Amended in Assembly May 8, 2013

Amended in Assembly May 7, 2013

Amended in Assembly April 25, 2013

Amended in Assembly March 21, 2013

California Legislature—2013–14 Regular Session

Assembly BillNo. 1000


Introduced by Assembly Members Wieckowski and Maienschein

February 22, 2013


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

LEGISLATIVE COUNSEL’S DIGEST

AB 1000, as amended, Wieckowski. Physical therapists: direct access to 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 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 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 expressly add physical therapists and occupational therapists to the list of healing arts professionals who may be professional employees of a medical corporation or podiatry corporationbegin insert, and would add licensed physical therapists to the list of healing arts practitioners who may be shareholders, officers, or directors of a medical corporation or a podiatric medical corporationend insert. 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 professional 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:

P3    1

SECTION 1.  

The Legislature finds and declares that an
2individual’s access to early intervention to physical therapy
3treatment may decrease the duration of a disability, reduce pain,
4and lead to a quicker recovery.

5

SEC. 2.  

Section 2406 of the Business and Professions Code is
6amended to read:

7

2406.  

A medical corporation or podiatry corporation is a
8corporation that is authorized to render professional services, as
9defined in Section 13401 of the Corporations Code, so long as that
10corporation and its shareholders, officers, directors, and employees
11rendering professional services who are physicians and surgeons,
12psychologists, registered nurses, optometrists, podiatrists,
13chiropractors, acupuncturists, naturopathic doctors, physical
14therapists, occupational therapists, or, in the case of a medical
15corporation only, physician assistants, marriage and family
16therapists, clinical counselors, or clinical social workers, are in
17compliance with the Moscone-Knox Professional Corporation Act,
18the provisions of this article, and all other statutes and regulations
19now or hereafter enacted or adopted pertaining to the corporation
20and the conduct of its affairs.

21With respect to a medical corporation or podiatry corporation,
22the governmental agency referred to in the Moscone-Knox
23Professional Corporation Act is the board.

24

SEC. 3.  

Section 2406.5 is added to the Business and Professions
25Code
, to read:

P4    1

2406.5.  

When a physician and surgeon, podiatrist, or other
2referring practitioner refers a patient to receive services by a
3physical therapist employed by a professional corporation as
4defined in Section 13401 of the Corporations Code, the referring
5practitioner shall comply with Article 6 (commencing with Section
6650) of Chapter 1, and shall provide notice of the following to the
7patient, orally and in writing, in at least 14-point type and signed
8by the patient:

9(a) That the patient may seek physical therapy treatment services
10from a physical therapy provider of his or her choice who may not
11necessarily be employed by the medical or podiatry corporation.

12(b) If the patient chooses to be treated by an employed physical
13therapist, any financial interest the referring practitioner has in the
14corporation.

15

SEC. 4.  

Section 2620.1 is added to the Business and Professions
16Code
, to read:

17

2620.1.  

(a) In addition to receiving those services authorized
18by Section 2620, a person may initiate physical therapy treatment
19directly from a licensed physical therapist if the treatment is within
20the scope of practice of physical therapists, as defined in Section
212620, and all of the following conditions are met:

22(1) If, at any time, the physical therapist has reason to believe
23that the patient has signs or symptoms of a condition that requires
24treatment beyond the scope of practice of a physical therapist or
25the patient is not progressing toward documented treatment goals
26as demonstrated by objective, measurable, or functional
27improvement, the physical therapist shall refer the patient to a
28person holding a physician and surgeon’s certificate issued by the
29Medical Board of California or by the Osteopathic Medical Board
30of California or to a person licensed to practice dentistry, podiatric
31medicine, or chiropractic.

32(2) The physical therapist shall comply with Section 2633, and
33shall disclose to the patient any financial interest he or she has in
34treating the patient and, if working in a physical therapy
35corporation, shall comply with Article 6 (commencing with Section
36650) of Chapter 1.

37(3) With the patient’s written authorization, the physical
38therapist shall notify the patient’s physician and surgeon, if any,
39that the physical therapist is treating the patient.

