Texas Reference

TEXAS JURISPRUDENCE ASSESSMENT MODULE REFERENCE
TABLE OF CONTENTS

RULES
PRACTICE ACT
FUNDAMENTAL ETHICAL PRINCIPLES AND DECISION-MAKING MODELS
GUIDE FOR PROFESSIONAL CONDUCT
GUIDE FOR CONDUCT OF THE PHYSICAL THERAPIST ASSISTANT
CODE OF ETHICS FOR THE PHYSICAL THERAPIST
STANDARDS OF ETHICAL CONDUCT FOR THE PHYSICAL THERAPIST ASSISTANT
CORE VALUES FOR THE PHYSICAL THERAPIST AND PHYSICAL THERAPIST ASSISTANT

ADMINISTRATIVE RULES

CHAPTER 321

DEFINITIONS

321.1. Definitions

The following words, terms, and phrases, when used in the rules of the Texas Board of Physical
Therapy Examiners, shall have the following meanings, unless the context clearly indicates otherwise.

Accredited curriculum in physical therapy education--A body of courses in a physical therapy program at a school, college, or university which has satisfied the accreditation standards of the Commission on Accreditation for Physical Therapy Education.
Accredited physical therapist assistant program--A body of courses at a school, college, or university which has satisfied the accreditation standards of the Commission on Accreditation for Physical Therapy Education.
Asymptomatic--Without obvious signs or symptoms of disease.
Board-approved organization or entity--an organization or entity to which the board has formally delegated a role in the licensure, regulation or enforcement functions of the Physical Therapy Practice Act and board rules.
Endorsement--The process by which the board issues a license to a person currently licensed in another state, the District of Columbia, or territory of the United States that maintains professional standards considered by the board to be substantially equivalent to those set forth in the Act.
Emergency circumstances--Instances where emergency medical care is called for, including first aid.
Emergency medical care--Bona fide emergency services provided after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in placing the patient's health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.
Evaluation--A dynamic process in which the physical therapist makes clinical judgments based on data gathered during the examination.
Evidence satisfactory to the board--Should all official school records be destroyed, sworn affidavits satisfactory to the board must be received from three persons having personal knowledge of the applicant's physical therapy education. These affidavits will not be used when official school records are available.
Examination--A comprehensive screening and specific testing process leading to diagnostic classification or, as appropriate, to a referral to another practitioner. The examination has three components: the patient/client history, the systems review, and tests and measures.
Foreign-trained applicant--Any applicant whose entry-level professional physical therapy education was obtained at a physical therapy program outside the U.S., its territories, or the District of Columbia.
Hearing--An adjudicative proceeding concerning the issuance, denial, suspension, reprimand, revocation of license, after which the legal rights of an applicant or licensee are to be determined by the board.
Jurisprudence exam--An open-book examination made up of multiple-choice and/or true/false questions covering information contained in the Texas Physical Therapy Practice Act and Board rules.
On-site supervision--The physical therapist or physical therapist assistant is on the premises and readily available to respond.
Physical therapy--The evaluation, examination, and utilization of exercises, rehabilitative procedures, massage, manipulations, and physical agents including, but not limited to, mechanical devices, heat, cold, air, light, water, electricity, and sound in the aid of diagnosis or treatment. Physical therapists may perform evaluations without referrals. Physical therapy practice includes the use of modalities, procedures, and tests to make evaluations. Physical therapy practice includes, but is not limited to the use of: Electromyographic (EMG) Tests, Nerve Conduction Velocity (NCV) Tests, Thermography, Transcutaneous Electrical Nerve Stimulation (TENS), bed traction, application of topical medication to open wounds, sharp debridement, provision of soft goods, inhibitive casting and splinting, Phonophoresis, Iontophoresis, and biofeedback services.
Supervision--The delegation and continuing direction by a person or persons responsible for the practice of physical therapist, physical therapist assistant, or physical therapy aide as specified in the Physical Therapy Practice Act.

Source Note: The provisions of this 321.1 adopted to be effective March 1, 1986, 11 TexReg 719; amended to be effective September 28, 1988, 13 TexReg 4575; amended to be effective December 12, 1989, 14 TexReg 6277; amended to be effective January 7, 1992, 16 TexReg 7644; amended to be effective January 12, 1993, 18 TexReg 63; amended to be effective November 11, 1993, 18 TexReg 7545; amended to be effective November 6, 1995, 20 TexReg 8793; amended to be effective May 8, 1996, 21 TexReg 3794; amended to be effective July 9, 1996, 21 TexReg 6078; amended to be effective April 28, 1997, 22 TexReg 3588; amended to be effective October 6, 1998, 23 TexReg 9978; amended to be effective April 15, 1999, 24TexReg 2935; amended to be effective May 14, 2000, 25 TexReg 4351; amended to be effective November 16, 2000, 25 TexReg 11285; amended to be effective August 15, 2001, 26 TexReg 6020; amended to be effective September 18, 2006, 31 TexReg 7997; amended to be effective February 13, 2012, 37 TexReg 689.

CHAPTER 322

PRACTICE

322.1. Provision of Services

Initiation of physical therapy services.
1. Referral requirement. Except as authorized by paragraph (2) of this subsection, a physical therapist is subject to discipline from the board for providing physical therapy treatment without a referral from a qualified healthcare practitioner licensed by the appropriate licensing board, who within the scope of the professional licensure is authorized to prescribe treatment of individuals. The list of qualifying referral sources includes physicians, dentists, chiropractors, podiatrists, physician assistants, and advanced nurse practitioners.
2. Exceptions to referral requirement.
  1. A PT may evaluate without referral.
  2. A PT may provide instructions to any person who is asymptomatic relating to the instructions being given without a referral, including instruction to promote health, wellness, and fitness.
  3. Emergency Circumstances. A PT may provide emergency medical care to a person after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity without referral if the absence of immediate medical attention could reasonably be expected to result in a serious threat to the patient's health, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.
  4. A PT may treat a patient for an injury or condition wthout a referral for not more than 10 consecutive business days of the PT:
    1. has been licensed to practice physical therapy for at least one year;
    2. is covered by professional liability insurance in the minimum amount of $100,000 per claim ad $300,000 aggregate per year; and
    3. either:
      1. possesses a doctoral degree in physical therapy from:
        
        a program that is accredited by the Commission on Accreditation in Physical Therapy Education; or
        
        an institution that is accredited by an agency or association recognized by the United States secretary of education; or
      2. has completed at least 30 CCUs in the area of differential diagnosis.
  5. A PT may treat a patient for an injury or condition without a referral for not more than 15 consecutive business days if the PT possesses a doctoral degree as described in subparagraph (D)(iii)(I)(-a-) or (-b-) of this paragraph and has satisfied the conditions set forth in subparagraph (D)(i) and (ii) of this paragraph, and either;
    1. has completed a physical therapy residency or fellowship; or
    2. is certified by an entity approved by the board. The board will maintain a list of approved entities on its website.
  6. A PT must obtain a referral from a qualified healthcare practitioner before continuation of treatment that exceeds that which is authorized in subparagraph (D) or (E) of this paragraph.
  7. A PT who treats a patient without a referral under subparagraph (D) or (E) of this paragraph must obtain a signed disclosure on a form prescribed by the board prior to the initiation of treatment. The disclosure form will be made available on the board's website.
3. Methods of referral. A referral may be transmitted by a qualifying referral source in the following ways:
  1. in a written document, including faxed and emailed documents; or
  2. verbally, in person or by telephone. If a referral is transmitted verbally, whether in person or by telephone, it must be received, recorded and signed by the PT, PTA or other authorized personnel, and include all of the information that would appear on a written referral.
Evaluation and screening.
1. Evaluation. Physical therapy treatment may not be provided prior to the completion of an evaluation of the patient's condition by a PT.
2. PTAs may screen patients designated by a PT as possible candidates for physical therapy services. Screening entails the collection of uniform information from all patients screened using a predetermined, standardized format. The information collected is delivered to the supervising PT. Only a PT may determine whether further intervention for patients screened is necessary.
Physical therapy plan of care development and implementation.
1. The PT must develop a written plan of care, based on his evaluation, for each patient.
2. Treatment may not be provided by a PTA or aide until the plan of care has been established.
3. The plan of care must be reviewed and updated as necessary following a reevaluation of the patient's condition.
4. The plan of care or treatment goals may only be changed or modified by a PT.
5. A PTA may modify treatment techniques as indicated in the plan of care.
6. A PT or PTA must interact with the patient regarding his/her condition, progress and/or achievement of goals during each treatment session.
Reevaluation.
1. Provision of physical therapy treatment by a PTA or an aide may not continue if the PT has not performed a reevaluation:
  1. at a minimum of once every 60 days after treatment is initiated, or at a higher frequency as established by the PT; and
  2. In response to a change in the patient's medical status that affects physical therapy treatment, when a change in the physical therapy plan of care is needed, or prior to any planned discharge.
2. A reevaluation must include:
  1. Direct physical therapist-to-patient interaction; and
  2. A review of the plan of care with appropriate continuation, revision, or termination of treatment.
Documentation of treatment.
1. At a minimum, documentation of physical therapy services must include the following:
  1. any referral authorizing treatment;
  2. the initial examination and evaluation;
  3. the plan of care;
  4. documentation of each treatment session by the PT or PTA providing the services; reevaluations as required by this section;
  5. any conferences between the PT and PTA, as described in this section; and
  6. the discharge summary.
2. The PTA must include the name of the supervising PT in his documentation of each treatment session.
3. Physical therapy aides may not write or sign any physical therapy documents in the permanent record. However, a physical therapy aide may enter quantitative data for tasks delegated by the supervising PT or PTA.
4. Discharge Summary. The PT must provide final documentation for discharge of a patient, including patient response to treatment at the time of discharge and any necessary follow-up plan. A PTA may participate in the discharge summary by providing subjective and objective patient information to the supervising physical therapist.

Source Note: The provisions of this 322.1 adopted to be effective April 15, 1999, 24 TexReg 2935; amended to be effective November 19, 2001, 26 TexReg 9382; amended to be effective September 18, 2006, 31 TexReg 7998; amended to be effective February 18, 2008, 33 TexReg 1335; amended to be effective April 4, 2011, 36 TexReg 2124; amended to be effective March 1, 2015, 40 TexReg 704; amended to be effective September 4, 2016, 41 TexReg 6497; amended to be effective November 1, 2019, 44 TexReg 6369; amended to be effective November 1, 2021, 46 TexReg 7213.

322.2. Role Delineation

The role of the PT.
1. The PT holds primary responsibility for physical therapy care rendered under his supervision.
2. The PT’s professional responsibilities include, but are not limited to:
  1. Performance and documentation of the initial physical therapy examination and evaluation of the patient;
  2. Interpretation of the practitioner's referral;
  3. Development and documentation of a plan of care;
  4. Implementation of, or directing implementation of, the plan of care;
  5. Delegation of tasks to appropriate personnel;
  6. Direction and supervision of the PTA and physical therapy aide;
  7. Completion and accuracy of the patient's physical therapy record;
  8. Performance and documentation of the reexamination and reevaluation of the patient as described in this section; and when necessary, modification of the plan of care;
  9. Discharge of a patient or discontinuation of treatment; Development of any follow-up plan for the patient; and
  10. Collaboration with members of the health care team when appropriate.
3. The PT shall not implement any plan of care that, in his judgment, is contraindicated.
The role of the PTA.
1. A PTA may provide physical therapy services only under the supervision of a PT (See 322.3 of this title (relating to Supervision)).
2. A PTA may be assigned responsibilities by a supervising PT to:
  1. screen patients designated by a PT as possible candidates for physical therapy services (See 322.1(b) of this title (relating to Evaluation and screening));
  2. provide physical therapy services as specified in the physical therapy plan of care (See 322.1(c) of this title (relating to Physical therapy plan of care development and implementation)) which may include but are not limited to:
    1. preparing patients, treatment areas, and equipment;
    2. implementing treatment programs that include therapeutic exercises; gait training and techniques; ADL training techniques; administration of therapeutic heat and cold; administration of ultrasound; administration of therapeutic electric current; administration of ultraviolet; application of traction; performance of intermittent venous compression; application of external bandages, dressings, and support; performance of goniometric measurement;
    3. modifying treatment techniques as indicated in the plan of care;
  3. respond to acute changes in physiological state;
  4. teach other health care providers, patients, and families to perform selected treatment procedures and functional activities; and
  5. identify architectural barriers and report them to the PT.
3. The PTA may not:
  1. specify and/or perform definitive (decisive, conclusive, final) evaluative and assessment procedures;
  2. alter a plan of care or goals;
  3. recommend wheelchairs, orthoses, prostheses, other assistive devices, or alterations to architectural barriers to persons;
  4. sign progress notes which design or modify the plan of care.
The role of the physical therapy aide.
1. All rules governing the services provided by a PTA are further modified for the physical therapy aide.
2. A physical therapy aide may be assigned responsibilities by the supervising PT or PTA to provide services as specified in the physical therapy plan of care within the scope of on-the-job training with supervision by a PT or PTA who is on the premises and readily available to respond in person.
3. A physical therapy aide may not:
  1. perform any evaluative or assessment activities;
  2. initiate physical therapy treatment, to include exercise instruction; or
  3. write or sign physical therapy documents in the permanent record, except as provided for in 322.1(e) of this title (relating to Documentation of treatment).

Source Note: The provisions of this 322.2 adopted to be effective April 15, 1999, 24 TexReg 2935; amended to be effective December 29, 2002, 27 TexReg 12214; amended to be effective April 4, 2011, 36 TexReg 2126.

322.3. Supervision

It is the responsibility of each PT and/or PTA to determine the number of PTAs and/or aides he or she can supervise safely.
Supervision of PTAs.
1. A supervising PT is responsible for and will participate in the patient's care.
2. A supervising PT must be on call and readily available when physical therapy services are being provided.
3. A PT may assign responsibilities to a PTA to provide physical therapy services, based on the PTA's training, that are within the scope of activities listed in 322.1, Provision of Services.
4. The supervising PT must hold documented conferences with the PTA regarding the patient. The PT is responsible for determining the frequency of the conferences consistent with accepted standards of practice.
Supervision of physical therapy aides.
1. A supervising PT or PTA is responsible for the supervision of, and the physical therapy services provided by, the PT aide.
2. A PT or PTA must provide onsite supervision of a physical therapy aide, and remain within reasonable proximity during the aide's interaction with the patient.

Source Note: The provisions of this 322.3 adopted to be effective April 15, 1999, 24 TexReg 2935; amended to be effective May 14, 2000, 25 TexReg 4352; amended to be effective September 18, 2006, 31 TexReg 7999.

322.4. Practicing in a Manner Detrimental to the Public Health and Welfare

The board may deny a license to or discipline an applicant/respondent who is found to be practicing in a manner detrimental to the public health and welfare. The board may deny a registration for a physical therapy facility to an applicant or discipline a physical therapy facility required to be registered by the act which is found to be practicing in a manner detrimental to the public health and welfare.
Practicing in a manner detrimental to the public health and welfare may include, but is not limited to, the following:
1. failing to document physical therapy services, inaccurately recording, falsifying, or altering patient/client records;
2. obtaining or attempting to obtain or deliver medications through means of misrepresentation, fraud, forgery, deception, and/or subterfuge;
3. failing to supervise and maintain the supervision of supportive personnel, licensed or unlicensed, in compliance with the Act and rule requirements;
4. aiding, abetting, authorizing, condoning, or allowing the practice of physical therapy by any person not licensed to practice physical therapy;
5. permitting another person to use an individual's physical therapist's or physical therapist assistant's license for any purpose;
6. failing to cooperate with the agency by not responding to agency correspondence addressed to the license holder's official address within 90 days, by not furnishing papers or documents requested or by not responding to subpoenas issued by the agency;
7. failing to complete the requirements of an agreed order;
8. interfering with an investigation or disciplinary proceeding by willful misrepresentation of facts before the agency or the board, or by the use of threats or harassment against any patient/client or witness to prevent them from providing evidence in a disciplinary proceeding or any other legal action;
9. engaging in sexual contact with a patient/client as the result of the patient/client relationship;
10. practicing or having practiced with an expired temporary or permanent license;
11. failing to conform to the minimal standards of acceptable prevailing practice, regardless of whether or not actual injury to any person was sustained, including, but not limited to:
  1. failing to assess and evaluate a patient's/client's status;
  2. performing or attempting to perform techniques or procedures or both in which the physical therapist or physical therapist assistant is untrained by education or experience;
  3. delegating physical therapy functions or responsibilities to an individual lacking the ability or knowledge to perform the function or responsibility in question; or
  4. causing, permitting, or allowing physical or emotional injury or impairment of dignity or safety to the patient/client;
12. intentionally or knowingly offering to pay or agreeing to accept any remuneration directly or indirectly, overtly or covertly, in cash or in kind, to or from any person, firm, association of persons, partnership, or corporation for receiving or soliciting patients or patronage, regardless of source of reimbursement, unless said business arrangement or payments practice is acceptable under 42 United States Code 1320a-7b(b) or its regulations;
13. advertising in a manner which is false, misleading, or deceptive;
14. knowingly falsifying and/or forging a referring practitioner's referral for physical therapy;
15. failing to notify the board of any conduct by another licensee which reasonably appears to be a violation of the Practice Act and rules, or aids or causes another person, directly or indirectly, to violate the Practice Act or rules of the board;
16. abandoning or neglecting a patient under current care without making reasonable arrangements for the continuation of such care;
17. failing to maintain the confidentiality of all verbal, written, electronic, augmentative, and nonverbal communication, including compliance with HIPAA regulations; and
18. violating the rules of the Physical Therapy Licensure Compact if holding a compact privilege to practice in Texas.

Source Note: The provisions of this 322.4 adopted to be effective April 15, 1999, 24 TexReg 2935; amended to be effective June 7, 2009, 34 TexReg 3515; amended to be effective April 4, 2011, 36 TexReg 212; amended to be effective May 17, 2015, 40 TXReg 2666; amended to be effective March 1, 2018, 43 TexReg 775; amended to be effective September 1, 2019, 44 TexReg 4184; amended to be effective March 1, 2023, 48 TexReg 892.

322.5. Telehealth

When used in the rules of the Texas Board of Physical Therapy Examiners, telehealth is the use of telecommunications or information technology to provide physical therapy services to a patient who is physically located at a site in Texas other than the site where the physical therapist or physical therapist assistant is located, whether or not in Texas.
Physical therapy telehealth services must be provided by a physical therapist or physical therapist assistant under the supervision of the physical therapist who possesses a current:
1. unrestricted Texas license; or
2. Compact Privilege to practice in Texas.
The provision of physical therapy services via telehealth requires synchronous audiovisual or audio interaction between the physical therapist or physical therapist assistant and the patient/client, which may be accompanied by the use of asynchronous store and forward technology.
Standard of Care. A physical therapist or physical therapist assistant that provides telehealth services:
1. is subject to the same standard of care that would apply to the provision of the same physical therapy service in an in-person setting; and
2. the physical therapist is responsible for determining whether an evaluation or intervention may be conducted via telehealth or must be conducted in an in-person setting.
Informed Consent. A physical therapist that provides telehealth services must obtain and maintain the informed consent of the patient, or of another individual authorized to make health care treatment decisions for the patient, prior to the provision of telehealth services.
Confidentiality. A physical therapist or physical therapist assistant that provides telehealth services must ensure that the privacy and confidentiality of the patient's medical information is maintained during and following the provision of telehealth services, including compliance with HIPAA regulations and other federal and state law.
The failure of a physical therapist or physical therapist assistant to comply with this section shall constitute detrimental practice and could subject the licensee to disciplinary action by the Board.
Provision of telehealth services by a physical therapist assistant, must occur under the supervision of the physical therapist in accordance with rule §322.3 of this title.
Telehealth is a mode for providing one-on-one physical therapy services to a patient/client and is not a means for supervision of physical therapy aides.

Source Note: The provisions of this 322.5 adopted to be effective November 11, 2018, 43 TexReg 7353; amended to be effective March 1, 2020, 45 TexReg 899.

CHAPTER 323

POWERS AND DUTIES OF THE BOARD

323.1. Types of Examination

It is the duty of the board to evaluate the qualifications of applicants for licensure and to examine applicants through the national examinations selected by the board to measure those qualifications. The passing score on the National Physical Therapy Examination for physical therapists and physical therapist assistants shall be set by the board. In addition, the board shall examine applicants to determine successful completion of the jurisprudence examination covering the Physical Therapy Practice Act and board rules.

Source Note: The provisions of this 323.1 adopted to be effective March 1, 1986, 11 TexReg 721; amended to be effective December 30, 1987, 12 TexReg 4682; amended to be effective November 16, 2000, 25 TexReg 11285.

323.2. Investigation Procedure.

Complaints must be made to the Investigation Committee or to the executive director.
The complaint will be forwarded to the chairman of the Investigation Committee.
If the Investigation Committee determines that a violation of the Act has not occurred, the complainant will be so notified and the case closed.
If the Investigation Committee determines a violation of the Act has occurred, it will:
1. seek legal recourse as provided for in the Act, 18; or
2. notify the person being complained about of the complaint, specifying the sections of the Act which are alleged to have been violated, and schedule an informal conference with the individual.
If the complaint is not resolved through the informal conference, the Investigation Committee will present it to the board.
The board will conduct a formal hearing as provided for in the Act, 20. Members of the Investigation Committee shall not participate or vote at the hearing.

Source Note: The provisions of this 323.2 adopted to be effective March 1, 1986, 11 TexReg 721; amended to be effective December 12, 1989, 14 TexReg 6277.

323.3. Adoption of Rules.

The board may adopt rules consistent with the Physical Therapy Practice Act to carry out its duties in administering the Act.
Continuing competence. The board may adopt rules relating to the approval of continuing competence activities. The board may establish reasonable and necessary fees for the administration of the approval of continuing competence activities.
Petition for adoption of rule changes.
1. In accordance with Texas Government Code, 2001.021, an interested person may request for the adoption, amendment, or repeal of a rule of the board by submitting a written petition to the board. In this section, "interested person" has the meaning as defined in Texas Government Code, 2001.021. The petition must contain:
  1. the name and contact information of the interested person or persons and affiliation or organization, if any;
  2. a description of the proposed rule change or amendment and the reason for it;
  3. the section numbers and titles of the rule(s) affected if applicable;
  4. the proposed rule change with an indication of language added and/or deleted.
  5. a statement of:
    1. the statutory authority under which the rule is to be adopted; and
    2. the public benefits anticipated as a result of adopting the rule or the anticipated injury or inequity that could result from the failure to adopt the proposed rule.
  6. the signature(s) of the requesting person or persons and date of signature(s).
2. The board shall evaluate the merits of the proposal.
3. In accordance with the Texas Government Code, 2001.021, the presiding officer or the board's designee shall acknowledge receipt of the petition to the person designated to receive communication regarding the petition.
4. Not later than the 60th day after the date of submission of a petition under this section, the board shall:
  1. deny the petition in writing, stating its reasons for denial; or
  2. initiate a rulemaking proceeding under this chapter.
5. If the board initiates rulemaking procedures in response to a petition, the rule text which the board proposes may differ from the rule text proposed by the petitioner.
6. Initial petitions for the adoption of a rule shall be presented to and decided by the Board in accordance with the provisions of this section. The Board may refuse to consider any subsequent petition from the same interested person for the adoption of the same or a similar rule submitted within twelve months after the date of the Board's rejection of the initial petition.

Source Note: The provisions of this 323.3 adopted to be effective January 4, 1989, 13 TexReg 6332; amended to be effective December 12, 1989, 14 TexReg 6277; amended effective October 5, 1992, 17 TexReg 6550; amended to be effective July 21, 2010, 35 TexReg 6285; amended to be effective January 1, 2016, 40 TexReg 8791.

323.4. Request for Proposals for Outsourced Services

The board shall conduct a request for proposals (RFP) and bid process for all outsourced services, including the issuance of agreements or memorandums of understanding with other entities, no less than once every four years beginning September 1, 2017. The board may also request RFPs at any time by an action of the board.
The board shall develop specific guidelines for each RFP and shall review the RFP as part of the biennual review.
The board shall review all outsourced services on a biennual basis.
An entity entering into an agreement with the board shall provide access to financial information as required by the RFP.

Source Note: The provisions of this 323.4 adopted to be effective November 27, 2016, 41 TexReg 9136

323.5. Negotiated Rulemaking

It is the policy of the board to engage in negotiated rulemaking procedures consistent with Texas Government Code, Chapter 2008, when appropriate.

Source Note: The provisions of this 323.5 adopted to be effective March 1, 2018, 43 TexReg 775.

323.6. Alternative Dispute Resolution

It is the policy of the board to use alternative dispute resolution where appropriate consistent with Texas Government Code Chapter 2009 and any model guidelines issued by the State Office of Administrative Hearings for the use of alternative dispute resolution by state agencies.

Source Note: The provisions of this 323.6 adopted to be effective March 1, 2018, 43 TexReg 775.

CHAPTER 325

ORGANIZATION OF THE BOARD

325.1. Elections

The governor shall designate a member of the board as the presiding officer of the board.
Elections of additional officers shall be held at the second board meeting after new members are appointed.
Officers will assume duties at the next board meeting following election.
Vacancies of offices other than the presiding officer shall be filled by election at the next board meeting following the vacancy.

Source Note: The provisions of this 325.1 adopted to be effective March 1, 1986, 11 TexReg 721; amended to be effective August 15, 2001, 26 TexReg 6020; amended to be effective May 26, 2014, 39 TexReg 3986; amended to be effective March 1, 2018, 43 TexReg 775.

325.3. Meetings

The board shall meet at least semi-annually.

Source Note: The provisions of this 325.3 adopted to be effective March 1, 1986, 11 TexReg 721.

325.4. Rules of Order

Board meetings shall be conducted in accordance with Roberts Rules of Order, newly revised.

Source Note: The provisions of this 325.4 adopted to be effective March 1, 1986, 11 TexReg 721.

325.5. Chairman

The chairman shall be the executive officer and preside at all meetings of the board. The chairman shall appoint committees as the board may authorize and shall perform all duties usually pertaining to the office and permitted by this Act.

Source Note: The provisions of this 325.5 adopted to be effective March 1, 1986, 11 TexReg 721.

325.6. Chairman Authority

In the absence of the chairman, the vice-chairman will fulfill the duties of the chairman.

Source Note: The provisions of this 325.6 adopted to be effective March 1, 1986, 11 TexReg 721.

325.7. Board Member Terms

Members of the board serve staggered six-year terms expiring in January of an odd-numbered year, or as appointed by the governor.
If a vacancy occurs during a member's term, the governor shall appoint a replacement to fill the unexpired part of the term.
A member's absence from a regularly scheduled board meeting that the member is eligible to attend may be excused by a majority vote of the board.

Source Note: The provisions of this 325.7 adopted to be effective July 12, 1996, 21 TexReg 6078; amended to be effective November 16, 2000, 25 TexReg 11285; amended to be effective March 1, 2018, 43 TexReg 776.

CHAPTER 327

COMPENSATION

327.1. Per Diem Calculated

Per diem shall be on a daily basis or any portion thereof portal to portal.

Source Note: The provisions of this 327.1 adopted to be effective March 1, 1986, 11 TexReg 721.

CHAPTER 329

LICENSING PROCEDURE

329.1. General Licensure Requirements and Procedures

Requirements. All applications for licensure shall include:
1. a completed board application form with a recent color photograph of the applicant;
2. the non-refundable application fee as set by the executive council. The application fee of applicants who are active U.S. military service members or veterans will be waived upon submission of official documentation of the active duty or veteran status of the applicant.
3. a successfully completed board jurisprudence exam on the Texas Physical Therapy Practice Act and board rules; and
4. documentation of academic qualifications.
  1. For applicants who completed their physical therapy education at an accredited PT or PTA program as defined in §321.1.(1) and §321.1.(2) of this title, the documentation required is:
    1. a transcript sent directly to the board from the degree-granting institution
      1. the transcript must show at least active enrollment in the final semester for applicants by exam;
      2. the transcript must show date degree was conferred for applicants by endorsement; and
    2. a statement submitted by the program director or other authorized school official stating that the applicant has successfully completed the PT or PTA program for applicants by exam.
  2. For applicants who completed their physical therapy education outside of the U.S., the documentation required is set out in 329.5 of this title (relating to Licensing Procedures for Foreign-Trained Applicants).
  3. For applicants who are active U.S. military service members or veterans, any military service, training or education verified and credited by an accredited PT or PTA program is acceptable to the board.
5. a criminal history record report from the Department of Public Safety and the Federal Bureau of Investigation obtained through fingerprinting.
Licensure by examination. If an applicant has not passed the national licensure exam, the applicant must also meet the requirements in 329.2 of this title (relating to License by Examination).
Licensure by endorsement. If the applicant is licensed as a PT or PTA in another state or jurisdiction of the U.S., the applicant must also meet the requirements as stated in 329.6 of this title (relating to Licensure by Endorsement).
Application expiration. An application for licensure is valid for one year after the date it is received by the board.
False information. An applicant who submits an application containing false information may be denied licensure by the board.
Rejection. Should the board reject an application for licensure, the reasons for the rejection will be stated. The applicant may submit additional information and request reconsideration by the board. If the applicant remains dissatisfied, a hearing may be requested as specified in the Act, 453.352.
Changes to licensee information.
1. Applicants and licensees must notify the board in writing of changes in home, mailing, or business addresses and phone numbers and email addresses within 30 days of the change.
2. A request for name change must be submitted on a form prescribed by the board with the appropriate fee and a copy of legal documentation enacting the name change.
Replacement copy of license. The board will issue a copy of a license to replace one lost or destroyed upon receipt of a written request and the appropriate fee from the licensee. The board will issue a new original license after a name change upon receipt of a written request, the appropriate fee, and a copy of the legal document enacting the name change.
A new licensee may provide physical therapy services upon online verification of licensure. The Board will maintain a secure resource for verification of license status and expiration date on its website.

Source Note: The provisions of this 329.1 adopted to be effective November 16, 2000, 25 TexReg 11286; amended to be effective October 13, 2002, 27 TexReg 9326; amended to be effective November 30, 2003, 28 TexReg 10505; amended to be effective May 27, 2012, 37 TexReg 3831; amended to be effective February 11, 2014, 39 TexReg 649; amended to be effective August 17, 2014, 39 TexReg 6049; amended to be effective January 1, 2016, 40 TexReg 8791; amended to be effective January 1, 2019, 43 TexReg 7353; amended to be effective September 1, 2021, 46 TexReg 4853; amended to be effective November 2, 2023, XX TexReg XXXX.

329.2. Licensure by Examination

Requirements. An applicant applying for licensure by examination must:
1. meet the requirements as stated in §329.1 of this title (relating to General Licensure Requirements and Procedures);
2. register to take the National Physical Therapy Exam (NPTE) and select Texas as the jurisdiction for which the applicant will be testing in order to have the first score report sent to this state; and
3. pass the NPTE for physical therapists or physical therapist assistants with the score approved by the board. Score reports must be sent directly to the board by the authorized score reporting service.
Re-examination.
1. An applicant who fails the exam is eligible to take the examination again if all eligibility requirements as set in policy by the Federation of State Boards of Physical Therapy (FSBPT) are met.
2. An applicant can take the exam a maximum of six (6) times.
3. An applicant who receives two (2) very low scores on the exam (scale scores 400 or below) will not be eligible to test again.
4. An applicant who has taken the exam six (6) times or received two (2) very low scores may appeal for one (1) additional attempt through the Board for reasons as set in policy by FSBPT.
5. An applicant can take the exam for PTs six (6) times and also take the exam for PTAs six (6) times if otherwise eligible to do so.
Failure of PT exam. An applicant who fails the physical therapy examination may apply for licensure as a PTA and take the physical therapist assistant examination if he meets all other requirements for licensure.
Exam Accommodations.
1. Reasonable testing accommodations for an exam candidate with a disability or challenge that is covered by the Americans with Disabilities Act will be provided for candidates who submit the appropriate documentation through the FSBPT.
2. Accommodations must be requested at the time of registration for the NPTE.
NPTE Security and Copyright.
1. An applicant for a license must agree to comply with the security and copyright provision of the NPTE.
2. The board will report any known violation of the security or copyright provision or a compromise or attempted compromise of the provision to the FSBPT.

