Part 1 General Information
Section 1.1 The Purpose of Licensure
The Director of the Office of Professional Regulation (referred
to as "the Director" in this rule) is responsible, pursuant to Vermont law, for
licensing physical therapists and physical therapist assistants in order to
protect the public health, safety and welfare. The Director's responsibilities
include setting standards for issuing licenses, regulating the practice of
physical therapy and enforcing Vermont's professional conduct
laws.
Section 1.2 Laws that
Govern Licensure
Chapter 38, Title 26 V.S.A. contains the enabling statutes that
govern professional physical therapy practice. Among the laws governing the
regulation of professional practice are: the Professional Regulation law ( 3
V.S.A. §§ 121-131); the Administrative Procedure Act ( 3 V.S.A.
§§ 801-849); the Open Meeting law ( 1 V.S.A. §§ 310-314);
and the Access to Public Records law ( 1 V.S.A. §§ 315-320). These
laws set forth the rights of an applicant, license holder or member of the
public. The complete "Vermont Statutes" are at www.leg.state.vt.us . These rules implement
and interpret the statutory laws governing the profession. Law libraries and
the offices of most Town Clerks maintain volumes of the Vermont Statutes
Annotated. The Office posts the most recent statutes and administrative rules
governing the practice of the profession at www.vtprofessionals.org and
http://vtprofessionals.org/oprl/p_therapists/ .
Section 1.3 Business Address
The Board's mailing address is the Office of the Secretary of
State, Office of Professional Regulation, Director, National Life Bldg., North,
FL2, Montpelier, VT 05620-3402 (the "Office"). Copies of these rules and more
information about the profession and its requirements can be obtained by
contacting the Office at 1-802-828-2363. This information may also be obtained
from the Office's web site at http://vtprofessionals.org/.
Part 2
Information for Applicants
Section 2.1
Definitions
(a) "The Act" means The Physical
Therapists Act, 26 Vermont Statutes Annotated, Chapter 38.
(b) "The Office" means the Office of
Professional Regulation in the Office of the Secretary of State.
(c) "V.S.A." means Vermont Statutes
Annotated: for example
26 V.S.A. §
2081 means section
2081 of Title
26 of the Vermont Statutes Annotated.
(d) "Physical therapy" is defined in
26 V.S.A. §
2081a(6).
(e) "Practice of physical therapy" is defined
in
26 V.S.A. §
2081a(8).
(f) "Physical therapist" is defined in
26 V.S.A. §
2081a(4).
(g) "Physical therapist assistant" is defined
in
26 V.S.A. §
2081a(5).
(h) "Physical therapy aide" is defined in
26 V.S.A. §
2081a(7).
(i) "General Supervision" means the
supervising physical therapist must be available at least by
telecommunications.
(j) "Direct
Supervision" means the supervising physical therapist must be on-site and
present in the department facility where the services are provided, is
immediately available to the person being supervised, and maintains continued
involvement in the aspects of each treatment session which are beyond the scope
of practice of a physical therapist assistant or aide.
(k) "Unprofessional Conduct" is defined by
26 V.S.A. §
2121 and 3 V.S.A. § 129a.
(l) "Continuing competence" refers to the
licensee's obligation to acquire and maintain the minimum necessary education,
training, experience and/or expertise to practice with reasonable skill and
safety and within the essential standards of acceptable and prevailing
practice. It also involves the process of maintaining and documenting
competence through ongoing self-assessment, development and implementation of a
personal learning plan and subsequent reassessment.
(m) "Distance Consultation" is defined in
26 V.S.A. §
2081a(3).
Section 2.2 Where to Get An
Application
An application for licensure or more information about the
application process may be found on the Office's web site or by contacting the
Office at the address found in Rule 1.3 above. Applicants must submit a
completed application with all supporting documentation and fee to the Office.
Supporting documentation may include, but is not limited to, evidence of
required education, supervised practice, examination results, evidence of a
license in any and all jurisdictions and their respective licensing standards,
or other licensing standards. An initial license issued to an applicant within
90 days of the current expiration date will be issued through the next full
license period. Applicants issued an initial license more than 90 days prior to
the renewal expiration date will be required to renew and pay the renewal
fee.
