Notice2022-16326
Notice of Request for Information on the Department of Veterans Affairs Kinesiotherapist Standard of Practice
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
July 29, 2022
Issuing agencies
Veterans Affairs Department
Abstract
The Department of Veterans Affairs (VA) is requesting information to assist in developing a national standard of practice for VA Kinesiotherapists. VA seeks comments on various topics to help inform VA's development of this national standard of practice.
Full Text
<html>
<head>
<title>Federal Register, Volume 87 Issue 145 (Friday, July 29, 2022)</title>
</head>
<body><pre>
[Federal Register Volume 87, Number 145 (Friday, July 29, 2022)]
[Notices]
[Pages 45857-45858]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-16326]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
Notice of Request for Information on the Department of Veterans
Affairs Kinesiotherapist Standard of Practice
AGENCY: Department of Veterans Affairs
ACTION: Request for Information.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) is requesting
information to assist in developing a national standard of practice for
VA Kinesiotherapists. VA seeks comments on various topics to help
inform VA's development of this national standard of practice.
DATES: Comments must be received on or before September 27, 2022.
ADDRESSES: Comments may be submitted through <a href="http://www.regulations.gov">www.regulations.gov</a>.
Comments received will be available at <a href="http://www.regulations.gov">www.regulations.gov</a> for public
viewing, inspection or copies.
FOR FURTHER INFORMATION CONTACT: Ethan Kalett, Office of Regulations,
Appeals and Policy (10BRAP), Veterans Health Administration, Department
of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, 202-
461-0500. This is not a toll-free number.
SUPPLEMENTARY INFORMATION:
Authority
38 U.S.C. 73 and 74 and 38 U.S.C. 303 permit the Secretary to
further regulate VA's health care professions to make certain that VA's
health care system provides safe and effective health care by qualified
health care professionals to ensure the well-being of those Veterans
who have borne the battle.
On November 12, 2020, VA published an interim final rule to confirm
that VA health care professionals may practice their health care
profession consistent with the scope and requirements of their VA
employment, notwithstanding any State license, registration,
certification or other requirements that unduly interfere with their
practice. 38 CFR 17.419; 85 FR 71838. Specifically, this rulemaking
confirmed VA's current practice of allowing VA health care
professionals to deliver health care services in a state other than the
health care professional's state of licensure, registration,
certification or other state requirement, thereby enhancing
beneficiaries' access to critical VA health care services. The
rulemaking also confirmed VA's authority to establish national
standards of practice for health care professionals which would
standardize a health care professional's practice in all VA medical
facilities.
The rulemaking explained that a national standard of practice
describes the tasks and duties that a VA health care professional
practicing in the health care profession may perform and may be
permitted to undertake. Having a national standard of practice means
that individuals from the same VA health care profession may provide
the same type of tasks and duties regardless of the VA medical facility
where they are located or the state license, registration,
certification or other state requirement they hold. We emphasized in
the rulemaking, and reiterate here, that VA will determine on an
individual basis that a health care professional has the necessary
education, training and skills to perform the tasks and duties detailed
in the national standard of practice and will only be able to perform
such tasks and duties after they have been incorporated into the
individual's privileges, scope of practice or functional statement. The
rulemaking explicitly did not create any such national standards and
directed that all national standards of practice would be subsequently
created via policy.
Need for National Standards of Practice
As the Nation's largest integrated health care system, it is
critical that VA develops national standards of practice to ensure
beneficiaries receive the same high-quality care regardless of where
they enter the system and to ensure that VA health care professionals
can efficiently meet the needs of beneficiaries when practicing within
the scope of their VA employment. National standards are designed to
increase beneficiaries' access to safe and effective health care,
thereby improving health outcomes. the COVID-19 pandemic underscored
the importance of this initiative. With an increased need for mobility
in our workforce, including through VA's Disaster Emergency Medical
Personnel System, creating a uniform standard of practice better
supports VA health care professionals who already practice across state
lines. In addition, developing national standards of practice aligns
with VA's long-term deployment of a new electronic health record (EHR).
National standards of practice are critical for optimal EHR
implementation to enable the specific roles for each health care
profession in EHR to be consistent across Veterans Health
Administration (VHA) and to support increased interoperability between
VA and the Department of Defense (DoD). DoD has historically
standardized practice for certain health care professionals, and VHA
closely partnered with DoD to learn from their experience.
Process To Develop National Standards of Practice
Consistent with 38 CFR 17.419, VA is developing national standards
of practice via policy. There will be one overarching National Standard
of Practice directive with each individual national standard of
practice as an appendix to the directive. The directive and all
appendices will be accessible on VHA Publications website at: <a href="https://vaww.va.gov/vhapublications/">https://vaww.va.gov/vhapublications/</a> (internal) and <a href="https://www.va.gov/vhapublications/">https://www.va.gov/vhapublications/</a> (external) once published.
To develop these national standards, VA is using a robust,
interactive process that is consistent with our authority under the
Supremacy Clause of the United States Constitution and consistent with
the guidance outlined in Executive Order (E.O.) 13132 to utilize such
authority. The process includes consulting with internal and external
[[Page 45858]]
stakeholders, including State licensing boards.
