Article 29.--PHYSICAL THERAPY

K.A.R. 100-29-1. Applications. (a) Each individual seeking licensure as a physical therapist or certification as a physical therapist assistant shall submit a completed application on a form provided by the board and shall include the following information in plain, legible writing:
(1) The applicant's full name;
(2) the applicant's social security number or individual tax identification number;
(3) the applicant's business address. If the applicant's business address is different from the applicant's residential address, the applicant shall also provide the residential address;
(4) the applicant's home and business telephone numbers;
(5) the applicant's date and place of birth;
(6) the name of an educational program recognized under K.A.R. 100-29-2 from which the applicant graduated, the degree awarded to the applicant, and the date of graduation;
(7) information regarding any licenses, registrations, or certifications issued to the applicant to practice as a physical therapist or physical therapist assistant;
(8) information regarding any prior acts specified in K.S.A. 65-2912, and amendments thereto, that could constitute grounds for denial of the application;
(9) a notarized release authorizing the board to receive any relevant information, files, or records requested by the board in connection with the application; and
(10) the number of times the applicant has taken the examination required by the board for licensure or certification, including the state where the examination was taken, each date that the examination was taken, and each examination score.
(b) Except as specified in subsection (d), each applicant shall submit the following with the application:
(1) The fee required by K.A.R. 100-29-7;
(2)(A)(i) A transcript from an educational program recognized by the board under K.A.R. 100-29-2; and
(ii) a notarized copy of a diploma from a recognized educational program; or
(B) a final transcript showing the degree awarded from an educational program recognized by the board under K.A.R. 100-29-2;
(3) a verification on a form provided by the board of each license, registration, or certification issued to the applicant by any state or the District of Columbia relating to physical therapy;
(4) a current photograph, three by four inches in size, of the applicant’s head and shoulders taken within 90 days before the date the application is received by the board; and
(5) the results of a written examination recognized and approved by the board under K.A.R. 100-29-4, which shall be provided directly to the board from the testing entity.
(c) The applicant shall sign the application under oath.
(d) Any applicant who cannot provide the documents required by paragraph (b)(2) may arrange for a certificate to be provided directly to the board by a recognized educational program, showing the program that the applicant attended, the dates of attendance, the degree obtained, and the date of graduation.
(e) The physical therapy advisory council shall consider the application from each person who has not been engaged in an educational program recognized by the board and has not engaged in the practice of physical therapy during the five years preceding the date of the application. The council shall then make its recommendation to the board. (Authorized by K.S.A. 2004 Supp. 65-2911; implementing K.S.A. 2004 Supp. 65-2903, 65-2906, and 65-2912; effective March 21, 1997; amended May 26, 2006.)

K.A.R. 100-29-2. Approval of physical therapy programs. (a) An educational program for licensure as a physical therapist shall be recognized by the board if the program meets the "evaluative criteria for accreditation of education programs for the preparation of physical therapists," revised April 2005 by the commission on accreditation in physical therapy education and hereby adopted by reference.
(b) An educational program for certification as a physical therapist assistant shall be recognized by the board if the program meets the "evaluative criteria for accreditation of education programs for the preparation of physical therapy assistants," adopted November 1, 2000 by the commission on accreditation in physical therapy education and hereby adopted by reference. (Authorized by K.S.A. 2005 Supp. 65-2911; implementing K.S.A. 2005 Supp. 65-2906; effective March 21, 1997; amended July 14, 2006.)

K.A.R. 100-29-3. Requirements for physical therapists and physical therapist assistants from nonapproved schools. (a) Each person who received training from a nonapproved school and who applies for licensure as a physical therapist or certification as a physical therapist assistant, shall submit with the application an evaluation prepared for the state of Kansas by a board-approved credentialing agency.
(b) If the evaluation shows that the applicant's educational program did not meet the criteria that a school is required to satisfy to be approved by the board, the applicant may be required by the board, with the advice of the physical therapy advisory council, to perform one of the following:
(1) Complete college courses in the areas that did not meet the required criteria with a grade average of at least "B" or its equivalent; or
(2) apply college-level examination program scores towards semester credit hours for the courses specified by the board. (Authorized by K.S.A. 2004 Supp. 65-2911; implementing K.S.A. 2004 Supp. 65-2906 ; effective March 21, 1997; amended May 26, 2006.)