Source Note: The provisions of this 329.2 adopted to be effective November 16, 2000, 25 TexReg 11286; amended to be effective August 15, 2001, 26 TexReg 6021; amended to be effective September 18, 2006, 31 TexReg 8000; amended to be effective September 17, 2009, 34 TexReg 6332; amended to be effective October 9, 2011, 36 TexReg 6768; amended to be effective October 4, 2012, 37 TexReg 7751; amended to be effective May 23, 2013, 38 TexReg 3000; amended to be effective January 01, 2016, 40 TexReg 2667; amended to be effective May 23, 2016, 41 TexReg 3695; amended to be effective January 01,2017, 41 TexReg 9709; amended to be effective March 1, 2018, 43 TexReg 776.

329.3. Temporary Licensure

For examination candidates.
1. Requirements.
  1. meet all requirements as stated in 329.1 of this title (relating to General Licensure Requirements and Procedures);
  2. register for the national physical therapy examination;
  3. submit temporary licensee and supervisor affidavits as provided by the board; and
  4. submit fees for temporary licensure as set by the executive council.
2. Eligibility.
  1. The board will issue a temporary license to work in Texas to an applicant who is taking the exam for the first time.
  2. An applicant who has received a license from another state is not eligible for temporary licensure.
  3. A candidate who has taken and failed the physical therapist examination is not eligible for temporary licensure as a physical therapist assistant.
3. Duration.
  1. The temporary license is valid until issuance of the permanent license or until the last day of the third month after the month the license is issued, whichever occurs first.
  2. The coordinator may extend the temporary license for no more than 30 days to offset an unreasonable delay in reporting the examination results to the applicant.
4. Failure of examination. If the applicant fails the exam, the temporary license is void and must be returned to the board when the notification of the failure is received.
For restoration of license by means of Supervised Clinical Practice (SCP).
1. Requirements.
  1. meet all requirements as stated in 341.6 (d) (A) – (D) (relating to License Restoration);
  2. submit temporary license and supervisor affidavits as provided by the board; and
  3. submit fees for temporary licensure as set by the executive council.
2. Duration.
  1. The temporary license is valid for the duration of the SCP as designated by the board;
  2. If the applicant fails to complete the SCP in the designated timeframe, the temporary license is void and must be returned to the board.
Supervision requirements. An applicant with a temporary PT license must have on-site supervision by a physical therapist with a permanent license to practice in Texas when providing physical therapy services. An applicant with a temporary PTA license must have on-site supervision by a physical therapist with a permanent license to practice in Texas when providing physical therapy services.
A new temporary licensee may provide physical therapy services upon online verification of licensure. The Board will maintain a secure resource for verification of license status and expiration date on its website.

Source Note: The provisions of this 329.3 adopted to be effective November 16, 2000, 25 TexReg 11286; amended to be effective September 17, 2009, 34 TexReg 6333; amended to be effective May 26, 2014, 39 TexReg 3987; amended to be effective March 1, 2015, 40 TexReg 704; amended to be effective March 1, 2022, 46 TexReg 7944.

329.5. Licensing Procedures for Foreign-Trained Applicants

A foreign-trained applicant must complete the license application process as set out in 329.1 of this title (relating to General Licensure Requirements and Procedures). In addition, the applicant must submit the following:

An evaluation of professional education and training prepared by a board approved credentialing entity. The board will maintain a list of approved credentialing entities on the agency website.
1. The evaluation must:
  1. be based on a Course Work Tool (CWT) adopted by the Federation of State Boards of Physical Therapy.
    1. Applicants by examination must be evaluated using the most current version of the CWT.
    2. Applicants by endorsement must be evaluated using the version of the CWT appropriate to the year the applicant graduated from the foreign physical therapy program or a more current version.
  2. provide evidence and documentation that the applicant's education is substantially equivalent to the education of a physical therapist who graduated from a physical therapy education program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE); and
  3. establish that the institution at which the applicant received his physical therapy education is recognized by the Ministry of Education or the equivalent agency in that country.
  4. a copy of an evaluation used as a requirement for licensure by another jurisdiction that has the authority to issue a license within that jurisdiction and sent directly to the board by the jurisdiction will be accepted for an applicant by endorsement if:
    1. documents required for credentialing are no longer available from the institution at which the applicant reeived their physical therapy education, or
    2. there is an undue delay in receiving an evaluation from the credentialer beyond the applicant's control.
2. If the credentialing entity determines that the physical therapy education is not substantially equivalent, the applicant is responsible for remedying those deficiencies. The applicant may use college credit obtained through applicable College Level Examination Placement (CLEP) or other college advanced placement exams to remedy any deficiencies in general education.
3. An evaluation prepared by a board-approved credentialer reflects only the findings and conclusions of the credentialer, and shall not be binding on the board.
4. If the applicant received an entry-level physical therapy degree from a CAPTEaccredited program located outside the U.S., the program is considered equivalent to a domestic CAPTE-accredited physical therapy program, and the applicant is exempt from meeting the requirements of a CWT.
Proof of English language proficiency. A foreign-trained applicant by examination must demonstrate the ability to communicate in English by making the minimum score accepted by the board on the Test of English as a Foreign Language (TOEFL) administered by the Educational Testing Service (ETS).
1. This requirement is waived for graduates of entry-level physical therapy programs in Australia, Canada (except Quebec), Ireland, New Zealand and the United Kingdom.
2. Minimum acceptable TOEFL iBT (internet-based test) scores are as follows: Reading = 22, Writing = 22, Speaking = 24, and Listening = 21.
3. The board may grant an exception to the English language proficiency requirements under the following conditions:
  1. the applicant holds a current license in physical therapy in a country listed in (2)(A) and has been licensed and practicing in that country for at least 5 years prior to application; or
  2. the applicant submits satisfactory proof that he/she is a citizen or lawful permanent resident of the U.S. or a current U.S. H-1B visa holder, and
    1. has attended four or more years of secondary or post-secondary education in the U.S. or
    2. has completed a post-professional physical therapy degree in English from a country listed in (2)(A).

Source Note: The provisions of this 329.5 adopted to be effective November 11, 1993, 18 TexReg 7546; amended to be effective October 26, 1994, 19 TexReg 8112; amended to be effective January 3, 1995, 19 TexReg 10099; amended to be effective April 12, 1995, 20 TexReg 2385; amended to be effective November 6, 1995, 20 TexReg 8794; amended to be effective May 8, 1996, 21 TexReg 3709; amended to be effective July 12, 1996, 21 TexReg 6079; amended to be effective April 28, 1997, 22 TexReg 3589; amended to be effective October 29, 1997, 22 TexReg 10508; amended to be effective April 19, 1999, 24 TexReg 2936; amended to be effective October 21, 1999, 24 TexReg8977; amended to be effective February 18, 2001, 26 TexReg 1338; amended to be effective August 15, 2001, 26 TexReg 6021; amended to be effective October 13, 2002, 27 TexReg 9327; amended to be effective March 29, 2004, 29 TexReg 3175; amended to be effective March 15, 2006, 31 TexReg 1299; amended to be effective September 18, 2006, 31 TexReg 8000; amended to be effective May 30, 2007, 32 TexReg 2862; amended to be effective May 6, 2008, 33 TexReg 3643; amended to be effective December 14, 2009, 34 TexReg 8967; amended to be effective April 4, 2011, 36 TexReg 2127; amended to be effective May 27, 2012, 37 TexReg 3831; amended to be effective November 1, 2020, 45 TexReg 7587; amended to be effective XX XX, 2024, xx TexReg xxxx.

329.6. Licensure by Endorsement

Eligibility. The board may issue a license by endorsement to an applicant currently licensed in another state, District of Columbia, or territory of the United States, if they have not previously held a permanent license issued by this board.
Requirements. An applicant seeking licensure by endorsement must:
1. meet the requirements as stated in 329.1 of this title (relating to General Licensure Requirements and Procedures);
2. provide a score report for the National Physical Therapy Examination sent directly to the board by the board-approved reporting service, or scores on the Registry Examination sent directly to the board by the American Physical Therapy Association. The score reported must have satisfied requirements for licensure in a state at the time the applicant took the exam; and
3. provide verification of license from every jurisdiction in which the applicant has held or still holds a license, sent directly to the board by the issuing jurisdiction. The board may accept webbased verification in place of verification sent by another jurisdiction if the board is satisfied that the applicant's license(s) is/are valid.
Licensure of a Military Service Member, Military Veteran, or Military Spouse. The board will waive the application fee and will expedite the issuance of a license by endorsement to a military service member, military veteran, or spouse of a military service member. The applicant must provide official documentation of active duty status or veteran status or the active duty status of the spouse.
1. A military service member or military spouse may qualify to practice in this state under the exemption described in §329.7(b)(5) Exemptions from Licensure if the military service member or military service member to whom a military spouse is married is stationed at a military installation in this state.
2. A military service member, military spouse or veteran may qualify to practice in this state under a Compact privilege as described in CHAPTER 348. PHYSICAL THERAPY LICENSURE COMPACT.
Provisional licensure. The board may grant a provisional license to an applicant who is applying for licensure by endorsement if there is a delay in the submission of required documents outside the applicant’s control. The applicant must submit the provisional license fee as set by the executive council. The board may not grant a provisional license to an applicant with disciplinary action in their licensure history. The provisional license is valid for 180 days, or until a permanent license is issued or denied, whichever is first.

Source Note: The provisions of this 329.6 adopted to be effective November 16, 2000, 25 TexReg 11286; amended to be effective December 29, 2002, 27 TexReg 12214; amended to be effective March 9, 2009, 34 TexReg 1605; amended to be effective March 14, 2010, 35 TexReg 2015; amended to be effective April 4, 2011, 36 TexReg 2128, amended to be effective February 11, 2014, 39 TXReg 649; amended to be effective March 1, 2015, 40 TexReg 705; amended to be effective January 1, 2016, 40 TexReg 8791; amended to be effective November 1, 2019, 44 TexReg 6372; amended to be effective November 2, 2023, XX TexReg XXXX.

329.7. Exemptions from Licensure

The following categories of individuals practicing physical therapy in the state are exempt from licensure by the board.
1. A person practicing physical therapy in the U.S. armed services, U.S. Public Health Service, or Veterans Administration in compliance with federal regulations for licensure of health care providers; and
2. A person who is licensed in another jurisdiction of the U.S. and who, by contract or employment, is practicing physical therapy in this state for not more than 60 days in a 12 month period for an athletic team or organization or a performing arts company temporarily competing or performing in this state.
The following categories of individuals practicing physical therapy in the state are exempt from licensure by the board and must notify the board of their intent to practice in the state.
1. A physical therapist who is licensed in good standing in another jurisdiction of the U.S. if the person is engaging, for not more than 90 days in a 12 month period and under the supervision of a physical therapist licensed in this state, in a special project or clinic required for completion of a post-professional degree in physical therapy from an accredited college or university.
  1. The individual must submit written notification stating the following:
    1. the beginning and ending dates of the period of practice;
    2. the name of the institution or facility in which the individual will be practicing;
    3. the name of the supervising physical therapist; and
    4. a list of the jurisdictions in which the individual has held or currently holds a license.
  2. Written notification must be received by the board prior to the start date of the practice.
2. A physical therapist or a physical therapist assistant who is licensed in good standing in another jurisdiction of the U.S. or authorized to practice physical therapy without restriction in another country if the person is engaging in patient contact and treatment as either an instructor or participant while attending an educational seminar or activity in this state for not more than 60 days in a 12 month period.
  1. The individual must submit written notification stating the following:
    1. the beginning and ending dates of the educational activity;
    2. the name of the course or activity sponsor;
    3. the location of the educational activity; and
    4. a list of the jurisdictions in which the individual has held or currently hold a license.
  2. Written notification must be received by the board prior to the start date of the educational activity.
3. A physical therapist or physical therapist assistant licensed in good standing in another jurisdiction of the U.S. who is practicing physical therapy for not more than 60 days during a declared local, state, or national disaster or emergency.
  1. The individual must submit written notification stating the following:
    1. the beginning and ending dates of the period of practice;
    2. the name of the facility in which the individual will be practicing; and
    3. a list of the jurisdictions in which the individual has held or currently holds a license.
  2. Written notification must be received by the board prior to the start date of the practice.
4. A physical therapist or physical therapist assistant licensed in good standing in another jurisdiction of the U.S. who is displaced from the person's residence or place of employment due to a declared local, state, or national disaster and is practicing physical therapy in this state for not more than 60 days after the date the disaster is declared.
  1. The individual must submit written notification stating the following:
    1. the beginning and ending dates of the period of practice;
    2. the name of the facility in which the individual will be practicing; and
    3. a list of the jurisdictions in which th individual has held or currently holds a license.
  2. Written notification must be received by the board prior to the start date of the practice.
5. A physical therapist or physical therapist assistant licensed in good standing in another jurisdiction of the U.S. who is a military service member or military spouse for the period during which the military service member to whom the military spouse is married is stationed at a military installation in Texas.
  1. The military service member or military spouse must submit written notification including the following:
    1. proof of the military service member or military spouse's residency in this state including a copy of the permanent change of station order for the military service member to whom the spouse is married;
    2. a copy of the military service member or military spouse's military identification card; and
    3. a list of the jurisdictions in which the military service member or military spouse has held or currently holds a license.
  2. The board will issue a written confirmation stating that:
    1. licensure in other jurisdictions has been verified;
    2. the military service member or military spouse is authorized to practice physical therapy in the state; and
    3. authorization does not exceed three years from the date the confirmation is received.
  3. This exemption establishes requirements and procedures authorized or required by Texas Occupations Code, Chapter 55, and does not modify or alter rights that might be provided under federal law.
For individuals exempt from licensure under (b), the following applies:
1. Any jurisdiction of the U.S. that licenses physical therapists and physical therapist assistants is deemed to have substantially equivalent requirements for licensure;
2. Verification of licensure in other jurisdictions may be through online primary source verification; and
3. The individual must comply with all of the laws and regulations applicable to the provision of physical therapy in Texas.

Source Note: The provisions of this 329.7 adopted to be effective December 15, 2009, 34 TexReg 8967; amended to be effective November 1, 2019, 44 TexReg 6372; amended to be effective November 1, 2021, 46 TexReg 7213; amended to be effective November 2, 2023, XX TexRegXXXX.

CHAPTER 335

PROFESSIONAL TITLE

335.1. Use of Title

A licensed physical therapist shall use the title physical therapist or the initials PT. A licensed physical therapist assistant shall use the title physical therapist assistant or the initials PTA. No other titles or initials are conferred by a license from this board.
Any letters designating other titles, academic degrees, or certifications must follow the initials PT or PTA (example: Jane Doe, PT, DPT).
In using the title "doctor" as a trade or professional asset or on any manner of professional identification, including a sign, pamphlet, stationery, or letterhead, or as a part of a signature, a physical therapist shall designate the college or honorary degree that gives rise to the use of the title, or the authority under which the title is used.
A degree described in subsection (b) of this section shall be granted by an institution accredited by an accrediting agency recognized by the National Commission on Accrediting or the US Department of Education.

Source Note: The provisions of this 335.1 adopted to be effective March 1, 1986, 11 TexReg 724; amended to be effective August 17, 2008, 33 TexReg 6593; amended to be effective May 23, 2013, 38 TexReg 3001.

CHAPTER 337

DISPLAY OF LICENSE

337.1. Display of License

The original license must be displayed in the licensee’s principal place of practice.
For physical therapy services provided through telehealth, home visits, or other non-traditional modes, the licensee must provide information on accessing the board’s online license verification system.
Displayed reproduction of the original license is unauthorized.
Reproduction of the original license is authorized for institutional file purpose only.

Source Note: The provisions of this 337.1 adopted to be effective March 1, 1986, 11 TexReg 724; amended to be effective November 11, 1993, 18 TexReg 7551; amended to be effective May 27, 2012, 37 TexReg 3832, amended to be effective February 11, 2014, 39 TexReg 650.

337.2. Consumer Information Sign

There shall at all times be prominently displayed in the place of business of each licensee a sign containing the name, mailing address, web address and telephone number of the board and a statement informing consumers that complaints against licensees can be directed to the board.
A consumer information sign shall be made readily available on the board's website.
For physical therapy services provided through telehealth, home visits, or other non-traditional modes, the licensee must provide information as described in subsection (a) of this section.

Source Note: The provisions of this 337.2 adopted to be effective March 1, 1986, 11 TexReg 724; amended to be effective September 28, 1988, 13 TexReg 4576; amended to be effective February 18, 1992, 17 TexReg 940; amended to be effective May 8, 1996, 21 TexReg 3709; amended to be effective October 4, 2012, 37 TexReg 7751; amended to be effective March 1, 2023, 48 TexReg 893.

CHAPTER 339

FEES

339.1. Fees

Fees are set by the executive council and may be subject to change by the legislature. Fees paid to the board or executive council may be in the form of a personal check, cashier's check, money order, or other certified funds.

NOTE: For the list of current fees, see Chapter 651, Fees, Executive Council of Physical Therapy and Occupational Therapy Examiners, included at the end of the rules.

Source Note: The provisions of this 339.1 adopted to be effective November 30, 1981, 6 TexReg 4246; amended to be effective September 1, 1984, 9 TexReg 4284; amended to be effective December 30, 1987, 12 TexReg 4683; amended to be effective December 12, 1989, 14 TexReg 6278; amended to be effective June 5, 1992, 17 TexReg 3783; amended to be effective November 11, 1993, 18 TexReg 7551; amended to be effective November 16, 2000, 25 TexReg 11288.

CHAPTER 341

LICENSE RENEWAL

341.1. Requirements for Renewal

Biennial renewal. Licensees are required to renew their licenses every two years by the end of their birth month. The Board will maintain a secure resource for verification of license status and expiration date on its website.
Notification of impending license expiration. The board will send notification to each licensee at least 30 days prior to the license expiration date. The licensee is responsible for ensuring that the license is renewed, regardless of receipt of notification.
General requirements. The renewal application is not complete until all required items are received by the board. The components required for license renewal are:
1. a completed renewal application documenting completion of board-approved continuing competence activities, as described in 341.2 of this title (relating to Continuing Competence Requirements);
2. the renewal fee, and any late fees which may be due;
3. a passing score on the jurisprudence examination;
4. a criminal history record report from the Department of Public Safety and the Federal Bureau of Investigation obtained through fingerprinting. A licensee is not required to submit fingerprints for the renewal of the license if the licensee has previously submitted fingerprints under:
  1. §329.1. for the initial issuance of the license; or
  2. Chapter 341, License Renewal as part of a prior license renewal or restoration; and
5. successful completion of a human trafficking prevention course approved by the executive commissioner of the Health and Human Services Commission (HHSC). Course must be a minimum of one contact hour in order to claim CCU credit.
If all required items are not postmarked (if submitted by mail) or date stamped (if submitted online) prior to the expiration date, the renewal is late and the license is expired. The licensees may not practice until the license is listed as current on the board’s website.
A licensee may renew a license expired less than one year. The items required for the reinstatement of a license are:
1. Expired for 90 days or less:
  1. All items listed in subsection (c) of this section; and
  2. The late fee as set by the executive council in 651.2 of this title (relating to Physical Therapy Board Fees).
2. Expired for more than 90 days but less than one year:
  1. All items listed in subsection (c) of this section;
  2. The late fee as set by the executive council; and
  3. Documentation showing completion of continuing competence requirements as specified in 341.2 of this title.
Renewal of a license expired one year or more. A license expired one year or more must be reinstated as specified in 341.6 of this title (relating to License Restoration).

Source Note: The provisions of this 341.1 adopted to be effective February 18, 2001, 26 TexReg 1339; amended to be effective August 15, 2001, 26 TexReg 6022; amended to be effective September 18, 2005, 30 TexReg 5801; amended to be effective July 21, 2010, 35 TexReg 6285; amended to be effective April 4, 2011, 36 TexReg 2128; amended to be effective May 27, 2012, 37 TexReg 3832; amended to be effective February 11, 2014, 39 TexReg 650; amended to be effective March 1, 2015, 40 TexReg 705; amended to be effective January 1, 2019, 43 TexReg 7354.

341.2. Continuing Competence Requirements

Continuing competence is the ongoing acquisition and maintenance of the professional knowledge, skill, and ability of the PT or PTA through successful completion of educational and professional activities related to the physical therapy profession.
All continuing competence activities submitted to satisfy renewal requirements must be board approved by an organization selected by the board as established in subsection (i) of this section.
For each biennial renewal, physical therapists must complete a total of 30 continuing competence units (CCUs); physical therapist assistants must complete a total of 20 CCUs. A CCU is the relative value assigned to continuing competence activities based on specific criteria developed by the Board.
Continuing competence activities utilized to fulfill renewal requirements must be completed within the 24 months prior to the license expiration date.
Licensees must maintain original continuing competence activity completion documents, as specified in 341.3 of this title (relating to Qualifying Continuing Competence Activities), for four years after the license expiration date.
All licensees must complete a board-approved jurisprudence assessment module as part of their total continuing competence requirement. The jurisprudence assessment module shall be assigned a CCU value and standard approval number by the board and shall include at a minimum the following components.
1. The theoretical basis for ethical decision-making;
2. APTA's Code of Ethics for the Physical Therapist and Guide for Professional Conduct, [;]
  and the Guide for Conduct of the Physical Therapist Assistant and Standards of Ethical
  Conduct for the Physical Therapist Assistant;
3. Legal standards of behavior (including but not limited to the Act and Rules of the board); and
4. Application of content to real and/or hypothetical situations.
The executive council will conduct an audit of a random sample of licensees at least quarterly to determine compliance with continuing competence requirements. Failure to maintain accurate documentation, or failure to respond to a request to submit documentation for an audit within 30 days of the date on the request, may result in disciplinary action by the board.
1. Licensees who are more than 90 days late in renewing a license are not included in the audit, and must submit documentation of continuing competence activities at time of renewal.
2. The board or its committees may request proof of completion of continuing competence activities claimed for renewal purposes at any time from any licensee.
If the board chooses to authorize an organization(s) to approve continuing competence activities, the board shall select an appropriate organization(s) pursuant to section 323.4 of this title, Request for Proposals for Outsourced Services.

Source Note: The provisions of this 341.2 adopted to be effective February 18, 2001, 26 TexReg 1339; amended to be effective August 15, 2001, 26 TexReg 6022; amended to be effective February 17, 2005, 30 TexReg 717; amended to be effective June 7, 2009, 34 TexReg 3516; amended to be effective July 21, 2010, 35 TexReg 6285; amended to be effective February 11, 2014, 39 TXReg 650; amended to be effective March 1, 2018, 43 TexReg 775, amended to be effective November 11, 2018, 43 TexReg 7354.

341.3. Qualifying Continuing Competence Activities

Licensees may select from a variety of activities to fulfill the requirements for continuing competence. These activities include the following:

Continuing education (CE).
1. Program content and structure must be approved by the board-approved organization, or be offered by a provider accredited by that organization. Programs must meet the following criteria:
  1. Program content must be easily recognizable as pertinent to the physical therapy profession and in the areas of ethics, professional responsibility, clinical application, clinical management, behavioral science, science, or risk management.
  2. The content must be identified by instructional level, i.e., basic, intermediate, advanced. Program objectives must be clearly written to identify the knowledge and skills the participants should acquire and be consistent with the stated instructional level.
  3. The instructional methods related to the objectives must be identified and be consistent with the stated objectives.
  4. Programs must be presented by a licensed health care provider, or by a person with appropriate credentials and/or specialized training in the field.
  5. Program providers are prohibited from self-promotion of programs, products, and/or services during the presentation of the program.
  6. The participants must evaluate the program. A summary of these evaluations must be made available to the board-approved organization upon request.
  7. Records of each licensee who participates in the program must be maintained for four years by the CE sponsor/provider and must be made available to the board-approved organization upon request.
2. CE programs subject to this subsection include the following:
  1. Live programs.
    1. One contact hour equals 1 continuing competence unit (CCU).
    2. Documentation must include the name and license number of the licensee; the title, sponsor/provider, date(s), and location of the course; the number of CCUs awarded, the signature of an authorized signer, and the accredited provider or program approval number.
    3. If selected for audit, the licensee must submit the specified documentation.
  2. Self-study programs – Structured, self-paced programs or courses offered through electronic media (for example, via the internet or on DVD) or on paper (for example, a booklet) completed without direct supervision or attendance in a class.
    1. One contact hour equals 1 CCU.
    2. Documentation must include the name and license number of the licensee; the title, sponsor/provider, date(s), and instructional format of the course; the number of CCUs awarded, the signature of an authorized signer, and the accredited provider or program approval number.
    3. If selected for audit, the licensee must submit the specified documentation.
  3. Regular inservice-type programs over a one-year period where individual sessions are granted 2 CCUs or less.
    1. One contact hour equals 1 CCU.
    2. Documentation must include the name and license number of the licensee; the title, sponsor/provider, date(s), and location of the inservice; the signature of an authorized signer, and the accredited provider or program approval number with the maximum CCUs granted and the CCU value of each session or group of sessions specified and justified.
    3. Additionally, proof of attendance to any or all inservice sessions must be provided so that individual CCUs earned can be calculated by the program sponsor/provider for submission to the board-approved organization.
    4. If selected for audit, the licensee must submit the specified documentation.
  4. Large conferences with concurrent programming.
    1. One contact hour equals 1 CCU.
    2. Documentation must include the licensee's name and license number; title, sponsor/provider, date(s); and location of the conference; the number of CCUs awarded, the signature of an authorized signer, and the accredited provider or course approval number.
    3. If selected for audit, the licensee must submit the specified documentation and proof of attendance.
College or university courses.
1. Courses at regionally accredited US colleges or universities easily recognizable as pertinent to the physical therapy profession and in the areas of ethics, professional responsibility, clinical application, clinical management, behavioral science, science, or risk management.
  1. The course must be at the appropriate educational level for the PT or the PTA.
  2. All courses in this subsection are subject to the following:
    1. One satisfactorily completed credit hour (grade of C or equivalent, or higher) equals 10 CCUs.
    2. Documentation required for consideration is the course syllabus for each course and a transcript indicating successful completion of the course.
    3. If selected for audit, the licensee must submit the approval letter from the board-approved organization.
2. College or university sponsored CE programs (no grade, no official transcript) must comply with paragraph (1)(A) of this subsection.
3. College or university courses that are part of a post-professional physical therapy degree program, or are part of a CAPTE-accredited program bridging from PTA to PT, are automatically approved and are assigned a standard approval number by the board-approved organization. If selected for an audit, the licensee must submit a transcript indicating successful completion of the course.
Scholarship
1. Publications. Publication(s) pertinent to physical therapy and in the areas of ethics, professional responsibility, clinical practice, clinical management, behavioral science, science, or risk management written for the professional or lay audience. The author(s) are prohibited from self-promotion of programs, products, and/or services in the publication.
  1. The publication must be published within the 24 months prior to the license expiration date.
  2. CCU values for types of original publications are as follows:
    1. A newspaper article (excluding editorials and opinion pieces) may be valued up to 3 CCUs.
    2. A regional/national magazine article (excluding editorials and opinion pieces) may be valued up to 10 CCUs.
    3. A case study in a peer reviewed publication, monograph, or book chapter(s) is valued at 20 CCUs.
    4. A research article in a peer reviewed publication, or an entire book is valued at 30 CCUs.
  3. Documentation required for consideration is:
    1. For newspaper articles, a copy of the article and the newspaper banner, indicating the publication date;
    2. For magazine articles and publications in peer reviewed journals, a copy of the article and the Table of Contents page of the publication showing the author’s name and the name and date of the publication.
    3. For monographs or single book chapters, a copy of the first page of the monograph or chapter, and the Table of Contents page of the publication showing the author’s name and the name and date of the publication.
    4. For an entire book or multiple chapters in a book, the author must submit the following: title page, copyright page, entire table of contents, preface or forward if present, and one book chapter authored by the licensee.
  4. If selected for audit, the licensee must submit the approval letter from the board-approved organization.
2. Manuscript review. Reviews of manuscripts for peer-reviewed publications pertinent to physical therapy and in the areas of ethics, professional responsibility, clinical practice, clinical management, behavioral science, science, or risk management. The Board will maintain and make available a list of peer-reviewed publications that are automatically approved for manuscript review and assigned a standard approval number by the board-approved organization.
  1. The review must be completed within the 24 months prior to the license expiration date.
  2. One manuscript review is valued at 3 CCUs.
  3. For each renewal:
    1. PTs may submit no more than 3 manuscript reviews (9 CCUs).
    2. PTAs may submit no more than 2 manuscript reviews (6 CCUs).
  4. If selected for audit, the licensee must submit a copy of the letter or certificate from the publisher confirming completion of manuscript review.
  5. A peer-reviewed publication not on the list of recognized publications for manuscript review but pertinent to the physical therapy profession may be submitted to the board-approved organization for consideration. Documentation required for consideration includes the following:
    1. The name of the peer-reviewed journal;
    2. The name of the manuscript; and
    3. A description of the journal’s relevance to the physical therapy profession.
3. Grant proposal submission. Submission of grant proposals by principal investigators or co-principal investigators for research that is pertinent to physical therapy and in the areas of ethics, professional responsibility, clinical practice, clinical management, behavioral science, science, or risk management.
  1. The grant proposal must be submitted to the funding entity within the 24 months prior to the license expiration date.
  2. One grant proposal is valued at 10 CCUs.
  3. Licensees may submit a maximum of 1 grant proposal (10 CCUs).
  4. Documentation required for consideration is a copy of the grant and letter submitted to the grant-provider.
  5. If selected for audit, the licensee must submit the approval letter from the board-approved organization.
4. Grant review for research pertinent to healthcare. The Board will maintain and make available a list of grant-issuing entities that are automatically approved for grant review and assigned a standard approval number by the board-approved organization.
  1. The review must be completed within the 24 months prior to the license expiration date.
  2. One grant review is valued at 3 CCUs.
  3. Licensees may submit a maximum of 2 grant reviews (6 CCUs).
  4. If selected for audit, the licensee must submit a letter or certificate confirming grant review from the grant provider.
  5. A grant-issuing entity not on the list of recognized entities for grant review but pertinent to the physical therapy profession may be submitted to the boardapproved organization for consideration. Documentation required for consideration includes the following:
    1. The name of the grant-issuing entity;
    2. The name of the grant; and
    3. A description of the grant’s relevance to the physical therapy profession.
Teaching and Presentation Activities.
1. First-time development or coordination of course(s) in a CAPTE-accredited PT or PTA program, a post-professional physical therapy degree program, or a CAPTEaccredited program bridging from PTA to PT. This activity type is automatically approved and is assigned a standard approval number by the board-approved organization.
  1. The course must be offered for the first time within the 24 months prior to the license expiration date.
  2. One student contact hour equals 4 CCUs.
  3. Licensees are limited to the following number of CCUs:
    1. PTs may submit a maximum of 10 CCUs for this activity.
    2. PTAs may submit a maximum of 8 CCUs for this activity.
  4. If selected for audit, the licensee must submit a copy of the course syllabus indicating the licensee as course coordinator or primary instructor.
2. First-time development or coordination of course(s) in a regionally accredited U.S. college or university program for other health professions.
  1. The course must be offered for the first time within the 24 months prior to the license expiration date.
  2. One student contact hour equals 4 CCUs.
  3. Licensees are limited to the following number of CCUs:
    1. PTs may submit a maximum of 10 CCUs for this activity.
    2. PTAs may submit a maximum of 8 CCUs for this activity.
  4. Documentation required for consideration is a copy of the course syllabus indicating the licensee as course coordinator or primary instructor.
  5. If selected for audit, the licensee must submit the approval letter from the board-approved organization.
3. Presentation or instruction as a guest lecturer in a CAPTE-accredited PT or PTA program, or a post-professional physical therapy degree program, or a CAPTEaccredited program bridging from PTA to PT. This activity type is automatically approved and is assigned a standard approval number by the board-approved organization.
  1. One student contact hour equals 2 CCUs.
  2. Licensees are limited to the following number of CCUs:
    1. PTs may submit a maximum of 10 CCUs for this activity.
    2. PTAs may submit a maximum of 8 CCUs for this activity.
  3. If selected for audit, the licensee must submit a copy of the course syllabus indicating the licensee as course presenter or instructor.
4. Presentation or instruction as a guest lecturer in a regionally accredited U.S. college or university program for other health professions.
  1. One student contact hour equals 2 CCUs.
  2. Licensees are limited to the following number of CCUs:
    1. PTs may submit a maximum of 10 CCUs for this activity.
    2. PTAs may submit a maximum of 8 CCUs for this activity.
  3. Documentation required for consideration is a copy of the course syllabus indicating the licensee as course coordinator or primary instructor.
  4. If selected for audit, the licensee must submit the approval letter from the board-approved organization.
5. First-time development, presentation or co-presentation at state, national or international workshops, seminars, or professional conferences, or at a board-approved continuing education course.
  1. The course must be offered for the first time within the 24 months prior to the license expiration date.
  2. One contact hour equals 4 CCUs.
  3. Licensees are limited to the following number of CCUs:
    1. PTs may submit no more than 10 CCUs for this activity.
    2. PTAs may submit no more than 8 CCUs for this activity.
  4. Documentation required for consideration includes one of the following: a copy of a brochure for the presentation indicating the licensee as a presenter; or, a copy of the cover from the program and page(s) indicating the licensee as a presenter.
  5. If selected for audit, the licensee must submit the approval letter from the board-approved organization.
6. Service as a clinical instructor for full-time, entry-level PT or PTA students enrolled in accredited education. This activity type is automatically approved and is assigned a standard approval number by the board-approved organization.
  1. The instructorship must be completed within the 24 months prior to the license expiration date.
  2. Valuation of clinical instruction is as follows:
    1. Supervision of full-time PT or PTA students for 5 – 11 weeks is valued at 5 CCUs.
    2. Supervision of full-time PT or PTA students for 12 weeks or longer is valued at 10 CCUs.
  3. Licensees are limited to the following number of CCUs:
    1. PTs may submit a maximum of 10 CCUs for this activity.
    2. PTAs may submit a maximum of 8 CCUs for this activity.
  4. If selected for audit, the licensee must submit a letter or certificate from the coordinator of clinical education confirming clinical supervision and the number of weeks supervised from the education program.
Advanced Training, Certification, and Recognition.
1. Specialty Examinations. The Board will maintain and make available a list of recognized specialty examinations. Successful completion of a recognized specialty examination (initial or recertification) is automatically approved and assigned a standard approval number by the board-approved organization.
  1. The specialty examination must be successfully completed within the 24 months prior to the license expiration date.
  2. Each recognized specialty examination is valued at 30 CCUs.
  3. If selected for audit, the licensee must submit a copy of the letter from the certifying body notifying the licensee of completion of the specialty from the credentialing body, and a copy of the certificate of specialization.
  4. A specialty examination not on the list of recognized examinations but pertinent to the physical therapy profession may be submitted to the boardapproved organization for consideration. Documentation required for consideration includes the following:
    1. Identification and description of the sponsoring organization and its authority to grant a specialization to PTs or PTAs;
    2. A complete description of the requirements for specialization;
    3. A copy of the letter notifying the licensee of completion of the specialty from the certifying body, and a copy of the certificate of specialization.
2. APTA Certification for Advanced Proficiency for the PTA. This activity type is automatically approved and is assigned a standard approval number by the boardapproved organization.
  1. The certification must be successfully completed within the 24 months prior to the license expiration date.
  2. Completion of specialty certification is valued at 20 CCUs.
  3. If selected for audit, the licensee must submit a copy of the letter notifying the licensee of completion of the advanced proficiency, and a copy of the certificate of proficiency.
3. Residency or fellowship relevant to physical therapy. The Board will maintain and make available a list of approved residencies and fellowships. This activity type is automatically approved and is assigned a standard approval number by the board approved organization.
  1. The residency or fellowship must be successfully completed within the 24 months prior to the license expiration date.
  2. Completion of the residency or fellowship is valued at up to 30 CCUs.
  3. If selected for audit, the licensee must submit a copy of the certificate of graduation indicating completion of the fellowship or residency.
4. Mentorship of a resident or fellow in an approved residency or fellowship program. This activity type is automatically approved and is assigned a standard approval number by the board-approved organization.
  1. Mentorship of a resident or fellow for a minimum of 150 hours of 1:1 mentoring is valued at 10 CCUs. The Board will consider partial credit for those mentors who provide mentorship for only a portion of the residency or fellowship.
  2. Licensees may submit a maximum of 20 CCUs for this activity.
  3. If selected for audit, the licensee must submit a copy of a letter from the residency or fellowship program confirming participation as a clinical mentor, with the dates and number of mentorship hours served as a clinical mentor.
Professional Membership and Service. Licensees may submit activities in this category for up to one half of their CC requirement (PT - 15 CCUs, PTAs – 10 CCUs) at time of renewal. Licensees must demonstrate membership or participation in service activities for a minimum of one year during the renewal period to receive credit. Credit is not prorated for portions of years.
1. Membership in the APTA. This activity type is automatically approved and is assigned a standard approval number by the board-approved organization.
  1. One year of membership is valued at 1 CCU.
  2. If selected for audit, the licensee must submit a copy of the current membership card.
2. Service on a board, committee, or taskforce for the Texas Board of Physical Therapy Examiners, the American Physical Therapy Association (APTA) (or an APTA component), or the Federation of State Boards of Physical Therapy (FSBPT). This activity type is automatically approved and is assigned a standard approval number by the board-approved organization.
  1. One year of service is valued at 3 CCUs.
  2. Licensees are limited to the following number of CCUs per renewal:
    1. PTs may submit a maximum of 9 CCUs for this activity.
    2. PTAs may submit a maximum of 6 CCUs for this activity.
  3. If selected for audit, the licensee must submit a copy of a letter on official organization letterhead or certificate confirming completion of service.
3. Service as a TPTA Continuing Competence Approval Program reviewer. This activity type is automatically approved and is assigned a standard approval number by the board-approved organization.
  1. One year of service is valued at 3 CCUs.
  2. Licensees are limited to the following number of CCUs per renewal:
    1. PTs may submit a maximum of 6 CCUs for this activity.
    2. PTAs may submit a maximum of 6 CCUs for this activity.
  3. If selected for audit, the licensee must submit a copy of a letter or certificate confirming completion of service on official organization letterhead.
4. Service as an item writer for the national PT or PTA exam or an American Board of Physical Therapy Specialties (ABPTS) exam. This activity type is automatically approved and is assigned a standard approval number by the board-approved organization.
  1. One year of service is valued at 5 CCUs.
  2. Licensees are limited to the following number of CCUs per renewal:
    1. PTs may submit a maximum of 10 CCUs for this activity.
    2. PTAs may submit a maximum of 10 CCUs for this activity.
  3. If selected for audit, the licensee must submit a copy of a letter or certificate confirming completion of service on official organization letterhead.
Voluntary charity care. Providing physical therapy services for no compensation as a volunteer of a charitable organization as defined in §84.003 of the Texas Civil Practice and Remedies Code. This activity type is automatically approved and is assigned a standard approval number by the board-approved organization.
1. Voluntary charity care must be non work-related.
2. Proof of voluntary charity care can count toward up to one-half (1/2) of the continuing competence requirement.
3. Ten (10) hours of voluntary charity care equals 1 CCU.
4. If selected for audit, the licensee must submit a letter indicating the dates and number of hours of voluntary charity care on official charitable organization(s) letterhead.

