Florida Senate - 2020 CS for CS for SB 792
By the Committees on Banking and Insurance; and Health Policy;
and Senators Albritton and Harrell
597-03514-20 2020792c2
1 A bill to be entitled
2 An act relating to physical therapy practice; amending
3 s. 486.021, F.S.; revising and defining terms;
4 amending s. 486.025, F.S.; revising the powers and
5 duties of the Board of Physical Therapy Practice;
6 requiring the board to establish minimum standards of
7 practice for the performance of dry needling by
8 physical therapists; providing construction; providing
9 an effective date.
10
11 Be It Enacted by the Legislature of the State of Florida:
12
13 Section 1. Subsections (10) and (11) of section 486.021,
14 Florida Statutes, are amended, and subsections (12) and (13) are
15 added to that section, to read:
16 486.021 Definitions.—In this chapter, unless the context
17 otherwise requires, the term:
18 (10) “Physical therapy assessment” means observational,
19 verbal, or manual determinations of the function of the movement
20 musculoskeletal or neuromuscular system relative to physical
21 therapy, including, but not limited to, range of motion of a
22 joint, motor power, motor control, posture postural attitudes,
23 biomechanical function, locomotion, or functional abilities, for
24 the purpose of physical therapy making recommendations for
25 treatment.
26 (11) “Practice of physical therapy” means the performance
27 of physical therapy assessments and the treatment of any
28 disability, injury, disease, or other health condition of human
29 beings, or the prevention of such disability, injury, disease,
30 or other health condition of health, and the rehabilitation of
31 such disability, injury, disease, or other health condition as
32 related thereto by alleviating impairments, functional movement
33 limitations, and disabilities by designing, implementing, and
34 modifying treatment interventions through therapeutic exercise;
35 functional movement training in self-management and in-home,
36 community, or work integration or reintegration; manual therapy;
37 massage; airway clearance techniques; maintaining and restoring
38 the integumentary system and wound care; physical agent or
39 modality; mechanical or electrotherapeutic modality; patient
40 related instruction the use of the physical, chemical, and other
41 properties of air; electricity; exercise; massage; the
42 performance of acupuncture only upon compliance with the
43 criteria set forth by the Board of Medicine, when no penetration
44 of the skin occurs; the use of radiant energy, including
45 ultraviolet, visible, and infrared rays; ultrasound; water; the
46 use of apparatus and equipment in the application of such
47 treatment, prevention, or rehabilitation the foregoing or
48 related thereto; the performance of tests of neuromuscular
49 functions as an aid to the diagnosis or treatment of any human
50 condition; or the performance of electromyography as an aid to
51 the diagnosis of any human condition only upon compliance with
52 the criteria set forth by the Board of Medicine.
53 (a) A physical therapist may implement a plan of treatment
54 developed by the physical therapist for a patient or provided
55 for a patient by a practitioner of record or by an advanced
56 practice registered nurse licensed under s. 464.012. The
57 physical therapist shall refer the patient to or consult with a
58 practitioner of record if the patient’s condition is found to be
59 outside the scope of physical therapy. If physical therapy
60 treatment for a patient is required beyond 30 days for a
61 condition not previously assessed by a practitioner of record,
62 the physical therapist shall have a practitioner of record
63 review and sign the plan. The requirement that a physical
64 therapist have a practitioner of record review and sign a plan
65 of treatment does not apply when a patient has been physically
66 examined by a physician licensed in another state, the patient
67 has been diagnosed by the physician as having a condition for
68 which physical therapy is required, and the physical therapist
69 is treating the condition. For purposes of this paragraph, a
70 health care practitioner licensed under chapter 458, chapter
71 459, chapter 460, chapter 461, or chapter 466 and engaged in
72 active practice is eligible to serve as a practitioner of
73 record.
74 (b) The use of roentgen rays and radium for diagnostic and
75 therapeutic purposes and the use of electricity for surgical
76 purposes, including cauterization, are not “physical therapy”
77 for purposes of this chapter.
78 (c) The practice of physical therapy does not authorize a
79 physical therapy practitioner to practice chiropractic medicine
80 as defined in chapter 460, including specific spinal
81 manipulation, or acupuncture as defined in chapter 457. For the
82 performance of specific chiropractic spinal manipulation, a
83 physical therapist shall refer the patient to a health care
84 practitioner licensed under chapter 460.
85 (d) This subsection does not authorize a physical therapist
86 to implement a plan of treatment for a patient currently being
87 treated in a facility licensed pursuant to chapter 395.
88 (12) “Dry needling” means a skilled technique based on
89 western medical concepts using apparatus or equipment of
90 filiform needles to stimulate a myofascial trigger point for the
91 evaluation and management of neuromusculoskeletal conditions,
92 pain, movement impairments, and disabilities.
93 (13) “Myofascial trigger point” means an irritable section
94 of the tissue often associated with palpable taut bands of
95 muscle fibers.
96 Section 2. Section 486.025, Florida Statutes, is amended to
97 read:
98 486.025 Powers and duties of the Board of Physical Therapy
99 Practice.—
100 (1) The board may administer oaths, summon witnesses, take
101 testimony in all matters relating to its duties under this
102 chapter, establish or modify minimum standards of practice of
103 physical therapy as defined in s. 486.021, including, but not
104 limited to, standards of practice for the performance of dry
105 needling by physical therapists, and adopt rules pursuant to ss.
106 120.536(1) and 120.54 to implement the provisions of this
107 chapter. The board may also review the standing and reputability
108 of any school or college offering courses in physical therapy
109 and whether the courses of such school or college in physical
110 therapy meet the standards established by the appropriate
111 accrediting agency referred to in s. 486.031(3)(a). In
112 determining the standing and reputability of any such school and
113 whether the school and courses meet such standards, the board
114 may investigate and personally inspect the school and courses
115 make personal inspection of the same.
116 (2) The board shall establish minimum standards of practice
117 for the performance of dry needling by physical therapists, to
118 include, at a minimum, all of the following:
119 (a) Completion of 2 years of licensed practice as a
120 physical therapist.
121 (b) Completion of 50 hours of face-to-face continuing
122 education from an entity accredited in accordance with s.
123 486.109 on the topic of dry needling which must include a
124 determination by the physical therapist instructor that the
125 physical therapist demonstrates the requisite psychomotor skills
126 to safely perform dry needling. The continuing education must
127 include instruction on all of the following areas:
128 1. Theory of dry needling.
129 2. Selection and safe handling of needles and other
130 apparatus and equipment used in dry needling, including
131 instruction on the proper handling of biohazardous waste.
132 3. Indications and contraindications for dry needling.
133 4. Psychomotor skills needed to perform dry needling.
134 5. Postintervention care, including adverse responses,
135 adverse event recordkeeping, and any reporting obligations.
136 (c)1. Completion of 25 patient sessions of dry needling
137 performed under the indirect supervision of a physical therapist
138 who holds an active license to practice physical therapy in any
139 state or the District of Columbia and who has actively practiced
140 dry needling for at least 1 year; or
141 2. Completion of 25 patient sessions of dry needling
142 performed as a physical therapist licensed in another state or
143 in the United States Armed Forces.
144 (d) A requirement that dry needling may not be performed
145 without patient consent and must be a part of a patient’s
146 documented plan of care.
147 (e) A requirement that dry needling may not be delegated to
148 any person other than a physical therapist who is authorized to
149 engage in dry needling under this chapter.
150 (3) The performance of dry needling in the practice of
151 physical therapy may not be construed to limit the scope of
152 practice of other licensed health care practitioners not
153 governed by this chapter.
154 Section 3. This act shall take effect July 1, 2020.