1. Physical Therapy Licensure Compact
An Overview of the Draft Language
The purpose of this presentation is to provide an overview of the model selected for the Physical Therapy Licensure Compact and a high level overview of the compact language.
My name is Jeff Rosa and I am the Executive Director for the Ohio PT Board. I also served as a member of the compact drafting team.

2. Physical Therapy Licensure Compact
Advisory phase – January 2014 – July 2014
Advisory Task Force
Licensing Board Members & Administrators
APTA representatives
Health Policy and Administration representative
Public Members
FSBPT representatives
Consultants
Recommended moving forward with a compact
Recommended a Compact Model
The entire process that culminated in the final draft took 16 months.
After 6 months of work, the Advisory Task Force made the recommendation to FSBPT Board of Directors to move forward with the development of a compact and also recommended a specific model for the PT compact

3. Physical Therapy Licensure Compact
Drafting Phase – November 2014 – April 2015
Drafting Task Force
Licensing Board Members & Administrators
APTA representatives
Public Members
FSBPT representatives
Consultants
Developed draft compact language based on model recommended by Advisory Task Force
The drafting team then spent 6 months developing the compact language based on the framework recommended by the Advisory Task Force

4. The Draft Language
Now that we covered how we got to this point, lets get into more detail on the actual provisions of the compact language. The compact consists of 12 sections.

5. Section 1. Purpose
The purpose of this compact is to facilitate 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/client is located at the time of the patient/client encounter
The Compact preserves the states’ regulatory authority to protect public health and safety through the current system of state licensure
Section 1 is the Purpose of the Compact. Two key points identified in the language are:
The practice of physical therapy occurs in the state where the client is located at the time of the client encounter; and
Each states’ regulatory authority to protect the health and safety through the current system of state licensure is preserved.

6. Section 1. Purpose (cont.)
This Compact is designed to achieve the following objectives:
Increase public access to physical therapy services
Enhance the states’ ability to protect the public’s health and safety
Support of spouses of relocating military members
Enhance the exchange of licensure, investigatory, and disciplinary information between member states.
Why even have a licensure compact? Section 1 also provides a roadmap on objectives that the compact will help to achieve.

7. Section 2. Definitions Home State Remote State Member State
means the member state that is the licensee’s primary state of residence
Remote State
means a member state other than the home state, where a licensee is exercising or seeking to exercise the privilege to practice
Member State
means a state that is participating in the compact
Party State
means any member state in which a licensee holds a current license or privilege to practice or is applying for a license
Section 2 of the compact provides definitions of various terms that are used in the compact. In total, 23 terms are defined.
Some key definitions refer to the various ways to identify states, which means any state, commonwealth, district, or territory of the US that regulates the practice of physical therapy.

8. Section 2. Definitions (cont.)
Privilege to practice
means the authorization granted by a remote state to allow a licensee from another member state to practice as a physical therapist/work as a physical therapist assistant in the remote state under its laws and rules
Under the compact provisions, a physical therapist or physical therapist assistant can legally provide physical therapy services in a REMOTE state without being licensed by that state.
This is known in the compact as having a privilege to practice in the remote state. When exercising the privilege to practice, an individual must follow the laws and rules governing the practice of physical therapy in the remote state.

9. Section 3. State Participation
Participate “Fully” in the Compact Commission’s Data Base
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
Section 3 outlines the requirements that a state must meet to participate in the compact.
A key component is the requirement that the state participate fully in the compact commission’s data system.
Member states must also notify the commission of any adverse actions taken or the availability of investigatory information regarding a licensee. Investigatory information is defined as information, records, and documents received or generated by a PT board pursuant to an investigation.

10. Section 3. State Participation
Require a criminal background check of all applicants for initial licensure
Comply with the rules of the Commission
Utilize the NPTE
Have continuing competence requirements
Other requirements that must be met before a state can participate are:
The state must require a criminal background check for all initial applicants – this requirement goes into effect no later than 5 years after the activation of the compact. As a result, a state that is early adopter of the compact that does not already require background checks, would have up to 5 years to comply. After 5 years, any new state joining the compact must have this requirement in place prior to joining the compact
The state must comply with the commission’s rules
The state must utilize the NPTE; and
The state must have continuing competence requirements for license renewal.

11. State X (10th state) Adoption 9 Member States Compact Commission:
State X must have
Continuing Competence requirements
Criminal Background Checks
Full participation in database
Use NPTE
Once the 10th state enacts the compact legislation, the compact is activated and the PT compact commission would begin drafting the rules and regulations governing the implementation of the compact
This slide graphically represents the process followed when a state joins the Compact
Compact Commission:
has complete licensure and
disciplinary database

12. Section 4. Compact Privilege to Practice
To exercise the privilege to practice, the licensee shall:
Hold a license in the home state
Have no encumbrances on any state license
Provide notice and pay any applicable fees
Have no adverse action against any license or privilege to practice within the previous 2 years
Meet any state jurisprudence requirements
Section 4 of the compact starts getting at the mechanics of how a licensee can legally practice in a remote state without a license.
Prior to exercising the privilege to practice in a remote state, a licensee must meet the requirements outlined in this section. These requirements include:
Holding a license in the individual’s home state
Having no encumbrance on any state license, including licenses held in non-compact states
Having no adverse actions taken against ANY license or privilege to practice within the previous 2 years
Notifying the compact commission that the individual is seeking the privilege to practice within a remote state
Paying the fees levied by the compact commission and by the remote state for the privilege to practice.
Meeting any jurisprudence requirements established by the remote state.
Individuals providing physical therapy services under the privilege to practice must also report to the Compact Commission any adverse actions taken by a non-member state within 30 days of the adverse action.