Source Note: The provisions of this 341.3 adopted to be effective November 11, 1993, 18 TexReg 7552; amended to be effective April 12, 1995, 20 TexReg 2386; amended to be effective May 8, 1996, 21 TexReg 3797; amended to be effective February 13, 2000, 25 TexReg 779; amended to be effective November 16, 2000, 25 TexReg 11288; amended to be effective February 17, 2005, 30 TexReg 717; amended to be effective March 5, 2007, 32 TexReg 1074; amended to be effective June 7, 2009, 34 TexReg 3516; amended to be effective July 21, 2010, 35 TexReg 6286; amended to be effective February 11, 2014, 39 TXReg 651; amended to be effective August 17, 2014, 39 TexReg 6049; amended to be effective March 1, 2015, 40 TexReg 705; amended to be effective February 21, 2016, 41 TexReg 1122; amended to be effective February 16, 2017, 42 TexReg 556; amended to be effective May 22, 2017, 42 TexReg 2723; amended to be effective March 1, 2024, 48 TexReg 6996.

341.5. Waiver of Continuing Competence Units (CCUs)

CCUs required for renewal of a license may be waived by the board because of hardship for health and medical problems that prevent a licensee from obtaining the CCUs. Waiver requests must be submitted prior to license expiration. The license cannot be renewed until the waiver has been approved by the Board.

Source Note: The provisions of this 341.5 adopted to be effective November 11, 1993, 18 TexReg 7552; amended to be effective March 2, 2006, 31 TexReg 1301; amended to be effective July 21, 2010, 35 TexReg 6288.

341.6. License Restoration

The board may reinstate a license that has been expired one year or more through the process of restoration if certain requirements are met.
Duration. The original expiration date of a restored license will be adjusted so that the license will expire two years at the end of the birth month of the licensee.
Persons who are currently licensed in good standing in another state, district, or territory of the U.S. The requirements for restoration are:
1. a completed restoration application form;
2. a passing score on the jurisprudence examination;
3. verification of Licensure from all states in which the applicant holds or has held a license;
4. the restoration fee;
5. a criminal history record report from the Department of Public Safety and the Federal Bureau of Investigation obtained through fingerprinting. A licensee is not required to submit fingerprints for the renewal of the license if the licensee has previously submitted fingerprints under:
  1. §329.1. for the initial issuance of the license; or
  2. Chapter 341, License Renewal as part of a prior license renewal or restoration; and
6. successful completion of a human trafficking prevention course approved by the executive commissioner of the Health and Human Services Commission (HHSC). Course must be a minimum of one contact hour in order to claim CCU credit.
Persons who are not currently licensed in another state or territory of the U.S.
1. A licensee whose Texas license is expired for one to five years. The requirements for restoration are:
  1. a completed restoration application form;
  2. a passing score on the jurisprudence examination;
  3. the restoration fee;
  4. verification of Licensure from all states in which the applicant has held a license;
  5. a criminal history record report from the Department of Public Safety and the Federal Bureau of Investigation obtained through fingerprinting. A licensee is not required to submit fingerprints for the renewal of the license if the licensee has previously submitted fingerprints under:
    1. §329.1. for the initial issuance of the license; or
    2. Chapter 341, License Renewal as part of a prior license renewal or restoration.
  6. successful completion of a human trafficking prevention course approved by the executive commissioner of the Health and Human Services Commission (HHSC). Course must be a minimum of one contact hour in order to claim CCU credit; and
  7. demonstration of competency. Competency may be demonstrated in one of the following ways:
    1. reexamination with a passing score on the national physical therapy exam;
    2. completion of an advanced degree in physical therapy within the last five years;
    3. supervised clinical practice (SCP) completed over a continuous 12 month period and board approved continuing competence activities. For PTs, the requirement is 480 hours of SCP and 30 CCUs. For PTAs, the requirement is 320 hours of SCP and 20 CCUs.
2. A licensee whose Texas license is expired for five years or more may not restore the license but may obtain a new license by taking the national examination again and getting a new license by relicensure. The requirements for relicensure are:
  1. a completed application form;
  2. a passing score on the jurisprudence examination;
  3. the application fee;
  4. a passing score on the national exam, reported directly to the board by the Federation of State Boards of Physical Therapy; and
  5. a criminal history record report from the Department of Public Safety and the Federal Bureau of Investigation obtained through fingerprinting. A licensee is not required to submit fingerprints for the renewal of the license if the licensee has previously submitted fingerprints under:
    1. §329.1. for the initial issuance of the license; or
    2. Chapter 341, License Renewal as part of a prior license renewal or restoration.
Military Service Members, Military Veterans, and Military spouses. The board will expedite the restoration of a license to a military service member, a military veteran or a spouse of a member of the U.S. armed forces on active duty. The applicant must provide official documentation of active duty status, military veteran status, or the active duty status of the spouse.
Renewal of a restored license. To renew a license that has been restored, a licensee must comply with all requirements in 341.1 of this title (relating to Requirements for Renewal).

Source Note: The provisions of this 341.6 adopted to be effective February 18, 2001, 26 TexReg 1339; amended to be effective March 9, 2009, 34 TexReg 1605; amended to be effective February 13, 2012, 37 TexReg 689; amended to be effective February 11, 2014, 39 TexReg 655; amended to be effective August 17, 2014, 39 TexReg 6053; amended to be effective March 1, 2015, 40 TexReg 706; amended to be effective September 20, 2015, 40 TexReg 6352; amended to be effective February 21, 2016, 41 TexReg 1122; amended to be effective February 16, 2017, 41 TexReg 9692; amended to be effective January 1, 2019, 43 TexReg 7354.

341.7. Restrictions on License Renewal and Restoration

The board will not renew a license if a licensee has defaulted on court or attorney general's notice of child support. Upon receipt of notification that a repayment agreement has been established, the license shall be renewed.

Source Note: The provisions of this 341.7 adopted to be effective February 18, 2001, 26 TexReg 1339; amended to be effective November 1, 2019, 44 TexReg 6374.

341.8. Inactive Status

Inactive status indicates the voluntary termination of the right or privilege to practice physical therapy in Texas. The Board may allow a licensee who is not actively engaged in the practice of physical therapy in Texas to inactivate the license instead of renewing it at time of renewal. A licensee may remain on inactive status for no more than six consecutive years.
Requirements for initiation of inactive status. The components required to put a license on inactive status are:
1. a signed renewal application form, documenting completion of board-approved continuing competence activities for the current renewal period, as described in 341.2 of this title (relating to Continuing Competence Requirements);
2. the inactive fee, and any late fees which may be due; and
3. a passing score on the jurisprudence exam.
Requirements for renewal of inactive status. An inactive licensee must renew the inactive status every two years. The components required to maintain the inactive status are:
1. a signed renewal application form, documenting completion of board-approved continuing competence activities for the current renewal period, as described in 341.2 of this title;
2. the inactive renewal fee, and any late fees which may be due; and
3. a passing score on the jurisprudence exam.
Requirements for reinstatement of active status. A licensee on inactive status may request a return to active status at any time. The components required to return to active status are:
1. a signed renewal application form, documenting completion of board-approved continuing competence activities for the current renewal period, as described in 341.2 of this title;
2. the renewal fee, and any late fees which may be due;
3. a passing score on the jurisprudence exam;
4. a criminal history record report from the Department of Public Safety and the Federal Bureau of Investigation obtained through fingerprinting. A licensee is not required to submit fingerprints for the renewal of the license if the licensee has previously submitted fingerprints under:
  1. §329.1. for the initial issuance of the license; or
  2. Chapter 341, License Renewal as part of a prior license renewal or restoration.
5. successful completion of a human trafficking prevention course approved by the executive commissioner of the Health and Human Services Commission (HHSC). Course must be a minimum of one contact hour in order to claim CCU credit.
Licensees on inactive status are subject to the audit of continuing education as described in 341.2 of this title.

Source Note: The provisions of this 341.8 adopted to be effective February 18, 2001, 26 TexReg 1339; amended to be effective August 15, 2001, 26 TexReg 6022; amended to be effective July 21, 2010, 35 TexReg 6288; amended to be effective October 4, 2012, 37 TexReg 7751; amended to be effective January 1, 2019, 43 TexReg 7354.

341.9. Retired Status; Performing Voluntary Charity Care

Retired status means that a licensee is providing physical therapy services only in the domain of voluntary charity care.
As used in the section:
1. "voluntary charity care" means physical therapy services provided for no compensation as a volunteer of a charitable organization as defined in 84.003 of the Texas Civil Practice and Remedies Code. Charitable organizations include any bona fide charitable, religious, prevention of cruelty to children or animals, youth sports and youth recreational, neighborhood crime prevention or patrol, or educational organization (excluding fraternities, sororities, and secret societies), or other organization promoting the common good and general welfare for the people in a community, including these types of organizations with a 501(c) or (4) exemption from federal income tax, some chambers of commerce, and volunteer centers certified by the Department of Public Safety.
2. "compensation" means direct or indirect payment of anything of monetary value.
To be eligible for retired status, a licensee must hold a current license on active or inactive status.
Requirements for initiation of retired status. The components required to put a license on retired status are:
1. a completed retired status application form;
2. completion of board-approved continuing competence activities for the current renewal period;
3. the retired status fee and any late fees which may be due;
4. a passing score on the jurisprudence exam;
5. a criminal history record report from the Department of Public Safety and the Federal Bureau of Investigation obtained through fingerprinting. A licensee is not required to submit fingerprints for the renewal of the license if the licensee has previously submitted fingerprints under:
  1. §329.1. for the initial issuance of the license; or
  2. Chapter 341, License Renewal as part of a prior license renewal or restoration.
6. successful completion of a human trafficking prevention course approved by the executive commissioner of the Health and Human Services Commission (HHSC). Course must be a minimum of one contact hour in order to claim CCU credit.
Requirements for renewal of retired status. A licensee on retired status must renew the retired status every two years on his/her license renewal date. The components required to renew the retired status are:
1. a completed retired status application form;
2. completion of six units of board-approved continuing competence activities by both PTs and PTAs;
3. the retired status renewal fee, and any late fees which may be due;
4. a passing score on the jurisprudence exam;
5. a criminal history record report from the Department of Public Safety and the Federal Bureau of Investigation obtained through fingerprinting. A licensee is not required to submit fingerprints for the renewal of the license if the licensee has previously submitted fingerprints under:
  1. §329.1. for the initial issuance of the license; or
  2. Chapter 341, License Renewal as part of a prior license renewal or restoration.
6. successful completion of a human trafficking prevention course approved by the executive commissioner of the Health and Human Services Commission (HHSC). Course must be a minimum of one contact hour in order to claim CCU credit.
Requirements for reinstatement of active status. A licensee on retired status may request a return to active status at any time. The components required to return to active status are:
1. a signed renewal application form, documenting completion of board-approved continuing competence activities for the current renewal period, as described in 341.2 of this title, 30 CCUs for PTs and 20 CCUs for PTAs;
  1. proof of voluntary charity care as defined in (b)(1) of this section can count toward up to one-half (1/2) of the continuing competence requirement;
  2. ten hours of voluntary charity care equals 1 CCU.
2. the renewal fee, and any late fees which may be due;
3. a passing score on the jurisprudence exam;
4. a criminal history record report from the Department of Public Safety and the Federal Bureau of Investigation obtained through fingerprinting. A licensee is not required to submit fingerprints for the renewal of the license if the licensee has previously submitted fingerprints under:
  1. §329.1. for the initial issuance of the license; or
  2. Chapter 341., License Renewal as part of a prior license renewal or restoration.
5. successful completion of a human trafficking prevention course approved by the executive commissioner of the Health and Human Services Commission (HHSC). Course must be a minimum of one contact hour in order to claim CCU credit.
A license may be maintained on retired status indefinitely.
A licensee on retired status may use the designation "PT, retired" or "PTA, retired", as appropriate.
Licensees on retired status are subject to the audit of continuing competence activities as described in 341.2 of this title, concerning Continuing Competence Requirements.
Licensees providing voluntary charity care are subject to the provisions of the Physical Therapy Practice Act and Rules; and as such, violations could result in disciplinary action.

Source Note: The provisions of this 341.9 adopted to be effective September 18, 2006, 31 TexReg 8000; amended to be effective July 21, 2010, 35 TexReg 6289; amended to be effective May 17, 2015, 40 TXReg 2667; amended to be effective January 1, 2019, 43 TexReg 7354.

341.20. Licensees Serving as a Military Service Member

Renewal. A licensee will be exempt from late fees and penalty if the individual establishes to the satisfaction of the board that failure to timely renew was because the individual was serving as a military service member.

Continuing competence units (CCUs). A licensee who is serving as a military service member may receive an extension of up to two years post expiration of license in order to complete the following:

Continuing competence activities as specified in 341.2 of this title (relating to Continuing Competence Requirements); and
The board’s jurisprudence exam.

“Military service member” as used in this section has the meaning as defined in Texas Occupations Code, 55.001.

Source Note: The provisions of this 341.20 adopted to be effective November 11, 1993, 18 TexReg 7552; amended to be effective September 18, 2005, 30 TexReg 5801; amended to be effective July 21, 2010, 35 TexReg 6289; amended to be effective January 1, 2016, 40 TexReg 8791.

341.21. Report of Malpractice Claims or Actions or Disciplinary Actions

Each licensee shall submit a copy of any judgment or settlement in a malpractice claim or any disciplinary action taken by another licensing authority in another state to the board within 30 days after such occurrences.

Source Note: The provisions of this 341.21 adopted to be effective April 12, 1995, 20 TexReg 2386.

CHAPTER 342

OPEN RECORDS

342.1. Open Records

Open record requests. Inspection of Public Records under the Texas Open Records Act, Texas Civil Statutes, Title 5, Government Code, Chapter 552, provides that all of the records of the board are public records and are available for public inspection during normal business hours except that investigative files and records of the board are confidential. In addition, the exceptions to disclosure in Government Code, Chapter 552 may protect certain information. This rule is promulgated pursuant to Government Code, Chapter 552 to establish a records review process that is efficient, safe, and timely to the public and to the agency.
1. Requests must be in writing and reasonably identify the records requested.
2. Records access will be by appointment only.
3. Records access is available only during the regular business hours of the agency.
4. Unless confidential information is involved, review may be by physical access or by duplication at the requestor's option. Any person, however, whose request would be unduly disruptive to the ongoing business of the office may be denied physical access and will be provided the option of receiving copies. Costs of duplication shall be the responsibility of the requesting party in accordance with the established board fee policy, payable at the time of receipt of records, if a person; or in advance, if by mail. The board may, in its discretion, waive fees if it is in the public interest to do so.
5. When the safety of any public record is at issue, physical access may be denied and the records will be provided by duplication as previously described.
6. Confidential files will not be made available for inspection or for duplication except under certain circumstances, e.g., court order.
7. All open records request appointments will be referred to the executive director or designee before complying with a request.
8. The open records coordinator for the agency is the executive director and the alternate is the director's designee.
Charges for copies of public records. The charge to any person requesting reproductions of any readily available record of the Texas State Board of Physical Therapy Examiners will be the charges established by the General Services Commission.
The board may waive these charges if there is a public benefit. The executive director of the Executive Council of Physical Therapy and Occupational Therapy Examiners is authorized to determine whether a public benefit exists on a case by case basis.

Source Note: The provisions of this 341.2 adopted to be effective November 11, 1993, 18 TexReg 7553; amended to be effective October 26, 1994, 19 TexReg 8113.

CHAPTER 343

CONTESTED CASE PROCEDURE

343.1. Definitions

The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.

Act--The Texas Physical Therapy Practice Act, Occupations Code, Chapter 453.
Agency--The Executive Council of Physical Therapy & Occupational Therapy Examiners.
Applicant--A qualified individual who presents application for licensure as a physical therapist or physical therapist assistant or for reinstatement of a previously suspended or revoked license.
Board--The Texas Board of Physical Therapy Examiners who members are appointed pursuant to Occupations Code, Chapter 453.051.
Board order--A final decision of the board issued in a contested or uncontested proceeding, which may include findings of fact and conclusions of law, separately stated.
Complaint--A written statement of allegations filed with the board which includes a statement of the matters asserted, including any supporting documentation available, the filing of which may initiate a contested case proceeding.
Contested case--A proceeding in which the legal rights, duties, or privileges of a party are to be determined by the board after an opportunity for adjudicative hearing.
Disciplinary action--Imposition of a sanction by the board which may include reprimand, suspension, probation, or revocation of a license, or other appropriate requirements.
Executive director--The chief officer of the Executive Council of Physical Therapy & Occupational Therapy Examiners.
Informal Settlement Conference (ISC)--a conference designed to resolve contested cases by informally disposing of matters by agreement and voluntary settlement without the need for a formal hearing at the State Office of Administrative Hearings (SOAH).
Investigation Committee--a standing committee of the board that reviews complaint investigations with recommendation of appropriate action made to the board.
Licensee--A person who holds a license either permanent or temporary under the Physical Therapy Practice Act.
Notice--A statement of intended date, time, place, and nature of a hearing, and the legal authority and jurisdiction under which a hearing is to be held. Notice may include a formal complaint filed to initiate a contested case proceeding.
Party--A person or a state agency named or admitted as a party in a contested case proceeding.
Probation--A period of time when a license is subject to conditions or limitations.
Reinstatement--To reactivate a license that was previously revoked or voluntarily surrendered.
Reprimand--A public and formal censure against a license.
Respondent--A person who has been made the subject of a formal or informal complaint alleging violation of the Act, rules, other laws or regulations, or orders of the board.
Revocation--The withdrawal or repeal of a license.
Staff--The investigative staff of the board.
Suspension--The temporary withdrawal of a license. The board may suspend for one day or a designated number of years or until a specified event occurs.
Voluntary surrender--The act of relinquishing a license at the will of the licensee in lieu of disciplinary action.

Source Note: The provisions of this 343.1 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective August 17, 2014, 39 TexReg 6054; amended to be effective November 15, 2024, 49 TexReg 6961.

343.2. Denial of a License and Disciplinary Actions by the Board

The board has the authority to deny an applicant a license or to suspend or revoke a license, to reprimand or otherwise discipline a licensee, or to place on probation a licensee whose license has been suspended. If a license is suspended, the licensee is placed on probation for the duration of the suspension.

Source Note: The provisions of this 343.2 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective January 12, 1993, 18 TexReg 64.

343.5. Licensure of Persons with a History of Substance Abuse

The board may deny a license to or discipline an applicant/respondent who used drugs or intoxicating liquors to an extent that affects the license holder's or applicant's professional competence.
In review of a complaint alleging intemperate use of drugs or alcohol by a respondent/applicant, the board shall consider the following evidence in determining the respondent's/applicant's present fitness to practice physical therapy:
1. documentation demonstrating the degree of sobriety obtained;
2. documentation showing completion of a drug or alcohol rehabilitation program;
3. evidence of participation in board-accepted aftercare;
4. a current status report from a drug/alcohol abuse counselor or board-accepted aftercare sponsor; and
5. letters of recommendation.
The burden to provide the foregoing documentation to the board shall be solely at the expense of the respondent/applicant.
Provided that the licensee participates in a substance abuse recovery program acceptable to the board, the license may continue on a probationary status with conditions set forth by the full board. Failure to comply and maintain the complete condition of the probation will cause immediate revocation of the license.

Source Note: The provisions of this 343.5 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective September 1, 2023, 48 TexReg 4256.

343.6. Other Grounds for Denial of a License or Discipline of a Licensee

Grounds for the board to deny a license to or discipline an applicant/respondent may include the following:
1. attempting to obtain or obtaining a license by fraud, falsification, or deception of an application or examination procedure; or
2. having a license to practice physical therapy or a license to practice another health care profession revoked or suspended or had other disciplinary action taken against him or had his application for license refused, revoked, or suspended by the proper licensing authority of another state, territory, or nation;
3. failure to meet the qualifications for licensure as set forth in the Act, §453.203, as applicable, and/or to any other rules or procedures set forth by the board relating to these sections;
4. cheating on the national examination.
If the board determines that an applicant has falsified his application for licensure in regard to any of the documents or procedures of the licensing process, a license may be denied.

Source Note: The provisions of this 343.6 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective January 12, 1993, 18 TexReg 64; amended to be effective November 11, 1993, 18 TexReg 7554; amended to be effective September 1, 2023, 48 TexReg 4256.

343.7. Gross Negligence in the Practice of Physical Therapy

The board may deny a license to or discipline an applicant/respondent who is found grossly negligent in the practice of physical therapy or in acting as a physical therapist assistant.
Gross negligence may include, but is not limited to, the provision of physical therapy which the therapist knew or should have known would result in severe physical injury or death of a patient.

Source Note: The provisions of this 343.7 adopted to be effective January 7, 1992, 16 TexReg 7645.

343.8. Licensure of Persons with a History of Voluntary or Involuntary Psychiatric Hospitalization

The board may deny a license to or discipline an applicant/respondent who has been adjudged mentally incompetent by a court of competent jurisdiction.
In review of a complaint alleging that the respondent/applicant has a history of voluntary or involuntary psychiatric hospitalization, the board shall consider the following evidence in determining the respondent's/applicant's present fitness to practice physical therapy:
1. conduct and work activity of the person prior to and after hospitalization;
2. documentation to indicate that the person is presently in good mental health. Specifically, a current psychological/psychiatric evaluation, which shall include such information as the agency may require;
3. a current status report from a counselor, therapist, or physician; and
4. letters of recommendation.
The burden to provide the foregoing documentation to the board shall be solely at the expense of the respondent/applicant.

Source Note: The provisions of this 343.8 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective September 1, 2023, 48 TexReg 4256.

343.9. Licensure of Persons with Criminal Convictions

The board may revoke or suspend an existing valid license, disqualify a person from receiving or renewing a license, or deny to a person the opportunity to be examined for a license because of a person's conviction of a felony or misdemeanor if the crime directly relates to the practice of physical therapy. Those crimes which the board considers to be directly related to the duties and responsibilities of a licensed physical therapist or physical therapist assistant shall include, but are not limited to:
1. any felony which involves an act of fraud, dishonesty, or deceit;
2. any criminal violation of the Act or other statutes regulating or pertaining to physical therapy or the medical profession;
3. any crime involving moral turpitude;
4. murder;
5. assault;
6. burglary;
7. robbery;
8. theft;
9. rape or sexual abuse;
10. patient/client abuse;
11. injury to an elderly person;
12. child molestation, abuse, endangerment, or neglect;
13. felony conviction for driving while intoxicated, driving under the influence of alcohol or drugs, or driving while ability is impaired;
14. sale, distribution, or illegal possession of narcotics, controlled substances, or dangerous drugs;
15. tampering with a governmental record;
16. offenses which include attempting or conspiring to commit any of the offenses in this subsection.
In determining whether a crime not listed previously relates to physical therapy, the board will consider:
1. the nature and seriousness of the crime;
2. the relationship of the crime to the purposes for requiring a license to practice physical therapy;
3. the extent to which a license might offer opportunities to engage in further criminal activity of the same type as that in which the person was previously engaged;
4. the relationship of the crime to the ability, capacity, or fitness required to perform the duties and to discharge the responsibilities of a physical therapist or physical therapist assistant; and
5. any correlation between the elements of the crime and the duties and responsibilities of a physical therapist or physical therapist assistant.
In review of a complaint alleging that the respondent/applicant has been convicted of a crime which directly relates to the duties and responsibilities of a physical therapist or physical therapist assistant, the board shall consider the following evidence in determining the respondent's/applicant's present fitness to practice physical therapy:
1. the extent and nature of the person's past criminal activity;
2. the age of the person at the time of commission of the crime;
3. the amount of time that has elapsed since the person's last criminal activity;
4. the conduct and work activity of the person before and after the criminal activity;
5. evidence of the person's rehabilitation or rehabilitative effort while incarcerated or after release;
6. evidence of the person's compliance with any condition of community supervision, parole, or mandatory supervision, including letters of recommendation from prosecution, law enforcement, and correctional officers who prosecuted, arrested, or had custodial responsibility for the person; letters from the sheriff or chief of police where the person resides; and other persons having contact with the convicted person; and
7. other evidence of the person's fitness, including letters or recommendation, records of steady employment, provision for dependents, payment of all court costs, supervision fees, fines, and restitution if ordered as a result of the person's conviction.
The burden and expense of providing and presenting the foregoing documentation to the board shall be solely that of the respondent/applicant.
A licensee or applicant is required to report to the board a felony of which he is convicted within 60 days after the conviction occurs.

Source Note: The provisions of this 343.9 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective January 12, 1993, 18 TexReg 64; amended to be effective September 1, 2023, 48 TexReg 4256.

