STATE PHYSICAL THERAPY BOARD POLICIES Table of Contents Delegated Authority ........................................................................................................................................... 2 Dry Needling ...................................................................................................................................................... 4 Process for Handling Initial Decisions Rendered by an Administrative Law Judge (ALJ) ............................... 5 Cases Dismissed with Confidential Letters of Concern ..................................................................................... 6 Process for Handling Complaints Involving State Physical Therapy Board ...................................................... 7 Scope of Physical Therapy Practice ................................................................................................................... 8 Streamlining Physical Therapist Assistant credentials for veterans. .................................................................. 9

1 State Physical Therapy Board Policies

Title: Delegated Authority Date Issued: January 13, 2012; Revised October 12, 2012; Revised May 16, 2014 Purpose: Outline the authority delegated to the Program Director in carrying out the Board’s duties.

The Board delegates to the Program Director or designee the authority to: 1. Perform the initial review of complaints relating to the practice of persons under the Board’s jurisdiction and to initiate complaints where otherwise authorized by the Board. 2. Initiate the investigation of a complaint without a Board meeting when a complaint has been received in the office that should not wait for the next scheduled meeting. If this occurs, the complaint will be placed on the agenda for the next meeting for full Board review and ratification. 3. Initiate complaints against those currently under Stipulation or other Final Board Order if, in the opinion of the Program Director or designee, the licensee has failed to comply with any of the terms of the Board Order. 4. Sign and issue subpoenas and otherwise gather information in order to assist the investigation of Board matters. The Office of the Attorney General is authorized to enforce the subpoena. 5. Utilize services of the Office of Investigations as warranted to carry out duties of the Board. 6. Sign Letters of Concern, Letters of Admonition, Cease and Desist Orders, Stipulations, Suspension Orders, Suspension Orders as required by the Child Support Enforcement Program, Final Board Orders, and other formal actions of the Board, once approved by the Board. 7. Suspend and reinstate the licenses of practitioners who are in violation and subsequently in compliance of the Child Support Enforcement Act as notified by the Colorado Department of Human Services. 8. Grant or deny extensions to due dates set forth in procedural rules, and respond to other procedural matters that may arise. 9. Issue the Board’s Procedural Order Regarding Review of Initial Decision, which the Program Director or designee shall issue upon receipt of all initial decisions. 10. Employ administrative law judges on a full-time or part-time basis to conduct any hearings that are necessary. 11. Share information with other licensing or law enforcement agencies on matters pursuant to sections 12-41-115 and 12-41-116, C.R.S. 12. Coordinate and conduct public rulemaking hearings.

2 State Physical Therapy Board Policies

13. Issue and renew licenses that meet statutory requirements. The Board will review applications where there is uncertainty if requirements have been met. At each meeting, the Board will be asked to ratify a list of the applicants administratively licensed since the previous meeting. 14. Approve continuing education coursework or other professional development activities as submitted by those applicants seeking licensure/certification by endorsement after consultation with the Board President or other designated Board person. 15. Approve continuing education coursework or other professional development activities for Stipulations after consultation with the Board President or other designated Board person. 16. Issue appropriate discipline to expired licenses including confidential letters of concern. 17. Coordinate and set the agenda for Board meetings. 18. Provide timely information and notice to Board members on matters concerning the status of legislative bills that may affect the Board’s operation, ability to carry out its duty, and the intent of its statutes. 19. Process reports of settlement of malpractice claims in the same manner as signed complaints are handled. 20. Perform additional delegated duties as set forth in other Board policies.