Section 2.3
Qualifications for Licensure As a Physical Therapist
(a) Physical Therapist Qualifications. An
applicant for a license as a physical therapist shall:
(1) be a graduate of a professional physical
therapy education program accredited by the Commission of Accreditation in
Physical Therapy Education (CAPTE), or accredited by a national accreditation
agency approved by the Director;
(2) pass the Federation of State Boards of
Physical Therapy (FSBPT) examination, or an equivalent examination approved by
the Director; and
(3) pass an
approved English proficiency exam if the applicant's native language is not
English.
(b) Foreign
Trained Physical Therapist Qualifications. An applicant who has been educated
outside the United States and graduated from an education program not
accredited by a national accreditation agency approved by the Director shall:
(1) undergo a credentials evaluation which
demonstrates the candidate has met uniform criteria for educational
requirements. The Office will provide applicants with a current list of
acceptable services. Applicants are responsible for the costs of this
evaluation; and
(2) pass an
approved English proficiency examination if the applicant's native language is
not English; and
(3) pass the FSBPT
examination, or an equivalent examination approved by the Director.
Section 2.4
Qualifications for Licensure as a Physical Therapist Assistant
An applicant for licensure as a physical therapist assistant
shall:
(a) be a graduate of a
professional physical therapist assistant education program accredited by the
Commission of Accreditation in Physical Therapy Education (CAPTE), or
accredited by a national accreditation agency approved by the
Director;
(b) pass an approved
English proficiency examination if the applicant's native language is not
English; and
(c) pass the
Federation of State Boards of Physical Therapy (FSBPT) examination, or an
equivalent examination approved by the Director.
Section 2.5 Licensure by Endorsement
An applicant licensed in good standing in another jurisdiction
may be eligible for a license in Vermont if the requirements for licensure in
the other jurisdiction are substantially equivalent to those of this
state.
Section 2.6 How to
Get a Temporary License
(a) A temporary
license to practice, for a period not to exceed 90 days, may be issued to a
physical therapist or physical therapist assistant currently licensed in
another jurisdiction who has applied for licensure by endorsement in
Vermont.
(b) A temporary license
allows an applicant to practice while the application is being considered. An
applicant for temporary license must submit the application, proof of other
state licensure, verification of supervision, and fee.
(c) Practice of a PTA applicant with a
temporary license must be under the daily, direct, on-site supervision of a
physical therapist currently licensed in Vermont. Practice of a PT applicant
with a temporary license must be under the daily, general supervision of a
physical therapist currently licensed in Vermont.
(d) A temporary license shall not be renewed,
and becomes null and void upon the issuance of a Vermont license, or upon the
denial of the application.
Section
2.7 Right to a Written Decision and Appeal
An applicant will be notified in writing whether he or she is
qualified to be licensed. If the Director denies an applicant a license, the
Director shall give the applicant specific reasons and inform the applicant of
the right to request a hearing for review of this decision. The hearing will be
held by an administrative law officer appointed by the Secretary of State.
After giving the applicant and the Director an opportunity to present the
application and any additional information, the administrative law officer
shall affirm, reverse, remand or modify the preliminary decision. The
administrative law officer's decision may be appealed to Washington Superior
Court.
Part 3
Information for Physical Therapists and PT Assistants
Section 3.1 Renewing a License Biennially
Licenses renew on a fixed biennial schedule, September 30 [th
]of the even numbered years, and must be renewed before they expire. Before the
expiration date, the office will mail a renewal notice to the licensee.
Licensees must pay a renewal fee, and must have completed at least 24 hours of
continuing competence activities for physical therapists and 16 hours of
continuing competence activities for physical therapist assistants during the
two years immediately preceding their respective renewal.
Section 3.2 Reinstatement of a License that
has been Expired for Less than Five Years
Licenses that are expired may be reinstated upon meeting all
requirements under 3.1 above, and payment of the late renewal
penalty.
Section 3.3
Reinstatement of a License that has been Expired for More than Five Years
Pursuant to
26 V.S.A. §
2108, if a license has been expired for more
than five consecutive years, that person may have his or her license reinstated
upon payment of all applicable renewal, late penalty, and reinstatement fees,
and demonstration of competence to practice by one or more of the following, as
determined by the Director:
(a)
acceptable "practice" under § 2108(1) means practice for at least one year
containing 1200 work hours within that year under a supervisor licensed in
Vermont as a physical therapist who has been practicing clinically for a period
of at least one year prior thereto. If there is more than one individual
supervising the person seeking reinstatement, only one supervisor at a time
shall bear responsibility for the supervisee. Supervision must be direct
supervision for at least 80% of the 1200 total hours. The remaining 20% may be
performed under general supervision. After completion of the 1200 work hours, a
letter shall be submitted to the Director from the applicant's most recent
supervisor indicating supervisory approval and that the applicant has the
requisite evaluation, treatment, management and professional interaction skills
to be reinstated.
