SB25INTRODUCED
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NRGOJT-1
By Senator Albritton
RFD: State Governmental Affairs
First Read: 07-Mar-23
PFD: 23-Feb-23
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SYNOPSIS:
Interstate licensure compacts are legislatively
enacted contractual agreements between states to allow
various health professionals with compact privileges to
provide services to individuals in other states.
Alabama enacted the Physical Therapy Licensure
Compact on March 18, 2021, Act 2021-115.
This bill would grant the Board of Physical
Therapy jurisdiction over physical therapists and
physical therapy assistants licensed in other states
who have compact privileges to practice in this state.
A BILL
TO BE ENTITLED
AN ACT
Relating to the Board of Physical Therapy; to amend
Sections 34-24-191, 34-24-193, 34-24-194, 34-24-196,
34-24-210, 34-24-210.1, 34-24-211, 34-24-212, 34-24-213,
34-24-214, and 34-24-217, Code of Alabama 1975; to give the
board authority over certain physical therapy professionals
licensed in other states.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. Sections 34-24-191, Relating to the Board of
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Physical Therapy; to amend Sections 34-24-191, 34-24-193,
34-24-194, 34-24-196, 34-24-210, 34-24-210.1, 34-24-211,
34-24-212, 34-24-213, 34-24-214, and 34-24-217, Code of
Alabama 1975; to give the board authority over certain
physical therapy professionals licensed in other states. ,
Code of Alabama 1975, are amended to read as follows:
"§34-24-191
(a) For the purposes of this article, the following
words and phrases shall have the meanings respectively
ascribed by this section:
(1) BOARD. The Board of Physical Therapy established by
Section 34-24-192.
(2) COMMISSION. The Physical Therapy Compact
Commission, the national administrative body whose membership
consists of all states that have enacted the interstate
compact.
(3) COMPACT PRIVILEGE. The authorization granted by a
remote state to allow a licensee from another state to
practice as a physical therapist or work as a physical
therapist assistant in the remote state under its laws and
rules. The practice of physical therapy occurs in the state
where the patient/client is located at the time of the
patient/client encounter.
(4) COMPACT PRIVILEGE HOLDER. An individual licensed as
a physical therapist or physical therapist assistant in a
compact state who has been granted a compact privilege by the
Commission.
(2)(5) FOREIGN EDUCATED PHYSICAL THERAPIST. A person
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trained or educated in the practice of physical therapy
outside of the United States or any of its territorial
possessions.
(3)(6) IMPAIRED. The inability of a physical therapy
licensee to practice physical therapy with reasonable skill
and safety to patients by reason of illness, inebriation,
excessive use of drugs, narcotics, alcohol, chemicals, or
other substances, or as a result of any physical or mental
condition.
(4)(9) PHYSICAL THERAPY. The treatment of a human being
by the use of exercise, massage, heat, cold, water, radiant
energy, electricity, or sound for the purpose of correcting or
alleviating any physical or mental condition or preventing the
development of any physical or mental disability, or the
performance of neuromuscular-skeletal tests and measurements
to determine the existence and extent of body malfunction;
provided, that physical therapy shall be practiced only upon
the referral of a physician licensed to practice medicine or
surgery, a dentist licensed to practice dentistry, a licensed
chiropractor, a licensed assistant to a physician acting
pursuant to a valid supervisory agreement, or a licensed
certified registered nurse practitioner in a collaborative
practice agreement with a licensed physician, except as
otherwise provided in this chapter. Physical therapy does not
include radiology or electrosurgery.
(5)(7) PHYSICAL THERAPIST. A person who practices
physical therapy.
(6)(11) PHYSICAL THERAPY LICENSEE. A physical therapist
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or physical therapist assistant who is licensed under this
article.
(7)(12) PHYSIOTHERAPIST. Synonymous with the term
"physical therapist," and the term shall be used to identify
only those persons licensed under this article. The physical
therapist may use the letters "P.T." or "R.P.T." in connection
with his or her name or place of business to denote his or her
registration hereunder.
