Florida Senate - 2020                        COMMITTEE AMENDMENT
       Bill No. SB 792
       
       
       
       
       
       
                                Ì3129367Î312936                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  01/21/2020           .                                
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       The Committee on Health Policy (Albritton) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsections (10) and (11) of section 486.021,
    6  Florida Statutes, are amended, and subsections (12) and (13) are
    7  added to that section, to read:
    8         486.021 Definitions.—In this chapter, unless the context
    9  otherwise requires, the term:
   10         (10) “Physical therapy assessment” means observational,
   11  verbal, or manual determinations of the function of the movement
   12  musculoskeletal or neuromuscular system relative to physical
   13  therapy, including, but not limited to, range of motion of a
   14  joint, motor power, motor control, posture postural attitudes,
   15  biomechanical function, locomotion, or functional abilities, for
   16  the purpose of physical therapy making recommendations for
   17  treatment.
   18         (11) “Practice of physical therapy” means the performance
   19  of physical therapy assessments and the treatment of any
   20  disability, injury, disease, or other health condition of human
   21  beings, or the prevention of such disability, injury, disease,
   22  or other health condition of health, and the rehabilitation of
   23  such disability, injury, disease, or other health condition as
   24  related thereto by alleviating impairments, functional
   25  limitations, and disabilities by designing, implementing, and
   26  modifying treatment interventions through therapeutic exercise;
   27  functional training in self-care and in-home, community, or work
   28  integration or reintegration; manual therapy; therapeutic
   29  massage; airway clearance techniques; maintaining and restoring
   30  the integumentary system and wound care; physical agent or
   31  modality; mechanical or electrotherapeutic modality; patient
   32  related instruction the use of the physical, chemical, and other
   33  properties of air; electricity; exercise; massage; the
   34  performance of acupuncture only upon compliance with the
   35  criteria set forth by the Board of Medicine, when no penetration
   36  of the skin occurs; the use of radiant energy, including
   37  ultraviolet, visible, and infrared rays; ultrasound; water; the
   38  use of apparatus and equipment in the application of such
   39  treatment, prevention, or rehabilitation the foregoing or
   40  related thereto; the performance of tests of neuromuscular
   41  functions as an aid to the diagnosis or treatment of any human
   42  condition; or the performance of electromyography as an aid to
   43  the diagnosis of any human condition only upon compliance with
   44  the criteria set forth by the Board of Medicine.
   45         (a) A physical therapist may implement a plan of treatment
   46  developed by the physical therapist for a patient or provided
   47  for a patient by a practitioner of record or by an advanced
   48  practice registered nurse licensed under s. 464.012. The
   49  physical therapist shall refer the patient to or consult with a
   50  practitioner of record if the patient’s condition is found to be
   51  outside the scope of physical therapy. If physical therapy
   52  treatment for a patient is required beyond 30 days for a
   53  condition not previously assessed by a practitioner of record,
   54  the physical therapist shall have a practitioner of record
   55  review and sign the plan. The requirement that a physical
   56  therapist have a practitioner of record review and sign a plan
   57  of treatment does not apply when a patient has been physically
   58  examined by a physician licensed in another state, the patient
   59  has been diagnosed by the physician as having a condition for
   60  which physical therapy is required, and the physical therapist
   61  is treating the condition. For purposes of this paragraph, a
   62  health care practitioner licensed under chapter 458, chapter
   63  459, chapter 460, chapter 461, or chapter 466 and engaged in
   64  active practice is eligible to serve as a practitioner of
   65  record.
   66         (b) The use of roentgen rays and radium for diagnostic and
   67  therapeutic purposes and the use of electricity for surgical
   68  purposes, including cauterization, are not “physical therapy”
   69  for purposes of this chapter.
   70         (c) The practice of physical therapy does not authorize a
   71  physical therapy practitioner to practice chiropractic medicine
   72  as defined in chapter 460, including specific spinal
   73  manipulation. For the performance of specific chiropractic
   74  spinal manipulation, a physical therapist shall refer the
   75  patient to a health care practitioner licensed under chapter
   76  460.
