RELATING TO THERAPY SERVICES.

HB629

HOUSE OF REPRESENTATIVES

H.B. NO.

629

THIRTY-THIRD LEGISLATURE, 2025

STATE OF HAWAII

A BILL FOR AN ACT

relating
to therapy services
.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

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SECTION 1.
�
The legislature finds that amending Hawaii's
occupational therapy, physical therapy, and speech pathology laws is necessary
to promote a more cost effective model for delivering therapeutic services to
students in the department of education.
�
Currently, the department of education is
unable to claim reimbursement unless licensed occupational therapists, physical
therapists, and speech pathologists employed by or contracted with the
department of education obtain a prescription from a physician or other
authorized health care provider before providing services to students.
�
This requirement creates barriers that hinder
the department of education's ability to be reimbursed for the services
provided.

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The legislature further finds that
timely access to occupational, physical, and speech therapy services is
critical for supporting students' development, particularly in physical,
sensory, cognitive, and communication skills.
�
These services enable students to participate
more fully in educational and social activities and to benefit more effectively
from their learning environments.

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Moreover, the legislature also finds
that expanding the scopes of practice for licensed occupational therapists,
physical therapists, and speech pathologists may facilitate the department of
education's ability to obtain reimbursement.
�

By allowing occupational therapy, physical therapy, and speech therapy
services to be provided after a diagnosis of a medical condition by these
providers without a physician's diagnosis, the department of education can more
effectively bill for these services, generating additional funding to support
and enhance therapeutic resources for students.

����
The purpose of this Act is to expand
the scopes of practice for occupational therapists, physical therapists, and
speech pathologists employed by or contracted with the department of education
to diagnose students with a medical condition and treat them, thereby
streamlining service delivery.

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SECTION
2
.
�
Section
457G-1.5, Hawaii Revised Statutes, is amended to read as follows:

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"
�457G-1.5
�
Practice of
occupational therapy.
�
(a)
�
The practice of
occupational therapy is the therapeutic use of everyday life activities with
individuals or groups for the purpose of participation in roles and situations
in home, school, workplace, community, and other settings.
�
It includes:

����
(1)
�
Evaluation of factors affecting activities of
daily living, instrumental activities of daily living, rest and sleep,
education, work, play, leisure, and social participation, including:

���������
(A)
�
Client factors, including body functions, such
as neuromusculoskeletal, sensory-perceptual, visual, mental, cognitive, and
pain factors; body structures, such as cardiovascular, digestive, nervous,
integumentary, genitourinary systems, and structures related to movement,
values, beliefs, and spirituality;

���������
(B)
�
Habits, routines, roles, rituals, and behavior
patterns;

���������
(C)
�
Occupational and social environments,
cultural, personal, temporal, and virtual contexts and activity demands that
affect performance; and

���������
(D)
�
Performance skills, including motor and
praxis, sensory-perceptual, emotional regulation, cognitive, communication, and
social skills;

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(2)
�
Methods or approaches selected to direct the
process of interventions, including:

���������
(A)
�
Establishment, remediation, or restoration of
a skill or ability that has not yet developed, is impaired, or is in decline;

���������
(B)
�
Compensation, modification, or adaptation of
activity or environment to enhance performance or prevent injuries, disorders,
or other conditions;

���������
(C)
�
Retention and enhancement of skills or
abilities without which performance in everyday life activities would decline;

���������
(D)
�
Promotion of health and wellness, including
the use of self-management strategies, to enable or enhance performance in
everyday life activities; and

���������
(E)
�
Prevention of barriers to performance and
participation, including injury and disability prevention; and

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(3)
�
Interventions and procedures to promote or
enhance safety and performance in activities of daily living, instrumental activities
of daily living, rest and sleep, education, work, play, leisure, and social
participation, including:

���������
(A)
�
Therapeutic use of occupations, exercises, and
activities;

���������
(B)
�
Training in self-care, self-management, health
management and maintenance, home management, community reintegration, work
reintegration, school activities, and work performance;

���������
(C)
�
Development, remediation, or compensation of
neuromusculoskeletal, sensory-perceptual, visual, mental, and cognitive
functions; pain tolerance and management; and behavioral skills;

