216-RICR-40-05-13. Physical Therapists and Physical Therapist Assistants (version Amendment, 08/29/2018 to 01/04/2022)

13.1 Authority These regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws § 5-40-5 , and are established for the purpose of adopting prevailing standards pertaining to the licensure of physical therapists and physical therapist assistants in this state. 13.2 Incorporated Materials A. These regulations hereby adopt and incorporate “ American Physical Therapy Association Code of Ethics ” (2010) by reference, not including any further editions or amendments thereof and only to the extent that the provisions therein are not inconsistent with these regulations. B. These regulations hereby adopt and incorporate “ American Physical Therapy Association, Guide for Professional Conduct ” (2010) by reference, not including any further editions or amendments thereof and only to the extent that the provisions therein are not inconsistent with these regulations. C. These regulations hereby adopt and incorporate “ American Physical Therapy Association, Standards of Ethical Conduct for the Physical Therapist Assistant ” (2010) by reference, not including any further editions or amendments thereof and only to the extent that the provisions therein are not inconsistent with these regulations. D. These regulations hereby adopt and incorporate “ American Physical Therapy Association, Guide for Conduct of the Physical Therapist Assistant ” (2010) by reference, not including any further editions or amendments thereof and only to the extent that the provisions therein are not inconsistent with these regulations. E. These regulations hereby adopt and incorporate “American Physical Therapy Association, Standards of Practice for Physical Therapy” (2010) by reference, not including any further editions or amendments thereof and only to the extent that the provisions therein are not inconsistent with these regulations. 13.3 Definitions A. Wherever used in this Part the following terms shall be construed as follows: 1. "Act" refers to R.I. Gen. Laws Chapter 5-40 , entitled, "Physical Therapists." 2. “APTA” means the American Physical Therapy Association. 3. "Board" means the Board of Physical Therapy within the Department established pursuant to the provisions of R.I. Gen. Laws § 5-40-3 . 4. “CAPTE” means the Commission on Accreditation of Physical Therapy Education. 5. “Department” means the Rhode Island Department of Health. 6. "Director" means the Director of the Rhode Island Department of Health. 7. "Examination" means an examination approved by the Department, in consultation with the Board. 8. “FSBPT” means the Federation of State Boards of Physical Therapy. 9. “License” means a license issued by the Department to practice physical therapy. 10. "On-site supervision" means the immediate and physical presence of patient, person being supervised, and supervisor. 11. "Physical therapist" means an individual who is licensed by the Department to practice physical therapy. 12. "Physical therapist assistant" means an individual who is licensed by the Department to assist in the practice of physical therapy under the supervision of a physical therapist. 13. “Physical therapy” means the care and services provided by or under the direction and supervision of a physical therapist who is licensed pursuant to R.I Gen. Laws Chapter 5-40. 14. "Practice of physical therapy" means those activities and services pursuant to R.I. Gen. Laws § 5-40-1; 15. "Supervision" means that a licensed physical therapist is, at all times, responsible for physical therapist assistants, supportive personnel and students. 16. "Supportive personnel" means an individual, other than a physical therapist assistant, who does not act independently and works under the direction and supervision of a physical therapist or physical therapist assistant as directed by a physical therapist who is licensed under R.I. Gen. Laws Chapter 5-40 . 13.4 Physical Therapists/Licensing Requirements 13.4.1 License Requirement A. Pursuant to R.I. Gen. Laws § 5-40-9 , it is unlawful for any person to represent him or herself as a physical therapist in this state unless the person has been licensed pursuant to the provisions of the Act and this Part. B. The right of use of the title of physical therapist shall be in accordance with R.I. Gen. Laws § 5-40-9 . 13.4.2 Qualifications for Licensure Any applicant for licensure shall meet all of the requirements as set forth in R.I. Gen. Laws § 5-40-6 . 13.4.3 Application for Licensure and Fee A. An applicant for licensure to practice physical therapy in this state must submit the following: 1. Application for licensure on forms provided by the Department that shall be completed and submitted to the Board. 2. The non-refundable, non-returnable application fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title). 3. Supporting official transcripts of education credentials as required in § 13.4.2 of this Part. 4. The examination scores of the national examination approved by the FSBPT submitted directly to the Board. 5. Full Bureau of Criminal Investigation (BCI) check from the Rhode Island Attorney General’s Office. B. Licensure by Endorsement. An applicant for licensure to practice physical therapy by endorsement in this state must submit the following: 1. Application for licensure on forms provided by the Department that shall be completed and submitted to the Board. 