Hannah plays key role in passage of new state law impacting N.C. physical therapists

The legislation allows physical therapists the expanded ability to practice spinal manipulation without a physician's referral, with Assistant Professor Mary Kay Hannah leading the charge for the legislative change.


A faculty member in Elon’s School of Health Sciences played a key role in securing passage of legislation in the North Carolina General Assembly which recently passed a new law that will allow physical therapists to perform all treatments within the physical therapy scope of practice with unfettered direct access for patient care.

Assistant Professor Mary Kay Hannah
Gov. Roy Cooper signed House Bill 548 into law last month, a measure that rewrites the Physical Therapy Practice Act law to allow physical therapists to manipulate the spine without a prescription from a licensed physician. The legislative change further empowers physical therapists who are taught spinal manipulation during the course of obtaining their doctoral physical therapy degrees to provide evidence-based best patient care.

Mary Kay Hannah, assistant professor of physical therapy education at Elon, has been a steadfast advocate for the legislative change that took years of work to make possible. Hannah launched an ad hoc committee of the N.C. Physical Therapy Association in 2013 called the Spinal Manipulation Task Force (SMTF) to advocate for the change in the law. The task force helped pass a bill in the state House in 2015 and again in 2017, but both times the effort stalled in the state Senate. This year, the task force successfully worked to move legislation through both chambers. 

As a side note, Elon President Connie Ledoux Book was present at the N.C. Senate session on the day the physical therapy bill passed the Senate. Sen. Rick Gunn, an Alamance County Republican, introduced President Book to the chamber with rousing praise for Elon.

“This success would not have been accomplished without many different people supporting the SMTF over six years and retired PT leader, Ben Massey, who first championed direct access for PTs in 1985,” Hannah said. Hannah gave special praise to the past presidents and executive directors of the N.C. Physical Therapy Association as well as for the lobbyist for the association, Alex Miller, along with the bill sponsors over the years. “I am grateful to everyone who gave any support; special thanks to the SMTF leaders," Hannah said. "You know who you are—kudos!”

In 1985, physical therapists in North Carolina were first granted the ability to see patients without a physician referral. Lawmakers at the time included a provision in the law that would still require patients to receive a prescription for a physical therapist to be able to conduct one single physical therapy treatment—spinal manipulation.

Since then, many other states have changed their laws to allow physical therapists to have direct access and to conduct spinal manipulation which is an educational requirement in accredited physical therapy programs.

Hannah spearheaded efforts to lobby for the legislative change during the past six years including soliciting support from physical therapists and physicians, as well as lobbying lawmakers for change. This year, those efforts yielded results with the passage of the law that permits spinal manipulation without a physician referral, and restricts physical therapists from delivering chiropractic care, which addressed concerns from the chiropractic association.

Hannah is a retired U.S. Army physical therapist who joined the full-time faculty at Elon in 2017 after several years as an adjunct instructor. She teaches Foundations of Musculoskeletal Management and Biomechanics and Evaluation and Treatment of Neuromusculoskeletal Dysfunction of the Spine. Next year Hannah will start teaching Today's Healthcare, a course including topics such as professional advocacy from which she can now speak from experience.

The legislative victory came just prior to Hannah assuming responsibilities as president of the N.C. Physical Therapy Association on July 1.