���������
(D)
�
Therapeutic use of self, including one's
personality, insights, perceptions, and judgments, as part of the therapeutic
process;

���������
(E)
�
Education and training of individuals,
including family members, caregivers, groups, populations, and others;

���������
(F)
�
Care coordination, case management, and
transition services;

���������
(G)
�
Consultative services to groups, programs,
organizations, or communities;

���������
(H)
�
Modification of environments, such as home,
work, school, or community, and adaptation of processes, including the
application of ergonomic principles;

���������
(I)
�
Assessment, design, fabrication, application,
fitting, and training in seating and positioning; assistive technology;
adaptive devices; orthotic devices; and training in the use of prosthetic
devices;

���������
(J)
�
Assessment, recommendation, and training in
techniques to enhance functional mobility, including management of wheelchairs
and other mobility devices;

���������
(K)
�
Low vision rehabilitation;

���������
(L)
�
Driver rehabilitation and community mobility;

���������
(M)
�
Management of feeding, eating, and swallowing
to enable eating and feeding performance;

���������
(N)
�
Application of physical agent modalities and
use of a range of specific therapeutic procedures, such as wound care
management, interventions to enhance sensory-perceptual and cognitive
processing, and manual therapy, to enhance performance skills; and

���������
(O)
�
Facilitating the
occupational performance of groups, populations, or organizations through the
modification of environments and the adaptation of processes.

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(b)
�

No person shall engage in the practice of occupational therapy
gratuitously or for pay, offer to practice occupational therapy, offer
occupational therapy, or represent, advertise, or announce, either publicly or
privately, that the person is an occupational therapist, unless the person is
appropriately licensed under this chapter.

����
(c)
�
No person shall use, in connection with the
person's name or business, the words "occupational therapist
licensed", "registered occupational therapist", "licensed
occupational therapist", "occupational therapist", or
"doctor of occupational therapy", or the letters "OT",
"
OTR
", "OTD",
"OT/L", "
OTR
/L",
or "OTD/L", or any other words, letters, abbreviations, or insignia
indicating or implying that the person is an occupational therapist unless the
person is appropriately licensed as an occupational therapist under this
chapter.

����
(d)
�
Effective January 1, 2017, except as
otherwise provided in this chapter, no person shall engage in the practice of
occupational therapy or represent the person's self as able to practice as an
occupational therapy assistant in the State unless:

����
(1)
�
The practice is
done under the supervision of and in partnership with an occupational therapist
who is licensed to practice occupational therapy in the State; and

����
(2)
�
The person
possesses a valid license issued pursuant to this chapter to practice
occupational therapy as an occupational therapy assistant.

����
(e)
�
No person shall use the title
"occupational therapy assistant licensed", "licensed
occupational therapy assistant", the letters "OTA/L" or
"COTA/L", or any other words, letters, abbreviations, or insignia
indicating or implying that the person is an occupational therapy assistant
unless that person is appropriately licensed as an occupational therapy
assistant under this chapter.

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(f)
�
A licensed occupational therapist employed by
or contracted with the department of education may diagnose medical conditions
that can be treated by occupational therapy services when providing
occupational therapy services to students of the department of education in an
educational setting.

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For the purposes of this
subsection, "occupational therapy services" means the therapeutic use
of everyday life activities with students for the purpose of participation in
roles and situations in school, home, and community settings.
�
"Occupational therapy services"
include but are not limited to:

����
(1)
�
Evaluating
students' needs and developing individualized treatment plans;

����
(2)
�
Providing
interventions to improve students' fine motor skills, gross motor skills,
sensory processing, visual-motor integration, and cognitive skills;

����
(3)
�
Adapting
classroom environments and materials to facilitate students' participation in
school activities;

����
(4)
�
Training
teachers and parents on strategies to support students' occupational needs;

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(5)
�
Recommending
assistive technology devices and adaptive equipment; and

����
(6)
�
Diagnosing
medical conditions that can be treated by occupational therapy.
"

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SECTION
3
.
�
Section 461J-2,
Hawaii Revised Statutes, is amended to read as follows:

����
"
�461J-2
�
Practice of physical therapy; qualifications.
�
(a)
�
No person shall practice physical therapy
gratuitously or for pay, offer to practice physical therapy, offer physical
therapy or physical therapy services, or represent, advertise, or announce,
either publicly or privately, that the person is a physical therapist or
physiotherapist, unless the person is appropriately licensed under this
chapter.