K.A.R. 100-29-3a. Examination of written and oral English communication. (a) For applicants who received training in a school at which English was not the language of instruction the examinations required and approved by the board to demonstrate the ability to communicate in written and oral English, shall be the test of English as a foreign language and the test of spoken English developed and administered by the educational testing service (ETS).
(b) To successfully pass the test of English as a foreign language, each applicant who is required to take this examination shall attain a score of at least 550.
(c) To successfully pass the test of spoken English each applicant who is required to take this examination shall attain a score of at least 50. (Authorized by K.S.A. 65-2911; implementing K.S.A. 1997 Supp. 65-2906 and K.S.A. 65-2909; effective Sept. 11, 1998.)

K.A.R. 100-29-4. Examination. (a) The examination required and approved by the board for licensure as a physical therapist shall be the physical therapist examination developed by the federation of state boards of physical therapy.
(b) The examination required and approved by the board for certification as a physical therapist assistant shall be the physical therapist assistant examination developed by the federation of state boards of physical therapy.
(c) To pass the examination for licensure or certification, each physical therapist and physical therapist assistant shall attain a criterion-referenced scaled score of at least 600 on a scale ranging from 200 to 800.
(d) Each applicant who fails to pass the examination after three attempts shall submit evidence of completion of additional education approved by the board before being allowed to take the examination an additional time. (Authorized by K.S.A. 2005 Supp. 65-2911; implementing K.S.A. 2005 Supp. 65-2906; effective March 21, 1997; amended July 14, 2006.)

K.A.R. 100-29-5. (Authorized by and implementing K.S.A. 65 2911; effective March 21, 1997; revoked May 26, 2006.)

K.A.R. 100-29-6. Lost or destroyed certificates; change of name; new certificates. (a) If a certificate of licensure or certification is lost or destroyed, the licensed or certified person may request a duplicate certificate. Each request shall be submitted in writing, shall include the number of the original certificate, and shall be accompanied by the fee specified in K.A.R. 100-29-7.
(b) If the name of a licensed or certified person is changed, the licensed or certified person shall send the name change to the board within 30 days of the change. This notification shall be submitted in writing, shall be accompanied by an attested document of the change of name, shall include the number of the original certificate, and shall be accompanied by the fee required for a duplicate certificate specified in K.A.R. 100-29-7. The licensed or certified person shall surrender the original certificate to the board. (Authorized by and implementing K.S.A. 2004 Supp. 65-2911; effective March 21, 1997; amended May 26, 2006.)

K.A.R. 100-29-7. Fees. The following fees shall be collected by the board:
            (a) Application based upon certificate of prior examination. . . . $80.00
            (b) Application based on examination. . . . . . . . . . . . . . . . . . . . . $80.00
            (c) Annual renewal:
            (1) Paper renewal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$70.00
            (2) On-line renewal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$67.00
            (d) Late renewal:
            (1) Paper late renewal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $5.00
            (2) On-line late renewal. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . $5.00
            (e) Reinstatement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .$80.00
            (f) Certified copy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $15.00
            (g) Duplicate certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$15.00
            (h) Temporary permit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $25.00
(Authorized by K.S.A. 2006 Supp. 65-2911; implementing K.S.A. 2006 Supp. 65-2910 and K.S.A. 2006 Supp. 65-2911; effective March 21, 1997; amended May 1, 1998; amended Sept. 29, 2000; amended Nov. 15, 2002; amended Nov. 19, 2004; amended March 7, 2008.)

K.A.R. 100-29-8. License and certificate renewal; expiration date; notification of supervision. (a) The license of each physical therapist and the certificate of each physical therapist assistant shall expire on December 31 of each year.
(b) At the time of license renewal, the physical therapist shall provide the name and certificate number of each physical therapist assistant who is working under the direction of the physical therapist on a form provided by the board.
(c) At the time of a renewal of certification, the physical therapist assistant shall provide, on a form furnished by the board, the name and license number of the physical therapist who is supervising the assistant. (Authorized by K.S.A. 2004 Supp. 65-2911; implementing K.S.A. 2004 Supp. 65-2910; effective March 21, 1997; amended May 26, 2006.)