343.20. Subpoenas

The board or its designee shall have the power to issue subpoenas and subpoenas duces tecum to compel the attendance of witnesses, the production of books, records, and documents; to administer oaths and to take testimony concerning all matters within its jurisdiction.

Source Note: The provisions of this 343.20 adopted to be effective January 7, 1992, 16 TexReg 7645.

343.21. Witness Fees and Expenses

A witness who is not a party to the proceeding and who is subpoenaed to appear at a deposition or hearing or to produce documents, records, or other tangible things, shall receive reimbursement for expenses incurred in complying with the subpoena. Reimbursement shall be in accordance with Government Code, §2001.103. Said amount shall be paid by the party at whose request the witness is subpoenaed.

Source Note: The provisions of this 343.21 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective September 1, 2023, 48 TexReg 4256.

343.22. Service of Notice

Service of notice of hearing on the respondent/applicant shall be complete and effective in accordance with Texas Government Code, §2001.051 and §2001.052.

Source Note: The provisions of this 343.22 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective September 1, 2023, 48 TexReg 4256.

343.23. Hearings

The State Office of Administrative Hearings (SOAH) shall conduct all administrative hearings of contested cases that are before the board in accordance with Texas Government Code 2001 and Title 1 Texas Administrative Code.

Source Note: The provisions of this 343.23 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective October 26, 1994, 19 TexReg 8113; amended to be effective November 15, 2024, 49 TexReg 6961.

343.24. Payment of Penalties after a Contested Case Hearing Resulting in the Discipline of a Licensee or the Denial of an Application for License

A contested case hearing on the denial of an application must be requested in writing to the board.
A person whose application for a license has been denied by the staff or a licensee who has been found in violation of the Act or rules as a result of a contested case hearing may be required to pay administrative penalties to the board. Payment of penalties are due to the Board in accordance with the final order.

Source Note: The provisions of this 343.24 adopted to be effective October 26, 1994, 19 TexReg 8113; amended to be effective November 15, 2024, 49 TexReg 6961.

343.25. Continuance

REPEALED.

Source Note: The provisions of this 343.25 adopted to be effective January 7, 1992, 16 TexReg 7645; repealed to be effective November 15, 2024, 49 TexReg 6961.

343.26. Computation of Time

Computing time. In computing any period of time prescribed or allowed by order or directive of the agency, or by any applicable statute, unless otherwise specified, the period shall begin on the day after the act or event in controversy and conclude on the last day of such computed period, unless it be a Saturday, Sunday, or legal holiday, in which event the period runs until the end of the next business day which is neither a Saturday, Sunday, nor a legal holiday.
Extension. Unless otherwise provided by statute, the time for filing any pleading, motion, or request may be extended by order of the executive director or designee, upon written motion filed prior to the expiration of the applicable period of time for the filing of the same, showing that the need for extension is not caused by the neglect, indifference, or lack of diligence of the requesting party.

Source Note: The provisions of this 343.26 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective November 15, 2024, 49 TexReg 6961.

343.27. Probation

If placing a person on probation whose license has been suspended, the board may impose such additional terms and conditions as it deems appropriate for the period of probation. The board shall specify the exact duration of the probationary period. Upon finding that a person placed on probation has failed to comply with the terms and condition of the board's order, the board may take additional disciplinary action as it deems appropriate, following notice and hearing.

Source Note: The provisions of this 343.27 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective November 15, 2024, 49 TexReg 6961.

343.28. Records Retention Schedule

All investigations files shall be maintained in accordance with the approved records retention schedule on file with the Texas State Library and Archives Commission.

Source Note: The provisions of this 343.28 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective November 15, 2024, 49 TexReg 6961.

343.29. Failure To Appear at Informal Settlement Conference or Hearing

Informal Settlement Conference. Failure to respond to the allegations, either by personal appearance at the informal settlement conference or in writing, may result in the allegations being confirmed at the informal settlement conference and the highest proposed sanction being recommended to the board. The notice of the informal settlement conference shall be served by delivering a copy to the respondent or licensee in accordance with Texas Government Code §2001.054(c)(1), to the licensee's last known address of record as shown by agency records, not less than 10 days prior to the date of the conference.
State Office of Administrative Hearings (SOAH) - If a respondent fails to appear in person or by attorney on the day and at the time set for hearing in a contested case, regardless of whether an appearance has been entered, the judge shall, upon adequate proof that proper notice under the Texas Government Code chapter 2001 and Title 1 Texas Administrative Code Part 7 was served upon the defaulting party, enter a default judgment in the matter adverse to the respondent.

Source Note: The provisions of this 343.29 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective November 15, 2024, 49 TexReg 6961.

343.35. Complaint Investigation and Disposition

Complaints shall be assigned a priority status in the following categories:
1. those indicating that credible evidence exists showing a violation of the Act involving actual deception, fraud or injury to clients or the public or a high probability of immediate deception, fraud, or injury to clients or the public;
2. those indicating that credible evidence exists showing a violation of the Act involving a high probability of potential deception, fraud, or injury to clients or the public;
3. those indicating that credible evidence exists showing a violation of the Act involving a potential for deception, fraud, or injury to clients or the public;
4. all other complaints.
Not later than the 30th day after a complaint is received, the staff shall place a timeline for completion, not to exceed one year, in the investigative file and notify all parties to the complaint. Any change in the timeline must be noted in the file and all parties notified of the change not later than seven days after the change was made. For purposes of this rule, completion of an investigation in a disciplinary matter occurs when:
1. staff determines there is insufficient evidence to demonstrate a violation of the act, board rules, or a board order; or
2. staff determines there is sufficient evidence to demonstrate a violation of the act, board rules, or board order and drafts proposed board order.
The staff shall provide summary data of complaints extending beyond the complaint timeline to the board so that the board may take necessary action on the complaint.
The board shall keep an information file on each complaint submitted to the board. The file will be kept current and include a record of all persons contacted in relation to the complaint, notes about the findings throughout the complaint process, and other relevant information.
The Investigation Committee may determine when and if a private investigator is needed for processing of a complaint.

Source Note: The provisions of this 343.35 adopted to be effective April 12, 1995, 20 TexReg 2386; amended to be effective March 1, 2018, 43 TexReg 777; amended to be effective November 15, 2024, 49 TexReg 6961.

343.36. Filing and Receipt of Complaints

Complaints may be received in writing on a form prescribed by the board. Complainants shall be invited to explain their allegations. The staff will provide reasonable assistance to a person who wishes to file a complaint.
When a complaint is received, the board, at least as frequently as quarterly and until final disposition of the complaint, shall notify the parties to the complaint of the status of the complaint unless the notice would jeopardize an undercover investigation.
Prior to commencing disciplinary proceedings, the staff shall serve the respondent with written notice in accordance with Government Code, §2001.054(c).
1. Such notice shall contain a statement of the facts or conduct alleged to warrant an adverse licensure action. The notice shall invite the respondent to show compliance with all requirements of the law for retention of the license.
2. The respondent shall have not less than ten days to respond in writing.

Source Note: The provisions of this 343.36 adopted to be effective April 12, 1995, 20 TexReg 2386; amended to be effective September 1, 2023, 48 TexReg 4256.

343.40. Informal Conference

At any time after the filing of a complaint, an informal settlement conference may be held prior to the contested case hearing for the purpose of:
1. simplifying the issues;
2. considering proposed admissions or stipulations of fact;
3. reviewing the procedure to govern the contested case hearing;
4. exchanging witness lists and agreeing to limit the number of witnesses; and/or
5. doing any act that may simplify the proceedings, and dispose of matters in controversy, including settlement of issues in dispute and preparation of an agreed order for presentation to the board as provided herein.
A licensee or applicant may request an informal settlement conference; however, the decision to hold a conference shall be made by the executive director or the investigation committee.
Participation in an informal settlement conference shall not be mandatory for the licensee or applicant, nor is it a prerequisite to a formal hearing.
The executive director or staff shall decide upon the time, date, and place of the informal settlement conference and provide written notice to the licensee or applicant of the same. Notice shall be provided no less than 10 days prior to the date of the informal settlement conference to the last known address of the licensee or applicant. The 10 days shall begin on the date the notice is sent electronically or deposited into the mail. The licensee or applicant may waive the 10-day notice requirement in writing.
1. The notice shall inform the licensee or applicant of the following:
  1. the nature of the alleged violation;
  2. that the licensee may be represented by legal counsel;
  3. that the licensee or applicant may offer the testimony of witnesses and present other evidence as may be appropriate;
  4. that board members may be present;
  5. that a representative of the office of the attorney general will be present;
  6. that the licensee's or applicant's attendance and participation is voluntary;
  7. that the complainant and any client involved in the alleged violations may be present; and
  8. that the informal settlement conference shall be cancelled if the licensee or applicant notifies the executive director or staff that he or she will not attend.
2. A copy of the board's rules may be referenced with the notice of the infornal settlement conference.
The notice of the informal settlement conference shall be sent to the complainant at his or her last known address. The complainant shall be informed that he or she may appear and testify or may submit a written statement for consideration at the informal settlement conference. The complainant shall be notified if the conference is cancelled.
Participants in the informal settlement conference may include board members, agency staff, the complainant, the licensee or applicant, attorneys representing any of the participants, and any other persons determined by the investigation committee or the executive director or board's designee to be necessary for proper conduct of the conference. All other persons shall be excluded.
The informal settlement conference shall not follow the procedures established in this chapter for contested cases and formal hearings.
The licensee, the licensee's attorney, investigation committee members, and board staff may question witnesses, make relevant statements, present statements of persons not in attendance, and present such other evidence as may be appropriate.
The board's attorney from the office of the attorney general shall attend the informal settlement conferences to advise the board members, executive director, and staff.
The licensee or applicant shall be afforded the opportunity to make statements that are material and relevant.
Access to the board's investigative file may be prohibited or limited in accordance with the Administrative Procedure Act (APA) and Texas Register Act (TRA).
No formal recording of the informal settlement conference shall be made.
At the conclusion of the informal settlement conference, the investigation committee members, executive director, or staff may propose an informal disposition of a complaint or contested case to the respondent subject to the board's approval. The informal disposition may include any disciplinary action authorized by the Act and rules. The investigation committee, executive director, or staff may also close the complaint investigation because the board lacks jurisdiction, a violation of the act or rules was not established, or determine further investigation is required.

Source Note: The provisions of this 343.40 adopted to be effective November 11, 1993, 18 TexReg 7554; amended to be effective September 1, 2023, 48 TexReg 4256.

343.41. Agreed Orders

A proposed agreed order may be negotiated with any person under the jurisdiction of the board, the terms of which shall be approved by the investigation committee.
The proposed agreed order will be sent to the respondent by a method of service in accordance with Government Code §2001.142. To accept the agreed order, the respondent must sign it and return it to the board staff within 10 days after receipt. Inaction by the respondent constitutes rejection. If the respondent rejects the proposed settlement, the matter shall be referred to the investigation committee, executive director, or staff for appropriate action.
The proposedf agreed order with the signature of the respondent will be presented to the board. The proposed agreed order shall have no effect until such time as the board may, at a regularly scheduled meeting, take action approving the agreed order. If approved by the board, the chair of the board is authorized to sign the agreed order on behalf of the board. When the board has approved and signed an agreed order, the board order will be sent to the licensee.
The respondent shall be notified of the date, time, and place of the board meeting at which the proposed agreed order will be considered. Attendance by the licensee or applicant is voluntary.
Consideration by the board.
1. The name and license number of the licensee or the name of the applicant will not be made available to the board until after the board has reviewed and made a decision on the agreed order.
2. Upon an affirmative majority vote, the board shall approve the agreed order, and the chairperson of the board will sign it on behalf of the board. The final board order will be provided to the respondent.
3. If the board does not approve the agreed order, the matter may be referred to the investigation committee, executive director, or designee for other appropriate action. The respondent and the complainant shall be so informed.

Source Note: The provisions of this 343.41 adopted to be effective January 12, 1993, 18 TexReg 64; amended to be effective November 11, 1993, 18 TexReg 7554; amended to be effective May 8, 1996, 21 TexReg 3710; amended to be effective September 1, 2023, 48 TexReg 4256.

343.42. Commencement of Disciplinary Proceedings

If a complaint is not resolved informally, the staff may commence disciplinary proceedings by filing written charges.
The charges shall contain the following information:
1. the name of the respondent;
2. a statement of the conduct alleged to be in violation of the act or of a rule, regulation, or order of the board; and
3. a reference to the section of the act or to the board rule, regulation, or order which respondent is alleged to have violated.

Source Note: The provisions of this 343.42 adopted to be effective April 12, 1995, 20 TexReg 2386.

343.48. Dismissal of Complaint

Complaints may be dismissed for the following reasons:
1. no evidence available;
2. unable to locate;
3. insufficient evidence;
4. other reasons which the Investigation Committee believe justify dismissal.
Upon the decision of the Investigation Committee to dismiss a complaint, the person who filed the complaint is provided with a letter explaining why the complaint has been dismissed.
At least four times a year the board is provided with a list of the complaints that were dismissed and the reasons for the dismissals.

Source Note: The provisions of this 343.48 adopted to be effective April 12, 1995, 20 TexReg 2386; amended to be effective November 15, 2024, 49 TexReg 6961.

343.49. Disposal of Complaints

At least annually, the board will advise the executive council of complaints which have been disposed.

Source Note: The provisions of this 343.49 adopted to be effective April 12, 1995, 20 TexReg 2386.

343.50. Request for Reinstatement of License

At the expiration of 180 days from the date of revocation, the Investigation Committee may consider a request for reinstatement by the former licensee.
The request for reinstatement must be submitted to the agency in writing and should include a short and plain statement of the reasons why the requestor believes the license should be reinstated.
Upon denial of any request for reinstatement, the board may not consider a subsequent request until the expiration of one year from the date of denial of the prior request.
In taking action to revoke a license, the board may, in its discretion, specify the terms and conditions upon which reinstatement shall be considered.

Source Note: The provisions of this 343.50 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective January 12, 1993, 18 TexReg 64; amended to be effective November 15, 2024, 49 TexReg 6961.

343.51. Evaluation for Reinstatement

In considering reinstatement of a revoked or voluntarily surrendered license, the board will evaluate:

the severity of the act which resulted in revocation or voluntary surrender of the license;
the conduct of the applicant subsequent to the revocation or voluntary surrender of license;
the lapse of time since revocation or voluntary surrender;
the degree of compliance with all conditions the board may have stipulated as a prerequisite for reinstatement;
the degree of rehabilitation attained by the applicant as evidenced by statements sent directly to the board from qualified people who have personal and professional knowledge of the applicant; and
the applicant's present qualifications to practice physical therapy based on his/her history of physical therapy related employment or education.

Source Note: The provisions of this 343.51 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective November 15, 2024, 49 TexReg 6961.

343.52. Procedure upon Request for Reinstatement

An applicant for reinstatement of a revoked license must personally appear before the Investigation Committee at a scheduled date and time to show why the license should be reinstated.
The applicant has the burden of proof to show present fitness and/or rehabilitation to practice physical therapy.
Where the applicant's license has been revoked or voluntarily surrendered based on a finding, admission, or allegation that the applicant was unfit to practice physical therapy by reasons of intemperate use of alcohol or drugs, misappropriation of controlled substances, an adjudication of mental incompetence, or the existence of any mental disorder, the applicant must submit a written psychiatric or psychological evaluation or written medical evaluation. Said evaluations shall be obtained solely at the applicant's expense and forwarded directly to the agency by the examiner. The psychiatric or psychological evaluation must be prepared by a licensed psychiatrist or psychologist and the medical evaluation must be prepared by a licensed physician. Said reports shall include such information as the agency may specifically require with notice to the applicant.
Upon receipt of a written request for reinstatement and all information required by subsection of this section, the applicant will be notified of the date and time of an appearance before the Investigation Committee.

Source Note: The provisions of this 343.52 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective November 15, 2024, 49 TexReg 6961.

343.53. Board Action upon Reinstatement of Revoked or Voluntarily Surrendered License

After evaluation, the board may:

deny reinstatement of a revoked or voluntarily surrendered license;
reinstate a revoked or voluntarily surrendered license;
require the satisfactory completion of a pending Agreed Order, or a specific program or remedial education approved by the board; and
require monitoring of the applicant's physical therapy practice as specified by the board.

Source Note: The provisions of this 343.53 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective November 15, 2024, 49 TexReg 6961.

343.54. Reinstatement of Suspended License

A suspended license is immediately reinstated at the end of the suspension period.

Source Note: The provisions of this 343.54 adopted to be effective January 7, 1992, 16 TexReg 7645.

343.55. Failure To Appear

An applicant for reinstatement of a revoked or voluntarily surrendered license who makes a commitment to appear before the board and fails to appear at a hearing set with notice by the agency, shall not be authorized to appear before the board before the expiration of six months. For good cause shown, the executive director may authorize an exception to this rule.

Source Note: The provisions of this 343.55 adopted to be effective January 7, 1992, 16 TexReg 7645; amended to be effective November 15, 2024, 49 TexReg 6961.

343.56. Monitoring of Licensees

A licensee who is ordered by the board to perform certain acts will be monitored by the agency to ensure that the required acts are completed per the order of the board.

Source Note: The provisions of this 343.56 adopted to be effective April 12, 1995, 20 TexReg 2386; amended to be effective November 15, 2024, 49 TexReg 6961.

CHAPTER 344

ADMINISTRATIVE FINES AND PENALTIES

344.1. Administrative Fines and Penalties

Any physical therapist or physical therapist assistant who violates any provision of these rules, or any provision of the Physical Therapy Practice Act shall be, at the discretion of the Board, subject to the following penalties.
1. The Board may impose suspension or revocation of a license, or other disciplinary action including probation, tutorial hours and additional education.
2. The Board may assess fines, not to exceed $200 for each day of the offense, based on the following schedule:
  1. first offense: $100-$1,000;
  2. subsequent offense: $200-$5,000.
The board may expunge any record of disciplinary action taken against a license holder before September 1, 2019, for practicing in a facility that failed to meet the registration requirements of Occupations Code, Section 453.213, as that section existed on January 1, 2019. The board may not expunge a record under this section after September 1, 2021.
The Board shall utilize the following Schedule of Sanctions in all disciplinary matters.

**Figure 22 TAC §344.1(c) Schedule of Sanctions**
Disciplinary Violations	PT Act/Rule	Minimum Discipline	Intermediate Discpline	Maximum Discipline	Remarks
Failing to document physical therapy services, inaccurately recording, falsifying, or altering patient/client records	Sec. 453.351(a)(7) §322.4(b)(1)	15-30 day license suspension+up to $100 per violation	45-90 day license suspension+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Obtaining or attempting to obtain or deliver medications through means of misrepresentation, fraud, forgery, deception, and/or subterfuge	Sec. 453.351(a)(7) §322.4(b)(2)	30-60 day license suspension+up to $100 per violation	30-60 day license suspension with restricted practice+up to $150 per violation	Revocation or Surrender of license +up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Failing to supervise and maintain the supervision of supportive personnel, licensed ord unlicensed, in compliance with the Act and rule requirements.	Sec. 453.351(a)(7)(10) §322.4(b)(3)	30-60 hours community service+up to $100 per violation	30-60 day license suspension+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Aiding, abetting, authorizing, condoning, or allowing the practice of physical therapy by any person not licensed to practice physical therapy	Sec. 453.351(a)(7) §322.4(b)(4)	30-60 day license suspension+up to $100 per violation	30-60 day license suspension with restricted practice+up to $150 per violation	Revocation or Surrender of license +up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Permitting another person to use an individual's physical therapist's or physical therapist assistant's license for any purpose	Sec. 453.351(a)(7) §322.4(b)(5)	30-60 day license suspension+up to $100 per violation	30-60 day license suspension with restricted practice+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Failing to cooperate with the agency by not furnishing papers or documents requested or by not responding to subpoenas issued by the agency	Sec. 453.351(a)(7) §322.4(b)(6)	30-60 hours community service+up to $100 per violation	30-60 day license suspension+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Interfering with an investigation or disciplinary action proceeding by willful misrepresentation of facts before the agency or the board, or by the use of threats or harassment against any patient/client or witness to prevent them from providing evidence in a disciplinary proceeding or any other legal action	Sec. 453.351(a)(7) §322.4(b)(7)	30-60 hours community service+up to $100 per violation	30-60 day license suspension+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Engaging in sexual contact with a patient/client as the result of the patient/client relationship	Sec. 453.351(a)(7) §322.4(b)(8)	30-60 day license suspension+up to $100 per violation	30-60 day license suspension with restricted practice+up to $150 per violation	Revocation or Surrender of license +up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Practicing or having practiced with an expired temporary or permanent license	Sec. 453.351(a)(7) §322.4(b)(9)	30-60 day license suspension+up to $100 per violation	30-60 day license suspension with restricted practice+up to $150 per violation	Revocation or Surrender of license +up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Failing to conform to the minimal standards of acceptable prevailing practice, regardless of whether or not actual injury to any person was sustained, including, but not limited to: (A) failing to assess and evaluate a patient's/client's status; (B) performing or attempting to perform techniques or procedures or both in which the physical therapist or physical therapist assistant is untrained by education or experience; (C) delegating physical therapy functions or responsibilities to an individual lacking the ability or knowledge to perform the function or responsibility in question; or (D) causing, permitting, or allowing physical or emotional injury or impairment of dignity or safety to the patient/client	Sec. 453.351(a)(7) §322.4(b)(10)	30-60 hours community service+up to $100 per violation	30-60 day license suspension+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Intentionally or knowingly offering to pay or agreeing to accept any remuneration directly or indirectly, overtly or covertly, in cash or in kind, to or from any person, firm, association of persons, partnership, or corporation for receiving or soliciting patients or patronage, regardless of source of reimbursement, unless said business arrangement or payments practice is acceptable under 42 United States Code §1320a-7b(b) or its regulations	Sec. 453.351(a)(7) §322.4(b)(11)	30-60 hours community service+up to $100 per violation	30-60 day license suspension+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Advertising in a manner in which is false, misleading, or deceptive	Sec. 453.351(a)(7) §322.4(b)(12)	Letter to cease and desist; if licensed, 30-60 hours community service+up to $100 per violation	If licensed, 30-60 day license suspension+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Knowingly falsifying and/or forging a referring practitioner's referral for physical therapy	Sec. 453.351(a)(7) §322.4(b)(13)	30-60 hours community service+up to $100 per violation	30-60 day license suspension with restricted practice+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Failing to notify the board of any conduct by another licensee which resaonably appears to be a violation of the Practice Act and rules, or aids or causes another person, directly or indirectly, to violate the Practice Act or rules of the board	Sec. 453.351(a)(7) §322.4(b)(16)	30-60 hours community service+up to $100 per violation	30-60 day license suspension+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Abandoning or neglecting a patient under current care without making reasonable arrangements or the continuation of such care	Sec. 453.351(a)(7) §322.4(b)(17)	30-60 hours community service+up to $100 per violation	30-60 day license suspension+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Failing to maintain the confidentiality of all verbal, written, electronic, augmentative, and nonverbal communication, including compliance with HIPAA regulations	Sec. 453.351(a)(7) §322.4(b)(18)	30-60 hours community service+up to $100 per violation	30-60 day license suspension+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Failing CCU Audit	§341.2(g)	30-60 hours community service+CE hours completed+up to $100 per violation	30-60 day license suspension+CE hours completed+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Failed to properly renew license	§341.2(c)(d)	30-60 hours community service+CE hours completed+up to $100 per violation	30-60 day license suspension+CE hours completed+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Except as provided by Section 453.301 or 453.302, provided physical therapy to a person without a referral from a referring practitioner	Sec. 453.351(a)(1)	30-60 hours community service+up to $100 per violation	30-60 day license suspension+up to $150 per violation	Revocation or Surrender of license +up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Used drugs or intoxicating liquors to an extent that affects the license holder's or applicant's professional competence	Sec. 453.351(a)(2) §343.5	30-60 day license suspension+up to $100 per violation	30-60 day license suspension with restricted practice+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Failure to report felony conviction; been convicted of a felony, including a finding or verdict of guilty, an admission of guilt, or a plea of nolo contendere, in this state or in any other state or nation	Sec. 453.351(a)(3) §343.6(a)(1) §343.9	30 day license suspension+up to $100 per violation	2-6 month license suspension with restricted license practice+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Obtained or attempted to obtain a license by fraud or deception	Sec. 453.351(a)(4) §343.6(a)(1)	Letter to cease and desist; if licensed, 60-90 day license suspension+up to $100 per violation	2-6 month license suspension with restricted license practice+up to $150 per violation; referrral for criminal investigative entity	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Been grossly neglegent in the practice of physical therapy or in acting as a physical therapist assistant	Sec. 453.351(a)(5) §343.7	30-60 day license suspension+up to $100 per violation	30-60 day license suspension with restricted practice+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Been found to be mentally incompetent by a court	Sec. 453.351(a)(6) §343.8	30-60 day license suspension with provisional restricted practice+up to $100 per violation	6-12 month license suspension with provisional restricted practice+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Having a license to practice physical therapy or a license to practice another health care profession revoked or suspended or had other disciplinary action taken against him or had his/her application for license refused, revoked, or suspended by the proper licensing authority of another state, territory, or nation	Sec. 453.351(a)(8)(9) §343.6(a)(2)	30 day license suspension+up to $100 per violation	2-6 month license suspension with restricted license practice+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development
Noncompliance professionally and/or ethically in conduct not otherwise specified	APTA Guide for professional conduct	30-60 hours community service; complete additional course in ethics+up to $100 per violation	30-60 day license suspension+up to $150 per violation	Revocation or Surrender of license+up to $200 per violation	Alternatively disciplinary decisions or pursuing other courses of action may depend on the nature of the situation, repeat of violation, or development

Assessment of the penalties will follow procedures as established in §343.41 of this title (relating to Agreed Orders). The Board shall consider the following factors in conjunction with the Schedule of Sanctions when determining the appropriate penalty/sanction in disciplinary matters:
1. the seriousness of the violation, including:
  1. nature, circumstances, extent, and gravity of the violation; and
  2. the hazard or potential hazard created to the health, safety, or economic welfare of the public;
2. the history of previous violations;
3. the amount necessary to deter future violations;
4. efforts to correct the violation;
5. the economic harm to the public interest or public confidence caused by the violation;
6. whether the violation was intentional; and
7. any other matter that justice may require.
The provisions of subsections (a)-(d) of this section shall not be construed so as to prohibit other appropriate civil or criminal action and remedy and enforcement under other laws.

Source Note: The provisions of this 344.1 adopted to be effective October 6, 1998, 23 TexReg 9978; amended to be effective November 11, 2018, 43 TexReg 7355; amended to be effective September 1, 2019, 44 TexReg 4184; amended to be effective November 1, 2020, 45 TexReg 7588.

CHAPTER 346

PRACTICE SETTINGS FOR PHYSICAL THERAPY

346.1. Educational Settings

In the educational setting, the physical therapist conducts appropriate screenings, evaluations, and assessments to determine needed services to fulfill educational goals. When a student is determined by the physical therapist to be eligible for physical therapy as a related service under Part B of the Individuals with Disabilities Education Act (IDEA), 20 USC §1414, or Section 504 of the Americans with Disabilities Act, as Amended, the physical therapist provides written recommendations to the Admissions Review and Dismissal Committee or the Section 504 Committee as to the amount of specific services needed by the student (i.e., direct and/or indirect services, as well as the frequency, duration, and location of services).
The physical therapist implements physical therapy services in accordance with the decisions of the school committee members and as reflected in the student's Admission Review and Dismissal Committee or Section 504 Committee reports. The physical therapist may implement services by delegating treatment to a physical therapist assistant under their supervision.
The physical therapist may provide general consultation, coaching, professional development, or other physical therapy program services for school administrators, educators, assistants, parents and others to address district, campus, classroom or student-centered issues. For the student who is eligible to receive physical therapy as a related service, the physical therapist will also provide the direct and/or indirect types of specific services needed to implement specially designed goals and objectives included in the student's Individualized Education Program or the 504 Plan.
The types of services which may require a physician's referral in the educational setting include the direct physical modeling or hands-on demonstration of activities with a student who has been determined eligible to receive physical therapy as a related service under the IDEA or under Section 504. Additionally, they may include the direct provision of activities which are of such a nature that they are only conducted with the eligible student by a physical therapist or physical therapist assistant. The physical therapist should refer to §322.1 of this title (relating to Provision of Services).
Evaluation and reevaluation in the educational setting will be conducted in accordance with federal mandates under Part B of the Individuals with Disabilities Education Act (IDEA), 20 USC §1414, or under Section 504 when warranted by a change in the child's condition, and include onsite reexamination of the child. The Plan of Care (Individual Education Program or Section 504 Plan) must be reviewed by the PT at least every 60 school days, or concurrent with every visit if the student is seen at intervals greater than 60 school days, to determine if revisions are necessary.

Source Note: The provisions of this 346.3 adopted to be effective October 13, 2002, 27 TexReg 9327; amended to be effective August 4, 2004, 29 TexReg 7303; amended to be effective March 5, 2007, 32 TexReg 1075; amended to be effective February 13, 2012, 37 TexReg 690; amended to be effective September 29, 2013, 38 TX Reg 6203; amended to be effective XX XX, 2024, XX TxReg xxxx.

346.2. Other Practice Settings

Other practice settings for physical therapy include but are not limited to: hospital, private clinic, industry, home health, and nursing home.

Source Note: The provisions of this 346.2 adopted to be effective November 11, 1993, 18 TexReg 7555.

346.3. Early Childhood Intervention (ECI) Setting

In the provision of early childhood services through the Early Childhood Intervention (ECI) program, the physical therapist conducts appropriate screenings, evaluations, and assessments to determine needed services to fulfill family-centered goals. When a child is determined by the PT to be eligible for physical therapy, the PT provides written recommendations to the Interdisciplinary Team as to the amount of specific services needed by the child.
Subject to the provisions of 322.1 of this title (relating to Provision of Services), the PT implements physical therapy services in accordance with the recommendations accepted by the Interdisciplinary Team, as stated in the Individual Family Service Plan (IFSP).
The types of services which require a referral from a qualified licensed healthcare practitioner include the provision of individualized specially designed instructions, direct physical modeling or hands-on demonstration of activities with a child who has been determined eligible to receive physical therapy. Additionally, a referral is required for services that include the direct provision of treatment and/or activities which are of such a nature that they are only conducted with the child by a physical therapist or physical therapist assistant.
The physical therapist may provide general consultation or other program services to address child/family-centered issues.
Evaluation and reevaluation in the early childhood intervention setting will be conducted in accordance with the Early Intervention Program for Infants and Toddlers with Disabilities, 34 CFR Subtitle B, Chapter III, Part 303.321 and must include direct physical therapist-to-child interaction.
The Plan of Care (Individual Family Service Plan) must be reviewed by the PT at least every 60 days, or concurrent with every visit if the child is seen at intervals greater than 60 days, prior to continuation of treatment by a PTA. Any modification or revision of physical therapy services identified during the review should be recommended to the Interdisciplinary Team.

Source Note: The provisions of this 346.3 adopted to be effective October 13, 2002, 27 TexReg 9327; amended to be effective August 4, 2004, 29 TexReg 7303; amended to be effective March 5, 2007, 32 TexReg 1075; amended to be effective February 13, 2012, 37 TexReg 690; amended to be effective September 29, 2013, 38 TXReg 6204; amended to be effective May 17, 2015, 40 TXReg 2668; amended to be effective September 1, 2023, 48 TexReg 4257.

CHAPTER 347

REGISTRATION OF PHYSICAL THERAPY FACILITIES

347.1. Definitions - Repealed

Source Note: The provisions of this 347.1 adopted to be effective December 24, 1993, 18 TexReg 9192; amended to be effective February 14, 2002, 27 TexReg 911; amended to be effective December 14, 2009, 34 TexReg 8967; repealed to be effective September 1, 2019, 44 TexReg 4185.

347.2. Requirement for Practice Setting of Licensees - Repealed

Source Note: The provisions of this 347.2 adopted to be effective December 24, 1993, 18 TexReg 9192, amended to be effective March 1, 2004, 28 TexReg 10506; repealed to be effective September 1, 2019, 44 TexReg 4185.