(8)(8) PHYSICAL THERAPIST ASSISTANT. A person who
assists in the practice of physical therapy and whose
activities require an understanding of physical therapy but do
not require professional or advanced training in the
anatomical, biological, and physical sciences involved in the
practice of physical therapy. The physical therapist assistant
shall practice only under the direction of a licensed physical
therapist.
(9)(10) PHYSICAL THERAPY AIDE. A person trained under
the direction of a physical therapist who performs designated
and supervised routine tasks related to physical therapy
services.
(10)(13) RESTRICTED LICENSE.
a. For a physical therapist, a license on which the
board has placed restrictions or conditions, or both, as to
the scope of practice, place of practice, supervision of
practice, duration of licensed status, or type or condition of
patient to whom the physical therapist may provide services.
b. For a physical therapist assistant, a license on
which the board has placed any restriction.
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(b) Words importing the masculine gender shall include
the feminine."
"§34-24-193
(a) It shall be the duty of t The board to shall have
the following duties:
(1) To pass upon the qualifications of applicants for
licensing as physical therapists and licensing as or physical
therapist assistants ,.
(2) Toto conduct examinations ,.
(3) Toto issue licenses andand license renewals to
physical therapists and physical therapist assistants
qualifying under this article .
(4) Toand in a proper case to suspend or revoke as
necessary the license or compact privilege of such persons
individuals.
(b) The board mayshall adopt rules and regulations not
inconsistent with law as it may deem necessary for the
performance of its duties ;, however, the board shall not issue
adopt any rules or regulations that require a physical
therapist assistant to be within sight of a consulting
physical therapist or a physical therapist supervisor while
working under the direction of that physical therapist , or
issue adopt any rules, regulations, or issue any orders
inconsistent with Section 34-24-217(b). The board shall
maintain a listing of the name of every living physical
therapist and physical therapist assistant licensed or granted
a compact privilege in this state, his or her last known place
of business and last known place of residence, and the date
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and number of his or her license.
(c) The board shall compile a list of physical
therapists and physical therapist assistants licensed to
practice or granted a compact privilege in this state, and
such list shall be available to any person upon application to
the board and the payment of such chargea fee as may be fixed
by the board.
(d) The board may establish and collect a fee for the
issuance of a compact privilege.
(e) Subject to the provisions of Section 34-24-195, the
board shall have the power to may make such expenditures and
employ such personnel as it may deem necessary for the
administration of the provisions of this article.
(f) The board shall hire and establish the
responsibilities and salary of an executive director.
(b)(g) The board is hereby specifically authorized to
may establish and collect a fee for certifying to other boards
or entities that a licensee is a member in good standing with
the Alabama board.
(c)(h) The board may collect a fee from providers of
continuing education programs.
(d)(i) The board is hereby authorized to may discipline
its licensees and compact privilege holders by the adoption
and collection of administrative fines, not to exceed one
thousand dollars ($1,000) per violation, and it is further
authorized to may institute any legal proceedings necessary to
effect compliance with this chapter.
(e)(j)(1) The board shall provide for an impaired
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practitioner program beginning January 1, 2014.
(1)(2) The board shall promote the early
identification, intervention, treatment, and rehabilitation of
physical therapy licensees or compact privilege holders who
may be impaired by reason of illness, inebriation, excessive
use of drugs, narcotics, alcohol, chemicals, or other
substances, or as a result of any physical or mental
condition.
(2)(3) In order to carry out this obligation , the board
may contract with any nonprofit corporation or medical
professional association for the purpose of creating,
supporting, and maintaining a committee to be designated the
Alabama Physical Therapy Wellness Committee. The committee
shall be selected in a manner prescribed by the board. The
board may expend available funds as necessary to adequately
provide for the operational expenses of the committee
including, but not limited to, the actual cost of travel,
office overhead, and personnel expense. The funds provided by
the board for the purpose of operating expenses are not
subject to any provision of law requiring competitive bidding.
(3)(4) The board may enter into an agreement with a
nonprofit corporation or medical professional association for
the committee to undertake those functions and
responsibilities specified in the agreement, which may include
any or all of the following:
a. Contracting with providers of treatment programs.
b. Receiving and evaluating reports of suspected
impairment from any source.