13. Section 4. Compact Privilege to Practice (cont.)
The licensee
shall function within the scope of practice of the remote state.
Be subject to the remote state’s regulatory authority.
A remote state may remove the privilege to practice
The privilege to practice is valid until the expiration date of the home license.
What are the limits for an individual providing services under the privilege to practice?
First and foremost, the individual must comply with the scope of practice of the remote state. Failure to do so could result in an adverse action being taken against the privilege to practice since the individual is subject to the remote state’s regulatory authority when providing services in that remote state.
Since a privilege to practice isn’t granted for eternity, the drafting team had to determine an administratively logical system for expiration of the privilege. Since each state has a different expiration date, the language does not tie the privilege expiration date to the license expiration date of the remote state.
Instead, the renewal cycle is tied to the home state license. As a result, a licensee only needs to remember one date.
The compact commission will notify the remote states regarding the expiration dates of the privileges to practice for individuals in that state.

14. Remits any fees to state Notifies the state Therapist Pat
Remote State Y
Compact commission
Assures eligibility
Remits any fees to state
Notifies the state
Therapist Pat
Pays fee: commission fee and any state fee
Home State X
This slide graphically represents the process followed by an individual seeking to obtain the privilege to practice in a remote state.
PT Pat is licensed in the state of primary residence. To be eligible for a privilege to practice in another compact member state, the following must apply:
Pat has no encumbered licenses
Pat has not had disciplinary action within the past 2 years
Pat may be required to meet a jurisprudence requirement in remote state Y
If Pat wants the Privilege to Practice, fees must be paid to the commission and any optional fee that the remote state charges.
The Compact Commission assures that Pat is eligible for the privilege to practice; remits any optional fees to the remote state; and notifies the remote state that Pat is seeking the privilege to practice in that state
Therapist Pat must
Have primary residence in home state
Have no encumbered licenses
Have no disciplinary action within the last 2 years
Meet State Y’s jurisprudence requirement, if applicable

15. Section 4. Compact Privilege to Practice (cont.)
If a home state license is encumbered, the licensee shall lose the privilege to practice 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
If a licensee’s privilege to practice in any remote state is removed, the individual shall lose the privilege to practice in any remote states until the following occur:
The specific period of time for which the privilege to practice was removed has ended;
All fines have been paid; and
What happens if the home state license is encumbered? The individual loses the privilege to practice in ANY remote state until:
The home state license is no longer encumbered; AND
Two years have elapsed from the date the board took the adverse action.
As a result, if the license was encumbered for 6 months, the privilege to practice would be lost for 2 years. On the other hand, if the license was encumbered for 3 years, the privilege to practice would be lost for 3 years.
What about the removal of the privilege to practice in a remote state? If this situation occurs, the individual again loses the privilege to practice in ANY remote state until:
The specific period of time for which the privilege to practice was removed has ended
All fines, if applicable, have been paid; and
Two years have elapsed from the date the remote state took the action to remove the privilege to practice.
As a result, if the privilege to practice was removed for 6 months, the privilege to practice would be lost for 2 years. If the privilege to practice was removed for 3 years, the privilege to practice would be lost for 3 years.
In both scenarios, an individual would need to meet the requirements of the compact as described on the previous slide before obtaining the privilege to practice in any remote state.
Nothing in the compact would prevent an individual who is ineligible for the privilege to practice from applying for a full license in a member state of the compact. The member state would review the application in the same manner as any licensure application. If a license is granted, however, the individual would not be eligible to obtain a privilege to practice in any other member state based on the non-home state license.

16. Section 5. Active Duty Military Personnel or their Spouses
Licensees who are active duty military or their spouse who are licensed may choose their home state from the following:
Home of record
Permanent Change of Station
State of current residence if different from PCS or home of record
Although the compact requires licensees to be licensed in their primary state of residence, how will that requirement apply to licensees who are active duty military or their spouses?
Under the compact provisions, those individuals can choose their home state from one of the following:
The home of record
A permanent change of station
The state of current residence, if it is different from the home of record or the permanent change of station.

17. Section 6. Adverse Actions
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 factual finding of the remote state, so long as the home state follows its own procedures for imposing adverse action
Since the home state license is issued by the home state, only that state can take action against the individual's license.
In addition, the compact language makes it clear that the home state has the legal authority to take action against the home state license based on factual findings of a remote state.

