BILL NUMBER: AB 1000	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 25, 2013
	AMENDED IN ASSEMBLY  MARCH 21, 2013

INTRODUCED BY   Assembly  Member  
Wieckowski   Members   Wieckowski  
and Maienschein 

                        FEBRUARY 22, 2013

   An act to amend Sections  2620   2406 
and 2660 of, and to add  Section  Sections
2406.5 and  2620.1 to, the Business and Professions Code, 
and to amend Section 13401.5 of the Corporations Code,  relating
to  physical therapy.   healing arts. 


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1000, as amended, Wieckowski. Physical therapists: direct
access to  services.   services: professional
corporations. 
   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. 
   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. 
   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  or if the patient is not
progressing , 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 who initiated services directly for the lesser of more
than 45 calendar days or 12 visits, except as specified, and would
prohibit a physical therapist from performing services on that
patient before obtaining the patient's signature on a specified
notice regarding these limitations on treatment.  The bill would
provide that failure to comply with these provisions constitutes
unprofessional conduct subject to disciplinary action by the board.
   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 Moscone-Knox Professional Corporation Act provides for the
organization of a corporation under certain existing law for the
purposes of qualifying as a professional corporation under that act
and rendering professional services. The act authorizes specified
healing arts practitioners to be shareholders, officers, directors,
or professional employees of a designated professional corporation,
subject to certain limitations relating to ownership of shares.
Existing law also defines a medical corporation or podiatry
corporation that is authorized to render professional services as
long as that corporation and its shareholders, officers, directors,
and employees rendering professional services who are physicians,
psychologists, registered nurses, optometrists, podiatrists or, in
the case of a medical corporation only, physician assistants, are in
compliance with the act.  
   This bill would specify that those provisions do not limit
employment by a professional corporation of only those specified
licensed professionals. The bill would authorize any person duly
licensed under the Business and Professions Code, the Chiropractic
Act, or the Osteopathic Act to be employed to render professional
services by a professional corporation. The bill would add physical
therapists to the list of healing arts professionals who may be
professional employees of a medical corporation or podiatry
corporation. 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 also
require a practitioner who refers a patient to a physical therapist
who is employed by a medical corporation or podiatry corporation to
make a specified disclosure to the patient. 
    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 2620 of the Business and
Professions Code is amended to read:
   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 examination and evaluation to determine a
physical therapy diagnosis, prognosis, treatment plan, instruction,
or consultative service. 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.
   (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.
    (c) 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. 
   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   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, clinical counselors, or clinical social workers, 
are in compliance with the Moscone-Knox Professional Corporation Act,
the provisions of this  article   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.  When a physician and surgeon, podiatrist, or other
referring practitioner refers a patient to receive services by a
physical therapist employed by a professional corporation as defined
in Sections 13401 and 13401.5 of the Corporations Code, the referring
practitioner shall comply with Article 6 (commencing with Section
650) of Chapter 1, and shall provide notice of the following to the
patient, orally and in writing, in at least 14-point type and signed
by the patient:
   (a) 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) If the patient chooses to be treated by an employed physical
therapist, any financial interest the referring practitioner has in
the corporation. 
   SEC. 3.   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,   those
services authorized by Section 2620,  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 
or the patient is not progressing toward documented treatment goals
as demonstrated by objective, measurable, or functional improvement
 , 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    comply with
Section 2633, and shall  disclose to the patient any financial
interest he or she has in treating the patient  and, if working
in a physical therapy corporation, shall comply with Article 6
(commencing with Section 650) of Chapter 1 .
   (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) The physical therapist shall not continue treating the patient
beyond 45 calendar 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 or from a person holding a certificate to
practice podiatric medicine from the California Board of Podiatric
Medicine and acting within his or her scope of practice, 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 in-person patient
examination and evaluation of the patient's condition and, if
indicated, testing by the physician and surgeon or podiatrist. 
   (b) The conditions in  paragraphs (1), (2), and (3)
  paragraph (4)  of subdivision (a) do not apply to
a physical therapist when  he or she is only  
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.   services rendered to a
patient who directly accessed the services of a physical therapist.
 
   (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 notice to the patient, orally and in writing, in at
least 14-point type and signed by the patient: 

   Direct Physical Therapy Treatment Services 

   You are receiving direct physical therapy treatment services from
an individual 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 up to 45 calendar 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, or from a person
holding a certificate to practice podiatric medicine from the
California Board of Podiatric Medicine and acting within his or her
scope of practice, a dated signature on the physical therapist's plan
of care indicating approval of the physical therapist's plan of care
and that an in-person patient examination and evaluation was
conducted by the physician and surgeon or podiatrist.  
   ________________________Patient's Signature/Date 
   SEC. 4.   SEC. 5.   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 bloodborne 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 bloodborne 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 bloodborne
infectious diseases.
   (m) The commission of verbal abuse or sexual harassment.
   (n) Failure to comply with the provisions of Section 2620.1.
   SEC. 6.    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:   corporation. This section does  
not limit employment by a professional corporation designated in
this section of only those licensed professionals listed under each
subdivision. Any person duly licensed under the Business and
Professions Code, the Chiropractic Act, or the Osteopathic Act may be
employed to render professional services by a professional
corporation designated in this section. 
   (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.
   (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.
   (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 therapists.  
   (7) Licensed audiologists.  
   (8) Registered nurses.  
   (9) Licensed psychologists.  
   (10) Licensed physician assistants. 
   SEC. 5.   SEC. 7.   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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