For each identified VA occupation, a workgroup comprised of health
care professionals is established to conduct state variance research to
identify internal best practices that may not be authorized under every
state license, certification or registration, but would enhance the
practice and efficiency of the profession throughout the agency. The
workgroup may consult with internal stakeholders at any point
throughout the process. If a best practice is identified that is not
currently authorized by every state, the workgroup determines what
education, training and skills are required to perform such task or
duty. The workgroup then drafts a proposed VA national standard of
practice using the data gathered during the state variance research and
incorporates internal stakeholder feedback to date.
The proposed national standard of practice is internally reviewed,
to include review by an interdisciplinary workgroup consisting of
representatives from Quality Management; Field Chief of Staff; Academic
Affiliates; Associate Director Patient Care Services; Ethics; Workforce
Management and Consulting; Surgery; Credentialing and Privileging;
Field Chief Medical Office; and Electronic Health Record.
Externally, the proposed national standard of practice is provided
to our partners in DoD. In addition, unions are engaged informally as
part of a pre-decisional collaboration. We note that the opportunity
for bargaining exists later in the process and prior to publication of
the national standard. Consistent with E.O. 13132, a letter is sent to
each State board that includes the proposed national standard and an
opportunity to further discuss the national standard with VA. After the
states have received notification, the proposed national standard of
practice is published to the Federal Register for 60 days to obtain
feedback from the public, including professional associations and
unions. At the same time, the proposed national standard is published
on an internal VA site to obtain feedback from VA employees. Feedback
from State boards, the Federal Register, VA employees and any other
person or organization who informally provides comments will be
reviewed. VA will make appropriate revisions based on comments,
including those that present evidence-based alternatives that help VA
meet our mission and goals, and that are better for Veterans or VA
health care professionals. We will publish a collective response to all
comments at. <a href="https://www.va.gov/standardsofpractice">https://www.va.gov/standardsofpractice</a>.
After the national standard of practice is published and effective,
any additional tasks or duties included in the national standard will
be incorporated into an individual health care professional's
privileges, scope of practice or functional statement only if their VA
medical facility performs this function for beneficiaries and the
health care professional has the necessary education, training and
skill to perform the task or duty.
National Standard for Kinesiotherapists
The proposed structure for national standards of practice when
there is a national registration body is as follows: the first
paragraph is general information about the profession and what the
health care professionals can do at a high level; the second paragraph
references the education and credential needed to practice this
profession at VA and confirms that this profession follows the standard
of practice set by the registration body; and a final statement
confirms that as of the date of the workgroup's research into
requirements, all individuals in this profession follow the same
standard of practice.
We note that proposed standards of practice do not contain an
exhaustive list of every task this profession can perform. Rather, it
is designed to highlight whether there are any areas of variance in how
this profession can practice across states and how this profession will
be able to practice within VA notwithstanding their state requirements.
VA qualification standards require Kinesiotherapists to be
registered with the Council on Professional Standards for
Kinesiotherapy (COPSKT). VA reviewed whether there are any alternative
registrations, certifications or state requirements that could be
required for a Kinesiotherapist and found that there were none. VA
proposes to adopt a standard of practice consistent with this national
registration; therefore, Kinesiotherapists will continue to follow the
same standard as set by their national registration. The standard of
practice for the national registration can be found at <a href="https://akta.org/professional-development/scope-of-practice">https://akta.org/professional-development/scope-of-practice</a>.
Proposed National Standard of Practice for Kinesiotherapists
The Kinesiotherapist is an allied health professional competent in
the administration of scientifically based musculoskeletal,
neurological, ergonomic, biomechanical, psychosocial and task-specific
functional tests and measures combined with other evidence-based
modalities used to physically, physiologically and psychologically
improve the human function, movement and well-being of the Veteran. The
Kinesiotherapist provides acute, sub-acute or post-acute rehabilitative
therapy and wellness interventions focusing on therapeutic exercise,
mobility, reconditioning, education and behavior change emphasizing the
psychological as well as physical interventions to enhance outcomes for
a holistic approach to rehabilitation.
Kinesiotherapists in VA possess the required education and
registration with COPSKT, which is a national board for
Kinesiotherapist in accordance with VA qualification standards, as more
specifically described in VA Handbook 5005, Staffing, Part II, Appendix
G21. This national standard of practice confirms Kinesiotherapists
practice in accordance with the American Board of Registration for
Kinesiotherapists standards from COPSKT, available at: <a href="https://akta.org/">https://akta.org/</a>. As of July 2021, Kinesiotherapists in all States follow this
national registration.
Request for Information:
1. Are there any required trainings for the aforementioned
practices that we should consider?
2. Are there any factors that would inhibit or delay implementing
the aforementioned practices for VA health care professionals in any
states?
3. Is there any variance in practice that we have not listed?
4. What should we consider when preempting conflicting state laws,
regulations or requirements regarding supervision of individuals
working toward obtaining their license or unlicensed personnel?
5. Is there anything else you would like to share with us about
this national standard of practice?
Signing Authority
Denis McDonough, Secretary of Veterans Affairs, approved this
document on July 11, 2022, and authorized the undersigned to sign and
submit the document to the Office of the Federal Register for
publication electronically as an official document of the Department of
Veterans Affairs.
Luvenia Potts,
Regulation Policy Coordinator, Office of Regulation Policy &
Management, Office of General Counsel, Department of Veterans Affairs.
[FR Doc. 2022-16326 Filed 7-28-22; 8:45 am]
BILLING CODE 8320-01-P
</pre></body>
</html>Indexed from Federal Register on July 29, 2022.
This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.