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Nova Scotia College of Physiotherapists Registration Regulations

made under Section 6 of the
Physiotherapy Act
S.N.S. 1998, c. 22
O.I.C. 1999-108 (March 19, 1999), N.S. Reg. 23/99

1 These regulations may be cited as the Nova Scotia College of Physiotherapists Registration Regulations.

2 In these regulations,

(a) “Act” means the Physiotherapy Act;

(b) “Annual Renewal Form” means the form used by members to renew their registration and licence and shall be in the form as determined by the Board;

(c) “Board” means the Board of the College;

(d) “College” means the Nova Scotia College of Physiotherapists;

(e) “expiry date” means the date or dates approved by the Board for the expiry of registrations and licences of members of the College;

(f) “Registrar” means the Registrar as defined in the Act;

(g) “registration fee” means the annual registration fee prescribed by the Board;

(h) “renewal date” means the date or dates approved by the Board, which are at least 2 weeks prior to the applicable expiry date;

(i) “scope of practice” means,

(i) the specialty in which the member is registered in the Specialists Register,

(ii) the type of practice as specified in any other Register in the Act,

(iii) the type of practice determined by any terms or conditions attached to a licence,

(iv) those aspects of the practice of physiotherapy for which a physiotherapist possesses appropriate education and experience, as determined by the Board, or

(v) any other non-clinical physiotherapy practice,

as the context requires;

(j) “spouse” means a person married to another person and includes a man and woman who, not being married to each other, live together as husband and wife for at least one year; and

(k) “TOEFL®” means the Test of English as a Foreign Language.

3 Where these regulations pertain to matters described in clause 6(3)(a) of the Act and conflict with the General Regulations of the Board made pursuant to clauses 6(2)(g), (i), (j), (m), (n) or (o) of the Act, the General Regulations shall prevail.

Annual fees
4 An applicant for membership in the College shall pay to the Registrar, or such person as the Registrar may designate, the registration fee.

5 In order to renew the member’s registration for the following licensing year, each member of the College shall pay to the Registrar, or such person as the Registrar may designate, the registration fee.

6 If an applicant is to be registered for a period of less than 3 months in any one licensing year, the applicant shall pay one-half of the registration fee referred to in Section 4.

7 Where an applicant is registered within 60 days prior to the renewal date in any year, the payment in full of the registration fee for the current year shall be deemed payment for the ensuing year as well.

8 The Board may, upon application for registration, waive payment of the registration fee of a physiotherapist who is registered in another jurisdiction and who will be practising in the Province for a period of less than 3 months for special purposes, as approved by the Board.

Expiry and renewal
9 The registration and licence of a member of the College shall expire each year on the applicable expiry date and the registration fee shall be payable by the applicable renewal date.

10 Each member shall be advised of the expiry date and the renewal date applicable to that member’s registration and licence at the time of the granting or renewal of the registration and licence.

Failure to renew
11 Despite Section 37, where a member of the College fails to submit a completed Annual Renewal Form or to pay the registration fee by the renewal date, the Registrar shall forthwith notify the member and the employer of the member, if any, by registered mail,

(a) that the registration and licence of the member will be suspended for failing to submit a completed Annual Renewal Form or for non-payment of fees effective on the expiry date; and

(b) that the member will not be not permitted to practise after the expiry date until the requirements of the Act and the regulations have been complied with and the member is given a notice of re-instatement by the Registrar.

12 If a completed Annual Renewal Form or the registration fee is not received by the expiry date, the member’s registration and licence shall be suspended by the Registrar effective on the expiry date and the Registrar shall notify the member and record the effective date of the suspension on the appropriate register.

13 (1) A member whose licence and registration has been suspended for failure to submit a completed Annual Renewal Form or to pay the registration fee may be re-instated by the Registrar upon compliance with the requirements and procedures set out in Sections 27 and 28 of the Act and these regulations or upon direction of the Board, as the case may be.

(2) Any re-instatement pursuant to this Section shall be effective upon receipt by the member of a notice of re-instatement from the Registrar.

Exemption from subsection 33(1) of the Act
14 Pursuant to subsection 33(2) of the Act, a member who is absent from the Province for 2 weeks or less shall be exempted from the requirements of subsection 33(1) of the Act.

15 (1) For the purpose of this Section,

(a) “practising” means actively engaging in the practice of physiotherapy in the Province by a physiotherapist who has met the requirements under the Act and regulations to practice; and

(b) “non-practising” means not currently engaging in the practice of physiotherapy in the Province by a physiotherapist who has met the requirements under the Act and the regulations to practice and desires to maintain his or her registration and licence.