2. The non-refundable, non-returnable application fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title). 3. The examination scores of the national examination approved by the FSBPT submitted directly to the Board. 4. A statement from the Board of Physical Therapy in each state in which the applicant has held or holds licensure submitted to the Board of this state, attesting to the licensure status of the applicant during the time period the applicant held licensure in said state. 5. Out-of-state applicants must obtain their full BCI report from their state of residence. C. Foreign Trained Applicants. Applicants from foreign physical therapy schools must present evidence that their educational credentials are equivalent of those requirements set forth in § 13.4.2 of this Part by an agency approved by the Board. Furthermore, foreign trained applicants must meet all of the requirements for licensure to the satisfaction of the Board and in accordance with the statutory and regulatory provisions of this Part. An applicant for licensure in this state must provide the following: 1. Application for licensure on forms provided by the Department that shall be completed and submitted to the Board. 2. The non-refundable, non-returnable application fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title). 3. Provide written proof of authorization to practice as a physical therapist without limitation(s) in the country(ies) where the professional education occurred and/or in country(ies) where the applicant practiced physical therapy. 4. Have successfully passed the national examination as described in § 13.4.4 of this Part. 5. Any applicant for licensure as a physical therapist who has received his or her physical therapy training in a country other than the United States of America, the United Kingdom, the Republic of Ireland, Canada except Quebec Province, Australia or New Zealand, shall submit to the Board evidence of attainment of a passing score, as determined by the Board, on the Test of English as a Foreign Language (TOEFL) examination, which test shall have been taken within the two (2) years immediately preceding the filing of the application for licensure. Such evidence must be submitted with the application for licensure. 6. Full Bureau of Criminal Investigation (BCI) check from the Rhode Island Attorney General’s Office. 13.4.4 Examinations for Licensure of Physical Therapists A. Applicants, except those exempt pursuant to R.I. Gen. Laws § 5-40-7 , shall be required to pass a national examination as set forth in R.I. Gen. Laws § 5-40-6 . 1. The Board will adopt the criterion-referenced passing point recommended by FSBPT. B. Without Examination by Endorsement 1. A license to practice physical therapy may be issued without examination in accordance with R.I. Gen. Laws § 5-40-7(b). a. Until such time as a license has been issued, the candidate for licensure by endorsement may not practice as a physical therapist in Rhode Island. C. Re-Examination 1. In order to qualify for re-examination after three (3) failures, the applicant must request a formal meeting with the Board, at which time requirements consisting of additional coursework and/or training for re-examination will be determined and must be fulfilled prior to admittance to a future examination. D. Graduate Practice 1. Graduate practice shall be in accordance with the provisions of R.I. Gen. Laws § 5-40-7 (c). 13.4.5 Issuance and Renewal of License A. A license to practice physical therapy in this state, unless sooner suspended or revoked, shall expire on the first day of May of the next even year following the date of issuance of the original license. B. Every licensed person who desires to renew his or her license shall file a renewal application and documentation in accordance with R.I. Gen. Laws § 5-40-10 together with the renewal fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title). C. Any person who allows his or her license to lapse by failing to renew it on or before the thirty-first day of March of the next even year may be renewed by the Department on payment of the current renewal fee plus an additional fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title). 1. Any person using the title "physical therapist" during the time that his or her license has lapsed shall be subject to the penalties provided for violations of this Part and the Act. D. Continuing Education Requirements 1. Applicants for biennial licensure renewal shall meet continuing education requirements as prescribed in this Part. 2. On application for renewal of license, physical therapists shall attest to completion of twenty- four (24) hours biennially in scope of practice-specific offerings that may include, but not be limited to: formal presentations, conferences, coursework from a regionally accredited college/university and/or self-study courses, such as on-line courses, one (1) continuing education hour awarded for each hour completed. Teaching and/or clinical supervision of student affiliates by licensed physical therapists in APTA approved