Hawaii Reference

HAWAII ADMINISTRATIVE RULES

TITLE 16 DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS CHAPTER 110 PHYSICAL THERAPY

SUBCHAPTER 1

GENERAL PROVISIONS

16-110-1 Objective.

The objective of this chapter is to establish licensing requirements for physical therapists and physical therapist assistants in the interest of safeguarding life and health.

16-110-2 Definitions.

As used in this chapter:

"Accredited physical therapist assistant program" means a post-secondary physical therapist assistant program that is accredited by the Commission on Accreditation in Physical Therapy Education, its predecessor organization, or its successor organization.

"Accredited physical therapy program" means a post-secondary physical therapy program that is accredited by the Commission on Accreditation in Physical Therapy Education, its predecessor organization, or its successor organization.

"APTA" means the American Physical Therapy Association, which is the primary, voluntary, national professional organization of physical therapists and physical therapist assistants.

"Commission on Accreditation in Physical Therapy Education" or "CAPTE" means an independent accrediting body that is recognized by the United States Department of Education and by the Commission on Recognition of Postsecondary Accreditation, or their successor organizations as the entity in the United States that is responsible for accrediting education programs for the preparation of physical therapists and physical therapist assistants.

"Department" means the department of commerce and consumer affairs, unless otherwise identified.

"Director" means the director of the department of commerce and consumer affairs or the director's departmental representative.

"Encumbered" means a license issued by any state or territory of the United States for the practice of physical therapy that is revoked, suspended, made probationary or conditional, or otherwise disciplined by the licensing or registering authority in that state or territory.

"Evaluation" means the process in which the physical therapist makes clinical judgments based on data gathered during the physical therapy examination. Findings from the physical therapy examination are integrated to establish a diagnostic classification, prognosis, and plan of care. This process may identify problems that require consultation with or referral to another provider.

"Federation of State Boards of Physical Therapy" or "FSBPT" means the not-for-profit organization established on February 12, 1987, under the laws of the State of Alabama. The FSBPT develops and administers the National Physical Therapy Examination and also works towards reasonable uniformity in regulation and standards through ongoing communications between it and the states and territories of the United States.

"Licensure examination" means a national physical therapy exam approved by the board for the licensure of a physical therapist or physical therapist assistant.

"Patient" means an individual who is the recipient of physical therapy examination, evaluation, diagnosis, prognosis, and intervention and who has a disease, disorder, condition, impairment, functional limitation, or disability and also includes a person who may engage the services of a physical therapist, who can benefit from the physical therapist's consultation, interventions, professional advice, prevention services, or services promoting health, wellness, and fitness.

"Physical therapy examination" means the process of obtaining a history, a systems review, and selecting and administering tests and measures to gather data about the patient. The initial physical therapy examination is a comprehensive screening and specific testing process. Tests and measurements may include, but are not limited to:

Muscle strength, force, endurance, and tone;
Joint motion, mobility, and stability;
Reflexes and automatic reaction;
Movement skill and accuracy;
Sensation and perception;
Peripheral nerve integrity;
Locomotor skill, stability, and endurance;
Activities of daily living;
Cardiac, pulmonary, and vascular functions;
The fit, function, and comfort of prosthetic, orthotic, and other assistive devices;
Posture and body mechanics;
Limb length, circumference, and volume;
Thoracic excursion and breathing patterns;
Vital signs;
The nature and locus of pain and conditions under which pain varies;
Photosensitivity; and
Home, community, and work physical environments. "Student" means an individual who is currently enrolled in an accredited physical therapist assistant program or in an accredited physical therapy program.

"Support or auxiliary personnel" means a temporary physical therapist licensee or a physical therapy student who performs duties delegated by a supervising physical therapist.

"Temporary physical therapist licensee" means a person who meets the applicable requirements set forth in section 16-110-40.

"Treatment" or "intervention" means purposeful and skilled interaction between the physical therapist, PTA, temporary physical therapist licensee or student and the patient in the care of the patient using various physical therapy methods and techniques to produce changes in the patient's condition that are consistent with the diagnosis and treatment. A physical therapy treatment or intervention may consist of the following components:

Air;
Sound;
Compression;
Light;
Mechanical stimulation;
Biofeedback;
Positioning;
Therapeutic heat and cold;
Therapeutic exercise;
Gait training;
Activities of daily living and functional training;
Therapeutic electric current;
Therapeutic massage;
Ultrasound;
Behavior modification;
Traction;
Hydrotherapy;
Pulmonary therapy;
Wound care and external dressings;
Orthoses and external supports;
Assistive/adaptive devices;
Therapeutic equipment;
Neurodevelopmental activities;
Mobilization and manipulation;
Posture training;
Prosthetic management;
Cardiopulmonary rehabilitation;
Coordination, communication and documentation;
Patient-related instruction; and
Procedural interactions including but not limited to:
1. Therapeutic exercise;
2. Functional training in self-care and home management, including activities of daily living and instrumental activities of daily living;
3. Functional training in work, including school and play, community and leisure integration or reintegration, including instrumental activities of daily living, work hardening, and work conditioning;
4. Manual therapy techniques, including mobilization or manipulation;
5. Prescription, application, and, as appropriate, fabrication of devices, and assistive, adaptive, orthotic, protective, supportive, and prosthetic equipment;
6. Airway clearance techniques;
7. Integumentary repair and protection techniques;
8. Electrotherapeutic modalities;
9. Physical agents; and
10. Mechanical modalities

16-110-3 When referrals required.

A licensed physical therapist may perform an evaluation of any person without a referral. A physical therapist may treat a patient with or without a referral unless the physical therapist has reasonable cause to believe that the patient has a symptom or condition that is either beyond the physical therapist's scope of practice, or for which physical therapy is contraindicated, in which case the physical therapist shall refer that patient to an appropriate healthcare provider.

16-110-4 Duties and minimum standards of a supervising physical therapist.

A physical therapist shall supervise all physical therapy care provided by physical therapist assistants, and support or auxiliary personnel.
A supervising physical therapist shall be responsible for managing all aspects of the physical therapy care of each patient. A licensed physical therapist shall utilize only the assistance of physical therapist assistants, or support or auxiliary personnel in the practice of physical therapy. A supervising physical therapist shall provide:
1. An interpretation of referrals when available;
2. An initial physical therapy examination, evaluation, diagnosis and prognosis of the patient;
3. The development or implementation of a plan of care based on the initial physical therapy examination or physical therapy reexamination, and which includes the physical therapy goals and anticipated outcomes;
4. A determination of the components and the intervention that shall be provided by a physical therapist and the components that may be delegated to physical therapist assistants, or support or auxiliary personnel;
5. Direct one-on-one reexamination of the patient and revision of the plan of care when indicated;
6. The establishment of the discharge plan and documentation of the patient's discharge status;
7. Oversight of all services rendered to each patient, including the applicable documentation in accordance with APTA guidelines; and
8. Telecommunications accessibility at all times when the supervising physical therapist is not on site and the ability to be on site within two hours if the supervising physical therapist's physical presence is needed.
A supervising physical therapist shall assure that the physical therapist assistants, and support or auxiliary personnel under the physical therapist's supervision are competent and able to safely complete all delegated activities.
A supervising physical therapist may supervise a maximum of three persons, which may include any combination of the following:
1. A temporary physical therapist licensee;
2. A student; or
3. A physical therapist assistant

16-110-5 Duties of physical therapist assistants, and support or auxiliary personnel. Physical therapist assistants, and support or auxiliary personnel may perform the following treatment or intervention components that they are qualified to perform and as delegated by the supervising physical therapist:

A physical therapist assistant, temporary physical therapist licensee, and a physical therapy student may perform:
1. Coordination, communication, and documentation;
2. Patient-related instruction;
3. Procedural interactions including but not limited to:
  1. Therapeutic exercise;
  2. Functional training in self-care and home management, including activities of daily living and instrumental activities of daily living;
  3. Functional training in work, including school and play, community and leisure integration or reintegration, including instrumental activities of daily living, work hardening, and work conditioning;
  4. Prescription, application, and, as appropriate, fabrication of devices, and assistive, adaptive, orthotic, protective, supportive, and prosthetic equipment;
  5. Airway clearance techniques;
  6. Integumentary repair and protection techniques;
  7. Electrotherapeutic modalities;
  8. Physical agents; and
  9. Mechanical modalities;
A physical therapist assistant may perform manual therapy, excluding thrust joint mobilization and spinal and peripheral joint mobilization or manipulation; and
A temporary physical therapist licensee or a physical therapy student may perform manual therapy techniques, including mobilization or manipulation.