P5    1(4) The physical therapist shall not continue treating the patient
2beyond 45 calendar days or 12 visits, whichever occurs first,
3without receiving, from a person holding a physician and surgeon’s
4certificate from the Medical Board of California or the Osteopathic
5Medical Board of California or from a person holding a certificate
6to practice podiatric medicine from the California Board of
7Podiatric Medicine and acting within his or her scope of practice,
8a dated signature on the physical therapist’s plan of care indicating
9approval of the physical therapist’s plan of care. Approval of the
10physical therapist’s plan of care shall include an in-person patient
11examination and evaluation of the patient’s condition and, if
12indicated, testing by the physician and surgeon or podiatrist.

13(b) The conditions in paragraph (4) of subdivision (a) do not
14apply to a physical therapist when he or she is only providing
15wellness physical therapy services to a patient as described in
16subdivision (a) of Section 2620.

17(c) This section does not expand or modify the scope of practice
18for physical therapists set forth in Section 2620, including the
19prohibition on a physical therapist diagnosing a disease.

20(d) This section does not require a health care service plan or
21insurer to provide coverage for services rendered to a patient who
22directly accessed the services of a physical therapist.

23(e) When a person initiates physical therapy treatment services
24directly, pursuant to this section, the physical therapist shall not
25perform physical therapy treatment services without first providing
26the following notice to the patient, orally and in writing, in at least
2714-point type and signed by the patient:

28

29Direct Physical Therapy Treatment Services

30

31You are receiving direct physical therapy treatment services
32from an individual who is a physical therapist licensed by the
33Physical Therapy Board of California.

34Under California law, you may continue to receive direct
35physical therapy treatment services for a period of up to 45 calendar
36days or 12 visits, whichever occurs first, after which time a physical
37therapist may continue providing you with physical therapy
38treatment services only after receiving, from a person holding a
39physician and surgeon’s certificate issued by the Medical Board
40of California or by the Osteopathic Medical Board of California,
P6    1or from a person holding a certificate to practice podiatric medicine
2from the California Board of Podiatric Medicine and acting within
3his or her scope of practice, a dated signature on the physical
4therapist’s plan of care indicating approval of the physical
5therapist’s plan of care and that an in-person patient examination
6and evaluation was conducted by the physician and surgeon or
7podiatrist.

8
9Patient’s Signature/Date

10

SEC. 5.  

Section 2660 of the Business and Professions Code is
11amended to read:

12

2660.  

The board may, after the conduct of appropriate
13proceedings under the Administrative Procedure Act, suspend for
14not more than 12 months, or revoke, or impose probationary
15conditions upon any license, certificate, or approval issued under
16this chapter for unprofessional conduct that includes, but is not
17limited to, one or any combination of the following causes:

18(a) Advertising in violation of Section 17500.

19(b) Fraud in the procurement of any license under this chapter.

20(c) Procuring or aiding or offering to procure or aid in criminal
21abortion.

22(d) Conviction of a crime that substantially relates to the
23qualifications, functions, or duties of a physical therapist or
24physical therapist assistant. The record of conviction or a certified
25copy thereof shall be conclusive evidence of that conviction.

26(e) Habitual intemperance.

27(f) Addiction to the excessive use of any habit-forming drug.

28(g) Gross negligence in his or her practice as a physical therapist
29or physical therapist assistant.

30(h) Conviction of a violation of any of the provisions of this
31chapter or of the Medical Practice Act, or violating, or attempting
32to violate, directly or indirectly, or assisting in or abetting the
33violating of, or conspiring to violate any provision or term of this
34chapter or of the Medical Practice Act.

35(i) The aiding or abetting of any person to violate this chapter
36or any regulations duly adopted under this chapter.

37(j) The aiding or abetting of any person to engage in the unlawful
38practice of physical therapy.

P7    1(k) The commission of any fraudulent, dishonest, or corrupt act
2that is substantially related to the qualifications, functions, or duties
3of a physical therapist or physical therapist assistant.