K.A.R. 100-29-9. Registration License and certificate renewal; continuing education. (a)(1)(A) As a condition of renewal for each odd-numbered year, each licensed physical therapist or certified physical therapist assistant shall submit, in addition to the annual application for renewal of licensure or certification, evidence of satisfactory completion within the preceding two-year period of a minimum of 40 contact hours of continuing education for a licensed physical therapist and a minimum of 20 contact hours of continuing education for a certified physical therapist assistant.
(B) Evidence of satisfactory completion of a program of continuing education shall not be required to be submitted with the application or renewal of licensure or certification in even-numbered years.
(2) A contact hour shall be 60 minutes of instruction.
(3) Meals and breaks shall not be included in the contact hour calculation.
(b) Any applicant for renewal who cannot meet the requirements of paragraph (a)(1)(A) may request an extension from the board to submit evidence of continuing education. The request shall include a plan for completion of the continuing education requirements within the requested extension period. An extension of up to six months may be granted by the board for good cause shown.
(c) A physical therapist initially licensed or physical therapist assistant initially certified within one year of a renewal date when evidence of continuing education must be submitted shall not be required to submit evidence of satisfactory completion of a program of continuing education required by paragraph (a)(1)(A) for that first renewal period. Each physical therapist or physical therapist assistant initially licensed or certified or whose license or certificate has
been reinstated for more than one year but less than two years from a renewal date when continuing education required by paragraph (a)(1)(A) must be submitted shall be required to submit evidence of satisfactory completion of at least 1/2 of the contact hours of continuing education required by paragraph (a)(1)(A).
(d) All continuing education classes and literature shall be related to the field of physical therapy.
(e) All continuing education shall meet the requirements of subsection (f).
(f) Continuing education experiences shall be related to the following:
(1) Clinical skills;
(2) administration and management techniques;
(3) educational principles when providing service to patients, families, health professionals, health professional students, or the community;
(4) research projects with published results;
(5) interaction with the community;
(6) legislative issues involving the profession;
(7) health care and the health care delivery system;
(8) documentation, reimbursement, cost-effectiveness, and activities;
(9) problem solving, critical thinking, and ethics; and
(10) multidisciplinary care.
(g) Continuing education experiences shall include the following:
(1) Lecture. "Lecture" shall mean a discourse given before an audience for instruction.
(2) Panel. "Panel" shall mean the presentation of a number of views by several professional individuals on a given subject, with none of the views considered a final solution.
(3) Workshop. "Workshop" shall mean a series of meetings designed for intensive study, work, or discussion in a specific field of interest.
(4) Seminar. "Seminar" shall mean directed advanced study or discussion in a specific field of interest.
(5) Symposium. "Symposium" shall mean a conference of more than a single session organized for the purpose of discussing a specific subject from various viewpoints and by various speakers.
(6) In-service training. "In-service training" shall mean an educational presentation pertaining solely to the enhancement of physical therapy skills in the evaluation, assessment, or treatment of patients.
(7) College or university courses. "College or university course" shall mean a course at the college or university level that directly enhances physical therapy skills or knowledge. Ten contact hours shall be given for each semester credit hour for which the student received a grade of at least “C” or its equivalent, or a “pass” in a pass/fail course.
(8) Administrative training. "Administrative training" shall mean a presentation that enhances the knowledge of a physical therapist or physical therapist assistant and that does not pertain solely to patient care. Approved presentation topics
shall include quality assurance, risk management, reimbursement, hospital and statutory requirements, and claim procedures.
(9) Self-instruction. "Self-instruction" shall mean the following:
(A) Reading professional literature. A maximum of two contact hours shall be given for reading;
(B) completion of a home study, correspondence, audio, video, or internet course for which a printed verification of successful completion is provided by the person or organization offering the course. A maximum of 10 contact hours shall be given for each course; and
(C) passage of a specialty certification examination approved by the board. A maximum of 40 contact hours shall be given for passage of a specialty certification examination.
(10) Professional publications. Contact hours for writing a professional publication shall be allotted as follows:
(A) Original paper: single author-20; senior author-15; coauthor-8
(B) Review paper or case report: single author-15; coauthor-8
(C) Abstract or book review-8
(D) Publication of a book-20
(h)(1) Each licensed physical therapist or certified physical therapist
assistant who presents a continuing education program shall receive three contact hours for each hour of presentation.
(2) No credit shall be granted for any repeated presentations of the same subject matter.
(i) To provide evidence of satisfactory completion of continuing education, the following shall be submitted to the board:
(1) Documented evidence of attendance at or completion of continuing education experiences;
(2) personal verification of self-instruction from reading professional literature; and
(3) copies of any professional publication. (Authorized by K.S.A. 2004 Supp. 65-2910 and 65-2911; implementing K.S.A. 2004 Supp. 65-2910; effective March 21, 1997; amended Nov. 14, 2003; amended May 26, 2006.)

