January 31, 2006, Introduced by Reps. Vander Veen, Stakoe, Garfield, Kooiman, Amos, Hoogendyk, Stahl, Hildenbrand, Emmons, Pearce and Mortimer and referred to the Committee on Health Policy.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 16263, 16315, 16335, 17801, 17820, and 17822
(MCL 333.16263, 333.16315, 333.16335, 333.17801, 333.17820, and
333.17822), section 16263 as amended by 2004 PA 97, section 16315
as amended by 2001 PA 232, section 16335 as added by 1993 PA 80,
section 17801 as amended by 1987 PA 213, and section 17820 and
17822 as amended by 2005 PA 281, and by adding sections 17823,
17824, and 17825.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 16263. (1) Except as provided in subsection (2), the
following words, titles, or letters or a combination thereof, with
or without qualifying words or phrases, are restricted in use only
to those persons authorized under this article to use the terms and
in a way prescribed in this article:
(a) "Chiropractic", "doctor of chiropractic", "chiropractor",
"d.c.", and "chiropractic physician".
(b) "Dentist", "doctor of dental surgery", "oral and
maxillofacial surgeon", "orthodontist", "prosthodontist",
"periodontist", "endodontist", "oral pathologist", "pediatric
dentist", "dental hygienist", "registered dental hygienist",
"dental assistant", "registered dental assistant", "r.d.a.",
"d.d.s.", "d.m.d.", and "r.d.h.".
(c) "Doctor of medicine" and "m.d.".
(d) "Physician's assistant" and "p.a.".
(e) "Registered professional nurse", "registered nurse",
"r.n.", "licensed practical nurse", "l.p.n.", "nurse midwife",
"nurse anesthetist", "nurse practitioner", "trained attendant", and
"t.a.".
(f) "Doctor of optometry", "optometrist", and "o.d.".
(g) "Osteopath", "osteopathy", "osteopathic practitioner",
"doctor of osteopathy", "diplomate in osteopathy", and "d.o.".
(h) "Pharmacy", "pharmacist", "apothecary", "drugstore",
"druggist", "medicine store", "prescriptions", and "r.ph.".
(i) "Physical therapy", "physical therapist", "doctor of
physiotherapy", "doctor of physical therapy", "physiotherapist",
"physiotherapy", "registered physical therapist", "licensed
physical therapist", "physical therapy technician", "physical
therapist assistant", "physical therapy assistant",
"physiotherapist assistant", "physiotherapy assistant", "p.t.
assistant", "p.t.", "r.p.t.", "l.p.t.", "c.p.t.", "d.p.t.",
"m.p.t.", "p.t.a.", "registered p.t.a.", "licensed p.t.a.",
"certified p.t.a.", "c.p.t.a.", "l.p.t.a.", "r.p.t.a.", and
"p.t.t.".
(j) "Chiropodist", "chiropody", "chiropodical", "podiatry",
"podiatrist", "podiatric", "doctor of podiatric medicine", "foot
specialist", "podiatric physician and surgeon", and "d.p.m.".
(k) "Consulting psychologist", "psychologist", "psychological
assistant", "psychological examiner", "licensed psychologist", and
"limited licensed psychologist".
(l) "Licensed professional counselor", "licensed counselor",
"professional counselor", and "l.p.c.".
(m) "Sanitarian", "registered sanitarian", and "r.s.".
(n) Until July 1, 2005, "social worker", "certified social
worker", "social work technician", "s.w.", "c.s.w.", and "s.w.t.".
Beginning July 1, 2005, "social worker", "licensed master's social
worker", "licensed bachelor's social worker", "registered social
service technician", "social service technician", "l.m.s.w.",
"l.b.s.w.", and "r.s.s.t.".
(o) "Veterinary", "veterinarian", "veterinary doctor",
"veterinary surgeon", "doctor of veterinary medicine", "v.m.d.",
"d.v.m.", "animal technician", or "animal technologist".
(p) "Occupational therapist", "occupational therapist
registered", "certified occupational therapist", "o.t.", "o.t.r.",
"c.o.t.", "certified occupational therapy assistant", "occupational
therapy assistant", or "c.o.t.a.".
