Current through Register Vol. 47, No. 17, September 10, 2024
A.
Supervision and/or Direction of Persons Not Licensed as a Physical
Therapist
This Rule is promulgated pursuant to sections
12-20-204,
12-185-106(2)(b),
and 12-285-116(1),
C.R.S., to clarify supervision and/or direction provisions for persons not
licensed as a physical therapist, which include a physical therapist assistant,
certified nurse aide, provisional physical therapist, physical therapy aide,
athletic trainer, massage therapist, student physical therapist, or student
physical therapist assistant. A therapist of record must be established if
physical therapy services are being provided by any of the persons not licensed
as a physical therapist listed above. A physical therapist who performs an
initial examination and evaluation, and develops an appropriate plan of care,
shall be the therapist of record for that patient, unless that physical
therapist transfers the responsibility to another licensed physical therapist,
or a provisional physical therapist under supervision of a physical therapist
or a student physical therapist under supervision of a clinical instructor
actively licensed by the State of Colorado as a physical therapist, experienced
and skilled enough to take on such responsibility through documentation in the
patient records, including the transfer of the procedures and responsibilities
provided in this Rule.
1. Delegation
of duties is determined by the education and training of the individual being
delegated responsibilities as allowed pursuant to Article
285 of Title
12, C.R.S., and these Board Rules. If a
task cannot be delegated, then a physical therapist must personally attend to
the task in-person and not through a patient chart review.
a. A physical therapist shall determine if
the individual not licensed as a physical therapist who is being delegated
responsibility has the appropriate education, training, and/or experience to
perform duties as allowed by statute and/or rule.
b. A physical therapist shall rely on the
individual's expertise and clinical reasoning when determining the most
appropriate utilization of a person not licensed as a physical therapist to
provide for the delivery of service that is safe, effective, and
efficient.
c. A physical therapist
must personally perform and cannot delegate to a person not licensed as a
physical therapist the initial clinical contact, interpretation of referrals,
initial examinations and evaluations, diagnosis and prognosis, development and
modification of plans of care, determination of discharge criteria, and
supervision of physical therapy services rendered to the patient/client, except
for a provisional physical therapist under supervision of a physical therapist
or a student physical therapist under supervision of a clinical instructor
actively licensed as a physical therapist, experienced and skilled enough to
take on such responsibility.
d. A
physical therapist shall not delegate wound debridement to a person not
licensed as a physical therapist, except to a provisional physical therapist
under supervision of a physical therapist or a student physical therapist under
supervision of a clinical instructor actively licensed as a physical therapist,
experienced and skilled enough to take on such responsibility, but may delegate
non-selective wound care to a physical therapist assistant.
2. A physical therapist is
responsible for providing adequate or proper supervision and/or direction to a
person not licensed as a physical therapist pursuant to section
12-285-120(1)(e),
C.R.S.
a. A physical therapist may supervise
up to four individuals at one time who are not physical therapists to assist in
the physical therapist's clinical practice. This limit does not include student
physical therapists and student physical therapist assistants supervised by a
physical therapist for educational purposes.
b. A physical therapist shall regularly
evaluate and observe the performance of any person under the individual's
supervision and/or direction to ensure that all physical therapy services
rendered meet the standard of care for delegation to be continued.
3. Pursuant to the definitions
provided in Rule 1.4 , a physical therapist shall provide:
a. General supervision to a physical
therapist assistant. However, pursuant to section
12-285-116(2),
C.R.S., direct supervision is required if the physical therapist assistant is
administering topical and aerosol medications when they are consistent within
the scope of physical therapy practice and when any such medication is
prescribed by a licensed health care practitioner who is authorized to
prescribe such medication. A prescription or order shall be required for each
such administration within a plan of care.
b. General supervision to a certified nurse
aide in a home health care setting, as part of a physical therapist plan of
care.
c. Direct supervision to a
provisional physical therapist. In addition, the supervising physical therapist
must perform records review and co-signature of notes.
d. Direct supervision to a physical therapy
aide.
e. Direct supervision to an
athletic trainer providing athletic training within a physical therapist plan
of care.
f. Direct supervision to a
massage therapist providing massage therapy within a physical therapist plan of
care.
g. Immediate supervision to a
student physical therapist or a student physical therapist assistant.
B.
