ARC 4702C
PROFESSIONAL LICENSURE DIVISION[645]
Adopted and Filed
Rule making related to physical therapy licensure and examination
The Board of Physical and Occupational Therapy hereby amends Chapter 200, “Licensure of Physical Therapists and Physical Therapist Assistants,” Iowa Administrative Code.
Legal Authority for Rule Making
This rule making is adopted under the authority provided in Iowa Code section 147.76 and chapter 148A.
State or Federal Law Implemented
This rule making implements, in whole or in part, Iowa Code chapters 147, 147C, and 148A.
Purpose and Summary
These amendments update numerous approval processes for testing eligibility to make it feasible for the Board to participate in the Federation of State Boards of Physical Therapy’s (Federation’s) Alternative Approval Pathway initiative. These amendments include updates to the procedure for requesting special accommodations as well as clarification and score updates for foreign-trained applicants.
Public Comment and Changes to Rule Making
Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on July 31, 2019, as ARC 4569C. A public hearing was held on August 21, 2019, at 8 a.m.	in the Fifth Floor Conference Room 526, Lucas State Office Building, Des Moines, Iowa. No one attended the public hearing. No public comments were received.
After publication of the Notice, the Board revised Item 7, which exempts foreign-trained applicants from taking the Test of English as a Foreign Language Internet-based test (TOEFL iBT test) when the applicant’s physical therapy education was completed at a school where instruction, textbooks and transcript were in English. The revision removes the requirement for the foreign school to also be approved by the Commission on Accreditation in Physical Therapy Education.  Item 7 was further revised to remove the language implementing the previously proposed minimum TOEFL iBT scores for 2020 because the Federation announced an indefinite delay on implementation of the new minimum scores. In addition, the hierarchy of the subrule in Item 7 was restructured for clarity.
Adoption of Rule Making
This rule making was adopted by the Board on September 13, 2019.
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 Board for a waiver of the discretionary provisions, if any, pursuant to 645—Chapter 18.
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 November 13, 2019.
The following rule-making actions are adopted:
	Item 1. Rescind subrule 200.2(6).
	Item 2. Renumber subrules 200.2(7) to 200.2(9) as 200.2(6) to 200.2(8).
	Item 3. Amend subrule 200.4(3) as follows:
	200.4(3) Before the board may approve an applicant for testing beyond three attempts, an applicant shall demonstrate evidence satisfactory to the board of having successfully completed additional coursework. The Federation of State Boards of Physical Therapy (FSBPT) determines the total number of times an applicant may take the examination in a lifetime. The board will not approve an applicant for testing when the applicant has exhausted the applicant’s lifetime opportunities for taking the examination, as determined by FSBPT.
	Item 4. Rescind subrule 200.4(4).
	Item 5. Renumber subrule 200.4(5) as 200.4(4).
	Item 6. Amend renumbered subrule 200.4(4) as follows:
	200.4(4) Special accommodations. To eliminate discrimination and guarantee fairness under Title II of the Americans with Disabilities Act (ADA), an individual who has a qualifying disability may request an examination accommodation.  The applicant must submit appropriate documentation to FSBPT.
	a. 	Disability requirements. An applicant is an individual who has a physical or mental impairment that substantially limits that individual in one or more major life activities, who has a record of such a physical or mental disability, or who is regarded as having such a physical or mental impairment.
	(1)	Physical impairment, as defined by the ADA, means any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genitourinary, hemic and lymphatic, skin, and endocrine.
	(2)	Mental impairment, as defined by the ADA, means any mental or psychological disorder, such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities.
	b. 	To be considered an impairment that limits a major life activity, the disability shall impair an activity that an average person can perform with little or no difficulty, for example, walking, seeing, hearing, speaking, breathing, learning, performing manual tasks, caring for oneself, working, sitting, standing, lifting, or reading.
	c. 	To verify the accommodation, the applicant must submit appropriate documentation that uses professionally recognized criteria; that details how the disability leads to functional limitations; and that illustrates how the limitation or limitations inhibit the individual from performing one or more major life activities.
	d. 	An evaluator shall on the documentation provide a signature, verify the diagnosis, verify the professionally recognized test/assessment, and recommend the accommodation. The evaluator shall be a licensed health care professional, including but not limited to a physician who practices in a field that includes, but may not be limited to, neurology, family practice, orthopedics, physical medical medicine and rehabilitation, and psychiatry; or a psychologist who performs evaluations to assess individuals for mental disorders that might impact those individuals’ academic or testing performance.
	e. 	An accommodation shall not give the individual an unfair advantage over others taking the examination, shall not change the purpose of the examination, and shall not guarantee that the individual will pass the examination.
	f. 	The board and staff shall maintain confidentiality of all medical and diagnostic information and records.