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c. Intervening in cases of verified impairment.
d. Referring impaired physical therapy licensees or
compact privilege holders to treatment programs.
e. Monitoring the treatment and rehabilitation of
impaired physical therapy licensees or compact privilege
holders.
f. Providing post-treatment monitoring and support of
rehabilitated impaired physical therapy licensees or compact
privilege holders .
g. Performing other activities as agreed by the board
and the committee.
(4)(5) The committee shall develop procedures in
consultation with the board for all of the following:
a. Periodic reporting of statistical information
regarding impaired physical therapy licensee program activity.
b. Periodic disclosure and joint review of all
information the board deems appropriate regarding reports
received, contracts or investigations made, and the
disposition of each report. The committee may not disclose any
personally identifiable information except as otherwise
provided in this article.
(5)(6) Any individual appointed to serve as a member of
the committee and any auxiliary personnel, consultant,
attorney, or other volunteer or employee of the committee
taking any action authorized by this article, engaging in the
performance of any duties on behalf of the committee, or
participating in any administrative or judicial proceeding
resulting therefrom, in the performance and operation thereof,
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shall be immune from any liability, civil or criminal, that
might otherwise be incurred or imposed. Any nonprofit
corporation or medical professional association or other
entity that contracts with or receives funds from the board
for the creation, support, and operation of the committee, in
so doing, shall be immune from any liability, civil or
criminal, that might otherwise be incurred or imposed.
(6)(7) All information, interviews, reports,
statements, memoranda, or other documents furnished to or
produced by the committee and any findings, conclusions,
recommendations, or reports resulting from any investigation,
intervention, treatment, or rehabilitation, or other
proceeding of the committee is privileged and confidential.
All records and proceedings of the committee pertaining to an
impaired physical therapy licensee or compact privilege holder
are confidential and shall be used by the committee and the
members of the committee only in the exercise of the proper
function of the committee and shall not be public record nor
available for court subpoena or for discovery proceedings. In
the event of a breach of contract between the committee and
the impaired physical therapy licensee or compact privilege
holder, all records pertaining to the conduct determined to
cause the breach of contract shall be disclosed to the board
upon its request for disciplinary purposes only. Nothing
contained in this subdivision shall apply to records made in
the regular course of business of a physical therapy licensee
and any information, document, or record otherwise available
from an original source is not to be construed as immune from
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discovery or use in any civil proceeding merely because it is
presented or considered during proceedings of the committee.
(7)(8) The committee shall render an annual report to
the board concerning the operations and proceedings of the
committee for the preceding year. The committee shall report
to the board any physical therapy licensee or compact
privilege holder who in the opinion of the committee is unable
to perform physical therapy duties with reasonable skill and
safety to patients by reason of illness, inebriation,
excessive use of drugs, narcotics, alcohol, chemicals, or
other substances, or as a result of any physical or mental
condition when it appears that the physical therapy licensee
or compact privilege holder is currently in need of
intervention, treatment, or rehabilitation and the licensee
individual has failed or refused to participate in any program
of treatment or rehabilitation recommended by the committee. A
report to the Alabama Physical Therapy Wellness Committee
shall be deemed a report to the board for the purposes of any
mandated reporting of physical therapy licensee impairment of
a licensee or compact privilege holder otherwise provided for
by law.
(8)(9) If the board has reasonable cause to believe
that a physical therapy licensee or compact privilege holder
is impaired, the board may cause an evaluation of the physical
therapy licensee that individual to be conducted by the
committee for the purpose of determining if there is an
impairment. The committee shall report the findings of its
evaluation to the board."
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"§34-24-194
(a) Any person may file a complaint with the board
against any licensed physical therapist , or licensed physical
therapist assistant , or compact privilege holder in the state
charging the person with a violation of this article. The
complaint shall set forth specifications of charges in
sufficient detail to disclose to the accused fully and
completely the alleged acts of misconduct for which he or she
is charged. When a complaint is filed, the executive director
of the board shall mail a copy thereof to the accused by
registered mail at his or her address of record, with a
written notice of the time and place of a hearing of the
complaint, advising the accused that he or she may be present
in person and by counsel if he or she so desires to offer
testimony and evidence in his or her defense.
