BILL NUMBER: SB 924	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JANUARY 26, 2012
	AMENDED IN SENATE  MAY 24, 2011
	AMENDED IN SENATE  MAY 9, 2011
	AMENDED IN SENATE  MARCH 30, 2011

INTRODUCED BY    Senator   Walters 
 Senators   Price,   Walters,   and
Steinberg 
    (   Coauthors:  
Senators   Emmerson,   
 Runner,     and Strickland
  ) 
    (   Coauthors:  
Assembly Members   Bill Berryhill, 
   Chesbro,   
 Knight,     Morrell,
    Norby,  
  and Silva   ) 

                        FEBRUARY 18, 2011

   An act to amend  Section 2660   Sections 2406
and 2690  of, and to add Section  
Sections 2406.5,  2620.1  , and 2694.5  to, the
Business and Professions Code,   and to amend Section 13401.5 of
the Corporations Code,   relating to  physical
therapists   healing arts  .



	LEGISLATIVE COUNSEL'S DIGEST


   SB 924, as amended,  Walters   Price  .
Physical therapists: direct access to services. 
 services: professional corporations.  
    Existing 
    (1)     Existing  law, the Physical
Therapy Practice Act, creates the Physical Therapy Board of
California and makes it responsible for the licensure and regulation
of physical therapists. The act defines the term "physical therapy"
for its purposes and makes it a crime to violate any of its
provisions.  The act authorizes the board to suspend, revoke,
or impose probationary conditions on a license, certificate, or
approval issued under the act for unprofessional conduct, as
specified. 
   This bill would specify that patients may access physical therapy
treatment directly, and would, in those circumstances, require a
physical therapist to refer his or her patient to another specified
healing arts practitioner if the physical therapist has reason to
believe the patient has a condition requiring treatment or services
beyond that scope of practice,  to disclose to the patient
any financial interest he or she has in treating the patient,
 and, with the patient's written authorization, to notify
the patient's physician and surgeon, if any, that the physical
therapist is treating the patient. The bill would prohibit a physical
therapist from treating a patient beyond  a 30-day period
  30 business days or 12 visits, whichever occurs first
 , unless the  patient has obtained a diagnosis from a
physician and surgeon   physical therapist receives a
specified authorization from a person with a physician and surgeon's
certificate. The bill would require a physical therapist, prior to
the initiation of treatment services, to provide a patient with a
specified notice concerning the limitations on   the direct
treatment services  .  The bill would provide that
failure to comply with these provisions constitutes unprofessional
conduct subject to disciplinary action by the board.  
   (2) Existing law regulating professional corporations provides
that certain healing arts practitioners may be shareholders,
officers, directors, or professional employees of a medical
corporation or a podiatric medical corporation, subject to certain
limitations.  
   This bill would add licensed physical therapists and licensed
occupational therapists to the list of healing arts practitioners who
may be shareholders, officers, directors, or professional employees
of those corporations. The bill would also provide that specified
healing arts licensees may be shareholders, officers, directors, or
professional employees of a physical therapy corporation. The bill
would require, except as specified, that a medical corporation,
podiatry corporation, and physical therapy corporation provide
patients with a specified disclosure notifying them that they may
seek physical therapy treatment services from any physical therapy
provider. The bill would also make conforming changes to related
provisions. 
   Because the bill would specify additional requirements under the
Physical Therapy Practice Act, the violation of which would be a
crime, it would impose a state-mandated local program.
    The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares that an individual's
access to early intervention to physical therapy treatment may
decrease the duration of a disability, reduce pain, and lead to a
quicker recovery.
   SEC. 2.    Section 2406 of the   Business
and Professions Code   is amended to read:
   2406.  A medical corporation or podiatry corporation is a
corporation  which   that  is authorized to