	Item 7. Amend subrule 200.5(2) as follows:
	200.5(2) Foreign-trained applicants.
	a.	Foreign-trained applicants who do not hold a license in another state or U.S. territory shall:
	a.  (1)	Submit an English translation and an equivalency evaluation of their educational credentials through the following organization: Foreign Credentialing Commission on Physical Therapy, Inc., 124 West Street South, Third Floor, Alexandria, VA 22314; telephone (703)684-8406; website www.fccpt.org. The credentials of a foreign-educated physical therapist or foreign-educated physical therapist assistant licensure applicant who does not hold a license in another state or territory of the United States and is applying for licensure by taking the examination should be evaluated using the most current version of the Federation of State Boards of Physical Therapy (FSBPT) Coursework Tool (CWT). The credentials of a foreign-educated physical therapist or physical therapist assistant who has been a licensed PT or PTA under the laws of another jurisdiction should be evaluated using the version of the FSBPT CWT that covers the date the applicant graduated from the applicant’s respective physical therapist or physical therapist assistant education program. The professional curriculum must be equivalent to the Commission on Accreditation in Physical Therapy Education standards. An applicant shall bear the expense of the curriculum evaluation.
	b.  (2)	Submit certified proof of proficiency in the English language by achieving on the Test of English as a Foreign Language (IBT-TOEFL) Internet-based test (TOEFL iBT test) a total score of at least 89 on the Internet-based TOEFL TOEFL iBT test as well as accompanying minimum scores in the four test components as follows: 24 in writing; 26 in speaking; 21 in reading comprehension; and 18 in listening comprehension. This examination test is administered by Educational Testing Services, Inc., P.O. Box 6157, Princeton, NJ 08541-6157. An applicant shall bear the expense of the TOEFL examination TOEFL iBT test. Applicants may be exempt from the TOEFL examination TOEFL iBT test when the native language is English, physical therapy education was completed in a school approved by the Commission on Accreditation in Physical Therapy Education (CAPTE), where the language of instruction in physical therapy was English, the language of the textbooks was English, and the applicant’s transcript was in English.
	c.  b.	Submit an official statement from each country’s or territory’s board of examiners or other regulatory authority regarding the status of the applicant’s license, including issue date, expiration date and information regarding any pending or prior investigations or disciplinary action. The applicants shall request such statements from all entities in which they are currently or formerly licensed.  Foreign-trained applicants who hold a license in another state or U.S. territory may apply for licensure by endorsement.
	d. 	Receive a final determination from the board regarding the application for licensure.
	Item 8. Amend subrule 200.7(1) as follows:
	200.7(1) An applicant who has been a licensed PT or PTA under the laws of another jurisdiction state or U.S. territory shall file an application for licensure by endorsement with the board office . The board may receive by endorsement any applicant from the District of Columbia or another state, territory, province or foreign country who by completing the following steps:
	a. 	Submits Submit to the board a completed application;
	b. 	Pays Pay the licensure fee;
	c. 	Shows Show evidence of licensure requirements that are similar to those required in Iowa;
	d. 	Submits Submit a copy of the scores from the appropriate professional examination to be sent directly from the examination service to the board;
	e. 	Submits Submit two completed fingerprint cards and a signed waiver form to facilitate a national criminal history background check by the Iowa division of criminal investigation (DCI) and the Federal Bureau of Investigation (FBI). The cost of the criminal history background check by the DCI and the FBI shall be assessed to the applicant;
	f. 	Provides Provide official copies of the academic transcripts sent directly from the school to the board; and
	g. 	Provides Provide verification of license(s) from every jurisdiction in which the applicant has been licensed, sent directly from the jurisdiction(s) to the board office. Web-based verification may be substituted for verification direct from the jurisdiction’s board office if the verification provides:
	(1)	Licensee’s name;
	(2)	Date of initial licensure;
	(3)	Current licensure status; and
	(4)	Any disciplinary action taken against the license.
	Item 9. Rescind subrule 200.7(6).
[Filed 9/17/19, effective 11/13/19]
[Published 10/9/19]
Editor’s Note: For replacement pages for IAC, see IAC Supplement 10/9/19.