16-110-6 Identification of personnel.

A licensed physical therapist shall wear a conspicuously placed name tag stating, at a minimum, the person's name and the title "physical therapist" or "PT".
The supervising physical therapist shall ensure that all physical therapist assistants, and support or auxiliary personnel wear a conspicuously placed name tag identifying the individual's name and professional designation at the time of care.

SUBCHAPTER 2

APPLICATIONS

16-110-10 Application for licensure.

All applicants for licensure shall apply on a form or forms prescribed by the board.
The proper documentation and fee shall accompany the application forms.
It shall be the applicant's responsibility to submit all evidence of qualifications, including the passage of any required licensure examination and payment of any applicable fee, within one year of the application date.
If a license is not issued within one year of the application date as a result of the applicant's failure to complete licensure requirements, take the required licensure examination, if required, or to submit the required documentation and evidence of qualifications, the applicant shall submit a new application form, documentation of qualifications, and applicable fees in addition to meeting licensure requirements that are in effect at the time of filing the new application.

SUBCHAPTER 3

PERMANENT LICENSE

16-110-20 Requirements for a permanent physical therapist or physical therapist assistant license.

A person seeking a permanent license to practice as a physical therapist or physical therapist assistant in the State shall submit an application for the license on forms provided by the board.
An applicant for licensure as a physical therapist shall provide the board with:
1. A certified transcript indicating graduation from a physical therapy education program from a school or college accredited by CAPTE; or
2. In the case of a person who is a graduate of a school or college of physical therapy located outside the United States that is not accredited by CAPTE, a certified credentials evaluation indicating successful completion of a program or programs, including education and training, equivalent to programs in the United States accredited pursuant to paragraph b.1.. That evaluation shall be prepared within one year from the date of the application's submission and shall be performed by a credentials evaluation agency approved by the board. Additionally, the applicant shall take and pass one of the following English language proficiency tests if the school or college is in a country, state, or province where the official language is other than English:
  1. The Test of English as a Foreign Language (TOEFL) with the passing score for each exam as recommended by the FSBPT; or
  2. The TOEFL internet based test with a passing score as recommended by the FSBPT.
An applicant for licensure as a physical therapist assistant shall provide the board with:
1. A certified transcript indicating graduation from a physical therapist assistant program or a physical therapy program accredited by CAPTE; or
2. In the case of a person who is a graduate of a school or college of physical therapy or physical therapist assistant program located outside the United States that is not accredited by CAPTE, a certified credentials evaluation indicating successful completion of a program or programs, including education and training, equivalent to programs in the United States accredited pursuant to paragraph c.1.. That evaluation shall be prepared within one year from the date of the application’s submission and shall be performed by a credentials evaluation agency approved by the board. Additionally, the applicant shall take and pass one of the following English language proficiency tests if the school or college is in a country, state, or province where the official language is other than English:
  1. The Test of English as a Foreign Language (TOEFL) with the passing score for each exam as recommended by the FSBPT; or
  2. The TOEFL internet based test with a passing score as recommended by the FSBPT.
Each applicant for licensure shall be required to take the physical therapist or physical therapist assistant licensure examination, as applicable, scheduled and administered by the board's designated licensing examination service;
The passing score for the licensure examination shall be the criterion-referenced passing score recommended by the FSBPT.
Each applicant shall ensure that after each administration of the licensure examination, the licensing examination service reports the applicant’s examination score directly to the board. The FSBPT shall notify the applicant directly of the applicant's licensure examination score.
Any applicant who fails to achieve a passing score on the licensure examination may be entitled to re-take the examination;
An applicant may apply for an examination waiver as follows:
1. The board may waive the licensure examination for a physical therapist applicant if the applicant:
  1. Submits proof that the applicant previously passed the same physical therapist licensure examination required by the boar d in another jurisdiction approved by the board, and received an examination score that meets or exceeds the passing score specified in this chapter; and
  2. Submits verification on the status of the applicant’s license in the other jurisdiction, including but not limited to whether the license is or has been encumbered, whether disciplinary action has been taken against the applicant or is curr ently pending, and whether the applicant is being investigated for any licensing violations in that jurisdiction.
2. The board may waive the licensure examination for a physical therapist assistant applicant if the applicant:
  1. Graduated from an accredited physical therapist assistant program, or an accredited physical therapy program recognize d by the United States Department of Education; and has five years of experience within the last eight years as a physical therapist assistant by December 31, 2014; provided that:
    1. The applicant shall provide written verification from each place of employment as a physical therapist assistan t during the aforementioned five-year period; and
    2. Employment verification shall include documentation of employment dates, job titles, job descriptions, employme nt status, names of all supervisors, and any other documentation requested by the board to verify employment; or
  2. Submits proof that the applicant previously passed the same physical therapist assistant licensure examination required by the board in another jurisdiction approved by the board, and received an examination score that meets or exceeds the passing score specified in this chapter.
An applicant may submit a letter of completion by the licensure examination date from the appropriate college authority which states that the student is in the final year of that physical therapy program and has completed the physical therapy program which at the time of graduation was accredited by CAPTE to be accepted in lieu of the final transcript to sit for the licensure examination. However, the license shall not be issued, even if the applicant has passed the licensure examination for physical therapists, until the final transcript is submitted showing graduation from the physical therapy program.

SUBCHAPTER 4

REPEALED

16-110-30 Repealed. [R 12/9/10]

SUBCHAPTER 5

TEMPORARY LICENSE

16-110-40 Requirements for temporary physical therapist or physical therapist assistant license.

An applicant for a temporary license who has applied for a permanent license, shall provide the board with:
1. The documents and evidence of qualifications as set forth in subsection 16-110-20b. or 16-110-20c.; and
2. Evidence that the applicant has submitted to the board either an application to take the licensure examination within six months or evidence showing that the applicant has taken the licensure examination and is awaiting its results; or
3. For examination waiver, evidence that the applicant has fulfilled the requirements of section 16-110-20h.
The applicant shall submit to the board a completed Statement of Supervising Licensed Physical Therapist, on a form prescribed by the board, from each proposed supervising physical therapist, verifying that the supervising physical therapist agrees to supervise the applicant. The Statement of Supervising Licensed Physical Therapist shall indicate the name of the applicant, the name and license number of each supervising physical therapist, the date when the supervision shall commence, and shall be signed by each supervising physical therapist. The temporary licensee shall be supervised throughout the period of temporary licensure by a physical therapist holding a permanent active license.
An applicant may submit a written request to the board for a change in supervising physical therapist. The request shall include the reason for the change, the date of change, and a Statement of Supervising Physical Therapist from the new proposed supervising physical therapist. The request shall be signed by the applicant, new proposed supervising physical therapist, and the immediate prior supervising physical therapist, unless the applicant can provide adequate documentation to establish that the immediate prior supervising physical therapist cannot be contacted after reasonable attempts by the applicant.
Except as provided herein, a temporary license shall expire within six months of its effective date or be terminated at an earlier date upon any of the following:
1. Termination of the supervisory relationship between the applicant and the supervising physical therapist verifying the supervise on of the applicant;
2. The applicant's failure to pass the applicable physical therapy licensure examination identified in subsection a.2.;
3. Determination by the board that the applicant's qualifications for licensure are not as represented by the applicant at the time of application;
4. If the board determines that there is cause for termination due to the temporary licensee committing any act specified in section 461J-12 or 436B-19, HRS, or section 16-110-50; or
5. The person has received a permanent license.
The six month period for a temporary license may be extended to one year by the board for good cause. Only one temporary license shall be issued per applicant.
A temporary license shall not be issued to a person who is not authorized to work in the United States.

16-110-41 Repealed. [R 12/9/10]

16-110-42 Repealed. [R 12/9/10]

SUBCHAPTER 6

PROFESSIONAL MISCONDUCT

16-110-50 Professional misconduct, gross carelessness, manifest incapacity defined. For purposes of section 461J-128., HRS, "professional misconduct, gross carelessness, or manifest incapacity in the practice of physical therapy" includes, but shall not be limited to:

Administering treatments or evaluation in a negligent manner;
Falsifying or otherwise altering patient records;
Misappropriating drugs, money, supplies, or equipment;
Aiding or abetting, or both, the practice of physical therapy by any person not licensed to practice as defined by chapter 461J, HRS;
Accepting fees for services not provided;
Improper delegation to or supervision of physical therapist assistants, or support or auxiliary personnel;
Practicing physical therapy outside the scope of this chapter;
Failure to abide by the APTA Guildelines for Physical Therapy Documentation, the APTA Code of Ethics, or the APTA Guide to Professional Conduct; or
Failing to immediately refer any patient to an appropriate healthcare provider if there is reasonable cause to believe that the patient's condition is beyond the physical therapist's scope of practice or is a co ndition for which physical therapy is contraindicated.

