Jurisprudence for Physical Therapists and Physical Therapist Assistants Practicing in Georgia

My name is Calista Kelly, PT, DPT.  I have been licensed in the past in a few different states and have a special interest in jurisprudence for physical therapists and physical therapist assistants.  Today, we will be discussing the rules and regulations in Georgia regarding physical therapy, some of which have recently changed.

Introduction

It is important to note that laws, rules, standards, and policies can change anytime.  The licensee is responsible for staying abreast of changes; the best way is through the Georgia State Board of Physical Therapy.

On the Secretary of State’s website, you will find the most recent Georgia PT Practice Act. Read the Practice Act in its entirety and become familiar with it.

The board’s website includes general provisions, board rules, proposed rules, policy statements, helpful, frequently asked questions, and more.  The board meets approximately six times a year and is made up of eight members who are appointed by the governor. The board may propose to amend, adopt new rules or repeal its rules, which are then filed.  It is the licensees’ responsibility to understand and abide by current rules.  Note that once changes are filed, they are in effect within 30 days.  Make it a regular practice to check the board’s website, particularly around meeting dates when changes to the rules may be discussed or enacted. 

Statutes

A statute is a written enactment of a legislative body.  It’s an act of the legislature declaring, commanding, or prohibiting something.  It is the written will of the legislative body solemnly expressed according to the forms necessary to constitute the state's law.  The primary rule of the courts is to carry out the intent of the legislature.  In our case, legislative acts declare what the practice of physical therapy is – that is, what actions physical therapists can perform and what actions are prohibited.

To practice physical therapy in the state of Georgia, the licensee must have a good understanding of the laws and regulations affecting practice, and those include the following we will discuss today: Georgia General Provisions (Title 43 Chapter 1 -specifically 43-1-9 and 43-1-19 through 43-1-27), Georgia Physical Therapy Practice Act (Title 43 Chapter 33), Board Rules (Chapter 490) and Board Policies.  

Georgia PT Practice Act, Article 1 General Provisions

The Georgia Physical Therapy Practice Act is found in Title 43, Chapter 33 of Georgia Code Annotated.  In layman's terms, if we're looking this up, it would be considered 44-33-1, and et seq. means “the following sections.” The latest edition is available from the Secretary of State's website https://sos.ga.gov/georgia-state-board-physical-therapy, under Rules and Regulations.  The board may adopt new rules or amend existing ones.  If that occurs, they will be listed on the Secretary of State’s website.  

Definition of Purpose

The Georgia code and the Georgia regulations are provisions that declare what the practice of physical therapy is and how physical therapists (PTs) and physical therapist assistants (PTAs) can perform certain duties or activities.  There are provisions that strictly prohibit certain actions or activities.  The act aims to safeguard the public's health, safety, and welfare.  In order to do that, the statute provides for state administrative control, supervision, and regulation of the practice of physical therapy.  

Definitions

Definitions as part of codes or acts are included to ensure that the readers are all speaking the same language as it pertains to regulation.  Here are a few that are pertinent to our discussion today.

• Board- the State Board of Physical Therapy
• License- a valid and current certificate of registration issued by the board that authorizes the authority to practice physical therapy
• Licensee- a person holding a license under the Georgia chapter and Article 1 or Article 2 of Compact Privilege, which we will go over later.
• Person- a human being only and not a legal entity.
• Physical Therapist- a person licensed to practice physical therapy who holds a license in good standing.  
• Physical Therapist Assistant- a person who is licensed by the board to assist a physical therapist whose activities are supervised and directed by a physical therapist.  
• Physical therapy means the care and services provided by or under the direction and supervision of a licensed physical therapist. The term 'physiotherapist' is synonymous with 'physical therapist".

The practice of physical therapy includes the following: 

(A) Examining, evaluating, and testing patients and clients with mechanical, physiological, and developmental impairments, activity limitations, participation restrictions, and disabilities or other movement-related conditions in order to determine a physical therapy diagnosis, prognosis, and plan of intervention and to assess the ongoing effects of intervention;

(B) Alleviating impairments of body structure or function by designing, implementing, and modifying interventions to improve activity limitations or participation restrictions for the purpose of preventing or reducing the incidence and severity of a physical disability, bodily malfunction, and pain;

(C) Reducing the risk of injury, impairment, activity limitations, participation restrictions, and disability, including the promotion and maintenance of health, fitness, and wellness in populations of all ages;

(D) Planning, administering, evaluating, and modifying intervention and instruction,  including the use of physical measures, activities, and devices, including but not limited to dry needling for preventative and therapeutic purposes; and

(E) Engaging in administration, consultation, education, teaching, research, telehealth, and the provision of instructional, consultative, educational, and other advisory services.

• Physical therapy aide: The aide only performs designated and supervised physical therapy tasks and must be under direct supervision at all times by a licensee.  The physical therapy aide is not licensed under the Georgia chapter.
• Trainee- an individual who is approved for a traineeship. 
• Traineeship- a period of activity during which a trainee works under the direct supervision of a licensed physical therapist who has practiced for not less than one year prior to assuming the supervisory role. 
• Training permit- a valid and current certificate of registration issued by the board that gives the person the authority to practice through a traineeship. 

Board Specifics

The next sections in the Act cover board specifics such as appointment, qualifications, telephone conferencing, reimbursement, and duty of the division director. As mentioned before, the board will consist of eight members, all of whom live in the state of Georgia.  The term is for three years until a successor is appointed and qualified.  No person can serve more than two full terms consecutively. 

The governor appoints the eight members of the board, and those members must be confirmed by the Georgia State Senate.  Any vacancies are also appointed by the governor. 

Six of the members must be licensed physical therapists and have taught or practiced physical therapy for at least three years.   

One of the members must be a licensed and practicing physical therapy assistant who has practiced for at least three years. 

The eighth member shall be someone appointed by the public at large and has no business connection with the practice of physical therapy. 

The board may conduct business by telephone conference, provided members of the board shall not receive compensation for business conducted in conference by telephone or other digital means. The only exception to this is hearings in contested cases. The board may conduct business by digital means other than telephone, with the exception of contested cases as was before.

Board members shall be reimbursed as provided pursuant to the Physical Therapy Act. 

The division director is the secretary of the board, and he/she performs administrative duties as determined by the board.  In an administratively contested case, the division director has the power to subpoena witnesses throughout Georgia, designated documents, papers, books, accounts, letters, photographs, objects, or other tangible things.  All legal processes and all documents required by law to be served upon or filed with the board should be given or filed with the division director at his or her office.

Powers and Duties

Section 43-33-10 deals with the powers and duties of the board.  According to the Practice Act, the board has 13 separate duties. 

Those powers include:

1. Preparation and approval of all examinations or applicants for licenses. 
2. Determine the qualifications and authorize the issuance of licenses to qualified physical therapists and physical therapist assistants. 
3. Determine the qualifications and approve educational programs for physical therapists and physical therapist assistants. 
4. Initiate investigations of alleged or suspected violations of the provisions of the Practice Act or any other laws of Georgia pertaining to physical therapy and any rules and regulations adopted by the board.  Any board member or authorized agent of the board has the power and right to enter and make reasonable inspection of any place where physical therapy is practiced in the state of Georgia.  This means that any of the board members can stop by your work site and do an inspection. 
5. Power and authority to conduct all hearings and contested cases according to the Georgia Administrative Procedure Act. 
6. Discipline any licensed person under the Practice Act as well as refuse to grant, renew or restore a license to any person for any grounds in the act. 
7. Authority to establish a licensing fee that has to be paid when licenses are renewed. 
8. Use of seal and signature for evidence of board approval. 
9. Adopt and publish a Code of Ethics
10. Issuing of training permits. 
11. Administering the Physical Therapy Licensure Compact (which will be discussed later in this course)
12. Adoption of additional rules and regulations that are necessary for the enforcement and implementation of the provisions and purposes of this chapter regarding the practice of PT in the state of Georgia.  As mentioned before, it is extremely important to regularly check the website for this reason.
13. Conduct national background checks by submitting fingerprints to the Federal Bureau of Investigation through the Georgia Crime Information Center.  Those background checks are not shared with entities outside of this state.

Titles and Identification

43-33-11 Is the part of the practice act that discusses the use of titles and identification. Simply put, the Physical Therapy Practice Act applies to those who are practicing physical therapy.  The only recent change to this area is the use of the term article versus chapter since there are now two articles under the chapter with the adoption of the Physical Therapy Compact.  

A physical therapist shall clearly inform the public of his or her professional credentials as a physical therapist. If using the term doctor, you also need to include that you are a physical therapist.  A physical therapist shall use the appropriate regulatory designator identified by the board. A physical therapist assistant is to use the letters 'PTA' immediately following his or her name to notate licensure. A person shall not use the title 'physical therapist assistant,' the letters 'PTA,' or any other words, abbreviations, or insignia in connection with that person's name to imply that the person is a physical therapist assistant unless that person is licensed as a physical therapist assistant under this article of the practice act. 

A person or business entity and its employees, agents, or representatives cannot use the terms: 'physical therapy, “physical therapist,” “physiotherapist,” or “doctor of physical therapy,” the letters “PT,” “CPT,” “DPT,” “LPT,” “RPT,” or “MPT,” or any other words, abbreviations implying either directly or indirectly, that physical therapy is provided or supplied unless services are provided by or under the direction of a licensed physical therapist in Georgia. 

In order to advertise and promote treatments as physical therapy or bill services as physical therapy, the individual directing and supervising those services has to be a person licensed under this article.  

Prevention/Restriction of Practice

43-33-11d states several circumstances in which the Practice Act is not to prevent or restrict practice. 

Those circumstances include: 

1. Any licensed individual under another Georgia law engaged in an appropriate practice under their respective licensing laws. 
2. A person in a physical therapy entry-level program working under the supervision of a licensed physical therapist fulfilling a clinical experience required for a PT or PTA degree. 
3. A person who is enrolled in a course to develop advanced physical therapy skills when physical therapy activities are required as part of an educational program sponsored by an educational institution approved by the board and when conducted under the supervision of a physical therapist licensed under the chapter. 
4. A physical therapist who is licensed in another state or country or employed by the U.S. government to teach or provide clinical demonstration in an academic or continuing education program.
5. A therapist or physical therapist assistant employed by the U.S. government and provides therapy under the direction of the organization to practice in the state of Georgia. 
6. A person who is currently licensed in another state and is present in the state of Georgia for a temporary resident only should not exceed treatment of 60 days total during any 12-month period.  
7. A person currently licensed in another state who is present in the state of Georgia providing physical therapy services during a declared local, jurisdictional, or national disaster or emergency is not restricted from practicing as long as it does not exceed a total of 60 days in any 12-month period.     

Requirements for Issuance of License to Practice Physical Therapy

A license to practice physical therapy is issued to a graduate of a physical therapy educational program that is accredited by a recognized accrediting agency and approved by the board.  If a person has been foreign trained, they must have submitted credentials approved by the board, with a demonstrated ability to speak, write and understand the English language satisfactorily, and has satisfactorily completed a three-month board-approved traineeship under the supervision of a physical therapist. 

In addition, a licensee has to pass a board-approved examination and any additional education or training required.  The licensee must not be disqualified from receiving a license under the provisions of the Practice Act, and those potential disqualifications will also be discussed later in this course. 

A final, more recent addition to this section includes a statement on background checks. An applicant must have satisfactory results from a fingerprint record check report and background check conducted by the Georgia Crime Information Center and the Federal Bureau of Investigation. The applicant is responsible for all fees associated with the background check.

Physical Therapist Assistant

The next part of the Georgia Physical Therapy Practice Act, article 1, 43-33-13, involves the requirements to practice as a physical therapist assistant.  This closely mirrors the requirements for issuance of a license to practice as a physical therapist.  The only difference I noted was there is no mention of the need to acquire any additional education or training required by the board, as mentioned in the second paragraph under Requirements for Issuance of License to Practice Physical Therapy above. 

Physical Therapy Aide

Next, The practice act defines the role of the physical therapy aide.  A physical therapy aide is a person other than a physical therapist or physical therapist assistant who is employed to assist a physical therapist or physical therapist assistant by performing only designated physical therapy tasks under the direct supervision of a physical therapist or physical therapist assistant licensee, as approved by the board by rule or regulation.  There are limited activities that a physical therapy aide can perform, which will be mentioned later under the physical therapy aide regulation section.

Competency (43-33-14)

This section addresses the competence of applicants.  It basically states that the board determines the competence of applicants to practice as physical therapists or physical therapist assistants by any method or procedure which the board deems necessary to test the applicant's qualifications. 

Reciprocity

In the next rule on reciprocity and other rules we have already reviewed, the legislature gives the board great discretion on how to operate and proceed and how and when to issue or renew licenses.  The board, at its discretion, may waive the examination as a requirement for licensure in Georgia and grant a license to practice physical therapy if that person has successfully passed an examination prior to licensure in another state or territory of the United States and practiced without restrictions in another state or territory of the United States.

The board may require additional education or training if they feel necessary when waiving the examination requirement.  

Renewal and Restoration of Licenses

We have now come to the renewal and restoration of licenses.  All licenses expire and must be renewed bi-annually.  All applications for renewal shall be filed with the division director prior to the expiration date and include the renewal fee. 

If the licensee fails to renew on time, the license will be restored after the application and payment of the restoration fee are completed within the prescribed period of time, provided the applicant meets any other board-approved requirements. 