347.4. Requirements for Registration Application - Repealed

Source Note: The provisions of this 347.4 adopted to be effective December 24, 1993, 18 TexReg 9192; amended to be effective March 1, 2004, 28 TexReg 10505; amended to be effective March 14, 2010, 35 TexReg 2015; amended to be effective January 1, 2016, 40 TexReg 8792; repealed to be effective September 1, 2019, 44 TexReg 4185.

347.5. Requirements for Registered Facilities - Repealed

Source Note: The provisions of this 347.5 adopted to be effective December 24, 1993, 18 TexReg 9192; amended to be effective April 28, 1997, 22 TexReg 3589; amended to be effective March 1, 2004, 28 TexReg 10505; amended to be effective August 17, 2008, 33 TexReg 6593; amended to be effective May 27, 2012, 37 TexReg 3832; amended to be effective January 1, 2016, 40 TexReg 8792; repealed to be effective September 1, 2019, 44 TexReg 4185.

347.6. Exemptions to Registration - Repealed

Source Note: The provisions of this 347.6 adopted to be effective December 24, 1993, 18 TexReg 9192; amended to be effective February 13, 2012, 37 TexReg 691; repealed to be effective September 1, 2019, 44 TexReg 4185.

347.8. Change in Facility Ownership - Repealed

Source Note: The provisions of this 347.8 adopted to be effective March 1, 2004, 28 TexReg 10507; amended to be effective May 27, 2012, 37 TexReg 3833; amended to be effective January 1, 2016, 40 TexReg 8792; repealed to be effective September 1, 2019, 44 TexReg 4185.

347.9. Renewal of Registration - Repealed

Source Note: The provisions of this 347.9 adopted to be effective December 24, 1993, 18 TexReg 9192; amended to be effective March 1, 2004, 28 TexReg 10505; amended to be effective March 14, 2010, 35 TexReg 2016; amended to be effective October 9, 2011, 36 TexReg 6768; amended to be effective May 27, 2012, 37 TexReg 3833; amended to be effective February 12, 2013, 38 TexReg 639; amended to be effective January 1, 2016, 40 TexReg 8792; repealed to be effective September 1, 2019, 44 TexReg 4185.

347.11. Failure to Register - Repealed

Source Note: The provisions of this 347.11 adopted to be effective December 24, 1993, 18 TexReg 9192; amended to be effective January 1, 2016, 40 TexReg 8792; repealed to be effective September 1, 2019, 44 TexReg 4185.

347.12. Restoration of Registration - Repealed

Source Note: The provisions of this 347.12 adopted to be effective December 24, 1993, 18 TexReg 9192; amended to be effective March 1, 2004, 28 TexReg 10505; amended to be effective May 27, 2012, 37 TexReg 3833; amended to be effective February 12, 2013, 38 TexReg 639; amended to be effective January 1, 2016, 40 TexReg 8792; repealed to be effective September 1, 2019, 44 TexReg 4185.

347.13. Cancellation of Registration - Repealed

Source Note: The provisions of this 347.13 adopted to be effective February 12, 2013, 38 TexReg 639; amended to be effective January 1, 2016, 40 TexReg 8792; repealed to be effective September 1, 2019, 44 TexReg 4185.

347.15. Disciplinary Action - Repealed

Source Note: The provisions of this 347.15 adopted to be effective December 24, 1993, 18 TexReg 9192; amended to be effective March 14, 2010, 35 TexReg 2016; repealed to be effective September 1, 2019, 44 TexReg 4185.

CHAPTER 348

PHYSICAL THERAPY LICENSURE COMPACT

348.1. Definitions

Physical Therapy Compact - an agreement between member states to improve access to physical therapy services for the public by increasing the mobility of eligible physical therapy providers to work in multiple states.
Compact Privilege - the authorization granted by a remote state to allow a licensee from another member state to practice as a physical therapist or work as a physical therapist assistant in the remote state under its laws and rules.

Source Note: The provisions of this 348.1 adopted to be effective August 19, 2018, 43 TexReg 5367.

348.2. Disciplinary Action

A licensee from another member state who is providing physical therapy in Texas under a compact privilege must comply with the laws and regulations set forth in:
1. Title 3, Subtitle H, Chapter 453, Texas Occupations Code (PT Practice Act), and
2. Title 22, Part 16, Texas Administrative Code (PT Rules).
Any violation of the PT Practice Act and/or the PT Rules could subject the compact privilege holder to disciplinary action by the PT Board and loss of the Compact Privilege.

Source Note: The provisions of this 348.2 adopted to be effective August 19, 2018, 43 TexReg 5367.

EXECUTIVE COUNCIL OF PHYSICAL THERAPY AND OCCUPATIONAL THERAPY EXAMINERS

CHAPTER 651

FEES

651.2. Physical Therapy Board Fees

Application/Permanent License.
1. PT--$190.
2. PTA--$125.
Application to Retake the Examination.
1. PT--$25.
2. PTA--$25.
Temporary License.
1. PT--$80.
2. PTA--$60.
Provisional License.
1. PT--$80.
2. PTA--$75.
Active to Inactive License.
1. PT--a fee equal to one-half of the renewal fee.
2. PTA--a fee equal to one-half of the renewal fee.
License Renewal.
1. Active license.
  1. PT--$248.
  2. PTA--$184.
2. Inactive License.
  1. PT--a fee equal to one-half of the renewal fee.
  2. PTA--a fee equal to one half of the renewal fee.
Inactive to Active License (Reactivation).
1. PT--a fee equal to the renewal fee.
2. PTA--a fee equal to the renewal fee.
Retired Status.
1. Application--$25.
2. Renewal--$25.
Late Fees--Renewal (all licensees).
1. Late 90 days or less--the renewal fee plus a late fee equal to one-half of the renewal fee.
2. Late more than 90 days, but less than one year--the renewal fee plus a fee equal to the renewal fee.
License Restoration (all licensees, under the conditions set out in 341.6 of the Physical Therapy Board Rules)--a fee equal to the renewal fee.
Facility Registration, All Facilities--$215.
Facility Renewal, All Facilities--$220.
Late Fees--All Facilities.
1. Late 90 days or less--a fee equal to one-half of the renewal fee, in addition to the renewal fee.
2. Late more than 90 days but less than one year--a fee equal to the renewal fee, in addition to the renewal fee.
Facility Restoration--Late one year or more--a restoration fee:
1. Cancelled registration--a fee equal to the facility renewal fee.
2. Expired registration--a fee that is double the facility renewal fee.
Compact Privilege Fee
1. Non military/spouse or veteran PT or PTA--$50.
2. Military/spouse or veteran PT or PTA--$0.00.

Source Note: The provisions of this 651.2 adopted to be effective May 28, 2001, 26 TexReg 3747; amended to be effective April 7, 2002, 27 TexReg 2437; amended to be effective June 2, 2002, 27 TexReg 4572; amended to be effective January 1, 2004, 28 TexReg 11095; amended to be effective December 2, 2004, 29 TexReg 11035; amended to be effective September 1, 2005, 30 TexReg 4834; amended to be effective October 12, 2006, 31 TexReg 8369; amended to be effective January 1, 2010, 34 TexReg 9212; amended to be effective January 1, 2011, 35 TexReg 11258; amended to be effective February 14, 2013, 38 TexReg 644; amended to be effective February 18, 2014, 39 TXReg 994; amended to be effective January 1, 2016, 40 TXReg 8792; amended to be effective March 1, 2018, 43 TexReg 1102.

651.3. Administrative Services Fees

Verification/Transfer of Licensure--$50.
Duplicate/Replacement License--$30.
Duplicate of Facility Registration Certificate--$30.
Reinstatement of Suspended or Revoked License--$50.
Insufficient Funds Check Fee--$25.
ACH Return Fee--$25.
Preliminary Criminal History Evaluation Letter--$50.

Source Note: The provisions of this 651.3 adopted to be effective August 16, 1996, 21 TexReg 7381; amended to be effective January 1, 2004, 28 TexReg 11095; amended to be effective September 1, 2005, 30 TexReg 4835; amended to be effective January 1, 2010, 34 TexReg
9212; amended to be effective February 14, 2013, 38 TexReg 644.

OCCUPATIONS CODE
TITLE 3 HEALTH PROFESSIONS
SUBTITLE H PROFESSIONS RELATED TO CERTAIN TYPES OF THERAPY

SUBCHAPTER A

GENERAL PROVISIONS

Sec. 453.001. DEFINITIONS

In this chapter:

"Board" means the Texas Board of Physical Therapy Examiners.
"Coordinator of physical therapy programs" is the person employed in that position under Section 452.101.
"Executive council" means the Executive Council of Physical Therapy and Occupational Therapy Examiners.
"Physical therapist" means a person who is licensed by the board as a physical therapist and practices physical therapy. The term includes a hydrotherapist, physiotherapist, mechano-therapist, functional therapist, physical therapy practitioner, physical therapist specialist, physical therapy specialist, physiotherapy practitioner, kinesiotherapist, physical rehabilitation specialist, and myofunctional therapist.
"Physical therapist assistant" means a person licensed by the board as a physical therapist assistant:
1. who assists and is supervised by a physical therapist in the practice of physical therapy; and
2. whose activities require an understanding of physical therapy.
"Physical therapy" means a form of health care that prevents, identifies, corrects, or alleviates acute or prolonged movement dysfunction or pain of anatomic or physiologic origin.
"Physical therapy aide" or "physical therapy technician" means a person:
1. who aids in the practice of physical therapy under the on-site supervision of a physical therapist or a physical therapist assistant; and
2. whose activities require on-the-job training.
"Referring practitioner" means a qualified licensed health care professional who, within the scope of professional licensure, may refer a person for health care services. The term includes:
1. a physician licensed to practice medicine by a state board of medical examiners;
2. a dentist licensed by a state board of dental examiners;
3. a chiropractor licensed by a state board of chiropractic examiners; and
4. a podiatrist licensed by a state board of podiatric medical examiners.

Acts 1999, 76th Leg., ch.388, Sec. 1, eff. Sept. 1, 1999. Amended by Acts 2017, 85th Leg., ch.535, Sec. 2.26(1), eff. Sept. 1, 2019.

Sec. 453.002. APPLICATION OF SUNSET ACT

The Texas Board of Physical Therapy Examiners is subject to Chapter 325, Government Code (Texas Sunset Act). Unless continued in existence as provided by that chapter, the board is abolished and this chapter expires September 1, 2029.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by Acts 2003, 78th Leg., ch. 1112, Sec. 3.07, eff. Sept. 1, 2003. Amended by: Acts 2007, 80th Leg., R.S., Ch. 928, Sec. 4.06, eff. June 15, 2007. Acts 2011, 82nd Leg., R.S., Ch. 1232, Sec. 3.08, eff. June 17, 2011. Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 3.01, eff. Sept. 1, 2017.

Sec. 453.003. CONFLICT WITH OTHER LAW

To the extent of any conflict between this chapter and Chapter 452, Chapter 452 controls.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.004. EFFECT OF CHAPTER; APPLICABILITY

This chapter does not restrict the holder of a license issued by another state agency from performing health care services within the scope of the applicable licensing act if the license holder:
1. does not represent to another that the license holder is a physical therapist;
2. does not violate Sections 453.201(a) and (c) and 453.304; and
3. practices strictly in conformity with the statutes and rules relating to the license holder's license.
This chapter does not apply to:
1. a physical therapy aide;
2. a physical therapy student or physical therapist assistant student:
  1. participating in an accredited physical therapy or physical therapist assistant educational program; and
  2. being supervised by a license holder under this chapter;
3. a student:
  1. participating in an accredited allied health science program leading to licensure by another state agency; and
  2. being supervised by properly licensed, certified, or registered personnel;
4. a physical therapist who is licensed in another jurisdiction of the United States if the person is engaging, for not more than 90 days in a 12-month period and under the supervision of a physical therapist licensed in this state, in a special project or clinic required for completion of a post-professional degree in physical therapy from an accredited college or university, and the person notifies the board of the person's intent to practice in this state; or
5. a person who practices physical therapy or as a physical therapy assistant and who is:
  1. practicing physical therapy in the United States armed services, United States Public Health Service, or Veterans Administration in compliance with federal regulations for licensure of health care providers;
  2. licensed in another jurisdiction of the United States or credentialed to practice physical therapy in another country if the person:
    1. is teaching, demonstrating, or practicing physical therapy in an educational seminar in this state for not more than 60 days in a 12-month period, and the person notifies the board of the person's intent to practice in this state; or
    2. by contract or employment, is practicing physical therapy in this state for not more than 60 days in a 12-month period for an athletic team or organization or a performing arts company temporarily competing or performing in this state; or
  3. in another jurisdiction of the United States, if the person notifies the board of the person's intent to practice in this state, and:
    1. is practicing physical therapy for not more than 60 days during a declared local, state, or national disaster or emergency; or
    2. is displaced from the person's residence or place of employment due to a declared local, state, or national disaster and is practicing physical therapy in this state for not more than 60 days after the date the disaster is declared.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2009, 81st Leg., R.S., Ch. 1188, Sec. 1, eff. June 19, 2009.

Sec. 453.005. PRACTICE OF PHYSICAL THERAPY

The practice of physical therapy requires that a person practicing have education, training, and experience in physical therapy.
The practice of physical therapy includes:
1. measurement or testing of the function of the musculoskeletal, neurological, pulmonary, or cardiovascular system;
2. rehabilitative treatment concerned with restoring function or preventing disability caused by illness, injury, or birth defect;
3. treatment, consultative, educational, or advisory services to reduce the incidence or severity of disability or pain to enable, train, or retrain a person to perform the independent skills and activities of daily living; and
4. delegation of selective forms of treatment to support personnel while a physical therapist retains the responsibility for caring for the patient and directing and supervising the support personnel.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.006. PRACTICE OF MEDICINE

A person may not engage in diagnosing diseases or in practicing medicine as defined by law on the basis of a license issued under this chapter.
A person may not use an affix indicating or implying that the person is a physician on the basis of a license issued under this chapter.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

SUBCHAPTER B

TEXAS BOARD OF PHYSICAL THERAPY EXAMINERS

Sec. 453.051. BOARD MEMBERSHIP

The Texas Board of Physical Therapy Examiners consists of nine members appointed by the governor with the advice and consent of the senate as follows:
1. six physical therapist members; and
2. three members who represent the public.
Appointments to the board shall be made without regard to the race, creed, sex, religion, disability, age, or national origin of the appointee.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.052. PURPOSE OF BOARD

The board shall regulate the practice of physical therapy in this state to safeguard the public health and welfare.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.053. PUBLIC MEMBER ELIGIBILITY

A person is not eligible for appointment as a public member of the board if the person or the person's spouse:

is registered, certified, or licensed by an occupational regulatory agency in the field of health care;
is employed by or participates in the management of a business entity or other organization regulated by the executive council or board or receiving funds from the executive council or board;
owns or controls, directly or indirectly, more than a 10 percent interest in a business entity or other organization regulated by the executive council or board or receiving funds from the executive council or board; or
uses or receives a substantial amount of tangible goods, services, or funds from the executive council or board, other than compensation or reimbursement authorized by law for executive council or board membership, attendance, or expenses.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.054. MEMBERSHIP RESTRICTIONS

In this section, "Texas trade association" means a cooperative and voluntarily joined statewide association of business or professional competitors in this state designed to assist its members and its industry or profession in dealing with mutual business or professional problems and in promoting their common interest.
A person may not be a member of the board if:
1. the person is an officer, employee, or paid consultant of a Texas trade association in the field of health care;
2. the person's spouse is an officer, manager, or paid consultant of a Texas trade association in the field of health care.
A person may not be a member of the board if the person is required to register as a lobbyist under Chapter 305, Government Code, because of the person's activities for compensation on behalf of a profession related to the operation of the board.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.02, eff. Sept. 1, 2017.

Sec. 453.055. TERMS; VACANCY

Members of the board serve staggered six-year terms with the terms of two physical therapist members and one public member expiring January 31 of each odd-numbered year.
If a vacancy occurs during a member's term, the governor shall appoint a replacement to fill the unexpired part of the term.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.056. GROUNDS FOR REMOVAL

It is a ground for removal from the board that a member:
1. does not have at the time of taking office the qualifications required by Section 453.051(a);
2. does not maintain during service on the board the qualifications required by Section 453.051(a);
3. is ineligible for membership under Section 453.053 or 453.054;
4. cannot, because of illness or disability, discharge the member's duties for a substantial part of the member's term; or
5. is absent from more than half of the regularly scheduled board meetings that the member is eligible to attend during a calendar year without an excuse approved by majority vote of the board.
The validity of an action of the board is not affected by the fact that it is taken when a ground for removal of a board member exists.
If the coordinator of physical therapy programs has knowledge that a potential ground for removal exists, the coordinator shall notify the presiding officer of the board of the potential ground. The presiding officer shall then notify the governor and the attorney general that a potential ground for removal exists. If the potential ground for removal involves the presiding officer, the coordinator shall notify the next highest ranking officer of the board, who shall then notify the govenor and the attorney general that a potential ground for removal exists.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.03, eff. Sept. 1, 2017.

Sec. 453.057. PER DIEM REIMBURSEMENT

A member of the board is entitled to a per diem as set by the General Appropriations Act for each day the member engages in the business of the board.
A member may receive reimbursement for meals, lodging, and transportation expenses as provided by the General Appropriations Act.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.058. OFFICERS

The governor shall designate a member of the board as the presiding officer of the board to serve in that capacity at the pleasure of the governor.
After the appointment of members every two years, the members of the board shall elect from among its members a secretary and other officers required to conduct the business of the board.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.04, eff. Sept. 1, 2017.

Sec. 453.059. MEETINGS

A special meeting of the board:
1. may be called jointly by the presiding officer and secretary; or
2. shall be called on the written request of any two members.
The secretary shall keep a record of each meeting of the board. The record shall be open to public inspection at all times.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.060. TRAINING

A person who is appointed to and qualifies for office as a member of the board may not vote, deliberate, or be counted as a member in attendance at a meeting of the board until the person completes a training program that complies with this section.
The training program must provide the person with information regarding:
1. the law governing board and executive council operations;
2. the programs, functions, rules, and budgets of the board and executive council;
3. the scope of and limitations on the rulemaking authority of the board and executive council;
4. the types of board and executive council rules, interpretations, and enforcement actions that may implicate federal antitrust law by limiting competition or impacting prices charged by persons engaged in a profession or business regulated by the board, including rules, interpretations, and enforcement actions that:
  1. regulate the scope of practice of persons engaged in a profession or business regulated by the board.
  2. restrict advertising by persons engaged in a profession or business regulated by the board;
  3. affect the price of goods or services provided by persons engaged in a profession or business regulated by the board; or
  4. restrict participation in a profession or business regulated by the board.
5. the results of the most recent formal audit of the board and executive council;
6. the requirements of:
  1. laws relating to open meetings, public information, administrative procedure, and disclosure of conflicts of interest; and
  2. other laws applicable to members of the board in performing their duties; and
7. any applicable ethics policies adopted by the board or the Texas Ethics Commission.
A person appointed to the board is entitled to reimbursement, as provided by the General Appropriations Act, for the travel expenses incurred in attending the training program regardless of whether the person's attendance at the program occurs before or after the person qualifies for office.
The director of the executive council shall create a training manual that includes the information required by Subsection (b). The director shall distribute a copy of the training manual annually to each board member. On receipt of the training manual, each board member shall sign and submit to the director a statement acknowledging receipt of the training manual.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.05, eff. Sept. 1, 2017.

Sec. 453.061. CIVIL LIABILITY

A member of the board is not liable in a civil action for an act performed in good faith in executing duties as a board member.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

SUBCHAPTER C

POWERS AND DUTIES

Sec. 453.101. GENERAL POWERS AND DUTIES

Except as provided by Chapter 452, the board shall administer and enforce this chapter.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.102. RULES

The board may adopt rules necessary to implement this chapter.
The board may adopt bylaws and rules necessary to govern its proceedings.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.103. RULES REGARDING ADVERTISING OR COMPETITIVE BIDDING

The board may not adopt rules restricting advertising or competitive bidding by a person regulated by the board except to prohibit false, misleading, or deceptive practices by the person.
The board may not include in rules to prohibit false, misleading, or deceptive practices a rule that:
1. restricts the person's use of any medium for advertising;
2. restricts the person's personal appearance or use of the person's voice in an advertisement;
3. relates to the size or duration of an advertisement by the person; or
4. restricts the person's advertisement under a trade name.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.104. FEES

The board may recommend to the executive council reasonable and necessary fees for licenses issued or services performed under this chapter that in the aggregate produce sufficient revenue to cover the cost of administering this chapter.
The board may not recommend to the executive council a fee that existed on September 1, 1993, for an amount less than the amount of that fee on that date.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.105. EMPLOYEES; DIVISION OF RESPONSIBILITIES

The board may request the executive council to assign administrative and clerical employees as necessary to carry out the board's functions.
The board shall develop and implement policies that clearly seperate the policymaking responsibilities of the board and the management responsibilities of the director and staff of the executive council.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.06, eff. Sept. 1, 2017.

Sec. 453.106. LIST OF LICENSE HOLDERS

The secretary shall maintain a list of the names of each physical therapist licensed under this chapter.
The list shall be open to public inspection at all times.
On March 1 of each year, the coordinator of physical therapy programs shall transmit an official copy of the list to the executive council.
A certified copy of the list of license holders is admissible as evidence in a court of this state.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2001, 77th Leg., ch. 1420, Sec. 14.209(a), eff. Sept. 1, 2001.

Sec. 453.1061. PLACE OF EMPLOYMENT

The board may require that a license holder provide current information in a readily accessible and usable format regarding the license holder's place of employment as a physical therapist or physical therapist assistant.

Acts 2017, 85th Leg., ch. 535, Sec. 2.07, eff. Sept. 1, 2019.

Sec. 453.107. BOARD DUTIES REGARDING COMPLAINTS

The board by rule shall:
1. adopt a form to standardize information concerning complaints made to the board; and
2. prescribe information to be provided to a person when the person files a complaint with the board.
The board shall provide reasonable assistance to a person who wishes to file a complaint.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.108. PROSECUTING VIOLATIONS

The board shall assist the proper legal authorities in prosecuting a person who violates this chapter.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.109. NEGOTIATED RULEMAKING; ALTERNATIVE DISPUTE RESOLUTION

The board shall develop a policy to encourage the use of:
1. negotiated rulemaking under Chapter 2008, Government Code, for the adoption of board rules; and
2. appropriate alternative dispute resolution procedures under Chapter 2009, Government Code, to assist in the resolution of internal and external disputes under the board's jurisdiction.
The board's procedures relating to alternative dispute resolution must conform, to the extent possible, to any model guidelines issued by the State Office of Administrative Hearings for the use of alternative dispute resolution by state agencies.
The board shall:
1. coordinate the implementation of the policy adopted under Subsection (a);
2. provide training as needed to implement the procedures for negotiated rulemaking or alternative dispute resolution; and
3. collect data concerning the effectiveness of those procedures.

Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.07, eff. Sept. 1, 2017.

SUBCHAPTER D

PUBLIC INTEREST INFORMATION AND COMPLAINT PROCEDURES

Sec. 453.151. PUBLIC INTEREST INFORMATION

The board shall prepare information of public interest describing the functions of the board and the procedures by which complaints are filed with and resolved by the board.
The board shall make the information available to the public and appropriate state agencies.
Information maintained by the executive council or the board under this chapter regarding the home address or personal telephone number of a person licensed under this chapter is confidential and not subject to disclosure under Chapter 552, Government Code. A person licensed under this chapter must provide the board with a business address or address of record that will be subject to disclosure under Chapter 552, Government Code.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2013, 83rd Leg., R.S., Ch. 867 (H.B. 588), Sec. 1, eff. September 1, 2013; Acts 2017, 85th Leg., R.S., Ch. 535, Sec. 2.08, eff. Sept. 1, 2019.

Sec. 453.152. COMPLAINTS

A license holder shall at all times prominently display in the license holder's place of business a sign containing:

the board's name, mailing address, and telephone number; and
a statement informing consumers that a complaint against a license holder can be directed to the board.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.153. RECORD OF COMPLAINTS

The board shall keep an information file about each complaint filed with the executive council and referred to the board. The board's information file must be kept current and contain a record for each complaint of:
1. each person contacted in relation to the complaint;
2. a summary of findings made at each step of the complaint process;
3. an explanation of the legal basis and reason for a complaint that is dismissed;
4. the schedule required under Section 453.154 and a notation about a change in the schedule; and
5. other relevant information.
If a written complaint is received by the board that the board has authority to resolve, the board, at least quarterly and until final disposition of the complaint, shall notify the parties to the complaint of the status of the complaint unless notice would jeopardize an undercover investigation.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.154. GENERAL RULES INVOLVING COMPLAINT INVESTIGATION AND DISPOSITION

The board shall adopt rules relating to the investigation of a complaint received by the board. The rules shall:
1. distinguish between categories of complaints;
2. ensure that complaints are not dismissed without appropriate consideration;
3. require that the board be advised of a complaint that is dismissed and that a letter be sent to the person who filed the complaint explaining the action taken on the dismissed complaint;
4. ensure that the person who filed the complaint has an opportunity to explain the allegations made in the complaint;
5. prescribe guidelines concerning the categories of complaints that require the use of a private investigator and the procedures for the board to obtain the services of a private investigator; and
6. require the board to advise the executive council of complaints that have been disposed of.
The board shall:
1. dispose of each complaint in a timely manner; and
2. establish a schedule for conducting each phase of the investigation of a complaint that is under the control of the board not later than the 30th day after the date the board receives the complaint.
Each party shall be notified of the projected time requirements for the complaint.
Each party to the complaint must be notified of a change in the schedule not later than the seventh day after the date the change is made.
The staff of the executive council shall notify the board of a complaint that is unresolved after the time prescribed by the board for resolving the complaint so that the board may take necessary action on the complaint.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.09, eff. Sept. 1, 2017.

Sec. 453.155. PUBLIC PARTICIPATION

The board shall develop and implement policies that provide the public with a reasonable opportunity to appear before the board and to speak on any issue under the board's jurisdiction.
The board shall prepare and maintain a written plan that describes how a person who does not speak English can be provided reasonable access to the board's programs.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

SUBCHAPTER E

LICENSE REQUIREMENTS

Sec. 453.201. LICENSE REQUIRED; USE OF TITLE

A person may not practice physical therapy or practice as a physical therapist assistant, unless the person is an individual who holds a license issued by the board.
A person, including the person's employee or other agent or representative, may not extend or provide physical therapy services unless the services are provided by a physical therapist.
A person is considered to be practicing physical therapy if the person:
1. performs, offers to perform, or attempts to perform physical therapy; or
2. publicly professes to be or holds the person out to be a physical therapist or as providing physical therapy.
Unless the person is a physical therapist, a person, including the person's employee or other agent or representative, may not use in connection with the person's name or business activity:
1. the words "physical therapy," "physical therapist," "physiotherapy," "physiotherapist," "licensed physical therapist," "registered physical therapist," or "physical therapist assistant";
2. the letters "PT," "PhT," "LPT," "RPT," “DPT,” “MPT,” or "PTA"; or
3. any other words, letters, abbreviations, or insignia indicating or implying, by any means or in any way, that physical therapy is provided or supplied.
A person may not use the title "Physical Therapist" unless the person is a physical therapist.
A person may not use the title "Physical Therapist Assistant" unless the person is a physical therapist assistant.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.2095, eff. Sept. 1, 2001. Amended by: Acts 2013, 83rd Leg., R.S., Ch. 474 (S.B. 1099), Sec. 1, eff. September 1, 2013.

Sec. 453.202. LICENSE APPLICATION

An applicant for a physical therapist license or a physical therapist assistant license must submit to the board a written application on a form provided by the board.
The application must be accompanied by a nonrefundable application fee prescribed by the executive council.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.11 & 2.26(2), eff. Sept. 1, 2017.

Sec. 453.203. QUALIFICATIONS FOR PHYSICAL THERAPIST OR PHYSICAL THERAPIST ASSISTANT LICENSE

An applicant for a physical therapist license must, in addition to other requirements and qualifications established by the board, present:
1. evidence satisfactory to the board that the applicant has completed an accredited physical therapy educational program; or
2. official documentation from an educational credentials review agency approved by the board certifying that the applicant has completed a program equivalent to a Commission on Accreditation in Physical Therapy Education accredited program.
An applicant for a physical therapist assistant license must, in addition to other requirements and qualifications established by the board, present evidence satisfactory to the board that the applicant has completed an accredited physical therapist assistant program or an accredited physical therapy educational program.
A physical therapy educational program or physical therapist assistant program is an accredited program if the program is accredited by the Commission on Accreditation in Physical Therapy Education.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.12, eff. Sept. 1, 2017.

Sec. 453.204. FOREIGN-TRAINED APPLICANTS

To obtain a license under this chapter, an applicant who is foreign-trained must satisfy the examination requirements of Section 453.208.
Before allowing a foreign-trained applicant to take the examination, the board shall require the applicant to furnish proof of completion of requirements substantially equal to those under Section 453.203.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.13, eff. Sept. 1, 2017.

Sec. 453.205. LICENSE EXAMINATION

The board by rule shall recognize a national testing entity to administer the examination required to obtain a physical therapist or physical therapist assistant license.
The physical therapist examination is a national examination that tests entry-level competence related to physical therapy theory, examination and evaluation, prognosis, treatment, intervention, prevention, and consultation.
The physical therapist assistant examination is a national examination that tests for required knowledge and skills in the technical application of physical therapy services.
An applicant for a license must agree to comply with the security and copyright provisions of the national examination. If the board has knowledge of a violation of the security or copyright provisions or a compromise or attempted compromise of the provisions, the board shall report the matter to the testing entity.
The board may disqualify an applicant from taking or retaking an examination for a period specified by the board if the board determines that the applicant engaged or attempted to engage in conduct that compromises or undermines the integrity of the examination process, including a violation of security or copyright provisions related to the national examination.
If the board enters into a contract with a national testing entity under Subsection (a), the contract must include a provision requiring the national testing entity to provide to the board an examination score report for each applicant for a license under this chapter who took the examination.
The board may require an applicant for a physical therapist or physical therapist assistant license to pass a jurisprudence examination.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.14, eff. Sept. 1, 2017.

Sec. 453.207. REEXAMINATION

An applicant who fails to pass an examination under Section 453.205 may retake the examination under the policies of the national testing entity.
Before retaking an examination, the applicant must:
1. submit to the board a reexamination application prescribed by the board; and
2. pay a nonrefundable application fee prescribed by the executive council.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.15, eff. Sept. 1, 2017.

Sec. 453.208. ISSUANCE OF LICENSE

The board shall issue a license to an applicant who:
1. passes the examination under Section 453.205;
2. meets the qualifications prescribed by Section 453.203; and
3. has not committed an act that constitutes a ground for denial of a license under Section 453.351.
The board may issue a physical therapist assistant license to a person who has not completed an accredited physical therapist assistant program if the person:
1. meets the requirements under Section 453.203(a); and
2. has not been the subject of disciplinary action in another state or nation.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.209. PROVISIONAL LICENSE

The board may issue a provisional license to an applicant licensed in another state that maintains professional standards considered by the board to be equivalent to and has licensing requirements that are substantially equivalent to the requirements under this chapter. An applicant for a provisional license under this section must:
1. present proof to the board that the applicant is licensed in good standing as a physical therapist or physical therapist assistant in that state;
2. have passed a national examination or other examination recognized by the board relating to the practice of physical therapy; and
3. be sponsored by a person licensed under this chapter with whom the provisional license holder may practice.
The board may waive the requirement of Subsection (a)(3) for an applicant if the board determines that compliance with that requirement constitutes a hardship to the applicant.
A provisional license is valid until the date the board approves or denies the provisional license holder's application for a physical therapist or physical therapist assistant license.
The board shall issue a physical therapist or physical therapist assistant license to the provisional license holder if:
1. the provisional license holder passes a jurisprudence examination, if required;
2. the board verifies that the provisional license holder has the academic and experience requirements for a physical therapist or physical therapist assistant license; and
3. the provisional license holder satisfies any other requirements for a physical therapist or physical therapist assistant license.
The board must complete the processing of a provisional license holder's application for a license not later than the 180th day after the date the provisional license is issued. The board may extend that deadline if the results on an examination have not been received by the board.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.210. TEMPORARY LICENSE

The board by rule may provide for the issuance of a temporary license.
The holder of a temporary license must practice under the supervision of a physical therapist.
A rule adopted under this section must include a time limit for a person to hold a temporary license.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.211. INACTIVE STATUS

The board by rule may provide for a license holder to place the holder's license under this chapter on inactive status.
A rule adopted under this section must include a time limit for a license holder's license to remain on inactive status.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.212. DISPLAY OF LICENSE

A license holder under this chapter shall display the license holder's license in a conspicuous place in the principal office in which the license holder practices physical therapy.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2013, 83rd Leg., R.S., Ch. 867 (H.B. 588), Sec. 2, eff. September 1, 2013.