render professional services, as defined in Sections 13401 and
13401.5 of the Corporations Code, so long as that corporation and its
shareholders, officers, directors  ,  and employees
rendering professional services who are physicians  and surgeons
 , psychologists, registered nurses, optometrists, podiatrists
 ,   chiropractors, acupuncturists, naturopathic
doctors, physical therapists, occupational therapists,  or, in
the case of a medical corporation only, physician assistants, 
marriage and family therapists, or clinical social workers,  are
in compliance with the Moscone-Knox Professional Corporation Act,
the provisions of this article  ,  and all other statutes
and regulations now or hereafter enacted or adopted pertaining to the
corporation and the conduct of its affairs.
   With respect to a medical corporation or podiatry corporation, the
governmental agency referred to in the Moscone-Knox Professional
Corporation Act is the  Division of Licensing  
board  .
   SEC. 3.    Section 2406.5 is added to the  
Business and Professions Code  , to read:  
   2406.5.  (a) A medical corporation or podiatry corporation that is
authorized to render professional services, as defined in Sections
13401 and 13401.5 of the Corporations Code, shall disclose to its
patients, orally and in writing, when initiating any physical therapy
treatment services, that the patient may seek physical therapy
treatment services from a physical therapy provider of his or her
choice who may not necessarily be employed by the medical or podiatry
corporation.
   (b) This disclosure requirement shall not apply to any medical
corporation that contracts with a health care service plan with a
license issued pursuant to the Knox-Keene Health Care Service Plan
Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 2
of the Health and Safety Code) if the licensed health care service
plan is also exempt from federal taxation pursuant to Section 501(c)
(3) of the Internal Revenue Code. 
   SEC. 2.   SEC. 4.   Section 2620.1 is
added to the Business and Professions Code, to read:
   2620.1.  (a) In addition to receiving wellness and evaluation
services from a physical therapist, a person may initiate physical
therapy treatment directly from a licensed physical therapist
provided that the treatment is within the scope of practice of
physical therapists, as defined in Section 2620, and that all the
following conditions are met:
   (1) If, at any time, the physical therapist has reason to believe
that the patient has signs or symptoms of a condition that requires
treatment beyond the scope of practice of a physical therapist, the
physical therapist shall refer the patient to a person holding a
physician and surgeon's certificate issued by the Medical Board of
California or by the Osteopathic Medical Board of California or to a
person licensed to practice dentistry, podiatric medicine, or
chiropractic.
   (2) The physical therapist shall  disclose to the patient
any financial interest he or she has in treating the patient and
shall  comply with Article 6 (commencing with Section 650)
of Chapter 1 of Division 2.
   (3) With the patient's written authorization, the physical
therapist shall notify the patient's physician and surgeon, if any,
that the physical therapist is treating the patient. 
   (4) With respect to a patient initiating physical therapy
treatment services directly from a physical therapist, the physical
therapist shall not continue treating that patient beyond 30 business
days or 12 visits, whichever occurs first, without receiving, from a
person holding a physician and surgeon's certificate from the
Medical Board of California or the Osteopathic Medical Board of
California, a dated signature on the physical therapist's plan of
care indicating approval of the physical therapist's plan of care.
Approval of the physical therapist's plan of care shall include an
appropriate patient examination by the person holding a physician and
surgeon's certificate from the Medical Board of California or the
Osteopathic Medical Board of California. For purposes of this
paragraph, "business day" means any calendar day except Saturday,
Sunday, or the following business holidays: New Year's Day,
Washington's Birthday, Memorial Day, Independence Day, Labor Day,
Columbus Day, Veterans Day, Thanksgiving Day, and Christmas Day.