Any license that has not been restored within such a period following its expiration may not be renewed, restored, or reissued thereafter. The holder of a canceled license will need to apply and obtain a valid one after complying with all requirements for a new one.  The board requires at least four hours of continuing education in order to renew any license issued.

Training Permits

The next section discusses training permits.  It is very important to know the regulations if you are chosen as the supervising therapist for a person with a training permit. 

The board issues a training permit to an applicant who has graduated from an approved physical therapy program and is approved to take the licensing examination or to individuals who have taken the examination but have not received their examination results yet.

The board may also issue a training permit to a foreign-trained applicant who has graduated from a physical therapy program outside the U.S. and was approved to take the National Physical Therapy Exam.

The board may issue a training permit to a reinstatement applicant whose license to practice as a physical therapist or physical therapist assistant has expired for more than two years. 

The individual with the training permit is allowed to work only under the direct supervision of a physical therapist who has been approved by the board.  A supervising physical therapist must have practiced for more than one year before assuming a supervisory role.  

Discipline, Suspension, Restoration of Licensees

Code 43-33-18 deals with the discipline of licensees, suspension/revocation/restriction of licenses, and refusal to grant or restore licenses.  Georgia has combined several things into this particular area in the practice act, which is fairly lengthy.  

Refusal to Grant or Restore License-Physical Therapist

The board has the ability to refuse to grant or restore a license to an applicant or to discipline a physical therapist under this chapter or any antecedent law upon the finding by the board that the licensee or applicant has done any of the following: 

1. Identified himself or herself as a doctor without informing the public of his or her professional credential as a physical therapist;
2. Performed physical therapy without a complete evaluation to determine a physical therapy diagnosis, prognosis, and plan of intervention, which, in the case of patients who have self-referred, means the physical therapist has: 
   • Failed to refer the patient if at any time the physical therapist has reason to believe that the patient has symptoms or conditions that require treatment beyond the scope of practice of the physical therapist or, regardless of the patient's condition, if, after 21 days or eight visits from the initiation of a physical therapy plan of intervention, the physical therapist has not received a referral from the patient's provider. 
     • The day and visit limitations shall not apply in the following circumstances:
       • In the case of services provided for health promotion, wellness, fitness, or maintenance purposes, in which case the physical therapist refers a client seen for health promotion, wellness, fitness, or maintenance purposes to an appropriate individual (licensed pursuant to Article 2 or 4 of Chapter 34 of Title 43) if the client exhibits or develops signs and symptoms beyond the scope of practice of the physical therapist
       • In the case of a patient diagnosed within the previous nine months with a neuromuscular or developmental condition, when the evaluation, treatment, or services are being provided for problems or symptoms associated with that previously diagnosed condition
       •  In the case of a patient diagnosed within the previous 90 days with a chronic musculoskeletal condition and noted by a current relevant document from an appropriately licensed healthcare provider.
   • Ordered radiology, performed surgery, ordered laboratory or body fluid testing, diagnosed disease, or practiced medicine
   • Failed to provide each self-referred patient with a written disclosure that a physical therapy diagnosis is not a medical diagnosis by a physician or based on radiological imaging and that such services might not be covered by the patient's health plan or insurer
   • Not satisfied the additional requirements for seeing a patient who has self-referred, which shall include: 
     • A doctorate in physical therapy or equivalent degree from an accredited institution plus two years of clinical practice experience;
     • A doctorate in physical therapy or equivalent and one of the following: Post-graduate certification, American Board of Physical Therapy Specialties Board Certification or Residency (or fellowship training), or five years of clinical practice experience
   • Performed dry needling treatment interventions without consulting an individual licensed pursuant to Article 2 or 4 of Chapter 34 of Title 43
3. Not following accepted standards of physical therapist practice, regardless of whether actual injury to a patient occurs or failure to provide the standard of patient management. Those standards include the following:  
   • Providing an initial evaluation, determination of physical therapy diagnosis, prognosis, and plan for intervention.  The physical therapist is to document the initial evaluation, periodic reevaluations, and the findings for each patient, as well as document each episode of care, including the patient's response to the plan of intervention at the time of completion of the episode of care. 
   • Ensuring the qualifications of all physical therapist assistants and physical therapy aides under his or her direction and supervision.  
   • Provide any and all intervention for every patient in his or her care that requires the education, skills, knowledge, and abilities of a physical therapist.
   • Determine the use of physical therapist assistants and aides to ensure safe, effective, and efficient care delivery.
   • Provide direction and supervision of physical therapy aides who can perform designated routine tasks. 
   • Communicating the overall plan of care with the patient or the patient's legally authorized representative.
   • Accurate documentation and billing of the services provided.
   • Adherence to the recognized standards for professional conduct and the code of ethics of the physical therapy profession.
   • Has liability coverage either independently or provided by the entity by which he or she is employed.

Refusal to Grant or Restore License-Physical Therapist Assistant

The board can refuse to grant or restore a license to an applicant or discipline a physical therapist assistant licensed in Georgia if that licensee or applicant has done one of the following: worked outside the supervision of a physical therapist, failed to provide accurate documentation, or billing of services provided,  did not adhere to standards of ethical conduct and code of ethics or worked outside of the PTA's scope of work regardless if a patient injury occurred.

Refusal to Grant or Restore License-Physical Therapist and Physical Therapist Assistant

The board can also refuse to grant or restore a license for both the PT and PTA in the below circumstances.  

• The individual displayed an inability or has become unable to practice as a PT or PTA because of drugs, alcohol, narcotics, mental disorder, physical condition, et cetera. The board may require the licensee or applicant to submit to a mental or physical examination by an appropriate healthcare provider designated by the board.  The licensee or applicant would be responsible for any fee incurred due to the examinations required by the board. The board also has the authority to obtain any and all records relating to the mental or physical condition of the licensee or applicant, including psychiatric records. Every person who applies to practice physical therapy in the state of Georgia gives his or her consent to submit to such mental or physical examination and to have waived all objections to the admissibility of the results in any hearing before the board upon the grounds that the same constitutes a privileged communication. If someone does refuse to test, the board may enter a final order with proof of refusal.   It goes on to state that any licensee or applicant who is not allowed to practice after the findings of the board can have the opportunity to petition the board for his/her ability to return to practice safely.    
• The individual has been convicted of a felony or a crime involving moral turpitude in the courts of Georgia, the United States, or a conviction of an offense in another jurisdiction which, if committed in Georgia, would be deemed a felony.  The term conviction includes a finding or a verdict of guilty, a plea of guilty, or a plea of nolo contendere in a criminal proceeding. An example of this would be a person that gets stopped on suspicion of driving under the influence (DUI) and gets charged with a DUI.  If that individual pleads guilty or no contest, that individual is subject to having their license revoked or suspended, or their license will not be renewed. 
• The individual made misleading, deceptive, untrue, or fraudulent representation to a patient, consumer, or other person or entity in connection with the practice of physical therapy.
• The individual practiced physical therapy contrary to the practice act or the rules and regulations of the board or has knowingly aided, assisted, procured, or advised any person to practice physical therapy contrary to this code. 
• Engaged in any unprofessional, unethical, deceptive conduct or practice harmful to the public (does not have to result in an actual injury to the patient) or failure to practice with minimal standards of physical therapy practice or comply with the code of ethics.
• Failed to report to the board any act or omission of a licensee, applicant, or any other person violating this subsection's provisions. 
• Divided fees or agreed to divide fees received for professional services from any person, firm, association, corporation, or other entity for bringing a referral or referring a patient. 

Discipline and Suspension

The board may take one or more of the following actions when they find that a person is unqualified to be granted a license or should be disciplined.  

• Refuse to grant or restore a license to an applicant
• Administer a public or private reprimand, but a private reprimand shall not be disclosed to any person except the licensee
• Suspend any license for a definite period
• Limit, restrict, or revoke any license
• Condition the penalty or withhold formal disposition upon the physical therapist or other person's submission to the care, counseling, or treatment of physicians or other professional persons and the completion of such care, counseling, or treatment as directed by the board.
• Impose a fine not to exceed $500 for each violation of law or rule, or regulation. 

The board has a lot of authority or leeway.  The board may find the individual guilty but withhold judgment and penalty, or they may impose judgment and penalty, suspend the enforcement of their findings, and place the licensee or applicant on probation. 

Restoration of License

The board may restore and reissue a license issued.

Civil and Criminal Liability

The practice act goes on to state that a person, firm, corporation, or any other entity is immune from civil and criminal liability for reporting and testifying on acts or omissions of a licensee or applicant which violate the act or any law relating to the ability of the individual to practice, as long as the report is done without fraud or malice. 

Unlicensed Practice

Practicing without a license and injunctive power is discussed in 43-33-19. It states that if a person is practicing without a license, the board or the district attorney of the circuit court where the unlicensed practice exists or any other person or organization having an interest may bring a petition to restrain such unlicensed practice in the superior court of the county where the licensed person resides.  

Penalty

At the end of the practice act (43-33-20), it states that a person convicted of violating this article is guilty of a misdemeanor. 

Georgia State Practice Act, Article 2 Physical Therapy Licensure Compact

Purpose/Objective

The purpose of this Compact is to facilitate the interstate practice of physical therapy with the goal of improving public access to physical therapy services. The practice of physical therapy occurs in the state where the patient or client is located at the time of the patient or client encounter. The Compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure.

This Compact is designed to achieve the following objectives:

• Increase public access to physical therapy services by providing for the mutual recognition of other member state licenses
• Enhance the states' ability to protect the public's health and safety;
• Encourage the cooperation of member states in regulating multi-state physical therapy practice;
• Support spouses of relocating military members;
• Enhance the exchange of licensure, investigative, and disciplinary information between member states and
• Allow a remote state to hold a provider of services with a compact privilege in that state accountable to that state's practice standards.

Definitions

As mentioned earlier, definitions give us a common framework from which to begin a discussion on a particular topic or issue. Please review the definitions as provided by the compact, as these are used in the discussion of the compact and may help understand the language in the upcoming areas.  

• "Active Duty Military" means full-time duty status in the active uniformed service of the United States, including members of the National Guard and Reserve on active duty orders pursuant to 10 U.S.C. Chapter 1209 and 10 U.S.C. Chapter 1211.
• "Adverse Action" means disciplinary action taken by a physical therapy licensing board based upon misconduct, unacceptable performance, or a combination of both.
• "Alternative Program" means a nondisciplinary monitoring or practice remediation process approved by a physical therapy licensing board. This includes but is not limited to, substance abuse issues.
• "Compact privilege" means the authorization granted by a remote state to allow a licensee from another member state to practice as a physical therapist or work as a physical therapist assistant in the remote state under its laws and rules. The practice of physical therapy occurs in the member state where the patient or client is located at the time of the patient or client encounter.
• "Data system" means a repository of information about licensees, including examination, licensure, investigative, compact privilege, and adverse action.
• "Encumbered license" means a license that a physical therapy licensing board has limited in any way.
• "Executive Board" means a group of directors elected or appointed to act on behalf of, and within the powers granted to them by, the Commission.
• "Home state" means the member state that is the licensee's primary state of residence.
• "Investigative information" means information, records, and documents received or generated by a physical therapy licensing board pursuant to an investigation.
• "Member state" means a state that has enacted the Compact.
• "Party state" means any member state where a licensee holds a current license or compact privilege or is applying for a license or compact privilege.
• "Physical Therapy Compact Commission" or "Commission" means the national administrative body whose membership consists of all states that have enacted the Compact.
• "Physical therapy licensing board" or "licensing board" means the agency of a state that is responsible for the licensing and regulation of physical therapists and physical therapist assistants.
• "Remote state" means a member state other than the home state where a licensee is exercising or seeking to exercise the compact privilege.
• "Rule" means a regulation, principle, or directive promulgated by the Commission with the force of law.
• "State" means any state, commonwealth, district, or territory of the United States of America that regulates the practice of physical therapy.

State Participation in the Compact

To participate fully in the compact, the state must:

• Participate fully in the Compact Commission's Data Base.
• Have a mechanism in place for receiving and investigating complaints about licensees.
• Notify the commission, in compliance with the terms of the compact and rules, of any adverse action or the availability of investigatory information regarding a licensee.
• Utilize the NPTE.
• Comply with the rules of the Commission.
• Have continuing competence requirements as a condition for license renewal.
• Fully implement a criminal background check requirement by receiving the results of the Federal Bureau of Investigation record search on criminal background checks and using the results in making licensure decisions.
• Have the authority to obtain biometric-based information from each physical therapy licensure applicant and submit this information to the Federal Bureau of Investigation for a criminal background check.

Compact Privilege

To utilize compact privilege under the terms of the Compact, the licensee is to do the following: 

• hold a license in the home state
• have no encumbrance on any state license
• be eligible for a compact privilege in any member state in accordance with subsections (d), (g), and (h);
• have not had any adverse action against any license or compact privilege within the previous two years
• notify the Commission that the licensee is seeking the compact privilege within a remote state(s);
• pay any applicable fees, including any state fee, for the compact privilege;
• meet any jurisprudence requirements established by the remote state(s) in which the licensee is seeking a compact privilege; and
• report to the Commission adverse action taken by any non-member state within thirty (30) days from the date the adverse action is taken.

     (b) The compact privilege is valid until the expiration date of the home license. The licensee must comply with subsection (a) requirements to maintain the compact privilege in the remote state.

     (c) A licensee providing physical therapy in a remote state under the compact privilege shall function within the laws and regulations of the remote state.

