activity is approved by the Board under § 40.193 (relating to continued competence for certified physical therapist assistant).
§ 40.193. Continuing competence for certified physical therapist assistant.
(a) Requirements. A certified physical therapist assistant may satisfy in part the requirements in § 40.192 (relating to continuing education for certified physical therapist assistant) by completing continuing competence activities approved by the Board as provided in this section. The Board will be guided by the following principles in applying this section.
(1) Continuing competence should be self-directed by the physical therapist assistant.
(2) Evaluation or assessment of current competence is critical for the physical therapist assistant. The results of an evaluation or assessment should be used by the physical therapist assistant to select appropriate development activities.
(3) A physical therapist assistant should have a wide variety of activities available to demonstrate his competence. There is not a single right way to demonstrate competence.
(b) Approval process. A certified physical therapist assistant shall apply to the Board on forms provided by the Board and receive approval from the Board to earn continuing education credit for continuing competence activities. The continuing competence activity shall be fully documented, including certification as appropriate. In determining whether to approve a continuing competence activity and how much credit to award, the Board will be guided by the following standards.
(1) Content within the continuing competence activity must be relevant to the physical therapy profession and the designated audience.
(2) The continuing competence activity must foster the participant's learning and professional engagement through reflection, interaction, participation and contribution.
(3) The continuing competence activity must incorporate, reflect and promote the use of evidence-based practice (patient values, available evidence and clinician experience) or be based on the act or this chapter.
(4) Qualified individuals with appropriate subject matter expertise and credentials shall develop and, when applicable, conduct the continuing competence activity.
(5) The continuing competence activity must include behavioral objectives that encompass the content of the activity. The objectives must promote a high level of learning in one or more of the cognitive, psychomotor and affective domains.
(6) The design of the activity must support the achievement of the objectives.
(7) Each continuing competence activity must include objective methods to assess the participant's attainment of the specified activity outcomes.
(8) There must be mechanisms in place for ongoing review and evaluation of the quality and the effectiveness of the continuing competence activity. The activity shall be modified based on information gained from review and evaluation.
(9) The continuing competence provider shall furnish clear, complete information to potential learners about continuing competence activities regarding administrative details, activity specifics and content, biography of the activity deliverer/presenter and participant requirements.
(10) The continuing competence provider shall have established processes for developing, administering and documenting the continuing competence activity.
(c) Credit. Credit for continuing competence activities may be awarded in accordance with this subsection. Credit will not be awarded for an activity that duplicates another continuing competence activity or continuing education for which credit is also awarded.
(1) Advanced proficiency designation by the APTA for a physical therapist assistant—15 contact hours to be credited in the renewal cycle during which the certified physical therapist assistant was designated.
(2) Taking the physical therapist assistant practice review tool of the FSBPT, when available—5 contact hours; passing the practice review tool of the FSBPT, when available—an additional 5 contact hours.
(3) Other activities evaluated and approved by the FSBPT—the number of continuing education units set by FSBPT with each continuing education unit worth 10 contact hours of credit.
(4) Becoming a Credentialed Clinical Instructor or a Credentialed Clinical Instructor Trainer as recognized by APTA—1 contact hour for each hour of coursework required to receive the credential, not to exceed 15 contact hours, to be credited in the renewal cycle during which the credential was issued.
(5) Submission of a request to a funding agency for a research grant as a principal or coprincipal investigator—10 contact hours; award of the grant—an additional 10 contact hours.
(6) Service as a grants reviewer—1 contact hour for every 2 hours of review, up to a maximum of 5 contact hours in a single renewal cycle.
(7) Authoring or editing a book dealing with a subject related to the practice of physical therapy—as determined by the Board, not to exceed 15 contact hours, to be awarded in the renewal cycle in which the book was published.
(8) Authoring or editing a chapter of a book dealing with a subject related to the practice of physical therapy—as determined by the Board, not to exceed 10 contact hours, to be awarded in the renewal cycle in which the book was published.
(9) Authoring a published peer-reviewed article relating to the practice of physical therapy—as determined by the Board, not to exceed 10 contact hours, to be awarded in the renewal cycle in which the article was published.
(10) Authoring a published non-peer-reviewed article relating to the practice of physical therapy—as determined by the Board, not to exceed 5 contact hours, to be awarded in the renewal cycle in which the article was published.
(11) Completing a professional self-assessment that is a process for the certified physical therapist assistant to evaluate current professional practice ability, establish goals to improve those abilities, develop a plan to meet those goals and document that the objectives are being accomplished—as determined by the Board, not to exceed a total of 5 contact hours in a single renewal cycle.
(12) Participating in a National physical therapy or interdisciplinary (including physical therapy) organization as an officer or chair of a physical therapy services committee or physical therapy services task force member for at least 1 year—5 contact hours for each full year of participation.
(13) Participation in a State physical therapy or interdisciplinary (including physical therapy) organization as an officer or chair of a physical therapy services committee for at least 1 year—5 hours for each full year of participation.
(14) Participation in a local physical therapy or interdisciplinary (including physical therapy) organization as an officer or chair of a physical therapy services committee for at least 1 year—as determined by the Board not to exceed 5 contact hours in any single renewal cycle.
(15) Participation in a physical therapy professional organization committee involved with physical therapy services for at least 1 year—as determined by the Board not to exceed 5 contact hours in a single renewal cycle.
(16) Other continuing competence activities—as determined by the Board.
[Pa.B. Doc. No. 11-1599. Filed for public inspection September 16, 2011, 9:00 a.m.]
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