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Code of Maryland Regulations - Title 10

 

Chapter   1 - General Regulations
Chapter   2 - Code of Ethics
Chapter   3 - Standards of Practice
Chapter   4 - Physical Therapy Aide
Chapter   5 - Rules of Procedure for Board Hearings
Chapter   6 - Foreign-Educated Licensure Requirements
Chapter   7 - Fee schedule
Chapter   8 - Continuing Education Requirements
Chapter   9 - Speech-Impaired Applicants
Chapter 10 - Disciplinary Sanctions, Monetary Penalties, and Civil Fines
Chapter 11 - Compelling Purpose Disclosure



Code of Maryland Regulations

Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE

Subtitle 38 BOARD OF PHYSICAL THERAPY EXAMINERS

 

Chapter 01 General Regulations

Authority: Health Occupations Article, §§1-101, 13-101, 13-206, 13-301—13-303, 13-305, 13-306, 13-307, 13-310, 13-311, 13-313, and 13-317, Annotated Code of Maryland

.01 Definitions.

A. In this subtitle, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Approved agency" means an independent credentialing agency, approved by the Board, which evaluates the credentials of foreign-trained applicants.

(2) "Approved curriculum for physical therapist assistants" means a curriculum that is approved by the American Physical Therapy Association.

(3) "Approved physical therapy curriculum" means a curriculum for physical therapists that is approved by the American Medical Association or the American Physical Therapy Association.

(4) "Biennial renewal" means renewal every other year with even-numbered licenses being renewed in even-numbered years and odd-numbered licenses being renewed in odd-numbered years.

(5) "Board" means the Board of Physical Therapy Examiners of Maryland created by Health Occupations Article, §13-201, Annotated Code of Maryland.

(6) "Direct supervision" means that a licensed physical therapist is personally present and immediately available within the treatment area to give aid, direction, and instruction when physical therapy procedures or activities are performed.

(7) "Hearing committee" means a committee of three or more Board members that has been delegated the authority to conduct hearings in accordance with Health Occupations Article, §13-317, Annotated Code of Maryland.

(8) "Interview" means a meeting with the Board or with one or more of its representatives.

(9) "Licensed physical therapist" means an individual licensed by the Board to practice physical therapy in Maryland.

(10) "Licensed physical therapist assistant" means an individual licensed by the Board to practice limited physical therapy in Maryland.

(11) "Licensing examinations" means the written examinations approved by the Board consisting of the:

(a) National licensing examination; and

(b) Maryland Physical Therapy Law examination.

(12) "Ongoing supervision" means that the physical therapist maintains continuing verbal and written contact with the physical therapist assistant to provide supervision and instruction adequate to ensure the safety and welfare of the patient.

(13) "Oral competency" means that the applicant who did not graduate from a recognized English-speaking educational institution has obtained a passing score, as determined by the Board, on the Test of English as a Foreign Language administered by the Educational Testing Service.

(14) "Passing score" means the result of two examinations:

(a) When taken before March, 1996, within the 1.5 standard deviation, based on the national average of the national licensing examination or, when taken in March, 1996, and after that, the criterion-referenced score set by the Federation of State Boards of Physical Therapy; and

(b) 90 percent of the total on the Maryland Physical Therapy Jurisprudence Examination.

(15) "Physical therapy aide" or "aide" means a person who performs certain physical therapy duties under the direct supervision of a licensed physical therapist. This individual may be known, also, as a physical therapist technician, a rehabilitation technician, an athletic trainer, or be described by some other similar title.

(16) "Post-graduation transcript of credits" means an official copy of an applicant's educational record, including the degree awarded and the date of graduation, sent directly from the educational institution to the Board.

(17) "Reporting service" means the Interstate Reporting Service, an agency approved by the Board for the purpose of recording, storing, and transmitting license examination scores.

(18) "State" means:

(a) A state, possession, or territory of the United States;

(b) The District of Columbia; or

(c) The Commonwealth of Puerto Rico.

(19) "Student" means an individual who is supervised directly by a licensed physical therapist in a Board-approved physical therapy educational program.

(20) "Supportive personnel" means aides and other unlicensed personnel who work under the direct supervision of a licensed physical therapist.

(21) "Verification" means confirmation of licensure obtained directly from the state in which the applicant is currently licensed, on a form provided by the Board.

(22) "Waiver of national licensing examination" means that the Board may waive the national licensing examination if the applicant previously took the examination in another state and met the requirements for a passing score as set forth in §B(14) of this regulation.

(23) "Written competency" means that the applicant who did not graduate from a recognized English-speaking educational institution has obtained a passing score, as determined by the Board, on the Test of English as a Foreign Language administered by the Educational Testing Service.

.02 Requirements for Licensure.

The following are requirements for an applicant educated in an approved physical therapy or approved physical therapist assistant curriculum in any state:

A. Examination. The following shall be filed with the Board at least 6 weeks before the examination:

(1) An application on the form the Board requires;

(2) The application and national licensing examination fees established in COMAR 10.38.07; and

(3) A post-graduation transcript of credits.

B. Transfer of Examination Scores. The following shall be filed with the Board:

(1) An application on the form the Board requires;

(2) The application fee established in COMAR 10.38.07;

(3) A post-graduation transcript of credits;

(4) A sworn statement that the applicant is not now nor has ever been licensed in another state;

(5) Evidence, satisfactory to the Board, that the applicant is registered to take, or has taken, the national licensing examination in another state; and

(6) A copy of a letter or form to the appropriate reporting service requesting that licensing examination scores be sent to the Board.

C. Waiver of Examination. The following shall be filed with the Board:

(1) An application on the form the Board requires;

(2) The application fee established in COMAR 10.38.07;

(3) A post-graduation transcript of credits;

(4) A copy of a current physical therapy license;

(5) Verification of current license on the form the Board requires; and

(6) A copy of a letter or form to the appropriate reporting service requesting that licensing examination scores be sent to the Board.

D. Additional Requirements. Applicants for licensure shall:

(1) Achieve a passing score on the licensing examinations; and

(2) Attend an interview unless the Board waives this requirement.

 

.03 Reexamination.

A. National Licensing Examination.

(1) An applicant who fails the examination shall repeat the examination.

(2) Fees.

(a) At least 6 weeks before the examination, the applicant shall pay to the Board the reexamination fee as established in COMAR 10.38.07.

(b) If the applicant has taken the licensing examination twice in Maryland, the applicant shall pay to the Board an application fee, as established in COMAR 10.38.07, in addition to the reexamination fee.

B. Examination on Maryland Physical Therapy Law. An applicant who fails the examination on the Maryland Physical Therapy Practice Act and associated regulations shall:

(1) Repeat the examination; and

(2) Attend an interview unless the Board waives this requirement.

.04 Issuance of Licenses.

A. When the applicant has met all the requirements for licensure, the Board may issue a physical therapist or physical therapist assistant license to the applicant.

B. Renewal of Physical Therapist or Physical Therapist Assistant License.

(1) The licensee shall renew the license biennially.

(2) The Board shall mail applications for renewal at least one month prior to the expiration date.

(3) The licensee shall be responsible for notifying the Board if a renewal notice is not received.

(4) A renewal license shall be issued to each licensee who meets the requirements of Health Occupations Article, §13-311(c), Annotated Code of Maryland.

C. A duplicate license shall be issued for a lost, stolen, or destroyed license provided the licensee:

(1) Makes a request in writing;

(2) Provides a sworn statement or police report attesting to the facts; and

(3) Pays the fee as established in COMAR 10.38.07.

.05 Restrictions.

A. The Board may refuse to grant a license to any applicant who begins practice as a physical therapist or a physical therapist assistant before being licensed to practice in Maryland.

B. Practice after the date of expiration of the license is prohibited.

C. An applicant shall complete the application process within 1 year of the date of the paid application or reapply for licensure.

D. The Board may refuse to grant or renew a license to an applicant who has failed to pay all outstanding fees to the Board.

Administrative History
Effective date: December 25, 1974 (1:6 Md. R. 299)

Regulation .01J amended effective June 29, 1979 (6:13 Md. R. 1129)

Regulations .01—.03 repealed effective August 2, 1982 (9:15 Md. R. 1514)

——————

Regulations .01—.04 adopted effective August 2, 1982 (9:15 Md. R. 1514)

Regulations .01—.04 repealed effective December 29, 1986 (13:26 Md. R. 2807)

——————

Regulations .01—.05 adopted effective December 29, 1986 (13:26 Md. R. 2807)

Regulation .01B amended effective July 8, 1991 (18:13 Md. R. 1482); February 26, 1996 (23:4 Md. R. 273); July 12, 1999 (26:14 Md. R. 1083)

Regulation .01B amended as an emergency provision effective January 1, 2001 (28:3 Md. R. 203); amended permanently effective April 16, 2001 (28:7 Md. R. 690)

Regulation .01B amended effective April 24, 2006 (33:8 Md. R. 734); April 6, 2009 (36:7 Md. R. 525)

Regulation .02A—C amended effective July 8, 1991 (18:13 Md. R. 1482)

Regulation .03A amended effective July 8, 1991 (18:13 Md. R. 1482)

Regulation .04 amended effective April 6, 2009 (36:7 Md. R. 525)

Regulation .04A amended effective July 8, 1991 (18:13 Md. R. 1482); July 12, 1999 (26:14 Md. R. 1083)

Regulation .04B amended effective July 12, 1999 (26:14 Md. R. 1083)

Regulation .05 amended effective April 24, 2006 (33:8 Md. R. 734)

Regulation .05C amended effective July 8, 1991 (18:13 Md. R. 1482)

 

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Chapter 02 Code of Ethics

Authority: Health Occupations Article, §§1-212, 13-206, and 13-316, Annotated Code of Maryland

.01 Code of Ethics.

A. The physical therapist and physical therapist assistant shall provide care, regardless of race, creed, color, age, sex, or national origin of the patient.

B. The physical therapist and the physical therapist assistant shall respect the dignity of the patient.

C. The physical therapist and physical therapist assistant shall protect the patient's right to privacy by not divulging confidential information without consent of the patient or guardian unless required by law.

D. The physical therapist shall provide information about fees upon request by the patient.

E. The physical therapist may not dispense or supply physical therapy equipment unless it is in the best interest of the patient.

F. The physical therapist and physical therapist assistant shall report to the Board of Physical Therapy Examiners all information that indicates a person is allegedly performing, or aiding and abetting, the illegal or unsafe practice of physical therapy.