SUBCHAPTER 7

PRACTICE AND PROCEDURE

16-110-60 Administrative practice and procedure. The rules of practice and procedure for physical therapists shall be as provided in chapter 16-201, the rules of administrative practice and procedure of the department of commerce and consumer affairs, as adopted and as may subsequently be amended, which are incorporated by reference and made a part of this chapter.

SUBCHAPTER 8

ORAL TESTIMONY

16-110-70 Oral testimony.

The board shall accept oral testimony on any item which is on the agenda, provided that the testimony shall be subject to the following conditions:
1. Each person seeking to present oral testimony is requested to notify the board not later than forty-eight hours before the meeting, and at that time, to state the item on which testimony is to be presented;
2. The board may request that any person providing oral testimony submit the remarks, or a summary of the remarks, in writing to the board;
3. The board may rearrange the items on the agenda for the purpose of providing for the most efficient and convenient presentation of oral testimony;
4. Persons presenting oral testimony at the beginning of the testimony shall identify themselves and the organization, if any, that they represent;
5. The board may limit oral testimony to a specified time period but in no case shall the period be less than five minutes, and the person testifying shall be informed prior to the commencement of the testimon y of the time constraints to be imposed; and
6. The board may refuse to hear any testimony which is irrelevant, immaterial, or unduly repetitious to the agenda item on which it is presented.
Nothing in this section shall require the board to hear or receive any oral or documentary evidence from a person on any matter which is the subject of another proceeding pending subject to the hearings relief, declarat ory relief, or rule relief provisions of chapter 16-201.
Nothing in this section shall prevent the board from soliciting oral remarks from persons present at the meeting or from inviting persons to make presentations to the board on any particular matter on the board's agenda.

SUBCHAPTER 9

FEES

16-110-80 Fees.

The fees for the board of physical therapy shall be as adopted by the director in chapter 16-53, after hearing, pursuant to chapter 91, HRS.
The dishonoring of any check upon first deposit shall be considered a failure to meet the requirements of this chapter.

CHAPTER 461J PHYSICAL THERAPY PRACTICE ACT

461J-1 Definitions.

As used in this chapter:

"Board" means the board of physical therapy.

"Competence" is the application of knowledge, skills, and behaviors required to function effectively, safely, ethically, and legally within the context of the individual's role and environment.

"Continuing competence" is the lifelong process of maintaining and documenting competence through ongoing self-assessment, development, and implementation of a personal learning plan, and subsequent reassessment.

"Educational institution" means public and private schools as defined under chapter 297, and colleges, the University of Hawaii, and other universities.

"Foreign-trained person" means a person who has completed an educational program or course of study in physical therapy in an institution located outside the United States.

"Physical therapist" means a person who is licensed to practice physical therapy in this State.

"Physical therapist assistant" means a person who is licensed as a physical therapist assistant in the State and assists the physical therapist in selected components of treatment or intervention.

Amended 01/15

"Physical therapy" or "physical therapy services" means the examination, treatment, and instruction of human beings to detect, assess, prevent, correct, alleviate, and limit physical disability, bodily malfunction, pain from injury, disease, and any other physical or mental condition as performed by a physical therapist appropriately licensed under this chapter. It includes but is not limited to:

Administration, evaluation, modification of treatment, and instruction involving the use of physical measures, activities, and devices, for preventive and therapeutic purposes; provided that should the care or treatment given by a physical therapist or physical therapist assistant contravene treatment diagnosed or prescribed by a medical doctor, osteopath, or as determined by the board, the physical therapist shall confer with the prof essional regarding the manner or course of treatment in conflict and take appropriate action in the best interest of the patient; and
The provision of consultative, educational, and other advisory services for the purpose of reducing the incidence and severity of physical disability, bodily malfunction, or pain.

"Practice of physical therapy" includes, but is not limited to, the use of the following:

Physical agents, such as heat, cold, water, air, sound, compression, light, electricity, and electromagnetic radiation;
Exercise with or without devices, joint mobilization, mechanical stimulation; biofeedback; postural drainage; traction; positioning, massage, splinting, training in locomotion, and other functional activities with or wi thout assisting devices; and correction of posture, body mechanics, and gait;
Tests and measurements of: muscle strength, force, endurance, and tone; joint motion, mobility, and stability; reflexes and automatic reaction; movement skill and accuracy; sensation and perception; peripheral nerve int egrity; locomotor skill, stability, and endurance; activities of daily living; cardiac, pulmonary, and vascular functions; and fit, function, and comfort of prosthetic, orthotic, and other assisting devices; posture and body mechanics; limb strength, circumference, and volume; thoracic excursion and breathing patterns; vital signs; nature and locus of pain and conditions under which pain varies; photosensitivity; and the home and work physical environments.

"Unit" is a relative value assigned to continuing competence activities in which one continuing competence unit is equivalent to at least fifty minutes of classroom or hands on instruction.

461J-2 Practice of physical therapy; qualifications.

No person shall practice physical therapy gratuitously or for pay, offer to practice physical therapy, offer physical therapy or physical therapy services, or represent, advertise, or announce, either publicly or privately, that the person is a physical therapist or physiotherapist, unless the person is appropriately licensed under this chapter.
No person shall use, in connection with the person's name or business, the words "licensed physical therapist", "physical therapist", or "physiotherapist", or the letters "RPT", "LPT", "DPT", "PT", or any other words, letters, abbreviations, or insignia indicating or implying that the person is a physical therapist, unless the person is appropriately licensed as a physical therapist under this chapter.
No person shall use the title "physical therapist assistant", the letters "PTA", or any other words, abbreviations, or insignia in connection with that person's name to indicate or imply, directly or indirectly, that the person is a physical therapist assistant unless that person is appropriately licensed as a physical therapist assistant under this chapter.
No person shall practice as a physical therapist or as a physical therapist assistant, except as licensed pursuant to this chapter and under the administrative rules determined by the board in accordance with chapter 91.

461J-2.3 Physical therapist use of support or auxiliary personnel.

A physical therapist may use support or auxiliary personnel, including licensed physical therapist assistants, to assist the physical therapist in the practice of physical therapy; provided that the support or auxiliary personnel shall:
1. Perform only the duties prescribed in the rules of the board; and
2. Perform these duties under the supervision and direction of a physical therapist.
Physical therapists and physical therapist assistants shall provide proof of compliance with this section upon written request from the board.

461J-2.5 Prohibited practices.

A physical therapist shall not use invasive procedures. For purposes of this section, an invasive procedure is the breaking or puncturing of a person's good skin integrity, for example, through surgery or injections.

461J-3 Exemptions.

Nothing in this chapter shall be construed to prohibit any person from acting within the scope of a license issued to that person under any other law; provided that the person shall not claim to be a physical therapist or a physical therapist assistant, or that the person is performing physical therapy or physical therapy services.
Nothing in this chapter shall be construed to prohibit students in an educational program for physical therapists, physical therapist assistants, or physical therapist support personnel from participating in activities that are conducted as part of the educational program and are under the guidance and direct supervision of a licensed physical therapist.
Nothing in this chapter shall be construed to prohibit a person licensed as a physical therapist or as a physical therapist assistant in another state or foreign country from practicing physical therapy in this State I f the person is part of an educational demonstration or instructional program or seminar sponsored by an educational institution, hospital, medical care program, the Hawaii Chapter of the American Physical Therapy Asso ciation, or any other similar person or group, for the duration of the program or seminar and confined to the purpose of the program or seminar.
Nothing in this chapter shall be construed to prohibit an individual from acting as an athletic trainer under chapter 436H.
Nothing in this chapter shall be construed to prohibit a physical therapist or physical therapist assistant who is practicing in the United States Armed Services, United States Public Health Service, or Department of Veteran Affairs pursuant to federal regulations for state licensure of healthcare providers from practicing as a physical therapist or physical therapist assistant; provided that if the person, while federally employed as a physical therapist or a physical therapist assistant, engages in the practice of physical therapy outside the course and scope of the person’s federal employment, the person shall be required to obtain a lic ense in accordance with this chapter.
Nothing in this chapter shall be construed to prohibit a physical therapist who is licensed in a jurisdiction of the United States or another country from engaging in the practice of physical therapy if that person by contract or employment is providing physical therapy to individuals affiliated with or employed by established athletic teams, athletic organizations, or performing arts companies that temporarily practice, compete, or perform in the State for no more than sixty days in a calendar year.