programs shall be approved for a maximum of three (3) hours per licensure cycle. Such programs or offerings shall be approved or sponsored by a Board-approved organization as set forth in § 13.4.5(D)(3) of this Part. 3. Continuing education programs or offerings sponsored or approved by the following organizations are deemed to be approved by the Board: a. Accreditation Council for Continuing Medical Education (ACCME) approved programs; b. American Academy of Family Physicians (AAFP); c. American Academy of Neurology; d. American Academy of Orthopedics; e. American Academy of Pediatrics; f. American Cancer Society; g. American College of Obstetricians and Gynecologists (ACOG); h. American Heart Association; i. American Hippotherapy Association (AHA); j. American Management Association; k. American Medical Association; l. American Nursing Association (ANA) or its state affiliate; m. American Occupational Therapy Association (AOTA); n. American Physical Therapy Association (APTA); o. American Red Cross cardiopulmonary resuscitation (CPR)/first aid; p. American Speech and Hearing Association (ASHA); q. Any course offered by a department or school of physical therapy, or professional organization, or accrediting agency as may be approved by the Board; r. Aquatic Exercise Association; s. Arthritis Foundation; t. Basic water safety certification; u. Commission for Accreditation of Rehabilitation Facilities (CARF); v. Federation of State Boards of Physical Therapy; w. Educational programs offered by non-profit associations with a primary purpose of providing health education and/or disability support; x. Educational programs offered by the Alpert Medical School at Brown University; y. Educational programs offered by the Alpert Medical School at Brown University in public health; z. Educational programs offered by the Rhode Island Department of Education; aa. Multiple Sclerosis Society; bb. National Association of Social Workers (NASW); cc. National Athletic Trainers Association (NATA); dd. National Strength and Conditioning Association (NSCA); ee. Neurodevelopmental Treatment Association; ff. Paralyzed Veterans of America; gg. Rhode Island American Physical Therapy Association or any other state physical therapy association; hh. Rhode Island Medical Society or other state medical society; ii. Rhode Island State Nurses Association or other state nurses association; jj. Or others as may be approved by the Board. 4. It shall be the sole responsibility of the physical therapist to obtain documentation, e.g., course descriptions, proof of attendance, from the sponsoring organization, agency, or institution of his/her participation in a continuing education program and/or activity. These documents shall be retained by each licensee for no less than four (4) years and are subject to random audit by the Department. 5. A licensee who fails to complete the continuing education requirements described in this Part may be subject to disciplinary action pursuant to R.I. Gen. Laws § 5-40-13 . 6. A license may be denied to any applicant who fails to provide satisfactory evidence of completion of continuing education relevant to physical therapy as required in this Part. 7. Physical therapists initially licensed by examination after the May 1st renewal date shall be exempt from the continuing education requirements stated in this Part until the date of the next renewal cycle, i.e., April 30th of the next even-numbered year. 8. The Department may extend for only one six (6) month period these educational requirements if the Department is satisfied that the applicant has suffered hardship, which prevented meeting the educational requirements. 13.4.6 The Practice of Physical Therapy A. Whenever a patient seeks or receives treatment from a physical therapist without referral from a doctor of medicine, osteopathy, dentistry, podiatry, or chiropractic, the physical therapist shall: 1. Disclose to the patient in writing the scope and limitations of the practice of physical therapy and shall obtain their consent in writing in accordance with the “American Physical Therapy Association, Standards of Practice for Physical Therapy” incorporated above by reference at § 13.2(E) of this Part; and 2. Refer the patient to such a practitioner within ninety (90) days after the date treatment commenced; provided, however, a physical therapist shall not be required to make such a referral after treatment is concluded. B. The physical therapist and the physical therapist assistant is responsible for his/her individual professional development and continued competence in physical therapy in. accordance with the “American Physical Therapy Association, Standards of Practice for Physical Therapy” incorporated above by reference at § 13.2(E) of this Part and the “American Physical Therapy Association, Standards of Ethical Conduct for the Physical Therapist Assistant” incorporated above by reference at § 13.2(C) of this Part. C. The physical therapist shall adhere to the “American Physical Therapy Association, Standards of Practice for Physical Therapy” incorporated above by reference at § 13.2(E) of this Part and the “American Physical Therapy Association, Code of Ethics” incorporated above by reference at § 13.2(A) of this