CHAPTER 6

LICENSURE AND REGISTRATION REQUIREMENTS

Section 1. Scope of Practice.

1. (a) Physical Therapist. Pursuant to W.S. §33-25-102 a physical therapist may participate in educational or evaluation activities without the authority, supervision, or prescription of a physician, dentist or podiatrist. Regardless of the setting in which the service is provided; the following shall be the sole responsibility of the physical therapist:

   1. (i) Before initiating any individual intervention program designed to prevent, correct, alleviate or limit a physical disabil- ity, a physical therapist must obtain a prescription of a practitioner or be under the authority or supervision of a practitioner;
   2. (ii) Interpretation of referrals;
   3. (iii) Initial examination, problem identification, and diag- nosis for physical therapy;
   4. (iv) Development or modification of a plan of care that is based on the initial examination and includes the goals for physical therapy intervention;
   5. (v) Determination of which tasks require the expertise and decision-making capacity of the physical therapist and must be person- ally rendered by the physical therapist, and which tasks may be del- egated;
   6. (vi) Assurance of the qualifications of all assistive per- sonnel to perform assigned tasks through written documentation of their education or training that is maintained and available at all times;
   7. (vii) Delegation and instruction of the services to be ren- dered by the physical therapist assistant, or other assistive person- nel, including, but not limited to, specific tasks or procedures, precautions, special problems and contraindicated procedures;
   8. (viii) Timely review of documentation, reexamination of the patient and revision of the plan of care when indicated;
   9. (ix) Establishment of a discharge plan;
   10. (x) Reassessment of the patient's status, and personal rendering of treatment to a patient at least every thirty-one (31) days;

2. (b) Foreign-Trained Physical Therapist. Foreign-trained physi- cal therapist applicants shall satisfactorily complete a period of service not to exceed one (1) year under the direct supervision of a licensed physical therapist in a physical therapy setting or in an institution either of which have been approved by the Board. The Board may waive all or any portion of the required period of service based on a favorable written report provided by the applicant's direct supervisor, or if the supervisory requirement has been met in another state;

   1. (i) It is recommended that all three of the following pass- ing scores on the respective examinations be requirements for licen- sure for a all candidates who have not graduated from a U.S. program accredited by CAPTE: Test of English as a Foreign Language (TOEFL): 560; Test of Written English (TWE): 4.5; Test of Spoken English (TSE); 50;

      1. (A) Individuals who meet both of the following condi- tions may be exempt from this requirement for language proficiency testing; 1) The native language of the country of origin is English.

         2) Graduation from a PT program which was conducted in English.

   2. (ii) The scope of practice requirements are identical to those found in Section 1(a) of this Chapter except that:

      1. (A) A supervising physical therapist shall be acces- sible by telecommunications to the temporary physical therapist at all times while treating patients.

3. (c) Physical Therapist Assistant. A Physical Therapist Assis- tant shall only practice under the supervision of a permanently li- censed physical therapist.

   1. (i) A supervising physical therapist shall be accessible by telecommunications to the physical therapist assistant at all times while treating patients.
   2. (ii) An initial visit shall be made by a supervising physi- cal therapist for evaluation of the patient and establishment of a plan of care.
   3. (iii) A joint visit by a supervising physical therapist and physical therapist assistant shall be made on the first physical therapist assistant visit to the patient.
   4. (iv) The ratio of supervising physical therapist to physical therapist assistants shall not exceed one (1) physical therapist to three (3) physical therapist assistants.
   5. (v) At least once every thirty-one (31) days, there shall be a joint on-site visit or a treatment visit rendered by a supervis- ing physical therapist. Every thirty-one (31) days a documented con- ference by a supervising physical therapist with the physical thera- pist assistant outlining current treatment goals and program modifica- tions shall occur.

   6. (vi) A supervisory visit should include:

      1. (A) A complete on-site functional assessment;
      2. (B) On-site review of activities with appropriate revision or termination of plan of care; and
      3. (C) Assessment of utilization of outside resources.

4. (d) Assistive Personnel. Assistive personnel may perform pa- tient care activities under the on-site supervision of a licensed physical therapist or a registered physical therapist assistant.

   1. (i) Physical therapists are responsible for the activities of the physical therapy assistive personnel when performing delegated activities. The physical therapist is responsible for maintaining documentation of the current level and training of the assistive per- sonnel. The Board has the authority to enter the premises of a lic- ensee to inspect their documentation on assistive personnel.
   2. (ii) Physical therapy assistive personnel shall perform patient care activities under on-site supervision of a licensed physi- cal therapist or registered physical therapist assistant. On-site supervision means the supervising physical therapist or physical therapist assistant must:
   3. (a) be continuously on-site and present in the depart- ment or facility where the assistive personnel are performing ser- vices; and
   4. (b) be immediately available to assist the person being supervised in the services being performed; and
   5. (c) maintain continued involvement in which a compo- nent of treatment is delegated to assistive personnel.
   6. (iii) A physical therapist may supervise no more than three
   7. (3) assistive personnel.
   8. (iv) A physical therapist assistant may supervise no more than one (1) assistive personnel.