461J-4 Board of physical therapy; establishment, appointment, membership.

There is established within the department of commerce and consumer affairs for administrative purposes the board of physical therapy. The board shall consist of seven members. Four members shall be physical therapists, one member shall be a physical therapist assistant, and two members shall be consumers. All members shall be at least eighteen years of age and residents of the State.
Each physical therapist member of the board shall possess a valid permanent license as a physical therapist and shall have, after graduation from a school of physical therapy, at least three years of full-time experienc e or the equivalent in any of the following areas or in any combination of the following: clinical physical therapy services, administration in physical therapy or related health fields, or teaching in an educational pr ogram to prepare practitioners of physical therapy.
The physical therapist assistant member of the board shall possess a valid permanent license as a physical therapist assistant and shall have, after graduation from an accredited physical therapist assistant program or an accredited physical therapy program, at least three years of full-time experience.
The governor may appoint and fill each vacancy on the board pursuant to section 26-34.

461J-5 Powers and duties of board. In addition to any other powers and duties authorized by law, the board may:

Adopt, amend, or repeal rules in accordance with chapter 91 for the purposes of this chapter;
Recommend the denial or withdrawal of accreditation from educational programs for failure to meet prescribed standards;
Conduct hearings upon charges calling for discipline of a licensee or denial, suspension, limitation, or revocation of a license;
Exercise the power to issue subpoenas, compel the attendance of witnesses, and administer oaths to persons giving testimony at hearings;
Enforce this chapter and the rules adopted pursuant thereto; and
Keep a record of all its proceedings.

461J-6 Permanent licenses.

An applicant for a permanent license to practice as a physical therapist or physical therapist assistant shall submit proof of educational qualifications and any other information required by the board on an application form prescribed by the board. The board shall maintain a current list of schools of physical therapy that are approved by an agency recognized by the United States Department of Education or Council on Postsecondary Accreditation.
In the case of foreign-trained persons, the board shall establish procedures for assessing the education and training to determine in each case whether it is equivalent to that of applicants trained in the United States.
Except as provided under section 461J-7, every applicant for a permanent license who meets the qualifications established by the board shall take an examination administered by the board or an examination administered b y a testing agency selected by the board. The board shall establish the schedule for examinations, determine the passing score, and notify applicants of the results of examinations according to rules adopted by the board.

461J-7 Examination waiver. The board may recommend licensing without written examination of an applicant who submits evidence satisfactory to the board that the applicant has scored equal to or higher than the established passing score of the examination administered by a testing agency selected by the board.

461J-7.5 Physical therapist assistant license without necessity of examination. Any applicant who submits proof of graduation from an accredited physical therapist assistant program or an accredited physical therapy program recognized by the United States Department of Education, and five years of work experience as a physical therapist assistant by December 31, 2014, may be licensed as a physical therapist assistant under this chapter without the necessity of examination.

461J-8 License without necessity of examination or meeting the education requirement. All persons holding licenses as physical therapists from the department of health and in practice on the day prior to January 1, 1986 shall be licensed under this chapter on January 1, 1986 without necessity of examination or meeting the education requirement.

461J-9 Temporary license. The board shall establish rules for issuing temporary licenses to applicants for permanent licenses either under section 461J-6 or 461J-7. The rules adopted by the board shall include provisions concerning the length of time for which temporary licenses are valid, the renewal of such licenses, and the need for supervision by a physical therapist holding a permanent license.

461J-10 Biennial renewal; failure to renew.

The biennial renewal fee shall be paid to the department of commerce and consumer affairs on or before December 31 of each even-numbered year. Failure, neglect, or refusal of any licensee to pay the biennial renewal fee on or before such date shall constitute a forfeiture of the license.
A forfeited license may be restored upon written application within one year from the date of forfeiture, and the payment of the delinquent fee plus an amount equal to fifty per cent of the delinquent fee. (Effective De cember 31, 2016: (b) will also include provision of proof of completion of the required continuing competence units.)

461J-11 REPEALED.

461J-12 Revocation, suspension, probation of license.

In addition to any other actions authorized by law, any license issued under this chapter may be revoked or suspended by the board at any time for any cause authorized by law, including but not limited to the following
1. Obtaining a fee on the assurance that a manifestly incurable disease can be permanently cured;
2. Wilfully betraying patient confidentiality;
3. Making an untruthful and improbable statement in advertising one's practice or business;
4. False, fraudulent, or deceptive advertising;
5. Being habituated to the excessive use of drugs or alcohol or being or having been addicted to, dependent on, or a habitual user of, a narcotic, barbiturate, amphetamine, hallucinogen, or other drug having similar effects;
6. Practicing physical therapy while the ability to practice is impaired by alcohol, drugs, or mental instability;
7. Procuring a license through fraud, misrepresentation, or deceit, or knowingly permitting an unlicensed person to practice physical therapy;
8. Professional misconduct, gross carelessness, or manifest incapacity in the practice of physical therapy;
9. Conduct or practice contrary to the ethics of the profession of physical therapy in the United States;
10. Violation of the conditions or limitations upon which a temporary license is issued or an exemption is granted; or
11. Violation of this chapter or the rules adopted pursuant thereto.
To reinstate a suspended license, or to grant licensure to an applicant whose license was previously revoked, the board may require further education or training or require proof of competence in performance.
In lieu of revoking or suspending a license, the board may place the licensee on probation, the terms of which may require observation of the licensee by an appropriate group or society of physical therapists.

461J-13 Penalty. Any person who violates or fails to comply with any of the provisions of this chapter shall be fined not more than $1,000 for each violation.

THE SECTIONS BELOW SHALL TAKE EFFECT ON DECEMBER 31, 2016:

461J-10.1 Continuing competence.

Beginning with the December 31, 2016, renewal, each licensed physical therapist shall be required to obtain at least thirty units of approved continuing competence units in each two-year license renewal period, where on e continuing competence unit is equivalent to at least fifty minutes of classroom or hands on instruction.
For first-time license renewals, if the initial license was issued less than twelve months prior to the renewal date, no continuing competence units will be required for the first renewal period. If the initial license was issued more than twelve months prior to the renewal date, the licensee shall be required to obtain fifteen units of approved continuing competence units for the first renewal period.
At the time of renewal, each licensee shall submit evidence of completing the required continuing competence units to the board or agency designated by the board. Failure to present evidence of compliance at the time of renewal shall constitute a forfeiture of the license, which may be restored only upon written application and payment to the board of a restoration fee and proof of compliance with continued competence requirements.
The board may randomly audit a licensee's continuing competence units, and may establish guidelines for random audits in rules adopted in accordance with chapter 91.

461J-10.11 Content standards of continuing competence.

Continuing competence units shall be obtained in subjects related to either the professional practice of physical therapy or patient/client management.
The "professional practice of physical therapy" includes but is not limited to professional accountability, professional behavior, and professional development.
"Patient/client management" includes but is not limited to examination, evaluation, diagnosis, and prognosis; plan of care; implementation; education; and discharge.

461J-10.12 Continuing competence subject matter requirements and other limitations. For each renewal period, a licensee's continuing competence units shall include the following:

Two units in ethics, laws, and rules (jurisprudence), or some combination thereof; and
Four units in life support for health care professionals; provided that such training shall be comparable to, or more advanced than, the American Heart Association's basic life support health care provider course.

461J-10.13 Authorize providers of continuing competence units. Continuing competence units shall be obtained from a provider or agency approved by the board, including but not limited to:

Continuing education courses, including home and self study courses, obtained from an agency recognized by the board;
College coursework from an educational institution accredited by the United States Department of Education or other agency recognized by the board; and
Other competence related activities approved by the board or an agency recognized by the board.

461J-10.14 Exemption from continuing competence requirements.

Prior to the expiration of a renewal period, a license may submit a written request to the board for an exemption from the continuing competence requirements in this chapter.
The request for an exemption shall include the following information:
1. Evidence that, during the two-year period prior to the expiration of the license, the licensee was residing in another country for one year or longer, reasonably preventing completion of the continuing competence requirements;
2. Evidence that, during the two-year period prior to the expiration of the license, the licensee was ill or disabled for one year or longer as documented by a licensed physician, surgeon, or clinical psychologist, preventing completion of the continuing competence requirements; or
3. Evidence that, during the two-year period prior to the expiration of the license, a dependent family member of the licensee was ill or disabled for one year or longer as documented by a licensed physician, surgeon, or clinical psychologist, preventing completion of the continuing competence requirements.
The above exemptions shall not be granted for more than one renewal period. In the event a licensee cannot complete the continuing competence requirements during the two-year period after receiving an exemption, the licensee may only renew the license on an inactive status.
When a licensee is absent from the State because of military service for a period of one year or longer during the two-year renewal period, preventing completion of the continuing competence requirement, the board may provide an exemption from the continuing competence requirement for more than one renewal period.