Part. D. The physical therapist assistant shall adhere to the “American Physical Therapy Association, Standards of Ethical Conduct for the Physical Therapist Assistant” incorporated above by reference at § 13.2(C) of this Part and the “American Physical Therapy Association, Guide for Conduct of the Physical Therapist Assistant” incorporated above by reference at § 13.2(D) of this Part. 13.4.7 Supervision A. Pursuant to R.I. Gen. Laws § 5-40-1(8) a licensed physical therapist shall at all times be responsible for the supervision of physical therapist assistants, supportive personnel, and students to ensure the safety and welfare of patients. Such supervision shall include but not be limited to the following: 1. A physical therapist shall be present on the premises, and immediately available whenever a physical therapist student is performing treatment procedures or patient- related activities. A physical therapist or physical therapist assistant shall be present on the premises, and immediately available whenever a physical therapist assistant student or supportive personnel is performing treatment procedures or patient-related activities. 2. A qualified physical therapist must be accessible by telecommunications to the physical therapist assistant at all times while the physical therapist assistant is treating patients. 3. The physical therapist shall maintain the following written documentation regarding the supervision of a physical therapist assistant: a. Necessary instruction; b. On-site supervision of the physical therapist assistant's performance; c. Review of the physical therapist assistant’s documentation; d. A reassessment; and, e. Appropriate update of the patient's program and goals. f. All of the above shall occur when re-evaluation of the patient is indicated but no less than once during a one (1) month period. 4. The physical therapist or physical therapist assistant shall maintain the following written documentation regarding the supervision of supportive personnel: a. Necessary instruction and documented competence; b. Line-of-sight supervision of the treatment performed by the supportive personnel; and c. Review of the supportive personnel’s documentation on a daily basis. 5. In licensed facilities providing chronic long term care services, in licensed facilities providing services for the developmentally impaired population, or in school settings certified by the Department of Education, physical therapist assistants and supportive personnel may implement programs designed and supervised by the physical therapist in the above-mentioned settings, if these programs are of the nature and purpose of practicing or maintaining a skill. a. These programs will be implemented under the direction of the physical therapist with regular interval on-site supervision by the physical therapist, no less than quarterly for physical therapist assistants, and no less than monthly by the physical therapist or physical therapist assistant for supportive personnel. 6. In the settings noted in § 13.4.7(A)(5) of this Part, the physical therapist shall maintain the following written documentation regarding the supervision of a physical therapist assistant or supportive personnel: a. Necessary instruction; b. On-site supervision of the physical therapist assistant's/ supportive personnel’s performance; c. Review of the physical therapist assistant’s/supportive personnel’s documentation; d. A reassessment; and, appropriate update of the patient's program and goals. e. All of the above shall occur no less than quarterly for a physical therapist assistant supervised by a physical therapist and no less than monthly for supportive personnel supervised by either a physical therapist or physical therapist assistant. B. When supervising supportive personnel, the physical therapist shall provide a written plan(s) for the training and supervision of supportive personnel. The plan shall be in accordance with current standards of professional practice and shall be reviewed at least annually and revised as necessary. The plan shall be readily available for review by all physical therapists and physical therapist assistants who work with the supportive personnel and shall include: 1. A list of clinical competencies of each supportive personnel; 2. The method for monitoring and supervising care provided by the supportive personnel; and 3. The date reviewed and signatures of the supervisor and supportive personnel governed by the plan. C. No physical therapist assistant and/or supportive personnel shall evaluate new patients admitted for physical therapy service and/or establish a physical therapy treatment program based on the physician's referral or prescription; and D. The physical therapist shall discharge such other supervisory activity(ies) as may be deemed appropriate and in accordance with policies and procedures of the health care facility and/or agency. 13.5 Physical Therapist Assistant / License Requirements 13.5.1 License Requirement A. Pursuant to R.I. Gen. Laws § 5-40-9 , it is unlawful for any person to represent him or herself as a physical therapist assistant in this state unless the person has been licensed pursuant to the provisions of the Act and this Part. B. The right of use of the title of physical therapist assistant shall be in accordance with R.I. Gen. Laws § 5-40-9 . 