(q) "Marriage advisor" or "marriage consultant"; "family
counselor", "family advisor", "family therapist", or "family
consultant"; "family guidance counselor", "family guidance
advisor", or "family guidance consultant"; "marriage guidance
counselor", "marriage guidance advisor", or "marriage guidance
consultant"; "family relations counselor"; "marriage relations
counselor", "marriage relations advisor", or "marriage relations
consultant"; "marital counselor" or "marital therapist"; "limited
licensed marriage and family therapist" or "limited licensed
marriage counselor"; "licensed marriage and family therapist" or
"licensed marriage counselor"; and "l.m.f.t.".
(r) "Nursing home administrator".
(s) "Respiratory therapist", "respiratory care practitioner",
"licensed respiratory therapist", "licensed respiratory care
practitioner", "r.t.", "r.c.p.", "l.r.t.", and "l.r.c.p.".
(t) "Audiometrist", "audiologist", "hearing therapist",
"hearing aid audiologist", "educational audiologist", "industrial
audiologist", and "clinical audiologist".
(2) Notwithstanding section 16261, a person who was specially
trained at an institution of higher education in this state to
assist a physician in the field of orthopedics and upon completion
of training, received a 2-year associate of science degree as an
orthopedic physician's assistant before January 1, 1977, may use
the title "orthopedic physician's assistant" whether or not the
person is licensed under this article.
Sec. 16315. (1) The health professions regulatory fund is
established in the state treasury. Except as otherwise provided in
this section, the state treasurer shall credit the fees collected
under sections 16319 to 16349 to the health professions regulatory
fund. The money in the health professions regulatory fund shall be
expended only as provided in subsection (5).
(2) The state treasurer shall direct the investment of the
health professions regulatory fund. Interest and earnings from
health professions regulatory fund investment shall be credited to
the health professions regulatory fund.
(3) The unencumbered balance in the health professions
regulatory fund at the close of the fiscal year shall remain in the
health professions regulatory fund and shall not revert to the
general fund.
(4) The health professions regulatory fund may receive gifts
and devises and other money as provided by law.
(5)
The department of consumer and industry services shall
use the health professions regulatory fund only to carry out its
powers and duties under this article and article 7 including, but
not limited to, reimbursing the department of attorney general for
the
reasonable cost of services provided to the department of
consumer
and industry services under this article and article 7.
(6) The nurse professional fund is established in the state
treasury. Of the money that is attributable to per-year license
fees collected under section 16327, the state treasurer shall
credit $2.00 of each individual annual license fee collected to the
nurse professional fund. The money in the nurse professional fund
shall be expended only as provided in subsection (9).
(7) The state treasurer shall direct the investment of the
nurse professional fund, and shall credit interest and earnings
from the investment to the nurse professional fund. The nurse
professional fund may receive gifts and devises and other money as
provided by law.
(8) The unencumbered balance in the nurse professional fund at
the close of the fiscal year shall remain in the nurse professional
fund and shall not revert to the general fund.
(9)
The department of consumer and industry services shall
use the nurse professional fund each fiscal year only as follows:
(a) The department may use not more than 1/3 of the nurse
professional fund for the establishment and operation of a nurse
continuing education program.
(b) The department may use not more than 1/3 of the nurse
professional fund to perform research and development studies to
promote and advance the nursing profession.
(c) The department shall use not less than 1/3 of the nurse
professional fund to establish and operate a nursing scholarship
program.
(10) The official prescription form program fund established
by the amendatory act that added this section is abolished. The
money remaining in the official prescription form program fund on
the
effective date of the amendatory act that added subsection (11)
January 3, 2002 shall be transferred by the state treasurer to the
pain management education and controlled substances electronic
monitoring and antidiversion fund created in subsection (11).
(11) The pain management education and controlled substances
electronic monitoring and antidiversion fund is established in the
state treasury.
(12) The state treasurer shall direct the investment of the
pain management education and controlled substances electronic
monitoring and antidiversion fund. Interest and earnings from
investment of the pain management education and controlled
substances electronic monitoring and antidiversion fund shall be
credited to the pain management education and controlled substances
electronic monitoring and antidiversion fund.