Sec. 453.213. PHYSICAL THERAPY FACILITY REGISTRATION - REPEALED

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2011, 82nd Leg., R.S., Ch. 833, Sec. 1, eff. September 1, 2011. Repealed by: Acts 2017, 85th Leg., R.S. Ch. 535, Sec. 2.26(4), eff. Sept. 1, 2019.

Sec. 453.214. LICENSE BY ENDORSEMENT

The board shall issue a physical therapist license or a physical therapist assistant license, as applicable, to an applicant who holds a current, unrestricted license in another jurisdiction that maintains licensing requirements that are substantially equivalent to the requirements under this chapter. An applicant for a license under this section must:
1. present proof to the board that the applicant is licensed in good standing as a physical therapist or physical therapist assistant in that jurisdiction;
2. provide to the board information regarding the status of any other professional license that the applicant holds or has held in this state or another jurisdiction;
3. present proof to the board that the applicant has passed a jurisprudence examination required by the board;
4. meet the qualifications required by Section 453.203 or 453.204, as applicable;
5. not have committed an act that is grounds for denial of a license under Section 453.351;
6. submit to the board a current photograph that meets the requirements for a United States passport; and
7. meet any additional requirements provided by the board rule.
The board shall adopt rules for issuing a provisional license under Section 453.209 to an applicant for a license by endorsement who encounters a delay thgat is outside the applicant's control in submitting to the board the documentation required by this section.

Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.16, eff. Sept. 1, 2017.

Sec. 453.215. CRIMINAL HISTORY RECORD INFORMATION FOR LICENSE ASSURANCE

The board shall require that an applicant for a license submit a complete and legible set of fingerprints, on a form prescribed by the board, to the board or to the Department of Public Safety for the purpose of obtaining criminal history record information from the Department of Public Safety and the Federal Bureau of Investigation.
The board may not issue a license to a person who does not comply with the requirement of Subsection (a).
The board shall conduct a criminal history record information check of each applicant for a license using information:
1. provided by the individual under this section; and
2. made available to the board by the Department of Public Safety, the Federal Bureau of Investigation, and any other criminal justice agency under Chapter 411, Government Code.
The board may:
1. enter into an agreement with the Department of Public Safety to administer a criminal history record information check required under this section; and
2. authorize the Department of Public Safety to collect from each applicant the costs incurred by the Department of Public Safety in conducting the criminal history record information check.

Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.16, eff. Sept. 1, 2017.

SUBCHAPTER F

LICENSE RENEWAL

Sec. 453.251. LICENSE EXPIRATION

A physical therapist or physical therapist assistant license expires on the later of:
1. the second anniversary of the date the license is issued; or
2. another date determined by the board.
The board may adopt a system under which licenses expire on various dates during the year. For the term in which the license expiration date is changed, license fees shall be prorated on a monthly basis so that each license holder pays only that portion of the license fee that is allocable to the number of months during which the license is valid. On renewal of the license on the new expiration date, the total license renewal fee is payable.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.17, eff. Sept. 1, 2017.

Sec. 453.252. RENEWAL OF LICENSE

A person may renew an unexpired license by paying the required renewal fee to the executive council before the expiration date of the license.
A person whose license has been expired for 90 days or less may renew the license by paying to the executive council the renewal fee and a late fee set by the executive council in an amount that does not exceed one-half of the amount charged for renewal of the license. If a person's license has been expired for more than 90 days but less than one year, the person may renew the license by paying to the executive council all unpaid renewal fees and a late fee set by the executive council in an amount that does not exceed the amount charged for renewal of the license.
A person whose license has been expired for one year or longer must comply with the board’s requirements and procedures to reinstate the license and pay a reinstatement fee in the amount set by the executive council. If the person is unable to comply with the board’s requirements to reinstate the license, the person may obtain a new license by submitting to reexamination and complying with the requirements and procedures for obtaining an original license.
At least 30 days before the expiration of a person's license, the executive council shall send written notice of the impending license expiration to the person at the person's last known address according to the records of the executive council.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2013, 83rd Leg., R.S., Ch. 867 (H.B. 588), Sec. 3, eff. September 1, 2013. Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.18, eff. Sept. 1, 2017.

Sec. 453.253. RENEWAL OF EXPIRED LICENSE BY OUT-OF-STATE PRACTITIONER

The board may renew without reexamination the expired license of a person who was licensed to practice as a physical therapist or physical therapist assistant in this state, moved to another state, is currently licensed and in good standing in the other state, and meets the board’s requirements for renewal.
The person must pay to the executive council a renewal fee set by the executive council under this section in an amount that does not exceed the renewal fee for the license.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2013, 83rd Leg., R.S., Ch. 867 (H.B. 588), Sec. 4, eff. September 1, 2013. Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.19, eff. Sept. 1, 2017.

Sec. 453.254. CONTINUING COMPETENCE

The board by rule shall:
1. adopt requirements for continuing competence for license holders in subjects pertaining to the practice of physical therapy;
2. establish a minimum number of continuing competence units required to renew a license; and
3. develop a process to approve continuing competence activities.
The board may require license holders to complete continuing competence activities specified by the board. The board shall adopt a procedure to assess a license holder's participation and performance in continuing competence activities.
The board may identify the key factors for the competent performance by a license holder of the license holder's professional duties.
In developing a process under Subsection (a) for the approval of continuing competence activities, the board may authorize appropriate organizations to approve the activities.
The board by rule shall establish a process for selecting an appropriate organization to approve continuing competence activities under Subsection (d). The selection process must include a request for proposal and bidding process. If the board authorizes an organization to approve continuing competence activities under Subsection (d), the board shall request bids and proposals from that organizations at least once every four years.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.210(a), eff. Sept. 1, 2001. Amended by: Acts 2009, 81st Leg., R.S., Ch. 1021, Sec. 1, eff. June 19, 2009. Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.20, eff. Sept. 1, 2017.

Sec. 453.255. CRIMINAL HISTORY RECORD INFORMATION REQUIREMENT FOR LICENSE RENEWAL

An applicant renewing a license issued under this chapter shall submit a complete and legible set of fingerprints for purposes of performing a criminal history record information check of the applicant as provided by Section 453.215.
The board may administratively suspend or refuse to renew the license of a person who does not comply with the requirement of Subsection (a).
A license holder is not required to submit fingerprints under this section for the renewal of the license if the license holder previously submitted fingerprints under:
1. Section 453.215 for the initial issuance of the license; or
2. this section as part of a prior license renewal.

Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.21, eff. Sept. 1, 2017.

SUBCHAPTER G

PRACTICE BY LICENSE HOLDER

Sec. 453.301. PRACTICE BY PHYSICAL THERAPIST

A physical therapist may treat a patient for an injury or condition in a manner described by Section 453.005 without a referral if the physical therapist:
1. has been licensed to practice physical therapy for at least one year;
2. is covered by professional liability insurance in the minimum amount required by board rule; and
3. either:
  1. possesses a doctoral degree in physical therapy from:
    1. a program that is accredited by the Commission on Accreditation in Physical Therapy Education; or
    2. an institution that is accredited by an agency or association recognized by the United States secretary of education; or
  2. has completed at least 30 hours of continuing competence activities in the area of differential diagnosis.

(a-1) Except as provided by Subsection (a-2), a physical therapist may treat a patient under Subsection (a) for not more than 10 consecutive business days.

(a-2) A physical therapist may treat a patient under Subsection (a) for not more than 15 consecutive business days if the physical therapist:

1. possesses a doctoral degree described by Subsection (a)(3)(A); and

2. either:

(A) has completed a residency or fellowship; or

(B) is certified by an entity approved by the board.

b. The physical therapist must obtain a referral from a referring practitioner before the physical therapist may continue treatment that exceeds treatment authorized under Subsection (a-1) or (a-2), as applicable.

c. A physical therapist who treats a patient without a referral shall obtain from the patient a signed disclosure on a form prescribed by the board in which the patient acknowledges that:

physical therapy is not a substitute for a medical diagnosis by a physician;
physical therapy is not based on radiological imaging;
a physical therapist cannot diagnose an illness or disease; and
the patient's health insurance may not include coverage for the physical therapist's services.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by Acts 2019, 86th Leg., R.S., ch. 1021, Sec. 1, eff. Sept. 1, 2019. Amended by Acts 2021, 88th Leg., ch XXX, Sec. 1, eff. Sept. 1, 2021.

Sec. 453.302. TREATING PATIENT WITHOUT REFERRAL

In this section:
1. "Emergency circumstance" means an instance in which emergency medical care is necessary.
2. "Emergency medical care" means a bona fide emergency service provided after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in:
  1. serious jeopardy to the patient's health;
  2. serious dysfunction of any bodily organ or part; or
  3. serious impairment to bodily functions.
In an emergency circumstance, including a minor emergency, a physical therapist may provide emergency medical care to a person to the best of the therapist's ability without a referral from a referring practitioner.
A physical therapist may provide physical assessments or instructions to an asymptomatic person without a referral from a referring practitioner.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.303. PROHIBITED USE OF CERTAIN PROCEDURES

In practicing physical therapy, a person may not use:

roentgen rays or radium for a diagnostic or therapeutic purpose; or
electricity for a surgical purpose, including cauterization.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.304. PROHIBITED PRACTICE

It is a violation of this chapter for an individual licensed by the board to violate Section 102.001.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.826, eff. Sept. 1, 2001.

SUBCHAPTER H

DISCIPLINARY ACTION AND PROCEDURE

Sec. 453.351. GROUNDS FOR DENIAL OF LICENSE OR DISCIPLINE OF LICENSE HOLDER

The board may deny a license or suspend or revoke a license, place a license holder on probation, reprimand a license holder, impose an administrative penalty, or otherwise discipline a license holder if the applicant or license holder has:
1. except as provided by Section 453.302, provided care to a person outside the scope of the physical therapist's practice;
2. used drugs or intoxicating liquors to an extent that affects the license holder's or applicant's professional competence;
3. been convicted of a felony, including a finding or verdict of guilty, an admission of guilt, or a plea of nolo contendere, in this state or in any other state or nation;
4. obtained or attempted to obtain a license by fraud or deception;
5. been grossly negligent in the practice of physical therapy or in acting as a physical therapist assistant;
6. been found to be mentally incompetent by a court;
7. practiced physical therapy in a manner detrimental to the public health and welfare;
8. had a license to practice physical therapy revoked or suspended or had other disciplinary action taken against the license holder or applicant;
9. had the license holder's or applicant's application for a license refused, revoked, or suspended by the proper licensing authority of another state or nation; or
10. in the case of a physical therapist assistant, treated a person other than under the direction of a physical therapist.
The board shall revoke or suspend a license, place on probation a person whose license has been suspended, or reprimand a license holder for a violation of this chapter or a rule adopted by the board.
If a license suspension is probated, the board may require the license holder to:
1. report regularly to the board on matters that are the basis of the probation;
2. limit practice to the areas prescribed by the board; or
3. continue or review continuing professional education until the license holder attains a degree of skill satisfactory to the board in those areas that are the basis of the probation.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by Acts 2019, 86th Leg., ch. XXX, Sec. 2, eff. Sept. 1, 2019.

Sec. 453.352. PROCEDURE FOR LICENSE DENIAL OR DISCIPLINARY ACTION; SCHEDULE OF SANCTIONS

A person whose application for a license is denied is entitled to a hearing before the State Office of Administrative Hearings if the applicant submits a written request for a hearing to the board.
A proceeding to take action under Section 453.351 or an appeal from the proceeding is a contested case for the purposes of Chapter 2001, Government Code.
The State Office of Administrative Hearings shall use the schedule of sanctions adopted by the board by rule for a sanction imposed as the result of a hearing conducted by the office.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.3525. SCHEDULE OF SANCTIONS

The board by rule shall adopt a schedule of administrative penalties and other sanctions that the board may impose under this chapter. In adopting the schedule of sanctions, the baord shall ensure that the amount of the penalty or severity of the sanction imposed is appropriate to the type of violation or conduct that is the basis for disciplinary action. In determining the appropriate disciplinary action, including the amount of any administrative penalty to assess, the board shall consider:
1. the seriousness of the violation, including:
  1. the nature, circumstances, extend, and gravity of the violation; and
  2. the hazard or potential hazard created to the health, safety, or economic welfare of the public;
2. the history of previous violations;
3. the amount necessary to deter future violations;
4. efforts to correct the violation;
5. the economic harm to the public interest or public confidence caused by the violation;
6. whether the violation was intentional; and
7. any other matter that justice may require.
The board shall make the schedule of sanctions adopted under Subsection (a) available to the public on request.

Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.22, eff. Sept. 1, 2017.

Sec. 453.353. SUBPOENAS

The board may request or compel by subpoena:
1. the attendance of a witness for examination under oath; and
2. the production for inspection or copying of evidence relevant to an investigation of an alleged violation of this chapter.
If a person fails to comply with the subpoena, the board, acting through the attorney general, may file suit to enforce the subpoena in a district court in Travis County or in the county in which a hearing conducted by the board may be held.
If the court determines that good cause exists for issuing the subpoena, the court shall order the person to comply with the subpoena. The court may punish for contempt a person who fails to obey the court order.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.354. TEMPORARY LICENSE SUSPENSION

The board may temporarily suspend a license issued under this chapter on an emergency basis if the board, by at least a two-thirds vote, determines from the evidence or information presented to the board that the continued practice by the license holder constitutes a continuing or imminent threat to the public health or welfare.
The board may suspend a license under this section without notice or a hearing if, at the time the suspension is ordered, a hearing on whether to institute disciplinary proceedings against the license holder is scheduled to be held not later than the 14th day after the date of the temporary suspension.
The board shall hold a second hearing on the license suspension not later than the 60th day after the date the temporary suspension was ordered. If the second hearing is not held within the required time, the suspended license is automatically reinstated.
The board shall adopt rules that establish procedures and standards for the temporary suspension of a license under this section.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.355. REISSUANCE OF LICENSE; ISSUANCE OF LICENSE AFTER DENIAL

On application by the person, the board may reissue a license to a person whose license has been revoked.
An application to reinstate a revoked license:
1. may not be made before the 180th day after the date the revocation order became final; and
2. must be made in the manner and form the board requires.
On application by the person, the board may issue a license to a person whose license application has been denied. The application may not be made before the first anniversary of the date of the denial.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.356. INFORMAL PROCEEDINGS

The board by rule shall adopt procedures governing:
1. informal disposition of a contested case under Section 2001.056, Government Code; and
2. informal proceedings held in compliance with Section 2001.054, Government Code.
A rule adopted under this section must:
1. provide the complainant and the license holder an opportunity to be heard; and
2. require the presence of the board's legal counsel or a representative of the attorney general to advise the board or the board's employees.

Acts 1999, 76th Leg., ch.388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.357. RECORD OF DISCIPLINARY ACTION; EXPUNGEMENT

The board by rule shall establish a process to expunge any record of disciplinary action taken against a license holder before September 1, 2019, for practicing in a facility that failed to meet the registration requirements of Section 453.213, as that section existed on January 1, 2019. The rules must provide that the board may not expunge a record under this section after September 1, 2021.
This section expires September 1, 2021.

Acts 2017, 85th Leg., ch. 535, Sec. 2.22, eff. Sept. 1, 2019.

SUBCHAPTER I

ADMINISTRATIVE PENALTY

Sec. 453.401. IMPOSITION OF PENALTY

The board may impose an administrative penalty on a person licensed or regulated under this chapter who violates this chapter or a rule or order adopted under this chapter.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by Acts 2017, 85th Leg., R.S., Ch. 535, Sec. 2.23, eff. Sept. 1, 2019.

Sec. 453.402. AMOUNT OF PENALTY

The amount of an administrative penalty may not exceed $200 for each violation. Each day a violation continues or occurs is a separate violation for purposes of imposing a penalty.
The amount of the penalty shall be determined according to the sanctions schedule adopted under Section 453.3525.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 2.24, eff. Sept. 1, 2017.

Sec. 453.403. ADMINISTRATIVE PROCEDURE

The board shall adopt rules that establish procedures for assessing an administrative penalty and that provide for notice and a hearing for a license holder that may be subject to a penalty under this subchapter.
A proceeding under this subchapter is subject to Chapter 2001, Government Code.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by Acts 2017, 85th Leg., R.S., Ch. 535, Sec. 2.25, eff. Sept. 1, 2019.

SUBCHAPTER J

OTHER PENALTIES AND ENFORCEMENT PROCEDURES

Sec. 453.451. INJUNCTIVE RELIEF

The attorney general, a district attorney, a county attorney, or any other person may institute a proceeding to enforce this chapter, including a suit to enjoin or restrain a person from practicing physical therapy without complying with this chapter.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.452. MONITORING OF LICENSE HOLDER

The board by rule shall develop a system for monitoring a license holder's compliance with this chapter. The rules must include procedures for:

monitoring for compliance a license holder who is ordered by the board to perform a certain act; and
identifying and monitoring each license holder who represents a risk to the public.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.453. CIVIL PENALTY

A person found by a court to have violated this chapter is liable to the state for a civil penalty of $200 for each day the violation continues.
A civil penalty may be recovered in a suit brought by the attorney general, a district attorney, a county attorney, or any other person.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.454. RECOVERY OF COSTS AND FEES

A person other than the attorney general, a district attorney, or a county attorney who brings an action to enforce this chapter or for injunctive relief may recover the person's court costs and attorney's fees.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 453.455. CRIMINAL OFFENSE

A person commits an offense if the person knowingly violates this chapter.
An offense under this section is a Class A misdemeanor.
Each day of violation constitutes a separate offense.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

SUBCHAPTER K

PHYSICAL THERAPY LICENSURE COMPACT

Sec. 453.501. PHYSICAL THERAPY LICENSURE COMPACT

The Physical Therapist Licensure Compact is enacted and entered into with all other jurisdictions that legally join in the compact, which reads as follows.

SECTION 1. PURPOSE

The purpose of this Compact is to facilitate interstate practice of physical therapy with the goal of improving public access to physical therapist services. The practice of physical therapy occurs in the state where the patient/client is located at the time of patient/client encounter. The Compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure. This compact is designed to achived the following objectives:

Increase public access to physical therapy services by provding for the mutual recognition of other member state licenses;
Enhance the states' ability to protect the public's health and safety;
Encourage the cooperation of member states in regulating multi-state physical therapy practice.
Support spouses of relocating military members;
Enhance the exchange of locensure, investigative, and disciplinary information between members states; and
Allow a remote state to hold a provider of services with a compact privilege in that state accountable to that state's practice standards.

SECTION 2. DEFINITIONS

As used in this Compact, and except as otherwise provided, the following definitions shally apply:

"Active Duty Military" means full-time duty status in the active uniformed service of the United States, including members of the National Guard and Reserve on active duty orders pursuant to 10 U.S.C. Section 1209 and 1211.
"Adverse Action" means disciplinary action taken by a physical therapy licensing board based upon misconduct, unacceptable performance, or a combination of both.
"Alternative Program" means a non-disciplinary monitoring or practice remediation process approved by a physical therapy licensing board. This includes, but is not limited to, substance abuse issues.
"Compact privilege" means the authorization granted by a remote state to allow a licensee from another member state to practice as a physical therapist or work as a physical therapist assistant in the remote state under its laws and rules. The practice of physical therapy occurs in the member state where the patient/client is located at the time of the patient/client encounter.
“Continuing competence” means a requirement, as a condition of license renewal, to provide evidence of participation in, and/or completion of, educational and professional activities relevant to practice or area of work.
“Data system” means a repository of information about licensees, including examination, licensure, investigative, compact privilege, and adverse action.
“Encumbered license” means a license that a physical therapy licensing board has limited in any way.
“Executive Board” means a group of directors elected or appointed to act on behalf of, and within the powers granted to them by, the Commission.
“Home state” means the member state that is the licensee’s primary state of residence.
“Investigative information” means information, records, and documents received or generated by a physical therapy licensing board pursuant to an investigation.
“Jurisprudence Requirement” means the assessment of an individual’s knowledge of the laws and rules governing the practice of physical therapy in a state.
“Licensee” means an individual who currently holds an authorization from the state to practice as a physical therapist or to work as a physical therapist assistant.
“Member state” means a state that has enacted the Compact.
“Party state” means any member state in which a licensee holds a current license or compact privilege or is applying for a license or compact privilege.
“Physical therapist” means an individual who is licensed by a state to practice physical therapy.
“Physical therapist assistant” means an individual who is licensed/certified by a state and who assists the physical therapist in selected components of physical therapy.
“Physical therapy,” “physical therapy practice,” and “the practice of physical therapy” mean the care and services provided by or under the direction and supervision of a licensed physical therapist.
“Physical Therapy Compact Commission” or “Commission” means the national administrative body whose membership consists of all states that have enacted the Compact.
“Physical therapy licensing board” or “licensing board” means the agency of a state that is responsible for the licensing and regulation of physical therapists and physical therapist assistants.
“Remote State” means a member state other than the home state, where a licensee is exercising or seeking to exercise the compact privilege.
“Rule” means a regulation, principle, or directive promulgated by the Commission that has the force of law.
“State” means any state, commonwealth, district, or territory of the United States of America that regulates the practice of physical therapy.

SECTION 3. STATE PARTICIPATION IN THE COMPACT

To participate in the Compact, a state must:
1. Participate fully in the Commission’s data system, including using the Commission’s unique identifier as defined in rules;
2. Have a mechanism in place for receiving and investigating complaints about licensees;
3. Notify the Commission, in compliance with the terms of the Compact and rules, of any adverse action or the availability of investigative information regarding a licensee;
4. Fully implement a criminal background check requirement, within a time frame established by rule, by receiving the results of the Federal Bureau of Investigation record search on criminal background checks and use the results in making licensure decisions in accordance with Section 3.B.;
5. Comply with the rules of the Commission;
6. Utilize a recognized national examination as a requirement for licensure pursuant to the rules of the Commission; and
7. Have continuing competence requirements as a condition for license renewal.
Upon adoption of this statute, the member state shall have the authority to obtain biometric-based information from each physical therapy licensure applicant and submit this information to the Federal Bureau of Investigation for a criminal background check in accordance 98 with 28 U.S.C. 534 and 42 U.S.C. 14616.
A member state shall grant the compact privilege to a licensee holding a valid unencumbered license in another member state in accordance with the terms of the Compact and rules. D. Member states may charge a fee for granting a compact privilege.

SECTION 4. COMPACT PRIVILEGE

To exercise the compact privilege under the terms and provisions of the Compact, the licensee shall:
1. Hold a license in the home state;
2. Have no encumbrance on any state license;
3. Be eligible for a compact privilege in any member state in accordance with Section 4D, G and H;
4. Have not had any adverse action against any license or compact privilege within the previous 2 years;
5. Notify the Commission that the licensee is seeking the compact privilege within a remote state(s);
6. Pay any applicable fees, including any state fee, for the compact privilege;
7. Meet any jurisprudence requirements established by the remote state(s) in which the licensee is seeking a compact privilege; and
8. Report to the Commission adverse action taken by any nonmember state within 30 days from the date the adverse action is taken.
The compact privilege is valid until the expiration date of the home license. The licensee must comply with the requirements of Section 4.A. to maintain the compact privilege in the remote state.
A licensee providing physical therapy in a remote state under the compact privilege shall function within the laws and regulations of the remote state.
A licensee providing physical therapy in a remote state is subject to that state’s regulatory authority. A remote state may, in accordance with due process and that state’s laws, remove a licensee’s compact privilege in the remote state for a specific period of time, impose fines, and/or take any other necessary actions to protect the health and safety of its citizens. The licensee is not eligible for a compact privilege in any state until the specific time for removal has passed and all fines are paid.
If a home state license is encumbered, the licensee shall lose the compact privilege in any remote state until the following occur:
1. The home state license is no longer encumbered; and
2. Two years have elapsed from the date of the adverse action.
Once an encumbered license in the home state is restored to good standing, the licensee must meet the requirements of Section 4A to obtain a compact privilege in any remote state.
If a licensee’s compact privilege in any remote state is removed, the individual shall lose the compact privilege in any remote state until the following occur:
1. The specific period of time for which the compact privilege was removed has ended;
2. All fines have been paid; and
3. Two years have elapsed from the date of the adverse action.
Once the requirements of Section 4G have been met, the license must meet the requirements in Section 4A to obtain a compact privilege in a remote state.

SECTION 5. ACTIVE DUTY MILITARY PERSONNEL OR THEIR SPOUSES

A licensee who is active duty military or is the spouse of an individual who is active duty military may designate one of the following as the home state:

Home of record;
Permanent Change of Station (PCS); or
State of current residence if it is different than the PCS state or home of record.

SECTION 6. ADVERSE ACTIONS

A home state shall have exclusive power to impose adverse action against a license issued by the home state.
A home state may take adverse action based on the investigative information of a remote state, so long as the home state follows its own procedures for imposing adverse action.
Nothing in this Compact shall override a member state’s decision that participation in an alternative program may be used in lieu of adverse action and that such participation shall remain non-public if required by the member state’s laws. Member states must require licensees who enter any alternative programs in lieu of discipline to agree not to practice in any other member state during the term of the alternative program without prior authorization from such other member state.
Any member state may investigate actual or alleged violations of the statutes and rules authorizing the practice of physical therapy in any other member state in which a physical therapist or physical therapist assistant holds a license or compact privilege.
A remote state shall have the authority to:
1. Take adverse actions as set forth in Section 4.D. against a licensee’s compact privilege in the state;
2. Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses, and the production of evidence. Subpoenas issued by a physical therapy licensing board in a party state for the attendance and testimony of witnesses, and/or the production of evidence from another party state, shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state where the witnesses and/or evidence are located; and
3. If otherwise permitted by state law, recover from the licensee the costs of investigations and disposition of cases resulting from any adverse action taken against that licensee.
Joint Investigations
1. In addition to the authority granted to a member state by its respective physical therapy practice act or other applicable state law, a member state may participate with other member states in joint investigations of licensees.
2. Member states shall share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.

SECTION 7. ESTABLISHMENT OF THE PHYSICAL THERAPY COMPACT COMMISSION

The Compact member states hereby create and establish a joint public agency known as the Physical Therapy Compact Commission:
1. The Commission is an instrumentality of the Compact states.
2. Venue is proper and judicial proceedings by or against the Commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the Commission is located. The Commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings.
3. Nothing in this Compact shall be construed to be a waiver of sovereign immunity.
Membership, Voting, and Meetings
1. Each member state shall have and be limited to one (1) delegate selected by that member state’s licensing board.
2. The delegate shall be a current member of the licensing board, who is a physical therapist, physical therapist assistant, public member, or the board administrator.
3. Any delegate may be removed or suspended from office as provided by the law of the state from which the delegate is appointed.
4. The member state board shall fill any vacancy occurring in the Commission.
5. Each delegate shall be entitled to one (1) vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the Commission.
6. A delegate shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for delegates’ participation in meetings by telephone or other means of communication.
7. The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.
The Commission shall have the following powers and duties:
1. Establish the fiscal year of the Commission;
2. Establish bylaws;
3. Maintain its financial records in accordance with the bylaws;
4. Meet and take such actions as are consistent with the provisions of this Compact and the bylaws;
5. Promulgate uniform rules to facilitate and coordinate implementation and administration of this Compact. The rules shall have the force and effect of law and shall be binding in all member states;
6. Bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any state physical therapy licensing board to sue or be sued under applicable law shall not be affected;
7. Purchase and maintain insurance and bonds;
8. Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a member state;
9. Hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of the Compact, and to establish the Commission’s personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters;
10. Accept any and all appropriate donations and grants of money, equipment, supplies, materials and services, and to receive, utilize and dispose of the same; provided that at all times the Commission shall avoid any appearance of impropriety and/or conflict of interest;
11. Lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, improve or use, any property, real, personal or mixed; provided that at all times the Commission shall avoid any appearance of impropriety;
12. Sell convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property real, personal, or mixed;
13. Establish a budget and make expenditures;
14. Borrow money;
15. Appoint committees, including standing committees composed of members, state regulators, state legislators or their representatives, and consumer representatives, and such other interested persons as may be designated in this Compact and the bylaws;
16. Provide and receive information from, and cooperate with, law enforcement agencies;
17. Establish and elect an Executive Board; and
18. Perform such other functions as may be necessary or appropriate to achieve the purposes of this Compact consistent with the state regulation of physical therapy licensure and practice.
The Executive Board shall have the power to act on behalf of the Commission according to the terms of this Compact
1. The Executive Board shall be composed of nine members:
  1. Seven voting members who are elected by the Commission from the current membership of the Commission;
  2. One ex-officio, nonvoting member from the recognized national physical therapy professional association; and
  3. One ex-officio, nonvoting member from the recognized membership organization of the physical therapy licensing boards.
2. The ex-officio members will be selected by their respective organizations.
3. The Commission may remove any member of the Executive Board as provided in bylaws.
4. The Executive Board shall meet at least annually.
5. The Executive Board shall have the following Duties and responsibilities:
  1. Recommend to the entire Commission changes to the rules or bylaws, changes to this Compact legislation, fees paid by Compact member states such as annual dues, and any commission Compact fee charged to licensees for the compact privilege;
  2. Ensure Compact administration services are appropriately provided, contractual or otherwise;
  3. Prepare and recommend the budget;
  4. Maintain financial records on behalf of the Commission;
  5. Monitor Compact compliance of member states and provide compliance reports to the Commission;
  6. Establish additional committees as necessary; and
  7. Other duties as provided in rules or bylaws.
Meetings of the Commission
1. All meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the rulemaking provisions in Section 9.
2. The Commission or the Executive Board or other committees of the Commission may convene in a closed, non-public meeting if the Commission or Executive Board or other committees of the Commission must discuss:
  1. Non-compliance of a member state with its obligations under the Compact;
  2. The employment, compensation, discipline or other matters, practices or procedures related to specific employees or other matters related to the Commission’s internal personnel practices and procedures;
  3. Current, threatened, or reasonably anticipated litigation;
  4. Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate;
  5. Accusing any person of a crime or formally censuring any person;
  6. Disclosure of trade secrets or commercial or financial information that is privileged or confidential;
  7. Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
  8. Disclosure of investigative records compiled for law enforcement purposes;
  9. Disclosure of information related to any investigative reports prepared by or on behalf of or for use of the Commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to the Compact; or
  10. Matters specifically exempted from disclosure by federal or member state statute.
3. If a meeting, or portion of a meeting, is closed pursuant to this provision, the Commission’s legal counsel or designee shall certify that the meeting may be closed and shall reference each relevant exempting provision.
4. The Commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, and the reasons therefore, including a description of the views expressed. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the Commission or order of a court of competent jurisdiction.
Financing of the Commission
1. The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.
2. The Commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services.
3. The Commission may levy on and collect an annual assessment from each member state or impose fees on other parties to cover the cost of the operations and activities of the Commission and its staff, which must be in a total amount sufficient to cover its annual budget as approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated based upon a formula to be determined by the Commission, which shall promulgate a rule binding upon all member states.
4. The Commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same; nor shall the Commission pledge the credit of any of the member states, except by and with the authority of the member state.
5. The Commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the Commission shall be subject to the audit and accounting procedures established under its bylaws. However, all receipts and disbursements of funds handled by the Commission shall be audited yearly by a certified or licensed public accountant, and the report of the audit shall be included in and become part of the annual report of the Commission.
Qualified Immunity, Defense, and Indemnification
1. The members, officers, executive director, employees and representatives of the Commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties or responsibilities; provided that nothing in this paragraph shall be construed to protect any such person from suit and/or liability for any damage, loss, injury, or liability caused by the intentional or willful or wanton misconduct of that person.
2. The Commission shall defend any member, officer, executive director, employee or representative of the Commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of Commission employment, duties, or responsibilities, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities; provided that nothing herein shall be construed to prohibit that person from retaining his or her own counsel; and provided further, that the actual or alleged act, error, or omission did not result from that person’s intentional or willful or wanton misconduct.
3. The Commission shall indemnify and hold harmless any member, officer, executive director, employee, or representative of the Commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error or omission that occurred within the scope of Commission employment, duties, or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from the intentional or willful or wanton misconduct of that person.