(2) Any registration or licence granted pursuant to the Act shall be recorded in the relevant register as having either “practising” or “non-practising” status.

(3) If the status of a physiotherapist changes from either practising to non-practising or non- practising to practising, the physiotherapist shall notify the Registrar in writing within 7 days.

16 All applications for registration shall be made in the form approved by the Board.

17 An application form shall be provided to an applicant by the Registrar upon request and the Registrar shall provide any applicant with a copy of the Act and regulations.

18 An applicant for registration shall satisfy the Registrar by a sworn statement indicating

(a) their good standing in any of the jurisdictions in which they have practised and that neither their professional conduct nor their practice is under investigation in any other jurisdiction;

(b) that the applicant has not been and is not the subject of any disciplinary proceedings in any jurisdiction; and

(c) that the applicant has not been convicted of a criminal offence that would reasonably have negative implications for the profession as a whole or the applicant’s practice of physiotherapy.

19 An applicant for registration shall

(a) be a Canadian citizen or satisfy the Registrar that they are legally entitled to live and work in Canada;

(b) be able to demonstrate competency in both written and oral English to the satisfaction of the Registrar or achieve a TOEFL® score as determined by the Board;

(c) be a graduate of a school of physiotherapy from a Canadian university that meets the standards considered acceptable by the Board or have completed the credentialing process required by the Board;

(d) complete the application form required under Section 16 and submit it to the Registrar with the following:

(i) an unmounted passport size photograph,

(ii) a birth certificate or other identification documents satisfactory to the Registrar,

(iii) a certified copy of any degrees or diplomas and certificates relating to physiotherapy and physiotherapy specialties,

(iv) a curriculum vitae with a chronological listing of previous education and employment that includes a description of that person’s clinical and non-clinical experience,

(v) a letter of good standing from the licensing body of any jurisdiction in which the applicant has practised in the past,

(vi) proof of professional liability insurance coverage in the minimum amount required by the Board, and

(vii) proof of successful completion of the examination process required by the Board; and

(e) consent to the release of information relevant to the application by such references as are requested by the Registrar.

20 Applicants may be required to have a personal interview with the Registrar, the Credentials Committee or the Board.

21 Applicants are required to pay any applicable fees for documentation, registration or any other fees relative to the application.

22 Applicants shall comply with any requirement of the Board for information pursuant to clause 25(d) of the Act.

Conditions on licence
23 The Board may impose such reasonable limitations or qualifications on a member’s licence as it considers appropriate, including, but not limited to, categories of clients, procedures and interventions.

Scope of practice
24 In addition to any conditions imposed under Section 23, it is a term, condition and limitation of registration that the member practise only within the scope of practice in which the member is educated and experienced.

25 When considering the scope of practice in which the member is educated and experienced, the Board may take into account their

(a) graduate education in physiotherapy or physiotherapy specialties;

(b) performance in qualifying examinations in physiotherapy and physiotherapy specialties;

(c) non-clinical physiotherapy practice, where registration is a requirement of employment;

(d) graduate education in, and evaluation of the member’s performance in, health disciplines not included in clauses (a) or (b), but considered appropriate by the Board; and

(e) scope of practice in which they were engaged in the 5 years prior to initial registration or annual renewal of licence.

26 Should a member wish to change the scope of practice from the one that the member has practised for the previous 5 years, the Board may request that the member provide the Board with evidence that the member is competent to engage in that scope of practice.

27 All requests from members to change their scopes of practice shall be handled on an individual basis.

General registration
28 An applicant who is accepted by the Board as a member of the College engaging in the general clinical practice of physiotherapy and who is not otherwise registered in the Provisional Register or the Defined Register may be registered in the Register pursuant to Section 19 of the Act.

29 (1) In order to be registered in the Register pursuant to Section 28, the applicant shall meet the minimum clinical practice hour requirements as determined by the Board.

(2) Where the applicant wishes to be registered in the Register pursuant to Section 28 and does not satisfy the minimum clinical practice hour requirements, the applicant shall be required to meet the requirements of Section 30 governing the re-entrance process.

Re-entrance process
30 (1) Any person who has practised for a period of less than 10 full time equivalent months within the 5 consecutive years immediately previous to the date of application for membership or for renewal shall be required to successfully complete the Physiotherapy National Exam offered by the Canadian Alliance of Physiotherapy Regulators in order to be registered pursuant to the Act.

