History of NC Board of Physical Therapy Examiners
By Constance W. Peake, PT & Ben F. Massey, Jr., PT
Updated – February 4, 2009
The first North Carolina Physical Therapy Practice Act was passed in 1951 to regulate the practice of physical therapy by registered physical therapists (RPTs). The State Examining Committee of Physical Therapists with 1MD and 4 PT members was empowered to make rules; to pass upon the qualifications of applicants for registration; to prepare and conduct examinations and determine who passes. A therapist had to be 21 years old, of good moral character, a high school graduate and graduated from an approved PT school. Those applying by July 1, 1952 were grandfathered in. The law provided for reciprocity. It protected the title RPT and words and insignia implying this. A license could be revoked for being habitually drunk or addicted to narcotics, obtaining registration under fraud or being guilty of an act derogatory to the standing and morals of the profession.
The 1959 revision included exemption from licensure for graduate students in special PT courses, licensure of foreign-trained therapists and adoption of a procedure for uniform revocation of licenses. Ten years later the Committee was increased to 7 members (2 PTAs) and provided for licensure rather than registration. (RPT was no longer used in NC.) The 1969 law allowed for PTA licensure, both graduates of approved schools and on-the-job trained aides. The age requirement was removed. Foreign-trained therapists were required to complete a course of instruction substantially equivalent to the U.S. trained applicant and to have proficiency in the English language. The law granted powers and duties for the purpose of enabling the Committee to safeguard the public health, safety and welfare against unqualified or incompetent practitioners of physical therapy.
Constance W. Peake, PT, was hired in 1969 to serve as the Board’s first Executive Secretary. In 1976, the Board adopted Rules pursuant to the Administrative Procedures Act. These rules have been amended several times since then. In 1977, the Board entered into a contract arrangement with John M. Silverstein to provide legal counsel.
In 1979 the Committee became the North Carolina Board of Physical Therapy Examiners. The licensing of aides as PTAs by equivalency was terminated. A definition of the aide as an unlicensed person was added as were grounds for disciplinary action and a provision for enjoining illegal practices.
In 1982 a public member was placed on the Board.
The 1985 revision had 2 major changes. Physician referral was no longer required. It is unlawful to treat a patient whose medical condition is beyond the scope of PT practice and should be referred to a MD. To accommodate uniform testing dates, a provision allowed recent graduates, who applied within 6 months of graduation, to be granted a permit to work as a PTG or PTAG under immediate supervision. This provision was eliminated in 1998.
The Board joined the Federation of State Boards of Physical Therapy as a Charter Member in January, 1987.
The Board secured its first official office space in Durham, NC in 1991.
The Board appointed a Joint Task Force with the North Carolina Physical Therapy Association in 1994, to address Supervision issues, an outgrowth of which was the Board’s publication of Practice Under Pressure.
In 1995, the Board established the Investigative Committee to address a growing number of complaints against licensees.
In 1996, after 26 years of dedicated service, Constance W. Peake, Executive Secretary, retired. Ben F. Massey, Jr., PT, was hired as the Executive Director to replace Ms. Peake. North Carolina became one of the first states to move from paper and pencil examinations to computer based testing which allows graduates to take their exam throughout the year.
In 1999, the Practice Act was revised to accommodate a fee increase and the Board relocated its office in Durham, NC.
In 2002, changes in the Board’s rules that define and describe the nature of physical therapy practice in North Carolina were approved by the NC Rules Review Commission (RRC) and the NC General Assembly (GA).
In 2003, a restructuring of the Board’s rule related to a physical therapist’s scope of practice was also approved by the RRC and the GA.
In 2004, the Board conducted 5 forums across the state (Asheville, Charlotte, Greensboro, Greenville, and Wilmington). The topics of the forums were continuing competence, jurisprudence examination, animal rehabilitation, spinal manipulation, professional corporations, and requirement of post baccalaureate education for foreign educated physical therapists. The forums were well attended and there was much rich discussion. Straw polls were taken at each forum and there was overwhelming support for a change in the Practice Act that would give the Board statutory authority to require continuing competence / continuing education. Also in 2004, the Board clarified its rule that requires post baccalaureate education for foreign educated physical therapists who graduate after January 1, 2003. Lastly, the Board adopted a position statement on the Scope and Authority of the PTA to assist the PT with Functional Capacity Evaluations.
In 2005, the Board addressed issues of supervision; iontophoresis and phonophoresis; and the Foreign Educated Physical Therapist (requirements for education and English language requirement). The Board developed processes to expedite and assist victims of hurricane disasters with the licensure process. At the NCPTA annual conference, the Board sponsored two presentations (continuing competence and mock investigative committee meeting).
In 2006, changes in the Board’s rules that clarify the educational requirements of the Foreign Educated Physical Therapist (FEPT) and documentation requirements for PTs and PTAs were approved by the NC Rules Review Commission (RRC) and the NC General Assembly (GA). In addition, the GA adopted legislation that added the following section to the North Carolina Physical Therapy Practice Act:
90-270.26. Powers of the Board. The Board shall have the following general powers and duties:
(3a) Establish mechanisms for assessing the continuing competence of licensed physical therapists or physical therapist assistants to engage in the practice of physical therapy, including approving rules requiring licensees to periodically, or in response to complaints or incident reports, submit to the Board: (i) evidence of continuing education experiences; (ii) evidence of minimum standard accomplishments; or (iii) evidence of compliance with other Board‑approved measures, audits, or evaluations; and specify remedial actions if necessary or desirable to obtain license renewal or reinstatement;
To address this legislation, the Board developed a 3-year strategic plan that included hosting 12 statewide forums for licensees to provide input and appointed a 7-member Advisory Committee to study various options available for continuing competence and make recommendations to the Board regarding rules for implementation. Additionally, in 2006, the Board developed a Jurisprudence Exercise for applicants that became effective on January 1, 2007. Lastly, the Board entered into an Agreement with the North Carolina Board of Nursing (BON) that would offer physical therapy licensees the opportunity to seek eligibility for enrollment in the treatment programs administered by the BON for practitioners who are impaired as a result of chemical dependency.
In 2007, the Board’s Executive Director and Attorney conducted 11 statewide forums to solicit input regarding proposed rules for continuing competence. The Advisory Panel on Continuing Competence began the process of drafting rules for submission to the Board of its consideration. Staff publicized the newly adopted rules regarding documentation of patient notes.
In 2008, the Board adopted rules for continuing competence that were submitted to the Rules Review Commission (RRC) in November and December, 2008. The rules, as amended by RRC, were adopted and took effect on January 1, 2009. The Board contracted with a consultant for continuing competence to assist with implementation of the newly adopted rules. In October, 2008, it conducted its first of seven statewide educational programs on implementation of continuing competence.
