HOUSE BILL No. 4637

 

May 6, 2003, Introduced by Reps. Vander Veen, Brandenburg, Pappageorge, Voorhees, Garfield, Kooiman, Hager, Acciavatti and Emmons and referred to the Committee on Health Policy.

        

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to amend 1978 PA 368, entitled                                             

                                                                                

    "Public health code,"                                                       

                                                                                

    by amending sections 16263, 16315, 16335, 17801, and 17820                  

                                                                                

    (MCL 333.16263, 333.16315, 333.16335, 333.17801, and 333.17820),            

                                                                                

    section 16263 as amended by 2001 PA 139, section 16315 as amended           

                                                                                

    by 2001 PA 232, section 16335 as added by 1993 PA 80, and                   

                                                                                

    sections 17801 and 17820 as amended by 1987 PA 213, and by adding           

                                                                                

    sections 17823, 17824, and 17825.                                           

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 16263.  (1) Except as provided in subsection (2), the                  

                                                                                

2   following words, titles, or letters or a combination thereof,               

                                                                                

3   with or without qualifying words or phrases, are restricted in              

                                                                                

4   use only to those persons authorized under this article to use              

                                                                                

5   the terms and in a way prescribed in this article:                          

                                                                                

6       (a) "Chiropractic", "doctor of chiropractic", "chiropractor",               

                                                                                


                                                                                

1   "d.c.", and "chiropractic physician".                                       

                                                                                

2       (b) "Dentist", "doctor of dental surgery", "oral and                        

                                                                                

3   maxillofacial surgeon", "orthodontist", "prosthodontist",                   

                                                                                

4   "periodontist", "endodontist", "oral pathologist", "pediatric               

                                                                                

5   dentist", "dental hygienist", "registered dental hygienist",                

                                                                                

6   "dental assistant", "registered dental assistant", "r.d.a.",                

                                                                                

7   "d.d.s.", "d.m.d.", and "r.d.h.".                                           

                                                                                

8       (c) "Doctor of medicine" and "m.d.".                                        

                                                                                

9       (d) "Physician's assistant" and "p.a.".                                     

                                                                                

10      (e) "Registered professional nurse", "registered nurse",                    

                                                                                

11  "r.n.", "licensed practical nurse", "l.p.n.", "nurse midwife",              

                                                                                

12  "nurse anesthetist", "nurse practitioner", "trained attendant",             

                                                                                

13  and "t.a.".                                                                 

                                                                                

14      (f) "Doctor of optometry", "optometrist", and "o.d.".                       

                                                                                

15      (g) "Osteopath", "osteopathy", "osteopathic practitioner",                  

                                                                                

16  "doctor of osteopathy", "diplomate in osteopathy", and "d.o.".              

                                                                                

17      (h) "Pharmacy", "pharmacist", "apothecary", "drugstore",                    

                                                                                

18  "druggist", "medicine store", "prescriptions", and "r.ph.".                 

                                                                                

19      (i) "Physical therapy", "physical therapist", "doctor of                    

                                                                                

20  physiotherapy", "doctor of physical therapy", "physiotherapist",            

                                                                                

21  "physiotherapy", "registered physical therapist", "licensed                 

                                                                                

22  physical therapist", "physical therapy technician", "physical               

                                                                                

23  therapist assistant", "physical therapy assistant",                         

                                                                                

24  "physiotherapist assistant", "physiotherapy assistant",                     

                                                                                

25  "p.t. assistant", "p.t.", "r.p.t.", "l.p.t.", "c.p.t.", "d.p.t.",           

                                                                                

26  "m.p.t.", "p.t.a.", "registered p.t.a.", "licensed p.t.a.",                 

                                                                                

27  "certified p.t.a.", "c.p.t.a.", "l.p.t.a.", "r.p.t.a.", and                 


                                                                                

1   "p.t.t.".                                                                   

                                                                                

2       (j) "Chiropodist", "chiropody", "chiropodical", "podiatry",                 

                                                                                

3   "podiatrist", "podiatric", "doctor of podiatric medicine", "foot            

                                                                                

4   specialist", "podiatric physician and surgeon", and "d.p.m.".               