SECTION 8. DATA SYSTEM

The Commission shall provide for the development, maintenance, and utilization of a coordinated database and reporting system containing licensure, adverse action, and investigative information on all licensed individuals in member states.
Notwithstanding any other provision of state law to the contrary, a member state shall submit a uniform data set to the data system on all individuals to whom this Compact is applicable as required by the rules of the Commission, including:
1. Identifying information;
2. Licensure data;
3. Adverse actions against a license or compact privilege;
4. Non-confidential information related to alternative program participation;
5. Any denial of application for licensure, and the reason(s) for such denial; and
6. Other information that may facilitate the administration of this Compact, as determined by the rules of the Commission.
Investigative information pertaining to a licensee in any member state will only be available to other party states.
The Commission shall promptly notify all member states of any adverse action taken against a licensee or an individual applying for a license. Adverse action information pertaining to a licensee in any member state will be available to any other member state.
Member states contributing information to the data system may designate information that may not be shared with the public without the express permission of the contributing state.
Any information submitted to the data system that is subsequently required to be expunged by the laws of the member state contributing the information shall be removed from the data system.

SECTION 9. RULEMAKING

The Commission shall exercise its rulemaking powers pursuant to the criteria set forth in this Section and the rules adopted thereunder. Rules and amendments shall become binding as of the date specified in each rule or amendment.
If a majority of the legislatures of the member states rejects a rule, by enactment of a statute or resolution in the same manner used to adopt the Compact within 4 years of the date of adoption of the rule, then such rule shall have no further force and effect in any member state.
Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.
Prior to promulgation and adoption of a final rule or rules by the Commission, and at least thirty (30) days in advance of the meeting at which the rule will be considered and voted upon, the Commission shall file a Notice of Proposed Rulemaking:
1. On the website of the Commission or other publicly accessible platform; and
2. On the website of each member state physical therapy licensing board or other publicly accessible platform or the publication in which each state would otherwise publish proposed rules.
The Notice of Proposed Rulemaking shall include:
1. The proposed time, date, and location of the meeting in which the rule will be considered and voted upon;
2. The text of the proposed rule or amendment and the reason for the proposed rule;
3. A request for comments on the proposed rule from any interested person; and
4. The manner in which interested persons may submit notice to the Commission of their intention to attend the public hearing and any written comments.
Prior to adoption of a proposed rule, the Commission shall allow persons to submit written data, facts, opinions, and arguments, which shall be made available to the public.
The Commission shall grant an opportunity for a public hearing before it adopts a rule or amendment if a hearing is requested by:
1. At least twenty-five (25) persons;
2. A state or federal governmental subdivision or agency; or
3. An association having at least twenty-five (25) members.
If a hearing is held on the proposed rule or amendment, the Commission shall publish the place, time, and date of the scheduled public hearing. If the hearing is held via electronic means, the Commission shall publish the mechanism for access to the electronic hearing.
1. All persons wishing to be heard at the hearing shall notify the executive director of the Commission or other designated member in writing of their desire to appear and testify at the hearing not less than five (5) business days before the scheduled date of the hearing.
2. Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing.
3. All hearings will be recorded. A copy of the recording will be made available on request.
4. Nothing in this section shall be construed as requiring a separate hearing on each rule. Rules may be grouped for the convenience of the Commission at hearings required by this section.
Following the scheduled hearing date, or by the close of business on the scheduled hearing date if the hearing was not held, the Commission shall consider all written and oral comments received.
If no written notice of intent to attend the public hearing by interested parties is received, the Commission may proceed with promulgation of the proposed rule without a public hearing.
The Commission shall, by majority vote of all members, take final action on the proposed rule and shall determine the effective date of the rule, if any, based on the rulemaking record and the full text of the rule.
Upon determination that an emergency exists, the Commission may consider and adopt an emergency rule without prior notice, opportunity for comment, or hearing, provided that the usual rulemaking procedures provided in the Compact and in this section shall be retroactively applied to the rule as soon as reasonably possible, in no event later than ninety (90) days after the effective date of the rule. For the purposes of this provision, an emergency rule is one that must be adopted immediately in order to:
1. Meet an imminent threat to public health, safety, or welfare;
2. Prevent a loss of Commission or member state funds;
3. Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule; or
4. Protect public health and safety.
The Commission or an authorized committee of the Commission may direct revisions to a previously adopted rule or amendment for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors. Public notice of any revisions shall be posted on the website of the Commission. The revision shall be subject to challenge by any person for a period of thirty (30) days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made in writing, and delivered to the chair of the Commission prior to the end of the notice period. If no challenge is made, the revision will take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the Commission.

SECTION 10. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT

Oversight
1. The executive, legislative, and judicial branches of state government in each member state shall enforce this Compact and take all actions necessary and appropriate to effectuate the Compact’s purposes and intent. The provisions of this Compact and the rules promulgated hereunder shall have standing as statutory law.
2. All courts shall take judicial notice of the Compact and the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of this Compact which may affect the powers, responsibilities or actions of the Commission.
3. The Commission shall be entitled to receive service of process in any such proceeding, and shall have standing to intervene in such a proceeding for all purposes. Failure to provide service of process to the Commission shall render a judgment or order void as to the Commission, this Compact, or promulgated rules.
Default, Technical Assistance, and Termination
1. If the Commission determines that a member state has defaulted in the performance of its obligations or responsibilities under this Compact or the promulgated rules, the Commission shall:
  1. Provide written notice to the defaulting state and other member states of the nature of the default, the proposed means of curing the default and/or any other action to be taken by the Commission; and
  2. Provide remedial training and specific technical assistance regarding the default.
2. If a state in default fails to cure the default, the defaulting state may be terminated from the Compact upon an affirmative vote of a majority of the member states, and all rights, privileges and benefits conferred by this Compact may be terminated on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default.
3. Termination of membership in the Compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to suspend or terminate shall be given by the Commission to the governor, the majority and minority leaders of the defaulting state’s legislature, and each of the member states.
4. A state that has been terminated is responsible for all assessments, obligations, and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination.
5. The Commission shall not bear any costs related to a state that is found to be in default or that has been terminated from the Compact, unless agreed upon in writing between the Commission and the defaulting state.
6. The defaulting state may appeal the action of the Commission by petitioning the U.S. District Court for the District of Columbia or the federal district where the Commission has its principal offices. The prevailing member shall be awarded all costs of such litigation, including reasonable attorney’s fees.
Dispute Resolution
1. Upon request by a member state, the Commission shall attempt to resolve disputes related to the Compact that arise among member states and between member and non-member states.
2. The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate.
Enforcement
1. The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this Compact.
2. By majority vote, the Commission may initiate legal action in the United States District Court for the District of Columbia or the federal district where the Commission has its principal offices against a member state in default to enforce compliance with the provisions of the Compact and its promulgated rules and bylaws. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of such litigation, including reasonable attorney’s fees.
3. The remedies herein shall not be the exclusive remedies of the Commission. The Commission may pursue any other remedies available under federal or state law.

SECTION 11. DATE OF IMPLEMENTATION OF THE INTERSTATE COMMISSION FOR PHYSICAL THERAPY PRACTICE AND ASSOCIATED RULES, WITHDRAWAL, AND AMENDMENT

The Compact shall come into effect on the date on which the Compact statute is enacted into law in the tenth member state. The provisions, which become effective at that time, shall be limited to the powers granted to the Commission relating to assembly and the promulgation of rules. Thereafter, the Commission shall meet and exercise rulemaking powers necessary to the implementation and administration of the Compact.
Any state that joins the Compact subsequent to the Commission’s initial adoption of the rules shall be subject to the rules as they exist on the date on which the Compact becomes law in that state. Any rule that has been previously adopted by the Commission shall have the full force and effect of law on the day the Compact becomes law in that state.
Any member state may withdraw from this Compact by enacting a statute repealing the same.
1. A member state’s withdrawal shall not take effect until six (6) months after enactment of the repealing statute.
2. Withdrawal shall not affect the continuing requirement of the withdrawing state’s physical therapy licensing board to comply with the investigative and adverse action reporting requirements of this act prior to the effective date of withdrawal.
Nothing contained in this Compact shall be construed to invalidate or prevent any physical therapy licensure agreement or other cooperative arrangement between a member state and a nonmember state that does not conflict with the provisions of this Compact.
This Compact may be amended by the member states. No amendment to this Compact shall become effective and binding upon any member state until it is enacted into the laws of all member states.

SECTION 12. CONSTRUCTION AND SEVERABILITY

This Compact shall be liberally construed so as to effectuate the purposes thereof. The provisions of this Compact shall be severable and if any phrase, clause, sentence or provision of this Compact is declared to be contrary to the constitution of any party state or of the United States or the applicability thereof to any government, agency, person or circumstance is held invalid, the validity of the remainder of this Compact and the applicability thereof to any government, agency, person or circumstance shall not be affected thereby. If this Compact shall be held contrary to the constitution of any party state, the Compact shall remain in full force and effect as to the remaining party states and in full force and effect as to the party state affected as to all severable matters.

Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 3.01, eff. Sept. 1, 2017.

Sec. 453.502. ADMINISTRATION OF COMPACT

The board is the Physical Therapy Licensure Compact administrator for this state.

Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 3.01, eff. Sept. 1, 2017.

Sec. 453.503. RULES

The board may adopt rules necessary to implement this subchapter.

Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 3.01, eff. Sept. 1, 2017.

Sec. 453.504. PHYSICAL THERAPY LICENSURE COMPACT; DISCLOSURE OF PERSONAL INFORMATION

In reporting information to the coordinated database and reporting system under Section 8 of the Physical Therapy Licensure Compact, the board may disclose personally identifiable information about a physical therapist or a physical therapist assistant, including the person's social security number.
The coordinated database and reporting system may not share personally identifiable information with a state that is not a party to the compact unless the state agrees to not disclose that information to any other person.

Acts 2017, 85th Leg., R.S. ch. 535 (S.B. 317), Sec. 3.01, eff. Sept. 1, 2017.

FUNDAMENTAL ETHICAL PRINCIPLES
AND
DECISION-MAKING MODELS

Fundamental Ethical Principles

The following ethical principles provide a generalized framework within which ethical situations and dilemmas may be analyzed.

The Principle of Autonomy
An obligation to respect the autonomy of other persons, which is to respect the decisions made by other people concerning their own lives. Also called the principle of human dignity.

Corollary principle: Respecting the right of patients to make decisions about their own healthcare.

The Principle of Beneficence
An obligation to bring about good in all actions.

Corollary principle: Providing care that is in the best interest of the patient and actively promotes health and well-being.

The Principle of Nonmaleficence
An obligation not to harm others.

Corollary principle: Minimize any potential harm to a patient when harm cannot be avoided.

The Principle of Justice
An obligation to provide others with whatever they are owed or deserve.

Corollary principle: Treating all patients equally, fairly, and impartially.

The Principle of Fidelity
An obligation to be loyalty.

Corollary principle: Treating all patients with loyalty, fairness, truthfulness, advocacy, and dedication and keeping promises.

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Ethical Decision-Making Model

The following ethical decision-making model is adapted from Corey, G., Corey, M, & Haynes, R. (1998). Ethics in Action: Student Workbook. Pacific Grove, CA: Brooks/Cole.

Step 1: Identify the problem.

Does a problem or dilemma actually exist?
Is this an ethical, legal, moral, professional, or clinical problem?
Is it a combination of more than one of these?
How can you know the nature of the problem?
Would you consult at this early stage as you are identifying the problem?
How might you begin the process of consultation with your client about the nature of the problem?

Step 2: Identify the potential issues involved.

How might you best evaluate the rights, responsibilities, and welfare of all those involved and those who are affected by the decision, including your own welfare as a practitioner?
How can you best promote your client's independence and self-determination?
What actions have the least chance of bringing harm to your client?
What decision will best safeguard the client's welfare?
How can vou create a trusting and collaborative climate where your clients can find their own answers?
What principles can you use in prioritizing the potential issues involved in this situation?
Are there any ways to encourage the client to participate in identifying and determining potential ethical issues?

Step 3: Review relevant ethical guidelines.

What guidance can you find on the specific problem under review by consulting with the professional codes?
Are your values in agreement with the specific ethical code in question?
How clear and specific are the codes on the specific area under consideration?
Are the codes consistent with applicable state laws?

Step 4: Know relevant laws and regulations.

Are there any laws or regulations that have a bearing on the situation under consideration?
What are the specific and relevant state and federal laws that apply to the ethical dilemma?
What are the rules, regulations, and policies of the agency or institution where you work?

Step 5: Obtain Consultation.

Do you know where to go to obtain consultation with professionals who are knowledgeable about ethical issues?
Assuming that vou will consult with a colleague or a supervisor, what would you expect from this consultation?
What kinds of questions do you want to ask of those with whom you consult?
With whom do you seek consultation? Do you consult only with those who share your orientation, or do you look for consultants with different perspectives?
How can vou use the consultation process as an opportunity to test the justification of a course of action you are inclined to take?
What kinds of information do you document when you consult?
When you do make use of a consultation process, do you inform your client about this? Are there any ways you might include the client in this consultation process?

Page 2

Step 6: Consider possible and probable courses of action.

What are some ways that you can brainstorm many possible courses of action?
Do you have a systematic method for analyzing ethical obligations and possible courses of action?
Are you willing to involve your client in the discussion of the various courses of action?
What might you document pertaining to discussions with your client about probable courses of action?

Step 7: List the consequences of the probable courses of action.

How can you best evaluate the potential consequences of each course of action, before implementing a particular action plan?
Are you willing to involve your client in the discussion of the implications of each course of action for the client?
What ethical principles can you use as a framework for evaluating the consequences of a given course of action?
Examine the consequences of various decisions for your client, for you as counselor, and for the profession in general.

Step 8: Decide on what appears to be the best course of action.

After carefully considering all the information you have gathered, how do you know what seems to be the best action to take?
Do you solicit the input of your client in making this decision at this phase?
Once you have formulated a plan of action, do you ask for feedback from a colleague or supervisor?
Once the course of action has been implemented, what are some ways that you might evaluate the course of action?
Are you willing to follow up to determine the outcomes and see if further action is necessary?

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The Realm-Individual Process-Situation (RIPS) Model of Ethical Decision Making

The following is an excerpt from Ethical Decision Making to Avoid Disciplinary Action, Originally published in Volume 22, Number 1 of the Federation Forum Magazine which was written from an educational session presented by Annette Iglarsh and Nancy Kirsch at the 2006 FSBPT Annual Meeting in Portland, Oregon.

Using the RIPS Model

There are many ethical decision-making tools but they really do not apply to the types of dilemmas physical therapists confront. The RIPS model has been adapted for physical therapists and is the result of a lot of work by Rushworth M. Kidder, who wrote the book, How Good People Make Tough Choices. It was developed by L. Dolly Swisher and the Ethics and Judicial Committee of the APTA.

RIPS Framework

Realms	Individual Process	Situation
Individual Organizational/Institutional Societal	Moral sensitivity Moral judgment Moral motivation Moral courage	Issue/Problem Dilemma Distress Temptation Silence

Is there is an ethical issue? Some things make you feel uncomfortable. This is the hardest part; accurately defining the problem, why we are concerned about the situation and what it is that is making us feel uncomfortable. Can you identify the ethical principles? Are they conflicting ethical principles? Is there a problem or distress or a dilemma?

Why is it a problem?

Professional: Does it conflict with professional values?
Personal: Does it conflict with personal values?
Economic: Is there a financial problem that may evolve? Are there going to be financial difficulties for you if you leave a particular situation?
Intellectual: Is it something you cannot understand or you cannot justify from a purely intellectual point of view?
Societal: Is this going to have an overall impact on society?

Which ethical principles are involved?

Autonomy: patients have the right to make some decisions as well as we do.
Beneficence: care in the best interest of the patient
Non maleficence: “do no harm”
Justice: equity or fair treatment
Veracity: truthfulness

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What type of an ethical situation is it? Is it an issue, distress or a dilemma?

Test for Right versus Wrong

Legal test: Is it legal? Know your practice act and rules and regulations.
“PU” test: Does it feel or “smell” wrong?
Front page test: How would it look on the front page of the newspaper?
Mom/Dad Test: How would your parents feel if they knew what you were doing?
The professional ethics test: What do the Code of Ethics, Standards of Ethical Conduct say?

What course of action are you going to take? Use your moral imagination. Is there another way to do it other than the obvious ways? Is the course of action consistent with ethical principles, with the Code of Ethics, with your practice act and rules and regulations?

After the action has been taken, were there any unexpected results, any collateral damages or anything that you may not have expected? Is there any further action required? What did you or anybody else involved learn from the process? Do any organizational structures or policies require revision?

Page 5

GUIDE FOR PROFESSIONAL CONDUCT

Purpose

The APTA Guide for Professional Conduct (Guide) is intended to serve physical therapists in interpreting the Code of Ethics for the Physical Therapist (Code of Ethics) of the American Physical Therapy Association (APTA) in matters of professional conduct. The APTA House of Delegates in June of 2009 adopted a revised Code of Ethics, which became effective on July 1, 2010.

The Guide provides a framework by which physical therapists may determine the propriety of their conduct. It also is intended to guide the professional development of physical therapist students. The Code of Ethics and the Guide apply to all physical therapists. These guidelines are subject to change as the dynamics of the profession change, and as new patterns of health care delivery are developed and accepted by the professional community and the public.

Interpreting Ethical Principles

The interpretations expressed in this Guide reflect the opinions, decisions, and advice of the APTA Ethics and Judicial Committee (EJC). The interpretations are set forth according to topic. These interpretations are intended to assist a physical therapist in applying general ethical principles to specific situations. They address some but not all topics addressed in the principles and should not be considered inclusive of all situations that could evolve.

This Guide is subject to change, and the Ethics and Judicial Committee will monitor and timely revise the Guide to address additional topics and principles when and as needed.

Preamble to the Code

The Preamble states as follows:

The Code of Ethics for the Physical Therapist (Code of Ethics) delineates the ethical obligations of all physical therapists as determined by the House of Delegates of the American Physical Therapy Association (APTA). The purposes of this Code of Ethics are to:

Define the ethical principles that form the foundation of physical therapist practice in patient/client management, consultation, education, research, and administration.
Provide standards of behavior and performance that form the basis of professional accountability to the public.
Provide guidance for physical therapists facing ethical challenges, regardless of their professional roles and responsibilities.
Educate physical therapists, students, other health care professionals, regulators, and the public regarding the core values, ethical principles, and standards that guide the professional conduct of the physical therapist.
Establish the standards by which the American Physical Therapy Association can determine if a physical therapist has engaged in unethical conduct.

No code of ethics is exhaustive nor can it address every situation. Physical therapists are encouraged to seek additional advice or consultation in instances where the guidance of the Code of Ethics may not be definitive.

This Code of Ethics is built upon the five roles of the physical therapist (management of patients/clients, consultation, education, research, and administration), the core values of the profession, and the multiple realms of ethical action (individual, organizational, and societal). Physical therapist practice is guided by a set of seven core values: accountability, altruism, compassion/caring, excellence, integrity, professional duty, and social responsibility. Throughout the document the primary core values that support specific principles are indicated in parentheses. Unless a specific role is indicated in the principle, the duties and obligations being delineated pertain to the five roles of the physical therapist. Fundamental to the Code of Ethics is the special obligation of physical therapists to empower, educate, and enable those with impairments, activity limitations, participation restrictions, and disabilities to facilitate greater independence, health, wellness, and enhanced quality of life.

Interpretation: Upon the Code of Ethics for the Physical Therapist being amended effective July 1, 2010, all the lettered principles in the Code of Ethics contain the word “shall” and are mandatory ethical obligations. The language contained in the Code of Ethics is intended to better explain and further clarify existing ethical obligations. These ethical obligations predate the revised Code of Ethics. Although various words have changed, many of the obligations are the same. Consequently, the addition of the word “shall” reinforces and clarifies existing ethical obligations. A significant reason that the Code of Ethics was revised was to provide physical therapists with a document that was clear enough to be read on its own without the need to seek extensive additional interpretation.

The Preamble states that “[n]o Code of Ethics is exhaustive nor can it address every situation.” The Preamble also states that physical therapists “are encouraged to seek additional advice or consultation in instances in which the guidance of the Code may not be definitive.” Potential sources for advice and counsel include third parties and the myriad resources available on the APTA Web site. Inherent in a physical therapist’s ethical decision-making process is the examination of his or her unique set of facts relative to the Code of Ethics.

Topics

Respect

Principle 1A states as follows:

1A. Physical therapists shall act in a respectful manner toward each person regardless of age, gender, race, nationality, religion, ethnicity, social or economic status, sexual orientation, health condition, or disability.

Interpretation: Principle 1A addresses the display of respect toward others. Unfortunately, there is no universal consensus about what respect looks like in every situation. For example, direct eye contact is viewed as respectful and courteous in some cultures and inappropriate in others. It is up to the individual to assess the appropriateness of behavior in various situations.

Altruism

Principle 2A states as follows:

2A. Physical therapists shall adhere to the core values of the profession and shall act in the best interests of patients and clients over the interests of the physical therapist.

Interpretation: Principle 2A reminds physical therapists to adhere to the profession’s core values and act in the best interest of patients and clients over the interests of the physical therapist. Often this is done without thought, but sometimes, especially at the end of the day when the physical therapist is fatigued and ready to go home, it is a conscious decision. For example, the physical therapist may need to make a decision between leaving on time and staying at work longer to see a patient who was 15 minutes late for an appointment.

Patient Autonomy

Principle 2C states as follows:

2C. Physical therapists shall provide the information necessary to allow patients or their surrogates to make informed decisions about physical therapy care or participation in clinical research.

Interpretation: Principle 2C requires the physical therapist to respect patient autonomy. To do so, he or she shall communicate to the patient or client the findings of the physical therapist examination, evaluation, diagnosis, and prognosis. The physical therapist shall use sound professional judgment in informing the patient or client of any substantial risks of the recommended examination and intervention and shall collaborate with the individual to establish the goals of treatment and the plan of care. Ultimately, the physical therapist shall respect the individual’s right to make decisions regarding the recommended plan of care, including consent, modification, or refusal.

Professional Judgment

Principles 3, 3A, and 3B as follows:

3: Physical therapists shall be accountable for making sound professional judgments. (Core Values: Excellence, Integrity)

3A. Physical therapists shall demonstrate independent and objective professional judgment in the patient’s/client’s best interest in all practice settings.

3B. Physical therapists shall demonstrate professional judgment informed by professional standards, evidence (including current literature and established best practice), practitioner experience, and patient/client values.

Interpretation: Principles 3, 3A, and 3B state that it is the physical therapist’s obligation to exercise sound professional judgment, based upon his or her knowledge, skill, training, and experience. Principle 3B further describes the physical therapist’s judgment as being informed by 3 elements of evidence-based practice.

With regard to the patient and client management role, once a physical therapist accepts an individual for physical therapy services he or she shall be responsible for: the examination, evaluation, and diagnosis of that individual; the prognosis and intervention; re-examination and modification of the plan of care; and the maintenance of adequate records, including progress reports. The physical therapist shall establish the plan of care and shall provide and/or supervise and direct the appropriate interventions. Regardless of practice setting, the physical therapist has primary responsibility for the physical therapy care of a patient or client and shall make independent judgments regarding that care consistent with accepted professional standards.

If the diagnostic process reveals findings that are outside the scope of the physical therapist's knowledge, experience, or expertise or that indicate the need for care outside the scope of physical therapy, the physical therapist shall so inform the patient or client and shall refer the patient/client to an appropriate practitioner.

The physical therapist shall determine when a patient or client will no longer benefit from physical therapist services. When the physical therapist's judgment is that a patient will receive negligible benefit from physical therapist services, the physical therapist shall not provide or continue to provide such services if the primary reason for doing so is to further the financial self-interest of the physical therapist or his or her employer. The physical therapist shall avoid overutilization of physical therapist services. See Principle 8C.

Supervision

Principle 3E states as follows:

3E. Physical therapists shall provide appropriate direction of and communication with physical therapist assistants and support personnel.

Interpretation: Principle 3E describes an additional circumstance in which sound professional judgment is required; namely, through the appropriate direction of and communication with physical therapist assistants and support personnel. Further information on supervision via applicable local, state, and federal laws and regulations (including state practice acts and administrative codes) is available. Information on supervision via APTA policies and resources is also available on the APTA website. See Principles 5A and 5B.

Integrity in Relationships

Principle 4 states as follows:

4: Physical therapists shall demonstrate integrity in their relationships with patients/clients, families, colleagues, students, research participants, other health care providers, employers, payers, and the public. (Core Value: Integrity)

Interpretation: Principle 4 addresses the need for integrity in relationships. This is not limited to relationships with patients and clients but includes everyone physical therapists come into contact with professionally. For example, demonstrating integrity could encompass working collaboratively with the health care team and taking responsibility for one’s role as a member of that team.

Reporting

Principle 4C states as follows:

4C. Physical therapists shall discourage misconduct by healthcare professionals and report illegal or unethical acts to the relevant authority, when appropriate.

Interpretation: Physical therapists shall seek to discourage misconduct by health care professionals. Discouraging misconduct can be accomplished through a number of mechanisms. The following is not an exhaustive list:

Do not engage in misconduct; instead, set a good example for health care professionals and others working in their immediate environment.
Encourage or recommend to the appropriate individuals that health care and other professionals, such as legal counsel, conduct regular (such as annual) training that addresses federal and state law requirements, such as billing, best practices, harassment, and security and privacy; as such training can educate health care professionals on what to do and not to do.
Encourage or recommend to the appropriate individuals other types of training that are not law based, such as bystander training.
Assist in creating a culture that is positive and civil to all.
If in a management position, think about promotion and hiring decisions and how they can impact the organization.
Access professional association resources when considering best practices.
Revisit policies and procedures each year to remain current.

Many other mechanisms may exist to discourage misconduct. The physical therapist should be creative, open-minded, fair, and impartial in considering how to best meet this ethical obligation. Doing so can actively foster an environment in which misconduct does not occur. The main focus when thinking about misconduct is creating an action plan on prevention. Consider that reporting may never make the alleged victim whole or undo the misconduct.

If misconduct has not been prevented, then reporting issues must be considered. This ethical obligation states that the physical therapist reports to the “relevant authority, when appropriate.” Before examining the meaning of these words it is important to note that reporting intersects with corporate policies and legal obligations. It is beyond the scope of this interpretation to provide legal advice regarding laws and policies; however, an analysis of reporting cannot end with understanding one’s ethical obligations. One may need to seek advice of legal counsel who will take into consideration laws and policies and seek to discover the facts and circumstances.

With respect to ethical obligations, the term “when appropriate” is a fact-based decision and will be impacted by requirements of the law. If a law requires the physical therapist to take an action, then, of course, it is appropriate to do so. If there is no legal requirement and no corporate policy, then the physical therapist must consider what is appropriate given the facts and situation. It may not be appropriate if the physical therapist does not know what occurred, or because there is no legal requirement to act and the physical therapist does not want to assume legal responsibility, or because the matter is being resolved internally. There are many different reasons that something may or may not be appropriate.

If the physical therapist has determined that is appropriate to report, the ethical obligation requires him or her to consider what entity or person is the “relevant authority.” Relevant authority can be a supervisor, human resources, an attorney, the Equal Employment Opportunities Commission, the licensing board, the Better Business Bureau, Office of the Insurance Commission, the Medicare hotline, the Office of the Inspector General hotline, the US Department of Health & Human Services, an institution using their internal grievance procedures, the Office of Civil Rights, or another federal agency, state agency, city or local agency, or a state or federal court, among others.

Once the physical therapist has decided to report, he or she must be mindful that reporting does not end his or her involvement, which can include office, regulatory, and/or legal proceedings. In this context, the physical therapist may be asked to be a witness, to testify, or to provide written information.

Sexual Harassment

Principle 4F states as follows:

4F. Physical Therapists shall not harass anyone verbally, physically, emotionally, or sexually.

Interpretation: As noted in the House of Delegates policy titled Sexual Harassment, “[m]embers of the association have an obligation to comply with applicable legal prohibitions against sexual harassment….” This statement is in line with Principle 4F that prohibits physical therapists from harassing anyone verbally, physically, emotionally, or sexually. While the principle is clear, it is important for APTA to restate this point, namely that physical therapists shall not harass anyone, period. The association has zero tolerance for any form of harassment, specifically including sexual harassment.

Exploitation

Principle 4E states as follows:

4E. Physical therapists shall not engage in any sexual relationship with any of their patients/clients, supervisees or students.

Interpretation: The statement is clear – sexual relationships with their patients or clients, supervisees, or students are prohibited. This component of Principle 4 is consistent with Principle 4B, which states:

Physical therapists shall not exploit persons over whom they have supervisory, evaluative, or other authority (eg, patients and clients, students, supervisees, research participants, or employees).

Consider this excerpt from the EJC Opinion titled Topic: Sexual Relationships With Patients or Former Patients:

A physical therapist stands in a relationship of trust to each patient and has an ethical obligation to act in the patient's best interest and to avoid any exploitation or abuse of the patient. Thus, if a physical therapist has natural feelings of attraction toward a patient, he or she must sublimate those feelings in order to avoid sexual exploitation of the patient.

One’s ethical decision making process should focus on whether the patient or client, supervisee, or student is being exploited. In this context, questions have been asked about whether one can have a sexual relationship once the patient or client relationship ends. To this question, the EJC has opined as follows:

The Committee does not believe it feasible to establish any bright-line rule for when, if ever, initiation of a romantic/sexual relationship with a former patient would be ethically permissible.

The Committee imagines that in some cases a romantic/sexual relationship would not offend ... if initiated with a former patient soon after the termination of treatment, while in others such a relationship might never be appropriate.

Colleague Impairment

Principle 5D and 5E state as follows:

5D. Physical therapists shall encourage colleagues with physical, psychological, or substance-related impairments that may adversely impact their professional responsibilities to seek assistance or counsel.

5E. Physical therapists who have knowledge that a colleague is unable to perform their professional responsibilities with reasonable skill and safety shall report the information to the appropriate authority.

Interpretation: The central tenet of Principles 5D and 5E is that inaction is not an option for a physical therapist when faced with the circumstances described. Principle 5D states that a physical therapist shall encourage colleagues to seek assistance or counsel while Principle 5E addresses reporting information to the appropriate authority.

5D and 5E both require a factual determination. This may be challenging in the sense that the physical therapist might not know or easily be able to determine whether someone in fact has a physical, psychological, or substance-related impairment. In addition, it might be difficult to determine whether such impairment may be adversely affecting his or her professional responsibilities.

Moreover, once the physical therapist does make these determinations, the obligation under 5D centers not on reporting, but on encouraging the colleague to seek assistance, while the obligation under 5E does focus on reporting. But note that 5E discusses reporting when a colleague is unable to perform; whereas, 5D discusses encouraging colleagues to seek assistance when the impairment may adversely affect their professional responsibilities. So, 5D discusses something that may be affecting performance, while 5E addresses a situation in which someone clearly is unable to perform. The 2 situations are distinct. In addition, it is important to note that 5E does not mandate to whom the physical therapist reports; it provides discretion to determine the appropriate authority.

The EJC Opinion titled: Topic: Preserving Confidences; Physical Therapist's Reporting Obligation With Respect to Unethical, Incompetent, or Illegal Acts provides further information on the complexities of reporting.

