THE PHYSICAL THERAPY ADVISOR
A Newsletter from the Physical Therapy Advisory Committee
Oklahoma State Board of Medical Licensure and Supervision
Summer 1999
Vol 3, Number 1
PTA Supervision
by L. Vincent Lepak, III, P.T.
The Physical Therapy Advisory Committee received several inquiries about the utilization of a physical therapist assistant (PTA) performing functional capacity evaluations (FCE). A physical therapist may delegate aspects of a FCE to a PTA. First, the physical therapist must evaluate the patient and then determine what portions of the FCE to delegate to the PTA. This means that a PTA cannot initially see the patient for a screening or FCE before the physical therapist evaluates the patient. If a PTA performs portions of the FCE then the physical therapist must interpret and comment on the data gathered before other parties are privy to the information.
The limits of practice of a PTA are well defined under the Oklahoma Administrative Code 435:20-7-1(d). It states that a physical therapist assistant may not:
(1) Specify, other than to a physical therapist, perform or interpret definitive (decisive, conclusive, final) evaluative and assessment procedures. Definitive evaluation procedures may not be recommended to other than the patient's physical therapist, unless previously approved by the physical therapist.
(2) Alter overall treatment, goals and/or plan.
(3) Recommend wheelchairs, orthoses, prostheses, other assistive devices, or alterations to architectural barriers to persons other than a physical therapist.
(4) *File initial or discharge documents for permanent record until approved by a physical therapist.
(5) Perform duties or tasks for which he/she is not trained.
*The language "initial or" in this sentence is in the process of being removed to prevent any misunderstandings.
Finally, this question has come up previously and was answered by the Board
through a Declaratory Ruling. Linda Resnick, P.T. wrote about the ruling in
the first edition of the Physical Therapy Advisory in 1997 with her article
on Declaratory Ruling Clarifies Roles in Medicare Recertifications.
A copy of the article is available at the Board office.
Oklahoma Exam Statistics
July 14, 1998 through April 16, 1999
Physical Therapists
- Total Examined 104
- Passed 76
- Failed (1st attempt) 17
- Failed (2nd attempt) 8
- Failed (3rd attempt) 3
By Program
(Numbers may include retakes)
University of Oklahoma
- Total Examined 56
- Passed 45
Langston University
- Total Examined 26
- Passed 12
Other
- Total Examined 22
- Passed 19
Physical Therapist Assistants
- Total Examined 103
- Passed 89
- Failed (1st attempt) 11
- Failed (2nd attempt) 3
By Program
(Numbers may include retakes)
Tulsa Community College
- Total Examined 18
- Passed 18
Caddo Kiowa Co. Vo-Tech
- Total Examined 16
- Passed 15
Oklahoma City Community College
- Total Examined 19
- Passed 16
Carl Albert State College
- Total Examined 7
- Passed 6
Northeastern Oklahoma A&M
- Total Examined 5
- Passed 4
Murray State College
- Total Examined 16
- Passed 13
Rose State College
- Total Examined 15
- Passed 12
Other
- Total Examined 7
- Passed 5
Continuing Education Reminder
By Carla Hinkle, PTA
We are drawing to a close on the last few months of our first compliance period for continuing education for PT's and PTA's in Oklahoma. January 31, 2000 is the actual close date on the initial two-year period and we all start back at zero in counting our CEU's. Quite a few questions are circulating with reference to what counts and what doesn't. It is recommended that each licensed individual take the time to read the continuing education portion of the PT Practice Act. Albeit somewhat dry, there are a few basic elements to regard:
a) This policy affects all licensed PT's and PTA's in Oklahoma, with the only exception being those who were licensed midway through the two year compliance period (i.e., after January 31, 1999).
b) The magic number is two continuing education units (CEUs) or 20 contact hours.
c) At least 1 CEU or 10 contact hours must fall into Category A which refers to formal educational opportunities. Some of the items that qualify under Category A need to be pre-approved for guaranteed credit. Those not requiring pre-approval include APTA or component sponsored courses, courses approved by other PT committees/boards in other states, full-time course work in bachelor's, master's or doctoral PT education, or APTA specialty certifications.
d) The remaining one CEU or 10 contact hours can be of a less formal nature with many different categories of possibilities. "It is recommended that continuing education in this category be pre-approved."
Now, there is nothing about the minimum CEU requirement for PT's and PTA's that should prevent anyone from attending any course. Again, the law states the minimum and stipulates that we must seek out educational opportunities that do fill the requirements of the law. Anything over and above the minimum is "gravy".
Be sure that after attending a course that you keep on file a record of all your courses, brochures, CEU certificates and any supporting documentation in the event that you are selected in the random audit. You do not need to send in anything unless you are requested to do so in writing by the PT Committee or OSBMLS for the audit process.
