ARC 3590C
PROFESSIONAL LICENSURE DIVISION[645]
Adopted and Filed
Rule making related to practice of physical and occupational therapy
The Board of Physical and Occupational Therapy hereby amends Chapter 201, “Practice of Physical Therapists and Physical Therapist Assistants,” and Chapter 208, “Practice of Occupational Therapists and Occupational Therapy Assistants,” Iowa Administrative Code.
Legal Authority for Rule Making
This rule making is adopted under the authority provided in Iowa Code section 147.76.
State or Federal Law Implemented
This rule making implements, in whole or in part, Iowa Code chapters 147, 148A, and 272C.
Purpose and Summary
These amendments add requirements for telehealth.
Public Comment and Changes to Rule Making
Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on November 8, 2017, as ARC 3435C. A public hearing was held on November 28, 2017, from 8 to 8:30 a.m.	in the Fifth Floor Board Conference Room 526, Lucas State Office Building, Des Moines, Iowa. One comment was received from the Iowa Physical Therapy Association in support of the proposed amendments. No changes from the Notice have been made.
Adoption of Rule Making
This rule making was adopted by the Board of Physical and Occupational Therapy on December 19, 2017.
Fiscal Impact
This rule making has no fiscal impact to the State of Iowa.
Jobs Impact
After analysis and review of this rule making, no impact on jobs has been found.
Waivers
Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Professional Licensure Division for a waiver of the discretionary provisions, if any.
Review by Administrative Rules Review Committee
The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).
Effective Date
This rule making will become effective on February 21, 2018.
The following rule-making actions are adopted:
	Item 1. Adopt the following new rule 645—201.3(147):
645—201.3(147) Telehealth visits. A licensee may provide physical therapy services to a patient utilizing a telehealth visit if the physical therapy services are provided in accordance with all requirements of this chapter.
	201.3(1) “Telehealth visit” means the provision of physical therapy services by a licensee to a patient using technology where the licensee and the patient are not at the same physical location for the physical therapy session.
	201.3(2) A licensee engaged in a telehealth visit shall utilize technology that is secure and HIPAA-compliant and that includes, at a minimum, audio and video equipment that allows two-way real-time interactive communication between the licensee and the patient. A licensee may use non-real-time technologies to prepare for a physical therapy session or to communicate with a patient between physical therapy sessions.
	201.3(3) A licensee engaged in a telehealth visit shall be held to the same standard of care as a licensee who provides in-person physical therapy. A licensee shall not utilize a telehealth visit if the standard of care for the particular physical therapy services cannot be met using technology.
	201.3(4) Any physical therapist or physical therapist assistant who provides a physical therapy telehealth visit to a patient located in Iowa shall be licensed in Iowa.
	201.3(5) Prior to the first telehealth visit, a licensee shall obtain informed consent from the patient specific to the physical therapy services that will be provided in a telehealth visit. At a minimum, the informed consent shall specifically inform the patient of the following:
	a. 	The risks and limitations of the use of technology to provide physical therapy services;
	b. 	The potential for unauthorized access to protected health information; and
	c. 	The potential for disruption of technology during a telehealth visit.
	201.3(6) A licensee shall only provide physical therapy services using a telehealth visit in the areas of competence wherein proficiency in providing the particular service using technology has been gained through education, training, and experience.
	201.3(7) A licensee shall identify in the clinical record when physical therapy services are provided utilizing a telehealth visit.
	Item 2. Adopt the following new rule 645—208.3(147):
645—208.3(147) Telehealth visits. A licensee may provide occupational therapy services to a patient utilizing a telehealth visit if the occupational therapy services are provided in accordance with all requirements of this chapter.
	208.3(1) “Telehealth visit” means the provision of occupational therapy services by a licensee to a patient using technology where the licensee and the patient are not at the same physical location for the occupational therapy session.
	208.3(2) A licensee engaged in a telehealth visit shall utilize technology that is secure and HIPAA-compliant and that includes, at a minimum, audio and video equipment that allows two-way real-time interactive communication between the licensee and the patient. A licensee may use non-real-time technologies to prepare for an occupational therapy session or to communicate with a patient between occupational therapy sessions.
	208.3(3) A licensee engaged in a telehealth visit shall be held to the same standard of care as a licensee who provides in-person occupational therapy. A licensee shall not utilize a telehealth visit if the standard of care for the particular occupational therapy services cannot be met using technology.
	208.3(4) Any occupational therapist or occupational therapist assistant who provides an occupational therapy telehealth visit to a patient located in Iowa shall be licensed in Iowa.
	208.3(5) Prior to the first telehealth visit, a licensee shall obtain informed consent from the patient specific to the occupational therapy services that will be provided in a telehealth visit. At a minimum, the informed consent shall specifically inform the patient of the following:
	a. 	The risks and limitations of the use of technology to provide occupational therapy services;
	b. 	The potential for unauthorized access to protected health information; and
	c. 	The potential for disruption of technology during a telehealth visit.
	208.3(6) A licensee shall only provide occupational therapy services using a telehealth visit in the areas of competence wherein proficiency in providing the particular service using technology has been gained through education, training, and experience.
	208.3(7) A licensee shall identify in the clinical record when occupational therapy services are provided utilizing a telehealth visit.
[Filed 12/19/17, effective 2/21/18]
[Published 1/17/18]
Editor’s Note: For replacement pages for IAC, see IAC Supplement 1/17/18.