G. The physical therapist and the physical therapist assistant shall comply with the probationary conditions of a Board order.

H. A licensee shall notify the Board in writing within 60 days if any license, certificate, permit, or registration granted by another state for the practice of physical therapy or limited physical therapy has been limited, restricted, suspended, revoked, or subjected to other disciplinary action by the licensing or certifying authority.

I. The physical therapist and physical therapist assistant shall provide and maintain medical records in accordance with Health-General Article, §§4-301—4-402, Annotated Code of Maryland.

J. The physical therapist or physical therapist assistant may not knowingly or willfully destroy, damage, alter, obliterate, or otherwise obscure a medical record or billing record or other information about a patient in an effort to conceal the information from use as evidence in an administrative, civil, or criminal proceeding.

K. The physical therapist or physical therapist assistant may not intimidate or influence any person to withhold or change testimony in hearings or proceedings before the Board or those otherwise delegated to the Office of Administrative Hearings.

L. The physical therapist or physical therapist assistant may not hinder, prevent, or otherwise delay any person from making information available to the Board in furtherance of any investigation of the Board.

.02 Sexual Misconduct.

A. A physical therapist or physical therapist assistant may not engage in sexual misconduct.

B. Sexual misconduct includes, but is not limited to:

(1) Sexual behavior with a client or patient in the context of a professional evaluation, treatment, procedure, or service to the client or patient, regardless of the setting in which the professional service is rendered;

(2) Sexual behavior with a client or patient under the pretext of diagnostic or therapeutic intent or benefit;

(3) Solicitation of a sexual relationship, whether consensual or nonconsensual, with a patient;

(4) Sexual advances requesting sexual favors;

(5) Therapeutically inappropriate or intentional touching of a sexual nature;

(6) A verbal comment of a sexual nature;

(7) Physical contact of a sexual nature with a patient;

(8) Discussion of unnecessary sexual matters while treating a patient;

(9) The taking of photographs of patients for a sexual purpose;

(10) Sexual harassment of staff or students;

(11) An unnecessary sensual act or comment; or

(12) Sexual contact with an incompetent or unconscious patient.
 

.03 Penalties.

Violation of Regulation .01 or .02 of this chapter may result in the Board taking action to reprimand a licensee or place the licensee on probation, or suspend or revoke the licensee's license. The Board may also impose a penalty not exceeding $5,000.

Administrative History
Effective date: April 6, 1979 (6:7 Md. R. 577)

Regulations .01—.03 repealed and new regulations .01 and .02 adopted effective August 2, 1982 (9:15 Md. R. 1514)

Regulation .01C amended effective April 24, 2006 (33:8 Md. R. 734)

Regulation .01G adopted effective September 18, 2000 (27:18 Md. R. 1665)

Regulation .01H—L adopted effective March 18, 2002 (29:5 Md. R. 504)

Regulation .02 amended effective November 7, 1994 (21:22 Md. R. 1877)

Regulation .02 amended and recodified to Regulation .03 and new Regulation .02 adopted effective September 6, 1999 (26:18 Md. R. 1376)

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Chapter 03 Standards of Practice

Authority: Health Occupations Article, §§13-206, 13-309, and 13-310, Annotated Code of Maryland

.01 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Board" means the Board of Physical Therapy Examiners of Maryland created by Health Occupations Article, §13-201, Annotated Code of Maryland.

(2) "Clinical treatment hour" means an hour in which physical therapy or limited physical therapy services are provided at some point during the hour.

(3) "Electronically signed" means an electronic sound, symbol, or process attached to or logically associated with a record and executed or adopted by a person with the intent to sign the record.

(4) "Evaluations" means procedures which include, but are not limited to:

(a) Testing of strength, sensation, and reflexes;

(b) Goniometric measurements and their interpretation;

(c) Assessments of function, muscle tone, developmental levels, accessory motions, posture, and pain scale.

(5) "Goals" means the expected outcome as the result of therapy.

(6) "Group therapy" means treatment procedures provided simultaneously to two or more patients that:

(a) Require constant attendance, but not one-on-one contact by the physical therapist or physical therapist assistant; and

(b) Can be, but need not be, the same treatment procedures.

(7) "History" means data that is pertinent to the current physical therapy problem.

(8) "Hour" means a 60-minute increment during a calendar day which is calculated by dividing the day into consecutive 60-minute increments beginning when the day's first physical therapy or limited physical therapy service starts and ending when the last physical therapy or limited physical therapy service terminates, the last consecutive increment of which may be a fraction of an hour.

(9) "Interpretation" means the analysis of findings for the purpose of establishing and justifying the plan of care.

(10) "License number" means the Maryland physical therapy license number issued by the Board.

(11) "Onset" means the date of occurrence of the condition for which physical therapy is being provided.

(12) "Physical therapy diagnosis" means the condition for which physical therapy is provided if different from the medical diagnosis.

(13) "Plan of care" means the plan of treatment aimed at achieving the anticipated functional goals.

(14) "Progress" means the measurable improvement as related to goals.

(15) "Reevaluation" means a measurement of progress, or lack of it, based on comparisons of tests, measurements, and assessments with previous evaluation or reevaluations.

(16) "Requirements for documentation" means the requirements as set forth in Regulation .02-1 of this chapter and approved by the Board.

(17) "Response to treatment" means a brief statement of the patient's condition at conclusion of treatment.

(18) "Services" means the evaluation or treatment, or both, as appropriate, of a patient.

(19) "Signature and title" means the name of the physical therapist or physical therapist assistant written by that person or electronically signed by that person in accordance with federal and State law and followed by the title "PT" or "PTA" and license number. A stamp of a signature is not acceptable as a signature for documentation.

(20) "Student" means an individual who is currently enrolled in a physical therapy or physical therapist assistant educational program approved by the Board.

(21) "Supervising physical therapist" means a physical therapist who provides ongoing supervision to a physical therapist assistant regarding the care of a patient.

(22) "Supportive personnel" includes aides and other unlicensed personnel.

(23) "Test results" means the measurable and objective findings obtained from the evaluations.

.02 Standards of Practice.

A. Physical Therapists.

(1) The physical therapist who establishes or changes the plan of care shall be ultimately responsible for patient care until another physical therapist:

(a) Provides services to the patient; or

(b) Provides supervision to the treating physical therapist assistant.

(2) The physical therapist shall:

(a) Exercise sound professional judgment in the use of evaluation and treatment procedures;

(b) Provide:

(i) Physical therapy services to not more than an average of three patients per clinical treatment hour per calendar day, excluding group therapy; and

(ii) Each patient with adequate treatment time consistent with accepted standards in delivering physical therapy care;

(c) Provide the patient with accurate information about the physical therapy services provided;

(d) Respect the right of the patient to refuse treatment;

(e) Evaluate the patient and develop a plan of care before the patient is treated;

(f) Work within the physical therapist's competency in physical therapy evaluation and treatment;

(g) Reevaluate the patient as the patient's condition requires, but at least every 30 days, unless the physical therapist, consistent with accepted standards of physical therapy care, documents in the treatment record an appropriate rationale for not reevaluating the patient;

(h) Provide direct supervision of students and aides;

(i) Ascertain and periodically reevaluate the ability of students and aides to perform the assigned duties;

(j) Delegate to the physical therapist assistant only treatment that is within the competency and scope of practice of the physical therapist assistant;

(k) Provide direction and instruction for the physical therapist assistant that is adequate to ensure the safety and welfare of the patient; and

(l) Document ongoing communication with the physical therapist assistant regarding changes in a patient's status and treatment plan.

(3) The physical therapist may:

(a) Enter into an agreement or employment relationship provided that such agreement or relationship does not impede the physical therapist's exercise of independent judgment in the treatment of a patient or cause the physical therapist to practice physical therapy contrary to the Maryland Physical Therapy Act; and

(b) Decline to carry out evaluation or treatment of a patient who has been referred to the physical therapist by a health care practitioner if:

(i) In the physical therapist's judgment, the evaluation or treatment is contraindicated or unjustified; and

(ii) The physical therapist documents the decision in the patient's record.

B. Physical Therapist Assistants.

(1) The physical therapist assistant shall:

(a) Follow the direction and plan of care of the physical therapist in the treatment of a patient;

(b) Exercise sound judgment and adequate care in the performance of duties;

(c) Immediately discontinue any treatment procedure that appears to be harmful to the patient and so notify the supervising physical therapist;

(d) Use only methods and procedures within the scope of the practice of limited physical therapy;

(e) Respect the right of the patient to refuse treatment;

(f) Work within the physical therapist assistant's competency in treatment that is within the scope of practice of limited physical therapy;

(g) Document ongoing communication regarding changes in a patient's status and treatment authorized by the physical therapist; and

(h) Provide the following services:

(i) Treat not more than an average of three patients per clinical treatment hour per calendar day, excluding group therapy; and

(ii) Provide each patient with adequate treatment time consistent with accepted standards in physical therapy care.

(2) The physical therapist assistant may:

(a) Enter into an agreement or employment relationship provided that the agreement or relationship does not impede the physical therapist assistant's exercise of appropriate patient treatment or cause the physical therapist assistant to practice limited physical therapy in violation of the Maryland Physical Therapy Act; and

(b) Participate in the clinical education activities of a physical therapist assistant student if direct supervision of the student is provided by the physical therapist.

(3) The physical therapist assistant may not initiate treatment until:

(a) The patient has been evaluated and the plan of care has been developed by a physical therapist; and

(b) A supervising physical therapist has been assigned to the physical therapist assistant.

.02-1 Requirements for Documentation.

A. The physical therapist shall document legibly the patient's chart each time the patient is seen for:

(1) The initial visit, by including the following information:

(a) Date;

(b) Condition, or diagnosis, or both, for which physical therapy is being rendered;

(c) Onset;

(d) History, if not previously recorded;

(e) Evaluation and results of tests (measurable and objective data);

(f) Interpretation;

(g) Goals;

(h) Modalities, or procedures, or both, used during the initial visit and the parameters involved including the areas of the body treated;

(i) Plan of care including suggested modalities, or procedures, or both, number of visits per week, and number of weeks; and

(j) Signature, title (PT), and license number.

(2) Subsequent visits, by including the following information (progress notes):

(a) Date;

(b) Cancellations, no-shows;

(c) Modalities, or procedures, or both, with any changes in the parameters involved and areas of body treated;

(d) Objective status;

(e) Response to current treatment, if any;

(f) Changes in plan of care; and

(g) Signature, title (PT), and license number, although the flow chart may be initialed.