K.A.R. 100-29-10. Canceled licenses and certificates; reinstatement. (a) Each physical therapist and physical therapist assistant desiring to reinstate a canceled license or certificate shall meet the following requirements:
(1) Submit a completed written application on a form prescribed by the board;
(2) pay the renewal fee and the reinstatement fee established by the board, no part of which shall be refunded; and
(3) submit proof of satisfactory completion of a program of continuing education as specified in subsection (b).
(b)(1) If the license of a physical therapist has been canceled for less than five years, the applicant shall complete the continuing education that was required at the time the license was canceled and a minimum of an additional 10 contact hours for each six months since the date the license was canceled.
(2) If the certification of a physical therapist assistant has been canceled for less than five years, the applicant shall complete the continuing education that was required at the time the certification was canceled and a minimum of an additional five contact hours for each six months since the date the certification was canceled.
(3) If the license or certificate has been canceled for five years or more, the applicant shall be required to complete an individually tailored continuing education program approved by the board.
(4) If the applicant has been in active practice in another state or the District of Columbia since the date on which the Kansas license or certificate was canceled, the applicant shall submit proof of a current license, registration, or certification, and proof of compliance with the continuing education requirements of that jurisdiction. (Authorized by K.S.A. 2004 Supp. 65-2910 and K.S.A. 2004 Supp. 65-2911; implementing K.S.A. 2004 Supp. 65-2910; effective March 21, 1997; amended Nov. 14, 2003; amended May 26, 2006.)

K.A.R. 100-29-11. (Authorized by K.S.A. 65-2903 and 65-2911; implementing K.S.A. 65-2912; effective March 21, 1997; revoked Nov. 27, 2006.)