                                                                                

5       (k) "Consulting psychologist", "psychologist", "psychological               

                                                                                

6   assistant", "psychological examiner", "licensed psychologist",              

                                                                                

7   and "limited licensed psychologist".                                        

                                                                                

8                                                                                (l) "Licensed professional counselor", "licensed counselor",                        

                                                                                

9   "professional counselor", and "l.p.c.".                                     

                                                                                

10      (m) "Sanitarian", "registered sanitarian", and "r.s.".                      

                                                                                

11      (n) "Social worker", "certified social worker", "social work                

                                                                                

12  technician", "s.w.", "c.s.w.", and "s.w.t.".                                

                                                                                

13      (o) "Veterinary", "veterinarian", "veterinary doctor",                      

                                                                                

14  "veterinary surgeon", "doctor of veterinary medicine", "v.m.d.",            

                                                                                

15  "d.v.m.", "animal technician", or "animal technologist".                    

                                                                                

16      (p) "Occupational therapist", "occupational therapist                       

                                                                                

17  registered", "certified occupational therapist", "o.t.",                    

                                                                                

18  "o.t.r.", "c.o.t.", "certified occupational therapy assistant",             

                                                                                

19  "occupational therapy assistant", or "c.o.t.a.".                            

                                                                                

20      (q) "Marriage advisor" or "marriage consultant"; "family                    

                                                                                

21  counselor", "family advisor", "family therapist", or "family                

                                                                                

22  consultant"; "family guidance counselor", "family guidance                  

                                                                                

23  advisor", or "family guidance consultant"; "marriage guidance               

                                                                                

24  counselor", "marriage guidance advisor", or "marriage guidance              

                                                                                

25  consultant"; "family relations counselor"; "marriage relations              

                                                                                

26  counselor", "marriage relations advisor", or "marriage relations            

                                                                                

27  consultant"; "marital counselor" or "marital therapist"; "limited           


                                                                                

1   licensed marriage and family therapist" or "limited licensed                

                                                                                

2   marriage counselor"; "licensed marriage and family therapist" or            

                                                                                

3   "licensed marriage counselor"; and "l.m.f.t.".                              

                                                                                

4       (r) "Nursing home administrator".                                           

                                                                                

5       (2) Notwithstanding section 16261, a person who was specially               

                                                                                

6   trained at an institution of higher education in this state to              

                                                                                

7   assist a physician in the field of orthopedics and upon                     

                                                                                

8   completion of training, received a 2-year associate of science              

                                                                                

9   degree as an orthopedic physician's assistant before January 1,             

                                                                                

10  1977, may use the title "orthopedic physician's assistant"                  

                                                                                

11  whether or not the person is licensed under this article.                   

                                                                                

12      Sec. 16315.  (1) The health professions regulatory fund is                  

                                                                                

13  established in the state treasury.  Except as otherwise provided            

                                                                                

14  in this section, the state treasurer shall credit the fees                  

                                                                                

15  collected under sections 16319 to 16349 to the health professions           

                                                                                

16  regulatory fund.  The money in the health professions regulatory            

                                                                                

17  fund shall be expended only as provided in subsection (5).                  

                                                                                

18      (2) The state treasurer shall direct the investment of the                  

                                                                                

19  health professions regulatory fund.  Interest and earnings from             

                                                                                

20  health professions regulatory fund investment shall be credited             

                                                                                

21  to the health professions regulatory fund.                                  

                                                                                

22      (3) The unencumbered balance in the health professions                      

                                                                                

23  regulatory fund at the close of the fiscal year shall remain in             

                                                                                

24  the health professions regulatory fund and shall not revert to              

                                                                                

25  the general fund.                                                           

                                                                                

26      (4) The health professions regulatory fund may receive gifts                

                                                                                

27  and devises and other money as provided by law.                             


                                                                                

1       (5) The department of consumer and industry services shall                  

                                                                                

2   use the health professions regulatory fund only to carry out its            

                                                                                

3   powers and duties under this article and article 7 including, but           

                                                                                

4   not limited to, reimbursing the department of attorney general              

                                                                                

5   for the reasonable cost of services provided to the department of           

                                                                                

6   consumer and industry services under this article and article 7.            

                                                                                

7       (6) The nurse professional fund is established in the state                 

                                                                                

8   treasury.  Of the money that is attributable to per-year license            

                                                                                

9   fees collected under section 16327, the state treasurer shall               

                                                                                

10  credit $2.00 of each individual annual license fee collected to             

                                                                                

11  the nurse professional fund.  The money in the nurse professional           

                                                                                

12  fund shall be expended only as provided in subsection (9).                  