(13) The unencumbered balance in the pain management education
and controlled substances electronic monitoring and antidiversion
fund at the close of the fiscal year shall remain in the pain
management education and controlled substances electronic
monitoring and antidiversion fund and shall not revert to the
general fund. The pain management education and controlled
substances electronic monitoring and antidiversion fund may receive
gifts and devises and other money as provided by law. Twenty
dollars
of the license fee received by the department of consumer
and
industry services under section 16319 shall be deposited with
the state treasurer to the credit of the pain management education
and controlled substances electronic monitoring and antidiversion
fund. The department shall use the pain management education and
controlled substances electronic monitoring and antidiversion fund
only in connection with programs relating to pain management
education for health professionals, preventing the diversion of
controlled substances, and development and maintenance of the
electronic monitoring system for controlled substances data
required by section 7333a.
(14) The physical therapy professional fund is established in
the state treasury. Of the money that is attributed to per-year
license fees collected under section 16335, the state treasurer
shall credit 10% of each individual annual license fee collected to
the physical therapy professional fund. The money in the physical
therapy professional fund shall be expended only for the
establishment and operation of a physical therapy continuing
education program established under section 17823.
(15) The state treasurer shall direct the investment of the
physical therapy professional fund and shall credit interest and
earnings from the investment to the physical therapy professional
fund. The physical therapy professional fund may receive gifts and
devises and other money as provided by law.
(16) The unencumbered balance in the physical therapy
professional fund at the close of the fiscal year shall remain in
the physical therapy professional fund and shall not revert to the
general fund.
Sec. 16335. Fees for a person licensed or seeking licensure to
engage in the practice of physical therapy under part 178 are as
follows:
(a) Application processing fee.......................... $ 20.00
(b) Examination fees:
Jurisprudence examination only...................... 25.00
(c)
License fee, per year....................... 50.00 60.00
(d)
Temporary license................................... 20.00
(d) (e)
Limited license, per year....................
25.00
Sec. 17801. (1) As used in this part:
(a) "Physical therapist" means an individual licensed under
this article to engage in the practice of physical therapy.
(b) "Physical therapist assistant" means an individual who
assists a physical therapist in physical therapy intervention and
is a graduate of a nationally accredited physical therapist
assistant education program.
(c) (b)
"Practice of physical
therapy", subject to
subsection (2), means the evaluation of, education of, consultation
with, or treatment of an individual by a physical therapist or
under the direction and responsibility of a physical therapist in
compliance with the rules promulgated under section 17824(1).
Practice of physical therapy includes, but is not limited to, the
employment of effective properties of physical measures and the use
of therapeutic exercises and rehabilitative procedures, with or
without
assistant assistive devices, for the purpose of
preventing, correcting, or alleviating a physical or mental
disability; .
It includes treatment planning, performance of tests
and measurements and interpretation and labeling of the results of
those physical therapy tests and measurements, interpretation of
referrals, intervention selection, initiation of referrals,
instruction, consultative services, and supervision of personnel.
Physical measures include massage, mobilization, heat, cold, air,
light, water, electricity, and sound.
(2) Practice
of physical therapy does not include the
identification
of underlying medical problems or etiologies,
establishment
of medical diagnoses , or the prescribing of
medical treatment.
(3) (2)
In addition to the definitions in this part,
article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161
contains definitions applicable to this part.
Sec. 17820. (1) A person shall not engage in the practice of
physical therapy unless licensed or otherwise authorized by this
article. A
Except as otherwise provided
under subsection (2), a
person shall engage in the actual treatment of an individual only
upon the prescription of an individual holding a license issued
under part 166, 170, 175, or 180, or the equivalent license issued
by another state.
(2) Subject to subsection (3), a person may engage in the
actual treatment of an individual without a prescription or
referral as described in subsection (1) if the individual had a
previous referral for physical therapy and that prior referral was
for treatment of the same injury or condition and was not more than
1 year prior to the date of his or her return for treatment of the
same and if the person satisfies any of the following:
(a) Has completed a nationally accredited doctoral level
physical therapist educational program that is acceptable to the
board.