(b) The board may issue subpoenas and compel the
attendance of any witness or the production of any book,
writing, or other documentation in the possession, custody, or
control of any person. Any person refusing to produce any
book, writing, or other documentation or to appear to testify,
without legal excuse, at a hearing of the board, after having
been served with a subpoena issued by the board requiring the
person to appear, produce any book, writing, or other form of
documentation or testify at the hearing, shall be guilty of
contempt. Upon certification of the act of contempt by the
board to the judge of the circuit court in whose jurisdiction
the hearing is held or is to be held, the judge shall punish
the contempt as though committed before the judge. The accused
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party shall, on application to the board, be furnished by the
board with a subpoena for any witness in his or her behalf or
for the production of any book, writing, or other
documentation to be used in his or her behalf at the hearing.
(c) At the hearing, the board shall receive evidence
upon the subject matter under consideration and shall accord
the accused person individual a full and fair opportunity to
be heard in his or her defense. The board shall not be bound
by strict or technical rules of evidence, but shall consider
all evidence fully and fairly except, that all oral testimony
considered by the board must be under oath. If the board is
convinced that the licensed physical therapist or the licensed
physical therapist assistant licensee or compact privilege
holder has violated this article, it may revoke his or her
license.
(d) The action of the board in revoking or refusing to
issue a license or compact privilege may be reviewed by the
Circuit Court of Montgomery County by a writ of mandamus,
accompanied by a bond to be approved by the court, to
determine whether the board acted arbitrarily, capriciously,
or illegally. The review procedure provided in this subsection
shall not suspend the action of the board in the revocation or
refusal of a license.
(e) The board may restrict a license or compact
privilege and may require the licensee a licensee or compact
privilege holder to report regularly to the board on matters
related to the reasons for the restricted license."
"§34-24-196
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(a) Each violation of Section 34-24-210 shall be
punishable by a fine of not less than one hundred dollars
($100)$100 nor more than five hundred dollars ($500) $500, or
by imprisonment for not less than 30 days nor more than 90
days, or both.
(b) Any person individual who knowingly makes a false
statement in his or her application for registration or a
license or compact privilege under this article , or in
response to any inquiry by the board , shall be fined not less
than one hundred dollars ($100) $100 nor more than five hundred
dollars ($500)$500 or by imprisonment for not less than 30
days nor more than 90 days, or both."
"§34-24-210
(a) License or compact privilege required. No person
individual shall practice nor hold himself or herself out to
be able to practice physical therapy in this state unless he
or she is licensed or has been granted a compact privilege in
accordance with this article chapter.
(b) License or compact privilege required. No person
individual shall act nor hold himself or herself out as being
able to act as a physical therapist assistant unless he or she
is licensed or has been granted a compact privilege in
accordance with this article.
(c) Other healing arts not affected. Nothing in this
article shall prohibit any person individual licensed to
practice any other of the healing arts in this state under any
other law from engaging in the practice for which he or she is
licensed."
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"§34-24-210.1
(a) Without prescription or referral, a licensed
physical therapist or compact privilege holder may perform an
initial evaluation or consultation of a screening nature to
determine the need for physical therapy and may perform the
physical therapy and other services provided in subdivisions
(1) to (5), inclusive, of subsection (b)(1) through (5).
Implementation of physical therapy shall otherwise be based on
the referral of a person licensed to practice medicine,
surgery, dentistry, chiropractic, licensed assistant to a
physician acting pursuant to a valid supervising agreement, or
a licensed certified registered nurse practitioner in a valid
collaborative practice agreement with a licensed physician.
(b) The physical therapy and other services referred to
in subsection (a), which may be performed without prescription
or referral, include and are limited to the following:
(1) To a child with a diagnosed developmental
disability pursuant to the plan of care for the child.
(2) To a patient of a home health care agency pursuant
to the plan of care for the patient.
(3) To a patient in a nursing home pursuant to the plan
of care for the patient.
(4) Related to conditioning or to providing education
or activities in a wellness setting for the purpose of injury
prevention, reduction of stress, or promotion of fitness.