The audit process will begin with letters to those selected randomly at least 60 days prior to the licensure renewal deadline. From the date of the letter, the licensee will have 30 days to submit proof of continuing education. For answers to your CEU questions please contact the office of the OSBMLS at (405) 848-6841.
The Complaint Process
The article to the right sets out the procedure for filing a complaint against a Physical Therapist or Assistant or any other professional licensed by the Board. The following is a little information about the complaint process.
The Board of Medical Licensure and Supervision is mandated by the Oklahoma Legislature to regulate the practice of physical therapy and seven other health care professions. The Board has jurisdiction only over the practices of persons licensed by the Board. It has no jurisdiction over corporations, hospitals, clinics or unlicensed persons.
Once a complaint is received by the Board, it is reviewed by one or more staff members, which may include the Director of Investigations, Board attorneys, the Board Secretary (a medical doctor) and/or the Executive Director. If it's determined that there is no violation of the practice act, the person filing the complaint is notified and the case is closed. The complaint is kept in a confidential file to be available if further related complaints on that licensee are received.
If it is possible that there has been a violation of the law, an investigator is assigned to the case and an in-depth investigation is done. After additional information is compiled, the case is reviewed again by the group of people listed above for a determination of disposition. Sometimes a case is closed at this point with no action if sufficient evidence is not found.
If there is some evidence of a violation of the law but not enough to hold up to a full evidentiary hearing, a Letter of Concern may be sent requesting the licensee meet with the Board Secretary or requesting a written response to resolve the issues brought out by the complaint.
If sufficient evidence of a violation is found, a formal Complaint and Citation may be issued requiring the licensee to appear before the Board for a full evidentiary hearing. Again, there are several possible outcomes. An agreement between the State and the licensee may be reached prior to a hearing or, after hearing the case, the Board may take one or more of the following actions:
— Dismiss the complaint due to lack of clear and convincing evidence to support the allegations;
— Reprimand the licensee;
— Probate the license under specific terms;
— Suspend the license for a specific period of time or until specific conditions for reapplication are met;
— Revoke the license.
Disciplinary action is a matter of public record and is reported to national professional databanks, federations, and other state and federal agencies. Criminal conduct is forwarded to the appropriate state or federal law enforcement agencies. By reporting violators, you are helping to protect the public health, safety and welfare as well as the integrity of your profession.
Filing Complaints
If you suspect a professional regulated by this Board has violated the laws/rules of his/her practice act, submit the information in writing. Give as much detail regarding your complaint as possible. Include any supporting documentation and names of other people (professional or lay) who may have relevant information. Send your complaint to:
Dept of Investigations
Board of Medical Licensure and Supervision
P.O. Box 18256
Oklahoma City OK 73154
Beginning in July 1999, complaints will be tracked by computer and a letter will be automatically generated acknowledging receipt of complaints. The Board hopes this will provide better response to those filing complaints. However, you still may call at any time to check on the status of your complaint. The Department of Investigations can be reached at (405) 848-6841 extension 120.
1999 Annual Meeting of the FSBPT
by Carla Hinkle, PTA
As the Delegate from Oklahoma, it was my pleasure to attend the Annual Meeting of the Federation of State Boards of Physical Therapy in San Antonio, TX. Also attending were Margy Gillispie who served as our alternate delegate, Vince Lepak who serves on the Education Committee and Linda Resnick who serves on the Exam Program Oversight Committee.
Margy and I both had quite an experience with the download of an overwhelming amount of information coming from the various projects going on within the FSBPT. These meetings are made up of PTs, PTAs and laypersons from almost every state who participate in some respect with the administration of Physical Therapy related law. Remembering that the construct of PT Practice Acts across the country are far from consistent, networking with other attendees often yields new twists and ideas about the administration of the law as well as new perspective on our common professional ethical guidelines.
Business at the Delegate Assembly (very similar to the APTAs House of Delegates but smaller) consisted of the election of new officers which concluded with the new President of the FSBPT being Blair Packard of Arizona. Much internal business was conducted that sought to clarify various policy points within the Federation. One motion that passed affected the Federation's policy of paying for reasonable ADA accommodations approved by state agencies for computer administration of the PT/PTA licensure exam. This will require 12 months notice to jurisdictions before deleting coverage for certain accommodations.
Aside from Delegate Assembly business, the continuing education portion of the meeting was quite engaging and discussions ranged from issues relating to the foreign trained PT, ADA, Professional Ethics and the Law, Continuing Competency, the Model Practice Act, Telehealth and the Healthcare Integrity & Protection Data Bank.
For more details regarding FSBPT or its Delegate Assembly actions please contact me or the OSBMLS staff.
