Citations Affected: IC 25-10; IC 25-27.
Synopsis: Physical therapy. Allows a physical therapist who meets
certain conditions to provide subsequent treatment to a patient who was
previously referred to the physical therapist for the same condition if
the referral was not more than12 months old and requires the physical
therapist to contact the individual's appropriate provider within three
days after the physical therapist provides treatment to the individual.
Allows a specified physical therapist to evaluate a patient without a
referral and requires the physical therapist to contact the patient's
provider within three days before providing treatment. Specifies when
a psychologist may refer a patient to a physical therapist. Allows a
physical therapist to perform debridement only under specified
circumstances.
Effective: July 1, 2004.
January 12, 2004, read first time and referred to Committee on Health and Provider
Services.
January 29, 2004, amended, reported favorably _ Do Pass.
February 2, 2004, read second time, amended, ordered engrossed.
A BILL FOR AN ACT to amend the Indiana Code concerning
professions and occupations.
SECTION 1. IC 25-10-1-1.5 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2004]: Sec. 1.5. (a) There is created
a board of chiropractic examiners. The board shall consist of seven (7)
members appointed by the governor, not more than four (4) of whom
may be affiliated with the same political party. Six (6) of the board
members must be licensed under this chapter and must have had at
least five (5) years of experience as a chiropractor prior to their
appointment. One (1) member is to represent the general public and
must be:
(1) a resident of this state; and
(2) in no way associated with the profession of chiropractic other
than as a consumer.
(b) All members shall be appointed for a term of three (3) years and
serve until their successors are appointed and qualified. A vacancy
occurring on the board shall be filled by the governor by appointment.
Each appointed member shall serve for the unexpired term of the
vacating member.
chapter.
(9) Establish a code of professional conduct.
(10) Adopt rules under IC 4-22-2 to allow chiropractors licensed
under this chapter to delegate the manual manipulation, manual
adjustment, or manual mobilization of the spinal column or the
vertebral column under section 14(c)(4) 14(d)(4) of this chapter.
(11) Adopt rules under IC 4-22-2 establishing standards for the
registration and regulation of chiropractic management
consultants (as defined by the board under IC 25-10-2).
(12) Set fees for the annual registration of a chiropractic
management consultant under IC 25-10-2.
(g) The board shall adopt rules establishing standards for the
competent practice of the science of the chiropractic in accordance
with IC 4-22-2.
(h) All expenses incurred in the administration of this chapter shall
be paid from the state general fund upon appropriation being made in
the manner provided by law for the making of appropriations.
SECTION 2. IC 25-10-1-14 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2004]: Sec. 14. (a) This section
applies to all persons, including persons listed in IC 25-22.5-1-2.
(b) As used in this section, "manual adjustment" means a
manual or mechanical intervention that may have velocity, lever,
amplitude, or recoil and that:
(1) may carry a joint complex beyond the normal
physiological range of motion;
(2) is applied without exceeding the boundaries of anatomical
integrity of the joint complex or other articulations; and
(3) is intended to result in a cavitation of the joint or a
reduction of a subluxation.
(c) A person may manually manipulate, manually adjust, or
manually mobilize the spinal column or the vertebral column of an
individual only if the person is:
(1) a chiropractor who has been issued a license under this
chapter;
(2) a physician who has been issued an unlimited license to
practice medicine under IC 25-22.5; or
(3) an osteopathic physician who has been issued a license to
practice osteopathic medicine under IC 25-22.5.
(c) (d) A person may not delegate the manual manipulation, manual
adjustment, or manual mobilization of the spinal column or the
vertebral column of an individual to another person, unless the other
person is:
advisory services for the purpose of preventing or reducing the
incidence and severity of physical disability, bodily
malfunction, and pain.
(2) "Physical therapist" means a person who practices physical
therapy as defined in this chapter.
(3) "Physical therapist's assistant" means a person who assists in
the practice of physical therapy as defined in this chapter.
(4) "Board" refers to the medical licensing board.
(5) "Committee" refers to the Indiana physical therapy committee
established under section 4 of this chapter.
(6) "Person" means an individual.