(3) Reevaluation, by including the following information in the report, which may be in combination with the visit note, if treated during the same visit:

(a) Date;

(b) Number of treatments since the initial evaluation or last reevaluation;

(c) Reevaluation, tests, and measurements of areas of body treated;

(d) Changes from previous objective findings;

(e) Interpretation of results;

(f) Goals met or not met and reasons;

(g) Updated goals;

(h) Updated plan of care including recommendations for follow-up; and

(i) Signature, title (PT), and license number;

(4) Discharge, by including the following information in the discharge summary, which may be combined with the final visit note, if seen by the physical therapist on the final visit and written by the physical therapist:

(a) Date;

(b) Reason for discharge;

(c) Objective status;

(d) Recommendations for follow-up; and

(e) Signature, title (PT), and license number.

B. Notwithstanding §A(4) of this regulation, a physical therapist may direct a physical therapist assistant to treat a patient on a final visit.

C. The physical therapist assistant shall document the patient's chart each time the patient is seen by the physical therapist assistant following the physical therapist's initial evaluation or reevaluation by including the following:

(1) Date;

(2) Cancellations and no-shows;

(3) Modalities, procedures, or both, including parameters involved, and areas of body treated;

(4) Objective status;

(5) Response to treatment, if any;

(6) Continuation of plan as established by the physical therapist or change of plan as authorized by the physical therapist; and

(7) Signature, title (PTA), and license number, although the flow chart may be initialed.

D. Subsequent visits, as referred to in §A(2) of this regulation, in the same day by the same physical therapist do not require separate progress notes unless there is a change in the patient's status.

E. Ongoing Communications. Both the physical therapist and the physical therapist assistant shall document ongoing communication between the physical therapist and physical therapist assistant regarding changes in a patient's status and treatment plan.

.03 Penalties.

Violation of these regulations may result in the Board taking action to reprimand a licensee, place a licensee on probation, or suspend or revoke a license. The Board may also impose a penalty not exceeding $5,000.

Administrative History
Effective date: August 2, 1982 (9:15 Md. R. 1515)

Regulation .01B amended effective January 20, 1991 (19:1 Md. R. 33); December 19, 1994 (21:25 Md. R. 2106); April 16, 2001 (28:7 Md. R. 690); March 18, 2002 (29:5 Md. R. 504); March 31, 2003 (30:6 Md. R. 421); April 24, 2006 (33:8 Md. R. 734)

Regulation .02 amended effective December 19, 1994 (21:25 Md. R. 2106)

Regulation .02 repealed and new Regulation .02 adopted effective March 18, 2002 (29:5 Md. R. 504)

Regulation .02 amended effective March 31, 2003 (30:6 Md. R. 421)

Regulation .02A amended as an emergency provision effective May 23, 2002 (29:12 Md. R. 924; amended permanently effective September 2, 2002 (29:17 Md. R. 1381)

Regulation .02A amended effective April 24, 2006 (33:8 Md. R. 734); February 25, 2008 (35:4 Md. R. 515)

Regulation .02R amended effective January 1, 1996 (22:26 Md. R. 2030)

Regulation .02-1 adopted effective January 20, 1992 (19:1 Md. R. 33)

Regulation .02-1B amended effective December 19, 1994 (21:25 Md. R. 2106)

Regulation .02-1 repealed and new Regulation .02-1 adopted effective March 18, 2002 (29:5 Md. R. 504)

Regulation .02-1 amended effective April 24, 2006 (33:8 Md. R. 734)

 

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Chapter 04 Physical Therapy Aide

Authority: Health Occupations Article, §§13-206, Annotated Code of Maryland

.01 Definition.

A. In these regulations, the following term has the meaning indicated.

B. Term Defined. "Physical therapy aide" or "aide" means a person who performs certain physical therapy duties under the direct supervision of a licensed physical therapist. This individual may be known, also, as a physical therapy technician, a rehabilitation technician, an athletic trainer, or be described by some other similar title.

.02 Requirements.

A. Supervision.

(1) The physical therapy aide shall be under the direct supervision of a licensed physical therapist when performing those physical therapy treatments that the aide is permitted to perform.

(2) Exceptions. An aide may:

(a) Perform non-treatment-related activities, such as secretarial, clerical, and housekeeping duties without direct supervision;

(b) Perform patient-related activities that do not involve treatment (such as transporting patients, undressing and dressing patients, removing and applying assistive and supportive devices) without direct supervision;

(c) Assist a physical therapist assistant when more than one individual is required to ensure the safety and welfare of the patient during ambulation, transfers, or functional activities without direct supervision.

B. In-Service Training. There shall be documented evidence of sufficient in-service training to assure safe performance of the duties assigned to the aide

.03 Activities Which May Be Performed by Aides under Direct Supervision.

The following activities may be performed by aides under direct supervision:

A. Assist in the practice of gait and ambulation;

B. Assist in the practice of functional activities;

C. Assist in the practice of transfers;

D. Assist in the routine follow-up of specific exercises;

E. Assist in the application of hot or cold packs;

F. Assist in the procedure of Hubbard tank;

G. Assist in the procedure of whirlpool;

H. Assist in the application of contrast bath;

I. Assist in the application of infrared; and

J. Assist in the application of paraffin bath.
 

.04 Prohibited Activities.

A. Evaluation may not be performed by aides.

B. Treatments other than those listed in Regulation .03 may not be performed by aides.
 

.05 Penalty.

A physical therapy aide who violates the above regulations shall be considered by the Board to be practicing physical therapy in violation of the Maryland Physical Therapy Practice Act and may be referred to the appropriate State's Attorney's Office with a recommendation by the Board that the physical therapy aide be prosecuted.

Administrative History
Effective date: November 8, 1982 (9:22 Md. R. 2197)

Regulation .01 amended effective April 16, 2001 (28:7 Md. R. 690)

Regulation .01B amended effective November 1, 1999 (26:22 Md. R. 1693)

Regulation .01 amended effective December 25, 2000 (27:25 Md. R. 2282)

Regulation .02C adopted effective November 1, 1999 (26:22 Md. R. 1693)

Regulation .03 amended effective November 1, 1999 (26:22 Md. R. 1693); December 25, 2000 (27:25 Md. R. 2282)

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Chapter 05 Rules of Procedure for Board Hearings

Authority: Health Occupations Article, §§13-206 and 13-317; State Government Article,
§§10-205 and 10-206; Annotated Code of Maryland

.01 Scope.

This chapter governs procedures for disciplinary matters and hearings before the State Board of Physical Therapy Examiners.

.02 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Administrative law judge” means the hearing officer assigned to preside over a hearing in a case which the Board has delegated to the Office of Administrative Hearings pursuant to State Government Article, §10-205, Annotated Code of Maryland.

(2) “Administrative Procedure Act” means State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland, which governs contested cases arising from charges issued by the Board.

(3) “Board” means the State Board of Physical Therapy Examiners.

(4) “Case resolution conference” means a voluntary, informal, and confidential meeting between the parties to a contested case and the Board’s case resolution conference committee to discuss possible settlement of a disciplinary matter pending before the Board.

(5) “Case resolution conference committee” means a committee comprised of one or more members of the Board who make recommendations to the Board regarding settlement of disciplinary matters.

(6) “Cease and desist order” means a public letter issued by the Board ordering:

(a) A licensee to cease doing a specified activity; or

(b) An unlicensed person to cease the unauthorized practice of physical therapy.

(7) “Charges” means a nonpublic record issued by the Board which:

(a) Alleges conduct by a licensee which the Board believes constitutes a violation under the Maryland Physical Therapy Act;

(b) Sets forth sections of the Maryland Physical Therapy Act that the Board believes were violated; and

(c) Provides notice to the licensee of disciplinary proceedings before the Board.

(8) “Complaint” means an allegation:

(a) That a licensee may have violated the Maryland Physical Therapy Act; and

(b) Which may be grounds for an investigation or disciplinary action by the Board.

(9) “Consent order” means a final order issued by the Board that has been negotiated and agreed to by both the licensee and the Board to resolve a formal disciplinary action.

(10) “Contested case” means a proceeding conducted pursuant to the Administrative Procedure Act.

(11) “Final order” means a public record issued by the Board resolving a formal disciplinary action, either by consent or after an adjudication, which:

(a) Denies a license;

(b) Sanctions by reprimand, probation, fine, or suspension or revocation of a license;

(c) Summarily suspends a license;

(d) Dismisses charges;

(e) Surrenders a license;

(f) Resolves the contested case by consent of the parties; or

(g) Takes any other action that the Board is authorized to do by law.

(12) “Formal disciplinary action” means action taken by the Board that:

(a) Is initiated by charges or a notice of initial denial;

(b) Is resolved by a consent order;

(c) Results in a summary suspension; or

(d) Results in a letter of surrender.

(13) “Hearing committee” means a committee of three or more members of the Board which conducts hearings.

(14) “Informal action” means that the Board closes a case, without any formal disciplinary action or without issuing a final order, by sending the licensee a:

(a) Letter of education; or

(b) Letter of admonishment.

(15) Letter of Admonishment.

(a) “Letter of admonishment” means an informal action taken by the Board consisting of a nonpublic letter closing the case when the Board believes a licensee has engaged in conduct which violated the Maryland Physical Therapy Act.

(b) “Letter of admonishment” may include a letter of agreement in which a licensee agrees to satisfy certain conditions in lieu of the Board issuing charges.

(16) Letter of Education.

 (a) “Letter of education” means an informal action taken by the Board consisting of a nonpublic letter in which the Board:

(i) Closes the case when the Board does not believe that the licensee’s conduct rose to the level of a violation of the Maryland Physical Therapy Act; and

(ii) Educates the licensee regarding the laws and standards of the practice of physical therapy.

(b) “Letter of education” may include a letter of agreement in which a licensee agrees to satisfy certain conditions.

(17) “Letter of surrender” means a public record accepted by the Board in which the licensee agrees to surrender the licensee’s license, which may include conditions for the Board’s acceptance of the surrender as a resolution of the case.

(18) “Licensee” means the holder of a license issued by the Board of Physical Therapy Examiners.

(19) “Maryland Physical Therapy Act” means Health Occupations Article, Title 13, Annotated Code of Maryland.