(5) To an individual for a previously diagnosed
condition or conditions for which physical therapy services
are appropriate after informing the health care provider
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rendering the diagnosis. The diagnosis shall have been made
within the immediately preceding 90 days. The physical
therapist shall provide the health care provider who rendered
the diagnosis with a plan of care for physical therapy
services within the first 15 days of physical therapy
intervention."
"§34-24-211
(a) An applicant for licensure as a physical therapist
or for a license as a physical therapist assistant shall file
a written application on forms provided by the board together
with a fee as set by the board, no part of which shall be
returnedrefundable. The applicant shall present evidence
satisfactory to the board that he or she is of good moral
character and has completed a program of physical therapy
education appropriate for training a physical therapist or a
physical therapist assistant , as the case may be, approved by
the board or a nationally recognized accrediting agency. Each
applicant shall also be a citizen of the United States or, if
not a citizen of the United States, a person who is legally
present in the United States with appropriate documentation
from the federal government.
(b) On and after June 1, 2021, an applicant for
licensure as a physical therapist or a physical therapist
assistant shall submit to the board, on a form sworn to by the
applicant, his or her name, date of birth, Social Security
number, and two complete sets of fingerprints for completion
of a criminal history background check. The board shall submit
the fingerprints to the Alabama State Law Enforcement Agency
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for a state criminal history background check. The
fingerprints shall be forwarded by the agency to the Federal
Bureau of Investigation for a national criminal history
background check. Costs associated with conducting a criminal
history background check shall be paid by the applicant."
"§34-24-212
(a) Generally. The board shall give an appropriate
physical therapy examination and a jurisprudence examination
to every applicant who complies with Section 34-24-211 and who
pays the fee prescribed for the examination. Examinations
shall be held within the state at least once each year, at
such times and places as the board determines. A practical or
demonstration examination may be required at the discretion of
the board when an applicant is retaking a written examination
after previously having failed such an examination.
(b) Physical therapist. The physical therapy
examination given applicants for licensure as a physical
therapist shall be a written examination , approved by the
board. Such examination shall to test the applicant's
knowledge of the basic and clinical sciences as they relate to
the practice of physical therapy, physical therapy theory and
procedures, and such other subjects as the board may deem
useful to test the applicant's fitness to practice physical
therapy. The board shall also administer a jurisprudence
examination to applicants for licensure as a physical
therapist, which shall be a written examination approved by
the board to test the applicant's knowledge of the laws and
rules of the State of Alabama as they relate to the practice
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of physical therapy and such other subjects as the board may
deem useful to test the applicant's knowledge of applicable
law. A practical or demonstration examination may be required
if so determined by the board. The board, in its discretion,
may waive the requirement for a jurisprudence examination.
(c) Physical therapist assistant. The physical therapy
examination given applicants for licensure as physical
therapist assistant willshall be a written examination ,
approved by the board . Such examination shall to test the
applicant's knowledge of the basic and clinical sciences as
they relate to the practice of physical therapy, physical
therapy theory and procedures, and such other subjects as the
board may deem useful to test the applicant's fitness to act
as a physical therapist assistant. The board shall also
administer a jurisprudence examination to applicants for
licensure as a physical therapist assistant, which shall be a
written examination approved by the board to test the
applicant's knowledge of the laws and rules of the State of
Alabama as they relate to the practice of physical therapy and
such other subjects as the board may deem useful to test the
applicant's knowledge of applicable law. A practical or
demonstration examination may be required if so determined by
the board. The board, in its discretion, may waive the
requirement for a jurisprudence examination.
(d) Foreign educated physical therapist. Any foreign
educated physical therapist who plans to practice in the state
must have their educational credentials evaluated by a
recognized educational evaluation agency and have that agency
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send their report directly to the board. The board will shall
determine the acceptability of equivalency in educational
preparation. If the board rules determines the education to be
acceptable, the routine application process will be followed.
(e) Compact privilege applicants. Individuals
purchasing a compact privilege for the State of Alabama shall
pass the jurisprudence examination required of licensed
physical therapists of licensed physical therapist assistants
before the privilege is issued by the Commission.