(b) completion of
a "remedial course" and "continuing competence requirements" under §
2108(2) & (3), meaning 24 Continuing Competency Units ("CCUs") for PTs plus
10 CCUs per year for the period greater than 5 years in which the license has
been expired. For PTAs, § 2108(2) & (3) means 16 CCUs plus 5 CCUs per
year for the period greater than 5 years in which the license has been
expired.
(c)
§ 2108(4) &
(5) are not further defined by these Rules.
Section 3.4 Supervision Standards
(a) Physical therapist assistants shall work
under a PT's supervision. The supervising physical therapist shall make regular
visits at reasonable frequency to the place where the assistant is providing
service and adjust the plan of care as needed. The physical therapist shall
document the visits in the patient's medical record. The physical therapist
shall re-evaluate and render treatment to a patient at least every fifth visit
or every 30 days, whichever occurs first, or if the treatment is performed more
than once a day, at least once per week. The PT shall communicate all plan of
care changes to the PTA.
(b) A
physical therapist or a physical therapist assistant practicing under a
temporary license shall have daily, direct, on-site supervision by a licensed
physical therapist for the duration of the temporary license. The supervising
physical therapist shall be available for advice and intervention, and shall
sign all notes entered in the patient's medical record.
(c) Physical therapy aides must have direct
on-site supervision by a licensed physical therapist. The supervising physical
therapist must:
(1) be continuously on-site
and present in the department or facility where the aide is performing
supervised tasks that do not require the knowledge and skill of a licensed
physical therapist or licensed physical therapist assistant;
(2) be immediately available to assist the
person being supervised in the tasks being performed; and
(3) maintain continued involvement in
appropriate aspects of each treatment session in which a component of treatment
is assigned to an aide.
(d) Supervisor to supervisee ratio:
(1) All PTAs: The supervising physical
therapist may not supervise more than four physical therapist assistants at one
time; or
(2) Non-PTAs or Mixed
Group: The supervising physical therapist may not supervise more than three
persons at one time, if said three person group includes aides, physical
therapist students, physical therapist assistant students, and/or temporary
licensees.
(e) The
following physical therapy services may be performed only by, and are the sole
responsibility of, the supervising physical therapist:
(1) Interpretation of referrals;
(2) Initial examination, problem
identification, and diagnosis for physical therapy;
(3) Development or modification of a plan of
care that is based on the initial examination and includes the goals for
physical therapy intervention;
(4)
Determination of which tasks require the expertise and decision-making capacity
of the physical therapist and must be personally rendered by the physical
therapist, and which tasks may be assigned;
(5) Assurance of the qualifications of all
physical therapist assistants and physical therapy aides to perform assigned
tasks through written documentation of their education or training that is
maintained and available at all times;
(6) Assignment and instruction of the
services to be rendered by the physical therapist assistant, or aide, including
but not limited to, specific treatment program, precautions, special problems
and contraindicated procedures;
(7)
Timely review of documentation, re-examination of the patient and revision of
the plan of care when indicated; and
(8) Establishment of a discharge plan and
documentation of discharge summary or status.
(f) All supervisors shall be in good standing
with an unencumbered license during the period of supervision.
Section 3.5 Complaint Procedure
The Office has a procedure for receiving, investigating and
acting on complaints of unprofessional conduct. Copies of the complaint form
and the procedure are available on the web at: www.vtprofessionals.org or by
contacting the Office.
Section
3.6 Disciplinary Actions
Hearings on charges of unprofessional conduct are held before
an administrative law officer appointed by the Secretary of State. A party
aggrieved by a decision of an administrative law officer may, within 30 days of
the decision, appeal by filing a written notice with the Director. The appeal
shall be decided by Washington Superior Court on the basis of the record before
the administrative law officer.
Part 4 Continuing Competence
Section 4.1 Continuing Competency Activities
Required
(a) A physical therapist licensee
must document completion of a total of 24 CCUs during the two-year licensing
period preceding renewal. A physical therapist assistant licensee must document
completion of 16 CCUs during the two-year licensing period preceding renewal.