(20) “Notice of initial denial” means a nonpublic record issued by the Board by which an applicant or licensee is notified that the Board intends to deny a license, change a licensure status, or change some other benefit sought by the licensee.

(21) “Party” means:

(a) The respondent or any person named or admitted as a party, or properly seeking and entitled as a right to be a party in a formal disciplinary proceeding; or

(b) The administrative prosecutor from the Office of the Attorney General presenting a case on behalf of the Board.

(22) “Post-deprivation hearing” means a show cause or an evidentiary hearing scheduled by the Board after the Board has issued an order for summary suspension pursuant to State Government Article, §10-226(c)(2), Annotated Code of Maryland, in which the licensee may challenge the Board’s basis for issuing the order of summary suspension.

(23) “Predeprivation hearing” means a show cause hearing at which the licensee has an opportunity to demonstrate to the Board why it should not:

(a) Issue an order for summary suspension pursuant to State Government Article §10-226(c)(2), Annotated Code of Maryland; or

(b) Take some other action which the Board is authorized to take.

(24) “Presiding officer” means the chair of the Board or, in the chair’s absence, a Board member designated by the chair, who:

(a) Conducts hearings before the Board; and

(b) Issues prehearing orders.

(25) “Probation” means a sanction imposed by the Board in a public final order where the licensee is:

(a) Monitored by the Board for a period of time; and

(b) Required to comply with certain conditions in order to avoid further disciplinary action.

(26) “Public record” means a document that the Board is permitted or required to disclose to the public pursuant to State Government Article, Title 10, Subtitle 6, Annotated Code of Maryland.

(27) “Recommended decision” means a nonpublic record issued by a hearing committee or by an administrative law judge which sets out proposed findings of fact, proposed conclusions of law, and a proposed sanction, or any combination of these items.

(28) “Recusal” means the disqualification of a member of the Board to participate in a proceeding because of interest, bias, or some other reason which may interfere with the Board member’s participation in the case.

(29) “Respondent” means a licensee subject to the jurisdiction of the Board, who has been:

(a) Given formal notice of allegations concerning violations of the Maryland Physical Therapy Act; and

(b) Notified as to the possible imposition of sanctions or a summary suspension.

(30) “Revocation” means the removal of a licensee’s license.

(31) “Sanction” means an action by the Board which:

(a) Reprimands;

(b) Places on probation;

(c) Fines;

(d) Suspends or revokes a license; or

(e) Disciplines by way of a consent order.

(32) “Show cause hearing” means a nonevidentiary hearing in which the licensee has the opportunity to demonstrate to the Board why the Board should not issue a proposed order or continue to take an action that the Board is legally authorized to take.

(33) “Summary suspension” means the indefinite suspension of a license pursuant to State Government Article, §10-226(c)(2), Annotated Code of Maryland, issued if the Board believes emergency action is necessary to protect the public health, safety, or welfare.

(34) “Suspension” means the temporary denial of the right to use a license and is usually defined by:

(a) A specified period of time;

(b) Specific dates; or

(c) Specific conditions.

.03 Confidentiality of Proceedings.

A. Except as otherwise provided by law, the proceedings of the Board are confidential and that confidentiality may not be waived by the parties.

B. The Office of Administrative Hearings’ proceedings involving the adjudication of a Board formal disciplinary action and the administrative law judge’s recommended decision are confidential.

C. The respondent may not waive the confidentiality of the:

(1) Proceedings; or

(2) Patients whose medical records or care are reflected in the record of the proceedings.

D. To the extent possible, even after the close of a formal disciplinary action, the parties shall refrain from revealing the identity of any patients involved in the matter, including but not limited to, information contained in:

(1) Legal documents; or

      (2) Oral statements.

.04 Representation by Counsel.

A. A respondent may be represented by counsel at any stage of a formal disciplinary action.

B. If a hearing is held, the respondent shall be represented:

(1) In proper person; or

(2) By an attorney who has been:

(a) Admitted to the Maryland Bar; or

(b) Specially admitted to practice law pursuant to Maryland Rules, Rules Governing Admission to the Bar of Maryland, Rule 16, Annotated Code of Maryland.

C. The Board may request the Office of the Attorney General to participate in a hearing to present the case on behalf of the State.

D. The member of the Office of the Attorney General presenting the case on behalf of the State shall have the same rights as any party with regard to:

(1) Submission of evidence;

(2) Examination and cross-examination of witnesses; and

(3) The filing of objections, exceptions, and motions.

E. The Board may also request a member of the Office of the Attorney General to act as legal advisor to the Board on questions of:

(1) Procedure;

(2) Evidence; and

(3) Law.

.05 Disposition of Complaints.

A. For each complaint, after reviewing any completed investigative information or reports, the Board shall:

(1) Dismiss the complaint;

(2) Close the case with informal action;

(3) Issue a cease and desist order;

(4) Refer the matter for further investigation;

(5) Refer the matter to an administrative prosecutor; or

(6) Vote to:

(a) Charge a licensee with a violation of the Maryland Physical Therapy Act;

(b) Consider the matter as a basis for a summary suspension;

(c) Initially deny a license or reinstatement of a license; or

(d) Accept the surrender of a license subject to conditions acceptable to the Board.

B. The Board may refer a complaint or other disciplinary matter to the administrative prosecutor at any time, whether or not it has voted to charge a licensee with violations of the Maryland Physical Therapy Act.

.06 Notice of Charges or Notice of Initial Denial.

A. If the Board issues charges or a notice of initial denial, the document shall be:

(1) Served on the respondent by certified mail at the address the respondent is required to maintain with the Board; or

(2) Hand-delivered in person.

B. Charges or notice of initial denial shall:

(1) Inform the respondent of the statutory basis for the charges or denial of a license;

(2) Allege sufficient facts that the Board believes constitute either a basis for:

(a) Violation of the Maryland Physical Therapy Act; or

(b) Denial of a license; and

(3) Include the notice of hearing.

C. If the Board issues a notice of initial denial to an applicant for a license, the applicant may not withdraw the application without approval from the Board.

.07 Notice of Hearing.

A. Except for a show cause hearing, written notice of all hearings shall be sent by the Executive Director or an officer of the Board to all parties at least 30 days before the hearing.

B. The Board shall serve the notice of hearing by either:

(1) Certified mail at the address the respondent is required to maintain with the Board; or

(2) Hand-delivery in person.

C. The notice of hearing shall state, if applicable:

(1) The date, time, place, and nature of the hearing;

(2) The right to call witnesses and submit documents or other relevant evidence;

(3) The right to request subpoenas for witnesses and evidence and the costs associated with such a request;

(4) The right to representation;

(5) That a failure to appear for the scheduled hearing may result in an adverse action against the party; and

(6) That the parties may agree to the evidence and waive their right to appear at the hearing.

D. The notice of hearing may include:

(1) Deadlines for discovery and motions; or

(2) Dates for the prehearing conference and case resolution conference.

.08 Prehearing Conference and Case Resolution Conference.

A. The Board may set a prehearing conference or a case resolution conference, or both.

B. The prehearing conference may be used to prepare for the hearing by:

(1) Delineating the issues;

(2) Stipulating to facts, laws, and other matters;

(3) Arranging a schedule for the exchange of documents and witnesses;

(4) Arranging a schedule for the submission of motions and responses to motions; or

(5) Addressing any other matters that will promote the orderly and efficient conduct of the hearing.

C. Prehearing Orders.

(1) If a prehearing conference has been held, a prehearing order may be issued by the presiding officer.

(2) The prehearing order shall set forth the actions taken or to be taken with regard to any matter addressed at the prehearing conference.

(3) If a prehearing conference is not held, the presiding officer may issue a prehearing order to regulate the conduct of the proceedings.

(4) Absent an exception from the presiding officer, the prehearing order shall be binding on the parties.

D. Case Resolution Conference.

(1) Matters admitted, revealed, negotiated, or otherwise discussed at a case resolution conference are without prejudice and may not be used by the respondent, administrative prosecutor, or the Board in any subsequent proceedings, unless the information is otherwise discoverable or available through another source.

(2) The Board is not bound by the recommendations of the case resolution conference committee and may:

(a) Modify the proposed settlement;

(b) Require additional conditions; or

(c) Reject the recommendation and require the respondent to proceed to a hearing.

(3) If the respondent disagrees with the recommendation of the case resolution conference committee, the respondent may elect to proceed to a hearing on the matter, regardless of whether or not the Board has ratified the recommendation of the case resolution conference committee.

(4) Participation in a case resolution conference is not a basis for recusal of a Board member, Board counsel, or Board prosecutor from further proceedings.

E. Motions.

(1) General Requirements.

(a) Unless otherwise set forth in a prehearing order or notice of hearing, all motions shall be:

(i) Accompanied by a memorandum of points and authorities; and

(ii) Filed with the Board at least 15 working days before the hearing.

(b) A copy of the motion shall be served on the opposing party.

(c) A response shall be filed with the Board at least 10 working days before the hearing and a copy served on the opposing party.

(d) The Board may refuse to consider a motion or response that is not timely filed.

(2) Motion for Summary Decision.

(a) A party may move for summary decision on any appropriate issue in the case.

(b) The Board may grant a proposed or final summary decision if the Board finds that:

(i) There is no genuine issue of material fact; and

(ii) A party is entitled to prevail as a matter of law.

.09 Discovery.

A. Discovery on Request. By written request served on the other party and filed with the Board or the Office of Administrative Hearings, as appropriate, a party may require another party to produce, within 15 days, the following:

(1) A list of witnesses to be called;

(2) Copies of documents intended to be produced at the hearing; or

(3) Both §A(1) and (2) of this regulation.

B. Mandatory Discovery.

(1) Each party shall provide to the other party not later than 15 days before the prehearing conference, if scheduled, or 45 days before the scheduled hearing date, whichever is earlier:

(a) The name and curriculum vitae of any expert witness who will testify at the hearing; and

(b) A detailed written report summarizing the expert’s testimony, which includes the:

(i) Opinion offered;

(ii) Factual basis for the opinion; and

(iii) Reasons underlying the opinion.

(2) If the Board or the Office of Administrative Hearings, as appropriate, finds that the report is not sufficiently specific, or otherwise fails to comply with the requirements of this section, the Board or the Office of Administrative Hearings, as appropriate, shall exclude from the hearing the testimony of the expert and any report of the expert.

(3) The Board or the Office of Administrative Hearings, as appropriate, shall consider and decide arguments regarding the sufficiency of the report:

(a) At the prehearing conference, if scheduled; or

(b) Immediately before the scheduled hearing.

