Second Substitute H.B. 367

This document includes Senate 2nd and 3rd Reading Floor Amendments incorporated into the bill on Tue, Mar 11, 2014 at 10:01 AM by lpoole. -->

Representative Gregory H. Hughes proposes the following substitute bill:

1 PHYSICAL THERAPY SCOPE OF PRACTICE AMENDMENTS
2 2014 GENERAL SESSION
3 STATE OF UTAH
4 Chief Sponsor: Gregory H. Hughes
5 Senate Sponsor: Todd Weiler
6
7 LONG TITLE
8 General Description:
9 This bill amends provisions of the Physical Therapy Practice Act related to trigger point
10 dry needling.
11 Highlighted Provisions:
12 This bill:
13 . allows a licensed physical therapist with two years of experience that meets certain
14 other requirements to practice trigger point dry needling; and
15 . makes technical and conforming amendments.
16 Money Appropriated in this Bill:
17 None
18 Other Special Clauses:
19 None
20 Utah Code Sections Affected:
21 AMENDS:
22 58-24b-102 , as last amended by Laws of Utah 2012, Chapter 117
23 ENACTS:
24 58-24b-505 , Utah Code Annotated 1953
25

26 Be it enacted by the Legislature of the state of Utah:
27 Section 1. Section 58-24b-102 is amended to read:
28 58-24b-102. Definitions.
29 As used in this chapter:
30 (1) "Animal physical therapy" means practicing physical therapy or physiotherapy on
31 an animal.
32 (2) "Board" means the Utah Physical Therapy Licensing Board, created in Section
33 58-24b-201 .
34 (3) "Consultation by telecommunication" means the provision of expert or professional
35 advice by a physical therapist who is licensed outside of Utah to a licensed physical therapist or
36 a health care provider by telecommunication or electronic communication.
37 (4) "General supervision" means supervision and oversight of a person by a licensed
38 physical therapist when the licensed physical therapist is immediately available in person, by
39 telephone, or by electronic communication to assist the person.
40 (5) "Licensed physical therapist" means a person licensed under this chapter to engage
41 in the practice of physical therapy.
42 (6) "Licensed physical therapist assistant" means a person licensed under this chapter
43 to engage in the practice of physical therapy, subject to the provisions of Subsection
44 58-24b-401 (2)(a).
45 (7) "Licensing examination" means a nationally recognized physical therapy
46 examination that is approved by the division, in consultation with the board.
47 (8) "On-site supervision" means supervision and oversight of a person by a licensed
48 physical therapist or a licensed physical therapist assistant when the licensed physical therapist
49 or licensed physical therapist assistant is:
50 (a) continuously present at the facility where the person is providing services;
51 (b) immediately available to assist the person; and
52 (c) regularly involved in the services being provided by the person.
53 (9) "Physical impairment" means:
54 (a) a mechanical impairment;
55 (b) a physiological impairment;
56 (c) a developmental impairment;

57 (d) a functional limitation;
58 (e) a disability;
59 (f) a mobility impairment; or
60 (g) a bodily malfunction.
61 [(11)] (10) (a) "Physical therapy" or "physiotherapy" means:
62 (i) examining, evaluating, and testing an individual who has a physical impairment or
63 injury;
64 (ii) identifying or labeling a physical impairment or injury;
65 (iii) formulating a therapeutic intervention plan for the treatment of a physical
66 impairment, injury, or pain;
67 (iv) assessing the ongoing effects of therapeutic intervention for the treatment of a
68 physical impairment or injury;
69 (v) treating or alleviating a physical impairment by designing, modifying, or
70 implementing a therapeutic intervention;
71 (vi) reducing the risk of an injury or physical impairment;
72 (vii) providing instruction on the use of physical measures, activities, or devices for
73 preventative and therapeutic purposes;
74 (viii) promoting and maintaining health and fitness;
75 (ix) the administration of a prescription drug pursuant to Section 58-24b-403 ;
76 (x) subject to Subsection 58-28-307 (12)(b), engaging in the functions described in
77 Subsections [(11)] (10)(a)(i) through (ix) in relation to an animal, in accordance with the
78 requirements of Section 58-24b-405 ; and
79 (xi) engaging in administration, consultation, education, and research relating to the
80 practices described in this Subsection [(11)] (10)(a).
81 (b) "Physical therapy" or "physiotherapy" does not include:
82 (i) diagnosing disease;
83 (ii) performing surgery;
84 (iii) performing acupuncture;
85 (iv) taking x-rays; or
86 (v) prescribing or dispensing a drug, as defined in Section 58-37-2 .
87 [(10)] (11) "Physical therapy aide" means a person who:

88 (a) is trained, on-the-job, by a licensed physical therapist; and
89 (b) provides routine assistance to a licensed physical therapist or licensed physical
90 therapist assistant, while the licensed physical therapist or licensed physical therapist assistant
91 practices physical therapy, within the scope of the licensed physical therapist's or licensed
92 physical therapist assistant's license.
93 (12) "Recognized accreditation agency" means an accreditation agency that:
94 (a) grants accreditation, nationally, in the United States of America; and
95 (b) is approved by the division, in consultation with the board.
96 (13) (a) "Testing" means a standard method or technique used to gather data regarding
97 a patient that is generally and nationally accepted by physical therapists for the practice of
98 physical therapy.
99 (b) "Testing" includes measurement or evaluation of:
100 (i) muscle strength, force, endurance, or tone;
101 (ii) cardiovascular fitness;
102 (iii) physical work capacity;
103 (iv) joint motion, mobility, or stability;
104 (v) reflexes or autonomic reactions;
105 (vi) movement skill or accuracy;
106 (vii) sensation;
107 (viii) perception;
108 (ix) peripheral nerve integrity;
109 (x) locomotor skills, stability, and endurance;
110 (xi) the fit, function, and comfort of prosthetic, orthotic, or other assistive devices;
111 (xii) posture;
112 (xiii) body mechanics;
113 (xiv) limb length, circumference, and volume;
114 (xv) thoracic excursion and breathing patterns;
115 (xvi) activities of daily living related to physical movement and mobility;
116 (xvii) functioning in the physical environment at home or work, as it relates to physical
117 movement and mobility; and
118 (xviii) neural muscular responses.

119 (14) (a) "Trigger point dry needling" means the stimulation of a trigger point using a
120 dry needle to treat neuromuscular pain and functional movement deficits.
121 (b) "Trigger point dry needling" does not include the stimulation of auricular or distal
122 points.
123 [(14)] (15) "Therapeutic intervention" includes:
124 (a) therapeutic exercise, with or without the use of a device;
125 (b) functional training in self-care, as it relates to physical movement and mobility;
126 (c) community or work integration, as it relates to physical movement and mobility;
127 (d) manual therapy, including:
128 (i) soft tissue mobilization;
129 (ii) therapeutic massage; or
130 (iii) joint mobilization, as defined by the division, by rule;
131 (e) prescribing, applying, or fabricating an assistive, adaptive, orthotic, prosthetic,
132 protective, or supportive device;
133 (f) airway clearance techniques, including postural drainage;
134 (g) integumentary protection and repair techniques;
135 (h) wound debridement, cleansing, and dressing;
136 (i) the application of a physical agent, including:
137 (i) light;
138 (ii) heat;
139 (iii) cold;
140 (iv) water;
141 (v) air;
142 (vi) sound;
143 (vii) compression;
144 (viii) electricity; and
145 (ix) electromagnetic radiation;
146 (j) mechanical or electrotherapeutic modalities;
147 (k) positioning;
148 (l) instructing or training a patient in locomotion or other functional activities, with or
149 without an assistive device;

150 (m) manual or mechanical traction; [and]
151 (n) correction of posture, body mechanics, or gait[.]; and
152 (o) trigger point dry needling, under the conditions described in Section 58-24b-505 .
153 Section 2. Section 58-24b-505 is enacted to read:
154 58-24b-505. Trigger point dry needling -- Experience required.
155 (1) A physical therapist may practice trigger point dry needling if the physical
156 therapist:
157 (a) has held a license to practice physical therapy under this chapter, and has actively
158 practiced physical therapy, for two years;
159 (b) has successfully completed a course in trigger point dry needling that:
160 (i) is approved by the division; and
161 (ii) includes at least 300 total course hours, including at least:
162 (A) 54 hours of in-person instruction; and
163 (B) 250 supervised patient treatment sessions;
164 (c) files a certificate of completion of the course described in Subsection (1)(b) with
165 the division;
166 (d) registers with the division as a trigger point dry needling practitioner; and
167 (e) meets any other requirement to practice trigger point dry needling established by the
168 division.
169 (2) The division shall make rules, in accordance with Title 63G, Chapter 3, Utah
170 Administrative Rulemaking Act, that establish:
171 (a) the criteria for approving a course described in Subsection (1)(b); and
172 (b) the requirements described in Subsection (1)(e).
172a S. (3) The division may charge, in accordance with Section 63J-1-504, a fee for the
172b registration described in Subsection (1)(d). .S