Supervision of
Physical Therapist Assistants and Physical Therapy Aides
This Rule is promulgated pursuant to sections
12-20-204 and
12-285-106(2)(b),
C.R.S., to specify supervisory provisions required by section
12-285-116(1),
C.R.S., for physical therapist assistants certified in accordance with section
12-285-204, C.R.S., and physical
therapy aides. This Rule applies to all physical therapists who utilize
physical therapist assistants and/or aides in their practice. The physical
therapist shall establish a patient relationship with the client prior to any
delegation that has been deemed as allowable and appropriate pursuant to
Article 285, Title
12, C.R.S., and Board Rules.
1. Physical Therapist Assistants
a. For the purposes of these Rules, physical
therapists may supervise physical therapist assistants performing physical
therapy services as defined in section
12-285-104(6),
C.R.S., and pursuant to Rule 1.4 and Rule 1.5 as determined by the physical
therapist of record, except for interventions or services that are otherwise
prohibited by law.
(1) Physical therapist
assistants may perform non-selective wound care, but may not perform wound
debridement.
(2) Physical therapist
assistants may not perform dry needling.
(3) Physical therapist assistants may not
perform joint mobilization, unless the supervising physical therapist has
determined that the physical therapist assistant has the necessary degree of
education, training and skill for safe patient care. Entry-level education is
inadequate; additional formal continuing education (psychomotor and didactic)
is required to perform joint mobilization. Thrust, high-velocity techniques are
not within the scope of the physical therapist assistants' practice.
(4) Physical therapist assistants may not
perform or assist a physical therapist in providing physical therapy of
animals.
b. The
following condition must be met before a physical therapist can utilize a
physical therapist assistant: a physical therapist must be designated and
recorded in the patient/client records as responsible for supervising the care
and interventions provided by the physical therapist assistant. The designated
physical therapist must consistently provide for the planning, evaluating, and
supervising of all care rendered to the patient/client.
c. The physical therapist is responsible for
the performance of all services performed by the physical therapist assistant.
This responsibility requires the physical therapist to assure services are
performed with a degree of care and skill appropriate to the physical therapist
assistant's education and training.
d. The physical therapist assumes
accountability for the acts delegated to or performed by a physical therapist
assistant. Before delegating performance of physical therapy services to a
physical therapist assistant working under general supervision, as defined in
Rule 1.4 , the supervising physical therapist shall ensure that the physical
therapist assistant is qualified by education and training to perform the
physical therapy services in a safe, effective, and efficient manner.
e. A physical therapist assistant may not
supervise other personnel in the provision of physical therapy services to a
patient.
f. A physical therapist
assistant under the general supervision, as defined in Rule 1.4 , of a physical
therapist may act as a clinical instructor for a physical therapist assistant
student. However, immediate supervision, as defined in Rule 1.4 , of the
student physical therapist assistant by the physical therapist is required if
the physical therapist assistant student is providing physical therapy
services.
2. Physical
Therapy Aides
a. All individuals not licensed
as a physical therapist, not licensed as a provisional physical therapist, not
certified as a physical therapist assistant, not authorized to practice as a
student physical therapist or physical therapist assistant, and not otherwise
regulated as a health care professional, shall be considered an aide for the
purposes of this Rule.
b. A
physical therapy aide may participate in limited designated tasks, as assigned
by a physical therapist. The supervising physical therapist must participate in
patient care on each date of service when a physical therapy aide is involved
in care. Supervision must also occur in compliance with Rule 1.4(A) and Rule
1.5(A).
c. As to recordkeeping, a
physical therapy aide may participate only in basic data recording in the
medical record.
d. Wound
care/debridement, dry needling, administration of medications, joint
mobilization, and treatment on animals shall not be delegated to a physical
therapy aide. The supervising physical therapist shall ensure that the physical
therapy aide is qualified by education and training to participate in limited
designated tasks as assigned by the physical therapist.
C.
Authorized Practice of
Physical Therapy by a Person Not Licensed In Colorado
This Rule is promulgated pursuant to sections
12-20-204 and
12-285-106(2)(b),
C.R.S., to clarify the following conditions under which a physical therapist
not licensed in Colorado may practice for a temporary period of time pursuant
to section
12-285-117(1)(e),
C.R.S., which allows the practice of physical therapy in Colorado for no more
than four consecutive weeks or more than once in any twelvemonth period by a
physical therapist licensed, certified, or registered in another state or
country when providing services in the absence of a physical therapist licensed
in Colorado. This provision is not available for a person applying for a
license in Colorado whose application is pending review and potential approval.