(4) If an expert adopts a sufficiently specific charging document as the expert’s report, that adoption satisfies the requirements set forth in this section.

C. Parties are not entitled to discovery of items other than as listed in §§A and B of this regulation.

D. Both parties have a continuing duty to supplement their disclosure of witnesses and documents.

E. Absent unforeseen circumstances that would otherwise impose an extraordinary hardship on a party, witnesses or documents may not be added to the list:

(1) After the prehearing conference, if scheduled; or

(2) Later than 15 days before the hearing, if no prehearing conference is scheduled.

F. The prohibition against adding witnesses does not apply to witnesses or documents to be used for impeachment or rebuttal purposes.

G. Construction.

(1) In hearings conducted by an administrative law judge of the Office of Administrative Hearings, this regulation shall, whenever possible, be construed as supplementing and in harmony with COMAR 28.02.01.

(2) In the event of a conflict between this regulation and COMAR 28.02.01, this regulation applies.

.10 Evidentiary Hearings.

A. Hearings shall be conducted pursuant to the Administrative Procedure Act.

B. The Board may delegate its authority to conduct hearings to:

(1) A hearing committee of the Board; or

(2) The Office of Administrative Hearings.

C. Confidentiality.

(1) Hearings are not open to the public.

(2) All records, including the hearing committee’s decision and the administrative law judge’s recommended decision, are confidential and sealed.

D. Record. The Board shall prepare an official record of hearings which shall include all:

(1) Pleadings;

(2) Testimony;

(3) Exhibits; and

(4) Other memoranda or material filed in the proceeding.

E. Transcript.

(1) Unless waived by all parties, a stenographic record of the proceedings shall be made at the expense of the Board.

(2) The stenographic record may not be transcribed, unless requested by a party or by the Board.

(3) The cost of any typewritten transcripts of any proceedings, or parts of the transcript, shall be paid by the party requesting the transcript.

F. Presiding Officer.

(1) The presiding officer shall:

(a) Conduct a full, fair, and impartial hearing;

(b) Take action to avoid unnecessary delay in the disposition of the proceedings;

(c) Maintain order; and

(d) Adjourn or recess the hearing from time to time.

(2) The presiding officer has the power to regulate the course of the hearing and the conduct of the parties, including the power to:

(a) Permit the examination of witnesses;

(b) Rule on offers of proof and admit relevant and material evidence;

(c) Consider and rule upon motions;

(d) Grant a continuance or postponement;

(e) Determine the order in which the parties shall present their cases;

(f) Limit unduly repetitious testimony;

(g) Reasonably limit the time for presentation; and

(h) Issue orders as necessary to:

(i) Secure procedural simplicity and administrative fairness; and

(ii) Eliminate unjustifiable expense and delay.

G. Examination of Witnesses and Introduction of Evidence.

(1) The rules of evidence in State Government Article, §10-213, Annotated Code of Maryland, apply to hearings before the Board.

(2) A party may:

(a) Submit evidence;

(b) Examine and cross-examine witnesses; and

(c) File objections, exceptions, and motions.

(3) If a party is represented by counsel, all submission of evidence, examination and cross-examination of witnesses, and filing of objections, exceptions, and motions shall be done and presented solely by counsel.

(4) The presiding officer, or a person designated by the presiding officer for that purpose, may examine a witness called by a party.

(5) The presiding officer may call as a witness a person necessary to ensure a full and complete record.

(6) Any Board member may examine any witness.

H. Briefs.

(1) A party may submit a brief on the issues of fact and law involved in the hearing.

(2) The presiding officer may designate:

(a) The form of the brief;

(b) The number of copies to be submitted; and

(c) The date and time of submission.

(3) The Board may refuse to consider a brief that is not timely filed or fails to conform to requirements imposed by the presiding officer.

I. If a party who is the respondent in the proceedings fails to appear at a hearing after due notice, the Board may:

(1) Reschedule the hearing; or

(2) In the Board’s discretion, proceed upon the investigation, report, documents, witnesses, and records before it.

J. Any testimony taken by the Board shall be taken under oath.

K. Decision and Order.

(1) A decision and order rendered by the Board shall:

(a) Be in writing; and

(b) Include the findings of fact and conclusions of law.

(2) A copy of the decision and order and accompanying findings and conclusions shall be delivered or mailed promptly to each party or the party’s attorney of record.

(3) The findings of fact, conclusions of law, and order shall be retained as a permanent record by the Board.

L. Judicial Review.

(1) A party who is aggrieved by a final decision of the Board under Health Occupations Article, §13-316, Annotated Code of Maryland, may seek judicial review of the Board’s decision.

(2) The judicial review shall be in accordance with the provisions of State Government Article, §§10-222—10-223, Annotated Code of Maryland.

M. Rehearings.

(1) Within 10 days after service on a party of the decision of the Board, the party may apply to the Board for rehearing.

(2) The application shall state the grounds for rehearing.

(3) The Board shall grant or deny the application within 20 days of its submission to the Board.

(4) Unless otherwise ordered, neither the rehearing nor the application for rehearing shall:

(a) Stay the enforcement of the order; or

(b) Excuse the persons affected by the order for failure to comply with the terms of the order.

(5) At a rehearing, the Board shall only consider facts not presented in the original proceeding, including facts arising after the date of the original proceeding.

(6) By new order, the Board may abrogate, change, or modify its original order.

.11 Recommended Decisions, Exceptions Hearings, and Oral Argument.

A. If a case has been delegated to a hearing committee of the Board or to the Office of Administrative Hearings pursuant to State Government Article, §10-205, Annotated Code of Maryland, the hearing committee or administrative law judge shall prepare a recommended decision for consideration by a quorum of the Board.

B. A quorum of the Board may include members of the hearing committee.

C. The hearing committee shall issue a recommended decision within 90 days of the conclusion of the hearing. This 90-day time frame may be extended by a majority vote of a quorum of the Board.

D. The Board shall notify the parties of the parties’ right to:

(1) File written exceptions to the recommended decision issued by the administrative law judge or the hearing committee; and

(2) Present oral argument to the Board.

E. A party may file written exceptions to the recommended decision issued by the administrative law judge or the hearing committee within 30 days of receipt of the recommended decision.

F. The party opposing the exceptions has 15 days to file a written response.

G. The Board may refuse to consider exceptions or responses filed in violation of §§E and F of this regulation.

H. Oral Arguments.

(1) If either party files exceptions, the Board shall schedule an oral argument to be held before a quorum of the Board.

(2) After oral argument, the Board shall prepare an order containing the:

(a) Accepted findings of fact;

(b) Conclusions of law; and

(c) Disposition.

(3) The Board may refuse to hear oral argument if exceptions are not timely filed.

(4) The presiding officer shall:

(a) Determine all procedural issues that are governed by this regulation;

(b) Make any rulings reasonably necessary to facilitate the effectiveness and efficiency of oral argument; and

(c) Impose reasonable time limitations on oral argument and, ordinarily, limit the parties to 30 minutes each.

(5) The party filing the exceptions shall proceed first.

I. If the parties do not file timely exceptions and no oral argument is scheduled, a quorum of the Board shall consider the recommended decision issued by the administrative law judge or hearing committee.

J. The Board shall prepare an order based on the Board’s review of the:

(1) Recommended decision of the administrative law judge or hearing committee;

(2) Record developed before the administrative law judge or hearing committee; and

(3) Any exceptions and responses filed by the parties.

.12 Revocation of Hearing Authority from the Office of Administrative Hearings.

A. Consistent with the provisions of State Government Article, §10-205, Annotated Code of Maryland, the Board may revoke authority delegated to the Office of Administrative Hearings by written notice.

B. Criteria for Revocation of Authority in a Specific Case. The Board may revoke all or part of the Office of Administrative Hearings’ authority in a specific case if the case:

(1) Involves novel or unanticipated factual or legal issues;                                             

(2) Has significant fiscal consequences to the Board;

(3) Involves policy issues of general applicability; or

(4) Is likely to have precedential value.

C. Procedures for Revocation of the Office of Administrative Hearings’ Authority in a Specific Case.

(1) The Board shall provide written notice of a revocation of the Office of Administrative Hearings’ authority:

(a) To:

(i) All parties; and

(ii) The Office of Administrative Hearings; and

(b) That includes:

(i) A brief statement of the reasons for the revocation;

(ii) Whether all or part of the Office of Administrative Hearings’ delegated authority has been revoked; and

(iii) If only part of the delegation has been revoked, the portions of the contested case for which the delegation has been revoked.

(2) The Board may revoke the Office of Administrative Hearings’ authority to decide a case at any time before the earlier of:

(a) Issuance of a ruling by the administrative law judge on a substantive issue; or

(b) Taking of oral testimony from the first witness.

(3) A decision issued by the Board shall reflect that the Office of Administrative Hearings’ authority was revoked.

        (4) The Board shall include as part of the record a copy of the revocation notice.

.13 Summary Suspensions.

A. The Board shall order the summary suspension of a license if the Board determines that there is a substantial likelihood that a licensee poses a risk of harm to the public health, safety, or welfare.

B. Based on information gathered in an investigation or otherwise provided to the Board, the Board may vote to issue:

(1) A notice of an intent to summarily suspend a license; or

(2) An order of summary suspension.

C. If the Board votes to issue a notice of intent to summarily suspend or an order of summary suspension, the Board shall refer the matter to an administrative prosecutor for prosecution.

D. Service of the notice of intent to summarily suspend a license shall be made by:

(1) Hand delivery in person to the respondent;

(2) Certified mail to the address the respondent is required to maintain with the Board; or

(3) Other reasonable means to effect service.

E. Notice of Intent to Summarily Suspend.

(1) A notice of intent to summarily suspend a license shall include, but is not limited to:

(a) A proposed order of summary suspension which is unexecuted by the Board and which includes:

(i) The statutory authority on which the action has been taken;

(ii) Allegations of fact which the Board believes demonstrate a substantial likelihood that the licensee poses a risk of harm to the public health, safety, or welfare; and

(iii) Notice to the respondent of the right to request an evidentiary hearing of the summary suspension if the Board executes the proposed order of summary suspension; and

(b) An order or summons to appear before the Board:

(i) To show cause why the Board should not execute the order of summary suspension; and

(ii) Which notifies the respondent of the consequences of failing to appear.

(2) Predeprivation Hearing.