Professional Competence

Principle 6A states as follows:

6A. Physical therapists shall achieve and maintain professional competence.

Interpretation: 6A requires the physical therapist to maintain professional competence within his or her scope of practice throughout their career. Maintaining competence is an ongoing process of self-assessment, identification of strengths and weaknesses, acquisition of knowledge, and skills based on that assessment, and reflection on and reassessment of performance, knowledge, and skills. Numerous factors including practice setting, types of patients and clients, personal interests, and the addition of new evidence to practice will influence the depth and breadth of professional competence in a given area of practice. Additional resources on continuing competence are available on the APTA website.

Professional Growth

Principle 6D states as follows:

6D. Physical therapists shall cultivate practice environments that support professional development, life-long learning, and excellence.

Interpretation: 6D elaborates on the physical therapist’s obligations to foster an environment conducive to professional growth, even when not supported by the organization. The essential idea is that this is the physical therapist’s responsibility, whether or not the employer provides support.

Charges and Coding

Principle 7E states as follows:

7E. Physical therapists shall be aware of charges and shall ensure that documentation and coding for physical therapy services accurately reflect the nature and extent of the services provided.

Interpretation: Principle 7E provides that the physical therapist must make sure that the process of documentation and coding accurately captures the charges for services performed. Additional resources on Documentation and Coding and Billing are available on the APTA website.

Pro Bono Services

Principle 8A states as follows:

8A. Physical therapists shall provide pro bono physical therapist services or support organizations that meet the health needs of people who are economically disadvantaged, uninsured, and underinsured.

Interpretation: The key word in Principle 8A is “or.” If a physical therapist is unable to provide pro bono services, then he or she can fulfill ethical obligations by supporting organizations that meet the health needs of people who are economically disadvantaged, uninsured, and underinsured. In addition, physical therapists may review the House of Delegates guidelines titled Guidelines: Pro Bono Physical Therapy Services and Organizational Support. Additional resources on pro bono physical therapy services are available on the APTA website.

8A also addresses supporting organizations to meet health needs. The principle does not specify the type of support that is required. Physical therapists may express support through volunteerism, financial contributions, advocacy, education, or simply promoting their work in conversations with colleagues.

Issued by the Ethics and Judicial Committee
American Physical Therapy Association October 1981

Last Amended: March 2019

GUIDE FOR CONDUCT OF THE PHYSICAL THERAPIST ASSISTANT

Purpose

The APTA Guide for Conduct of the Physical Therapist Assistant (Guide) is intended to serve physical therapist assistants in interpreting the Standards of Ethical Conduct for the Physical Therapist Assistant (Standards of Ethical Conduct) of the American Physical Therapy Association (APTA). The APTA House of Delegates in June of 2009 adopted the revised Standards of Ethical Conduct, which became effective on July 1, 2010.

The Guide provides a framework by which physical therapist assistants may determine the propriety of their conduct. It also is intended to guide the development of physical therapist assistant students. The Standards of Ethical Conduct and the Guide apply to all physical therapist assistants. These guidelines are subject to change as the dynamics of the profession change and as new patterns of health care delivery are developed and accepted by the professional community and the public.

Interpreting the Standards of Ethical Conduct

The interpretations expressed in this Guide reflect the opinions, decisions, and advice of the Ethics and Judicial Committee (EJC). The interpretations are set forth according to topic. These interpretations are intended to assist a physical therapist assistant in applying general ethical standards to specific situations. They address some but not all topics addressed in the Standards of Ethical Conduct and should not be considered inclusive of all situations that could evolve.

This Guide is subject to change, and the Ethics and Judicial Committee will monitor and revise the Guide to address additional topics and standards when and as needed.

Preamble to the Standards of Ethical Conduct

The Preamble states as follows:

Interpretation: Upon the Standards of Ethical Conduct for the Physical Therapist Assistant being amended effective July 1, 2010, all the lettered standards contain the word “shall” and are mandatory ethical obligations. The language contained in the Standards of Ethical Conduct is intended to better explain and further clarify existing ethical obligations. These ethical obligations predate the revised Standards of Ethical Conduct. Although various words have changed, many of the obligations are the same. Consequently, the addition of the word “shall” serves to reinforce and clarify existing ethical obligations. A significant reason that the Standards of Ethical Conduct were revised was to provide physical therapist assistants with a document that was clear enough to be read on its own without the need to seek extensive additional interpretation.

The Preamble states that “[n]o document that delineates ethical standards can address every situation.” The Preamble also states that physical therapist assistants “are encouraged to seek additional advice or consultation in instances where the guidance of the Standards of Ethical Conduct may not be definitive.” Potential sources for advice or counsel include third parties and the myriad resources available on the APTA website. Inherent in a physical therapist assistant’s ethical decision-making process is the examination of his or her unique set of facts relative to the Standards of Ethical Conduct.

Topics

Respect

Standard 1A states as follows:

1A. Physical therapist assistants shall act in a respectful manner toward each person regardless of age, gender, race, nationality, religion, ethnicity, social or economic status, sexual orientation, health condition, or disability.

Interpretation: Standard 1A addresses the display of respect toward others. Unfortunately, there is no universal consensus about what respect looks like in every situation. For example, direct eye contact is viewed as respectful and courteous in some cultures and inappropriate in others. It is up to the individual to assess the appropriateness of behavior in various situations.

Altruism

Standard 2A states as follows:

2A. Physical therapist assistants shall act in the best interests of patients/clients over the interests of the physical therapist assistant.

Interpretation: Standard 2A addresses acting in the best interest of patients and clients over the interests of the physical therapist assistant. Often this is done without thought, but, sometimes, especially at the end of the day when the clinician is fatigued and ready to go home, it is a conscious decision. For example, the physical therapist assistant may need to make a decision between leaving on time and staying at work longer to see a patient who was 15 minutes late for an appointment.

Sound Decisions

Standard 3C states as follows:

3C. Physical therapist assistants shall make decisions based upon their level of competence and consistent with patient/client values.

Interpretation: To fulfill 3C, the physical therapist assistant must be knowledgeable about his or her legal scope of work as well as level of competence. As a physical therapist assistant gains experience and additional knowledge, there may be areas of physical therapy interventions in which he or she displays advanced skills. At the same time, other previously gained knowledge and skill may be lost due to lack of use. To make sound decisions, the physical therapist assistant must be able to self-reflect on his or her current level of competence.

Supervision

Standard 3E states as follows:

3E. Physical therapist assistants shall provide physical therapy services under the direction and supervision of a physical therapist and shall communicate with the physical therapist when patient/client status requires modifications to the established plan of care.

Interpretation: Standard 3E goes beyond simply stating that the physical therapist assistant operates under the supervision of the physical therapist. Although a physical therapist retains responsibility for the patient or client throughout the episode of care, this standard requires the physical therapist assistant to take action by communicating with the supervising physical therapist when changes in the individual's status indicate that modifications to the plan of care may be needed. Further information on supervision via APTA policies and resources is available on the APTA website.

Integrity in Relationships

Standard 4 states as follows:

4: Physical therapist assistants shall demonstrate integrity in their relationships with patients/clients, families, colleagues, students, other health care providers, employers, payers, and the public.

Interpretation: Standard 4 addresses the need for integrity in relationships. This is not limited to relationships with patients and clients, but includes everyone physical therapist assistants come into contact with in the normal provision of physical therapist services. For example, demonstrating integrity could encompass working collaboratively with the health care team and taking responsibility for one’s role as a member of that team.

Reporting

Standard 4C states as follows:

4C. Physical therapist assistants shall discourage misconduct by health care professionals and report illegal or unethical acts to the relevant authority, when appropriate.

Interpretation: Physical therapist assistants shall seek to discourage misconduct by health care professionals. Discouraging misconduct can be accomplished through a number of mechanisms. The following is not an exhaustive list:

Do not engage in misconduct; instead, set a good example for health care professionals and others
working in their immediate environment.
Encourage or recommend to the appropriate individuals that health care and other professionals, such as legal counsel, conduct regular (such as annual) training that addresses federal and state law requirements, such as billing, best practices, harassment, and security and privacy; as such training can educate health care professionals on what to do and not to do.
Encourage or recommend to the appropriate individuals other types of training that are not law based, such as bystander training.
Assist in creating a culture that is positive and civil to all.
If in a management position, consider how promotion and hiring decisions can impact the organization.
Access professional association resources when considering best practices.
Revisit policies and procedures each year to remain current.

Many other mechanisms may exist to discourage misconduct. The physical therapist assistant should be creative, open-minded, fair, and impartial in considering how to best meet this ethical obligation. Doing so can actively foster an environment in which misconduct does not occur. The main focus when thinking about misconduct is creating an action plan on prevention. Consider that reporting may never make the alleged victim whole or undo the misconduct.

If misconduct has not been prevented, then reporting issues must be considered. This ethical obligation states that the physical therapist assistant reports to the “relevant authority, when appropriate.” Before examining the meaning of these words it is important to note that reporting intersects with corporate policies and legal obligations. It is beyond the scope of this interpretation to provide legal advice regarding laws and policies; however, an analysis of reporting cannot end with understanding one’s ethical obligations. One may need to seek advice of legal counsel who will take into consideration laws and policies and seek to discover the facts and circumstances.

With respect to ethical obligations, the term “when appropriate” is a fact-based decision and will be impacted by requirements of the law. If a law requires the physical therapist assistant to take an action, then, of course, it is appropriate to do so. If there is no legal requirement and no corporate policy, then the physical therapist assistant must consider what is appropriate given the facts and situation. It may not be appropriate if the physical therapist does not know what occurred, or because there is no legal requirement to act and the physical therapist assistant does not want to assume legal responsibility, or because the matter is being resolved internally. There are many different reasons that something may or may not be appropriate.

If the physical therapist assistant has determined that is appropriate to report, the ethical obligation requires him or her to consider what entity or person is the “relevant authority.” Relevant authority can be a supervisor, human resources, an attorney, the Equal Employment Opportunities Commission, the licensing board, the Better Business Bureau, Office of the Insurance Commission, the Medicare hotline, the Office of the Inspector General hotline, the US Department of Health and Human Services, an institution using their internal grievance procedures, the Office of Civil Rights, or another federal, state, city, or local agency, of a state or federal court, among others.

Once the physical therapist assistant has decided to report, he or she must be mindful that reporting does not end his or her involvement, which can include office, regulatory, and/or legal proceedings. In this context, the physical therapist assistant may be asked to be a witness, to testify, or to provide written information.

Sexual Harassment

Standard 4F states as follows:

4F. Physical therapist assistants shall not harass anyone verbally, physically, emotionally, or sexually.

Interpretation: As noted in the House of Delegates policy titled “Sexual Harassment,” “[m]embers of the association have an obligation to comply with applicable legal prohibitions against sexual harassment….” This statement is in line with Standard 4F that prohibits physical therapist assistants from harassing anyone verbally, physically, emotionally, or sexually. While the standard is clear, it is important for APTA to restate this point, namely that physical therapist assistants shall not harass anyone, period. The association has zero tolerance for any form of harassment, specifically including sexual harassment.

Exploitation

Standard 4E states as follows:

4E. Physical therapist assistants shall not engage in any sexual relationship with any of their patients/clients, supervisees, or students.

Interpretation: The statement is clear – sexual relationships with their patients or clients, supervisees or students are prohibited. This component of Standard 4 is consistent with Standard 4B, which states:

4B. Physical therapist assistants shall not exploit persons over whom they have supervisory, evaluative, or other authority (e.g., patients and clients, students, supervisees, research participants, or employees).

Consider this excerpt from the EJC Opinion titled Topic: Sexual Relationships With Patients or Former Patients (modified for physical therapist assistants):

A physical therapist [assistant] stands in a relationship of trust to each patient and has an ethical obligation to act in the patient's best interest and to avoid any exploitation or abuse of the patient. Thus, if a physical therapist [assistant] has natural feelings of attraction toward a patient, he or she must sublimate those feelings in order to avoid sexual exploitation of the patient.

One’s ethical decision making process should focus on whether the patient or client, supervisee or student is being exploited. In this context, questions have been asked about whether one can have a sexual relationship once the patient or client relationship ends. To this question, the EJC has opined as follows:

The Committee does not believe it feasible to establish any bright-line rule for when, if ever, initiation of a romantic/sexual relationship with a former patient would be ethically permissible.

Colleague Impairment

Standard 5D and 5E state as follows:

5D. Physical therapist assistants shall encourage colleagues with physical, psychological, or substance-related impairments that may adversely impact their professional responsibilities to seek assistance or counsel.

5E. Physical therapist assistants who have knowledge that a colleague is unable to perform their professional responsibilities with reasonable skill and safety shall report this information to the appropriate authority.

Interpretation: The central tenet of Standard 5D and 5E is that inaction is not an option for a physical therapist assistant when faced with the circumstances described. Standard 5D states that a physical therapist assistant shall encourage colleagues to seek assistance or counsel while Standard 5E addresses reporting information to the appropriate authority.

5D and 5E both require a factual determination on the physical therapist assistant’s part. This may be challenging in the sense that the physical therapist assistant might not or easily be able to determine whether someone in fact has a physical, psychological, or substance-related impairment. In addition, it might be difficult to determine whether such impairment may be adversely affecting someone’s work responsibilities.

Moreover, once the physical therapist assistant does make these determinations, the obligation under 5D centers not on reporting, but on encouraging the colleague to seek assistance while, the obligation under 5E does focus on reporting. But note that 5E discusses reporting when a colleague is unable to perform; whereas, 5D discusses encouraging colleagues to seek assistance when the impairment may adversely affect their professional responsibilities. So, 5D discusses something that may be affecting performance, whereas 5E addresses a situation in which someone is clearly unable to perform. The 2 situations are distinct. In addition, it is important to note that 5E does not mandate to whom the physical therapist assistant reports; it gives you discretion to determine the appropriate authority.

The EJC Opinion titled Topic: Preserving Confidences; Physical Therapist's Reporting Obligation With Respect to Unethical, Incompetent, or Illegal Acts provides further information on the complexities of reporting.

Clinical Competence

Standard 6A states as follows:

6A. Physical therapist assistants shall achieve and maintain clinical competence.

Interpretation: 6A should cause physical therapist assistants to reflect on their current level of clinical competence, to identify and address gaps in clinical competence, and to commit to the maintenance of clinical competence throughout their career.

The supervising physical therapist can be a valuable partner in identifying areas of knowledge and skill that the physical therapist assistant needs for clinical competence and to meet the needs of the individual physical therapist, which may vary according to areas of interest and expertise. Further, the physical therapist assistant may request that the physical therapist serve as a mentor to assist him or her in acquiring the needed knowledge and skills. Additional resources on Continuing Competence are available on the APTA website.

Lifelong Learning

Standard 6C states as follows:

6C. Physical therapist assistants shall support practice environments that support career development and lifelong learning.

Interpretation: 6C points out the physical therapist assistant’s obligation to support an environment conducive to career development and learning. The essential idea here is that the physical therapist assistant encourage and contributes to his or her career development and lifelong learning, whether or not the employer provides support.

Organizational and Business Practices

Standard 7 states as follows:

7. Physical therapist assistants shall support organizational behaviors and business practices that benefit patients/clients and society.

Interpretation: Standard 7 reflects a shift in the Standards of Ethical Conduct. One criticism of the former version was that it addressed primarily face-to-face clinical practice settings. Accordingly, Standard 7 addresses ethical obligations in organizational and business practices on both patient and client and societal levels.

Documenting Interventions

Standard 7D states as follows:

7D. Physical therapist assistants shall ensure that documentation for their interventions accurately reflects the nature and extent of the services provided.

Interpretation: 7D addresses the need for physical therapist assistants to make sure that they thoroughly and accurately document the interventions they provide to patients and clients and document related data collected from the patient or client. The focus of this Standard is on ensuring documentation of the services rendered, including the nature and extent of such services.

Support - Health Needs

Standard 8A states as follows:

8A. Physical therapist assistants shall support organizations that meet the health needs of people who are economically disadvantaged, uninsured, and underinsured.

Interpretation: 8A addresses the issue of support for those least likely to be able to afford physical therapist services.

The standard does not specify the type of support that is required. Physical therapist assistants may express support through volunteerism, financial contributions, advocacy, education, or simply promoting their work in conversations with colleagues. When providing such services, including pro bono services, physical therapist assistants must comply with applicable laws, and as such work under the direction and supervision of a physical therapist. Additional resources on pro bono physical therapy services are available on the APTA website.

Issued by the Ethics and Judicial Committee
American Physical Therapy Association October 1981

Last Amended: March 2019

CODE OF ETHICS FOR THE PHYSICAL THERAPIST

Preamble

1. Define the ethical principles that form the foundation of physical therapist practice in patient and client management, consultation, education, research, and administration.
2. Provide standards of behavior and performance that form the basis of professional accountability to the public.
3. Provide guidance for physical therapists facing ethical challenges, regardless of their professional roles and responsibilities.
4. Educate physical therapists, students, other health care professionals, regulators, and the public regarding the core values, ethical principles, and standards that guide the professional conduct of the physical therapist.
5. Establish the standards by which the American Physical Therapy Association can determine if a physical therapist has engaged in unethical conduct.

No code of ethics is exhaustive nor can it address every situation. Physical therapists are encouraged to seek additional advice or consultation in instances where the guidance of the Code of Ethics may not be definitive. The APTA Guide for Professional Conduct and Core Values for the Physical Therapist and Physical Therapist Assistant provide additional guidance.

This Code of Ethics describes the desired behavior of physical therapists in their multiple roles (eg, management of patients and clients, consultation, education, research, and administration), addresses multiple aspects of ethical action (individual, organizational, and societal), and reflects the core values of the physical therapist (accountability, altruism, collaboration, compassion and caring, duty, excellence, integrity, and social responsibility). Throughout the document the primary core values that support specific principles are indicated in parentheses. Unless a specific role is indicated in the principle, the duties and obligations being delineated pertain to the five roles of the physical therapist. Fundamental to the Code of Ethics is the special obligation of physical therapists to empower, educate, and enable those with impairments, activity limitations, participation restrictions, and disabilities to facilitate greater independence, health, wellness, and enhanced quality of life.

Principles

Principle #1: Physical therapists shall respect the inherent dignity and rights of all individuals.

(Core Values: Compassion and Caring, Integrity)

1B. Physical therapists shall recognize their personal biases and shall not discriminate against others in physical therapist practice, consultation, education, research, and administration.

Principle #2: Physical therapists shall be trustworthy and compassionate in addressing the rights and needs of patients and clients.

(Core Values: Altruism, Collaboration, Compassion and Caring, Duty)

2A. Physical therapists shall adhere to the core values of the profession and shall act in the best interests of patients and clients over the interests of the physical therapist.

2B. Physical therapists shall provide physical therapist services with compassionate and caring behaviors that incorporate the individual and cultural differences of patients and clients.

2C. Physical therapists shall provide the information necessary to allow patients or their surrogates to make informed decisions about physical therapist care or participation in clinical research.

2D. Physical therapists shall collaborate with patients and clients to empower them in decisions about their health care.

2E. Physical therapists shall protect confidential patient and client information and may disclose confidential information to appropriate authorities only when allowed or as required by law.

Principle #3: Physical therapists shall be accountable for making sound professional judgments.

(Core Values: Collaboration, Duty, Excellence, Integrity)

3A. Physical therapists shall demonstrate independent and objective professional judgment in the patient’s or client’s best interest in all practice settings.

3C. Physical therapists shall make judgments within their scope of practice and level of expertise and shall communicate with, collaborate with, or refer to peers or other health care professionals when necessary.

3D. Physical therapists shall not engage in conflicts of interest that interfere with professional judgment.

3E. Physical therapists shall provide appropriate direction of and communication with physical therapist assistants and support personnel.

Principle #4: Physical therapists shall demonstrate integrity in their relationships with patients and clients, families, colleagues, students, research participants, other health care providers, employers, payers, and the public.

(Core Value: Integrity)

4A. Physical therapists shall provide truthful, accurate, and relevant information and shall not make misleading representations.

4B. Physical therapists shall not exploit persons over whom they have supervisory, evaluative or other authority (eg, patients/clients, students, supervisees, research participants, or employees).

4C. Physical therapists shall not engage in any sexual relationship with any of their patients and clients, supervisees, or students.

4D. Physical therapists shall not harass anyone verbally, physically, emotionally, or sexually.

4E. Physical therapists shall discourage misconduct by physical therapists, physical therapist assistants, and other health care professionals and, when appropriate, report illegal or unethical acts, including verbal, physical, emotional, or sexual harassment, to an appropriate authority with jurisdiction over the conduct.

4F. Physical therapists shall report suspected cases of abuse involving children or vulnerable adults to the appropriate authority, subject to law.

Principle #5: Physical therapists shall fulfill their legal and professional obligations.

(Core Values: Accountability, Duty, Social Responsibility)

5A. Physical therapists shall comply with applicable local, state, and federal laws and regulations.

5B. Physical therapists shall have primary responsibility for supervision of physical therapist assistants and support personnel.

5C. Physical therapists involved in research shall abide by accepted standards governing protection of research participants.

5E. Physical therapists who have knowledge that a colleague is unable to perform their professional responsibilities with reasonable skill and safety shall report this information to the appropriate authority.

5F. Physical therapists shall provide notice and information about alternatives for obtaining care in the event the physical therapist terminates the provider relationship while the patient or client continues to need physical therapist services.

Principle #6: Physical therapists shall enhance their expertise through the lifelong acquisition and refinement of knowledge, skills, abilities, and professional behaviors.

(Core Value: Excellence)

6A. Physical therapists shall achieve and maintain professional competence.

6B. Physical therapists shall take responsibility for their professional development based on critical selfassessment and reflection on changes in physical therapist practice, education, health care delivery, and technology.

6C. Physical therapists shall evaluate the strength of evidence and applicability of content presented during professional development activities before integrating the content or techniques into practice.

6D. Physical therapists shall cultivate practice environments that support professional development, lifelong learning, and excellence.

Principle #7:Physical therapists shall promote organizational behaviors and business practices that benefit patients and clients and society.

(Core Values: Integrity, Accountability)

7A. Physical therapists shall promote practice environments that support autonomous and accountable professional judgments.

7B. Physical therapists shall seek remuneration as is deserved and reasonable for physical therapist services.

7C. Physical therapists shall not accept gifts or other considerations that influence or give an appearance of influencing their professional judgment.

7D. Physical therapists shall fully disclose any financial interest they have in products or services that they recommend to patients and clients.

7E. Physical therapists shall be aware of charges and shall ensure that documentation and coding for physical therapist services accurately reflect the nature and extent of the services provided.

7F. Physical therapists shall refrain from employment arrangements, or other arrangements, that prevent physical therapists from fulfilling professional obligations to patients and clients.

Principle #8: Physical therapists shall participate in efforts to meet the health needs of people locally, nationally, or globally.

(Core Value: Social Responsibility)

8B. Physical therapists shall advocate to reduce health disparities and health care inequities, improve access to health care services, and address the health, wellness, and preventive health care needs of people.

8C. Physical therapists shall be responsible stewards of health care resources and shall avoid overutilization or under- utilization of physical therapist services.

8D. Physical therapists shall educate members of the public about the benefits of physical therapy and the unique role of the physical therapist.

In 2019, the House of Delegates passed a motion that combined Core Values for the Physical Therapist (HOD P06-18-25-33) and Values-Based Behaviors for the Physical Therapist Assistant (HOD P06-18-26-34) into an amended position Core Values for the Physical Therapist and Physical Therapist Assistant (HOD P06-19-48-55). To assist the Board in responding to changes to the core values, the EJC took on the task of reviewing the Code of Ethics for the Physical Therapist (HOD S06-19-47-67) and integrating the amended core values within this document and are recommending the following edits to ensure that these documents align.

History: Originally adopted by APTA HOD June 1973. Last amended by APTA HOD June 2020.

STANDARDS OF ETHICAL CONDUCT FOR THE
PHYSICAL THERAPIST ASSISTANT

Preamble

The Standards of Ethical Conduct for the Physical Therapist Assistant (Standards of Ethical Conduct) delineate the ethical obligations of all physical therapist assistants as determined by the House of Delegates of the American Physical Therapy Association (APTA). The Standards of Ethical Conduct provide a foundation for conduct to which all physical therapist assistants shall adhere. Physical therapist assistants are guided by a set of core values (accountability, altruism, collaboration, compassion and caring, duty, excellence, integrity, and social responsibility). Throughout the document the primary core values that support specific principles are indicated in parentheses. Fundamental to the Standards of Ethical Conduct is the special obligation of physical therapist assistants to enable patients and clients to achieve greater independence, health and wellness, and enhanced quality of life.

No document that delineates ethical standards can address every situation. Physical therapist assistants are encouraged to seek additional advice or consultation in instances where the guidance of the Standards of Ethical Conduct may not be definitive. The APTA Guide for Conduct of the Physical Therapist Assistant and Core Values for the Physical Therapist and Physical Therapist Assistant provide additional guidance.

Standards

Standard #1 Physical therapist assistants shall respect the inherent dignity, and rights, of all individuals.

(Core Values: Compassion and Caring, Integrity)

1B. Physical therapist assistants shall recognize their personal biases and shall not discriminate against others in the provision of physical therapist services.

Standard #2: Physical therapist assistants shall be trustworthy and compassionate in addressing the rights and needs of patients and clients.

(Core Values: Altruism, Collaboration, Compassion and Caring, Duty)

2A. Physical therapist assistants shall act in the best interests of patients and clients over the interests of the physical therapist assistant.

2B. Physical therapist assistants shall provide physical therapist interventions with compassionate and caring behaviors that incorporate the individual and cultural differences of patients and clients.

2C. Physical therapist assistants shall provide patients and clients with information regarding the interventions they provide.

2D. Physical therapist assistants shall protect confidential patient and client information and, in collaboration with the physical therapist, may disclose confidential information to appropriate authorities only when allowed or as required by law.

Standard #3: Physical therapist assistants shall make sound decisions in collaboration with the physical therapist and within the boundaries established by laws and regulations.

(Core Values: Collaboration, Duty, Excellence, Integrity)

3A. Physical therapist assistants shall make objective decisions in the patient’s or client’s best interest in all practice settings.

3B. Physical therapist assistants shall be guided by information about best practice regarding physical therapist interventions.

3C. Physical therapist assistants shall make decisions based upon their level of competence and consistent with patient and client values.

3D. Physical therapist assistants shall not engage in conflicts of interest that interfere with making sound decisions.

3E. Physical therapist assistants shall provide physical therapist services under the direction and supervision of a physical therapist and shall communicate with the physical therapist when patient or client status requires modifications to the established plan of care.

Standard #4: Physical therapist assistants shall demonstrate integrity in their relationships with patients and clients, families, colleagues, students, research participants, other health care providers, employers, payers, and the public.

(Core Value: Integrity)

4A. Physical therapist assistants shall provide truthful, accurate, and relevant information and shall not make misleading representations.

4B. Physical therapist assistants shall not exploit persons over whom they have supervisory, evaluative or other authority (eg, patients and clients, students, supervisees, research participants, or employees).

4C. Physical therapist assistants shall not engage in any sexual relationship with any of their patients and clients, supervisees, or students.

4D. Physical therapist assistants shall not harass anyone verbally, physically, emotionally, or sexually.

4E. Physical therapist assistants shall discourage misconduct by physical therapists, physical therapist assistants, and other health care professionals and, when appropriate, report illegal or unethical acts, including verbal, physical, emotional, or sexual harassment, to an appropriate authority with jurisdiction over the conduct.

4F. Physical therapist assistants shall report suspected cases of abuse involving children or vulnerable adults to the appropriate authority, subject to law.

Standard #5: Physical therapist assistants shall fulfill their legal and ethical obligations.

(Core Values: Accountability, Duty, Social Responsibility)

5A. Physical therapist assistants shall comply with applicable local, state, and federal laws and regulations.

5B. Physical therapist assistants shall support the supervisory role of the physical therapist to ensure quality care and promote patient and client safety.

5C. Physical therapist assistants involved in research shall abide by accepted standards governing protection of research participants.

5D. Physical therapist assistants shall encourage colleagues with physical, psychological, or substancerelated impairments that may adversely impact their professional responsibilities to seek assistance or counsel.

Standard #6: Physical therapist assistants shall enhance their competence through the lifelong acquisition and refinement of knowledge, skills, and abilities.

(Core Value: Excellence)

6A. Physical therapist assistants shall achieve and maintain clinical competence.

6B. Physical therapist assistants shall engage in lifelong learning consistent with changes in their roles and responsibilities and advances in the practice of physical therapy.

6C. Physical therapist assistants shall support practice environments that support career development and lifelong learning.

Standard #7: Physical therapist assistants shall support organizational behaviors and business practices that benefit patients and clients and society.

(Core Values: Integrity, Accountability)

7A. Physical therapist assistants shall promote work environments that support ethical and accountable decision-making.

7B. Physical therapist assistants shall not accept gifts or other considerations that influence or give an appearance of influencing their decisions.

7C. Physical therapist assistants shall fully disclose any financial interest they have in products or services that they recommend to patients and clients.

7D. Physical therapist assistants shall ensure that documentation for their interventions accurately reflects the nature and extent of the services provided.

7E. Physical therapist assistants shall refrain from employment arrangements, or other arrangements, that prevent physical therapist assistants from fulfilling ethical obligations to patients and clients.

Standard #8: Physical therapist assistants shall participate in efforts to meet the health needs of people locally, nationally, or globally.

(Core Value: Social Responsibility)

8A. Physical therapist assistants shall support organizations that meet the health needs of people who are economically disadvantaged, uninsured, and underinsured.

8B. Physical therapist assistants shall advocate for people with impairments, activity limitations, participation restrictions, and disabilities in order to promote their participation in community and society.

8C. Physical therapist assistants shall be responsible stewards of health care resources by collaborating with physical therapists in order to avoid overutilization or underutilization of physical therapist services.

8D. Physical therapist assistants shall educate members of the public about the benefits of physical therapy.

History: Originally adopted by APTA HOD June 1982. Last amended by APTA HOD June 2020.

CORE VALUES FOR THE PHYSICAL THERAPIST AND PHYSICAL THERAPIST ASSISTANT

The core values guide the behaviors of physical therapists (PTs) and physical therapist assistants (PTAs) to provide the highest quality of physical therapist services. These values imbue the scope of PT and PTA activities. The core values retain the PT as the person ultimately responsible for providing safe, accessible, cost-effective, and evidence-based services; and the PTA as the only individual who assists the PT in practice, working under the direction and supervision of the PT. The core values are defined as follows:

Accountability

Accountability is active acceptance of the responsibility for the diverse roles, obligations, and actions of the physical therapist and physical therapist assistant including self-regulation and other behaviors that positively influence patient and client outcomes, the profession, and the health needs of society.

Altruism

Altruism is the primary regard for or devotion to the interest of patients and clients, thus assuming the responsibility of placing the needs of patients and clients ahead of the physical therapist’s or physical therapist assistant’s self-interest.

Collaboration

Collaboration is working together with patients and clients, families, communities, and professionals in health and other fields to achieve shared goals. Collaboration within the physical therapist-physical therapist assistant team is working together, within each partner’s respective role, to achieve optimal physical therapist services and outcomes for patients and clients.

Compassion and Caring

Compassion is the desire to identify with or sense something of another’s experience; a precursor of caring.

Caring is the concern, empathy, and consideration for the needs and values of others.

Duty

Duty is the commitment to meeting one’s obligations to provide effective physical therapist services to patients and clients, to serve the profession, and to positively influence the health of society.

Excellence

Excellence in the provision of physical therapist services occurs when the physical therapist and physical therapist assistant consistently use current knowledge and skills while understanding personal limits, integrate the patient or client perspective, embrace advancement, and challenge mediocrity.

Integrity

Integrity is steadfast adherence to high ethical principles or standards, being truthful, ensuring fairness, following through on commitments, and verbalizing to others the rationale for actions.

Social Responsibility

Social responsibility is the promotion of a mutual trust between the profession and the larger public that necessitates responding to societal needs for health and wellness.

History: Originally adopted by APTA HOD May 2007. Last amended by APTA HOD June 2019.