Additional requirements for eligibility including the following:
1. The entity wishing to employ or engage the
services of a visiting, physical therapist who is not otherwise licensed in
Colorado must notify the Board at least one week prior to the start date and
must document the need for employing or engaging the services of a visiting
physical therapist.
2. The visiting
physical therapist must possess a current and active license, certification, or
registration in good standing in another state or country and provide a copy of
the license, certification, or registration to the Board at least one week
prior to practicing in Colorado.
3.
The visiting physical therapist must have been engaged in the active, clinical
practice of physical therapy for two of the last five years in order to be
eligible.
D.
Licensure by Examination for Physical Therapists
This Rule is promulgated pursuant to sections
12-20-204 and
12-285-106(2)(b),
C.R.S., to delineate the requirements for licensure by examination for physical
therapists pursuant to section
12-285-110, C.R.S.
1. An applicant is required to demonstrate
that they have successfully completed a physical therapy program that is
either:
a. Accredited by a nationally
recognized accrediting agency pursuant to Rule 1.4(C); or
b. Substantially equivalent pursuant to Rule
1.5(E).
2. If applying
to take the National Physical Therapy Examination (NPTE), an applicant:
a. Must have successfully completed a
physical therapy program or be eligible to graduate within ninety days of a
program pursuant to section (1) of this Rule; and
b. Must apply through the Federation of State
Boards of Physical Therapy (FSBPT).
3. An applicant for licensure by examination
must graduate from a physical therapy program pursuant to section (1) of this
Rule and pass the NPTE within the two years immediately preceding the date of
the application.
4. An applicant
who is unable to meet the requirements under section (3) of this Rule may
request to demonstrate competency by any other means. The Board shall consider
such a request on a case-by-case basis. The decision to approve such a request
shall be at the sole discretion of the Board. In considering whether to approve
such a request, the Board shall consider public safety, the particular
circumstances and hardships faced by the applicant, and such other factors as
the Board deems appropriate. If the Board grants a license under this section
(4), the Board may subject said license to such lawful conditions as the Board
finds are necessary to protect the public.
5. An applicant must submit fingerprints for
the purpose of obtaining criminal history record information from the Federal
Bureau of Investigation and the Colorado Bureau of Investigation, which is
responsible for retaining the state's criminal records set forth in section
24-60-3702(3)(B),
C.R.S.
E.
Licensing of Foreign-Trained Physical Therapist Graduates of
Non-Accredited Programs
The purpose of this Rule is to establish procedures for
determining whether a foreign-trained physical therapist applicant who has
graduated from a non-accredited program has substantially equivalent education
and training as required pursuant to section
12-285-113(1)(a),
C.R.S.
1. A foreign-trained applicant
who has graduated from a non-accredited program must have education and
training in physical therapy substantially equivalent to the entry-level
education and training required at accredited physical therapy programs in the
United States in effect at the time of the applicant's graduation. This
includes an assessment of the applicant's general and professional education,
as well as training in wound care and debridement.
2. Applicants who wish to have their general
and professional education considered "substantially equivalent" in order to
take the National Physical Therapy Examination (NPTE) through Colorado and
qualify for licensure shall submit their credentials to the Foreign
Credentialing Commission of Physical Therapy (FCCPT). The applicant must submit
a credentials evaluation utilizing the version of the Coursework Evaluation
Tool for Foreign-Educated Physical Therapists developed by the Federation of
State Boards of Physical Therapy (FSBPT) that applies to the applicant's year
of graduation in order to evaluate the applicant's credentials against the
requirements at accredited physical therapy programs in place at the time of
the applicant's graduation. The Board will not accept a credentials evaluation
from an organization not listed in this Rule.
3. A foreign-trained applicant who has
graduated from a non-accredited program and already passed the NPTE may submit
a credentials evaluation from a credentialing agency other than FCCPT provided
that:
a. The credentialing agency utilized the
version of the Coursework Evaluation Tool for Foreign-Educated Physical
Therapists developed by FSBPT that applies to the applicant's year of
graduation in order to evaluate the applicant's credentials against the
requirements at accredited physical therapy programs in place at the time of
the applicant's graduation, and
b.
The applicant has been licensed in good standing and actively engaged in
clinical practice as a licensed physical therapist in the United States for two
out of the five years immediately preceding their application for
licensure.
4. All
expenses associated with the credential evaluation are the responsibility of
the applicant.
5. Failure to have a
credentials evaluation pursuant to the terms of this Rule will result in the
Board denying the application.
6.
