The following words, terms, and phrases, when used in the rules of the Texas Board of Physical Therapy Examiners, shall have the following meanings, unless the context clearly indicates otherwise.

1. (1) Accredited curriculum in physical therapy education--A body of courses in a physical therapy program at a school, college, or university which has satisfied the accreditation standards of the Commission on Accreditation for Physical Therapy Education.
2. (2) Accredited physical therapist assistant program--A body of courses at a school, college, or university which has satisfied the accreditation standards of the Commission on Accreditation for Physical Therapy Education.
3. (3) Evidence satisfactory to the board--Should all official school records be destroyed, sworn affidavits satisfactory to the board must be received from three persons having personal knowledge of the applicant's physical therapy education. These affidavits will not be used when official school records are available.
4. (4) Foreign-trained applicant--Any applicant whose education is from a country outside the United States, the District of Columbia, or Territories of the United States.
5. (5) Hearing--An adjudicative proceeding concerning the issuance, denial, suspension, reprimand, revocation of license, after which the legal rights of an applicant or licensee are to be determined by the board.
6. (6) On-site supervision--The physical therapist or physical therapist assistant is on the premises and readily available to respond.

7. (7) Physical therapist assistant--The supervision of the physical therapist assistant shall include the following:

   1. (A) The supervising physical therapist is responsible for and will participate in the patient's care.
   2. (B) The supervising physical therapist must be on call and readily available.
   3. (C) A current written plan of care will be formulated for each patient by the physical therapist. The plan of care shall be revised following periodic reevaluations by the physical therapist, not to exceed 30 days. The physical therapist is responsible for the content and validity of the discharge summary and must sign the discharge summary.
   4. (D) Each progress note in a patient's chart made by a physical therapist assistant must include the name of the supervising physical therapist.

   5. (E) The physical therapist may assign responsibilities to the physical therapist assistant to:

      1. (i) provide physical therapy services as specified in the written plan of care developed by the physical therapist prior to treatment by a physical therapist assistant which includes:

         1. (I) preparing patients, treatment areas, and equipment;
         2. (II) implementing treatment programs that include therapeutic exercises; gait training and techniques; ADL training techniques; administration of therapeutic heat and cold; administration of ultrasound; administration of therapeutic electric current; administration of ultraviolet; application of traction; performance of intermittent venous compression; application of external bandages, dressings, and support; performance of goniometric measurement;
         3. (III) modifying treatment techniques as indicated in the plan of care;
      2. (ii) respond to acute changes in physiological state;
      3. (iii) teach other health care providers, patients, and families to perform selected treatment procedures and functional activities;
      4. (iv) identify architectural barriers;

      5. (v) interact with patients and families in a manner which provides the desired psycho-social support by:

         1. (I) recognizing his own reaction to illness and disability;
         2. (II) recognizing patients' and families' reactions to illness and disability;
         3. (III) respecting individual cultural, religious, and socioeconomic differences in people;
         4. (IV) utilizing appropriate communicative processes;
      6. (vi) demonstrate appropriate and effective written, oral, and nonverbal communication with patients and their families, colleagues, and the public;
      7. (vii) recognize his own strengths and limitations and interpret for others his scope and function;
      8. (viii) demonstrate safe, ethical, and legal practice;
      9. (ix) understand basic concepts related to the health care system, including multidisciplinary team approach, quality care, governmental agencies, private sector, role of other health care providers, health care facilities, issues, and problems;
      10. (x) understand basic principles of levels of authority and responsibility, planning, time management, supervisory process, performance evaluations, policies and procedures, and fiscal consideration (provider and consumer).

   6. (F) The physical therapist assistant may not:

      1. (i) specify and/or perform definitive (decisive, conclusive, final) evaluative and assessment procedures; however, physical therapist assistants may screen patients designated by the physical therapist by gathering information using a uniform predetermined format and reporting the findings on all patients screened to the physical therapist. Further intervention will be determined by the physical therapist;
      2. (ii) alter a plan of care or goals;
      3. (iii) recommend wheelchairs, orthoses, prostheses, other assistive devices, or alterations to architectural barriers to persons;
      4. (iv) sign progress notes which include assessments used to design or modify patient care.
8. (8) Physical therapy--The evaluation, examination, and utilization of exercises, rehabilitative procedures, massage, manipulations, and physical agents including, but not limited to, mechanical devices, heat, cold, air, light, water, electricity, and sound in the aid of diagnosis or treatment. Physical therapists may perform evaluations without referrals. Physical therapy practice includes the use of modalities, procedures, and tests to make evaluations. Physical therapy practice includes, but is not limited to the use of: Electromyographic (EMG) Tests, Nerve Conduction Velocity (NCV) Tests, Thermography, Transcutaneous Electrical Nerve Stimulation (TENS), bed traction, application of topical medication to open wounds, sharp debridement, provision of soft goods, inhibitive casting and splinting, Phonophoresis, Iontophoresis, and biofeedback services.

9. (9) Physical therapy aide--All rules governing the direction of the physical therapist assistant are further modified for the physical therapy aide.

   1. (A) The physical therapist or physical therapist assistant is responsible for the supervision of the physical therapy aide.
   2. (B) The physical therapy aide may support physical therapy activities within the scope of on-the-job training and with on-site supervision by a physical therapist or physical therapist assistant within reasonable proximity of the physical therapy aide. The physical therapist or physical therapist assistant must interact with the patient regarding the patient's condition, progress and/or achievement of goals during each treatment session.

   3. (C) The physical therapy aide may not:

      1. (i) evaluate, assess, and/or initiate physical therapy treatment including exercise instruction; or
      2. (ii) write or sign physical therapy documents in the permanent record. However, an aide may record quantitative data for tasks delegated by the supervising PT or PTA. Any document reflecting aide activities must identify the aide and the supervising PT or PTA.
10. (10) Supervision--The delegation and continuing direction by a person or persons responsible for the practice of physical therapist, physical therapist assistant, or physical therapy aide as specified in the Physical Therapy Practice Act.

Source Note:The provisions of this §321.1 adopted to be effective March 1, 1986, 11 TexReg 719; amended to be effective September 28, 1988, 13 TexReg 4575; amended to be effective December 12, 1989, 14 TexReg 6277; amended to be effective January 7, 1992, 16 TexReg 7644; amended to be effective January 12, 1993, 18 TexReg 63; amended to be effective November 11, 1993, 18 TexReg 7545; amended to be effective November 6, 1995, 20 TexReg 8793; amended to be effective May 8, 1996, 21 TexReg 3794; amended to be effective July 9, 1996, 21 TexReg 6078; amended to be effective April 28, 1997, 22 TexReg 3588; amended to be effective October 6, 1998, 23 TexReg 9978.