����
(b)
�

No person shall use, in connection with the person's name or business,
the words "licensed physical therapist", "physical
therapist", or "physiotherapist", or the letters "
RPT
", "LPT", "DPT",

"PT", or any other words,
letters, abbreviations, or insignia indicating or implying that the person is a
physical therapist, unless the person is appropriately licensed as a physical
therapist

under this chapter.

����
(c)
�

No person shall use the title "physical therapist assistant",
the letters "
PTA
", or
any other words, abbreviations, or insignia in connection with that person's
name to indicate or imply, directly or indirectly, that the person is a
physical therapist assistant unless that person is appropriately licensed as a
physical therapist assistant under this chapter.

����
(d)
�
No person shall practice as a physical
therapist or as a physical therapist assistant, except as licensed pursuant to
this chapter and under the administrative rules determined by the board in
accordance with chapter 91.

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(e)
�
A licensed physical therapist employed by or
contracted with the department of education may diagnose medical conditions
that can be treated by physical therapy services when providing physical
therapy services to students of the department of education in an educational
setting.

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For the purposes of this
subsection, "physical therapy services" includes the following:

����
(1)
�
Assessing
students' physical abilities and limitations;

����
(2)
�
Developing and
implementing individualized treatment plans to address students' physical
therapy needs;

����
(3)
�
Providing
interventions to improve students' strength, flexibility, range of motion,
balance, coordination, and mobility;

����
(4)
�
Adapting
physical education activities and school environments to meet the needs of
students with physical disabilities;

����
(5)
�
Educating
teachers, parents, and students on proper body mechanics and injury prevention;

����
(6)
�
Recommending
adaptive equipment to facilitate students' participation in school activities;
and

����
(7)
�
Diagnosing
medical conditions that can be treated by physical therapy.
"

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SECTION
4
.
�
Section 468E-3,
Hawaii Revised Statutes, is amended to read as follows:

����
"
�468E-3
�
Practice as speech
pathologist or audiologist; title or description of services.
�
(a)
�
A
person represents oneself to be a speech pathologist when the person:

����
(1)
�
Holds oneself out
to the public by any title or description of services incorporating the words
"speech pathologist", "speech pathology", "speech
therapy", "speech correction", "speech correctionist",
"speech therapist", "speech clinic", "speech
clinician", "language pathologist", "language
pathology", "logopedics", "logopedist",
"communicology", "communicologist",
"asphasiologist", "voice therapy", "voice
therapist", "voice pathology", or "voice pathologist",
"language therapist", or "phoniatrist", or any similar
titles;

����
(2)
�
Purports to treat
stuttering, stammering, or other disorders of speech;

����
(3)
�
Is employed as a
faculty member in speech pathology;
or

����
(4)
�
Is employed as a
speech pathologist by the State or any county agency.

����
(b)
�

A licensed speech pathologist employed by or contracted with the
department of education may diagnose medical conditions that can be treated by
speech pathology services when providing speech pathology services to students
of the department of education in an educational setting.

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[
(b)
]
(c)
�
A person represents oneself to be an
audiologist when the person:

����
(1)
�
Holds oneself out
to the public by any title or description of services incorporating the terms
"audiology", "audiologist", "audiological",
"hearing clinic", "hearing clinician", "hearing
therapist", or any similar titles;

����
(2)
�
Is employed as a
faculty member in audiology;
or

����
(3)
�
Is employed as an
audiologist by the State or any county agency."

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SECTION
5.
�
Statutory material to be repealed is
bracketed and stricken.
�
New statutory
material is underscored.

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SECTION 6.
�
This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

Report Title:

Department
of Education; Occupational Therapists; Physical Therapists; Speech
Pathologists; Diagnosis; Treatment

Description:

Expands the
scopes of practice for occupational therapists, physical therapists, and speech
pathologists employed by or contracted with the Department of Education to
diagnose students with a medical condition in an educational setting and treat the
students.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.