(a) If the Board issues a notice of intent to summarily suspend a license, the Board shall offer the respondent the opportunity to appear before the Board to show cause why the respondent’s license should not be summarily suspended.

(b) The show cause hearing shall be a nonevidentiary hearing to provide the parties with an opportunity for oral argument on the proposed summary suspension.

(c) The presiding officer:

(i) Shall determine all procedural issues;

(ii) May impose reasonable time limits on each party’s oral argument; and

(iii) Shall make any rulings reasonably necessary to facilitate the effective and efficient operation of the show cause hearing.

F. Order of Summary Suspension.

(1) The Board may order the summary suspension of a license without first issuing a notice of intent to summarily suspend or providing a respondent with a predeprivation hearing if the Board determines that the threat to public health, safety, and welfare requires the immediate suspension of the license.

(2) Post-Deprivation Hearing.

(a) The respondent shall be provided with a show cause hearing within a reasonable time after the effective date of the order of summary suspension.

(b) The show cause hearing pursuant to §F(2)(a) of this regulation shall:

(i) Be conducted before the Board as provided in §E(2) of this regulation; and

(ii) Provide the respondent with an opportunity to show cause why the Board should lift the summary suspension.

(3) After a show cause hearing, if the Board votes to continue the summary suspension, the respondent may request an evidentiary hearing before the Board.

(4) An evidentiary hearing:

(a) May be consolidated with a hearing on charges issued by the Board which include the facts which form the basis for the summary suspension; and

(b) Shall be conducted pursuant to the Administrative Procedure Act.

G. Disposition.

(1) If the Board issues a notice of intent to summarily suspend a license, the Board may, after the show cause hearing, vote to:

(a) Order a summary suspension;

(b) Deny the summary suspension;

(c) Enter into a consent order; or

(d) Enter into any interim order warranted by the circumstances of the case, including one providing for the stay of the summary suspension subject to certain conditions.

(2) If the Board orders a summary suspension before a show cause hearing, the Board may, at the conclusion of the show cause hearing, vote to:

(a) Affirm its order of summary suspension;

(b) Rescind the order of summary suspension;

(c) Enter into a consent order; or

(d) Enter into any interim order warranted by the circumstances of the case, including one providing for a stay of the summary suspension subject to certain conditions.

(3) An order for summary suspension or any other order of the Board issued after the initiation of summary suspension proceedings is a:

(a) Final order of the Board; and

(b) Public record.

.14 Surrender of a License.

A. The Board may accept the surrender of a license.

B. The Board may require conditions for surrender of a license, including but not limited to:

(1) The admission of a violation of the Maryland Physical Therapy Act;

(2) The admission of facts;

(3) A statement of the circumstances under which the surrender was offered or accepted;

(4) Restrictions on future licensing;

(5) Conditions for reinstatement of the license; or

(6) An agreement that the respondent may not again apply for a license.

C. A letter of surrender is a:

(1) Final order of the Board; and

(2) Public record.

 

Administrative History
Effective date: November 8, 1982 (9:22 Md. R. 2197)

Regulation .02A amended effective November 7, 1994 (21:22 Md. R. 1878)

Regulation .02C amended effective July 12, 1999 (26:14 Md. R. 1083)

Regulation .04 amended effective January 24, 2000 (27:1 Md. R. 77)

Regulation .05 amended as an emergency provision effective January 1, 2001 (28:3 Md. R. 203); amended permanently effective April 16, 2001 (28:7 Md. R. 690)

Regulation .05B, C amended effective November 7, 1994 (21:22 Md. R. 1878)

Regulation .05-1 adopted effective March 18, 2002 (29:5 Md. R. 504)

Regulations .01 -- .08 repealed and new Regulations .01.MD.16 adopted effective November 15, 2010 (37:23 Md. R. 1609)

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Chapter 06 Foreign-Educated Licensure Requirements

Authority: Health Occupations Article, §§13-206, 13-207, 13-301—13-303, 13-305—13-307, 13-311, and 13-313, Annotated Code of Maryland

.01 Requirements for Licensure.

A. Application Options.

(1) An applicant educated in a physical therapy core curriculum outside the United States or its territories shall apply for licensure under one of the categories described in §A(2)—(4) of this regulation.

(2) Examination. The applicant shall file with the Board:

(a) An application on the form the Board provides;

(b) The application and examination fees as specified in COMAR 10.38.07;

(c) Evaluation of educational credentials forwarded directly to the Board from an approved agency that provides evidence that the applicant's education is equivalent to that of an accredited core physical therapy program in the United States;

(d) Evidence of oral competency in the English language; and

(e) Evidence of written competency in the English language.

(3) Transfer of Examination Scores. The applicant shall file the following with the Board:

(a) An application on the form the Board provides;

(b) The application fee as specified in COMAR 10.38.07;

(c) Evaluation of educational credentials forwarded directly to the Board from an approved agency that provides evidence that the applicant's education is equivalent to that of an accredited physical therapy program in the United States;

(d) Evidence of oral competency in the English language;

(e) Evidence of written competency in the English language;

(f) A sworn statement that the applicant is not licensed in another state;

(g) Evidence, satisfactory to the Board, that the applicant is registered to take, or has taken, the national licensing examination in another state; and

(h) A copy of a letter or form to the appropriate reporting service requesting that licensing examination scores be sent to the Board.

(4) Waiver of Examination. The applicant shall file the following with the Board:

(a) An application on the form the Board provides;

(b) The application fee as specified in COMAR 10.38.07;

(c) Evaluation of educational credentials forwarded directly to the Board from an approved agency that provides evidence that the applicant's education is equivalent to that of an accredited core physical therapy program in the United States;

(d) Evidence of oral competency in the English language;

(e) Evidence of written competency in the English language;

(f) A copy of a current physical therapy license;

(g) Verification of current licensure on the form the Board provides; and

(h) A copy of a letter or form to the appropriate reporting service requesting that licensing examination scores be sent to the Board.

B. In addition to the requirements of §A of this regulation, an applicant educated in a core physical therapy curriculum outside the United States or its territories shall comply with §C of this regulation.

C. Additional Requirements. Applicants for licensure shall:

(1) Achieve a passing score on the licensing examinations; and

(2) Attend an interview unless the Board waives this requirement.

.02 Reexamination.

A. National Licensing Examination.

(1) An applicant who fails shall repeat the examination.

(2) Fees.

(a) The applicant shall pay to the Board the reexamination fee as specified in COMAR 10.38.07.

(b) An applicant who fails the licensing examination twice shall pay to the Board an application fee as specified in COMAR 10.38.07 in addition to the reexamination fee.

B. Examination on Maryland Physical Therapy Law. An applicant who fails the examination on the Maryland Physical Therapy Practice Act and associated regulations shall:

(1) Repeat the examination; and

(2) Attend an interview unless the Board waives this requirement
 

.03 Issuance of Licenses.

A. When the applicant has met all the requirements for licensure, the Board may issue a physical therapist license to the applicant.

B. Renewal of Physical Therapist License.

(1) The licensee shall renew the physical therapist license biennially.

(2) The Board shall mail applications for renewal at least 1 month prior to the expiration date.

(3) The licensee shall be responsible for notifying the Board if a renewal notice is not received.

(4) The Board may issue a renewal license to the licensee who meets the requirements of Health Occupations Article, §13-311(c), Annotated Code of Maryland.

C. The Board may issue a duplicate license for a lost, stolen, or destroyed license provided the licensee:

(1) Makes a request in writing;

(2) Provides a sworn statement or police report attesting to the facts; and

(3) Pays the fee as established in COMAR 10.38.07.
 

.04 Restrictions.

A. The Board may refuse to grant a license to an applicant who:

(1) Begins practice as a physical therapist before being licensed to practice in Maryland;

(2) Practices after the date of expiration of the license;

(3) Fails the licensing examinations; or

(4) Fails to pay all outstanding fees to the Board.

B. An applicant shall complete the application process within 1 year of the date of the paid application or reapply for licensure.

C. The Board may refuse to renew a license of an applicant who fails to pay all outstanding fees to the Board.

Administrative History
Effective date: December 29, 1986 (13:26 Md. R. 2807)

Regulation .01B—D amended effective August 5, 1991 (18:15 Md. R. 1727)

Regulation .01D amended effective December 19, 1994 (21:25 Md. R. 2106)

Regulation .02A amended effective August 5, 1991 (18:15 Md. R. 1727)

Regulation .03A amended effective August 5, 1991 (18:15 Md. R. 1727); December 19, 1994 (21:25 Md. R. 2106)

Regulation .04C amended effective August 5, 1991 (18:15 Md. R. 1727)

——————

Regulation .01 amended effective April 17, 2000 (27:7 Md. R. 706); April 24, 2006 (33:8 Md. R. 734)

Regulation .01A, B amended effective February 25, 2008 (35:4 Md. R. 515)

Regulation .01C amended effective April 16, 2001 (28:7 Md. R. 690)

Regulation .02 amended effective April 17, 2000 (27:7 Md. R. 706)

Regulation .03 amended effective April 17, 2000 (27:7 Md. R. 706); April 6, 2009 (36:7 Md. R. 525)

Regulation .03A amended effective April 24, 2006 (33:8 Md. R. 734)

Regulation .04 amended effective April 17, 2000 (27:7 Md. R. 706); April 24, 2006 (33:8 Md. R. 734)

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Chapter 07 Fee schedule

Authority: Health Occupations Article, §§13-206 and 13-207, Annotated Code of Maryland

.01 Scope.

These regulations govern all persons licensed or applying for licensure by the Board.

.02 Fees.

A. The following fees are established by the Board:

(1) Application fee $150;

(2) Biennial renewal fee:

(a) Physical therapist $325;

(b) Physical therapist assistant $300;

(3) Reinstatement fee $400;

(4) Restricted license $125;

(5) Duplicate license $75;

(6) Penalty for returned check $40;

(7) Written verification of licensure $25;

(8) Law booklet (free to applicants) $20;

(9) Approval for CEUs to course sponsor $50;

(10) Penalty for failure to maintain correct address with the Board $100.

B. The Federation of State Boards of Physical Therapy determines the fees for the National Licensure Examination for physical therapists and physical therapist assistants.

C. The Maryland Health Care Commission (MHCC) assesses a fee for health care professionals which the applicant shall pay at the time of license renewal as specified in COMAR 10.25.02.
 

.03 Refunds.

Fees paid to the Board are nonrefundable.
 