     (d) A licensee providing physical therapy in a remote state is subject to that state's regulatory authority. In accordance with due process and that state's laws, a remote state may remove a licensee's compact privilege in the remote state for a specific period, impose fines, and take any other necessary actions to protect the health and safety of its citizens. The licensee is not eligible for a compact privilege in any state until the specific time for removal has passed, and all fines are paid.

     (e) If a home state license is encumbered, the licensee shall lose the compact privilege in any remote state until the following occur:

• the home state license is no longer encumbered and 
• two years have elapsed from the date of the adverse action.

     (f) Once an encumbered license in the home state is restored to good standing, the licensee must meet the requirements of subsection (a) to obtain a compact privilege in any remote state.

     (g) If a licensee's compact privilege in any remote state is removed, the individual shall lose the compact privilege in any remote state until the following occur:

• the specific period of time for which the compact privilege was removed has ended;
• all fines have been paid; and
• two years have elapsed from the date of the adverse action.

     (h) Once the requirements of subsection (g) have been met, the licensee must meet the requirements in subsection (a) of this chapter to obtain a compact privilege in a remote state.

Active Duty Military Personnel and Spouses

A licensee who is active duty military or is the spouse of an individual who is active duty military may designate one of the following as the home state:

• home of record
• permanent change of station (PCS); or
• state of current residence if it differs from the PCS state or home of record.

Adverse Actions

Home State

A home state shall have exclusive power to impose adverse action against a license issued by the home state.

A home state may take adverse action based on the investigative information of a remote state so long as the home state follows its own procedures for imposing adverse action.

Member State

Nothing in this Compact shall override a member state's decision that participation in an alternative program may be used in lieu of adverse action and that such participation shall remain nonpublic if required by the member state's laws. Member states must require licensees who enter any alternative programs in lieu of discipline to agree not to practice in any other member state during the term of the alternative program without prior authorization from such other member state.

Any member state may investigate actual or alleged violations of the statutes and rules authorizing the practice of physical therapy in any other member state in which a physical therapist or physical therapist assistant holds a license or compact privilege.

Remote State

A remote state shall have the authority to:

• Take adverse actions against a licensee's compact privilege in the state;
• Issue subpoenas for hearings and investigations that require the attendance and testimony of witnesses and the production of evidence. Subpoenas issued by a physical therapy licensing board in a party state for the attendance and testimony of witnesses, and the production of evidence from another party state, shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state where the witnesses and evidence are located; and
• If otherwise permitted by state law, recover from the licensee the costs of investigations and disposition of cases resulting from any adverse action taken against that licensee.

Joint Investigations

• In addition to the authority granted to a member state by its respective physical therapy practice act or other applicable state law, a member state may participate with other member states in joint investigations of licensees.
• Member states shall share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.

Establishment of Physical Therapy Compact Commission

The Compact member states established a joint public agency, the Physical Therapy Compact Commission. Each member state shall have and be limited to one delegate selected by that member state's licensing board. The delegate shall be a current licensing board member, a physical therapist, a physical therapist assistant, a public member, or a board administrator.

Meetings and Voting  

Any delegate may be removed or suspended from office as provided by the state law from which the delegate is appointed. The member state board shall fill any vacancy occurring in the Commission. Each delegate shall be entitled to one vote regarding the rules and creation of bylaws and the opportunity to participate in the business and affairs of the Commission.  A delegate shall vote in person or by other means as provided in the bylaws. Meetings may also be attended remotely. Meetings are held annually, and additional can be set up according to the bylaws.  

Duties of the Compact Commission

• Establish bylaws.
• Promulgate rules.
• Establish a budget, maintain financial records, and borrow money.
• Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any real, personal, or mixed property.
• Accept any and all appropriate donations and grants of money, equipment, supplies, materials, and services, and receive, utilize, and dispose of the same, provided that at all times, the Commission shall avoid any appearance of impropriety and conflict of interest.
• Elect executive board.
• Terminate a state from the compact.
• Establish committees and task forces.
• Purchase and maintain insurance and bonds.
• Provide and receive information from, and cooperate with, law enforcement agencies.
• Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a member state.
• Hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals the appropriate authority to carry out the purposes of the Compact, and establish the Commission's personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters.
• Bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any state physical therapy licensing board to sue or be sued under applicable law is not affected.

Executive Board

Elected by the Compact Commission and the Executive Board and has the power to act on behalf of the Commission. Meet annually or more often if necessary.  

• There are 9 members. 
  • 7 elected from the membership of the Commission
  • 1 from FSBPT and 1 from APTA.  Both are non-voting, ex officio members of the commission

Duties of the Executive Board

• Recommend to the entire Commission changes to the rules or bylaws, changes to this Compact legislation, fees paid by Compact member states such as annual dues, and any commission Compact fee charged to licensees for the compact privilege.
• Prepare and recommend the budget.
• Maintain financial records on behalf of the Commission.
• Monitor Compact compliance of member states and provide compliance reports to the Commission.
• Establish other committees as necessary. 
• Ensure Compact administration services are appropriately provided.

Data System; Requirements for Submitting Data 

The commission provides a coordinated database and reporting system containing licensure, adverse action, and investigative information on all licensed individuals in member states.

The Commission will notify all member states of any adverse action taken against a licensee or an individual applying for a license, and adverse action information pertaining to a licensee in any member state will be available to any other member state.

Georgia General Provisions (Title 43, Chapter 33, Article 1) 

Point Credit for Veterans Taking Examinations Given by Professional Licensing Boards

Any veteran applicant taking an examination will receive points in the following manner:

Any applicant who served in active duty or reserves in the armed forces of the United States for at least one year and at least 90 days served during wartime or conflict is entitled to a credit of five points. Points are added by the person grading the examination.

Any applicant who is a disabled veteran and who served on active duty or in the reserves in the armed forces of the United States during wartime or during any conflict is entitled to a credit of five points if the disability was for an injury or illness incurred in the line of duty and such disability is officially rated at less than 10 percent at the time of taking the examination.  A credit of 10 points will be issued if the disability is officially rated at 10 percent or above at the time of examination.  Points are added by the person grading the examination.

Refusal to Grant, Revocation, and Reinstatement of Licenses; Surrender; Probationary License

A professional licensing board has the authority to refuse to grant or revoke a license to an applicant or to discipline a person licensed if the licensee or applicant has:

• Failed to demonstrate the qualifications or standards for a license. If the board is not satisfied with the applicant’s qualifications, it may deny a license without a prior hearing, but the applicant is allowed to appear before the board.
• Made misleading, deceptive, untrue, or fraudulent representations in practice or on any document on purpose; Practiced fraud or deceit or intentionally made any false statement in obtaining a license to practice the licensed business or profession; or made a false statement or deceptive registration with the board;
• Convicted of any felony or of any crime involving moral turpitude in the courts of this state or any other state, territory, or country or in the courts of the United States.  Been arrested, charged, and sentenced for the commission of any felony or any crime involving moral turpitude. 
• Had his or her license to practice a business or profession licensed under this title revoked, suspended, or annulled by any lawful licensing authority other than the board; had other disciplinary action taken against him or her by any such lawful licensing authority other than the board; was denied a license by any such lawful licensing authority other than the board, pursuant to disciplinary proceedings; or was refused the renewal of a license by any such lawful licensing authority other than the board, pursuant to disciplinary proceedings;
• Engaged in any unprofessional, immoral, unethical, deceptive, or deleterious conduct or practice harmful to the public that materially affects the fitness of the licensee or applicant to practice a business or profession licensed under this title or is of a nature likely to jeopardize the interest of the public; such conduct or practice need not have resulted in actual injury to any person or be directly related to the practice of the licensed business or profession but shows that the licensee or applicant has committed any act or omission which is indicative of bad moral character or untrustworthiness. Such conduct or practice shall also include any departure from, or the failure to conform to, the minimal reasonable standards of the acceptable and prevailing practice of the business or profession licensed under this title;
• Knowingly performed any act which in any way aids, assists, procures, advises, or encourages any unlicensed person or any licensee whose license has been suspended or revoked by a professional licensing board to practice a business or profession licensed under this title or to practice outside the scope of any disciplinary limitation placed upon the licensee by the board.
• Violated a statute, law, or any rule or regulation of this state, any other state, the professional licensing board regulating the business or profession licensed under this title, the United States, or any other lawful authority without regard to whether the violation is criminally punishable when such statute, law, or rule or regulation relates to or in part regulates the practice of a business or profession licensed under this title and when the licensee or applicant knows or should know that such action violates such statute, law, or rule; or violated a lawful order of the board previously entered by the board in a disciplinary hearing, consent decree, or license reinstatement;
• Found mentally incompetent by a court within or outside this state. This will automatically suspend the license of any such person and prevent the renewal of any license until the adjudication of incompetence is no longer in effect.
• Inability to practice or unable to practice with reasonable skill and safety to the public due to illness or the use of alcohol, drugs, narcotics, chemicals, or any other type of material; or
• Failed to comply with an order for child support.  The applicant or licensee must provide a notice of release to the board from the child support agency within the Department of Human Services indicating that the applicant or licensee has come into compliance with the child support order so that the license may be issued or granted (if all other conditions for licensure are met).

A professional licensing board has the authority to acquire, utilizing a subpoena granted by the division director, pertinent records concerning the mental or physical well-being of a licensee or applicant. These records, if obtained based on reasonable grounds, hold admissibility in hearings conducted by the board.

If a person is found unqualified to be granted a license or finds that any person should be disciplined by the board, the board may take any one or more of the following actions:

• Refuse to grant or renew a license to an applicant
• A public or private reprimand, but a private reprimand is disclosed only to the licensee
• Suspend any license for a definite period or for an indefinite period in connection with any condition
• Limit or restrict any license as the board deems necessary
• Revoke any license
• Condition the penalty upon, or withhold formal disposition pending, the applicant’s or licensee’s submission to counseling or treatment
• Impose a fine not to exceed $500.00 for each violation of a law, rule, or regulation relating to the licensed business or profession OR
• Require that the licensee or applicant pay fees or charges to reimburse the professional licensing board for the administrative and legal costs incurred by the board in conducting an investigative or disciplinary proceeding.

The professional licensing board may make a finding against the licensee or applicant in addition to or with those actions mentioned above but withhold the judgment and penalty, or the board may impose the judgment and penalty but suspend enforcement by placing the licensee on probation.  The probation may be canceled if the licensee is noncompliant with the board's terms.

The initial judicial review of a final decision made by a professional licensing board happens exclusively in the superior court located in the county where the board is based. In this review, if the court deems it appropriate, it can award reasonable attorney's fees and litigation expenses. This could be in cases where the appeal lacks substantial justification, is frivolous, groundless, vexatious, or was raised solely for the purpose of delay or harassment. Similarly, if an attorney or a party unreasonably extends the proceedings through improper actions, the court can impose such costs.

The professional licensing board may reinstate a license that has been revoked or issue a license that has been denied or refused. 

The Division Director is empowered with the authority to conduct investigations, either directly or through division staff, in collaboration with the relevant board. These investigations are essential for enforcing the regulations outlined in this Code section and the laws pertaining to licensed businesses and professions falling under the board's jurisdiction. Those authorized to carry out investigations on behalf of a professional licensing board are granted the right to access and review documents and materials related to the qualifications of licensees and applicants. In cases where reasonable grounds indicate a potential violation of this Code section or other laws regulating the licensed business or profession overseen by the board, the Division Director or their appointed representative may issue subpoenas to secure access to pertinent documents or materials.

The findings of all inquiries instigated by the board will be communicated exclusively to the board itself. The division director will be responsible for maintaining records of these inquiries on behalf of the board, and the board will retain the privilege of accessing these records whenever necessary. These records are not to be disclosed to any entity except the board, unless required for board hearings; furthermore, such records are exempt from subpoena. However, the board is permitted to share these records with other law enforcement agencies or legitimate licensing authorities when appropriate.

In cases where a licensee is the subject of a board inquiry, all records pertaining to individuals who received services from that licensee in their professional capacity will be admissible during any hearing aimed at determining if a violation of the chapter has occurred. This admissibility extends regardless of any statutory privilege; however, documentary evidence related to such individuals will be reviewed confidentially and will not be disclosed to the public.

The board holds the authority to clear the proceedings of all non-essential parties during its deliberations on disciplinary actions. Additionally, the board can hold private discussions concerning disciplinary matters with the concerned licensee or applicant, accompanied by their legal counsel.

In the event that a member of the public lodges a complaint against a licensee with a professional licensing board or the division director, the board or director has the responsibility to inform the complainant about the outcome of the complaint within 30 days after the investigation's conclusion. This communication must include details about any actions taken by the board in response to the complaint and the nature of such actions. Moreover, upon request, the division director and the board must inform the complainant about the complaint's pending status during the investigation period.

Any individual, entity, or organization, including persons, firms, corporations, associations, and authorities, will be protected from civil and criminal liability when reporting or investigating the actions or oversights of a licensee or applicant that contravene the regulations, or any other relevant legal provisions related to a licensee's or applicant's suitability for practicing a business or profession under this title. This immunity extends to those initiating or conducting proceedings against such licensees or applicants, provided that the actions are executed in good faith and without fraud or malice.

Furthermore, individuals who provide testimony or recommendations to a professional licensing board as part of peer review proceedings, done in good faith and without fraud or malice, are also safeguarded against civil and criminal liability for their statements.

