1. (a)

   1. (1) Physical therapy services address the promotion of sensorimotor function through enhancement of their musculoskeletal status, neurobehavioral organization, perceptual and motor development, cardiopulmonary status, and effective environmental adaptation and include (but are not limited to):

      1. (A) Screening, evaluation, and assessment of children to identify movement dysfunction;
      2. (B) Obtaining, interpreting, and integrating information appropriate to program planning to prevent, alleviate, or compensate for movement dysfunction and related functional problems in order to support child participation in typical child and family activities in the home, early learning environments, and community settings the child and family frequent;
      3. (C) Providing individual and, or, or both group services or to prevent, alleviate, or compensate for movement dysfunction and related functional problems; and
      4. (D) Provide consultation with parents and other caregivers to identify challenges, needs, interests, priorities, and child and family strengths in order to design intervention and parent and, or, or both caregiver training, education, coaching, and mentoring that enhances the capacity of the child’s adult caregivers to promote the child’s participation, early learning, and development between therapy sessions in accordance with 20 CAR § 1002-601.
   2. (2) Physical therapy services require a written prescription signed and dated by the child's primary care provider or attending licensed physician, documentation of PCP or attending physician’s refusal, or documentation of three (3) valid attempts to obtain the prescription.
   3. (3) Physical therapy services sessions (home and community visits or IFSP service provided outside of a child’s natural environment) must be entered into the child’s electronic record in the state-approved data system as a delivered services note within thirty (30) days of each delivered service in accordance with 20 CAR § 1002-602.
   4. (4) Physical therapy services must be performed by a licensed physical therapist or physical therapy assistant in good standing who has been certified by First Connections to provide physical therapy evaluations and services and works under the supervision of a licensed and certified physical therapist.

2. (b)

   1. (1)

      1. (A)

3. (i) Physical therapy evaluations assess the child’s functional motor abilities and ability to participate in typical daily activities as well as assess sensory motor function, musculoskeletal status, neurobehavioral organization, perceptual and motor development, cardiopulmonary status, and effective adaptation of a child to their natural environment.

   1. (ii) Physical therapy evaluations assess the child’s strengths and needs as it relates to the child’s ability to participate in typical activities.

      1. (B) Any physical therapy evaluation instrument administered must be from the state-approved list.
      2. (C) Physical therapy evaluations require a written prescription signed by the child’s primary care provider or attending licensed physician, or documentation of PCP or attending physician denial, or documentation of three (3) valid attempts to obtain the Rx.
      3. (D) Physical therapy evaluations must be performed by a licensed physical therapist in good standing who has been certified by First Connections to provide physical therapy evaluations and services.

   2. (2) Each completed physical therapy evaluation and report must be keyed into the child’s electronic record in the state-approved data system within twenty-one (21) calendar days of parent consent for the evaluation with a copy of the evaluation report attached. See 20 CAR § 1002-407.

      1. (c) To be certified by First Connections as a physical therapist or a physical therapy assistant, the individual must:
   3. (1) Hold a physical therapy or physical therapy assistant license in good standing with the Arkansas State Medical Board;
   4. (2) Complete First Connections Core Competencies for Therapists Certification course and be up to date on ongoing annual professional development and other training requirements; and

   5. (3) Enroll with the Arkansas Medicaid Program.

      1. (d) A physical therapy assistant must:
   6. (1) Be supervised by a physical therapist; and
   7. (2) Have their supervising physical therapist’s certification uploaded into state-approved data system.

4. (e)

   1. (1) A physical therapist may supervise a maximum of three (3) physical therapy assistants at any time.

   2. (2) A physical therapist must:

      1. (A) Work at the same local provider program organization as any physical therapy assistant he or she is supervising unless the Part C coordinator provides a documentation in writing of an exception to this policy to meet an urgent need of the statewide system of early intervention;
      2. (B) Upload into state-approved data system the certification of any physical therapy assistant they are supervising;

      3. (C)

         1. (i) Complete a quarterly written evaluation on each physical therapy assistant they are supervising, which must include a complete evaluation of the physical therapy assistant’s performance based on the supervising physical therapist’s in-person observation of a session with a child and parent.
         2. (ii) One (1) of the four (4) quarterly reports during each twelve-month period must be an annual written evaluation.

Codification Notes: "PCP" means primary care physician. "Rx" means prescription.