(f) By January 1, 2024, the board shall adopt rules to
implement this chapter. "
"§34-24-213
The board shall issue a license to each applicant who
passes the appropriate examination for licensure as a physical
therapist or licensure as a physical therapist assistant in
accordance with standards fixed by it and who is not
disqualified to receive a license under the provisions of
Section 34-24-217."
"§34-24-214
On Upon payment to the board of a fee set by the board
and the submission of a written application on forms provided
by the board, the board shall issue a license without
examination to:
(1) A person An individual who is qualified within the
meaning of this article as a physical therapist by another
state of the United States of America, its possessions, or the
District of Columbia, if the requirements for licensing or
registration in such state, possession, or district were at
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the date of his or her licensing or registration by such that
state substantially equal to the requirement for the initial
licensing of persons individuals practicing physical therapy
when this article became effective, August 20, 1965, or for
licensing by examination prepared by the professional
examining service as set forth in thethis article and any
additional requirements prescribed by the board.
(2) A person An individual who is qualified within the
meaning of this article as a physical therapist assistant by
another state of the United States of America, its
possessions, or the District of Columbia, if the requirements
for licensing in such state, possession, or district were at
the date of his or her licensing by such that state
substantially equal to the requirements set forth in this
article."
"§34-24-217
(a) The board shall refuse to issue a license to any
person individual and, after notice and hearing in accordance
with its regulations and rules, shall suspend or revoke the
license or compact privilege of any person individual who has
done any of the following :
(1) Practiced physical therapy other than upon the
referral of a physician licensed to practice medicine or
surgery, a dentist licensed to practice dentistry, a licensed
chiropractor, a licensed assistant to a physician acting
pursuant to a valid supervisory agreement, or a licensed
certified registered nurse practitioner in a valid
collaborative practice agreement with a licensed physician,
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except as provided in Section 34-24-210.1, or practiced as a
physical therapist assistant other than under the direction of
a licensed physical therapist ;.
(2) Used drugs or intoxicating liquors alcoholic
beverages to an extent which affects his or her professional
competency;.
(3) Been convicted of a felony or of a crime involving
moral turpitude;.
(4) Obtained or attempted to obtain a license or
compact privilege by fraud or deception ;.
(5) Been grossly negligent in the practice of physical
therapy or in acting as a physical therapist assistant ;.
(6) Been adjudged mentally incompetent by a court of
competent jurisdiction ;.
(7) Been guilty of conduct unbecoming a person licensed
as a physical therapist or licensed as a physical therapist
assistantlicensee or compact privilege holder or of conduct
detrimental to the best interest of the public ;.
(8) Been convicted of violating any state or federal
narcotic law;.
(9) Treated or undertaken to treat human ailments
otherwise than by physical therapy as defined in this
article;.
(10) Advertised unethically according to standards as
set by the board ; or.
(11) Failed or refused to obey any lawful order or
regulation of the board.
(b) For purposes of this article and notwithstanding
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any other provision of this article or any rules or
regulations adopted by the board, any person licensedlicensee
or compact privilege holder under this article who has a bona
fide employment or independent contract with a physician, a
physician group, or an entity with which a physician has a
legal compensation arrangement, including fair market value
wages, compensation, benefits, or rents for services or
property provided, or in which a physician has a legal
financial interest, including any direct or indirect ownership
or investment interest, shall not be deemed to be engaged in
conduct unbecoming a person licensedlicensee or compact
privilege holder under this article, or to be engaged in
conduct detrimental to the best interest of the public, or to
be in violation of any other provision of this article by
virtue of any of the above relationships, and shall not be
subject to licensure or compact privilege denial, suspension,
revocation, or any other disciplinary action or penalty under
this article: (1) by virtue of such employment or contract, or
(2) by virtue of the provision of physical therapy services
pursuant to a referral from the employing or contracting
physician, or from a physician with a legal compensation
arrangement with or a legal financial interest in the
employing or contracting physician group."
Section 2. This act shall become effective on the first
day of the third month following its passage and approval by
the Governor, or its otherwise becoming law.
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