(2) Despite subsection (1), persons may be granted registration in the Defined Register pursuant to the Defined Register Regulations where they give a written undertaking to the College that they will not engage in any form of clinical practice.

Provisional registration
31 For the purpose of Section 20 of the Act, a provisional registration may be granted to an applicant who meets the requirements for registration contained in the Act and regulations

(a) where written confirmation of a requirement for registration is temporarily unavailable but will be provided within a reasonable period of time in the opinion of the Registrar and where the Registrar is able to verify the information through some other acceptable means; or

(b) where the applicant is a visiting physiotherapist currently licensed in another province and is in the Province to participate in a sports event or to attend an educational course, or

for such other reasons as the Board may deem appropriate.

32 A provisional registration and licence may be granted subject to terms and conditions

(a) as to the length of time and the place in which the person may be permitted to practice;

(b) as to the nature of the services the person is permitted to perform,

or any other conditions that the Registrar may, in his or her sole discretion, consider necessary and appropriate.

Supervised practice
33 (1) Applicants and physiotherapists may be required to undergo a period of supervised practice and to demonstrate competence to practice.

(2) Persons who require supervised practice may include, but are not limited to, persons who are enrolled to take the Physiotherapy National Exam and physiotherapists who wish to change their scope of practice.

34 (1) A person who requires supervised practice shall notify the College of the name of a physiotherapist who agrees to act as the person’s sponsor.

(2) A sponsor referred to in subsection (1) shall

(a) be registered with the College but not be registered on the Defined Register or the Provisional Register;

(b) reside in the Province;

(c) practise physiotherapy at the same site as the sponsored person;

(d) be engaged in a scope of practice comparable to that of the sponsored person;

(e) enter into a written agreement with the College with such terms and conditions as may be determined by the Board to be applicable to the relationship between the College, the sponsor and the sponsored person;

(f) report in writing on a regular basis, as considered necessary by the Board, on the performance of the sponsored person;

(g) notify the College promptly if concerned about the practice of the sponsored person or if any change in supervision occurs; and

(h) comply with any other requirements considered necessary by the Board.

35 Where a member’s licence or registration is suspended or revoked,

(a) a notice of the suspension or revocation shall be published in at least one newspaper with circulation throughout the Province;

(b) the College shall notify licensing authorities in other Canadian jurisdictions;

(c) the College shall notify the Canadian Alliance of Physiotherapy Regulators; and

(d) the College shall notify the Federation of State Boards of the United States.

Records and accounts
36 Physiotherapists and professional corporations are required to maintain such records and accounts as may be required by the Standards of Practice approved by the Board, as amended from time to time, and such records and accounts shall be made available for examination and inspection by the College upon request and the College may make copies of such records and accounts at its own expense.

Suspension of licence
37 The licence of a member may be suspended by the Registrar without notice or investigation upon contravention of any regulation that requires the member to pay a fee, file a document or to do any other act by a specified or ascertainable date.

38 A licence suspended pursuant to Section 37 shall not be re-instated until such time as the member has paid the fee, filed the document or carried out whatever act was required.

39 Where the Registrar suspends the licence of a member pursuant to Section 37, the member shall immediately cease practice until such time as they are re-instated by the Registrar and a notice of re-instatement is received from the Registrar.

Minimum professional liability insurance
40 Every physiotherapist shall ensure that they are covered by a minimum of $1 000 000.00 professional liability insurance prior to engaging in the practice of physiotherapy and no member shall engage in the practice of physiotherapy unless they are insured in accordance with this Section.

Designated titles
41 A member in the practice of physiotherapy shall only use the titles “Physiotherapist”, “Licensed Physiotherapist”, “Physical Therapist”, “Licensed Physical Therapist”, “Registered Physiotherapist” or “Registered Physical Therapist” and may use in association with the member’s name any academic degree, diplomas or certificates held by the member and approved by the Board for such use.

42 A physiotherapist under this Act who advertises or uses the words “Clinic”, “Institute”, “Health Service” or any other non-personal designation shall include with the designation the name or names of the physiotherapists working at such service.

43 (1) No physiotherapist shall use or condone the use of any terms, titles or designations indicating specialization or expertise in any branch of physiotherapy or with respect to any particular aspect of physiotherapy or with respect to any area of preferred practice, whether approved by the Board as a specialist class or not, unless that person is registered in the Specialists Register and is using a term, title or designation approved by the Board.