In the event a foreign-trained applicant's general education is found to be
deficient, the applicant may take and pass subject examinations from the
College-Level Examination Program (CLEP) to overcome the deficiency in general
education.
7. In the event a
foreign-trained applicant's professional education is found to be deficient,
the applicant shall either:
a. Successfully
complete a Board-approved plan to overcome deficiencies; or
b. Overcome the deficiency by obtaining a
master or doctorate degree at an accredited physical therapy program.
8. Degrees obtained in a
transitional program are not equivalent to a professional entry-level physical
therapy degree and will not be accepted for initial licensure.
9. An applicant must submit fingerprints for
the purpose of obtaining criminal history record information from the Federal
Bureau of Investigation and the Colorado Bureau of Investigation, which is
responsible for retaining the state's criminal records set forth in section
24-60-3702(3)(B),
C.R.S.
F.
Licensure by Endorsement for Physical Therapists
This Rule is promulgated pursuant to sections
12-20-202(3),
12-20-204, and
12-285-106(2)(b),
C.R.S., to delineate the requirements for licensure by endorsement for physical
therapists pursuant to the Occupational Credential Portability Program under
sections 12-20-202(3) and
12-285-112, C.R.S.
1. The Board may decline to issue a license
to an applicant for licensure by endorsement pursuant to the Occupational
Credential Portability Program if the Board demonstrates by a preponderance of
evidence, after notice and opportunity for a hearing, that the applicant:
a. Lacks the requisite substantially
equivalent education, experience, or credentials to practice physical therapy;
or
b. Has committed an act that
would be grounds for disciplinary action under the law governing the practice
of physical therapy.
2.
In accordance with section
12-20-202(3)(d),
C.R.S., the Board has established the following criteria for determining
whether an applicant possesses experience and credentials that are
substantially equivalent to section
12-285-110, C.R.S. An applicant
who possesses a current and unrestricted license, in good standing, to practice
physical therapy under the laws of another jurisdiction may apply for licensure
by endorsement.
All of the following factors must be attested to at the time
of application for Colorado licensure by endorsement in order for the applicant
to establish that their experience and credentials are substantially equivalent
to the requirements of section
12-285-110, C.R.S.:
a. The applicant has graduated from an
accredited physical therapy program or graduated from a physical therapy
program that the Board has determined to be substantially equivalent;
b. The applicant has passed the National
Physical Therapy Examination (NPTE);
c. The applicant must attest that they:
(1) Have reported to the Board any injunction
entered against the individual and any injunctive action pending against the
individual on any license.
(2) Have
reported any malpractice judgment, settlement, or claim, and any pending action
or claim.
(3) Have reported any
pending complaint, investigation, or disciplinary proceeding before the
licensing, grievance, or disciplinary Board of any jurisdiction in which a
license, registration or certification to practice physical therapy is held and
where the complaint, investigation, or proceeding concerns the practice of
physical therapy.
(4) Have reported
any applicable felony conviction(s).
(5) Have reported to the Board any prior
disciplinary action by another jurisdiction
(6) Have not committed any other acts that
would be grounds for disciplinary action under section
12-285-120, C.R.S.
3. Applicants for
endorsement must submit verification from each jurisdiction, federal agency, or
military service branch in or through which applicant has even been licensed,
registered, certified, or enrolled. Applicants must submit proof that the
applicant has held for at least one year a current and valid license,
certification, registration, or enrollment under a jurisdiction with a scope of
practice that is substantially similar to the scope of practice of physical
therapy as specified in section
12-285-101,
et.
seq., C.R.S. The verification can be retrieved by the applicant from
the jurisdiction's or agency's website as long as the following information is
included and can be verified if necessary:
a.
Date license was originally issued;
b. Date of license expiration, if applicable;
and
c. Disciplinary history, if
applicable.
If the complete information is not available from the
jurisdiction's or agency's website then the Verification of License Form must
be completed by the jurisdiction or agency.
4. An applicant must submit fingerprints for
the purpose of obtaining criminal history record information from the Federal
Bureau of Investigation and the Colorado Bureau of Investigation, which is
responsible for retaining the state's criminal records set forth in section
24-60-3702(3)(B),
C.R.S.
G.
Reinstatement or Reactivation of an Expired or Inactive Physical
Therapist License
This Rule is promulgated pursuant to sections
12-20-204 and
12-285-106(2)(b),
C.R.S., to establish the qualifications and procedures for applicants seeking
reinstatement of an expired physical therapist license or reactivation of an
inactive physical therapist license pursuant to sections
12-20-202,
12-285-114 and
12-285-115, C.R.S.