13.5.2 Qualifications for Licensure Any applicant for licensure shall meet all of the requirements as set forth in R.I. Gen. Laws § 5-40-6.1. 13.5.3 Application for Licensure A. An applicant for licensure to practice as a physical therapist assistant in this state must submit the following: 1. Application for licensure on forms provided by the Department that shall be completed and submitted to the Board; 2. The non-refundable, non-returnable application fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title); 3. Supporting official transcripts of educational credentials as set forth in § 13.5.2 of this Part; 4. The examination scores of the national examination approved by the FSBPT submitted directly to the Board. 5. Full Bureau of Criminal Investigation (BCI) check from the Rhode Island Attorney General’s Office. B. License by Endorsement. An applicant for licensure to practice as a physical therapy assistant by endorsement in this state must submit the following: 1. Application for licensure on forms provided by the Department that shall be completed and submitted to the Board; 2. The non-refundable, non-returnable application fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title); 3. The examination scores of the national examination approved by the FSBPT submitted directly to the Board. 4. A statement from the board of physical therapy in each state in which the applicant has held or holds licensure to be submitted to the Board of this state, attesting to the licensure status of the applicant during the time period the applicant held licensure in said state. 5. Out-of-state applicants must obtain their full BCI report from their state of residence. C. Foreign Trained Applicants. Applicants from foreign physical therapy assistant schools must present evidence that their educational credentials are equivalent of those requirements set forth in § 13.5.2 of this Part by an agency approved by the Board. Furthermore, foreign trained applicants must meet all of the requirements for licensure to the satisfaction of the Board and in accordance with the statutory and regulatory provisions of this Part. An applicant for licensure in this state must provide the following: 1. Application for licensure on forms provided by the Department that shall be completed and submitted to the Board; 2. The non-refundable, non-returnable application fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title); 3. Provide written proof of authorization to practice as a physical therapist assistant without limitation(s) in the country(ies) where the professional education occurred and/or in country(ies) where the applicant practiced as a physical therapy assistant; 4. Have successfully passed the national examination as required in § 13.5.2 of this Part. 5. Any applicant for licensure as a physical therapist assistant who has received his or her physical therapy assistant training in a country other than the United States of America, the United Kingdom, the Republic of Ireland, Canada except Quebec Province, Australia or New Zealand, shall submit to the Board evidence of attainment of a passing score, as determined by the Board, on the Test of English as a Foreign Language (TOEFL) examination, which test shall have been taken within the two (2) years immediately preceding the filing of the application for licensure. Such evidence must be submitted with the application for licensure. 6. Full Bureau of Criminal Investigation (BCI) check from the Rhode Island Attorney General’s Office. 13.5.4 Examinations for Licensure of Physical Therapist Assistants A. By Examination: 1. Applicants, except those exempt pursuant to R.I. Gen. Laws § 5-40-7.1 , shall be required to pass a national examination as set forth in R.I. Gen. Laws § 5-40-6.1. a. The Board will adopt the criterion-referenced passing point recommended by FSBPT. B. Without Examination by Endorsement 1. A license may be issued without examination in accordance with the provisions of R.I. Gen. Laws § 5-40-7.1. a. Until such time as a license has been issued, the candidate for licensure by endorsement may not practice as a physical therapist assistant in Rhode Island. C. Re-Examination 1. In order to qualify for re-examination after three (3) failures, the applicant must request a formal meeting with the Board, at which time requirements consisting of additional coursework and/or training for re-examination will be determined and must be fulfilled prior to admittance to a future examination. D. Graduate Practice 1. Every student upon graduating from a physical therapist assistant educational program accredited by CAPTE who has filed a physical therapist assistant application for licensure may, upon receiving a permit from the Department, perform as a physical therapist assistant, under the supervision of a physical therapist licensed in this state. a. During this interim period, the applicant shall identify himself or herself only as a "graduate physical therapist assistant" or use the abbreviation “GPTA.” b. If an applicant fails to take the examination within ninety (90) days from the effective date of graduate status, without due cause or fails to pass the examination and receive a license, all the aforementioned privileges set forth in §§ 13.5.4(D)(1) and 13.5.4(D)(1)(a) of this Part shall automatically cease. c. The provisions of § 13.5.4(D) of this Part shall apply only to students upon graduating from a physical therapist assistant educational program accredited by CAPTE and shall not apply to any physical therapist assistant previously licensed under any licensure jurisdiction. 