.04 Change of Fees.

Fees are subject to change by action of the Board of Physical Therapy Examiners. The Board shall notify licensees and applicants of changes.

Administrative History
Effective date: December 29, 1986 (13:26 Md. R. 2808)

Regulation .02 amended effective March 2, 1992 (19:4 Md. R. 474); January 1, 1996 (22:26 Md. R. 2030)

Regulation .02 amended as an emergency provision effective August 5, 1992 (19:17 Md. R. 1605); amended permanently effective November 23, 1992 (19:23 Md. R. 2041)

Regulation .03B amended effective March 2, 1992 (19:4 Md. R. 474)

——————

Chapter revised effective December 15, 1997 (24:25 Md. R. 1719)

Regulation .02A amended effective April 16, 2001 (28:7 Md. R. 690)

Regulation .02A amended as an emergency provision effective December 7, 2001 (29:3 Md. R. 213); amended permanently effective April 1, 2002 (29:6 Md. R. 567)

Regulation .02A amended effective April 24, 2006 (33:8 Md. R. 734)

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Chapter 08 Continuing Education Requirements

Authority: Health Occupations Article, §§13-206 and 13-311, Annotated Code of Maryland

.01 Scope.

This chapter governs:

A. A licensee applying for renewal;

B. An individual applying for reinstatement of licensure; and

C. Sponsors of continuing education courses.

.02 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Continuing education unit (CEU)" means the basic unit of measurement for a licensee's direct participation in continuing education consisting of 10 contact hours.

(2) Contact Hour.

(a) "Contact hour" means a period of 60 minutes in which actual learning takes place.

(b) "Contact hour" does not include:

(i) A portion of the program devoted to registration, breaks, meals; or

(ii) Fractions of an hour.
 

.03 Continuing Education Requirements.

A. Continuing education is a requirement for renewal or reinstatement of licenses for physical therapists and physical therapist assistants and may be obtained by:

(1) Postgraduate studies;

(2) Attendance or presentation at seminars, conferences, or workshops;

(3) Authoring, co-authoring, or editing of a book, book chapter, refereed article, or abstract; or

(4) Home study, including internet courses.

B. Professional education eligible for continuing education credit shall be:

(1) Relevant to the clinical practice of physical therapy; and

(2) Directed to a professional audience.

C. The Board shall have final approval of the relevancy of the program to the practice of physical therapy.

D. Continuing education courses shall have course materials that include clear and concise written statements of:

(1) Intended learning outcomes;

(2) Behavioral objectives; and

(3) Performance objectives.

E. Continuing education courses sponsored by the American Physical Therapy Association are automatically approved by the Board.
 

.04 Continuing Education Course Approval.

A. To obtain approval of a continuing education course, a course sponsor shall submit the following materials to the Board 6 weeks before the course:

(1) An application on a Board-approved application form, accompanied by any required fee;

(2) A complete hour-by-hour agenda of the course;

(3) A clear and concise written statement describing the course's intended learning outcomes, behavioral objectives, or performance objectives;

(4) A curriculum vitae for each instructor describing the instructor's competence in the course subject matter and skill in instructional methodologies; and

(5) If an instructor is not licensed by the Board and plans to perform physical therapy in conjunction with the course, an application for a restricted license obtained from the Board.

B. Public Representations.

(1) If a course is approved by the Board, the Board shall notify the sponsor of the approval.

(2) If a sponsor receives notification under §B(1) of this regulation, the sponsor may represent that a course has been approved by the Board.

(3) Approved course certificates and advertisements shall contain the following statement: "This course has been approved by the Maryland State Board of Physical Therapy Examiners for ______ CEUs."

(4) A record of course attendees shall be retained by the sponsor for at least 4 years.

(5) The sponsor shall submit to the Board for approval any changes in an approved course, such as changes in speaker, content, or length.

C. Term of Approval.

(1) The Board shall approve a continuing education course for a period of 4 years.

(2) At the expiration of the 4-year approval period, the course sponsor may resubmit the course and shall meet the approval requirements of §A of this regulation.

.05 Renewal Requirements.

A. A licensee shall earn CEUs between April 1 and March 31 during the 2-year period before renewal and maintain the records of the course subject, hours, date, and continuing education units to present to the Board on request.

B. CEUs completed after March 31 of the year of the renewal may not be accepted.

C. All renewal applications shall be accompanied by a continuing education form to be completed by the licensee.

D. A physical therapist shall earn 3 CEUs equal to 30 contact hours for the renewal period.

E. A physical therapy assistant shall earn 2 CEUs equal to 20 contact hours for the renewal period.

F. CEUs may not be carried over from one renewal period to the next.

G. Failure to substantiate CEUs if requested by the Board shall result in denial of license renewal or of reinstatement of a license.

H. If the licensee has met all the requirements for renewal, the Board may renew a license for the first renewal period following the issuance of the original license without requiring the physical therapist or physical therapist assistant to complete any CEUs if, at the time of renewal, the original license was issued 1 year or less before the renewal period.

.06 Auditing Compliance with Continuing Education Requirements.

A. The Board shall audit the continuing education records of as many licensees as time and resources allow.

B. The Board shall send an audit letter to those to be audited at the close of the renewal period.

C. At the time of audit, the audited licensees shall submit:

(1) Continuing education certificates earned between April 1 and March 31 during the 2-year period before renewal; and

(2) A completed continuing education form.

D. The Board may request from the licensee a brochure, agenda, or other material for courses that have not been previously approved by the Board.
 

.07 Reinstatement Requirements.

A. A physical therapist shall earn 3 CEUs in the 2-year period immediately preceding reinstatement.

B. A physical therapy assistant shall earn 2 CEUs in the 2-year period immediately preceding reinstatement.

.08 Continuing Education Unit Requirements for Physical Therapy Clinical Practice.

A. Continuing Education is a requirement for renewal or reinstatement of licenses for a physical therapy clinical practice.

B. Activities meeting the criteria for continuing education requirements for practice of physical therapy may be classified as follows:

(1) Postgraduate academic course work in physical therapy taken at an accredited college or university may earn 1 CEU per credit hour;

(2) Attendance at Board-approved or American Physical Therapy Association sponsored continuing education courses or workshops may earn 1 CEU for every 10 contact hours;

(3) Presentation of a continuing education course or workshop may earn 2 contact hours for every hour of presentation with presentations of the same subject matter receiving CEU credit only once in a 2-year period;

(4) Authoring, co-authoring, or editing of a book, book chapter, or refereed journal article may earn 3 CEUs with proof accompanying the request for approval;

(5) Authoring an abstract may earn 1 CEU;

(6) Completion of an approved self-study course may earn 1 contact hour per interactive hour;

(7) Completion of an approved internet course may earn 1 contact hour per interactive hour;

(8) Completion of continuing education relevant to the administration of physical therapy practice may earn up to 1.5 CEUs; or

(9) Postgraduate academic course work in administration of the practice of physical therapy may earn a maximum of 1.5 CEUs in each 2-year period.

C. CEUs may not be carried over from one renewal period to the next.

D. Failure to substantiate CEUs if requested by the Board shall result in denial of license renewal or of reinstatement of a license.

E. If the licensee has met all the requirements for renewal, the Board may renew a license for the first renewal period following the issuance of the original license without requiring the physical therapist or the physical therapist assistant to complete any CEUs, if, at the time of renewal, the original license was issued 1-year or less before the renewal date.

F. To aid licensees in the selection of appropriate continuing education courses, the Board may review, without charge, a course brochure, outline, or agenda before the licensee attends the course, if the request is submitted at least 1 month before the course date.

Administrative History
Effective date: December 9, 1991 (18:24 Md. R. 2644)

Regulation .02B amended effective November 7, 1994 (21:22 Md. R. 1878)

Regulation .03 amended effective November 7, 1994 (21:22 Md. R. 1878)

——————

Regulations .01—.03 repealed and new Regulations .01—.03 adopted effective September 23, 1996 (23:19 Md. R. 1376)

Regulation .03I amended effective July 12, 1999 (26:14 Md. R. 1083)

——————

Regulations .01—.03 repealed and new Regulations .01—.08 adopted effective March 18, 2002 (29:5 Md. R. 504)

Regulation .03B, D amended effective February 25, 2008 (35:4 Md. R. 515)

Regulation .03E adopted effective February 25, 2008 (35:4 Md. R. 515)

Regulation .04 amended effective February 25, 2008 (35:4 Md. R. 515)

Regulation .06B, C amended effective February 25, 2008 (35:4 Md. R. 515)

Regulation .08B, F amended effective February 25, 2008 (35:4 Md. R. 515)

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Chapter 09 Speech-Impaired Applicants

Authority: Health Occupations Article, § 13-206 and 13-302(e)(3), Annotated Code of Maryland

.01 Speech-Impaired Applicants.

A. An applicant who claims a speech impairment shall fulfill all requirements for application and shall submit to the Board the following:

(1) Documentation of the applicant's impairment from an otolaryngologist, who has current certification from the American Board of Otolaryngology; and

(2) Documentation of the applicant's impairment from a speech-language pathologist who has current certification from the American Speech-Language Hearing Association.

B. The Board shall require the speech-impaired applicant to prove ability to communicate adequately with patients and other health care professionals. The proof of ability to communicate shall include:

(1) Three letters from supervising physical therapists or instructors in a physical therapy program, attesting to the applicant's ability to communicate in a professionally competent manner; and

(2) A meeting before the Board where the applicant shall be required to demonstrate the manner in which communication with patients will occur.

C. A speech-language pathologist or otolaryngologist may be asked to attend the meeting in an advisory capacity to the Board to aid in assessing the applicant's ability to communicate.

.02 Other Requirements.

A. A foreign-trained speech-impaired applicant shall notify the Board before taking a Board-approved standardized test of oral competency.

B. The Board shall attempt to locate a speech-language pathologist fluent in the applicant's native language to assess the impairment.

C. A foreign-trained applicant who is in need of foreign accent reduction, but has competency in his or her native language, may obtain assistance from a bilingual speech-language pathologist before attempting to pass the test of spoken English.

Administrative History
Effective date: December 7, 1992 (19:24 Md. R. 2126)
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Chapter 10 Disciplinary Sanctions, Monetary Penalties, and Civil Fines 

Authority: Health Occupations Article, §§1-606, Annotated Code of Maryland

.01 Scope.