1. An applicant seeking reinstatement or
reactivation of a physical therapist license shall complete a reinstatement or
reactivation application and pay a fee as established by the
Director.
2. If the license has
been expired or inactive for two years or less, then applicant must attest to
one of the following:
a. Completing continuing
professional competency pursuant to section
12-285-119, C.R.S., and Rule 1.5
for the two years immediately preceding the date the application is received;
or
b. Passing the National
Physical Therapy Examination (NPTE) within two years before the date of
application.
3. If the
license has been expired or inactive for more than two years, then an applicant
must demonstrate "competency to practice" pursuant to section
12-20-202(2)(c)(II)(A)
-(E), C.R.S. An applicant may also request to demonstrate competency by any
other means pursuant to section
12-20-202(2)(c)(II)(F),
C.R.S. The Board shall consider such a request on a case-by-case basis. The
decision to approve such a request shall be at the sole discretion of the
Board. In considering whether to approve such a request, the Board shall
consider public safety, the particular circumstances and hardships faced by the
applicant, and such other factors as the Board deems appropriate. If the Board
grants a license under this paragraph, the Board may subject said license to
such lawful conditions as the Board finds are necessary to protect the
public.
4. An applicant for
reinstatement or reactivation who has actively practiced in Colorado on an
expired or inactive license in violation of section
12-285-109, C.R.S., is subject to
denial of application, disciplinary action, and/or other penalties as
authorized in the Physical Therapy Practice Act at section
12-285-101, et
seq., C.R.S., and in accordance with section
12-20-202, et
seq., C.R.S.
H.
Use of Titles Restricted
This Rule is promulgated pursuant to sections
12-20-204 and
12-285-106(2)(b),
C.R.S., to clarify the use of titles and educational degrees pursuant to
section 12-285-107, C.R.S.
1. Obtaining a physical therapy license does
not automatically entitle or confer upon the licensee the right to use the
title "Dr." or "Doctor".
2. A
licensed physical therapist can use the title "Doctor" or "Dr." only when such
licensee has, in fact, been awarded a physical therapy doctorate degree
(D.P.T.), or another academic or clinical doctorate degree (e.g., Ph.D., Sc.D.)
from an accredited program by a nationally recognized accrediting agency as
required pursuant to section
6-1-707, C.R.S., pertaining to the
use of titles and degrees.
3. A
physical therapist holding a doctorate degree may include the title "Doctor" or
"Dr." only when accompanied by the words of the conferred degree following
his/her legal name and after the title "P.T.", for example: "Dr. Jane/John Doe,
P.T., D.P.T." or "Dr. Jane/John Doe, P.T., Ph.D."
4. A physical therapist not holding a
physical therapy doctorate or transitional doctorate degree may not use the
title D.P.T.
I.
Requirements for Physical Therapists to Perform Physical Therapy of
Animals
This Rule is promulgated pursuant to sections
12-20-204 and
12-285-106(2)(b),
C.R.S., to implement the requirements of sections
12-285-106(2)(b)(II)
and
12-285-116(4),
C.R.S., regarding the authority of physical therapists to treat animals.
1. A physical therapist must have the
knowledge, skill, ability, and documented competency to perform an act that is
within the scope of practice for physical therapists.
2. The Division of Professions and
Occupations shall maintain a data base of all physical therapists that are
qualified pursuant to this Rule to practice physical therapy of animals in this
state.
3. All physical therapists
that choose to practice physical therapy of animals shall provide the Board
with such therapist's name, current address, education, and qualifications to
perform physical therapy of animals for inclusion in the data base referenced
in section (2) of this Rule. Information in the data base shall be open to
public inspection at all times. Forms for physical therapists to provide such
information shall be provided by the Board.
4. A physical therapist that desires to
perform physical therapy of animals must comply with the following educational
requirements:
a. Minimum of eighty contact
hours over and above entry-level human physical therapy program course work for
non-human animals, to include:
(1)
FOUNDATION/CLINICAL SCIENCES
(a) Gross and
applied non-human animal anatomy/physiology;
(b) Wound healing and response of tissues to
disuse and remobilization in the non-human animal;
(c) Animal behavior;
(d) Animal restraint; and
(e) Zoonotic and infectious
diseases.
(2)
EXAMINATION/EVALUATION/PROGNOSIS/PT DIAGNOSIS
(a) Medical and surgical management of
orthopedic, neurological, critically injured, geriatric, arthritic, and obese
non-human animals; and
(b) Gait and
other movement analyses.