461J-10.15 Record keeping for continuing competence.

Each licensee shall keep and maintain records showing that each course or activity for which credit is claimed has been completed.
These records shall reflect the title of the course or activity, the date taken or completed, and the record of participation.
Each licensee shall retain such documentation for a period of seven years after the course or activity concludes.
Each licensee shall provide copies of such documentation to the board or its designee within fourteen calendar days after being requested to provide such documentation.

461J-12.5 Inactive status.

A licensee may apply in writing to have the licensee's license placed on inactive status. While on inactive status, the licensee shall not engage in the practice of physical therapy.
A license on inactive status shall be renewed during the same time period as active licenses. While on inactive status, the licensee shall not be required to comply with the continuing competence requirements in this chapter.
To reactivate a license on inactive status, the licensee shall:
1. Pay the renewal and any applicable fees; and
2. Have obtained continuing competence units equivalent to that required for a single renewal period of an active license within the last two years prior to applying to restore the license to active status.
The inactive status of any licensee shall not deprive the board of its authority to institute or continue any disciplinary or enforcement action against the licensee

PROFESSIONAL AND VOCATIONAL LICENSING ACT

PART I

GENERAL PROVISIONS

436B-1 Short title. This chapter shall be known as and may be cited as the Professional and Vocational Licensing Act.

436B-2 General definitions. As used in this chapter:

"Board" means any board or commission which is created and authorized by statute to issue a professional or vocational license, and is established within or transferred to the department for administrative purposes or subject to the administrative control or supervision of the director.

"Department" means the department of commerce and consumer affairs.

"Director" means the director of commerce and consumer affairs.

"Executive secretary" or equivalent expressions means the individual employed by the department subject to chapters 76 and 77, who shall assist the licensing authority in administering this chapter, its licensing laws, rules, and orders, and who shall perform such other ministerial duties and delegated functions as authorized by law.

"Forfeit" or "forfeiture" means the immediate and automatic termination or cancellation without any prior consultation with the licensee of a license issued by a board, caused by a licensee's voluntary or involuntary failure to comply with the requirements for maintaining or renewing a license.

"License" means the permission to engage in a profession or vocation granted by the applicable licensing authority to a person who has satisfied every requirement for licensure, and shall include any registration, certificate, or other document issued by the licensing authority reflecting proof of permission.

"Licensee" means the person in whose name the licensing authority grants a license.

"Licensing authority" or "authority" means the director, or any licensing board or commission under the administrative control of the director pursuant to section 26-9(c), authorized by statute to grant or to deny licenses.

"Licensing laws" means the applicable chapter providing for the regulation, licensing, and practice of a profession or vocation by the licensing authority.

"Person" includes an individual, partnership, joint venture, corporation, association, business, trust, or any organized group of persons or legal entity, or any combination thereof.

"Program" means any regulatory program in which the director is authorized by law to grant or to deny a license to a person seeking permission to engage in a profession or vocation.

"Reinstate" or "reinstatement" means the permission to engage in a profession or vocation granted by the applicable licensing authority to a person whose license has been previously suspended by the licensing authority.

"Renew" or "renewal" means the permission to engage in a profession or vocation granted by the applicable licensing authority to a licensee who has applied for an extension of a current and valid license.

"Restore" or "restoration" means the permission to engage in a profession or vocation granted by the applicable licensing authority to a person whose license has been previously forfeited by the licensing authority.

436B-3 Applicability; prevailing provisions; construction.

The provisions of this chapter shall only be applicable to the professions and vocations required by law to be regulated by the licensing authority.
Unless otherwise stated in this chapter, chapters 26, 26H, 91, and 92 and the licensing laws or rules for the respective profession or voca tion shall prevail. This chapter shall apply whenever chapters 26, 26H, 91, and 92 and the licensing laws or rules for the respective profession or vocation are silent.
This chapter shall be liberally construed to protect the health, safety, and welfare of consumers of services provided by a profession or v ocation regulated by the licensing authority.

436B-4 Rules. The licensing authority may adopt rules pursuant to chapter 91 to effectuate this chapter and its licensing laws, and to carry out its purpose of protecting the health, safety, and welfare of consumers of services provided by a profession or vocation regulated by the licensing authority. The enumeration of specific matters which may properly be made the subject of rules shall not be construed to limit the licensing authority's broad general power to make all rules necessary to fully effectuate the purpose of this chapter.

PART II.

ORGANIZATION

436B-5 Conditions of office.

Each member of a board shall be selected and shall serve under the provisions of section 26-34, and before beginning a term of office, shal l take an oath of office before a notary public, or other officer empowered to administer oaths.
Each member of a board shall serve without pay. However, the actual and necessary traveling expenses incurred in connection with the perfor mance of the member's official duties shall be paid by the department, upon the presentation of vouchers approved by the department.

436B-6 Organization of boards.

Immediately upon the qualification and appointment of the original members, and annually thereafter, the board shall elect one member as ch air and one member as vice-chair. In the absence of both the chair and the vice-chair to preside at a meeting, the members present shall select a chair pro tem.
Each board shall meet not less than twice a year at a time and place determined by the board.
The majority of the members to which the board is entitled shall constitute a quorum. The concurrence of a majority of the members to which the board is entitled shall be necessary to make any action taken by the board valid. Each board shall conduct its meetings in accordance with chapters 91 and 92.

436B-7 Powers and duties of licensing authority. In addition to any other powers and duties authorized by law, each licensing authority may:

Adopt, amend, or repeal rules, issue declaratory rulings or informal non-binding interpretations, and conduct contested case proceedings pursuant to chapter 91;
Grant, deny, convert, forfeit, renew, reinstate or restore licenses, including the issuance of conditional licenses;
Revoke, suspend, or otherwise limit the license of any licensee for any violation of the provisions in this chapter, the licensing laws, or any rule or order of the licensing authority;
Develop requirements for licensure through the applicable licensing laws or rules;
Investigate and conduct hearings regarding any violation of this chapter, the licensing laws, and any rule or order of the licensing authority;
Monitor the scope of practice of the profession or vocation regulated by the licensing authority;
Prepare, administer, and grade examinations; provided that the licensing authority may contract with a testing agency to provide those services, and the licensing authority may also reserve the right to modify, amend, change, or regrade the examination;
Create fact-finding committees which may make recommendations to the licensing authority for its deliberations;
Contract with qualified persons including investigators who may be exempt from chapters 76 and 77 and who shall assist the licensing authority in exercising its powers and duties; and
Subpoena witnesses and documents, administer oaths, and receive affidavits and oral testimony, including telephonic communications, and do any and all things necessary or incidental to the exercise of the licensing authority's power and duties, including the authority to conduct contested case proceedings under chapter 91.

436B-8 Delegation of authority.

The board shall delegate to the department the authority to receive, arbitrate, investigate, and prosecute any complaint against a licensee.
A licensing authority may delegate to the executive secretary, or other designee, any of its powers or duties as it deems reasonable and proper. The delegation of powers and duties by the licensing authority shall be made in accordance with the procedures set forth in section 4 36B-6(c). However, the licensing authority shall not delegate its discretionary functions resulting in a final decision, including but not limited to the following:
1. Adopting, amending, or repealing rules;
2. Ordering disciplinary action against a licensee, including the revocation, suspension, or imposition of conditions or fines; provided that summary suspensions may be delegated; and
3. Granting, denying, or otherwise conditioning license applications, unless the granting, denying, or conditioning of a license does not require the exercise of the licensing authority's expertise and discretion.

436B-8.5 Review of examinations. The department, in its discretion, may allow an applicant to review the most recent examination failed by the applicant, provided that under no circumstances shall the licensing authority or the department allow an examination to be copied.

PART III.

APPLICATION FOR LICENSURE

436B-9 Action on applications; abandoned applications.