(7) "Manual therapy" means a group of techniques
comprising a continuum of skilled passive movements to the
joints or related soft tissues throughout the normal range of
physiological motion that are applied at varying speeds and
amplitudes without engaging in a technique that is intended
to result in a cavitation of the joint or a reduction of a
subluxation.
SECTION 4. IC 25-27-1-2 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2004]: Sec. 2. (a) Except as
otherwise provided in this chapter, it is unlawful for a person to
practice physical therapy or to profess to be a physical therapist,
physiotherapist, or physical therapy technician or to use the initials
"P.T.", "P.T.T.", or "R.P.T.", or any other letters, words, abbreviations,
or insignia indicating that the person is a physical therapist, or to
practice or to assume the duties incident to physical therapy without
first obtaining from the board a license authorizing the person to
practice physical therapy in this state.
(b) Except as provided under section 2.5 of this chapter, it is
unlawful for a person to practice physical therapy other than upon the
order or referral of a physician, podiatrist, psychologist (only as
allowed under subsection (e)), chiropractor, or dentist holding an
unlimited license to practice medicine, podiatric medicine, psychology,
chiropractic, or dentistry, respectively. It is unlawful for a physical
therapist to use the services of a physical therapist's assistant except as
provided under this chapter. For the purposes of this subsection, the
function of:
(1) teaching;
(2) doing research;
(3) providing advisory services; or
(4) conducting seminars on physical therapy; or
(5) conducting an initial evaluation and providing fitness and
wellness services to an asymptomatic individual in a
nonmedical setting;
is not considered to be a practice of physical therapy.
(c) Except as otherwise provided in this chapter, it is unlawful for
a person to act as a physical therapist's assistant or to use initials,
letters, words, abbreviations, or insignia indicating that the person is a
physical therapist's assistant without first obtaining from the board a
certificate authorizing the person to act as a physical therapist's
assistant. It is unlawful for the person to act as a physical therapist's
assistant other than under the direct supervision of a licensed physical
therapist who is in responsible charge of a patient or under the direct
supervision of a physician. However, nothing in this chapter prohibits
a person licensed or registered in this state under another law from
engaging in the practice for which the person is licensed or registered.
These exempted persons include persons engaged in the practice of
osteopathy, chiropractic, or podiatric medicine.
(d) Except as provided in section 2.5 of this chapter, this chapter
does not authorize a person who is licensed as a physical therapist or
certified as a physical therapist's assistant to:
(1) evaluate any physical disability or mental disorder except
upon the order or referral of a physician, podiatrist, psychologist,
chiropractor, or dentist;
(2) practice medicine, surgery (as described in
IC 25-22.5-1-1.1(a)(1)(C)), dentistry, optometry, osteopathy,
psychology, chiropractic, or podiatric medicine; or
(3) prescribe a drug or other remedial substance used in medicine.
(e) A psychologist may only refer a patient to a physical
therapist under this chapter for treatment directly related to a
condition:
(1) for which the psychologist is treating the individual; and
(2) that is under the psychologist's scope of practice described
in IC 25-33-1.
SECTION 5. IC 25-27-1-2.5 IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2004]: Sec. 2.5. (a) A physical therapist may provide subsequent
treatment to an individual who was previously referred to the
physical therapist for the same condition if the referral was not
more than twelve (12) months before the date the individual
requests subsequent treatment from the physical therapist. The
physical therapist shall consult with the individual's physician not
later than three (3) days after the physical therapist provides
treatment to the individual under this subsection.
(b) This subsection applies to a physical therapist who has at
least one (1) year experience in the actual practice of physical
therapy as a licensed physical therapist. If an individual does not
meet the requirements set forth in subsection (a), a physical
therapist may evaluate the individual without a referral from a
provider described in section 2(b) of this chapter. However, the
physical therapist shall contact the individual's appropriate
provider for a referral not later than three (3) business days after
the physical therapist evaluates the individual but before the
physical therapist provides treatment to the individual.
(c) A physical therapist providing an evaluation or treatment
under this section may not delegate the physical therapist's duties
to a person who is not a physical therapist licensed under this
article.
SECTION 6. IC 25-27-1-3.5 IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2004]: Sec. 3.5. A physical therapist may not perform
debridement unless the physical therapist performing the
debridement is acting upon the order and referral of a physician
licensed under:
(1) IC 25-22.5; or
(2) IC 25-29.