(b) Has completed at least 2 years of experience engaged in
the practice of physical therapy as a licensed physical therapist
and has references from at least 2 physicians with whom the
physical therapist has had a working relationship.
(c) Is employed by a physician or health facility, under
contract or subcontract with a physician or health facility, or has
privileges at a physician's office or health facility.
(3) A physical therapist who is authorized to evaluate and
treat an individual without a prescription or referral under
subsection (2) shall comply with all of the following:
(a) Inform the patient's primary care physician or other
health care professional designated by the patient of the
evaluation within 5 days after the evaluation is made.
(b) Complete the additional continuing education requirements
established under section 17823(3).
(c) Hold a valid certification in cardiopulmonary
resuscitation approved by the department and offered or approved by
the American red cross, American heart association, or a comparable
organization or institution.
(d) Provide physical therapy services to that patient for no
more than 45 consecutive days or 20 visits, whichever occurs first.
(e) If the physical therapist determines that no substantial
progress has been made with respect to that patient within 30 days
since the patient's initial visit, consult with, or refer to, an
appropriate health care professional unless the patient was
previously diagnosed with chronic, neuromuscular, or developmental
conditions and the physical therapy services being provided are for
problems or symptoms associated with the previous diagnosis.
(4) Nothing in this section shall be construed to create
liability of any kind for a health care provider described under
subsection (1) who diagnosed the injury or condition for which
physical therapy services were originally prescribed for a
condition, illness, or injury that manifested itself after that
prior referral or for any alleged damages as a result of physical
therapy services performed without a prescription or referral from
a health care provider as described under subsection (1).
(5) As used in this section, "health facility" means a health
facility or agency licensed under article 17.
Sec. 17822. This part does not prohibit a hospital, as a
condition of employment or the granting of staff privileges, from
requiring a physical therapist to practice in the hospital only
upon the prescription of an individual holding a license issued
under part 166, 170, 175, or 180 or the equivalent license issued
by another state or as otherwise authorized under section 17820(2).
Sec. 17823. (1) The department, in consultation with the
board, shall promulgate rules to establish continuing education
requirements for physical therapists. Notwithstanding the
requirements of part 161, beginning the license year after the
effective date of the rules promulgated under this subsection, an
individual shall meet the continuing education requirements
established under this subsection. The department, in consultation
with the board, shall promulgate rules to require licensees seeking
renewal to furnish evidence acceptable to the department and the
board of the successful completion, during the preceding license
year, of those continuing education requirements.
(2) As required under section 16204, the department, in
consultation with the board, shall promulgate rules requiring each
applicant for license renewal to complete as part of the continuing
education requirement of subsection (1) an appropriate number of
hours or courses in pain and symptom management.
(3) In addition to the rules promulgated under subsection (1),
the department, in consultation with the board, shall promulgate
rules to establish continuing education requirements that a
physical therapist must complete before evaluating or treating an
individual without a prescription or referral as provided under
section 17820. The continuing education requirements established
under this subsection shall include, at a minimum, at least 20
additional hours of continuing education in subjects related to the
practice of physical therapy and at least 18 hours of instruction
designed to enable a physical therapist to identify signs and
symptoms of systemic disease.
Sec. 17824. (1) The department, in consultation with the
board, shall promulgate rules to establish standards of ethics and
standards of practice for physical therapists.
(2) A physical therapist shall adhere to the standards of
ethics, standards of practice, and supervision guidelines
established in the rules promulgated under subsection (1).
(3) A physical therapist shall refer a patient to an
appropriate health care professional if the physical therapist has
reasonable cause to believe that symptoms or conditions are present
that require services beyond the scope of practice of physical
therapy.
(4) A physical therapist shall consult with an appropriate
health care professional if a patient does not show reasonable
response to treatment in a time period consistent with the
standards of practice established in the rules promulgated under
subsection (1).
Sec. 17825. This part does not require new or additional third
party reimbursement or mandated worker's compensation benefits for
physical therapy services rendered by an individual licensed or
otherwise authorized under this article.