Unless otherwise provided by law, each licensing authority shall take the following actions within one year after the filing of a complete application for licensure:
1. If it deems appropriate, conduct an investigation of the applicant; and
2. Notify the applicant in writing by mail of the decision regarding the application for licensure. If the application has been denied, written notice of the decision shall state specifically the reason for denying the application and shall inform the applicant of the right to a hearing under chapter 91.
An application shall be considered to be abandoned if an applicant fails to provide evidence of continued efforts to complete the licensing process for two consecutive years; provided that the failure to provide evidence of continued efforts includes but is not limited to:
1. Failure to submit the required documents and other information requested by the licensing authority within two consecutive years from the last date the documents or other information were requested; or
2. Failure to provide the licensing authority with any written communication during two consecutive years indicating that the applicant is attempting to complete the licensing process, including but not limited to attempting to complete the examination requirement; and provide further that the licensing authority may extend the above time periods by rule. The licensing authority shall not be required to act on any abandoned application, and the application may be destroyed by the licensing authority or its delegate. If the application is deemed abandoned by the licensing authority, the applicant shall be required to reapply for licensure and comply with the licensing requirements in effect at the time of reapplication.

436B-10 Application and requirements for licensure.

Application for a license shall be made on an application form to be furnished by the licensing authority. An applicant shall provide the following information on the application form:
1. The applicant's legal name
2. Affirmation that the applicant is beyond the age of majority;
3. The applicant's current residence, business and mailing addresses, and phone numbers;
4. The applicant's social security number if the licensing authority is authorized by federal law to require the disclosure;
5. The date and place of any conviction of a penal crime directly related to the profession or vocation in which the applicant is applying for licensure, unless the conviction has been expunged or annulled, or is oth erwise precluded from consideration by section 831-3.1;
6. Proof that the applicant is a United States citizen, a United States national, or an alien authorized to work in the United States;
7. Disclosure of similar licensure in any state or territory;
8. Disclosure of disciplinary action by any state or territory against any license held by the applicant; and
9. Any other information the licensing authority may require to investigate the applicant's qualifications for licensure. Failure to provide the above information and pay the required fees shall be grounds to deny th e application for licensure.
In addition to any other requirements provided by law, all applicants shall be:
1. Beyond the age of majority; and
2. A United States citizen, a United States national, or an alien authorized to work in the United States.

436B-11 Additional licensure requirements. In addition to any other requirements provided by law, the licensing authority may also require by rule that the applicant provide the following:

In the case of a partnership applicant, each general partner shall attest that each partner is beyond the age of majority;
Proof that the applicant is competent, trustworthy, fair, and has financial integrity; and
Proof that the applicant has satisfied all applicable business registration requirements prior to applying for licensure.

436B-12 Criminal conviction. When an applicant has been convicted of a penal crime directly related to the profession, vocation, or occupation for which licensure is sought, and it is determined that the conviction may be considered under section 831-3.1, the department, executive secretary, or the licensing authority's designee may request the following documents from the applicant:

Copies of any court records, orders, or other documents that state the facts and statutes upon which the applicant was convicted, the verdict of the court with regard to that conviction, the sentence imposed, and the ac tual terms of the sentence; and
Affidavits from any parole officer, employer, or other persons who can attest to a firm belief that the applicant has been sufficiently rehabilitated to warrant public trust.

436B-13 Renewal of license.

Each licensee shall be responsible for timely renewing the licensee's license and satisfying the renewal requirements provided by law.
At the time of license renewal, each licensee shall submit a completed renewal application and all applicable fees, and shall comply with any other requirement provided by law. A completed renewal application sent by United States mail shall be considered timely filed if the envelope bears a postmark of the required renewal date.
The failure to timely renew a license, the failure to pay all applicable fees, the dishonoring of any check upon first deposit, or the failure to comply with any other requirement provided by law, shall cause the license to be automatically forfeited.

436B-13.3 Inactive license; reactivation of inactive license.

Unless otherwise provided by law, each licensing authority may allow a licensee to place its license on inactive status and provide conditions for the reactivation of the license.
If a licensing authority desires to authorize an inactive license status, the licensing authority may decide to accept in total the provisions in subsection (c) to immediately effectuate an inactive license status. If a licensing authority desires to establish provisions for an inactive license status that differ from the provisions in subsection (c), the licensing authority may establish those alternative provisions by rules adopted pursuant to chapter 91.
The following general provisions shall be applied by the licensing authority:
1. Upon written request by a licensee during the licensure period or at renewal, and upon payment of an inactive license fee, the licensing authority shall place that licensee's active license on an inactive status;
2. A licensee may continue on inactive status for the biennial or triennial period, whichever is applicable;
3. A licensee on inactive status shall be considered as unlicensed and shall not engage in the practice of the licensed profession or vocation. Any person who violates this prohibition shall be subject to discipline under this chapter and the laws and rules of the licensing authority for that license;
4. It shall be the responsibility of each licensee on inactive status to maintain knowledge of current licensing and renewal requirements; and
5. A licensee may request to reactivate the license at any time during the licensure period or at renewal by completing an application for reactivation and fulfilling all requirements in effect at the time of application to return the license to active status, including the payment of an activation fee and other fees that may be required. The licensing authority may require information from the applicant to ensure the applicant is fit to engage in the profession, including but not limited to reporting license sanctions, pending disciplinary actions, or conviction of a crime in which the conviction has not been annulled or expunged.
The licensing authority may deny an application for reactivation if the applicant does not fulfill all requirements or for the bases set forth in section 436B-19 or in the laws and rules of the licensing authority for that license. If the licensing authority denies the application, written notice of the denial shall state specifically the reason for denying the reactivation and shall inform the applicant of the right to a hearing under chapter 91. The applicant shall be required to reapply for licensure and comply with the licensing requirements in effect at the time of reapplication.

436B-14 Restoration of forfeited license. A license which has been forfeited may be restored by the licensing authority within one year after the date of forfeiture upon compliance with the licensing renewal requirements provided by law and upon written application and payment of all applicable renewal fees, penalty fees, compliance resolution fund fees and, if applicable, recovery fund assessments. Any person who fails to have the person's license restored within one year from the date of forfeiture may be required by the licensing authority to reapply for licensure as a new applicant.

436B-14.5 Extension of licenses for members of the armed forces, national guard, and reserves.

Notwithstanding any other law to the contrary, any license held by a member of the armed forces, national guard, or a reserve component that expires, is forfeited, or deemed delinquent while the member is on active duty and deployed during a state or national crisis shall be restored under the restoration requirements provided in this section.
For the purposes of this section, "state or national crisis" includes but is not limited to:
1. A situation requiring the proper defense of nation or state;
2. A federal or state disaster or emergency;
3. A terrorist threat; or
4. A homeland security or homeland defense event or action.
The licensing authority shall restore a license upon the payment of the current renewal fee if the member:
1. Requests a restoration of the license within one hundred twenty days after being discharged or released from active duty deployment;
2. Provides the licensing authority with a copy of the member's order calling the member to active duty deployment and the member's discharge or release orders; and
3. If required for renewal, provides documentation to establish the financial integrity of the licensee or to satisfy a federal requirement.
This section:
1. Shall not apply to a member who is on scheduled annual or specialized training, or to any person whose license is suspended or revoked, or who otherwise has been adjudicated and is subject to disciplinary action on a license; and
2. Shall also apply to a member whose license is current, but will expire within one hundred twenty days of the member's discharge or release from active duty deployment.

436B-14.6 Licensure by endorsement or licensure by reciprocity; experience requirements.

Unless otherwise provided by law, an applicant for licensure by endorsement or licensure by reciprocity who is a nonresident military spouse may demonstrate competency in a specific profession or vocation as determined by the licensing authority in lieu of a requirement that the applicant has worked or practiced in that profession or vocation for a specified period of time prior to the application for licensure by endorsement or licensure by reciprocity.
The licensing authority shall expedite consideration of the application and issuance of a license by endorsement or license by reciprocity to a nonresident military spouse who meets the requirements of this section.

436B-14.7 Licensure by endorsement or licensure by reciprocity; initial acceptance by affidavit; temporary license; military spouse.