   (b) The conditions in paragraphs (1), (2),  and 
(3)  , and (4)  of subdivision (a) do not apply to a
physical therapist when providing evaluation or wellness physical
therapy services to a patient as described in subdivision (a) of
Section 2620  or treatment provided upon referral or diagnosis by
a physician and surgeon, podiatrist, dentist, chiropractor, or other
appropriate health care provider acting within his or her scope of
practice. Nothing in this subdivision shall be construed to alter the
disclosure requirements of Section 2406.5  .
   (c) Nothing in this section shall be construed to expand or modify
the scope of practice for physical therapists set forth in Section
2620, including the prohibition on a physical therapist diagnosing a
disease.
   (d) Nothing in this section shall be construed to require a health
care service plan, insurer,  workers' compensation insurance
plan,  or any other person or entity, including, but not limited
to, a state program or state employer, to provide coverage for
direct access to treatment by a physical therapist. 
   (e) A physical therapist shall not continue treating a patient
beyond a 30-day period, unless the patient has obtained a diagnosis
by a physician and surgeon. 
   (e) When a person initiates physical therapy treatment services
directly pursuant to this section, the physical therapist shall not
perform physical therapy treatment services without first providing
the following written notice, orally and in writing, on one page, in
at least 14-point type, and obtaining a patient signature on the
notice: 