3 State Physical Therapy Board Policies

Title: Dry Needling Date Issued: March 21, 2014 Purpose: Clarify the dry-needling education requirement in Board Rule 211.D.2

If the required course of at least 46 hours of in-person dry needling training is broken up into more than one part, then a licensed physical therapist is permitted the limited practice of dry needling once he or she has completed each part of the training as long as such practice is confined to the scope of the training already successfully completed, and with the understanding that all parts of the coursework will be successfully completed within 2 years of the start date of the course. If the licensee has not completed at least 46 hours of in-person dry needling training within 2 years, then he/she must stop performing dry-needling at any level until he/she has completed at least 46 hours. Once the licensed physical therapist has completed a minimum of 46 hours of in-person training in dry needling, then he or she may practice dry needling fully and without limitation as allowed in a physical therapist’s scope of practice and commensurate with his or her knowledge, skill, ability, and competency.

4 State Physical Therapy Board Policies

Title: Process for Handling Initial Decisions Rendered by an Administrative Law Judge (ALJ) Date Issued: May 16, 2014 Purpose: To provide a written Board Procedural Order Regarding Review of Initial Decision to parties involved in a case or cases before the Board, which initiates review of the Initial Decision on the Board’s own motion, provides general filing requirements, provides applicable deadlines and procedures, and covers ex parte communications and additional relevant information for the parties.

It is the policy of the State Physical Therapy Board that any Initial Decision of an Administrative Law Judge (ALJ) from the Office of Administrative Courts (OAC) will be appropriately served with the approved Board Procedural Order Regarding Review of Initial Decision (“Order”) upon parties involved in a case or cases before the Board. The Board delegates authority to the Program Director or his/her designee to issue procedural orders for the Board, and to rule upon motions, including but not limited to requests for extensions of time for good cause. The Board further delegates authority to the Deputy Director or his/her designee and the prosecuting attorney to determine whether or not to file exceptions on behalf of the Board.

5 State Physical Therapy Board Policies

Title: Cases Dismissed with Confidential Letters of Concern Date Issued: May 16, 2014 Purpose: To clarify the basis for this type of dismissal, when the Board may reopen such a case and designation of a specific retention period for these types of cases.

It is the policy of the State Physical Therapy Board that complaints which are dismissed with confidential letters of concern are not dismissed as being without merit but rather are dismissed due to no reasonable cause to warrant further action at that time. Cases that are dismissed with a confidential letter of concern will be retained in the Board’s files for a period of five years. The Board may reopen a case that was dismissed with a confidential letter of concern in the face of a change in circumstances. Such a change in circumstances would include but not be limited to: 

Discovery of new evidence supporting the underlying charges; and/or



Evidence that the licensee/certification holder has engaged in further unprofessional conduct/grounds for discipline following issuance of the confidential letter of concern in which there is a nexus between the new conduct and that which was addressed in the case that was dismissed with the confidential letter of concern.

After five years from the date of the confidential letter of concern, the file will be disposed of in accordance with the Division’s records management procedures. If the licensee/certification holder has other active cases pending at the end of the five year retention period, the confidential letter of concern may be kept for a longer period of time at the discretion of the Board staff.

6 State Physical Therapy Board Policies

Title: Process for Handling Complaints Involving State Physical Therapy Board Date Issued: May 16, 2014 Purpose: To assure the integrity of the disciplinary process and prevent any appearance of (“Board”) Members bias or preferential treatment.

It is the policy of the State Physical Therapy Board that any signed complaint received by the Board against a physical therapist who is currently serving as a Board member or one who has served on the Board within the past 5 years, or a physical therapist who has an ongoing formal relationship with the Board, will be handled as follows if the complaint alleges: 1. A violation of the Physical Therapy Practice Act - the complaint will be sent to the Office of Investigations within the Division of Professions and Occupations for processing; or 2. Substandard practice – the Office of Investigations will process the complaint and also have the case reviewed by an independent physical therapist consultant selected by the Office of Investigations. Upon completion of the investigation, the report of investigations will be referred back to the Board for review, discussion, and appropriate action.

7 State Physical Therapy Board Policies

Title: Scope of Physical Therapy Practice Date Issued: March 21, 2014 Purpose: Clarifying scope of practice for physical therapists authorized by statute

A licensed physical therapist may order or perform, with clinical justification, any diagnostic imaging which is within the recognized standards of the practice of physical therapy, including magnetic resonance imaging (MRI).