K.A.R. 100-29-12. Unprofessional conduct. (a) "Unprofessional conduct" means any of the following:
(1) Engaging in physical therapy using either of the following means:
(A) A false or assumed name; or
(B) impersonating another person licensed as a physical therapist or certified as a physical therapist assistant;
(2) practicing physical therapy without reasonable skill and safety because of any of the following:
(A) Illness;
(B) alcoholism;
(C) use of drugs, controlled substances, chemicals, or any other type of material; or
(D) any mental or physical condition that impairs judgment or ability to provide care;
(3) having a physical therapist or physical therapist assistant license, registration, or certification revoked, suspended, or limited by the proper regulatory authority of another state, territory, or country, or the District of Columbia for acts or conduct that would constitute grounds for disciplinary action under K.S.A. 65-2912 and amendments thereto;
(4) having a physical therapist or physical therapist assistant application denied by the proper regulatory authority of another state, territory, or country, or the District of Columbia for acts or conduct that would constitute grounds for disciplinary action under K.S.A. 65-2912 and amendments thereto;
(5) cheating or attempting to subvert the validity of the examination required for licensure or certification;
(6) failing to provide adequate supervision to a physical therapist assistant or other person who performs services pursuant to delegation by a physical therapist;
(7) failing to furnish to the board, its investigators, or representatives any information legally requested by the board;
(8) being sanctioned or disciplined by a peer review committee or medical care facility for acts or conduct that would constitute unprofessional conduct under this regulation;
(9) surrendering a license, registration, or certification to practice physical therapy in another state while disciplinary proceedings are pending for acts or conduct that would constitute grounds for denial, refusal to renew, suspension, or revocation under K.S.A. 65-2912 and amendments thereto;
(10) committing one or more instances involving failure to adhere to the applicable standard of care to a degree that constitutes gross negligence, as determined by the board;
(11) committing repeated instances involving failure to adhere to the applicable standard of care to a degree that constitutes ordinary negligence, as determined by the board.;
(12) engaging in a pattern of practice or other conduct that demonstrates a manifest incapacity or incompetence to practice physical therapy;
(13) representing to a patient or client that a manifestly incurable disease, condition, or injury can be permanently cured;
(14) providing physical therapy to a patient or client without the consent of the patient or client or the patient's or client’s legal representative;
(15) willfully betraying confidential information provided by the patient or client;
(16) advertising a guarantee of any professional service relating to physical therapy;
(17) using any advertisement that is false, misleading, or deceptive in any material respect;
(18) committing conduct likely to deceive, defraud, or harm the public;
(19) making a false or misleading statement regarding the license or certificate holder's skill;
(20) committing any act of sexual abuse, misconduct, or exploitation relating to the professional practice of physical therapy;
(21) obtaining any fee by fraud, deceit, or misrepresentation;
(22) failing to maintain adequate written records detailing the course of treatment of the patient or client;
(23) delegating physical therapy to a person who the license or certificate holder knows or has reason to know is not qualified by training or experience to perform the physical therapy;
(24) referring a patient or client to a health care entity for services if the license or
certificate holder has a significant investment interest in the health care entity, unless the patient or client is informed of the following in writing:
(A) The significant investment interest; and
(B) the fact that the patient or client can obtain the services elsewhere;
(25) performing tests, examinations, or services that have no legitimate purpose;
(26) violating any regulations adopted by the board relating to the practice of physical therapy;
(27) directly or indirectly giving or receiving any fee, commission, rebate, or other compensation for professional services not actually and personally rendered, other than through the legal functioning of a professional partnership, professional corporation, limited liability company, or similar business entity;
(28) practicing or offering to practice beyond the scope of the legal practice of physical therapy;
(29) charging excessive fees for services performed;
(30) aiding and abetting a person who is not licensed or certified in the performance of activities requiring a license or certificate; or
(31) providing treatment unwarranted by the condition of the patient or continuing treatment beyond the merit of reasonable benefit.
(b) Each physical therapist and physical therapist assistant shall maintain an adequate record for each patient or client for whom the physical therapist or physical therapist assistant performs a professional service. Each record shall meet the following criteria:
(1) Be legible;
(2) identify the patient or client; and
(3) contain an evaluation, a diagnosis, a plan of care, and a treatment and discharge plan.
(c) As used in this regulation, "health care entity" and "significant investment interest" shall have the meanings ascribed to them in K.S.A. 65-2837 and amendments thereto. (Authorized by K.S.A. 2004 Supp. 65-2911; implementing K.S.A. 2004 Supp. 65-2912; effective March 21, 1997; amended May 26, 2006.)

K.A.R. 100-29-13. Notification to board. (a) Before a physical therapist allows a physical therapist assistant to work under the physical therapist's direction, the physical therapist shall inform the board of the following:
(1) The name of each physical therapist assistant who intends to work under the direction of that physical therapist; and
(2) the physical therapist assistant's practice address.
(b) Each physical therapist and each physical therapist assistant shall inform the board in writing within 30 days of any changes in the mailing, residence, or practice address. (Authorized by K.S.A. 2004 Supp. 65-2911; implementing K.S.A. 2004 Supp. 65-2901; effective March 21, 1997; amended May 26, 2006.)

K.A.R. 100-29-14. (Authorized by K.S.A. 65-2911; implementing K.S.A. 1996 Supp. 65-2906; effective March 21, 1997; revoked July 14, 2006.)

