What to Expect Regarding New Spinal Manipulation Law, HB 2160

As you may know Governor Jay Inslee signed our spinal manipulation bill, HB 2160, into law last month. The provisions of this law take effect on July 1, 2015. The Washington State Board of Physical Therapy will decide on how to provide acceptable evidence in order to practice spinal manipulation in Washington.

The Board of PT will send out a public notice to write rules to clarify the law and decided at its April 21, 2014 meeting that because the law is so specific and explicit it won’t need to do exhaustive rule making. Because this process hasn’t yet started, it’s premature for PTWA to provide definitive guidance regarding the exact requirements. However, if you are committed and qualified to provide spinal manipulation techniques for your patients, then taking these steps shouldn’t be a huge burden. The process isn’t expected to be as rigorous as qualifying to sit for an ABPTS specialist certification board exam.

Here’s what we can tell you:

  • You will need to get an endorsement on your license to practice spinal manipulation.This is similar for physical therapists practicing wound care and/or needle EMG in Washington.
  • You need to have a minimum of one year of orthopedic physical therapy experience as a licensed PT.
  • The required 500 hours of didactic and practical training in the three categories of differential diagnosis, spinal manipulation procedures and spinal imaging could be met in a variety of ways including graduate and post-graduate experiences.
  • The required 300 hours of clinical supervised experience can be completed in-state or out-of-state under a qualified clinical supervisor.
  • We anticipate that many physical therapists licensed in our state will meet the qualifications to be clinical supervisors now. We’ll know more about this once the Board of PT makes its decisions.
  • We’re working on a chart regarding some of the requirements: examples of types of coursework, certifications, residencies and fellowships that will meet the educational and supervisory requirements. We will provide this to our members after the rulemaking process is far enough along that we can be confident of its accuracy.
  • Look for future continuing education course work relating to the didactic and practical training in the three categories of differential diagnosis, spinal manipulation procedures and spinal imaging. This will help those who graduated before 2009 and need extra hours to meet the requirements.

How did we get here? This law is the result of negotiations between PTWA and the Washington State Chiropractic Association with help from Representative Laurie Jinkins. After consulting with our lobbyist, the PTWA mediation team, Legislative Committee and Board of Directors, PT educators, APTA staff, the APTA Orthopedic Section and legal counsel, the advice we received was to accept this negotiated bill. No law is perfect, including this one, but we see it as a workable solution to the problem of removing the prohibition on spinal manipulation practice in Washington state.

Elaine Armantrout
PTWA President