If a military spouse holds a current license in another state, district, or territory of the United States with licensure requirements that the licensing authority determines are equivalent to or exceed those established by the licensing authority of this State, that military spouse shall receive a license pursuant to applicable statutes or requirements of the licensing authority of this State regarding licensure by endorsement or licensure by reciprocity; provided that the military spouse:
1. Has not committed an act in any jurisdiction that would have constituted grounds for the limitation, suspension, or revocation of a license; has never been censured or had other disciplinary action taken; has not had an application for licensure denied; or has not refused to practice a profession or vocation for which the military spouse seeks licensure;
2. Has not been disciplined by a licensing or credentialing entity in another jurisdiction; is not the subject of an unresolved complaint, review procedure, or disciplinary proceeding conducted by a licensing or credentialing entity in another jurisdiction; and has not surrendered membership on any professional staff in any professional association, society, or faculty for another state or licensing jurisdiction while under investigation or to avoid adverse action for acts or conduct similar to acts or conduct which would constitute grounds for disciplinary action in this State;
3. Pays any fees required by the licensing authority of this State;
4. Submits with the application a signed affidavit stating that application information, including necessary prior employment history, is true and accurate. Upon receiving the affidavit, if the licensing authority issues the license to the military spouse, the licensing authority may revoke the license at any time if the information provided in the application is found to be false; and
5. Is the spouse of a military member who is a member in good standing in the active or a reserve component of any of the armed forces of the United States and the military member has orders issued by the appropriate agencies of the armed forces to be stationed in Hawaii for a duration of at least one year.
The licensing authority shall issue to the military spouse a temporary license to allow the military spouse to perform specified services, under the supervision of a professional licensed by this State if appropriate, while completing any requirements necessary for licensure in this State; provided that a temporary license shall only be issued in those professions where credentials, experience, or passage of a national exam is substantially equivalent to or exceed those established by the licensing authority of this State.
The licensing authority shall expedite consideration of the application and issuance of a license by endorsement, license by reciprocity, or temporary license to a military spouse who meets the requirements of this section.
A license by endorsement or reciprocity issued under subsection (a) shall be valid for the same period of time as a license issued pursuant to the requirements of title 25 for the particular profession; provided that the total time period that a military spouse holds a license issued by endorsement or reciprocity under subsection (a) shall not exceed five years in the aggregate.

436B-15 Fees and expenses. No applicant or licensee shall be granted a license pursuant to the licensing laws unless the appropriate fees have been paid. Unless otherwise provided by law, the director shall establish the amount for all fees and expenses by rules adopted pursuant to chapter 91. The fees to be established by the director may include but not be limited to an application fee, filing fee, license fee, renewal fee, examination fee, and other reasonable and necessary fees related to the department's administrative costs. Unless otherwise provided by law, the fees shall be deposited with the director to the credit of the compliance resolution fund established pursuant to section 26-9(o).

436B-15.5 Conversion of license.

Notwithstanding any other provision of law to the contrary, a licensee who has converted its form of business entity in accordance with sections 414271, 414D-207, 415A-16.5, -1102, and 428-902.5, and desires to continue engaging in a profession or vocation subject to this chapter in its new form of business entity shall:
1. File an application for conversion of a license and pay the initial application fee specified in the statutes or rules of the profession or vocation, within thirty calendar days after the effective date of the conversion; and
2. Continue to meet the other licensing requirements of that profession or vocation.
Failure to comply with the requirements of this section shall cause the license to be automatically forfeited. A licensee whose license is forfeited shall not engage in the profession or vocation until the license is restored or the licensee obtains a new license.

PART IV.

LICENSEE REPORTING REQUIREMENTS

436B-16 Notice of judgments, penalties.

Each licensee shall provide written notice within thirty days to the licensing authority of any judgment, award, disciplinary sanction, order, or other determination, which adjudges or finds that the licensee is civilly, criminally, or otherwise liable for any personal injury, property damage, or loss caused by the licensee's conduct in the practice of the licensee's profession or vocation. A licensee shall also give notice of such determinations made in other jurisdictions.
In addition to any other penalties provided by law, the failure of a licensee to comply with the provisions of this section is a violation punishable by a fine of not less than $100 for the first violation, $250 to $500 for the second violation, and $500 to $1,000 for subsequent violations. Any action taken to impose or collect the fine provided for in this subsection shall not be considered a criminal action.

436B-17 Filing of current addresses. Each licensee shall file with the licensing authority the licensee's current mailing, business, and residence address. It shall be the licensee's duty to provide written notice to the licensing authority of any change of address within thirty days of the change. Failure of the licensee to provide the notice shall absolve the licensing authority, executive secretary, or any designee from any duty to provide notice of any matter required by law to be provided the licensee.

PART V.

LICENSING SANCTIONS

436B-18 Disciplinary action. In addition to the licensing sanctions or remedies provided by section 92-17 against any licensee, the licensing authority may also impose conditions or limitations upon a licensee's license after a hearing conducted in accordance with chapter 91. The violation of any condition or limitation on a licensee's license may be cause to impose additional sanctions against the licensee. Unless otherwise provided by law, any fine imposed by the licensing authority after a hearing in accordance with chapter 91 shall be no less than $100 for each violation, and each day's violation may be deemed a separate violation.

436B-19 Grounds for refusal to renew, reinstate or restore and for revocation, suspension, denial, or condition of licenses. In addition to any other acts or conditions provided by law, the licensing authority may refuse to renew, reinstate or restore or may deny, revoke, suspend, or condition in any manner, any license for any one or more of the following acts or conditions on the part of the licensee or the applicant thereof:

Failure to meet or maintain the conditions and requirements necessary to qualify for the granting of a license;
Engaging in false, fraudulent, or deceptive advertising, or making untruthful or improbable statements;
Being addicted to, dependent on, or a habitual user of a narcotic, barbiturate, amphetamine, hallucinogen, opium, or cocaine, or other drugs or derivatives of a similar nature;
Practicing the licensed profession or vocation while impaired by alcohol, drugs, physical disability, or mental instability;
Procuring a license through fraud, misrepresentation, or deceit;
Aiding and abetting an unlicensed person to directly or indirectly perform activities requiring a license;
Professional misconduct, incompetence, gross negligence, or manifest incapacity in the practice of the licensed profession or vocation;
Failure to maintain a record or history of competency, trustworthiness, fair dealing, and financial integrity;
Conduct or practice contrary to recognized standards of ethics for the licensed profession or vocation;
Violating any condition or limitation upon which a conditional or temporary license was issued;
Engaging in business under a past or present license issued pursuant to the licensing laws, in a manner causing injury to one or more members of the public;
Failure to comply, observe, or adhere to any law in a manner such that the licensing authority deems the applicant or holder to be an unfit or improper person to hold a license;
Revocation suspension, or other disciplinary action by another state or federal agency against a licensee or applicant for any reason provided by the licensing laws or this section;
Criminal conviction, whether by nolo contendere or otherwise, of a penal crime directly related to the qualifications, functions, or duties of the licensed profession or vocation;
Failure to report in writing to the licensing authority any disciplinary decision issued against the licensee or the applicant in another jurisdiction within thirty days of the disciplinary decision;
Employing, utilizing, or attempting to employ or utilize at any time any person not licensed under the licensing laws where licensure is required; or
Violating this chapter, the applicable licensing laws, or any rule or order of the licensing authority.

436B-19.5 Suspension or denial of license for noncompliance with child support order. In addition to any other acts or conditions provided by law, the licensing authority shall refuse to renew, reinstate, or restore, or shall deny or suspend any license if the authority has received certification from the child support enforcement agency pursuant to the terms of section 576D-13 that the licensee or applicant is not in compliance with an order of support or has failed to comply with a subpoena or warrant relating to a paternity or child support proceeding. Unless otherwise provided by law, the licensing authority shall renew, reinstate, restore, or grant the license only upon receipt of an authorization from the child support enforcement agency, the office of child support hearings, or the family court. Sections 92-17, 436B-20, 436B-21, 436B-24, and 436B-25 shall not apply to a license suspension or denial pursuant to this section.

436B-19.6 Denial or suspension of license for default of student loan, student loan repayment contract, or scholarship contract.

In addition to any other acts or conditions provided by law, the licensing authority shall not renew or reinstate, or shall deny or suspend any license or application, if the department has received certification from an administering entity pursuant to chapter 436C that the licensee or applicant is in default or breach of any obligation under any student loan, student loan repayment contract, or scholarship contract that financed the licensee's or applicant's education, or has failed to comply with a repayment plan.
The licensing authority in receipt of a certification pursuant to chapter 436C shall, as applicable, and without further review or hearing:
1. Suspend the license;
2. Deny the application or request for renewal of the license; or
3. Deny the request for reinstatement of the license, and unless otherwise provided by law, shall renew, reinstate, or grant the license only upon receipt of an authorization from the administering entity. Chapter 91 and sections 92-17, 436B-18, 436B-20, 436B-21, 436B-24, and 436B-25 shall not apply to a license suspension or denial under this section.

436B-20 Suspended license. No license shall be suspended by the licensing authority for a period exceeding five years. A person whose license has been suspended may apply for reinstatement of the license to the extent authorized by law and upon complete compliance with any term or condition imposed by the order of suspension. The application for reinstatement shall be accompanied by all applicable fees, including but not limited to reinstatement fees, any compliance resolution fund fees, and any recovery fund assessments.

