Washington Code 18.74.190 – Spinal manipulation — Endorsement
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(1) Subject to the limitations of this section, a physical therapist may perform spinal manipulation only after being issued a spinal manipulation endorsement by the secretary. The secretary, upon approval by the board, shall issue an endorsement to a physical therapist who has at least one year of full-time, orthopedic, postgraduate practice experience that consists of direct patient care and averages at least thirty-six hours a week and who provides evidence in a manner acceptable to the board of all of the following additional requirements:
Terms Used In Washington Code 18.74.190
- Board: means the board of physical therapy created by RCW 18. See Washington Code 18.74.010
- Close supervision: means that the supervisor has personally diagnosed the condition to be treated and has personally authorized the procedures to be performed. See Washington Code 18.74.010
- Direct supervision: means the supervisor must (a) be continuously on-site and present in the department or facility where the person being supervised is performing services; (b) be immediately available to assist the person being supervised in the services being performed; and (c) maintain continued involvement in appropriate aspects of each treatment session in which a component of treatment is delegated to assistive personnel or is required to be directly supervised under RCW 18. See Washington Code 18.74.010
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Physical therapist: means a person who meets all the requirements of this chapter and is licensed in this state to practice physical therapy. See Washington Code 18.74.010
- Physical therapy: means the care and services provided by or under the direction and supervision of a physical therapist licensed by the state. See Washington Code 18.74.010
- Secretary: means the secretary of health. See Washington Code 18.74.010
- Spinal manipulation: includes spinal manipulation, spinal manipulative therapy, high velocity thrust maneuvers, and grade five mobilization of the spine and its immediate articulations. See Washington Code 18.74.010
(a) Training in differential diagnosis of no less than one hundred hours outlined within a course curriculum;
(b) Didactic and practical training related to the delivery of spinal manipulative procedures of no less than two hundred fifty hours clearly delineated and outlined in a course curriculum;
(c) Specific training in spinal diagnostic imaging of no less than one hundred fifty hours outlined in a course curriculum; and
(d) At least three hundred hours of supervised clinical practical experience in spinal manipulative procedures. The supervised clinical practical experience must:
(i) Be supervised by a clinical supervisor who:
(A) Holds a spinal manipulation endorsement under this section; or
(B) Is a licensed chiropractor or osteopathic physician and surgeon;
(ii) Be under the close supervision of the clinical supervisor for a minimum of the first one hundred fifty hours of the supervised clinical practical experience, after which the supervised clinical practical experience must be under the direct supervision of the clinical supervisor;
(iii) Be completed within eighteen months of completing the educational requirements in (a) through (c) of this subsection, unless the physical therapist has completed the educational requirements in (a) through (c) of this subsection prior to July 1, 2015, in which case the supervised clinical practical experience must be completed by January 1, 2017.
(2) A physical therapist holding a spinal manipulation endorsement under subsection (1) of this section shall consult with a health care practitioner, other than a physical therapist, authorized to perform spinal manipulation if spinal manipulative procedures are required beyond six treatments.
(3) A physical therapist holding a spinal manipulation endorsement under subsection (1) of this section may not:
(a) Have a practice in which spinal manipulation constitutes the majority of the services provided;
(b) Practice or utilize chiropractic manipulative therapy in any form;
(c) Delegate spinal manipulation; or
(d) Bill a health carrier for spinal manipulation separately from, or in addition to, other physical therapy procedures.
(4) A physical therapist holding a spinal manipulation endorsement under this section shall complete at least ten hours of continuing education per continuing competency reporting period directly related to spinal manipulation. At least five hours of the training required under this subsection must be related to procedural technique and application of spinal manipulation.
(5) If a physical therapist is intending to perform spinal manipulation on a patient who the physical therapist knows is being treated by a chiropractor for the same diagnosis, the physical therapist shall make reasonable efforts to coordinate patient care with the chiropractor to prevent conflict or duplication of services.
(6) By November 15, 2019, the board shall report to the legislature any disciplinary actions taken against physical therapists whose performance of spinal manipulation and manipulative mobilization of the spine and its immediate articulations resulted in physical harm to a patient. Prior to finalizing the report required under this subsection, the board shall consult with the chiropractic quality assurance commission.
NOTES:
Effective date—2014 c 116 § 2: “Section 2 of this act takes effect July 1, 2020.” [ 2014 c 116 § 7.]
Effective date—2014 c 116: “Except for section 2 of this act, this act takes effect July 1, 2015.” [ 2014 c 116 § 6.]