Physical Therapy Compact Moves Forward

Following the lead of emergency medical services and doctors, a group of physical therapists and state board administrators are working to develop a licensing compact that would make it easier for physical therapists to practice in multiple states. 

This type of agreement could significantly increase access to physical therapy services in rural and hard-to-serve areas, which in turn has the potential to reduce costs for patients, states and the federal government. The compact also could allow providers to take advantage of improving technologies and offer more telehealth services. 

“In an increasingly global world, interstate licensing agreements provide a means to ensure access to high quality care, while promoting continuity between patients and health care providers,” said Nancy Kirsch, director of the physical therapy program at Rutgers University.

Efforts to draft a Physical Therapy Licensing Compact continued this week in Alexandria, Va. The drafting team, which was convened by the Federation of State Boards of Physical Therapy with assistance from The Council of State Governments’ National Center for Interstate Compacts, has been working over the last several months to develop a compact that would promote license portability across state lines in an effort to increase access to physical therapy services, while better protecting patient safety.

During the meeting the drafters discussed:

  • Conditions that must be met for licensure in a member state;

  • Ways to include the spouses of service members;

  • What happens when an adverse action occurs;

  • The establishment of a database to monitor compact participants; and

  • Criminal background checks.

Additionally, the drafters deliberated on what the commission’s governance structure should look like and what rule-making authority to grant the commission. 

The work of the drafting team builds on the recommendations initially made by the advisory team in July 2014. That group, comprised of about 25 subject matter experts, formally endorsed the creation of a Physical Therapy Licensing Compact.

Kirsch, who also serves as the vice president of The Federation of State Boards of Physical Therapy, said a licensing compact for physical therapists just makes sense. 

“Well, it certainly fits in with our mission, which is to protect the public by providing service and leadership and to promote safe and competent physical therapy practice,” she said. “It also fits in with our vision, which, of course, is to provide a high level of public protection and to look at whatever effective tools are out there that will help us do that.”

With the continued growth of telehealth and the implementation Affordable Care Act, a number of professional health organizations are seeking creative ways to promote interstate cooperation between state regulatory boards. Licensing compacts are increasingly being seen as an avenue to improving access to high quality health care across various medical professions. Compacts also provide a mechanism to ensure state regulatory agencies maintain their licensing and disciplinary authority, while simultaneously allowing information to be shared across boarders.

“A compact is both a statue and a contract (between states) and for that reason, these compacts take on a special status in our legal system with respect to legislation,” said Rick Masters, special counsel and legal consultant for the National Center for Interstate Compacts. “In order to achieve uniformity, in order to achieve economies of scale, in order to speak with one voice collectively as states, frequently compacts can be used to achieve all those objectives.”

Several compacts dealing specifically with licensing issues already exist. Compacts such as the Driver’s License Compact and the Nurse Licensure Compact provide precedence for member states to honor licenses issued in another member state. 

Interstate compacts are unique tools that encourage multistate cooperation and innovative policy solutions while asserting and preserving state sovereignty. The National Center for Interstate Compacts is working with several groups to determine the feasibility of a compact related to their particular profession. These medical licensing compacts are in various stages of development. 

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