Post on 06-Feb-2016
description
PTA 1500-043WHITNEY SMITH
OBJECTIVE #3:DIRECTION AND
SUPERVISION
DIRECTION/SUPERVISION
There are many rules and regulations for any physical
therapist personnel concerning direction/supervision
and what they can and cannot do. Things like where
you live, practice, and where you were licensed depict
what rules and regulations you must follow. These
rules generally come from the APTA, state regulations,
and third-party payers. Knowing these rules and
regulations is very important in being a successful PTA
and to provide the “best practice.”
STATE REGULATIONS
There are many federal laws that affect the provision of physical
therapy. These laws are usually referred to as a state’s physical
therapy practice act. The practice acts are there to protect the
public and ensure the competence of those providing the services.
The Federation of State Boards of Physical Therapy (FSBPT) has
developed a Model Practice Act, which is considered to be a
“preeminent standard” for states to follow as they update and clarify
their practice acts.
STATE REGULATIONS
The regulation of a PTA is designed to ensure that those providing care
to the public will do it safely. There are three different levels of
regulation that might be used for PTAs.
Registration: Usually there is no requirement for specific training or
education.
Certification: Usually requires some type of specific education and
passing an examination.
Licensure: The highest level of oversight due to the risk of the
public. Those who are licensed generally are subject to discipline by
a state board if they fail to meet regulatory standards.
S TAT E R E G U L AT I O N S - P H Y S I C A L S U P E R V I S I O N
The practice act should describe the type of supervision
exercised by the PT while the PTA is working. It also may
describe things such as face-to-face interaction between the PT
and PTA.
Many practice acts also may have restrictions on the number of
PTAs that a PT can supervise.
Physical supervision also includes what PTA are allowed to
perform in the clinic, and what the PT can not delegate to
others.
APTA RULES
Although the APTA has many positions and documents
concerning the responsibilities of a PTA, they are not legal
binding. According to the APTA their guidelines represent the
“best practice”, and if not followed could be used against a
practitioner if a lawsuit is filed.
The best way to access these policies is either accessing the
APTA: PTA Direction Algorithm, PTA Supervision Algorithm, or
on the APTA’s web site (www.apta.org) under the PTA link.
APTA RULES
The APTA’s viewpoints are classified into three categories, each has its own levels of
expectation of compliance.
Guidelines: least binding, considered a “statement of advice”
Positions: considered to be “a firmly held association stance or point of view.”
Standards: highest level of expectation because they are “a binding statement used to
judge quality of action for activity” and often pertain to “right and wrong” conduct.
Along with the expectations the APTA have three types of supervision for PTAs including:
General Supervision: PT is not required to be in the same building as the PTA while the
PTA is delivering interventions.
Direct Supervision: Requires the on-site presence of the PT and daily interaction
between the supervising PT and each patient being seen by the supervisee.
Direct Personal Supervision: Not only requires the PT to be physically present but also
to continuously direct and supervise the person who is performing the tasks.
THIRD-PARTY PAYER
Requirements of a third-party payer should be heavily
considered as they affect the PTAs ability to participate in the
patient care. If the PTA does not match the requirements set
by the payer, the provider is likely not to be paid or even
charged with fraud.
Examples would be found in the Medicare system.
Third-party payers usually control things such as
supervision, participation, and licensing requirements for
them to reimburse the provider.
COMPARE/CONTRAST
As you can see, the rules and regulations
concerning direction and supervision can vary
depending on which group (APTA, state, etc.) you
are concentrating on. Even though there are some
regulations that are similar it’s important you know
the regulations for each one so that you don’t run
into any problems or violations that could cause you
to lose your license or to lose patients.