Regarding specific procedures, actions like the issuance of a private reprimand, denial of a license by reciprocity, denial of reinstatement for a revoked license, or refusal to grant a previously denied license do not qualify as contested cases under the "Georgia Administrative Procedure Act." These actions do not necessitate the formal notice and hearing procedures as outlined in the mentioned chapter. However, the applicant or licensee retains the right to appear before the board if they so choose.

Additionally, a board can resolve ongoing matters by issuing a "letter of concern," which doesn't constitute a disciplinary action or a contested case. This letter is confidential and only accessible by the licensee or applicant concerned.

If a licensee or applicant does not appear at a hearing after being given reasonable notice, the licensing board can proceed with the hearing and take action as if the licensee or applicant was there. The notice of the hearing, initial or recommended decision, or final decision from the board in a disciplinary case must be personally served to the licensee or applicant or sent by certified mail or overnight delivery that requires a return receipt to the last known address on record with the board. 

If the notice is sent by certified mail or overnight delivery and returns unclaimed, refused, or undeliverable, and the licensee or applicant can't be located after diligent effort, the division director or their designee will be considered the agent for service for that licensee or applicant under this law section. Service on the director or their designee is considered service on the licensee or applicant.

Voluntarily surrendering a license or failing to renew it by the deadline has the same effect as revoking the license, subject to possible reinstatement at the board's discretion. A board may restore and reissue a license to practice under the law related to that board. As a condition, the board may impose any disciplinary action allowed by this law section or the law related to that board.

This law section applies equally to all licensees or applicants, whether they are individuals, partners, members of any incorporated or unincorporated associations, corporations, limited liability companies, or any other kind of associations.

Regulation of a licensed business or profession by a professional licensing board does not exempt that business or profession from regulation under any other applicable law, including but not limited to Part 2 of Article 15 of Chapter 1 of Title 10, the "Fair Business Practices Act of 1975."

The subsections of this law section supplement and do not prohibit any professional licensing board from acting under other laws that may authorize different disciplinary grounds and actions for that particular board. In cases where those other laws authorize disciplinary grounds and actions but subsections of this law section limit them, those other provisions will apply as long as the requirements of subsection below of this law section are met.

Notwithstanding the first two bullet points of this section or any other provision of law, and unless a felony or crime involving moral turpitude directly relates to the occupation for which the license is sought or held, no professional licensing board shall refuse to grant a license to an applicant or revoke the license of an individual licensed by that board due solely or in part to an applicant or licensee's:

1. Conviction of any felony or any crime involving moral turpitude, whether it occurred in the courts of this state or any other state, territory, or country or in the courts of the United States;
2. Arrest, charge, and sentence for the commission of such offense;
3. Sentence for such offense as a result of a plea of nolo contendere;
4. Adjudication of guilt or sentence was otherwise withheld or not entered or
5. Being under supervision by a community supervision officer, as defined in Code Section 42-3-1, for a conviction of any felony or crime involving moral turpitude, whether it occurred in Georgia courts or any other state, territory, country or federal court, so long as the individual was not convicted of a felony violation of Chapter 5 of Title 16 or a crime requiring registration as a sex offender.

To determine if a felony or crime involving moral turpitude directly relates to the occupation for which the license is sought or held, the professional licensing board shall consider:

1. The nature and seriousness of the felony or crime involving moral turpitude and its relationship to the occupation for which the license is sought or held;
2. The age of the individual when the felony or crime involving moral turpitude was committed;
3. The time elapsed since the felony or crime involving moral turpitude was committed;
4. All circumstances related to the felony or crime involving moral turpitude, including any mitigating circumstances or social conditions surrounding its commission and
5. Evidence of rehabilitation and present fitness to perform the duties of the occupation for which the license is sought or held.

Waiver of Deductibles or Copayments in Health Insurance Plans; Deceptive or Misleading Advertising

It is considered a deceptive or misleading practice for any person licensed to provide any type of health care services to advertise a waiver of a deductible or copayment required to be made to such person under the patient’s health insurance policy or plan in order to attract patients. 

Notwithstanding the provisions of any other law, it shall not be considered a misleading, fraudulent, or deceptive act for a provider to occasionally waive a deductible or copayment required to be made under the patient’s health insurance contract, policy, or plan if the waiver is authorized by the insurer or if the waiver is based on an evaluation of the individual patient and is not a regular business practice of the person providing the health care services.

License Applications to Include Questions on Prior Revocation or Denial of License

An application for a license to practice includes a question as to whether the applicant:

• Has had a license revoked, suspended, or sanctioned by any board or agency in Georgia or any other state; or
• Was denied issuance of a license or refused renewal of a license by any board or agency in Georgia or any other state.

The question is to be answered under oath, and the answer shall include the name of the board or agency which revoked, suspended, denied, refused renewal of, or otherwise sanctioned the license.

Actions to Enjoin Unlicensed Practice

A professional licensing board, the division director, or the appropriate prosecuting attorney may bring an action to prohibit the unlicensed practice by any person of a profession or business required to be licensed by a professional licensing board. The action will be brought in the county's superior court where the unlicensed person resides.

Cease and Desist Orders Against Persons Practicing Without a License; Fine for Violating Order  

The board may issue a cease and desist order (after notice and a hearing) prohibiting any person from engaging in the practice of a business or profession without a license. 

If the cease and desist order is not followed, the person violating the order will have further proceedings before the board. The board is authorized to fine the individual up to $500 a day that they practice in violation of the order.  

A review of the board's decision will be available in the superior court of the county of domicile of the board.

Release of Information Regarding Investigations

The director of the professional licensing boards division in the Secretary of State's office (Division director) may provide information regarding a past or pending investigation of or disciplinary sanction against any applicant for licensure by that board or licensee of that board to any licensing authority of Georgia or any other state, upon inquiry.  

Inactive Status Licenses

The division director may provide for inactive status licenses for the professional licensing boards

Exemption of Licensees of Professional Licensing Boards From Filing With Clerk of Superior Court

No licensee of a professional licensing board is required to file or record his license with the clerk of the superior court. The clerk is not required to report the filing or recording of a license. 

Licensed Professionals Subject to Regulation by Professional Licensing Board.

Any person licensed by a professional licensing board and who practices a “profession” or who renders “professional services” is subject to regulation by that professional licensing board. In your case, that is the Georgia State Board of Physical Therapy.  

Authority of Professional Licensing Boards to Promulgate Rules and Regulations

This allows the Georgia State Board of Physical Therapy to enact rules and regulations.

Licensee Required to Notify Licensing Authority of Felony Conviction.

Any licensed individual who is convicted of a felony under the laws of Georgia, the United States, or any other state, territory, or country is required to notify the Georgia State Board of Physical Therapy of the conviction within ten days of the conviction. If an individual fails to notify the licensing Board of that conviction, that is grounds for revocation of his or her license. 

Suspension of License for Nonpayment of Student Loans Prohibited

A professional licensing board shall not suspend the license of a person licensed by that board because he or she is a borrower in default under the Georgia Higher Education Loan Program as determined by the Georgia Higher Education Assistance Corporation or because he or she has been certified by any entity of the federal government for nonpayment or default or breach of a repayment or service obligation under any federal educational loan, loan repayment, or service conditional scholarship program.

Volunteers in Health Care Specialties

This section is known as the Georgia Volunteers in Health Care Specialties Act.  

Each health care board must issue a special license to qualifying practitioners within their specialty. To qualify, you need to either:

1. Hold an unrestricted, in-good-standing license for your specialty from any U.S. health care licensing jurisdiction.

2. Be retired from practice, and before retiring or going inactive, you must have maintained an unrestricted, in-good-standing license in the U.S. health care jurisdiction for your specialty.

Special license holders can only practice their health care specialty in unpaid roles within specific contexts. This includes public agencies, non-profit organizations, institutions, corporations, or associations providing specialty services to underserved or indigent patients, designated by the specialty's licensing board or under Article 8 of Chapter 8 of Title 31.

To apply for this license, submit your specialty degree copy, past or present specialty license copy from your previous jurisdiction, and a notarized statement from your employer on the board's prescribed form, confirming your no-compensation commitment for services rendered under this license.

Fees for exams, applications, licenses, and renewals can be waived for special license holders. If not meeting continuing education requirements during application, a nonrenewable temporary license for six months may be granted, given other qualifications are met. 

Liability for practitioners and employers practicing under this special license complies with Code Section 51-1-29.1.

Expiration of Professional Licenses of Service Members on Active Duty Outside of State

As used in this Code section, the term “service member” means an active duty member of the regular or reserve component of the United States armed forces, the United States Coast Guard, the Georgia National Guard, or the Georgia Air National Guard on ordered federal duty for a period of 90 days or longer.

(b) Any service member whose license to practice a profession issued pursuant to any provision of this title expired while such service member was serving on active duty outside the state shall be permitted to practice such profession in accordance with such expired license and shall not be charged with a violation of this title related to practicing a profession with an expired license for a period of six months from the date of his or her discharge from active duty or reassignment to a location within the state. Any such service member shall be entitled to renew such expired license without penalty within six months after the date of his or her discharge from active duty or reassignment to a location within the state. The service member must present to the applicable professional licensing board either a copy of the official military orders or a written verification signed by the service member’s commanding officer to waive any charges.

Advertisement, Signage, and Identifier Requirements for Health Care Practitioners

This act is also known as the Consumer Information and Awareness Act.  

The General Assembly hereby finds and declares that:

(1) There are numerous professional degrees that include the term “doctor,” such as Doctor of Medicine (M.D.); Doctor of Osteopathy (D.O.); Doctor of Dental Surgery (D.D.S.); Doctor of Dental Medicine (D.M.D.); Doctor of Podiatric Medicine (D.P.M.); Doctor of Optometry (O.D.); Doctor of Chiropractic (D.C.); registered professional nurses or advanced practice registered nurses (nurse practitioners, clinical nurse specialists, certified nurse midwives, and certified nurse anesthetists) with doctorate degrees (D.N.P., D.N.S., Ph.D., or Ed.D.); audiologists with doctorate degrees (A.U.D.); speech-language pathologists with doctorate degrees (S.L.P.D. or Ph.D.); and other designations, which may be used by health care practitioners; and

(2) Each health care professional receives education and training that qualifies them to provide general and specialized services respectively. This training is necessary to correctly detect, diagnose, prevent, and treat serious health conditions.

(c) As used in this Code section, the term:

(1) “Advertisement” means any communication or statement, whether printed, electronic, or verbal, that names a health care practitioner in relation to his or her practice, profession, or institution in which the practitioner is employed, volunteers, or otherwise provides health care services. This term includes business cards, letterhead, patient brochures, e-mail, Internet, audio, and video.

(2) “Health care practice or facility” means a hospital, physician practice setting, nursing home, assisted living community, or personal care home.

(3) “Health care practitioner” included a physical therapist. 

An advertisement by a health care practitioner shall identify the type of license the health care practitioner holds.

(2) This subsection shall not apply to an advertisement by a health care practice or facility and shall not be construed to require any such practice or facility in which multiple health care practitioners are employed to list in an advertisement the name of every health care practitioner so employed by such practice or facility.

(e)(1) A health care practitioner providing services in this state in a health care practice or facility shall conspicuously post and affirmatively communicate the practitioner’s specific licensure to all current and prospective patients as follows:(A)(i) The health care practitioner shall wear an identifier during all patient encounters that shall include:

(I) The health care practitioner’s name; and

(II) The type of license or educational degree the health care practitioner holds.

(ii) The identifier shall be of sufficient size and be worn in a conspicuous manner so as to be visible and apparent. A lab coat or similar distinguishing clothing or uniform indicating the practitioner’s specific licensure may be considered an identifier if such clothing or uniform meets the requirements of division (i) of this subparagraph.

(iii) An identifier shall not be required in an operating room or other setting where surgical or other invasive procedures are performed or in any other setting where maintaining a sterile environment is medically necessary.

(iv) An identifier shall not be required in any mental health setting where it would impede the psychotherapeutic relationship.

(v) If a safety or health risk to the health care practitioner or a patient would be created as a result of the practitioner wearing such identifier in a specified practice setting, an identifier shall not be required or may be modified by omitting or concealing the last name of the practitioner in accordance with the requirements of the health care practice or facility; and

(B) A health care practitioner in a health care practice or facility other than a hospital shall display in the reception area of such practice or facility a notice that clearly identifies the type of health care practitioners employed in such practice or facility and the right of a patient to inquire as to the type of license of the health care practitioner treating such patient. The notice shall be of sufficient size so as to be visible and apparent to all current and prospective patients.

(2) A health care practitioner who practices in more than one office shall place the identifier information conspicuously on such practitioner’s website if he or she maintains a website.

(3) A health care practitioner who practices in a nonpatient care setting and who does not have any direct patient care interactions shall not be subject to the provisions of this subsection.

(4) A health care practice or facility which requires, as of the effective date of this Code section, its health care practitioners to wear an identification badge shall not be required to replace such badges to conform to the requirements of subparagraph (A) of paragraph (1) of this subsection.

(5) Except as otherwise provided by paragraph (6) of this subsection, this subsection shall only apply to health care practices and facilities where more than one type of health care practitioner interacts with patients in exam settings. This subsection shall not apply to health care practices or facilities in which only one type of health care practitioner practices.

(6) This subsection shall only apply to a dentist if such dentist is practicing in a hospital. This subsection shall only apply to a chiropractor or optometrist if such chiropractor or optometrist is practicing in a hospital, nursing home, assisted living community, or personal care home.