(2) For the purpose of this Section, in any proceedings under the Act, the onus of proving that a term, title, or designation is approved by the Board shall be on the physiotherapist seeking to rely upon such approval.

(3) This Section shall apply mutatis mutandis to a professional corporation under the Act.

44 Subject to Section 46, a physiotherapist may advertise the services they provide.

45 Any proposed notice or advertisement that deviates from Sections 41, 42, 43 or 46 shall be submitted to the Board, which may grant or refuse permission to publish such notice or advertisement.

46 No physiotherapist shall advertise the services they provide in a manner that

(a) claims superiority of practice over that of another physiotherapist;

(b) is inaccurate;

(c) is capable of misleading the public;

(d) is in the nature of a testimonial or a comparative statement;

(e) makes any claim as to the quality or efficacy of the services provided;

(f) tends to promote the excessive or unnecessary use of the services provided; or

(g) is of a character which could reasonably be regarded as likely to bring the profession of physiotherapy into disrepute.

47 (1) No physiotherapist shall insert his or her name on any exercise program sheets except those of his or her personal patients.

(2) A physiotherapist may insert his or her name on a general patient information sheet.

48 Professional signs shall

(a) be dignified and restrained in character;

(b) be limited in position, size, design and wording to no more than is reasonably required to indicate the exact location of and entrance to the premises where the practice is carried on; and

(c) not display anything other than as outlined in Sections 41, 42, and 43.

Professional standards
49 (1) A member in the practice of physiotherapy shall exercise generally accepted standards of practice and procedures in the performance of professional services and shall

(a) maintain the premises in which the member engages in the practice of physiotherapy in a sanitary and hygienic condition;

(b) maintain the equipment with which the member engages in the practice of physiotherapy in working order and in a hygienic condition; and

(c) maintain a legible record respecting each patient of the member that shall include

(i) the name, address, age and sex of the patient,

(ii) the name of the patient’s physician,

(iii) the patient’s case history, including relevant medical and social data,

(iv) the evaluation procedures used, the findings obtained, and the problem or problems identified,

(v) progress notes containing a record of the treatment provided, the methods and the effects of treatment, and the status of the patient on discharge,

(vi) copies of reports respecting the patient received from other sources or issued to other sources,

(vii) a record of each date on which the patient is seen or treated or rendered a professional service by the member,

(viii) where applicable, a record of the member’s fees and charges, and

(ix) the written diagnosis from the patient’s physician and the referral or prescription by the physician for the patient.

(2) A member shall keep the records required under clause (1)(c) in a systematic manner and shall retain each record for a period of not less than 6 years after the date of the last entry in the record and, upon cessation of practice, shall ensure the safe custody of the member’s records.

(3) A member shall make records kept pursuant to clause (1)(c) and books, records, documents, equipment and things relevant thereto available at reasonable hours for inspection by a member or members of a committee of the College.

Conflict of interest
50 (1) In this Section, “member of the family” means a child, parent, grandparent, uncle, aunt, brother, sister, grandchild, niece, nephew, first cousin, and spouse of the member.

(2) A member shall not engage in the practice of physiotherapy where the member has a conflict of interest.

(3) It is a conflict of interest for a member to

(a) charge a fee to an agency making payment for professional services rendered to a member of the family;

(b) share fees with any person who has referred a patient, or receive fees from any person to whom a member has referred a patient, or directly or indirectly receive, make or confer a rebate, credit, commission or other benefit by reason of the referral of a patient from or to any other person; or

(c) practise in any situation or enter into any arrangement by reason of which the interest of the member or any person associated with the member in the member’s physiotherapy practice or in the provision of the member’s professional services influences, or is likely to influence, adversely the discharge of the member’s professional obligations as a physiotherapist.

Sale of equipment
51 (1) No member shall sell or supply equipment or any appliance, splint or other assistive or supportive device to a patient for profit.

(2) Despite subsection (1), a member may charge to the patient the cost of materials used and a reasonable fee for handling and time spent by the member in the fabrication of any such appliance, splint or device.

52 Any notice required to be given to a member pursuant to the Act or these regulations may be by prepaid registered mail to the address indicated on the Register and shall be deemed to have been received on the 3rd day after the notice is sent.

53 Where notice of any act or thing is required to be given to the Registrar or the Board pursuant to the Act or these regulations, it shall be in writing by prepaid registered mail and shall be deemed to have been received by the Registrar or Board, as the case may be, on the 3rd day after the notice is sent.