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Physical Therapy Licensure Compact Frequently Asked Questions 

Information on why the FSBPT is involved in developing a compact and where the FSBPT is in the process

What is an interstate compact? 

Interstate compacts are contracts between two or more states creating an agreement on a particular policy issue, adopting a certain standard or cooperating on regional or national matters.

Compacts are the most powerful, durable and adaptive tools for ensuring cooperative action among states. Unlike federally imposed mandates that often dictate unfunded and rigid requirements, interstate compacts provide a state-developed structure for collaborative action, while building consensus among states and federal partners.

Why create an interstate compact?

Reasons for creating an interstate compact include:
  • Establishing a formal, legal relationship among states to address common problems or promote a common agenda;
  • Creating independent, multistate governmental authorities—such as commissions—that can address issues more effectively than a single state agency or when no state has the authority to act unilaterally;
  • Establishing uniform guidelines, standards or procedures for agencies in the compact’s member states;
  • Creating economies of scale to reduce administrative and other costs;
  • Responding to national priorities in consultation or in partnership with the federal government;
  • Retaining state sovereignty in matters traditionally reserved for the states; and
  • Settling interstate disputes.

Why did the Federation of State Boards of Physical Therapy decide to develop a licensure compact? 

FSBPT and its member jurisdictions became concerned about the challenges that the current model of licensure brought to access to patient care in early 2010.  New care delivery models, ease of movement of consumers and providers, workforce issues, and new technologies brought opportunities for better consumer access but these opportunities often stopped at state borders.  Here is a brief look at the history of FSBPT's exploration of various ways to improve access and ultimately move toward a licensure compact: 
  • 2010: Delegate Assembly motion to look at the Nursing Licensure Compact
  • 2011:A review of the issues
  • 2012: Delegate Assembly motion to identify possible tools
  • 2013: Delegate Assembly supported moving forward with a compact
  • 2014:  FSBPT PT Compact Advisory Team determined a compact was feasible for physical therapy and would improve access to care.

Who funded the project? 

The Federation of State Boards of Physical Therapy has funded the project. FSBPT's mission is: To protect the public by providing service and leadership that promote safe and competent physical therapy practice.

Does the physical therapy professional association support the concept of a licensure compact for physical therapy? 

The American Physical Therapy Association (APTA) 2014 House of Delegates passed a motion supporting the concept of a physical therapy licensure compact.  Representatives from APTA have participated in the PT Compact Advisory Team and are also participating in the Drafting Team. 

What are the steps in developing a compact? 

The Council of State Governments (CSG)  which has expertise in interstate compacts recommends a 3 phase approach:

  1. Advisory Phase (4-6 months) Complete for PT Compact
    • Examine the issues and current policy spectrum
    • Examine best practices and alternative structures
    • Establish recommendations as to the content of an interstate compact

  2. Drafting phase (8-12 Months) Complete for PT Compact
    • Craft interstate compact solution based on Advisory Group recommendations
    • Circulate draft compact to specific states and relevant stakeholder groups for comment

  3. Education and Enactment (18 months) Ongoing
    • Drafting team considers comments and incorporates into compact
    • Final product circulated to Advisory Group
    • Released to states for consideration

What groups were represented on the PT Compact Advisory Task Force? 

Physical therapy licensing board representatives

  • Physical therapists
  • Physical therapist assistant
  • Public members
  • Administrators
  • State Senator and physical therapist
  • American Physical Therapy Association
    • Board of Directors
    • Staff

  • American Physical Therapy Health Policy and Administration Section
  • Council of State Governments (CSG) Consultants
  • Federation of State Boards of Physical Therapy
    • Board of Directors
    • Staff

Does the PT Compact include both physical therapists and physical therapist assistants?

Yes.

What other health care professions have developed or are developing a licensure compact? 

The Association of State and Provincial Psychology Boards finalized the language for their Compact (PSYPACT) in 2015and began implementation and introduction into state legislatures in 2016. In 2015, the National Association of EMS Officials (NASEMSO) and the Federation of State Medical Boards (FSMB) first introduced their licensure compacts in state legislatures. In 2000 National Council of State Boards of Nursing (NCSBN) launched their compact initiative for licensed nurses, and in 2016 they are revising some statutory language in their Compact and returning to legislatures.

Does a compact have to be adopted by each state legislature? 

Yes. Each state’s legislature must adopt the final compact language. However, compact statutes are written with a minimum number of states that must adopt in order for the compact to become operational. A compact is typically not required to have all 50 states adopt the legislation in order for it to become live. The Physical Therapy Licensure Compact requires 10 jurisdictions to pass the legislation.

How far along is the FSBPT in developing a compact? 

In 2017, the PT Compact reached the threshold requirement of 10 states to create the Compact. The rules and bylaws were finalized November 5, 2017. The database and system to support the Compact are in development. Active Compact states began issuing and accepting compact privileges July 2018.
Please see www.ptcompact.org for updates.

What is a Compact Privilege?

Compact Privilege is the authorization to work in a Compact member state other than your home state. A PT or PTA is required to have a license in the home state and meet other eligibility criteria such as having no disciplinary action against the license for at least two years. When eligibility is verified and all fees are paid, the licensee receives the Compact Privilege and may begin legally working in the other “remote” state.

  • The licensee participant must: 
    • hold one valid, current, unrestricted license his or her primary state of residence
    • notify any remote states in which s/he will be practicing 
  • The notification by the licensee participant and the payment of a any required fee gives the “Compact Privilege;” the legal authorization to work as a physical therapist or physical therapist assistant in the remote state.

To obtain a Compact Privilege, go to www.ptcompact.org

Does one Compact Privilege cover every state in which I want to work?

A licensee will need to have a Compact Privilege in each state in which he/she wants to work. A licensee may have a Compact Privilege or a license in a member state to work legally.  Non-member states will still require a license.

Is there a time limit that someone can practice on a compact privilege in a remote state? 

All compact privileges expire with the home state license.  The PT would simply need to renew the home state license and renew the compact privilege, but can practice through the entire licensure period with the Compact Privilege.

Where can I get additional information on the PT Compact? 

For the most current information on the PT Compact, go to www.ptcompact.org. If you have any additional questions, please send them to compact@fsbpt.org.