This chapter establishes standards for the imposition of disciplinary sanctions, monetary penalties, and civil fines for violations of the Maryland Physical Therapy Act.
 

.02 Definitions.

 A. In this chapter, the following terms have the meanings indicated.
 
 B. Terms Defined.
     (1) “Act” means the Maryland Physical Therapy Act, Health Occupations Article, Title 13, Annotated Code of Maryland.
     (2) "Board" means the State Board of Physical Therapy Examiners.
     (3) “Civil fine” means a fine assessed by the Board against an individual for practicing physical therapy or limited physical therapy 
          without a license.
     (4) "License" means a license issued by the Board to practice physical therapy or limited physical therapy.
     (5) "Licensee" means a physical therapist or physical therapist assistant who is licensed by the Board to practice physical therapy 
          or limited physical therapy.
     (6) "Penalty" means monetary penalty.
     (7) “Sanction” means a disciplinary action reprimanding, restricting, suspending, or revoking a license.
 

.03 Imposition of a Penalty—General.

         Imposition of a Penalty after a Hearing. If the Board finds that there are grounds under Health Occupations Article, §13-316, Annotated Code of Maryland, to reprimand a licensee or suspend or revoke a license, the Board may impose a penalty as set forth in this chapter:

     A. Instead, of, or in addition to, reprimanding the licensee or suspending the license; or
     B. In addition to revoking the license.

.04 Guidelines for Imposition of Disciplinary Sanctions or Monetary Penalties.

     A. Subject to the provisions of this chapter, the Board may impose the following sanctions and, if appropriate, penalties for violations of
          the Act and its regulations according to the minimum and maximum sanctions and penalties set forth in the following categories:
 
Violation Minimum Sanction Maximum Sanction Minimum Penalty Maximum Penalty
(1) Continuing education violation Reprimand Active suspension for 1 year $100 $1000
(2) Criminally convicted of, or pled guilty to, a felony, crime of moral turpitude, or violation of narcotics law Probation for 3 years Denial of license application or revocation $500 Maximum amount allowable under the Act
(3) Documentation violation Reprimand Active suspension for 2 years $500 $2,500
(4) Professional incompetence; grossly negligent practice Reprimand Revocation $500 Maximum amount allowable under the Act
(5) Mental or physical impairment Probation for 2 years Denial of license application or revocation N/A N/A
(6) Submitting false billings Reprimand Revocation $500 Maximum amount allowable under the Act
(7) Practicing beyond the scope of license Reprimand Active suspension for 2 years $500 Maximum amount allowable under the Act
(8) Failure to cooperate with a lawful Board investigation Reprimand Denial of license application or revocation $1,000 Maximum amount allowable under the Act
(9) Reciprocal discipline Reprimand Denial of license application or revocation $500 Maximum amount allowable under the Act
(10) Sexual misconduct Active suspension for 1 year Revocation $3,000 Maximum amount allowable under the Act
(11) Unprofessional conduct in the practice of physical therapy; Code of Ethics violation not specifically enumerated in this chapter Reprimand Revocation $500 Maximum amount allowable under the Act
(12) Aiding the unauthorized practice of physical therapy Reprimand Active suspension for 1 year $1,500 Maximum amount allowable under the Act
(13) Improper supervision Reprimand Revocation $500 Maximum amount allowable under the Act
(14) Standard of practice violation not specifically enumerated in this chapter Reprimand Revocation $500 Maximum amount allowable under the Act
(15) Other violation of the Act not specifically enumerated in this chapter Reprimand Denial of license application or revocation $100 Maximum amount allowable under the Act
(16) Fraudulently or deceptively obtaining, attempting to obtain, or using a license Reprimand Denial of license application or revocation $500 Maximum amount allowable under the Act
(17) Treating more than an average of 3 patients per clinical treatment hour per calendar day Reprimand Active suspension for 1 year $500 Maximum amount allowable under the Act
(18) Treating patients without evaluation or reevaluation Reprimand Active suspension for 1 year $500 Maximum amount allowable under the Act
(19) Failure to comply with probationary condition of an order Active suspension for 1 year Revocation $1,000 Maximum amount allowable under the Act

B. If a licensee is found in violation of more than one category enumerated in this regulation, the category or categories containing the
    highest maximum sanction and penalty shall control.
 
C. Notwithstanding the guidelines set forth in this regulation, in order to resolve a pending disciplinary action, the Board and licensee may
    agree to a surrender of license or a consent order with terms, sanction, and penalty agreed to by the Board and the licensee.
D. A departure from the guidelines set forth in this regulation, on its own, is not grounds for any hearing or appeal of a Board action.
E. The Board may not consider a petition for reinstatement of a license that has been revoked until at least 3 years have passed from the
    date of revocation.

.05 Mitigating and Aggravating Factors to be Considered in the Assessment of the Sanction and Penalty.

A. Depending on the facts and circumstances of each case, and to the extent that the facts and circumstances apply, the Board may
    consider, but not be limited to, the mitigating and aggravating factors outlined in §§B and C of this regulation in determining whether the
    sanction in a particular case should fall outside the range of sanctions established by the guidelines.

B. Mitigating Factors. The Board may consider the following mitigating factors:

(1) The licensee’s lack of a prior disciplinary record.
(2) The licensee self-reported the violation to the Board;
(3) The licensee’s full and voluntary admission of misconduct to the Board and cooperation during Board proceedings;
(4) The licensee implemented remedial measures to correct or mitigate harm arising from the misconduct;
(5) The licensee made timely good-faith effort to make restitution or to rectify the consequences of the misconduct;
(6) Evidence of rehabilitation or rehabilitative potential;
(7) Absence of premeditation to commit the misconduct;
(8) Absence of potential harm to the public or adverse impact; and
(9) The licensee’s conduct was an isolated incident and not likely to recur.
C. Aggravating Factors. The Board may consider the following aggravating factors:
(1) The licensee has a previous criminal or administrative disciplinary history;
(2) The violation was committed deliberately or with gross negligence or recklessness;
(3) The violation had the potential for, or caused, serious patient harm;
(4) The violation was part of a pattern of detrimental conduct;
(5) The licensee was motivated to perform the violation for financial gain;
(6) The vulnerability of the patient or patients;
(7) The licensee attempted to hide error or misconduct from patients or others;
(8) Previous attempts at rehabilitation of the licensee were unsuccessful; and
(9) The licensee committed the violation under the guise of treatment.
 
D. The existence of one or more of these factors does not impose on the Board or an Administrative Law Judge any requirement to
    articulate its reasoning for not exercising its discretion to impose a sanction outside of the range of sanctions set forth in this chapter.
E. Nothing in this regulation requires the Board or an Administrative Law Judge to make findings of fact with respect to any of these
    factors.

 
.06 Civil Fines.
  A. Practicing on an Expired License. The Board may assess a civil fine against a physical therapist or physical therapist assistant who
      practices physical therapy or limited physical therapy on an expired license in the amount of $100 per day of practice past the
      expiration date of the license.
  B. Practicing Without a License.
     (1) The Board may assess a civil fine of no less than $5,000 and no more than $50,000 against an individual who practices physical
          therapy or limited physical therapy without a license.
     (2) Factors in determining the amount of a fine include, but are not limited to, the following:
         (a) The extent to which the individual derived any financial benefit from the unauthorized practice;
         (b) The willfulness of the unauthorized practice;
         (c) Actual or potential public harm caused by the unauthorized practice; and
         (d) The length of time in which the individual engaged in the unauthorized practice.
 

.07 Payment of a Penalty.

  A. Unless the Board specifies otherwise, a licensee shall pay to the Board a penalty imposed under this chapter as of the date the
      Board's order is issued.
  B. Filing an appeal under State Government Article, §10-222, Annotated Code of Maryland, or Health Occupations Article, §13-318, 
      Annotated Code of Maryland, does not automatically stay payment of a penalty imposed by the Board pursuant to this chapter.
  C. If a licensee fails to pay, in whole or in part, a penalty imposed by the Board pursuant to this chapter, the Board may not restore,
      reinstate, or renew a license until the penalty has been paid in full.
  D. In its discretion, the Board may refer all cases of delinquent payment to the Central Collection Unit of the Department of Budget and
      Management to institute and maintain proceedings to ensure prompt payment.
  E. Deposit of Monies.
 
     (1) The Board shall pay all monies collected pursuant to this chapter, except for civil fines collected under Regulation .06 of this
          chapter, into the State's General Fund.
     (2) The Board shall pay all civil fines collected under Regulation .06 of this chapter into the State Board of Physical Therapy Examiners
         Fund, in accordance with Health Occupations Article, §13-407(b)(2), Annotated Code of Maryland
Administrative History
Effective date: May 15, 2000 (27:9 Md. R. 858)
Regulation .04C amended effective April 16, 2001 (28:7 Md. R. 690); April 6, 2009 (36:7 Md. R. 525)
Regulations .01—.06 under chapter, Monetary Penalties repealed and new Regulations .01—.07 under chapter Disciplinary Sanctions, Monetary Penalties, and Civil Fines adopted effective January 23, 2012 (39:1 Md. R. 18)
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Chapter 11 Compelling Purpose Disclosure

Authority: Health Occupations Article, §13-206; State Government Article, §10-617(h)(3); Annotated Code of Maryland

.01 Scope.

This chapter does not apply to the disclosure of information in the Board's files to a health occupations regulatory board of this State or another state that licenses or disciplines persons practicing a health occupation.

.02 Disclosure for Compelling Public Purpose.

A custodian of the Board may find that a compelling public purpose warrants disclosure of information in a certification, licensing, or investigative file, regardless of whether there has been a request for the information, and may disclose information concerning competent evidence of:

A. Possible criminal activity, if disclosure is to a federal, state, or local law enforcement or prosecutorial official or authority;

B. A possible violation of law, if disclosure is to a federal, state, or local authority that has jurisdiction over the individual whose conduct may be a violation and the information disclosed is limited to information relevant to the possible violation by that individual; or

C. Conduct by an individual which the Board reasonably believes may pose a risk to the public health, safety, or welfare, if disclosure is to a law enforcement authority, administrative official, agency that regulates the individual, or to a hospital or other health care facility where the individual has privileges.
 

.03 Other Disclosures.

This chapter does not prohibit or limit the ability of the Board to disclose general licensing information under State Government Article, §10-617(h), Annotated Code of Maryland, or any information that the Board may otherwise disclose by law.

Administrative History
Effective date: November 11, 2002 (29:22 Md. R. 1721)