PURPOSE: This rule provides the instructions for physical therapist assistants applying for licensure via the grandfather clause. AND INSURANCE

1. (1) All applicants must be at least nineteen
2. (19) years of age.
3. (2) All applicants shall furnish satisfactory evidence as to their good moral character, education, qualifications and professional history.

4. (3) Individuals who may or may not be graduates of an associate degree program of physical therapy education accredited by the Commission on Accreditation of Physical Therapy Education who were actively engaged in practice as a physical therapist assistant on August 28, 1993, may apply for licensure within ninety (90) days after this rule is codified. Documentation of employment shall include, but not be limited to, the following:

   1. (A) Applicants must have employment verification, made under oath, submitted from their employer(s), documenting employment dates, job title, job description, employment status, name(s) of all supervisor(s), dates of supervision, type of supervision, and any other documentation requested by the board to verify employment.

5. (4) Individuals who are not graduates of an associate degree program of physical therapy education accredited by the Commission on Accreditation of Physical Therapy Education may apply for licensure by examination until ninety (90) days after this rule is codified provided that the applicant can furnish evidence that s/he has been employed in Missouri for at least three (3) of the last (5) years under the supervision of a Missouri licensed physical therapist.

   1. (A) The applicant must possess the knowledge and training equivalent to that obtained in an accredited school as determined by the board. Applicants shall submit documentation to the board as necessary to assist the board in determining the applicant’s knowledge and training as a physical therapist assistant. This documentation shall include, but not be limited to, the following:

      1. 1. Applicants must have an Employment

Verification Form, made under oath, submitted from their employer(s), documenting employment dates, job title, job description, employment status, name(s) of all supervisor(s), dates of supervision, type of supervision, and any other documentation requested by the board to verify employment; and

1. 2. Applicants must submit a Com-

petency Verification Form, made under oath, documenting any and all formal education, all educational training courses, classes, workshops, in-service trainings and seminars, internship records, employment evaluations, employment statements, student supervision forms, patient record reviews, and any other documentation requested by the board to verify competency.

1. (5) All applicants must submit a copy of any and all legal name change documents incurred since birth.
2. (6) All applicants shall have licensure, registration or certification verification submitted from every state or country in which s/he has ever held privileges to practice as a physical therapist or physical therapist assistant. This verification must be submitted directly from the licensing agency and include the type of license, registration or certification, the issue and expiration date, and information concerning any disciplinary or investigative actions.
3. (7) All applicants must submit an activities statement documenting all employment, professional and nonprofessional activities, from high school graduation to the date of licensure application.

AUTHORITY: sections 334.125, 334.650 and 334.655, RSMo Supp. 1997.* This rule originally filed as 4 CSR 150-3.130. Original rule filed Sept. 4, 1997, effective March 30, 1998. Moved to 20 CSR 2150-3.130, effective Aug. 28, 2006. *Original authority: 334.125, RSMo 1959, amended 1993, 1995; 334.650, RSMo 1996; and 334.655, RSMo 1996, amended 1997.