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Disclaimer: Law, rules and regulations, not Guidelines, specify the requirements for practice and violating them constitutes professional misconduct. Not adhering to this Guideline may be interpreted as professional misconduct only if the conduct also violates pertinent law, rules and regulations.

Guideline 5: Using and Providing Consultation/Supervision

Using Consultation

During the initial years of professional practice, you should acquire frequent and regular individual guidance focused primarily on improving skills and knowledge in client care and professional development. The competent practitioner may consult a more experienced person in the same area of physical therapy or, when that is not possible, from a physician (physician assistant), dentist, podiatrist, nurse practitioner or midwife who may refer for the services
When practicing independently, you should consult with experienced colleagues particularly whenever you are only minimally qualified in a specific intervention or when you believe a client could benefit from a collaborative approach to service.

Providing Supervision

A physical therapist assistant, with limited exceptions noted in Guideline 5.7, may only work under the on-site supervision of a licensed physical therapist. When the supervising physical therapist is not present, due to vacation, illness, or other commitments, the physical therapist assistant may not provide care.
A physician or other licensed health professional may not supervise a physical therapist assistant.
The supervising physical therapist is responsible for conducting the initial evaluation of the patient and developing the plan of care. The physical therapist may delegate to another licensed person (e.g., certified physical therapist assistant, licensed massage therapist, or physical therapist or physical therapist assistant under a limited permit) those activities that are within the scope and not beyond the competency of the supervisee. The Physical Therapist Assistant is prohibited from evaluating, testing, interpreting, or planning, modifying or terminating the treatment plan.
As a supervisor, you are responsible for maintaining appropriate boundaries with all supervisees, including students, employees, and contract supervisees.
On-site supervision of a physical therapist assistant is not required in certain settings and when the PTA has appropriate experience, as defined in Education Law and regulations. Even in these specific settings, however, the supervising physical therapist must be involved in the implementation of the plan for patient care, including shared visits and evaluations at specified intervals. [See Education Law Section 6738(b)(c)(d)]
Students fulfilling the clinical portion of a physical therapy or physical therapist assistant education program must be under the on-site but not necessarily direct, personal supervision of a licensed physical therapist. The student must be enrolled in a program conducted in a school of physical therapy approved by the New York State Education Department or in a clinical facility affiliated with the school. Supervision of a PTA student must be by a licensed physical therapist. It must be on-site supervision, but not necessarily direct, personal supervision. A PTA may act as a Clinical Instructor for the PTA student. However, overall responsibility for the supervision of the PTA student rests with the PT.
A PT may not supervise more than four permittees. On days that the supervising PT is not on-site or a replacement is not available, the permittee is not allowed to provide physical therapy services.
On-site supervision means that the supervising physical therapist is in the same facility and readily available to the permittee. Supervision of a person on a limited permit need not be on-site when the supervising physical therapist has determined, through evaluation, the setting of goals, and the establishment of a treatment plan, that the program is one of maintenance.

Citations of Pertinent Law, Rules or Regulations:
Education Law, Section 6509(2) - "incompetence and negligence"
Education Law, Section 6509(7) - "permitting unlicensed practice"
Education Law, Section 6509(9) - "unprofessional conduct"
Regents Rule, Part 29.1(b)(9) – "practicing beyond competency and without adequate supervision"
Regents Rule, Part 29.1(b)(10) – "improper delegation of duties"
Regents Rule, Part 29.2(a)(5) – "failing to supervise appropriately"
Education Law, Section 6735 – "physical therapist limited permits"
Education Law, Section 6738 – "definition of physical therapist assistant"
Commissioner's Regulation, Subpart 77.6 – "supervision of physical therapist assistants"
Education Law, Section 6741-a – "physical therapist assistant limited permit"
Commissioner's Regulation, Subpart 77.3 – "physical therapist limited permits"
Commissioner's Regulation, Subpart 77.8 – "physical therapist assistant limited permits"