436B-21 Revoked license. A person may apply for a new license after five years from the effective date of the revocation of the license by filing an application and complying with all current requirements for new applicants. The licensing authority may waive any applicable education or examination requirements upon being satisfied that the applicant whose license has been previously revoked, has submitted documentation that the applicant has maintained equivalent knowledge, competence, and qualifications through work experience, training, or education.

436B-22 Relinquishment no bar to jurisdiction. The forfeiture, nonrenewal, surrender, or voluntary relinquishment of a license by a licensee shall not bar jurisdiction by the licensing authority to proceed with any investigation, action, or proceeding to revoke, suspend, condition, or limit the licensee's license or fine the licensee.

436B-23 Summary suspension. Notwithstanding any law to the contrary, the licensing authority or its delegate may cause the immediate suspension or restriction of a license, subject to subsequent notice and hearing or other adequate procedures, upon a specific determination that the failure to take such an action may result in: (1) an immediate and unreasonable threat to personal safety; or (2) fraud or misrepresentation upon consumers, and that, for the protection of the public from the possible consequences of practices, the licensee's license should be immediately suspended or restricted.

The licensing authority or its delegate may order the summary suspension of the license for a period not to exceed twenty days. The order of suspension shall be served upon the licensee at the same time as the notice of hearing for disciplinary action, and the hearing shall be scheduled prior to the expiration of the order of suspension. The period of suspension prior to the hearing shall not be extended beyond twenty days except upon request of the licensee for a reasonable continuance to adequately prepare the licensee's defense. Any attempt by the licensee to continue the licensed activity while the license has been summarily suspended shall of itself be sufficient to warrant a permanent revocation of the license and shall subject the licensee to all penalties prescribed by this chapter, the applicable licensing laws, or any rule or order of the licensing authority.

436B-24 Hearings. Unless otherwise provided by law, in every case in which the licensing authority refuses to issue, renew, restore or reinstate a license, or proposes to take disciplinary action or other licensing sanctions against a licensee, the proceeding before the licensing authority shall be conducted in accordance with chapter 91.

In all proceedings before it, the board and each member thereof shall have the same powers respecting administering oaths, compelling the attendance of witnesses and the production of documentary evidence, and examining witnesses as are possessed by circuit courts. In case of disobedience by any person of any order of the board or of a member thereof, or of any subpoena issued by it or a member, or the refusal of any witness to testify to any matter regarding which the witness may be questioned lawfully, any circuit judge, on application by the board or a member thereof, shall compel obedience as in the case of disobedience of the requirements of a subpoena issued by a circuit court, or a refusal to testify therein.

436B-25 Judicial review by circuit court. Any person aggrieved by a final decision and order of the board in a "contested case", as defined in chapter 91, is entitled to judicial review thereof by the circuit court of the circuit in which the board making the final decision and order has jurisdiction. The review shall be as provided by chapter 91.

PART VI.

CIVIL AND CRIMINAL SANCTION

436B-26 No compensation for unlicensed activity; civil action. The failure of any person to maintain a current and a valid license prior to engaging in any activity requiring licensure by the licensing authority shall prevent such person from recovering in a civil action for work or services performed or materials or supplies furnished, or both, on a contract or on any legal basis to recover the reasonable value thereof.

436B-26.5 Citation for unlicensed activity; civil penalties.

In addition to any other remedy available, the investigator may issue citations to persons acting in the capacity of or engaging in business within the State without having a license previously obtained under and in compliance with this chapter, the licensing laws for the respective profession or vocation, and the rules adopted thereunder.
Each citation shall be in writing and shall describe the basis of the citation, including the specific statutory provisions alleged to have been violated, and may contain an order of abatement, and an assessment of civil penalties as provided in this section. All penalties collected under this section shall be deposited in the special fund established under section 26-9 (o).
Any person who violates this section shall be assessed a civil penalty of not more than $500 or forty per cent of the total amount of the goods and services provided or to be provided, whichever is greater, for the first violation; not more than $1,000 or forty per cent of the total amount of the goods and services provided or to be provided, whichever is greater, for the second violation; and not more than $5,000 or forty per cent of the total amount of the goods and services provided or to be provided, whichever is greater, for any subsequent violation.
Service of a citation issued under this section shall be made by personal service or by certified mail, restricted delivery, sent to the last known business or residence address of the person cited.
Any person cited under this section may submit a written request to the director for a hearing, within twenty days from the service of the citation, with respect to the violations alleged, the scope of the order of abatement, or the amount of the civil penalties assessed.
If the person cited under this section timely notifies the director of the request for a hearing, the director shall afford an opportunity for a hearing under chapter 91. The hearing shall be conducted by the director or the director may designate a hearings officer to hold the hearing. The director or any hearings officer designated by the director shall have the power to issue subpoenas, administer oaths, hear testimony, find facts, make conclusions of law, and issue a final order.
If the person cited under this section does not submit a written request to the director for a hearing within twenty days from the receipt of the citation, the citation shall be deemed a final order of the director.
The director may apply to the appropriate court for a judgment to enforce the provisions of any final order issued by the director or designated hearings officer pursuant to this section, including the provision for abatement and civil penalties imposed.
If any party is aggrieved by the decision of the director or the designated hearings officer, the party may appeal in the manner provided in chapter 91 to the circuit court of the circuit in which the party resides or has the party's principal place of business or in which the action in question occurred. The operation of an abatement order shall not be stayed on appeal unless specifically ordered by a court of competent jurisdiction after applying the stay criteria enumerated in section 91-14(c).
The sanctions and disposition authorized under this section shall be separate from and in addition to all other remedies either civil or criminal provided in any other applicable statutory provision.
The director may adopt rules pursuant to chapter 91 necessary for the purpose of this section.

436B-27 Civil and criminal sanctions for unlicensed activity; fines; injunctive relief; damages; forfeiture.

Any licensee aiding or abetting an unlicensed person to directly or indirectly evade this chapter or the applicable licensing laws, or combining or conspiring with an unlicensed person, or permitting one's license to be used by an unlicensed person, or acting as agent, partner, associate, or otherwise, of an unlicensed person with the intent to evade this chapter or the applicable licensing laws may be fined up to $1,000 for the first offense; up to $2,000 or, if applicable, forty per cent of the total contract price, whichever is greater, for the second offense; and up to $5,000 or, if applicable, forty per cent of the total contract price, whichever is greater, for any subsequent offense. For purposes of this section, "contract price" means the total monetary consideration offered by the consumer for the provision of goods and services.
Any person, who engages in an activity requiring a license issued by the licensing authority and who fails to obtain the required license, or who uses any word, title, or representation to induce the false belief that the person is licensed to engage in the activity, other than a licensee who inadvertently fails to maintain licensing requirements under the appropriate licensing statute and who subsequently corrects the failure so that there was no lapse in licensure, shall be guilty of a misdemeanor and each day of unlicensed activity shall be deemed a separate offense.
The department, licensing authority, or any person may maintain a suit to enjoin the performance or the continuance of any act or acts by a person acting without a license where a license is required by law, and if injured thereby, for the recovery of damages. The department may also seek the imposition of fines provided by subsection (a). The plaintiff or petitioner in a suit for an injunction need not allege or prove actual damages to prevail. Reasonable attorney fees and costs shall be allowed by the court to the plaintiff or petitioner as the prevailing party.
All tools, implements, armamentariums, documents, materials, or any other property used by any person to provide professional or vocational services without a license required by law shall be declared forfeited to the State by the court and turned over to the department for disposition as it deems appropriate.

436B-28 Remedies or penalties cumulative. Unless otherwise expressly provided, the remedies or penalties provided by this chapter are cumulative to each other and to the remedies or penalties available under all other laws of this State.

436B-29 Severability. If any provision of this chapter or the application thereof to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of the chapter which can be given effect without the invalid provision or application, and to this end the provision of this chapter are severable.

Effective July 1, 2012:

436B-Licensure acceptance of military education, training, or service. Notwithstanding any law to the contrary, every licensing authority subject to this chapter, upon presentation of satisfactory evidence by an applicant, shall consider relevant education, training, or service completed by an individual as a member of the armed forces or reserves of the United States, the national guard of any state, the military reserves of any state, or the navy militia of any state as part of the evaluation process toward the qualification requirements to receive the license. Evidence presented for consideration for fulfillment or partial fulfillment of licensing requirements shall demonstrate substantial equivalency to state standards.