   Direct Physical Therapy Treatment Services
   


   You are receiving direct physical therapy treatment services from
an individual who is not a physician and surgeon, but who is a
physical therapist licensed by the Physical Therapy Board of
California.  
   Under California law, you may continue to receive direct physical
therapy treatment services for a period of 30 business days or 12
visits, whichever occurs first, after which time a physical therapist
may continue providing you with physical therapy treatment services
only after receiving, from a person holding a physician and surgeon's
certificate issued by the Medical Board of California or by the
Osteopathic Medical Board of California, a dated signature on the
physical therapist's plan of care indicating approval of the physical
therapist's plan of care.  
   If you have received direct physical therapy treatment services
for a duration of 30 business days or 12 visits, whichever occurs
first, from a physical therapist, it may constitute unprofessional
conduct for that physical therapist or for another physical therapist
to provide direct physical therapy treatment services without
receiving from a person holding a physician and surgeon's certificate
issued by the Medical Board of California or by the Osteopathic
Medical Board of California a dated signature on the physical
therapist's plan of care, indicating approval of the physical
therapist's plan of care. 

 __________________________ 
 (Patient's Signature/Date) 


  SEC. 3.    Section 2660 of the Business and
Professions Code is amended to read:
   2660.  The board may, after the conduct of appropriate proceedings
under the Administrative Procedure Act, suspend for not more than 12
months, or revoke, or impose probationary conditions upon any
license, certificate, or approval issued under this chapter for
unprofessional conduct that includes, but is not limited to, one or
any combination of the following causes:
   (a) Advertising in violation of Section 17500.
   (b) Fraud in the procurement of any license under this chapter.
   (c) Procuring or aiding or offering to procure or aid in criminal
abortion.
   (d) Conviction of a crime that substantially relates to the
qualifications, functions, or duties of a physical therapist or
physical therapist assistant. The record of conviction or a certified
copy thereof shall be conclusive evidence of that conviction.
   (e) Habitual intemperance.
   (f) Addiction to the excessive use of any habit-forming drug.
   (g) Gross negligence in his or her practice as a physical
therapist or physical therapist assistant.
   (h) Conviction of a violation of any of the provisions of this
chapter or of the Medical Practice Act, or violating, or attempting
to violate, directly or indirectly, or assisting in or abetting the
violating of, or conspiring to violate any provision or term of this
chapter or of the Medical Practice Act.
   (i) The aiding or abetting of any person to violate this chapter
or any regulations duly adopted under this chapter.
   (j) The aiding or abetting of any person to engage in the unlawful
practice of physical therapy.
   (k) The commission of any fraudulent, dishonest, or corrupt act
that is substantially related to the qualifications, functions, or
duties of a physical therapist or physical therapist assistant.
   (  l  ) Except for good cause, the knowing
failure to protect patients by failing to follow infection control
guidelines of the board, thereby risking transmission of blood-borne
infectious diseases from licensee to patient, from patient to
patient, and from patient to licensee. In administering this
subdivision, the board shall consider referencing the standards,
regulations, and guidelines of the State Department of Public Health
developed pursuant to Section 1250.11 of the Health and Safety Code
and the standards, regulations, and guidelines pursuant to the
California Occupational Safety and Health Act of 1973 (Part 1
(commencing with Section 6300) of Division 5 of the Labor Code) for
preventing the transmission of HIV, hepatitis B, and other
blood-borne pathogens in health care settings. As necessary, the
board shall consult with the Medical Board of California, the
California Board of Podiatric Medicine, the Dental Board of
California, the Board of Registered Nursing, and the Board of
Vocational Nursing and Psychiatric Technicians of the State of
California, to encourage appropriate consistency in the
implementation of this subdivision.
   The board shall seek to ensure that licensees are informed of the
responsibility of licensees and others to follow infection control
guidelines, and of the most recent scientifically recognized
safeguards for minimizing the risk of transmission of blood-borne
infectious diseases.
   (m) The commission of verbal abuse or sexual harassment.
   (n) Failure to comply with the provisions of Section 2620.1.
   SEC. 5.    Section 2690 of the   Business
and Professions Code   is amended to read: 
   2690.  A physical therapy corporation is a corporation that is
authorized to render professional services, as defined in 
Section   Sections  13401  and 13401.5  of
the Corporations Code, so long as that corporation and its
shareholders, officers, directors, and employees rendering
professional services who are physical therapists  , physicians
and surgeons, podiatrists, acupuncturists, naturopathic doctors,
occupational therapists,   speech-language pathologists,
audiologists, registered nurses, psychologists, and physician
assistants  are in compliance with the Moscone-Knox Professional
Corporation Act, this article  ,  and all other statutes
and regulations now or hereafter enacted or adopted pertaining to the
corporation and the conduct of its affairs.
   With respect to a physical therapy corporation, the governmental
agency referred to in the Moscone-Knox Professional Corporation Act
is the  Physical Therapy Board of California  
board  .
   SEC. 6.    Section 2694.5 is added to the  
Business and Professions Code   , to read:  
   2694.5.  A physical therapy corporation that is authorized to
render professional services, as defined in Sections 13401 and
13401.5 of the Corporations Code, shall disclose to its patients,
orally and in writing, when initiating any physical therapy treatment
services, that the patient may seek physical therapy treatment
services from a physical therapy provider of his or her choice who
may not necessarily be employed by the physical therapy corporation.