(f) A health care practitioner who intentionally violates any provision of this Code section may be subject to disciplinary action by the health care practitioner’s professional licensing board. Notwithstanding the imposition of any sanction, the health care practitioner’s professional licensing board may seek an injunction or other legal means as appropriate against such health care practitioner violating this Code section.

(g) A violation of this Code section shall not constitute a private cause of action.

Expedited license by endorsement for spouses of active or transitioning members of the armed forces; license by endorsement for certain professions. 

Notwithstanding any contrary provisions of law, a professional licensing board or another relevant board is required to issue an expedited license by endorsement to an individual who qualifies as the spouse of a service member or transitioning service member stationed within the State of Georgia. This applies under the following conditions:

1. The individual currently holds a valid license to practice the same occupation or profession issued by another state. The training, experience, and testing prerequisites of that state must be substantially equivalent in terms of qualifications and scope to the requirements set forth by the state of Georgia for obtaining a license in the same field.

2. The individual's status in the originating state is in good standing, and there are no ongoing investigations or disciplinary proceedings being conducted by a professional licensing board or a relevant board in that state.

3. The individual successfully completes any examination that might be mandated, specifically focused on gauging their familiarity with the laws, rules, and regulations pertinent to the state of Georgia, particularly as they relate to the specific practice of the profession, trade, or business for which the expedited license by endorsement is being pursued.

A professional licensing board or another relevant board is obligated to grant a license by endorsement to any individual seeking licensure for a profession (excluding firefighters, healthcare providers, and law enforcement officers), provided that the individual fulfills the following conditions:

1. The individual has moved from another state and established residency within the current state.

2. The individual possesses a valid license to practice the occupation or profession issued by another state before establishing residency in the present state. This license must reflect that the training, experience, and testing prerequisites are substantially comparable in terms of qualifications and scope to the requirements laid out by the current state for obtaining a license in the same field.

3. The individual maintains good standing in the former state and is not currently under investigation or facing disciplinary proceedings by a professional licensing board or another relevant board in that state.

4. The individual successfully completes any mandated examination aimed at assessing their understanding of the laws, rules, and regulations unique to the current state. These pertain specifically to the practice of the relevant profession, business, or trade for which the license by endorsement is being pursued.

An expedited license by endorsement must be granted within 90 days from the receipt date of an application, along with the accompanying information and documents that confirm fulfillment of all requirements.

Regulations-Physical Therapy Board Rules, Chapter 490

Rules and regulations are held in the Georgia compilation of rules, laws, and regulations, Title 490, parts 1 through 13.  A regulation is a rule or order prescribed for management or government.  It's a regulating principle, a precept.  It is that which various governmental departments issue to carry out the intent of the law. The Georgia Administrative Code encompasses the Rules of the Georgia Board of Physical Therapy (Chapter 490)

The first part of the rules and regulations of the State of Georgia is the administrative history for Chapter 490.  This history allows you to see when a particular rule went into effect if it was amended, and if it was repealed.  This could be a quick way to see what changes have taken place since the last time you reviewed the rules and regulations of physical therapy practice in the state of Georgia.    

Organization of the Board 

As we saw in the statutes, the governor appoints eight members to make up the Board of Physical Therapy.  The public may receive information from the board and may make submissions or requests to the board by contacting the Joint Secretary of the Professional Licensing Board Division, 237 Coliseum Drive, Macon, Georgia 31217

A president and vice president are elected annually by the board members.  They may be re-elected.  The election is held during a regular December meeting with the elected officers to preside at the following meeting.  It is the duty of the president to call and preside at all meetings. An exception is that four board members may call a meeting, provided all members are adequately notified. 

The vice president is to call and preside at meetings in the president's absence. 

It is the responsibility of the Joint Secretary to keep accurate minutes of all meetings and submit a report at each meeting; maintain all records; carry on the official correspondence of the Board; and collect and disburse all fees.

Licensure Requirements

Application for Licensure and Examination

A completed application for examination must be submitted and approved before taking the examination. 

This is more of an obvious statement but was added more recently when the PT compact was approved, which we will discuss shortly.  Any PT or PTA who desires to practice in Georgia must be licensed by the Board or hold a Georgia Compact Privilege issued by the Physical Therapy Compact Commission before practicing as a PT or PTA.

Any applicant who does not submit the required documentation indicated in the Joint Secretary Rules and/or policies. If not completed in that time frame, applications will not be given further consideration by the board until submission of a new application and payment of appropriate fees occurs.  All applicants are subject to the Georgia code.

Licensure: Examination

This section goes into licensure by examination.  There are a few paths to licensure in the state of Georgia, and we will be going over all of them briefly today.

As mentioned earlier, all applicants are required to submit a completed application, pay the appropriate fee and pass an examination for licensure to practice the profession in Georgia unless they are applying for Licensure by reciprocity.   The Board may grant a license to an applicant who has previously taken and passed the appropriate physical therapy examination. 

Graduates of schools accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) and applying for licensure in the state of Georgia must submit the following:  

• A passing score on the national licensing examination
• Passing scores from examination on the laws governing the practice of physical therapy in Georgia and the rules of the Georgia State Board of Physical Therapy
• Proof of graduation that comes from the college/university that issued the PT or PTA degree with the date of graduation.  

Verification of licensure in all states in which the licensure candidate holds a license or has ever held a license may be conducted by board staff. 

In summary, in order to practice in Georgia, one needs to pass the licensing exam, pass the jurisprudence exam, and then have their physical therapy/physical therapist assistant school transcript provided to the board. 

Licensure: Foreign-Educated Applicants

Then we have the rule regarding licensure for foreign-educated applicants who are graduates of foreign educational programs conducted in a foreign country that are not accredited by CAPTE and approved by the Board. 

Those individuals must do the following: 

• They must submit their transcripts to be evaluated by a credential evaluation agency to ensure their education is equivalent to entry-level U.S.-educated therapists.   A list of credentialing agencies approved by the Board shall be included in each application packet.
• Submit evidence of current and valid licensure/certification/registration to practice physical therapy, or provide proof of eligibility to practice physical therapy in the country of education.
• Verification of licensure/certification/registration in all jurisdictions in which the candidate holds or has ever held a license/certification/registration must be submitted.
• Applicants who were educated in an English-speaking physical therapy program need to have a school official submit a letter to the board stating that the physical therapy courses were taught in English. 
• Applicants who completed a physical therapy program in a non-English speaking institution must achieve a minimum passing score of 89 on the IBT TOEFL. This includes obtaining a passing score of 22 on the writing section, 22 on the reading section, 21 on the listening section, and 24 on the speaking section. Official score results must be submitted to the Board before being eligible to sit for the licensure examination.
• Once a completed application is on file and before initiation of a traineeship, all foreign-educated applicants must take and pass the NPTE, an examination on the laws governing the practice of physical therapy in Georgia, and the rules of the Georgia State Board of Physical Therapy. 
• Complete a board-approved traineeship consisting of 480 hours which must be completed within three months of the issuance of the traineeship permit.  The board may waive this requirement if the applicant demonstrates clinical competency, a minimum of five years of continuous active practice, and a license in good standing.

Any applicant educated in a foreign physical therapy program that is accredited by CAPTE and approved by the Board does not have to do the above, but they must meet the conditions of the Board Rule regarding Licensure by Examination discussed earlier.   

Training Permits

A training permit may be issued to applicants following the Board's approval of a properly submitted application.

Qualified applicants are:

• Graduates of an introductory program for PT or PTAs  (either CAPTE or non-CAPTE accredited school) who have taken and passed the NPTE and an examination on the laws and rules governing the practice of physical therapy in Georgia.
• Applicants for reinstatement or applicants for endorsement who have not practiced for two years up to five years
• Applicants for reinstatement or applicants for endorsement who have not practiced for more than five years and have successfully taken and passed the NPTE and the examination of the laws and rules, and regulations of physical therapy in Georgia

Initial Application. The initial training permit application must be notarized and submitted by the trainee's supervisor. 

The following must be included in the application:

1. Name and license number of the trainee supervisor and the contact information for the supervisor. 
2. Effective dates of the traineeship and the type of facility
3. Name, address, phone, fax number, and e-mail address of all sites where the trainee and supervisors may be working during the course of the traineeship
4. The supervisor must accept responsibility for the supervision of the trainee and completion of the performance evaluation
5. Termination of the trusteeship is defined 

Renewal. A trainee permit may be renewed once for no more than six months. A written request is required and needs to be approved by the board.  The Board will determine if the reason for renewal is a good and exceptional reason. Failure to pass the licensing exam is not considered a good and exceptional reason.

Good and exceptional reasons include the death of an immediate family member, illness of the applicant or immediate family member of which a physician’s note is needed, and jury duty, which also requires proof.

Validity of Permit. The traineeship permit is subject to the following conditions. 

• The permit is able to be initiated in the State of Georgia within three months of issuance.  
• The permit must be returned to the board by the trainee with an explanation of why it was not used. 
• A 480-hour traineeship must be completed within three months of initiation.  A 1000-hour traineeship must be completed in no less than six months or no more than one year if approved by the board. 
• A trainee permit shall become invalid and must be immediately returned to the board office by the trainee if the trainee fails to complete the traineeship within the time limits or if performance is not deemed satisfactory by the supervisor.

Supervision

We talked about supervision earlier in the statutes.  This discussion on supervision is related only to traineeships.  The supervisor or alternate supervisor named on a training permit application holds full responsibility under their license for direct, continuous, on-site supervision of the trainee at all times. The supervisor must ensure the trainee does not perform any patient care activities in his or her absence.  The supervising therapist can supervise no more than two trainees at one time. 

The supervisor and alternate supervisor must hold a Georgia license in good standing and must have practiced physical therapy for more than one year.  The supervisor must regularly evaluate trainee performance in all areas specified by the board.  All documentation by the trainee must be reviewed and cosigned by the supervisor. 

If, of course, the primary supervisor cannot fulfill their duties as a supervisor, a new application requesting an alternative supervisor must be approved by the board.  The trainee may not practice until the board approves an alternate supervisor. 

The supervisor must notify the board of unsatisfactory performance.  If that occurs, the training permit becomes null and void.

The supervisor must notify the Board within ten business days when the trainee completes the traineeship and submit a performance evaluation on the board-approved Traineeship Performance Evaluation Reporting form.  

Fees

The next rule in this section is regarding fees.  The board has the right to set the fees.  The fees are reviewed and changed at the discretion of the board.

Practical and Oral Exams

In addition to the NPTE and the exam over the laws for physical therapy practice in the state of Georgia, the board has the right to require a practical and oral examination if and when the board feels it is necessary to determine the qualifications of an individual.  So, on its own initiative, the board can require an applicant's practical or oral examination. 

Licensure by Reciprocity 

The board may register a physical therapist or physical therapist assistant without examination after payment of applicable fees. 

Any applicant applying for licensure who is a graduate of a PT or PTA program accredited by CAPTE and approved by the board must provide the following: 

• Verification of an active license in good standing from another state board
• Verification of any licensure held in good standing from all state boards in which the applicant has a license to practice 
• Official transcript with graduation date from the school from which they graduated and scores on the NPTE. 
• Passing scores from the national licensing exam and from the Georgia Ethics and Jurisprudence Examination
• Transcript from the college/university that issued the entry-level PT or PTA degree with the graduation date.  
• Verification of active practice in the two years immediately preceding the date of application; or proof of completion of 26 hours of acceptable continuing education coursework.

The requirements for a PT or PTA applicant applying via reciprocity who graduated from a non-accredited program or was not approved by the Board are very similar.  They include those listed above, except, instead of the accredited school transcript, the requirements include an official evaluation and transcript from a credential evaluation organization approved by the State of Georgia.  

Licensure by Endorsement/Reciprocity for Military Spouses and Transitioning Service Members

A military spouse or transitioning service member can apply for licensure by reciprocity if the applicant is a holder of a valid physical therapy or physical therapist assistant license in another State if the training, experience, and testing substantially meet or exceed the requirements under Georgia regulation for licensure. 

The military spouse or transitioning service member must be a graduate of a physical therapy or physical therapist assistant program accredited by the CAPTE and approved by the Board and must provide the following: 

• Current license to practice in another state is in good standing
• Verification of licensure in good standing from the state board of all states where the applicant has held a license to practice actively. This must happen within the first six months of the license being issued.
• Continued competence in physical therapy for two years before the application date as shown by verification of employment or 26 hours of acceptable continuing education coursework as discussed in Board rules for continued competence.  
• A passing score on the national licensing examination
• Passing scores from the Georgia State Board of Physical Therapy ethics and jurisprudence examination.
• Transcript from the college/university that issued the PT or PTA degree with the graduation date.  

Military spouses or transitioning service members applying for licensure under reciprocity who is a graduate of a program that is not CAPTE or Board approved have similar requirements as those that are CAPTE approved.  

Requirements include: 

• Verification of an active license in good standing from another state.
• Verification of licensure in good standing from the state board of all states in the past two years in which the applicant has held a license to practice actively. This must happen within the first six months of the license being issued.
• Continued competence in physical therapy for two years before the application date as shown by verification of employment or 26 hours of acceptable continuing education coursework as discussed in Board rules for continued competence. 
• A passing score on the national licensing examination
• Passing scores from the Georgia State Board of Physical Therapy ethics and jurisprudence examination.
• Official evaluation and transcript from a credential evaluation organization approved by the State of Georgia.  