                                                                                

13      (7) The state treasurer shall direct the investment of the                  

                                                                                

14  nurse professional fund, and shall credit interest and earnings             

                                                                                

15  from the investment to the nurse professional fund.  The nurse              

                                                                                

16  professional fund may receive gifts and devises and other money             

                                                                                

17  as provided by law.                                                         

                                                                                

18      (8) The unencumbered balance in the nurse professional fund                 

                                                                                

19  at the close of the fiscal year shall remain in the nurse                   

                                                                                

20  professional fund and shall not revert to the general fund.                 

                                                                                

21      (9) The department of consumer and industry services shall                  

                                                                                

22  use the nurse professional fund each fiscal year only as                    

                                                                                

23  follows:                                                                    

                                                                                

24      (a) The department may use not more than 1/3 of the nurse                   

                                                                                

25  professional fund for the establishment and operation of a nurse            

                                                                                

26  continuing education program.                                               

                                                                                

27      (b) The department may use not more than 1/3 of the nurse                   


                                                                                

1   professional fund to perform research and development studies to            

                                                                                

2   promote and advance the nursing profession.                                 

                                                                                

3       (c) The department shall use not less than 1/3 of the nurse                 

                                                                                

4   professional fund to establish and operate a nursing scholarship            

                                                                                

5   program.                                                                    

                                                                                

6       (10) The official prescription form program fund established                

                                                                                

7   by the amendatory act that added this section is abolished.  The            

                                                                                

8   money remaining in the official prescription form program fund on           

                                                                                

9   the effective date of the amendatory act that added                        

                                                                                

10  subsection (11)  January 3, 2002 shall be transferred by the                

                                                                                

11  state treasurer to the pain management education and controlled             

                                                                                

12  substances electronic monitoring and antidiversion fund created             

                                                                                

13  in subsection (11).                                                         

                                                                                

14      (11) The pain management education and controlled substances                

                                                                                

15  electronic monitoring and antidiversion fund is established in              

                                                                                

16  the state treasury.                                                         

                                                                                

17      (12) The state treasurer shall direct the investment of the                 

                                                                                

18  pain management education and controlled substances electronic              

                                                                                

19  monitoring and antidiversion fund.  Interest and earnings from              

                                                                                

20  investment of the pain management education and controlled                  

                                                                                

21  substances electronic monitoring and antidiversion fund shall be            

                                                                                

22  credited to the pain management education and controlled                    

                                                                                

23  substances electronic monitoring and antidiversion fund.                    

                                                                                

24      (13) The unencumbered balance in the pain management                        

                                                                                

25  education and controlled substances electronic monitoring and               

                                                                                

26  antidiversion fund at the close of the fiscal year shall remain             

                                                                                

27  in the pain management education and controlled substances                  


                                                                                

1   electronic monitoring and antidiversion fund and shall not revert           

                                                                                

2   to the general fund.  The pain management education and                     

                                                                                

3   controlled substances electronic monitoring and antidiversion               

                                                                                

4   fund may receive gifts and devises and other money as provided by           

                                                                                

5   law.  Twenty dollars of the license fee received by the                     

                                                                                

6   department of consumer and industry services under section 16319            

                                                                                

7   shall be deposited with the state treasurer to the credit of the            

                                                                                

8   pain management education and controlled substances electronic              

                                                                                

9   monitoring and antidiversion fund.  The department shall use the            

                                                                                

10  pain management education and controlled substances electronic              

                                                                                

11  monitoring and antidiversion fund only in connection with                   

                                                                                

12  programs relating to pain management education for health                   

                                                                                

13  professionals, preventing the diversion of controlled substances,           

                                                                                

14  and development and maintenance of the electronic monitoring                

                                                                                

15  system for controlled substances data required by section 7333a.            

                                                                                

16      (14) The physical therapy professional fund is established in               

                                                                                

17  the state treasury.  Of the money that is attributed to per-year            

                                                                                

18  license fees collected under section 16335, the state treasurer             

                                                                                

19  shall credit 10% of each individual annual license fee collected            

                                                                                

20  to the physical therapy professional fund.  The money in the                

                                                                                

21  physical therapy professional fund shall be expended only for the           

                                                                                

22  establishment and operation of a physical therapy continuing                

                                                                                

23  education program established under section 17823.                          

