Florida Senate - 2020 COMMITTEE AMENDMENT
Bill No. SB 792
Ì3129367Î312936
LEGISLATIVE ACTION
Senate . House
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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.