   77         (d) This subsection does not authorize a physical therapist
   78  to implement a plan of treatment for a patient currently being
   79  treated in a facility licensed pursuant to chapter 395.
   80         (12)“Dry needling” means a skilled technique based on
   81  western medical concepts using apparatus or equipment of
   82  filiform needles to stimulate a myofascial trigger point for the
   83  evaluation and management of neuromusculoskeletal conditions,
   84  pain, movement impairments, and disabilities.
   85         (13)“Myofascial trigger point” means an irritable section
   86  of the tissue often associated with palpable taut bands of
   87  muscle fibers.
   88         Section 2. Section 486.025, Florida Statutes, is amended to
   89  read:
   90         486.025 Powers and duties of the Board of Physical Therapy
   91  Practice.—
   92         (1) The board may administer oaths, summon witnesses, take
   93  testimony in all matters relating to its duties under this
   94  chapter, establish or modify minimum standards of practice of
   95  physical therapy as defined in s. 486.021, including, without
   96  limitation, standards of practice for the performance of dry
   97  needling by physical therapists, and adopt rules pursuant to ss.
   98  120.536(1) and 120.54 to implement the provisions of this
   99  chapter. The board may also review the standing and reputability
  100  of any school or college offering courses in physical therapy
  101  and whether the courses of such school or college in physical
  102  therapy meet the standards established by the appropriate
  103  accrediting agency referred to in s. 486.031(3)(a). In
  104  determining the standing and reputability of any such school and
  105  whether the school and courses meet such standards, the board
  106  may investigate and personally inspect the school and courses
  107  make personal inspection of the same.
  108         (2)The board shall establish minimum standards of practice
  109  for the performance of dry needling by physical therapists, to
  110  include, at a minimum, all of the following:
  111         (a)Completion of 2 years of licensed practice as a
  112  physical therapist.
  113         (b)Completion of 50 hours of face-to-face continuing
  114  education from an entity accredited in accordance with s.
  115  486.109 on the topic of dry needling which must include a
  116  determination by the physical therapist instructor that the
  117  physical therapist demonstrates the requisite psychomotor skills
  118  to safely perform dry needling. The continuing education must
  119  include instruction on all of the following areas:
  120         1.Theory of dry needling.
  121         2.Selection and safe handling of needles and other
  122  apparatus and equipment used in dry needling, including
  123  instruction on the proper handling of biohazardous waste.
  124         3.Indications and contraindications for dry needling.
  125         4.Psychomotor skills needed to perform dry needling.
  126         5.Postintervention care, including adverse responses,
  127  adverse event recordkeeping, and any reporting obligations.
  128         (c)1.Completion of 25 patient sessions of dry needling
  129  performed under the indirect supervision of a physical therapist
  130  who holds an active license to practice physical therapy in any
  131  state or the District of Columbia and who has actively practiced
  132  dry needling for at least 1 year; or
  133         2.Completion of 25 patient sessions of dry needling
  134  performed as a physical therapist licensed in another state or
  135  in the United States Armed Forces.
  136         (d)A requirement that dry needling may not be performed
  137  without patient consent and must be a part of a patient’s
  138  documented plan of care.
  139         (e)A requirement that dry needling may not be delegated to
  140  any person other than a physical therapist who is authorized to
  141  engage in dry needling under this chapter.
  142         (3)The performance of dry needling in the practice of
  143  physical therapy may not be construed to limit the scope of
  144  practice of other licensed health care practitioners not
  145  governed by this chapter.
  146         Section 3. This act shall take effect July 1, 2020.
  147  
  148  ================= T I T L E  A M E N D M E N T ================
  149  And the title is amended as follows:
  150         Delete everything before the enacting clause
  151  and insert:
  152                        A bill to be entitled                      
  153         An act relating to physical therapy practice; amending
  154         s. 486.021, F.S.; revising and defining terms;
  155         amending s. 486.025, F.S.; revising the powers and
  156         duties of the Board of Physical Therapy Practice;
  157         requiring the board to establish minimum standards of
  158         practice for the performance of dry needling by
  159         physical therapists; providing construction; providing
  160         an effective date.