                                                                                

24      (15) The state treasurer shall direct the investment of the                 

                                                                                

25  physical therapy professional fund and shall credit interest and            

                                                                                

26  earnings from the investment to the physical therapy professional           

                                                                                

27  fund.  The physical therapy professional fund may receive gifts             


                                                                                

1   and devises and other money as provided by law.                             

                                                                                

2       (16) The unencumbered balance in the physical therapy                       

                                                                                

3   professional fund at the close of the fiscal year shall remain in           

                                                                                

4   the physical therapy professional fund and shall not revert to              

                                                                                

5   the general fund.                                                           

                                                                                

6       Sec. 16335.  Fees for a person licensed or seeking licensure                

                                                                                

7   to engage in the practice of physical therapy under part 178 are            

                                                                                

8   as follows:                                                                 

                                                                                

9     (a) Application processing fee..........................$ 20.00           

                                                                                

10    (b) Examination fees:                                                     

                                                                                

11        Jurisprudence examination only......................  25.00           

                                                                                

12    (c) License fee, per year.......................   50.00  60.00           

                                                                                

13     (d) Temporary license.................................  20.00            

                                                                                

14    (d)  (e)  Limited license, per year.....................  25.00           

                                                                                

15      Sec. 17801.  (1) As used in this part:                                      

                                                                                

16      (a) "Physical therapist" means an individual licensed under                 

                                                                                

17  this article to engage in the practice of physical therapy.                 

                                                                                

18      (b) "Physical therapist assistant" means an individual who                  

                                                                                

19  assists a physical therapist in physical therapy intervention and           

                                                                                

20  is a graduate of a nationally accredited physical therapist                 

                                                                                

21  assistant education program.                                                

                                                                                

22      (c)  (b)  "Practice of physical therapy", subject to                        

                                                                                

23  subsection (2), means the evaluation of, education of,                      

                                                                                

24  consultation with, or treatment of an individual by a physical              

                                                                                

25  therapist or under the direction and responsibility of a physical           

                                                                                

26  therapist in compliance with the rules promulgated under                    

                                                                                

27  section 17824(1).  Practice of physical therapy includes, but is            


                                                                                

1   not limited to, the employment of effective properties of                   

                                                                                

2   physical measures and the use of therapeutic exercises and                  

                                                                                

3   rehabilitative procedures, with or without  assistant  assistive            

                                                                                

4   devices, for the purpose of preventing, correcting, or                      

                                                                                

5   alleviating a physical or mental disability;  .  It includes                

                                                                                

6   treatment planning, performance of tests and measurements and               

                                                                                

7   interpretation and labeling of the results, interpretation of               

                                                                                

8   referrals, intervention selection, initiation of referrals,                 

                                                                                

9   instruction, consultative services, and supervision of                      

                                                                                

10  personnel.  Physical measures include massage, mobilization,                

                                                                                

11  heat, cold, air, light, water, electricity, and sound.                      

                                                                                

12      (2) Practice of physical therapy does not include the                       

                                                                                

13  identification of underlying medical problems or etiologies,               

                                                                                

14  establishment of medical diagnoses  ,  or the prescribing of                

                                                                                

15  medical treatment.                                                          

                                                                                

16      (3)  (2)  In addition to the definitions in this part,                      

                                                                                

17  article 1 contains general definitions and principles of                    

                                                                                

18  construction applicable to all articles in this code and part 161           

                                                                                

19  contains definitions applicable to this part.                               

                                                                                

20      Sec. 17820.  (1) A person shall not engage in the practice                  

                                                                                

21  of physical therapy unless licensed or otherwise authorized by              

                                                                                

22  this article.   A person shall engage in the actual treatment of            

                                                                                

23  an individual only upon the prescription of an individual holding           

                                                                                

24  a license, other than a subfield license, issued under part 166,            

                                                                                

25  170, 175, or 180, or the equivalent license issued by another               

                                                                                

26  state.                                                                      

                                                                                

27      (2) Except as provided in subsection (3), after December 31,                


                                                                                

1   2019, an individual seeking licensure under this part shall                 

                                                                                

2   provide satisfactory evidence to the board that he or she has met           

                                                                                