8 State Physical Therapy Board Policies

Title: Streamlining Physical Therapist Assistant credentials for veterans. Date Issued: References:

May 19, 2017 Colorado HB 16-1197; CRS 24-34-102 (8.5), 12-41-205, and 12-41-206; State Physical Therapy Board Rules and Regulations, Rule 102, Rule 103, Rule 104, Rule 303, and Rule 305.

Purpose: To determine substantial equivalence for Physical Therapist Assistant education and/or experience gained in military service and provide direction on certification, so as to fulfill HB 16-1197. ______________________________________________________________________________

POLICY: Veterans with education and/or experience equivalent to Physical Therapist Assistant certification requirements, as outlined in State Physical Therapy Board Rules and Regulations may request the State Physical Therapy Board (Board) evaluate submitted documents for equivalency. To qualify for a Physical Therapist Assistant certification, applicants must meet the requirements listed in State Physical Therapy Board Rules and Regulations. Items 1-6 outline process requirements for this policy.

1. Education, training, or service gained in military services outlined in section 24-34-102(8.5), C.R.S., that is to be accepted and applied towards receiving a certification must be substantially equivalent, as determined by the Board, to the qualifications otherwise applicable at the time of the receipt of the application. It is the applicant’s responsibility to provide timely and complete evidence of the education, training, and/or service gained in the military for review and consideration. Satisfactory evidence of such education, training, or service will be assessed on a case-by-case basis. 2. The Division of Professions and Occupations (Division) will evaluate the extent to which veteran applicants meet Physical Therapist Assistant certification requirements listed in State Physical Therapy Board Rules and Regulations.i 3. For reciprocity consideration, veteran applicants who do not currently have a revoked, suspended, restricted, or conditional license, certification, or registration to practice as a Physical Therapist Assistant, or is currently pending disciplinary action against such license, certification, or registration in another state or territory of the United States, must apply for certification by endorsement as found in State Physical Therapy Board Rules and Regulations, Rule 305.ii Veteran applicants who meet Rule 305 requirements may be certified by the Division’s Office of Licensing and later ratified by the Board. 4. Veteran applicants not qualified for certification by endorsement must apply for certification by examination as found in State Physical Therapy Board Rules and Regulations, Rule 303.iii Veteran applicants who meet Rule 303 requirements may be certified by the Division’s Office of Licensing and later ratified by the Board. 9 State Physical Therapy Board Policies

5. Veteran applicants applying for certification by examination or by endorsement that are found not to meet Physical Therapist Assistant education requirements will be assisted by Division staff who will provide recommendations regarding deficiencies in education that may be addressed through enrollment and successful completion of a Commission on Accreditation in Physical Therapy Education approved Physical Therapist Assistant training program located in Colorado.iv 6. The examination developed by Federation of State Boards of Physical (FSBPT) entitled the National Physical Therapy Examination for physical therapist assistants is approved as the required examination in the certification process. An applicant must achieve a passing score as determined by FSBPT in order to be eligible for certification as a Physical Therapist Assistant.v Fulfills Colorado HB 16-1197 requirement to “evaluate the extent to which military training meets all or part of the state requirements to be authorized to practice an occupation.” ii Fulfills Colorado HB 16-1197 requirement to “identify reciprocity mechanisms with other states.” iii Fulfills Colorado HB 16-1197 requirement to “determine if an occupational exam is available to authorize a veteran to practice an occupation.” iv Fulfills Colorado HB 16-1197 requirement to “consult with Community Colleges and other post-secondary educational institutions with regard to a) courses or programs to cover the gap between military occupational specialty training and the training required to be authorized to practice an occupation, and b) refresher courses for the reinstatement of lapsed civilian credentials.” v Fulfills Colorado HB 16-1197 requirement to “consider adopting a national credentialing exam.” i

10 State Physical Therapy Board Policies

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