13.5.5 Issuance and Renewal of License A. A license to practice as a physical therapist assistant in this state, unless sooner suspended or revoked, shall expire on the first (1st) day of May of the next even year following the date of issuance of the original license. B. Every licensed person who desires to renew his or her license shall file a renewal application and documentation in accordance with R.I. Gen. Laws § 5-40-10 together with the renewal fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title). C. Any person who allows his or her license to lapse by failing to renew it on or before the thirty first (31st) day of March of the next even year may be renewed by the Department on payment of the current renewal fee plus an additional fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title). 1. Any person using the title "physical therapist assistant" during the time that his or her license has lapsed shall be subject to the penalties provided for violations of this Part and the Act. D. Continuing Education Requirements 1. Applicants for biennial licensure renewal shall meet continuing education requirements as prescribed in this Part. 2. On application for renewal of license, physical therapist assistants shall attest to completion of twenty-four (24) hours biennially in scope of practice-specific offerings that may include, but not be limited to: formal presentations, conferences, coursework from a regionally accredited college/university and/or self-study courses, such as on-line courses (one (1) continuing education hour awarded for each hour completed). Teaching and/or clinical supervision of student affiliates by licensed physical therapist assistants in APTA approved programs shall be approved for a maximum of three (3) hours per licensure cycle. Such programs or offerings shall be approved or sponsored by a Board-approved organization as set forth in § 13.4.5(E) of this Part. 3. It shall be the sole responsibility of the physical therapist assistant to obtain documentation (e.g., course descriptions, proof of attendance) from the sponsoring organization, agency, or institution of his/her participation in a continuing education program and/or activity. These documents shall be retained by each licensee for no less than four (4) years and are subject to random audit by the Department. 4. A licensee who fails to complete the continuing education requirements described in this Part may be subject to disciplinary action pursuant to R.I. Gen. Laws § 5-40-13 . 5. A license may be denied to any applicant who fails to provide satisfactory evidence of completion of continuing education relevant to physical therapy as required in this Part. 6. Physical therapist assistants initially licensed by examination after the May 1st renewal date shall be exempt from the continuing education requirements stated in this Part until the date of the next renewal cycle (i.e., April 30th of the next even-numbered year). 7. The Department may extend for only one six (6) month period these educational requirements if the Department is satisfied that the applicant has suffered hardship, which prevented meeting the educational requirements. 13.5.6 Supervision A. Pursuant to R.I. Gen. Laws § 5-40-1(8) , a licensed physical therapist shall be responsible for the supervision, at all times, of the performance of patient care services and treatments provided by physical therapist assistants, supportive personnel and students, consistent with the provisions of § 13.4.7 of this Part. B. The physical therapist assistant may be the supervisor for physical therapist assistant students, but must be on the premises and immediately available. C. The physical therapist assistant may be the supervisor for supportive personnel, but must be on the premises, in line-of-sight, and immediately available. 13.6 Grounds for Denial, Suspension or Revocation, Violations, Procedure for Discipline 13.6.1 Grounds for Denial, Suspension or Revocation of License/Violations The Board shall have power to deny, revoke or suspend any license applied for or issued by the Department in accordance with the provisions of R.I. Gen. Laws § 5-40-13 . 13.6.2 Procedure for Discipline Procedures for discipline shall be in accordance with the provisions of R.I. Gen. Laws § 5-40-14 . 13.6.3 Penalties for Violations Penalties for violations shall be in accordance with the provisions of R.I. Gen. Laws § 5-40-17. 13.6.4 Rules Governing Practices and Procedures All hearings and reviews required under the provisions of R.I. Gen. Laws Chapter 5-40 shall be held in accordance with the provisions of the Act and the rules and regulations regarding Practices and Procedures Before the Department of Health (Part 10-05-4 of this Title) and Access to Public Records (Part 10-05-1 of this Title).