Second Substitute H.B. 367

Representative Gregory H. Hughes proposes the following substitute bill:




Chief Sponsor: Gregory H. Hughes

Senate Sponsor: Todd Weiler

             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

             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).

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