(3) INTERVENTION/PLAN OF CARE/OUTCOME
(a) Therapeutic exercise applied to non-human
animals;
(b) Therapeutic
modalities; and
(c) Outcome
assessment and documentation.
(4) CLINICAL EXPERIENCE
(a) Documented successful completion of a
minimum of 120 hours under the supervision of a licensed physical therapist
listed in the data base maintained by the Division of Professions and
Occupations to perform physical therapy of animals or a licensed
veterinarian.
5. Prior to performing physical therapy of an
animal, the physical therapist shall obtain veterinary medical clearance of the
animal by a Colorado-licensed veterinarian and must document such clearance in
the animal patient's record.
6.
Veterinary medical clearance means:
a. The
veterinarian has previously examined the animal patient and has provided a
differential diagnosis, if appropriate; and
b. The veterinarian has cleared the animal
for physical therapy.
7.
It is expected that the physical therapist and the veterinarian will continue
professional collaboration as necessary for the well-being of the animal
patient.
8. Once veterinary medical
clearance has been received; the physical therapist is responsible for
developing the plan of care for the animal patient's physical
therapy.
9. The animal patient's
record must include the verbal or written veterinary medical clearance. If
verbal clearance is received, the physical therapist must document the verbal
clearance in the animal patient's record, including the name of the
veterinarian, date, and time clearance was received.
10. Complaints against physical therapists
alleging a violation related to animal physical therapy will be forwarded to
the State Board of Veterinary Medicine for its review and advisory
recommendation to the State Physical Therapy Board. The State Physical Therapy
Board retains the final authority by statute for decisions related to
discipline of any physical therapist.
J.
Requirements for Physical Therapists
to Perform Dry Needling
This Rule is promulgated pursuant to sections
12-20-204 and
12-285-106(2)(b),
C.R.S., to establish requirements for a physical therapist to perform dry
needling in accordance with section
12-285-116(5),
C.R.S.
1. Dry needling is a physical
intervention that uses a filiform needle to stimulate trigger points, diagnose
and treat neuromuscular pain and functional movement deficits; is based upon
Western medical concepts; requires an examination and diagnosis; and treats
specific anatomic structures selected according to physical signs.
2. The performance of dry needling in
accordance with this Rule is not the performance of acupuncture as defined in
section 12-200-103, C.R.S., and is not a
violation of section
12-200-108, C.R.S.
3. In order to perform dry needling, a
physical therapist must have the knowledge, skill, ability, and documented
competency to perform dry needling.
4. To be deemed competent to perform dry
needling, a physical therapist must successfully complete a formalized course
of study provided by a qualified licensed healthcare provider that:
a. Includes a minimum of fifty hours of
education of which forty hours must be in-person education. The education may
be broken up into more than one part. A physical therapist is permitted the
limited practice of dry needling once the physical therapist has completed
thirty hours, as long as such practice is confined to the scope of the
education already successfully completed. All parts of this education must be
successfully completed within four years.
b. Includes specific knowledge and
psychomotor objectives;
c. Includes
clinical decision-making;
d.
Includes written and psychomotor assessment of knowledge and skills.
5. The formalized course of study
set forth in section (4) of this Rule may be completed during the physical
therapist's entry level education. To apply this education to the requirements
in section (4) of this Rule, the remaining parts of the education must be
successfully completed within four years of the date of original
licensure.
6. If the physical
therapist has not completed at least fifty hours of dry needling training
within four years, then the licensee must stop performing dry needling at any
level until the licensee has completed at least fifty hours.
7. A physical therapist who meets the
requirements set forth in section (4) of this Rule must maintain documentation
regarding the successful completion of these requirements and shall provide the
documentation upon request by the Board.
8. Dry needling in areas where there is a
risk of pneumothorax or where neurovascular compromise could be
life-threatening, shall be included after the licensee has been formally
educated and has had the opportunity to practice in lower risk areas.
9. Physical therapists performing dry
needling in their practice must have written informed consent signed by each
patient for whom dry needling is provided. A copy of the signed consent form
shall be available to the patient upon request. The written informed consent
must include risks and benefits of dry needling, including the risk of
pneumothorax, neurovascular compromise, and infection.
10. When dry needling is performed,
documentation must include a description of the technique, tissues treated, and
post treatment assessment.
11. Dry
needling shall not be delegated and must be directly performed by a qualified,
physical therapist including needle removal and post treatment
assessment.