4(l) Except for good cause, the knowing failure to protect patients
5by failing to follow infection control guidelines of the board,
6thereby risking transmission of bloodborne infectious diseases
7from licensee to patient, from patient to patient, and from patient
8to licensee. In administering this subdivision, the board shall
9consider referencing the standards, regulations, and guidelines of
10the State Department of Public Health developed pursuant to
11Section 1250.11 of the Health and Safety Code and the standards,
12regulations, and guidelines pursuant to the California Occupational
13Safety and Health Act of 1973 (Part 1 (commencing with Section
146300) of Division 5 of the Labor Code) for preventing the
15transmission of HIV, hepatitis B, and other bloodborne pathogens
16in health care settings. As necessary, the board shall consult with
17the Medical Board of California, the California Board of Podiatric
18Medicine, the Dental Board of California, the Board of Registered
19Nursing, and the Board of Vocational Nursing and Psychiatric
20Technicians of the State of California, to encourage appropriate
21consistency in the implementation of this subdivision.

22The board shall seek to ensure that licensees are informed of the
23responsibility of licensees and others to follow infection control
24guidelines, and of the most recent scientifically recognized
25safeguards for minimizing the risk of transmission of bloodborne
26infectious diseases.

27(m) The commission of verbal abuse or sexual harassment.

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

29

SEC. 6.  

Section 13401.5 of the Corporations Code is amended
30to read:

31

13401.5.  

Notwithstanding subdivision (d) of Section 13401
32and any other provision of law, the following licensed persons
33may be shareholders, officers, directors, or professional employees
34of the professional corporations designated in this section so long
35as the sum of all shares owned by those licensed persons does not
36exceed 49 percent of the total number of shares of the professional
37corporation so designated herein, and so long as the number of
38those licensed persons owning shares in the professional
39corporation so designated herein does not exceed the number of
40persons licensed by the governmental agency regulating the
P8    1designated professional corporation. This section does not limit
2employment by a professional corporation designated in this section
3of only those licensed professionals listed under each subdivision.
4Any person duly licensed under the Business and Professions Code,
5the Chiropractic Act, or the Osteopathic Act may be employed to
6render professional services by a professional corporation
7designated in this section.

8(a) Medical corporation.

9(1) Licensed doctors of podiatric medicine.

10(2) Licensed psychologists.

11(3) Registered nurses.

12(4) Licensed optometrists.

13(5) Licensed marriage and family therapists.

14(6) Licensed clinical social workers.

15(7) Licensed physician assistants.

16(8) Licensed chiropractors.

17(9) Licensed acupuncturists.

18(10) Naturopathic doctors.

19(11) Licensed professional clinical counselors.

begin insert

20(12) Licensed physical therapists.

end insert

21(b) Podiatric medical corporation.

22(1) Licensed physicians and surgeons.

23(2) Licensed psychologists.

24(3) Registered nurses.

25(4) Licensed optometrists.

26(5) Licensed chiropractors.

27(6) Licensed acupuncturists.

28(7) Naturopathic doctors.

begin insert

29(8) Licensed physical therapists.

end insert

30(c) Psychological corporation.

31(1) Licensed physicians and surgeons.

32(2) Licensed doctors of podiatric medicine.

33(3) Registered nurses.

34(4) Licensed optometrists.

35(5) Licensed marriage and family therapists.

36(6) Licensed clinical social workers.

37(7) Licensed chiropractors.

38(8) Licensed acupuncturists.

39(9) Naturopathic doctors.

40(10) Licensed professional clinical counselors.

P9    1(d) Speech-language pathology corporation.

2(1) Licensed audiologists.

3(e) Audiology corporation.

4(1) Licensed speech-language pathologists.

5(f) Nursing corporation.

6(1) Licensed physicians and surgeons.

7(2) Licensed doctors of podiatric medicine.

8(3) Licensed psychologists.

9(4) Licensed optometrists.

10(5) Licensed marriage and family therapists.

11(6) Licensed clinical social workers.

12(7) Licensed physician assistants.

13(8) Licensed chiropractors.

14(9) Licensed acupuncturists.

15(10) Naturopathic doctors.

16(11) Licensed professional clinical counselors.

17(g) Marriage and family therapist corporation.

18(1) Licensed physicians and surgeons.

19(2) Licensed psychologists.

20(3) Licensed clinical social workers.

