1     
PHYSICAL THERAPY AMENDMENTS

2     
2017 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Robert M. Spendlove

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9          This bill amends the Physical Therapy Practice Act.
10     Highlighted Provisions:
11          This bill:
12          ▸     expands the scope of physical therapy to include the ordering of x-rays;
13          ▸     defines radiology practitioners to include physical therapists under specific
14     supervision; and
15          ▸     makes technical changes.
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 2014, Chapter 354
23          58-54-102, as last amended by Laws of Utah 2013, Chapter 387
24     

25     Be it enacted by the Legislature of the state of Utah:
26          Section 1. Section 58-24b-102 is amended to read:
27          58-24b-102. Definitions.

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

59          (g) a bodily malfunction.
60          (10) (a) "Physical therapy" or "physiotherapy" means:
61          (i) examining, evaluating, and testing an individual who has a physical impairment or
62     injury;
63          (ii) identifying or labeling a physical impairment or injury;
64          (iii) formulating a therapeutic intervention plan for the treatment of a physical
65     impairment, injury, or pain;
66          (iv) assessing the ongoing effects of therapeutic intervention for the treatment of a
67     physical impairment or injury;
68          (v) treating or alleviating a physical impairment by designing, modifying, or
69     implementing a therapeutic intervention;
70          (vi) reducing the risk of an injury or physical impairment;
71          (vii) providing instruction on the use of physical measures, activities, or devices for
72     preventative and therapeutic purposes;
73          (viii) promoting and maintaining health and fitness;
74          (ix) the administration of a prescription drug pursuant to Section 58-24b-403;
75          (x) subject to Subsection 58-28-307(12)(b), engaging in the functions described in
76     Subsections (10)(a)(i) through (ix) in relation to an animal, in accordance with the
77     requirements of Section 58-24b-405; [and]
78          (xi) ordering x-rays; and
79          [(xi)] (xii) engaging in administration, consultation, education, and research relating to
80     the practices described in this Subsection (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          (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          (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;
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 58-54-102 is amended to read:
154          58-54-102. Definitions.
155          In addition to the definition in Section 58-1-102, as used in this chapter:
156          (1) "Board" means the Radiologic Technologist Licensing Board established under this
157     chapter.
158          (2) "Critical access hospital" means a hospital in a rural or medically underserved area
159     that is recognized by the Centers for Medicare and Medicaid Services as meeting the conditions
160     of participation specified in 42 C.F.R. 485.601-647.
161          (3) "General supervision" means the supervising radiologist is available to provide
162     immediate communication with the supervised person and is aware of the procedure before it is
163     performed.
164          (4) "Indirect supervision" means the supervising radiologist:
165          (a) has given either written or verbal instructions to the person being supervised;
166          (b) is present in the facility in which the person being supervised is providing services;
167     and
168          (c) is available to provide immediate face-to-face communications with the person
169     being supervised.
170          (5) "Practice of radiologic technology" means using radiation from a radioactive
171     substance, radiology equipment, or any other source, in amounts beyond normal background
172     levels, for diagnostic or therapeutic purposes on humans.
173          (6) "Practice of radiologist assistant" means the performance of non-invasive and
174     minimally invasive radiological procedures:
175          (a) delegated to a radiologist assistant by a radiologist; and
176          (b) performed under the indirect supervision of a radiologist.
177          (7) "Radiologic technologist" means a person licensed under this chapter to engage in
178     the practice of radiologic technology under the general supervision of a radiologist or radiology
179     practitioner including the administration of parenteral contrast media, radionuclides, and other
180     medications incidental to radiology procedures provided the administrations are under the
181     direct supervision of a qualified physician and the technologist is currently certified in
182     cardiopulmonary resuscitation (CPR) and appropriate patient care procedures.

183          (8) "Radiologist" means a physician certified by the American Board of Radiology, the
184     American Osteopathic Board of Radiology, the British Royal College of Radiology, or the
185     Canadian College of Physicians and Surgeons.
186          (9) "Radiologist assistant" means a person licensed under this chapter to engage in the
187     practice of a radiologist assistant.
188          (10) "Radiology equipment" means any medical radiation device that emits ionizing or
189     nonionizing radiation or detects that radiation for the purpose or intended purpose of:
190          (a) diagnosing disease or other medical conditions in humans; or
191          (b) treating, curing, mitigating, or preventing disease in humans.
192          (11) "Radiology practical technician" means a person licensed under this chapter to
193     engage in a practice of radiologic technology performing limited diagnostic radiology
194     procedures:
195          (a) as defined and permitted by rule in accordance with Title 63G, Chapter 3, Utah
196     Administrative Rulemaking Act; and
197          (b) under the supervision of a radiologist or radiology practitioner.
198          (12) "Radiology practitioner" means any person or individual licensed in this state as a
199     physician and surgeon, osteopathic physician, podiatric physician, chiropractic physician,
200     dentist, dental hygienist, or a physician's assistant, nurse practitioner, [or] nurse specialist, or
201     physical therapist practicing under the supervision of an approved supervising physician and in
202     accordance with an approved protocol and utilization plan.
203          (13) "Unlawful conduct" [is as] means the same as that term is defined in Sections
204     58-1-501 and 58-54-501.
205          (14) "Unprofessional conduct" [is as] means the same as that term is defined in
206     Sections 58-1-501 and 58-54-501 and as may be further defined by administrative rule adopted
207     by the division.






Legislative Review Note
Office of Legislative Research and General Counsel