Evaluation of Examinations

Scores on the NPTE range from 200-800.  The passing level for the NPTE shall be determined by the board. The minimum passing score is 600 for both PT and PTA examinations.

Re-examination. An applicant who fails the examination on the first attempt can retake the examination up to the maximum lifetime limit in accordance with the eligibility criteria established by the exam administrator and approved by the Board. 

An applicant who has failed the examination will receive notification from the Board of scores received with a request that the applicant reviews the score report provided to them by the exam administrator. The notification from the board will also include information on improving proficiency and assistance in preparation to retake the exam.  

In the event that the applicant was notified by the exam administrator or the Board that he or she is ineligible to register to retake the national examination,  the applicant may submit an appeal form to the Board for one additional attempt to retake and pass the national exam. 

If the applicant has not successfully passed the NPTE within two years of the initial test date, the Board may require the applicant to complete a board-approved traineeship upon passing the examination and before issuing a license.  

An applicant may request a hearing before the board if the board refuses an examination. Any of these hearings before a board are generically termed “administrative hearings”.  If the hearing is approved, the applicant will set forth his/her case in front of the board in order to seek approval to take the examination again.   

Renewal and Reinstatement of License and Penalties

Every physical therapist and physical therapist assistant shall bi-annually apply to the board for renewal, submit proof of continuing competency requirements, and pay the renewal fee by December 31st of odd years.  

At the board's discretion, an applicant may be exempted from continuing competence requirements if the person holds a license in good standing in another state or if the individual is employed as a physical therapist or physical therapist assistant by the U.S. government and provides physical therapy services. 

A license that is not renewed on or before December 31 of odd years shall be assessed a late fee, and a license that is not renewed by February 1st of the following year shall lapse and shall be revoked. 

A physical therapist and physical therapist assistant who has been licensed in the state of Georgia previously who allowed his/her license to be revoked by not renewing needs to submit an application for reinstatement and pay a fee as well as meet specific requirements, depending on how long the license has lapsed.

An applicant who is able to document that he or she has been a practicing physical therapist or physical therapist assistant within the past two years will be required to submit proof of continuing competence requirements required by the Board that we will discuss next. 

An applicant who is unable to document that he or she is a practicing physical therapist or physical therapist assistant within two to five years shall be required to submit proof of continuing competence and is required to work under the supervision of a physical therapist licensed in Georgia for 480 hours, completed within three months and pass the exam on the laws regarding the practice of physical therapy in the state of Georgia and the rules of Georgia State Board of Physical Therapy. 

An applicant who is unable to provide any documentation that they practiced for the past five or more years will be under the supervision of a licensed Georgia physical therapist for 1000 hours of continuous supervised practice, which can be completed in no less than six months but no more than one year if approved by the Board. The applicants must also pass the licensing exam again and pass the laws governing physical therapy practice and the Georgia Board of Physical Therapy rules. 

Continuing Competence Requirements

This is a very important part of the course for most of you. I have a slight bias due to being in the continuing education field myself.  I feel this is an extremely important part of being a physical therapist or physical therapist assistant, and keeping up with what is new in our field should be a requirement but also a desire as we strive to better ourselves and improve outcomes for our patients. 

I presume you are taking this course to be in compliance with Georgia Administrative Code 490-4-.02.  This rule states that each licensed physical therapist and physical therapist assistant in Georgia has to take a minimum of 30 clock hours per licensure period to promote continuing competence. A limit of no more than ten (10) credit hours per calendar day is to be completed. 

It goes on to say that the content of the continuing education experience must relate to patient care in physical therapy regardless if the subject is research, treatment, documentation, education, management, or some other content area. According to the Board, continued competence should be planned learning experiences with content beyond the licensee's present level of knowledge and competence, which may be subject to audit by the board.

Of that 30-hour requirement, 4 hours must be specifically in Georgia Ethics and Jurisprudence or by taking and passing the  Georgia Ethics and Jurisprudence Examination. Passing that examination is equal to taking a 4-hour course specifically in Georgia Ethics and Jurisprudence however, the same test result can not have been previously submitted to the Board as part of an application for licensure or to satisfy the requirements of an order of the Board.

Courses and activities considered for approval are the following: 

• Programs approved by the American Physical Therapy Association (APTA) and its affiliate components
• American Physical Therapy Association of Georgia and any other state chapters
• Programs approved by the Federation of State Boards of Physical Therapy 
• Programs provided at CAPTE Accredited colleges and universities with programs in physical therapy when the continuing competency course is held under the school of physical therapy. 
• Programs offered by similar professional organizations offering experiences that meet the guidelines discussed earlier
• Fifteen (15) hours for undergoing a peer review OR Ten (10) hours for conducting a peer review when that activity is an adjunct responsibility and not the primary employment 

• If you are a presenter for a continuing education course or seminar and have been approved by one of the sources mentioned a little bit ago, the continuing competence credit is based on contact hours and cannot exceed 10 hours per topic. 

• Authoring a scientific poster, platform presentation, or published article is 10 hours per event and may not exceed 20 hours.

• Adjunct teaching at a physical therapist or physical therapist assistant program when that teaching is an adjunct responsibility and not the primary employment; Continuing competence credit is based on contact hours not to exceed 20 hours; 

• Certification of clinical specialization by the American Board of Physical Therapy Specialties. Continuing competence credit is 30 hours and is recognized only in the biennium in which certification or recertification is awarded.

• Self-instruction from reading professional literature; Continuing competence credit is limited to a maximum of three hours; or

• Attendance at a scientific poster session, lecture, panel, symposium, or university course is one hour per contact hour of activity or

• Being a clinical instructor for a PT or PTA student. Continuing competence credit is one (1) hour per eight contact hours with a maximum credit of ten hours or

• Being a  clinical instructor or an intern for a formal, nonacademic, advanced clinical internship or as a mentor or a learner for a formal, nonacademic mentorship with a maximum credit of ten hours.

• Donating time in the role of a Physical Therapist or Physical Therapist Assistant, within the scope of practice, to a charity event; Continuing competence credit is one hour per eight contact hours, limited to a maximum of five hours;

• Post-licensure physical therapist educational programs that provide academic credit count as one university credit hour, equaling ten continuing competence hours. For example, a two credit hour course in which a passing grade is achieved would equal 20 continuing competence hours.

A license will not be renewed if a licensee does not meet this requirement.

Unacceptable activities for continued competence per these rules include:

• Orientation/in-service hours
• Meetings where the purpose is policy decisions
• Non-educational meetings at the annual association, chapter, or organizational meetings
• Entertainment or recreational meetings
• Committee meetings, holdings of offices, serving as an organization delegate
• Visiting exhibits
•  CPR. 

Continuing competence hours are a requirement within the first biennium that a physical therapist or physical therapist assistant becomes licensed in Georgia, with a few exceptions. Those who recently graduated and passed the NPTE are exempt from the continuing competence requirement during that biennium only. Another exception for the continuing competence requirement is if the licensee was licensed during the last six months of a biennium renewal period. The final exception is if an individual has been reinstated within the last six months of a biennium period, they may use the continuing competence coursework used for reinstatement to satisfy the hours needed.    

CE Broker. All licensed physical therapists or physical therapist assistants must maintain a record of completed continuing education courses and experiences by registering with an online recording and reporting system approved by the Board.  The Board approved CEbroker, which is provided at no cost to the licensee or applicant.

Licensees and applicants subject to the rules of the Georgia State Board of Physical Therapy are said to consent to the Board and its representatives to access their continuing competence record on the online database (CEbroker) to audit and verify completion of the continuing competence requirement.  The individual waves any objections to the admissibility of the record in any proceedings or hearing before the board. 

Audit

What happens if you are selected for an audit?   

Those licensees selected for audit are to submit documentation of compliance upon receipt of the notice. To do that, one should include: 

• An official program or outline of the course attended or taught or a copy of the publication that clearly shows that the objectives and content were related to patient care in physical therapy and shows the number of contact hours, as appropriate. The information also should clearly identify the licensee's responsibility in teaching or authorship and
• A certificate of completion of home study that identifies the provider or maintains a copy of the final grade report in the case of a University credit course(s), specialization certificate, or proof of attendance with a copy of the program for the other acceptable activities, or documentation of self-instruction or reading professional literature; or
• Verification of a peer review of practice with verification of acceptable practice by a recognized entity such as the APTA Board Policy (G03-05-15-40).

The Licensee has several responsibilities, which are: 

• Keep all original continuing competence documents for at least five years after receiving the continuing education credit/activity.  
• Complete all steps necessary to meet the re-licensure requirements on or before December 31st of odd-numbered years.
• Provide the Board with any information they request during an audit
• A current mailing address and email address should always be on file with the Board.  

Placing License in Inactive Status

Any licensee who is no longer practicing as a physical therapist or physical therapist assistant may request an inactive license status by filing the application and paying the appropriate fee.  An inactive person may not practice as a physical therapist or physical therapist assistant within Georgia, and that individual is not subject to the biennial renewal fees or continuing competence requirements. 

Note that any individual whose license is under sanction may not transfer to inactive status while sanctions are in effect.

The board allows you to reinstate a license if you are currently in an inactive status by submitting an application for reinstatement and paying the fee, and then submitting other requirements depending on years out of practice.  If you have been out of practice for less than two years, you must submit proof that the continuing competence requirements established by the Board are met.

If you have been out of practice for two to five years, you need to submit proof that the continuing competence requirements are met, and you will need to work under the continuous supervision of a licensed Georgia physical therapist for 480 hours to be completed in three months.  You will also need to pass the examination on laws governing the practice of physical therapy in Georgia and the rules of the Georgia State Board of Physical Therapy. 

If you have been out of practice and inactive for over five years, you will be required to pass the licensing examination again before working under the continuous supervision of a licensed Georgia physical therapist for 1000 hours, which will need to be completed in six to 12 months, and you will need to pass the licensing examination again. 

At the discretion of the board, you may be exempt from continuing competence and supervision requirements if you hold a license in good standing in another state or if you are currently employed as a physical therapist or physical therapist assistant by the U.S. government under their direction.  This should sound very familiar to the rules and requirements if your license was revoked.     

Supervision

It is imperative for you to understand, if you are a physical therapist or physical therapist assistant, what the rules and regulations are in the state or states in which you practice.

In Georgia, a licensed physical therapist shall always be responsible for providing adequate supervision of the assistant. The licensed physical therapist shall be present in the same institutional setting such as a nursing home, acute hospital, convalescent hospital, rehabilitation hospital, or any other in-patient/out-patient facility, including private offices, 25% percent of any work week, Monday through Friday and shall be readily available to the assistant at all times (including weekend coverage) for advice, assistance, and instruction. Notice we do not see home care in the above list, as they have separate rules. 

The licensed physical therapist in the home healthcare setting is responsible for the patient, supervises the physical therapist assistant working with the patient, performs the initial patient evaluation, and establishes physical therapy, diagnosis, goals, treatment, frequency, duration, and plan of care.  The physical therapist needs to meet with the physical therapy assistant no less than once weekly to review the patient's treatments and document the meetings and any decisions made. The physical therapist also needs to be available to the physical therapist assistant for advice, instruction, and assistance at all times.  I am sure most of us did not realize how much documentation is involved in physical therapy when we were in school, but it is a vital task for billing and ensuring our patients get the care they need.

The other setting with a special part in this section of the regulations is the physical therapist's role in a school setting.  In a school setting, a licensed physical therapist must be designated as the supervising physical therapist for the physical therapist assistant. The supervising physical therapist must perform all physical therapy evaluations to develop or amend physical therapy interventions stated in the student's Individualized Education Program (IEP). This is done to assist with meeting the student's educational goals and objectives, including the frequency and duration of physical therapy services. The supervising physical therapist must interact appropriately with the physical therapist assistant regarding the specific goals and objectives stated in the IEP of any student scheduled for sessions with the physical therapist assistant.

The supervising therapist in the school setting also sets the frequency and duration of physical therapy services. An onsite visit by the supervising physical therapist to each student scheduled for weekly services by the physical therapy assistant will be completed at least once every two months. A visit to students by the supervising physical therapist is scheduled at least once every five months for those being treated by the PTA once monthly or less. The onsite visit must include a case review, reassessment of the program and physical therapy services, and documentation prepared by the physical therapist assistant.  Then, the supervising physical therapist must document the onsite visit, including any changes in the treatment plan and communication with the physical therapist assistant.  The physical therapist must always be available to the assistant for advice, assistance, and instructions. 

Adequate Supervision. I have mentioned the term “adequate supervision” today.  It is defined in this section regarding supervision. 

Adequate supervision is to include the following:

• Evaluate each patient and interpret the results to determine and document a physical therapy diagnoses
• Plan each patient's treatment program to determine which elements can be delegated to the assistant
• Provide periodic reevaluation of the treatment program and of the assistant's performance in relation to the patient,
• Perform and record an evaluation of the patient and his response to the treatment at the termination
• Interact with the assistant appropriately specific to the plan of care of the patients being treated by the assistant.

Procedural Rules

The Georgia State Board of Physical Therapy adopted as its permanent rule Chapters 295-3 through 295-13, and any future amendments, the Rules and Regulations of the Office of the Joint Secretary, State Examining Boards, relating to the procedure for hearings before the several State Examining Boards.

The Board has the authority to refuse to grant or renew a license. The Board may also restrict, suspend or revoke the registration of any licensed person. 

Licensure Verification and/or Charge for Furnishing Scores

After receiving the appropriate written request and fee from an applicant, the Board will supply examination scores and license verification to another state.