21(4) Registered nurses.

22(5) Licensed chiropractors.

23(6) Licensed acupuncturists.

24(7) Naturopathic doctors.

25(8) Licensed professional clinical counselors.

26(h) Licensed clinical social worker corporation.

27(1) Licensed physicians and surgeons.

28(2) Licensed psychologists.

29(3) Licensed marriage and family therapists.

30(4) Registered nurses.

31(5) Licensed chiropractors.

32(6) Licensed acupuncturists.

33(7) Naturopathic doctors.

34(8) Licensed professional clinical counselors.

35(i) Physician assistants corporation.

36(1) Licensed physicians and surgeons.

37(2) Registered nurses.

38(3) Licensed acupuncturists.

39(4) Naturopathic doctors.

40(j) Optometric corporation.

P10   1(1) Licensed physicians and surgeons.

2(2) Licensed doctors of podiatric medicine.

3(3) Licensed psychologists.

4(4) Registered nurses.

5(5) Licensed chiropractors.

6(6) Licensed acupuncturists.

7(7) Naturopathic doctors.

8(k) Chiropractic corporation.

9(1) Licensed physicians and surgeons.

10(2) Licensed doctors of podiatric medicine.

11(3) Licensed psychologists.

12(4) Registered nurses.

13(5) Licensed optometrists.

14(6) Licensed marriage and family therapists.

15(7) Licensed clinical social workers.

16(8) Licensed acupuncturists.

17(9) Naturopathic doctors.

18(10) Licensed professional clinical counselors.

19(l) Acupuncture corporation.

20(1) Licensed physicians and surgeons.

21(2) Licensed doctors of podiatric medicine.

22(3) Licensed psychologists.

23(4) Registered nurses.

24(5) Licensed optometrists.

25(6) Licensed marriage and family therapists.

26(7) Licensed clinical social workers.

27(8) Licensed physician assistants.

28(9) Licensed chiropractors.

29(10) Naturopathic doctors.

30(11) Licensed professional clinical counselors.

31(m) Naturopathic doctor corporation.

32(1) Licensed physicians and surgeons.

33(2) Licensed psychologists.

34(3) Registered nurses.

35(4) Licensed physician assistants.

36(5) Licensed chiropractors.

37(6) Licensed acupuncturists.

38(7) Licensed physical therapists.

39(8) Licensed doctors of podiatric medicine.

40(9) Licensed marriage and family therapists.

P11   1(10) Licensed clinical social workers.

2(11) Licensed optometrists.

3(12) Licensed professional clinical counselors.

4(n) Dental corporation.

5(1) Licensed physicians and surgeons.

6(2) Dental assistants.

7(3) Registered dental assistants.

8(4) Registered dental assistants in extended functions.

9(5) Registered dental hygienists.

10(6) Registered dental hygienists in extended functions.

11(7) Registered dental hygienists in alternative practice.

12(o) Professional clinical counselor corporation.

13(1) Licensed physicians and surgeons.

14(2) Licensed psychologists.

15(3) Licensed clinical social workers.

16(4) Licensed marriage and family therapists.

17(5) Registered nurses.

18(6) Licensed chiropractors.

19(7) Licensed acupuncturists.

20(8) Naturopathic doctors.

21(p) Physical therapy corporation.

22(1) Licensed physicians and surgeons.

23(2) Licensed doctors of podiatric medicine.

24(3) Licensed acupuncturists.

25(4) Naturopathic doctors.

26(5) Licensed occupational therapists.

27(6) Licensed speech-language therapists.

28(7) Licensed audiologists.

29(8) Registered nurses.

30(9) Licensed psychologists.

31(10) Licensed physician assistants.

32

SEC. 7.  

No reimbursement is required by this act pursuant to
33Section 6 of Article XIII B of the California Constitution because
34the only costs that may be incurred by a local agency or school
35district will be incurred because this act creates a new crime or
36infraction, eliminates a crime or infraction, or changes the penalty
37for a crime or infraction, within the meaning of Section 17556 of
38the Government Code, or changes the definition of a crime within
P12   1the meaning of Section 6 of Article XIII B of the California
2Constitution.



O

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