18. Section 6. Adverse Actions
Member states must require licensees who enter any alternative programs to agree not to practice in any other member state during the term of the alternative program without prior authorization from the other member state
Any member state may investigate actual or alleged violations of the laws and rules authorizing the practice of physical therapy in any other member state in which a PT or PTA holds a license
If a state has a confidential, non-disciplinary alternative program, it must require a licensee to agree not to practice in a remote state without the authorization of that remote state.
The compact also makes it clear that a member state is permitted to investigate violations of the PT laws and rules in any other member state in which the PT/PTA holds a license.

19. Section 6. Adverse Actions (cont.)
A remote state shall have the following authority:
Take adverse actions against a licensee’s privilege to practice in the state
Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses, and the production of evidence
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
Although a remote state cannot take action against the individual’s license, since that is the exclusive jurisdiction of the home state, it can take action against an individual’s privilege to practice in the remote state.
Part of the authority related to adverse actions includes the ability to:
Issue subpoenas requiring testimony of witnesses and/or the production of evidence; and
The ability to recover the costs of investigations, if permitted by the remote state’s law.

20. Section 6. Adverse Actions (cont.)
Joint Investigations
A member board may participate with other member boards in joint investigations of licensees
Member states may share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact
Under the compact, member states may legally participate in joint investigations of individuals and may share any investigative, litigation, or compliance materials to assist with the joint investigation.

21. Section 7. Establishment of the Physical Therapy Compact Commission
Made up of one delegate from each member state
Must be a current Board Member (PT,PTA or Public Member) or Administrator
Meet annually or more often if necessary
Meetings may be remote
FSBPT and APTA are non-voting, ex officio members of the Commission
Section 7 establishes the Physical Therapy Compact Commission
Each member state has one voting delegate, who must be a current board member or the board administrator. For states where other professions are serving on the Board (e.g.: an OT or physician), if not the Board administrator or public/consumer member, the delegate must be a PT or PTA member of the Board
In addition to the delegates from the member states, FSBPT and APTA are non-voting, ex officio members of the Commission

22. Section 7. Establishment of the Physical Therapy Compact Commission(cont.)
Duties of the Compact Commission
Establish bylaws
Promulgate rules
Establish budget
Meet annually or more often if needed
Elect Executive Board
Terminate a State from the Compact
Establish committees and task forces
The compact outlines the various duties of the compact commission, including establishing bylaws, adopting rules, establishing a budget, and electing an executive board.

23. Section 7. Establishment of the Physical Therapy Compact Commission(cont.)
Executive Board
Elected by Compact Commission
9 members
7 elected from the membership of the Commission
1 ex officio non voting member from the professional association
1 ex officio non-voting member from the FSBPT
Meet annually or more often if necessary
The Executive Board shall have the power to act on behalf of the Commission according to the terms of this Compact
The executive board is elected by the Compact Commission delegates and has the power to act on behalf of the commission.

24. Section 7. Establishment of the Physical Therapy Compact Commission(cont.)
Duties of the Executive Board
Ensure compact administration services are appropriately provided
Prepare and recommend the budget
Maintain financial records
Establish committees as necessary
Recommend
Changes to Compact
levy of fees or change compact fees
Rules changes
Monitor compact compliance of Member Boards
Some of the duties of the executive board include:
Ensuring that compact administration services are appropriately provided,
Monitoring member board compliance with compact provisions, and
Recommending changes to rules, fees, and/or the compact language.

25. Section 8: Data System
The Commission shall provide for the development, maintenance, and utilization of a coordinated database and reporting system containing licensure, adverse action, and investigatory information on all licensed individuals in member states
The Commission shall promptly notify all member states of any adverse action taken against a licensee or an individual applying for a license. Adverse action information pertaining to a licensee in any member state will be available to any other member state
The only way to ensure that the compact works effectively is through a comprehensive data system. Section 8 of the compact outlines the uniform data set that member states must submit to the compact.
This data includes, but is not limited to, identifying information, licensure data, adverse actions against a license or privilege to practice, public information related to alternative program participation, and any license application denials.
The availability of investigative information will only be available to other states where the individual has a privilege to practice or license.
Finally, the commission is required to promptly notify ALL member states of any adverse action taken by another member state.

26. Other Sections Section 9. Rulemaking
Section 10. Oversight, Dispute Resolution, and Enforcement
Section 11. Date of implementation of the Interstate Commission and Associated rules, Withdrawal and Amendment
Section 12. Construction and Severability
Sections 9-12 of the compact are the standard boilerplate provisions that are common to all interstate compacts.
In the rule making section, prior to adoption of a rule by the commission, the commission must file a notice of propose rulemaking on the commission’s website and the website of each member state board. A public hearing on the rule would be held if a hearing is requested by
At least 25 persons
A state or federal governmental subdivision or agency; or
An association having at least 25 members.
Otherwise, the commission may proceed with the adoption of the rule without a public hearing.

27. Questions and Feedback
fsbpt.org/Compact
If you have any additional question or would like to provide your thoughts or feedback on the compact, please send an to
Additional information on the compact, including the full text of the compact language, is available on the FSBPT website at the link listed on the slide.
Thank you for taking time to learn more about the proposed Physical Therapy Licensure Compact and for any feedback you might provide.