Physical Therapy Aide Definition and Requirements

A physical therapy aide is someone who aids the licensed physical therapist or physical therapist assistant in the licensee’s physical therapy treatments or services.  The aide is not licensed, and the activities he/she performs do not require training through a college/university.

Supervision. The physical therapy aide must always have direct supervision on the premises when providing supportive activities for the physical therapist or physical therapist assistant.  For the purposes of this rule, direct supervision means being on the premises and immediately available at all times.  For the purposes of this rule, on the premises shall mean the immediate area of the patient.

A licensee may supervise a maximum of two physical therapy aides when they are aiding the licensee's provision of patient evaluation and intervention.

Duties. However, a physical therapy aide may perform tasks without supervision by a licensed physical therapist or physical therapist assistant. Those activities include things such as clerical tasks, transporting patients, assembling and disassembling equipment, and housekeeping activities. 

Supportive activities may be provided by a physical therapy aide and include assisting a patient in preparation for treatment, assisting the patient after treatment, or assisting the physical therapist or physical therapist assistant during treatment provided by that physical therapist or physical therapist assistant.  A physical therapy aide may not create or generate treatment documentation but may transcribe, record or copy treatment documentation that was generated by a Georgia-licensed physical therapist or physical therapist assistant.  Once completed, the documentation must be signed by the supervising physical therapist or physical therapist assistant. 

Licensed physical therapists and physical therapist assistants are the only providers of physical therapy.

Code of Ethics

The code of ethics applies to all licensed physical therapists, physical therapist assistants, and all individuals recognized in the delivery of patient care under the Physical Therapy Practice Act.  This is intended to provide guidelines by which the licensees and others can determine the propriety of conduct.

Principles of Conduct for Physical Therapists

The principles of conduct are somewhat lengthy.  Any individual who is licensed as a physical therapist shall abide by the ethical standards found in 490-0.02.  Those standards include acting within the scope of physical therapy for the rights and dignity of all individuals, holding confidential information obtained while acting as a physical therapist, and providing optimal physical therapy for all patients regardless of race, gender, age, religion, disability, or sexual preference, balancing considerations of the patient's physical, psychological, socio-economic welfare in professional decisions and actions and documenting these in the patient's record of care, and communicating with patients in a courteous manner.  Finally, the behavior of the physical therapist shall not include harassment or abuse of a patient, colleague, or associate. 

The physical therapist shall communicate and interact with patients and all persons encountered in a professional capacity with courteous regard and timeliness. The standards also include that the physical therapist must comply with the laws and regulations governing the practice of physical therapy in the state of Georgia. 

Physical therapists are to practice in accordance with the state Practice Act, treatment, education, administration, and preventative care.  The physical therapist has to accept responsibility for exercising sound judgment when implementing treatment. 

Under that umbrella falls a few other subsections, including that the physical therapist is responsible for evaluating the individual, planning and implementing, supervising the therapeutic program, reevaluating as necessary, changing the program, and maintaining adequate records.  The physical therapist will provide optimum care when performing wellness and preventative services.  The physical therapist will inform the patient and refer to an appropriate provider if the patient’s needs are beyond the scope of the physical therapist’s expertise.  The physical therapist will inform the patient when he/she feels the patient can no longer benefit from physical therapy services, and any treatment beyond that point is unethical.

The physical therapist's ability to make independent judgments must not be limited or compromised by professional affiliations, including employment relationships.  Physical therapists are not to delegate to a less qualified person any activity requiring a physical therapist's unique skills, knowledge, and judgment.  The primary responsibility for physical therapy care assisted by supportive personnel rests with the supervising physical therapists.

Adequate Supervision. Adequate supervision requires, at a minimum, that the supervising therapist perform the following activities: establish effective channels of communication, interpret and communicate critical information about the patient to support personnel, perform an initial evaluation, develop a plan of care (including short- and long-term goals), delegate appropriate tasks to supportive personnel, assess the supportive personnel's competence performance on tasks, and provide supervision in accordance with the law and the patient's condition in the specific situation. 

Other responsibilities of the physical therapist include identifying and documenting precautions, special programs and goals, anticipated progress, and plans for re-evaluation. Re-evaluating the patient, modifying the plan of care when necessary, and performing the final evaluation established by the plan are also included in the responsibilities of a physical therapist. 

Physical therapists are also obliged to advise their employers of any practice which causes a physical therapist to be in conflict with the ethical principles of this section.  Therapists are to attempt to rectify any aspects of their employment which are in conflict with the principles of this section. 

Physical therapists can seek remediation for your services that is deserved and reasonable. Fees for physical therapy services should be reasonable according to the service performed, setting, geographic area, et cetera.

Fees. Accepting or dividing fees is an ethical issue and is also mentioned in the principles of conduct. The physical therapist shall not directly or indirectly request, receive or participate in dividing, transferring, assigning, or rebating an unearned fee.  Profit by means of a credit or other valuable consideration such as unearned commission, discount, or gratuity in connection with the furnishing of physical therapy services or use influence upon individuals or families of individuals under their care for utilization of any product or service based upon the direct or indirect financial interest of the physical therapist. 

Accurate Information/Protect Public. The therapist has to provide accurate information to the consumer. Physical therapists are not to use or participate in the use of any form of communication containing false, plagiarized, fraudulent, misleading, deceptive, or unfair statements.  The physical therapist must accept responsibility to protect the public and the profession from unethical and incompetent acts.  The physical therapist is obliged to report any activity which even appears to be unethical, incompetent, or illegal to the proper authorities. Physical therapists are not to participate in any arrangement in which patients are exploited due to the referring sources enhancing their personal incomes due to referring, prescribing, or recommending physical therapy or a specific physical therapy practice.  If the physical therapist is in a relationship with a referring source in which income is derived from the services, the physical therapist has an obligation to disclose to the patient the nature of the income. 

Principles of Conduct for Physical Therapist Assistants

These principles are somewhat lengthy, and I recommend that you review these regularly. I have provided the links to these regulations on your handout.

Any individual who is licensed as a physical therapist assistant shall abide by the ethical standards found in 490-0.02.  Those standards include acting within the scope of physical therapy for the rights and dignity of all individuals, holding confidential information obtained while acting as a physical therapist assistant, and providing optimal physical therapy for all patients regardless of race, gender, age, religion, disability or sexual preference, balance considerations of the patient's physical, psychological, socio-economic welfare in professional decisions and actions and document these in the patient's record of care, communicate with patients in a courteous manner.  The behavior of the physical therapist assistant shall not include harassment or abuse of the patient, colleague, or associate. 

The physical therapist assistant shall communicate and interact with patients and all persons encountered in a professional capacity with courteous regard and timeliness. The standards also include that the physical therapy assistant must comply with the laws and regulations governing the practice of physical therapy in the state of Georgia, including only practicing under the supervision of a licensed physical therapist.

Like the physical therapist, the physical therapist assistant accepts responsibility for sound judgment, which encompasses providing services within the plan of care established by the physical therapist, notifying the supervising physical therapist when the patient’s needs are beyond the scope of the physical therapist assistant’s expertise, requesting a re-evaluation or possible discharge by the supervising physical therapist when he/she feels a change in the plan of care or possibly a discharge is needed, not delegating to a less qualified person any activity that requires the unique skills, knowledge, and judgment of a physical therapist assistant, and finally knowing that adequate supervision is the responsibility of both the physical therapist and physical therapist assistant. 

The physical therapist assistant is expected to do the following: 

• Effectively communicate both orally and in written form;
• Communicate critical information about the patient to the physical therapist in a timely manner;
• Function within the established plan of care;
• Document all treatment occurrences;
• Requesting the physical therapist perform a re-evaluation of the patient or modify the plan of care when necessary.   

All physical therapist assistants are obliged to advise their employers of any practice that caused him/her to be in conflict with the ethical principles mentioned previously.  Physical therapist assistants need to attempt to rectify any aspect of their employment that conflicts with these principles we have discussed.

Fees. Fees for PTA service should be reasonable according to the service performed, setting, geographic area, et cetera.  The next section is the exact same as the physical therapist principles regarding remuneration for service and fees. The physical therapist assistant shall not directly or indirectly request, receive or participate in dividing, transferring, assigning, or rebating an unearned fee.  Physical therapist assistants should not profit by means of a credit or other valuable consideration such as unearned commission, discount, or gratuity in connection with the furnishing of physical therapy services or use influence upon individuals or families of individuals under their care for utilization of any product or service based upon the direct or indirect financial interest of the physical therapist assistant. 

Accurate Information/Protect Public. The therapist assistant also has an obligation to provide accurate information to the consumer. Physical therapist assistants are not to use or participate in the use of any form of communication containing false, plagiarized, fraudulent, misleading, deceptive, or unfair statements.  The PTA must accept responsibility for protecting the public and the profession from unethical and incompetent acts.  The physical therapist assistant is obliged to report any activity which appears to be unethical, incompetent, or illegal to the proper authorities. Physical therapist assistants are not to participate in any arrangement in which patients are exploited due to the referring sources enhancing their personal incomes due to referring, prescribing, or recommending physical therapy or a specific physical therapy practice.  If the physical therapist assistant is in a relationship with a referring source in which income is derived from the services, the physical therapist assistant has an obligation to disclose to the patient the nature of the income. 

Disciplinary Sanctions

Disciplinary sanctions deal with complaints against physical therapists.  When providing physical therapy treatment, unprofessional and unethical conduct shall include but is not limited to failing to adhere to the Code of Ethics for physical therapists and physical therapist assistants, delegating to an aide or unlicensed person any physical therapy task other than those codified in this rule, failure to provide continuous, immediate and physically present supervision of an aide or unlicensed person when a designated task is performed, and performing the technique of dry needling without having met the training and competency requirements as codified in the next rule that we will go over shortly.

Unprofessional and unethical conduct for physical therapists also includes failing to provide a physical therapy evaluation on each patient, establishing a physical therapy diagnosis, or establishing a treatment program based on evaluation, failing to perform regular evaluations of the patient and document in the patient’s record, and make adjustments to the plan of care according to progress as well as failing to create and record a patient’s discharge plan.     

If the therapist directly or indirectly requests, receives, or participates in the division, transferring, assigning, or rebating fees, that is also considered unprofessional and unethical conduct.  No physical therapist or physical therapist assistant shall engage, acting on his or her behalf, in any agreement or arrangement with any individual, entity or employee, or agent thereof acting on his behalf for the payment or acceptance of compensation in any form for the referral or recommending of the professional services of either. This prohibition also includes a rebate or percentage of a rental agreement or any arrangement for facility, equipment, or personnel services.  This rule does not preclude a discount, waiver of co-payment or other reduction in the price of services by a physical therapist if the reduction in the price of services is disclosed to the consumer and third-party payers and is reflected in the costs claimed or charges made. 

Dry Needling

Georgia has a specific provision dealing with dry needling. Dry needling is a skilled technique performed by a licensed physical therapist using filiform needles. The therapist penetrates the skin and underlying tissues to affect changes in body structures and functions. This is done for the evaluation and management of neuromusculoskeletal conditions, pain, movement impairments, and disability. It is performed for preventative and therapeutic purposes. It states that dry needling must be directly performed by a licensed physical therapist who is specifically trained and competent by virtue of education and training to perform dry needling.  Of course, it says online study for dry needling instruction is not considered appropriate training and not accepted as a demonstration of competence and training (with the exception of OSHA Blood Borne Pathogens Standards).  

A physical therapist has demonstrated competent and specific education and training in dry needling when they have submitted the following documentation to the Licensing Board:

Proof of education in the OSHA bloodborne pathogens standard and one of the following:

• Graduation from an entry-level physical therapy program that included dry needling instruction of 50 hours total and a competency assessment and achievement in its curriculum
• Graduation from a post-graduate credentialed residency or fellowship program that included dry-needling instruction consisting of 50 hours and an assessment showing competency achievement
• Proof of documented, successful completion of a dry needling course consisting of at least 50 total hours and an assessment showing competency achievement 

All PTs wishing to practice dry needling must enter proof of dry needling education and training into an online recording and reporting system, which the Board has chosen to use CE Broker. There is no fee for this service, and an attestation that the licensee is practicing dry needling under the rules and regulations of the Georgia State Board of Physical Therapy is required at each license renewal. The Board can access the licensee records at any time to audit for completion of requirements for dry needling. Violating the provisions outlined in this Licensing Board rule or falsely attesting information on the license renewal application provides grounds for disciplinary action as determined by the Licensing Board.

Telehealth

The purpose of this rule is to establish a guideline for the practice of telehealth. 

Telehealth is the use of electronic communication to provide physical therapy-related services over any distance (small or large), and it may include education, interventions, and monitoring of interventions.  Any PT services through telehealth must follow all federal and state regulations as well as policies regarding the practice of PT in Georgia.  A physical therapist licensed in another state in the US may provide a consult via telehealth to a physical therapist in Georgia.  Those providing PT via telehealth to a patient in Georgia must be licensed in Georgia except for the practices/services discussed previously in 43-33-11.  

Preventative Services

Preventative services are also mentioned and included in the regulations.  A physical therapist or physical therapist assistant under the supervision of a physical therapist may perform preventative services that are not considered implementing a physical therapy treatment program without consultation.  This covers providing education and/or activities in a wellness/community setting for injury prevention, stress reduction, and fitness promotion but does not include the administration of physical therapy treatment. 

Consultation

Consultation means the provision of professional advice. 