3   either of the following educational qualifications:                         

                                                                                

4       (a) Completed a nationally accredited doctoral level                        

                                                                                

5   physical therapist educational program that is acceptable to the            

                                                                                

6   board.                                                                      

                                                                                

7       (b) Received a physical therapy degree from a postsecondary                 

                                                                                

8   institution that is located outside of the United States and is             

                                                                                

9   determined by the board to be substantially equivalent to a                 

                                                                                

10  nationally accredited doctoral level physical therapist                     

                                                                                

11  educational program.                                                        

                                                                                

12      (3) An individual holding a license under this part or the                  

                                                                                

13  equivalent license issued by another state as of December 31,               

                                                                                

14  2019 shall be granted grandfather status and is not required to             

                                                                                

15  complete a doctoral level physical therapist educational program            

                                                                                

16  or a substantially equivalent program as provided in subsection             

                                                                                

17  (2) to maintain or renew his or her license.                                

                                                                                

18      Sec. 17823.  (1) Notwithstanding the requirements of                        

                                                                                

19  part 161, beginning 2 years after the effective date of the                 

                                                                                

20  amendatory act that added this section, the board shall require a           

                                                                                

21  licensee seeking renewal of a physical therapy license to furnish           

                                                                                

22  the board with satisfactory evidence that during the 2 years                

                                                                                

23  immediately preceding an application for renewal the licensee has           

                                                                                

24  attended continuing education courses or programs approved by the           

                                                                                

25  board and totaling not less than 40 hours in subjects related to            

                                                                                

26  the practice of physical therapy and designed to further educate            

                                                                                

27  licensees.                                                                  


                                                                                

1       (2) As required under section 16204, the department, in                     

                                                                                

2   consultation with the board, shall promulgate rules requiring               

                                                                                

3   each applicant for license renewal to complete as part of the               

                                                                                

4   continuing education requirement of subsection (1) an appropriate           

                                                                                

5   number of hours or courses in pain and symptom management.                  

                                                                                

6       Sec. 17824.  (1) The department, in consultation with the                   

                                                                                

7   board, shall promulgate rules to establish standards of ethics              

                                                                                

8   and standards of practice for physical therapists.  The                     

                                                                                

9   department shall incorporate by reference into the rules the                

                                                                                

10  standards of ethics, standards of practice, and supervision                 

                                                                                

11  guidelines contained in the document entitled "Guide to Physical            

                                                                                

12  Therapy Practice", second edition, published by the American                

                                                                                

13  physical therapy association, Alexandria, Virginia, January                 

                                                                                

14  2001.                                                                       

                                                                                

15      (2) A physical therapist shall adhere to the standards of                   

                                                                                

16  ethics, standards of practice, and supervision guidelines                   

                                                                                

17  established in the rules promulgated under subsection (1).                  

                                                                                

18      (3) A physical therapist shall refer a patient to an                        

                                                                                

19  appropriate health care practitioner if the physical therapist              

                                                                                

20  has reasonable cause to believe that symptoms or conditions are             

                                                                                

21  present that require services beyond the scope of practice of               

                                                                                

22  physical therapy.                                                           

                                                                                

23      (4) A physical therapist shall consult with an appropriate                  

                                                                                

24  health care practitioner if a patient does not show reasonable              

                                                                                

25  response to treatment in a time period consistent with the                  

                                                                                

26  standards of practice established in the rules promulgated under            

                                                                                

27  subsection (1).                                                             


                                                                                

1       Sec. 17825.  This part does not require or preclude third                   

                                                                                

2   party reimbursement for services provided under this part and               

                                                                                

3   does not preclude a health maintenance organization, a health               

                                                                                

4   care benefit plan, a nonprofit health care corporation, a                   

                                                                                

5   worker's disability compensation insurer, or the medicaid program           

                                                                                

6   from requiring a member or enrollee to fulfill benefit                      

                                                                                

7   requirements for physical therapy services, including, but not              

                                                                                

8   limited to, prescription, referral, or preapproval.  As used in             

                                                                                

9   this section, "medicaid" means the program for medical assistance           

                                                                                

10  created under title XIX of the social security act, chapter 531,            

                                                                                

11  49 Stat. 620, 42 U.S.C. 1396 to 1396r-6 and 1396r-8 to 1396v.