Amended in Assembly March 21, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 1000

Introduced by Assembly Member Wieckowski

February 22, 2013

An act to amend begin delete Section 2630 of end delete begin insert Sections 2620 and 2660 of, and to add Section 2620.1 to, end insert the Business and Professions Code, relating to physical therapy.

LEGISLATIVE COUNSEL’S DIGEST

AB 1000, as amended, Wieckowski. begin delete Physical therapy. end delete begin insert Physical therapists: direct access to services. end insert

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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 as, among other things, including physical therapy evaluation, treatment planning, instruction, and consultative services. The act 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.

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This bill would revise the definition of “physical therapy” to instead include examination and evaluation to determine a physical therapy diagnosis, as defined, prognosis, treatment plan, instruction, or consultative service.

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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 provide that failure to comply with these provisions constitutes unprofessional conduct subject to disciplinary action by the board.

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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.

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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.

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This bill would provide that no reimbursement is required by this act for a specified reason.

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Existing law, until January 1, 2014, establishes the Physical Therapy Board of California, which oversees the licensing and regulation of physical therapists. Existing law prohibits any person or persons from practicing or offering to practice physical therapy in this state for compensation, or to hold himself or herself out as a physical therapist, unless he or she holds a valid license, as specified.

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This bill would make a technical, nonsubstantive change to these provisions.

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Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program:  begin delete no end delete begin insert yes end insert .

The people of the State of California do enact as follows:

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begin insert SECTION 1. end insert   

end insert begin insert

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.

end insert

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 2620 of the end insert begin insert Business and Professions Code end insert begin insert is
amended to read: end insert

2620.  

(a) Physical therapy means the art and science of
physical or corrective rehabilitation or of physical or corrective
treatment of any bodily or mental condition of any person by the
use of the physical, chemical, and other properties of heat, light,
water, electricity, sound, massage, and active, passive, and resistive
exercise, and shall include begin insert examination and evaluation to determine
a end insert physical therapy begin delete evaluation, end delete begin insert diagnosis, prognosis, end insert treatment
begin delete planning, instruction and end delete begin insert plan, instruction, or end insert consultative begin delete services. end delete
begin insert service. end insert The practice of physical therapy includes the promotion
and maintenance of physical fitness to enhance the bodily
movement related health and wellness of individuals through the
use of physical therapy interventions. The use of roentgen rays
and radioactive materials, for diagnostic and therapeutic purposes,
and the use of electricity for surgical purposes, including
cauterization, are not authorized under the term “physical therapy”
as used in this chapter, and a license issued pursuant to this chapter
does not authorize the diagnosis of disease.

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(b) For the purposes of this section, “physical therapy
diagnosis” means a systematic examination process that culminates
in assigning a diagnostic label identifying the primary dysfunction
toward which physical therapy treatment will be directed, but shall
not include a medical diagnosis or a diagnosis of disease.

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(b)

end delete

begin insert (c) end insert  Nothing in this section shall be construed to restrict or
prohibit other healing arts practitioners licensed or registered under
this division from practice within the scope of their license or
registration.

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begin insert SEC. 3. end insert   

end insert

begin insert Section 2620.1 is added to the end insert begin insert Business and Professions
Code end insert begin insert , to read: end insert

begin insert

begin insert 2620.1. end insert   

(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 if the
treatment is within the scope of practice of physical therapists, as
defined in Section 2620, and all of 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.

(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.

(b) The conditions in paragraphs (1), (2), and (3) 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.

(c) This section does not 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) This section does not require a health care service plan or
insurer to provide coverage for direct access to treatment by a
physical therapist.

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begin insert SEC. 4. end insert   

end insert

begin insert Section 2660 of the end insert begin insert Business and Professions Code end insert begin insert is
amended to read: end insert

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.

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(n) Failure to comply with the provisions of Section 2620.1.

end insert

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begin insert SEC. 5. end insert   

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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.

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begin delete

SECTION 1.  

Section 2630 of the Business and Professions Code
is amended to read:

2630.  

It is unlawful for any person or persons to practice, or
offer to practice, physical therapy in this state for compensation
received or expected, or to hold himself or herself out as a physical
therapist, unless at the time of so doing he or she holds a valid,
unexpired, and unrevoked license issued under this chapter.

Nothing in this section shall restrict the activities authorized by
their licenses on the part of any persons licensed under this code
or any initiative act, or the activities authorized to be performed
pursuant to Article 4.5 (commencing with Section 2655) or Chapter
7.7 (commencing with Section 3500).

A physical therapist licensed pursuant to this chapter may utilize
the services of one aide engaged in patient-related tasks to assist
the physical therapist in his or her practice of physical therapy.
“Patient-related task” means a physical therapy service rendered
directly to the patient by an aide, excluding non-patient-related
tasks. “Non-patient-related task” means a task related to
observation of the patient, transport of the patient, physical support
only during gait or transfer training, housekeeping duties, clerical
duties, and similar functions. The aide shall at all times be under
the orders, direction, and immediate supervision of the physical
therapist. Nothing in this section shall authorize an aide to
independently perform physical therapy or any physical therapy
procedure. The board shall adopt regulations that set forth the
standards and requirements for the orders, direction, and immediate
supervision of an aide by a physical therapist. The physical
therapist shall provide continuous and immediate supervision of
the aide. The physical therapist shall be in the same facility as, and
in proximity to, the location where the aide is performing
patient-related tasks, and shall be readily available at all times to
provide advice or instruction to the aide. When patient-related
tasks are provided to a patient by an aide, the supervising physical
therapist shall, at some point during the treatment day, provide
direct service to the patient as treatment for the patient’s condition,
or to further evaluate and monitor the patient’s progress, and shall
correspondingly document the patient’s record.

The administration of massage, external baths, or normal exercise
not a part of a physical therapy treatment shall not be prohibited
by this section.

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