12. Dry needling must
be performed in a manner consistent with generally accepted standards of
practice, including clean needle technique, use of gloves, and safe needle and
biohazardous waste disposal.
13.
Physical therapists who were qualified to perform dry needling under previous
versions of this Rule remain qualified as of the effective date of this
Rule.
K.
Inactive
License Status for Physical Therapists
This Rule is promulgated pursuant to sections
12-20-204 and
12-285-106(2)(b),
C.R.S., to outline the conditions and procedures governing inactive licensure
status pursuant to section
12-285-115, C.R.S.
1. A physical therapist with an inactive
license must not engage in any act or conduct that constitutes the practice of
physical therapy while the physical therapist's license is inactive.
2. A physical therapist with an inactive
license is exempt from the professional liability insurance requirements of
section 12-285-118, C.R.S.
3. A physical therapist with an inactive
license is exempt from the continuing professional competency requirements of
section 12-285-119, C.R.S., and Rule
1.5(L).
4. A physical therapist may
apply for reactivation of an inactive license by successfully meeting the
requirements of Rule 1.5(G).
L.
Continuing Professional Competency
Requirements for Licensure Renewal
This Rule is promulgated pursuant to sections
12-20-204 and
12-285-106(2)(b),
C.R.S., to establish a continuing professional competency program pursuant to
section 12-285-119, C.R.S., wherein a
physical therapist shall maintain and demonstrate continuing professional
competency in order to renew a license to practice physical therapy in the
state of Colorado.
Furthermore, pursuant to section
12-285-119(2),
C.R.S., records of assessment or other documentation developed or submitted in
connection with the continuing professional competency program are confidential
and not subject to inspection by the public or discovery in connection with a
civil action against a physical therapist. A person or the Board shall not use
the records or documents unless used by the Board to determine whether a
physical therapist is maintaining continuing professional competency to engage
in the profession.
1. Definitions
a. Continuing Professional Competency: The
ongoing ability of a physical therapist to learn, integrate, and apply the
knowledge, skills, and judgment to practice as a physical therapist according
to generally accepted standards and professional ethical standards.
b. Continuing Professional Development (CPD):
The Board program through which a licensee can satisfy the continuing
professional competency requirements in order to renew, reinstate, or
reactivate a license.
c. Deemed
Status: A method to satisfy continuing professional competency requirements. A
licensee who satisfies the continuing professional competency requirements of a
Colorado state agency or department, an accrediting body recognized by the
Board, or an entity approved by the Board pursuant to section
12-285-119(1)(c),
C.R.S., may qualify under this method in lieu of completing the Board's CPD
program.
d. Learning Plan: A Board
approved form on which a licensee documents their goals and plans of learning
that were developed from the licensee's Self-Assessment Tool (SAT). The plan
can be amended/updated as needed during the renewal period.
e. Military Exemption: A method to satisfy
continuing professional competency requirements. A licensee who has been
approved for this exemption will not be required to meet continuing
professional competency requirements during the renewal period in which they
were approved by the Division of Professions and Occupations.
f. Professional Development Activities (PDA):
learning activities undertaken to increase the licensee's knowledge and skill
or hone existing knowledge and skill for the purpose of continuing professional
development.
g. Self-Assessment
Tool (SAT): a practice tool in which a licensee can reflect upon a licensee's
knowledge and skills pertaining to the foundational areas of physical therapy
practice taking into account the licensee's current level and area of
practice.
2. Continuing
Professional Competency Requirements
a.
Effective after the 2020 license renewal, or upon the completion of the first
renewal of a license thereafter, the licensee shall demonstrate continuing
professional competency in order to renew a license by:
(1) Participation in the Continuing
Professional Development (CPD) program;
(2) Completion of the requirements for deemed
status as defined in sections (1)(c) and (4) of this Rule; or
(3) Completion of the requirements for
Military Exemption as defined in sections (1)(e) and (5) of this
Rule.
b. A licensee
shall attest at the time of the renewal of a license to their compliance with
continuing professional competency requirements.
3. Continuing Professional Development
Program
a. The Continuing Professional
Development (CPD) program entails the following:
(1) The licensee shall complete the
Self-Assessment Tool (SAT) once per two-year renewal period. A licensee shall
use the Board approved form.
(2)
The licensee shall complete the Learning Plan once per two-year renewal period
using the Board approved form.