   SEC. 7.    Section 13401.5 of the  
Corporations Code   is amended to read: 
   13401.5.  Notwithstanding subdivision (d) of Section 13401 and any
other provision of law, the following licensed persons may be
shareholders, officers, directors, or professional employees of the
professional corporations designated in this section so long as the
sum of all shares owned by those licensed persons does not exceed 49
percent of the total number of shares of the professional corporation
so designated herein, and so long as the number of those licensed
persons owning shares in the professional corporation so designated
herein does not exceed the number of persons licensed by the
governmental agency regulating the designated professional
corporation:
   (a) Medical corporation.
   (1) Licensed doctors of podiatric medicine.
   (2) Licensed psychologists.
   (3) Registered nurses.
   (4) Licensed optometrists.
   (5) Licensed marriage and family therapists.
   (6) Licensed clinical social workers.
   (7) Licensed physician assistants.
   (8) Licensed chiropractors.
   (9) Licensed acupuncturists.
   (10) Naturopathic doctors.
   (11) Licensed professional clinical counselors. 
   (12) Licensed physical therapists.  
   (13) Licensed occupational therapists. 
   (b) Podiatric medical corporation.
   (1) Licensed physicians and surgeons.
   (2) Licensed psychologists.
   (3) Registered nurses.
   (4) Licensed optometrists.
   (5) Licensed chiropractors.
   (6) Licensed acupuncturists.
   (7) Naturopathic doctors. 
   (8) Licensed physical therapists.  
   (9) Licensed occupational therapists. 
   (c) Psychological corporation.
   (1) Licensed physicians and surgeons.
   (2) Licensed doctors of podiatric medicine.
   (3) Registered nurses.
   (4) Licensed optometrists.
   (5) Licensed marriage and family therapists.
   (6) Licensed clinical social workers.
   (7) Licensed chiropractors.
   (8) Licensed acupuncturists.
   (9) Naturopathic doctors.
   (10) Licensed professional clinical counselors.
   (d) Speech-language pathology corporation.
   (1) Licensed audiologists.
   (e) Audiology corporation.
   (1) Licensed speech-language pathologists.
   (f) Nursing corporation.
   (1) Licensed physicians and surgeons.
   (2) Licensed doctors of podiatric medicine.
   (3) Licensed psychologists.
   (4) Licensed optometrists.
   (5) Licensed marriage and family therapists.
   (6) Licensed clinical social workers.
   (7) Licensed physician assistants.
   (8) Licensed chiropractors.
   (9) Licensed acupuncturists.
   (10) Naturopathic doctors.
   (11) Licensed professional clinical counselors.
   (g) Marriage and family therapist corporation.
   (1) Licensed physicians and surgeons.
   (2) Licensed psychologists.
   (3) Licensed clinical social workers.
   (4) Registered nurses.
   (5) Licensed chiropractors.
   (6) Licensed acupuncturists.
   (7) Naturopathic doctors.
   (8) Licensed professional clinical counselors.
   (h) Licensed clinical social worker corporation.
   (1) Licensed physicians and surgeons.
   (2) Licensed psychologists.
   (3) Licensed marriage and family therapists.
   (4) Registered nurses.
   (5) Licensed chiropractors.
   (6) Licensed acupuncturists.
   (7) Naturopathic doctors.
   (8) Licensed professional clinical counselors.
   (i) Physician assistants corporation.
   (1) Licensed physicians and surgeons.
   (2) Registered nurses.
   (3) Licensed acupuncturists.
   (4) Naturopathic doctors.
   (j) Optometric corporation.
   (1) Licensed physicians and surgeons.
   (2) Licensed doctors of podiatric medicine.
   (3) Licensed psychologists.
   (4) Registered nurses.
   (5) Licensed chiropractors.
   (6) Licensed acupuncturists.
   (7) Naturopathic doctors.
   (k) Chiropractic corporation.
   (1) Licensed physicians and surgeons.
   (2) Licensed doctors of podiatric medicine.
   (3) Licensed psychologists.
   (4) Registered nurses.
   (5) Licensed optometrists.
   (6) Licensed marriage and family therapists.
   (7) Licensed clinical social workers.
   (8) Licensed acupuncturists.
   (9) Naturopathic doctors.
   (10) Licensed professional clinical counselors.
   (  l  ) Acupuncture corporation.
   (1) Licensed physicians and surgeons.
   (2) Licensed doctors of podiatric medicine.
   (3) Licensed psychologists.
   (4) Registered nurses.
   (5) Licensed optometrists.
   (6) Licensed marriage and family therapists.
   (7) Licensed clinical social workers.
   (8) Licensed physician assistants.
   (9) Licensed chiropractors.
   (10) Naturopathic doctors.
   (11) Licensed professional clinical counselors.
   (m) Naturopathic doctor corporation.
   (1) Licensed physicians and surgeons.
   (2) Licensed psychologists.
   (3) Registered nurses.
   (4) Licensed physician assistants.
   (5) Licensed chiropractors.
   (6) Licensed acupuncturists.
   (7) Licensed physical therapists.
   (8) Licensed doctors of podiatric medicine.
   (9) Licensed marriage and family therapists.
   (10) Licensed clinical social workers.
   (11) Licensed optometrists.
   (12) Licensed professional clinical counselors.
   (n) Dental corporation.
   (1) Licensed physicians and surgeons.
   (2) Dental assistants.
   (3) Registered dental assistants.
   (4) Registered dental assistants in extended functions.
   (5) Registered dental hygienists.
   (6) Registered dental hygienists in extended functions.
   (7) Registered dental hygienists in alternative practice.
   (o) Professional clinical counselor corporation.
   (1) Licensed physicians and surgeons.
   (2) Licensed psychologists.
   (3) Licensed clinical social workers.
   (4) Licensed marriage and family therapists.
   (5) Registered nurses.
   (6) Licensed chiropractors.
   (7) Licensed acupuncturists.
   (8) Naturopathic doctors. 
   (p) Physical therapy corporation.  
   (1) Licensed physicians and surgeons.  
   (2) Licensed doctors of podiatric medicine.  
   (3) Licensed acupuncturists.  
   (4) Naturopathic doctors.  
   (5) Licensed occupational therapists.  
   (6) Licensed speech-language pathologists.  
   (7) Licensed audiologists.  
   (8) Registered nurses.  
   (9) Licensed psychologists.  
   (10) Licensed physician assistants. 
   SEC. 4.   SEC. 8.   No reimbursement is
required by this act pursuant to Section 6 of Article XIII B of the
California Constitution because the only costs that may be incurred
by a local agency or school district will be incurred because this
act creates a new crime or infraction, eliminates a crime or
infraction, or changes the penalty for a crime or infraction, within
the meaning of Section 17556 of the Government Code, or changes the
definition of a crime within the meaning of Section 6 of Article XIII
B of the California Constitution.