A licensed practitioner of the healing arts is defined in this area as a person who is licensed in the state of Georgia to diagnose and treat individuals with a physical or mental disability or functional limitations and is operating within the scope of practice. 

To determine whether a licensed practitioner is appropriate, a physical therapist is to consider:

• The physical condition of the patient
• Nature of the ailment
• The extent to which the consulting practitioner has knowledge of the patient's history and condition such that an informed judgment can be made concerning the course of treatment. Physical therapists need to document the consult with the practitioner before implementing a physical therapy treatment program.   

Practice of Physical Therapy During a Declared National Disaster

A person currently licensed in another state who is present in the state of Georgia to provide physical therapy services during a declared local, jurisdictional, or national disaster or emergency can practice without penalty for a period not to exceed a total of 60 days during any 12 month period provided that the practice of physical therapy is in compliance with the rules and regulations of Georgia.  

If a physical therapist violates any laws, rules, and regulations of Georgia or continues to practice in the state of Georgia beyond 60 days during any 12-month period, the Board will issue a cease and desist order prohibiting the practice of physical therapy without a license.

Physical Therapy Compact

This is a relatively newer regulation, as it was enacted in Oct. 2020.  The Georgia State Board of Physical Therapy adopted the standard set of Physical Therapy Compact Commission Rules with the following additions:

• Those applying for a compact privilege to Georgia must pay the necessary fees and take and pass the Georgia Jurisprudence Assessment Module (GA-JAM) prior to issuance of the compact privilege;
•  All the laws, rules, and policies related to the practice of physical therapy in Georgia must be followed by a licensee from another member state who is providing physical therapy services in Georgia under a compact privilege.
• The compact privilege holder may be subject to disciplinary action by the Georgia State Board of Physical Therapy and loss of the Compact Privilege if any violation of the laws, rules, and policies of the Board occurs.
• A compact privilege holder must report to the Georgia State Board of Physical Therapy any actions placed upon their license in a non-member state within thirty (30) business days of the effective date; This requirement applies to public and private actions that may be taken by a non-member state.

Georgia Board of Physical Therapy Policy Statements

General Application Information

Policy number one is titled General Application Information.  Applications and reinstatement applications will be administratively approved once all criteria have been met.  The staff will not administratively approve any applications with an affirmative answer to the conviction or board-sanctioned question. 

A yes response for the examination may be administratively approved in compliance with the board's rules and policies.  All administratively approved licenses will be voted on at the next board meeting.  The average processing time for a complete application is approximately 15 working days.

Application for licensure, where the applicant has a history of arrest(s), will follow the guidelines in this policy.  Those guidelines include the following:

• If the offense is a one-time DUI with no active probation and no active parole or if the conviction is older than five years, proceed with licensure. 
• If the conviction of a DUI is less than five years, the license will be issued with a letter of concern. 
• If the offense is bad checks, municipal ordinance violations, driving with a suspended or revoked license, and it occurred once or is older than five years, licensure with be approved with a letter of concern. 
• Petty theft, shoplifting, and non-violent property crimes not related to drugs that have occurred two times or less with no probation and no parole, or if it's past five years ago, licensure permitted with a letter of concern. 
• Marijuana possession of less than one ounce which occurred once without active probation and no parole and occurred over five years ago; proceed with licensure with a letter of concern. 
• For misdemeanor offenses, with the exception of drug-related misdemeanors, there is no limit on the frequency.  If the offense is older than five years, then you get a letter of concern, but you still receive licensure. 
• Any offenses of a sexual nature, any felony offense, and applicants with multiple offenses have to present their petition directly to the board to determine whether the board will proceed to allow licensure.

Applications that do not fall within the parameters listed above will be referred to the Board for consideration.

Examination Applications

The second policy is regarding examination applications.  The board will make eligible Applicants for licensure by examination upon receipt from an approved college, university, or registered dean program, stating the applicant has successfully completed the physical therapy program but is awaiting degree conferment.  As part of the application form, the board has provided that that statement must be completed by the appropriate school representative and submitted to the board.

One member of the Board is designated to review all non-CAPTE and foreign-educated examination applications for approval. 

An applicant who has not passed the NPTE or the Georgia Jurisprudence examination by the fourth time will not be allowed to sit through the examination a fifth time without extensive further study, which may include completing a physical therapy education program approved by CAPTE or additional coursework if the Board deems necessary.

Applicants for initial licensure by exam must take and pass the electronic Georgia jurisprudence exam offered by the Federation of State Boards of Physical Therapy (FSBPT).

The Board may grant an applicant approval to take the national examination a sixth time after extensive further study, which is in accordance with the lifetime eligibility limit established by FSBPT. 

Endorsement Applications

The board has designated a board member to review non-CAPTE and foreign applications for approval.  Endorsement applicants who have passed the examination within one year of graduation may apply by examination instead of endorsement, but they must include licensure verification from each state that they have a license. 

All endorsement applicants must pass the electronic Georgia jurisprudence examination through FSBPT. Any applicant who has not passed the Georgia Jurisprudence exam by the 4th time will not be allowed to take a 5th time without completing additional coursework on Jurisprudence if the Board deems it necessary.  

Renewal Applications

Any renewal applicant who answers "no" to the continuing competency question must provide proof of completing their continuing competency requirements.

Traineeship

As mentioned prior, the board has designated a board member to review all non-CAPTE and foreign-educated exam applications for approval.  Once traineeship supervision is approved, a letter will be sent to the physical therapist approved as the primary and alternate supervisor.  All supervision must be in compliance with the board rule, which we have already reviewed. Once an individual passes the NPTE and supervisors have submitted documentation of successful practice under the traineeship, an early exit from the traineeship can occur.   

Reinstatement of a License

We come to Policy number six regarding the reinstatement of a license.  All licensees who fail to renew their license by the established deadline are placed in lapsed status and must apply to reinstate their license. 

Upon discovering that a reinstatement applicant has practiced without a current license, reinstatement may be considered upon the issuance and docketing of a public consent agreement or a public reprimand, including, but not limited to, a $25 fine for each day of unlicensed practice, pass the jurisprudence exam within six months of the docket date of the consent agreement or reprimand, and report the period of unlicensed practice to their employers. 

Continuing Competence

We have discussed continued competence requirements previously, but this board policy also details this area.  The board requires each licensed physical therapist or physical therapist assistant to participate in a minimum of 30 clock hours of experience to promote continuing competence.  No more than ten credit hours may be earned in one calendar day.  The board recommends the requirements for continuing competence as planned learning experiences with content beyond the licensee's present level of knowledge and competence, which may be subject to audit by the board.  Of course, the content must relate to patient care in physical therapy and may include research, treatment, documentation, education, management, or some other content area.  

A minimum of four contact hours of the 30 required must specifically be in ethics and jurisprudence or by passing the Georgia Jurisprudence Examination. Passing that examination is equal to the four-hour requirement as long as the individual did not receive credit for the exam when he/she obtained licensure.  

Cognizant Matters, Investigations, and Disciplinary Matters

The Georgia Physical Therapy Board maintains strict confidentiality in all investigations of alleged violations of the board's rules and laws and the identity of the individuals involved. The board has one member who acts as a cognizant. 

The cognizant member shall have access to all records and documents related to applications outside the established guidelines for administrative issuance, complaints, and investigations.  The cognizant member is not to disclose any information regarding the identity of the involved persons until the board votes to pursue formal disciplinary action.  In addition, all complaints received alleging irregular insurance and billing practices will automatically be referred to the insurance commissioner's office for investigation and to the appropriate agencies for Medicaid and Medicare fraud.  The billing and insurance issues go to a different review. 

The board staff receives all applications that fall outside the established guidelines for administrative license issuance and complaints of alleged violations. The board presents those applications to the cognizant member. The applicant or complainant will be notified in an appropriate timeframe of any deficiencies or complaints that have been received by the board office and forwarded to the cognizant member for review and action.  

The cognizant member of the board has the authority to do the following: 

• Review the application with any supporting documentation and issue the license if it is determined all qualifications have been met.
• Recommend that the application be reviewed by the full board. 
• Recommend to the full board that a complaint be dismissed due to no alleged violation of laws or rules.
• Refer a complaint directly to the enforcement division for investigation.
• Conduct an investigative interview.

After an investigation, the cognizant member can either recommend to the full board to close the file due to no violation found or sanction if a violation has occurred.

In all situations, the cognizant member reports to the board the actions taken regarding the application or investigation of the complaint.  The cognizant member timely receives and reviews copies of the enforcement referrals and/or dispositions to investigations in each case.  All requests for additional information from staff or the cognizant member shall be in writing. 

If a matter regarding a licensee is referred to the attorney general's office for a consent order, the order will include a requirement that the disciplined licensee must pass the jurisprudence examination within three months of the docket date of the order.

Peer Review

To be a peer reviewer for the board, one must have no disciplinary history, five years of current clinical expertise, and be capable of providing expert opinion on the subject matter, general questions of patient care, and recordkeeping ability.  Peer reviewers are selected by the board on a case-to-case basis. 

Mental Physical Evaluations

The board will accept the guidelines for mental and physical evaluations as provided in the Practice Act. 

Meetings and Records

The board will hold an annual policy review meeting.  Minutes will be drafted, and the board agenda will be provided to the board at least one week prior to the meeting or conference call.  Meetings will be held on dates established yearly by the board.

Medications

The position on medications is defined in Policy 12.  The Georgia Board of Physical Therapy adopts the APTA position on medications in the provision of physical therapy.  That position statement states the scope of practice of physical therapy often requires the use of medications in the course of patient/client management, such as the administration of phonophoresis and iontophoresis, nebulized bronchodilators, and integumentary repair and protection.  The application and storage of medications used in physical therapy are within the scope of the physical therapy practice.

Georgia Jurisprudence

The Georgia jurisprudence continuing competency course must include a review of the Georgia General Provisions, the Georgia Practice Act, Board Rules (Chapter 490), and the Board Policies, and a general review of the Board's website, including the Frequently Asked Questions (FAQ's).  I would suggest you visit the website regularly to see if there have been any recent changes to the Practice Act or board rules.  Georgia's user-friendly website includes frequently asked questions and proposed rule changes.    

As mentioned prior, the four-hour requirement in Ethics and Jurisprudence can be met through a course or by passing the Georgia Jurisprudence Exam offered by FSBPT. Please note that you will not receive credit towards the current continuing competency requirements for any passing score on a Georgia Jurisprudence Exam that was taken for initial licensure, prior renewal cycles, or the terms and conditions of a Board Order. 

Foreign Credentialing

The Board requires 60 hours of general education and 90 hours of professional education for a total of 150 hours for foreign-educated applicants. The Board has authorized the use of FSBPT Retro Tools for applicants educated prior to 1997.  The board has also approved the ICA, IERF, and FCCPT as foreign credentialing agencies. 

Residency/Internship Programs

The board will consider and approve educational institutions for the purpose of offering programs to develop advanced physical therapy skills.  An interesting notation to this policy is that all educational institutions offering this type of training must petition the board before allowing the practice of any residents/fellows that are not licensed in Georgia and enrolled in the residency program. 

Telehealth Policy

This policy statement establishes guidelines for the practice of telerehabilitation. It is defined as using electronic communications to provide and deliver various health-related information and health services, including physical therapy, over large or small distances. All physical therapy practitioners using telehealth must abide by the statutes, rules, and policies governing the practice of physical therapy in Georgia. Any individual providing physical therapy via telehealth to a patient in Georgia must be licensed in Georgia unless the individual is licensed in another jurisdiction of the U.S. and is providing a consult via telehealth to a physical therapist in Georgia.

Physical Therapist/Physical Therapist Relationship

As I have mentioned previously, the physical therapist is responsible for the quality of care provided by support personnel.  At their discretion, physical therapists may allow physical therapy treatments to be performed by physical therapist assistants to include the period in the 21 days or eight (8) visits, whichever comes first, prior to discharge or receipt of a referral from the patient’s provider. Physical therapist assistants, trainees, and students should know who the supervising physical therapist is for each patient and how to contact that supervising physical therapist. 

This policy recommends that the physical therapist supervise no more than three support clinicians at any time.  The term supportive clinicians are defined in this policy as including physical therapist assistants, trainees, and PT/PTA students. 

Care coordination discussions are expected in all settings and should be documented in the patient’s medical record. The frequency at which the communication occurs depends on the patient's condition, progression, and setting.   

Proposed Rules

There is a section for proposed rules at the bottom of the Rules and Laws page on the Georgia State Board of Physical Therapy website.  It is recommended that you check that area out regularly.  

Frequently Asked Questions (FAQ)

There is a page on the Secretary of State website under the Georgia State Board of Physical Therapy that reviews common questions regarding the practice of physical therapy in the State of Georgia. There are answers to questions such as the scope of practice, how to receive verification of good standing, and how to change one's name.   The page may be found here.  There is also a special FAQ section on the compact privilege legislation that took effect on March 1, 2021. 

CE Broker

Under the FAQ section of the website, if toggle down, there is a page that explains how to establish a CE Broker account, including step-by-step instructions.  Again, you are required to register and report continuing education coursework through CE Broker.  

Conclusion

That concludes our review of jurisprudence as it affects Georgia physical therapists and physical therapist assistants.  We have addressed the statutes and regulations, reviewed policy statements issued by the board, and examined how the board handles administrative hearings.  

Please remember that you are responsible for keeping up with the rules and regulations for each state in which you practice and hold a license.  Note the website for the State Board. Thank you for your time.