(3)
Accrual of thirty hours of Professional Development Activities (PDA) per
two-year renewal period.
b. Professional Development Activities (PDA)
(1) Professional Development Activities (PDA)
must be relevant to the licensee's practice as a physical therapist and
pertinent to the licensee's Learning Plan. The Board will not pre-approve
specific courses or providers. The licensee shall determine which activities
and topics will meet their Learning Plan, and select an appropriate
provider.
(2) One contact hour
equals one credit hour of Professional Development Activities (PDA).
(3) Professional Development Activities List.
Activities are organized into the following two categories:
(a) Educational Coursework, Fellowships, or
Residencies; or
(b) Other
Professional Development Activities:
(i)
Formalized Assessments;
(ii)
Presentations, Research, and Publications;
(iii) Mentoring or Supervision;
(iv) Independent or Group Study or
In-Service; and
(v) Volunteer
Service.
(4)
Hours will be accepted if the activity is included in the Board's Professional
Development Activities List. The Board may accept or reject activities
submitted for consideration that are not identified on its list.
(5) Professional Development Activities will
only apply for one two-year renewal period.
(6) A minimum of twenty of the thirty
required hours must be in the Educational Coursework, Fellowships, or
Residencies category.
b.
Audit of Compliance. The following documentation is required for an audit of
compliance of a licensee's Continuing Professional Development:
(1) The Learning Plan that is signed and
executed which contains the licensee's goals in the form and manner as approved
by the Board.
(2) Documentation of
thirty hours of Professional Development Activities in compliance with the
State Physical Therapy Board's Professional Development Activities List for
documentation requirements for PDAs.
4. Deemed Status. The following criteria must
be met in order to claim this status:
a. In
order to renew a license, a licensee shall attest to their Deemed
Status.
b. To qualify, the licensee
must be in full compliance with the requirements of the state agency or
department during the entire two-year renewal period of the physical
therapist's license and on track to successfully complete that program or have
successfully completed it.
c.
Licensees claiming Deemed Status are subject to an audit of compliance. To
satisfy an audit of compliance, the licensee shall submit appropriate evidence
of participation in a qualifying program through submission of:
(1) Proof from the Colorado state agency or
department or contractual entity verifying that the licensee is in compliance
with its continuing professional competency program; and
(2) A letter from the licensee's employer
certifying dates of employment for the entire two-year license renewal period,
without any break; or
(3) Other
documentation approved by the Board which reflects the licensee's compliance
with a program of continuing professional competency.
5. Military Exemption. Pursuant to
section 12-20-302, C.R.S., licensees who
have been called to federally funded active duty for more than 120 days for the
purpose of serving in a war, emergency, or contingency may request an exemption
from the continuing professional competency requirements for the renewal,
reinstatement, or reactivation of a license for the two-year renewal period
that falls within the period of service or within six months following the
completion of service.
a. Military exemptions
must be approved by the Division of Professions and Occupations. Licensees
seeking a military exemption shall submit a request in writing with evidence
that the licensee's military service meets the criteria established in section
12-20-302, C.R.S.
b. After being granted a military exemption,
in order to complete the renewal process, a licensee shall attest to their
military exemption.
6.
Records Retention. A licensee shall retain documentation demonstrating their
compliance for two complete two-year renewal periods.
7. Non-Compliance. Falsifying an attestation
or other documentation regarding the licensee's compliance with continuing
professional competency requirements constitutes the falsification of
information in an application and may be grounds for discipline pursuant to
sections 12-285-120(1)(k) and
(r), C.R.S.
8. Reinstatement and Reactivation. A licensee
seeking to reinstate or reactivate a license which has been expired or
inactivated for two years or less shall meet the competency requirements
outlined in Rule 1.5(G)(2).
M.
Provisional Physical Therapist
License
This Rule is promulgated pursuant to sections
12-20-204 and
12-285-106(2)(b),
C.R.S., to establish the qualifications and procedures for applicants seeking a
provisional license to practice as a physical therapist pursuant to section
12-285-111, C.R.S. Refer to Rule
1.5 for applicable supervision requirements.
1. If the individual passes the NPTE after
the license was issued, then the provisional license will expire no later than
the 120 days after the date it was issued, or a regular license to practice as
a physical therapist is issued to the licensee.
2. A provisional physical therapist shall
purchase and maintain professional liability insurance, or be insured under a
supervising physical therapist, for the amounts specified in section
12-285-118(1),
C.R.S., unless the provisional physical therapist is exempted pursuant to
section 12-285-118(3),
C.R.S.