This provision shall apply to all renewal periods.
(b) CCUs must be obtained in subjects related
to either the professional practice of physical therapy or patient/client
management.
(1) The professional practice of
physical therapy includes but is not limited to professional accountability,
professional behavior and professional development.
(2) Patient/client management includes but is
not limited to examination, evaluation and diagnosis and prognosis; plan of
care; implementation; education; and discharge.
Section 4.2 Standards for Continuing
Competence Activities
(a) They have
intellectual or practical content based on best available scientific evidence
and the primary objective is to increase the participant's professional
competence and proficiency as a licensee.
(b) They constitute learning experiences
dealing with matters directly related to the practice of physical therapy or
patient welfare.
(c) Live
instruction mechanically or electronically recorded, reproduced or transmitted
material, other electronic media, or a computer website accessed via internet
may be used.
(d) Continuing
competence materials shall be prepared, and activities conducted, by an
individual or group qualified by practical or academic experience in a setting
physically suitable to the educational activity of the program or clinical
experience and, with sufficient space.
(e) Written materials must be distributed to
all attendees at or before the time a course is presented. A syllabus/outline,
learning objectives, and reference list with citations for pertinent evidence
based practice information shall be provided.
(f) For activities that are directed to more
than one discipline, or are directed primarily to another health care
discipline, a determination by OPR would be made regarding whether the content
of the activity would sufficiently enhance physical therapy knowledge and
skills or aid in the practice of physical therapy.
Section 4.3 Approval of Providers
Providers must adhere to the following requirements:
(a) Topics and subject matter for each course
shall be pertinent to the practice of physical therapy.
(b) Instructors for each course shall be
competent in the subject matter and shall be qualified by appropriate
education, training, experience, and scope of practice or licensure.
(c) Each course shall have a syllabus that
includes learning objectives, reference list and either a schedule, for courses
offered in-person, or an outline, for courses offered online.
(d) Each course shall have written
educational goals and specific learning objectives which are measurable and
which serve as a basis for an evaluation of the effectiveness of the
course.
(e) Each participant shall
be given the opportunity to evaluate each course and offer feedback to the
approved provider. The approved provider shall consider any such evaluations
for the purpose of updating or revising courses.
(f) Each approved provider shall maintain
records regarding course content and licensee attendance for a minimum of two
years.
(g) Each approved provider
shall provide a certificate of completion to attendees.
Section 4.4 Approval for Continuing
Competence Activities
(a) The Director shall
approve a provider if the Director is satisfied that the provider's activities
meet the standards set forth in Rule 4.3.
(b) Once a provider is approved, the
continuing competence activity sponsored by that provider is approved for
credit and no application to the Director must be made for approval. The Office
shall maintain a PT CCU Table that sets forth the specific units/credits,
documentation requirements, and the unit limitations for activities sponsored
by an approved provider, as well as a list of approved providers. The CCU Table
for Activities Sponsored by Approved Providers, as well as the List of Approved
Providers, may be obtained from the Office's web site at
http://vtprofessionals.org/.
(c) The Office shall also maintain
a PT CCU Table that sets forth a list of continuing competence activities,
their corresponding units/credits, documentation requirements, and unit
limitations for activities that are not sponsored by an approved provider. The
CCU Table for Activities Not Sponsored by Approved Providers may be obtained
from the Office's web site at
http://vtprofessionals.org/. Any
licensee may seek individual approval of an activity not sponsored by an
approved provider by applying to the Office at anytime but no later than 90
days before licensing renewal.
(d)
The requirements related to maintaining records and the random audit provision
set forth in Rule
4.5 apply to both activities
sponsored by approved providers and activities not sponsored by approved
providers.
Section 4.5
Evidence of Compliance
(a) Each licensee shall
keep and maintain records showing that each course or activity for which credit
is claimed has been completed.
(b)
The Office shall perform a random audit of licensees' continuing competency
activity requirements. An Audit Notice will be sent to the audited licensees.
Within 30 days from receipt of an Audit Notice from the Office, the licensee
must furnish the Office with the documentary evidence showing completion of the
CCUs required for the audited reporting period.
(c) Each licensee shall retain such
documentation for a period of five years after the course or activity
concludes.