K.A.R. 100-29-15. Professional liability insurance. (a) Each person licensed by the board as a physical therapist shall, before rendering professional services within the state, submit to the board evidence that the person is maintaining the professional liability insurance coverage required by K.S.A. 65-2920 and amendments thereto, for which the limit of the insurer’s liability shall be not less than $100,000 per claim, subject to an annual aggregate of not less than $300,000 for all claims made during the period of coverage.
(b) Each person licensed by the board as a physical therapist and rendering professional services in this state shall submit, with the annual application for renewal of the license, evidence that the person is maintaining the professional liability insurance coverage specified in subsection (a). (Authorized by K.S.A. 2004 Supp. 65-2911; implementing K.S.A. 2004 Supp. 65-2920; effective May 26, 2006.)

K.A.R. 100-29-16. Supervision of physical therapist assistants and support personnel. (a) Each physical therapist shall be responsible for the following:
(1) The physical therapy services provided to a patient or client by any physical therapist assistant working under the direction of the physical therapist; and
(2) the tasks relating to the physical therapy services provided to a patient or client by any support personnel working under the personal supervision of the physical therapist or by the physical therapist assistant acting under the direction of the physical therapist.
(b) Each physical therapist and each physical therapist assistant acting under the direction of a physical therapist shall provide personal supervision of the support personnel during any session in which support personnel are utilized to carry out a task.
(1) "Personal supervision" shall mean oversight by a physical therapist or by a physical therapist assistant acting under the direction of the physical therapist who is on-site and immediately available to the support personnel.
(2) “Support personnel” shall mean any person other than a physical therapist or physical therapist assistant. Support personnel may be designated as or describe themselves as physical therapy aides, physical therapy technicians, physical therapy paraprofessionals, rehabilitation aides, or rehabilitation technicians.
(3) "Task" shall mean an activity that does not require the formal education or training of a physical therapist or a physical therapist assistant.
(c) The determination by the physical therapist to utilize a physical therapist assistant for selected components of physical therapy interventions shall require the education, expertise, and professional judgment of the physical therapist. Before
delegating an intervention by a physical therapist to a physical therapist assistant and before delegating a designated task to support personnel, the physical therapist shall consider the following:
(1) The education, training, experience, and skill level of the physical therapist assistant;
(2) the complexity and acuteness of the patient's or client's condition or health status;
(3) the predictability of the consequences;
(4) the setting in which the care is being delivered to the patient or client; and
(5) the frequency of reexamination of the patient or client.
(d) Only a physical therapist may perform any of the following:
(1) Interpretation of a referral;
(2) performance and documentation of an initial examination, testing, evaluation, diagnosis, and prognosis;
(3) development or modification of a plan of care that is based on a reexamination of the patient or client that includes the physical therapy goals for intervention;
(4) determination of the qualifications of support personnel performing an assigned task;
(5) delegation of and instruction about the service to be rendered by the physical therapist assistant;
(6) timely review of documentation, reexamination of the patient or client, and revision of the plan of care when indicated;
(7) establishment and documentation of the discharge plan and discharge summary; and
(8) oversight of all documentation for services, including documents for billing, rendered to each patient or client under the care of the physical therapist.
(e) In all practice settings, the performance of selected interventions by the physical therapist assistant and the delegation of designated tasks to support personnel shall be consistent with the safe and legal practice of physical therapy and shall be based on the following factors:
(1) The complexity and acuteness of the patient's or client's condition or health status;
(2) the physical therapist's proximity and accessibility to the patient or client;
(3) the supervision available for all emergencies or critical events;
(4) the type of setting in which the physical therapy intervention is provided;
(5) the ability of the physical therapist assistant to perform the selected interventions or the support personnel to perform designated tasks; and
(6) an assessment by the physical therapist of the ability of the support personnel to perform designated tasks.
(f) A physical therapist shall not have more than four physical therapist assistants working concurrently under the direction of that physical therapist.
(g) Failure to meet the provisions of this regulation shall constitute unprofessional conduct. (Authorized by K.S.A. 2005 Supp. 65-2911; implementing K.S.A. 2005 Supp. 65-2912; effective July 14, 2006.)