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Forum - Winter 2016

Table of Contents

President’s Perspective

It is an honor and a privilege to have been elected to serve as President of the Federation of State Boards of Physical Therapy. I have some rather big shoes to fill as I assume the leadership role following Maggie Donohue and the outstanding presidents that preceded her.

Maggie summarized the many accomplishments of the Federation during her tenure, and that exhaustive summary is included in this issue of the Federation Forum. We are all aware that the accomplishments of the Federation are the result of the hard work of volunteers and staff collaborating together and that very effective relationship prevails regardless of the leadership of the organization.

Administrative Staff Corner

Annual CBA Forum
This year, CBA Chair Connie Clarkston from Missouri called the Council of Board Administrators (CBA) Forum business meeting to order on Thursday, November 3, 2016 in Columbus, Ohio.

Vice Chair Mo Miskell from Colorado called roll and reported that 34 jurisdictions were present. In 2015, Mo was appointed to serve the balance of Glenn Davis’ term. The 19 jurisdictions not present were Alaska, Connecticut, Delaware, Illinois, Maine, Massachusetts, Nebraska, New Jersey, New Mexico, New York, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Utah, Vermont, Washington.

The Federation of State Boards of Physical Therapy (FSBPT) funds one administrator from each state to attend the Federation’s CBA Forum/annual meeting. Please add the 2017 annual meeting to your calendar now! It’s November 2-4, 2017 in Santa Ana Pueblo, New Mexico.

Legal Notes: What Do PT Boards Need to Know About the PT Licensure Compact Commission?

Like most compacts the Physical Therapy Licensure Compact (‘PTLC’) is ‘statutory,’ and therefore enforceable within each member state and ‘contractual’ in terms of the relationships among the member states. As a contract between the member states codified by statute, PTLC, like other compacts supersedes state laws that are inconsistent with the terms of the compact under the Contract Clause of the U.S. Constitution. Therefore, the member states may not take unilateral actions, such as the adoption of conflicting legislation or the issuance of executive orders or court rules that violate the terms of a compact.

PT Licensure Compact- The Countdown is On!

Four Down, 49 to Go! This was an interactive session with the four states to pass the Physical Therapy Licensure Compact (PTLC) in 2016: Arizona, Missouri, Oregon, and Tennessee. Meanwhile, Kentucky has been busily preparing and proactively planning for introduction of legislation of the PTLC in 2017. It takes 10 states to make the Compact operational and 2017 could be the year! The panelists shared the decision-making process to move forward with the PTLC, the preparation done to ensure a smooth introduction of the bill, and the lessons learned from their unique experiences in the legislative session. The session concluded with a question and answer session with the panel.

NPTE Remediation- To Require or Not to Require

Should your jurisdiction require remediation for candidates who fail the NPTE? Is this the responsibility of the PT board, educational program, or the candidate? This panel discussion reviewed the experiences of three jurisdictions and a PT education program. Information was shared on how jurisdictions handle remediation, including when remediation takes place, how it is tracked, and its perceived effectiveness. Additionally, panelists discussed remediation at a PT educational program and how evidence-based tools can be suggested for remediation. The panel addressed questions from the audience.

Updates from the Foreign Educated Standards Committee

This interactive workshop introduced a variety of resources available to jurisdictions and foreign-educated applicants, including the Performance Evaluation Tool for Supervised Clinical Practice and a course offered by Duke University that is designed to address deficiencies of foreign applicants specifically related to the United States healthcare system. Attendees learned about current tools available to jurisdictions, committee recommendations for best practices in initial licensure and endorsement for foreign-educated applicants, and new initiatives for 2017.

Proactive Regulation: Does Your Board Attach or React?

Beth Sarfaty, PT, MBA is vice president of Clinical Services and Quality Management, Select Medical. She is a graduate of Northeastern University with a Bachelor of Science degree in Physical Therapy, and was awarded her MBA with a concentration in Healthcare Management from Regis University. She was appointed to the New Jersey State Board of Physical Therapy Examiners in January of 2012. In both her work role, as well as being privileged to serve on the N.J. State Board, Ms. Sarfaty finds the importance of maintaining high quality care, both for the patient’s and staff’s well-being, is paramount to strong outcomes and a healthy physical therapy environment. She also stresses that emphasizing communication and relationship building is paramount in strong working teams.

The Misguided PT – Can Ethics Remediation Set Them Straight?

Boards are often perplexed regarding how to manage a licensee with professional behavior issues, including a lack of understanding of acceptable ethical behaviors. This session briefly reviewed options for modifying ethical behavior and discussed the current research on the effectiveness of those options. A clear description of the ProBE program for ethics remediation was provided with insight as to how and why it is effective in addressing the issues that Boards often find challenging to remediate.

Let’s Have a Chat about Continuing Competence

In this moderated session, representatives from Georgia, New Jersey, and New Hampshire shared their continuing competence stories. These conversations highlighted their experiences and explored how they worked through their challenges to come out on top. They explored three FSBPT products and their experiences with them: ProCert, Jurisprudence Assessment Module (JAM), and aPTitude.

Professional, Legal and Employment Issues for Physical Therapy Practitioners Who May Have a Substance Use Disorder

This presentation provided a look at the risk factors for developing a Substance Use Disorder (SUD) and recognition of the signs and symptoms of SUD. How can this come to the attention of the licensure board — by the licensee or by the filing of a complaint? The presenters discussed possible legal and licensure consequences as well as what are the structural processes for return to practice and accountability of the licensee while under a board order of reinstatement.

Competence and Engagement: Two Sides of the Same Coin?

Is competence actually an either-or process? Ask most practitioners and they will say “no”: day-to-day or moment-to-moment individuals feel more or less competent depending on context, situation, and their general mood or frame of mind. Understanding the psychology of competence drift can provide regulators, educators, employers, and practitioners with new insights into how best to manage and avoid the label of “incompetence.” This presentation reviewed recent literature exploring the role of personal and professional engagement in competence drift and focused on strategies to support practitioners across a lifetime of professional practice.

Getting to the Point- Experiences in Dry Needling Legislation and Regulation

Four states shared the very unique experiences and approaches to allowing physical therapists to perform dry needling. Representatives from Kansas, Texas, Virginia, and Washington discussed how the issue of dry needling and the professional and legal scope of physical therapist practice has been dealt with in each state.

Advancing Scope of Practice- Physical Therapists Ordering X-Rays in Wisconsin

On April 26, 2016, Governor Scott Walker signed and authorized the enactment of 2015 Wisconsin Act 375, which updated the Physical Therapy Practice Act (PTPA) to allow physical therapists (PTs) to order X-rays and also updated the Radiologic Technology Practice Act (RTPA) to allow radiologic technologists to accept X-ray orders from PTs. The presentation reviewed: the evolution of imaging as a component of PT practice; reasons for introducing this legislation in Wisconsin; stakeholder feedback during the legislative process from other medical/professional associations, insurance payers, and legislators; and the impact on rules promulgation for the Wisconsin Physical Therapy Examining Board (WPTEB).

Prior to April, Wisconsin statute stated, “Physical therapy does not include using roentgen rays of radium for any purpose, using electricity for surgical purposes, including cauterization, or prescribing drugs or devices.”