BILL ANALYSIS                                                                                                                                                                                                    Ó







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        |Hearing Date:April 29, 2013        |Bill No:SB                         |
        |                                   |198                                |
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                      SENATE COMMITTEE ON BUSINESS, PROFESSIONS 
                               AND ECONOMIC DEVELOPMENT
                          Senator Curren D. Price, Jr., Chair
                                           

                          Bill No:        SB 198Author:Price
                     As Amended:April 25, 2013          Fiscal:Yes

        
        SUBJECT:   Physical Therapy Board of California.
        
        SUMMARY:  Reorganizes, revises, recasts and updates the Physical  
        Therapy Practice Act. 

        Existing law:
        
        1)Establishes the Physical Therapy Practice Act (Act) which provides  
          for the licensing and regulation of physical therapists (PTs) and  
          physical therapist assistants (PTAs) by the Physical Therapy Board  
          of California (PTB).  (Business and Professions Code (BPC) § 2600 et  
          seq.)

        2)Subjects the PTB to review by the appropriate policy committees of  
          the Legislature and sunsets the PTB on January 1, 2014.  (BPC §  
          2602)

        3)Specifies that the PTB shall consist of seven members and that not  
          more than one member shall be appointed from the full-time faculty  
          of any university, college, or other educational institution.  (BPC  
          § 2604)

        4)Specifies that the public members of the PTB shall be appointed from  
          persons having all of the following qualifications:  (BPC § 2604.5)

           a)   Be a citizen of California.
           b)   Shall not be an officer or faculty member of any college,  
             school or institution engaged in physical therapy education.
           c)   Shall not be a licentiate of the Medical Board of California  
             or any other health-related board.





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        5)Provides that the PTB shall do all of the following:

           a)   Evaluate the qualification of applicants for licensure.  (BPC  
             § 2634)
           b)   Provide for the examinations of PTs and PTAs and establish a  
             passing score for each examination.  (BPC § 2636)
           c)   Issue all licenses for the practice of physical therapy in  
             California.  (BPC §§ 2609, 2632)
           d)   Suspend and revoke licenses, and otherwise enforce the  
             provisions of the Act.
           (BPC § 2609)

        6)Provides that the PTB may employ such clerical assistants and other  
          employees as it may deem necessary to carry out the powers and  
          duties, and may as necessary select and contract with physical  
          therapy consultants to assist it in its programs on an intermittent  
          basis and may contract with these consultants on a sole source  
          basis.  However, such consultants shall be considered as public  
          employees.  (BPC § 2607)

        7)Provides that notice of each meeting of the PTB shall be given in  
          accordance with the Bagley-Keene Open Meeting Act.  (BPC § 2612)

        8)Defines the scope of practice for PTs.  (BPC § 2620)

        9)Requires a PT to document his or her evaluation, goals, treatment  
          plan, and summary of treatment in the patient record, and to also  
          include the care actually provided and to sign the patient record  
          and maintain patient records for no less than seven years or  
          otherwise as specified.  (BPC § 2620.7)

        10)Provides that nothing shall be construed in the Act to authorize a  
          PT to practice medicine, surgery, or any other form of healing  
          except as authorized under the PTs scope of practice.  (BPC § 2621)

        11)Provides for the supervision of PTAs as specified.  (BPC § 2655.2)

        12)Specifies the requirements for a person to use the title as  
          "physical therapy assistant" and for the approval of PTA education  
          programs by the PTB.  (BPC §§ 2655.3, 2655.7, 2655.71, 2655.8,  
          2655.9, 2655.91, 2655.93 and 2655.11)

        13)Specifies licensure exemptions for students performing physical  
          therapy in a course of study.  (BPC §§ 2650.2, 2655.75)






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        14)Provides for specific examination requirements for a PT or PTA from  
          another state or territory.  (BPC § 2636.5)

        15)Allows a graduate of an approved PT education program who has filed  
          an application with the PTB to perform as a "PT license applicant"  
          under the supervision of a licensed PT pending results of their PT  
          examination.  (BPC § 2639)

        16)Provides for the renewal requirements and exemptions of a PT and  
          PTA.  (BPC §§ 2683, 2684, 2685)

        17)Specifies education and curriculum requirements for a PT.  (BPC §  
          2650) 

        18)Provides that the PTB shall approve those PT education programs  
          that prove to the satisfaction of the PTB that they comply with the  
          minimum PT educational requirements as approved by the PTB, and  
          provides that those education programs that are accredited by the  
          Commission on Accreditation in Physical Therapy Education (CAPTE) of  
          the American Physical Therapy Association (APTA) shall be deemed  
          approved by the PTB unless the PTB determines otherwise.  (BPC §  
          2651)

        19)Provides that an applicant who has been issued a diploma by a PT  
          education program that is not approved by the PTB and is not located  
          in the United States shall meet other specified requirements.  (BPC  
          § 2653)

        20)Specifies grounds for unprofessional conduct and for the PTB to  
          suspend, revoke, or impose probationary conditions upon a licensee.   
          (BPC § 2660)

        21)Establishes a Diversion Program under the PTB and provides that the  
          PTB shall seek ways and means to identify and rehabilitate PTs and  
          PTAs whose competency is impaired due to abuse of dangerous drugs or  
          alcohol so that they may be treated and returned to practice of  
          physical therapy in a manner which will not endanger the public  
          health and safety.
        (BPC §§ 2662, 2663, 2664, 2665. 2666, 2667, 2668 and 2669)

        This bill:

        1)Reorganizes and recasts the Act, eliminates redundant and outdated  
          provisions, updates and clarifies numerous provisions, makes other  
          technical and conforming changes, and renumbers various sections  
          within the Act.





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        2)Clarifies and reorganizes defined terms including the "board,"  
          "psysiotherapy," "physical therapist," physical therapist assistant"  
          and redefines "physical therapist technician" to be equivalent to a  
          "physical therapy aide."

        3)Clarifies and reorganizes provisions regarding the qualifications of  
          professional and public members.

        4)Clarifies and reorganizes provisions regarding board member  
          appointing authority and specific appointments.

        5)Clarifies and reorganizes provisions regarding the following:

           a)   Qualification of applicants for licensure.
           b)   Examinations of physical therapists and physical therapist  
             assistants.
           c)   Issuing licenses for the practice of physical therapy in  
             California.
           d)   Suspending and revoking licenses, and otherwise enforcing the  
             provisions of the Act.

        6)Provides that the PTB shall do the following:

           a)   Administer a continuing competency program.
           b)   Participate in Federation of State Boards of Physical Therapy  
             meetings.
           c)   Publish a newsletter.
           d)   Provide timely orientation and training to new board  
             appointees.
           e)   Adopt and administer a program of education in matters  
             relevant to the regulation of physical therapy.

        7)Clarifies for purposes of selecting physical therapy consultants  
          that the PTB may enter into contracts to enforce the Act.

        8)Provides additional authority for the PTB to employ individuals to  
          fill specified positions, and allow the PTB to fix compensation for  
          these positions and services.

        9)Clarifies that all enforcement proceedings, including those related  
          to probationary restrictions, are governed by the Government Code.

        10) Specifies the number of times the PTB may meet and that four  
          members of the PTB shall constitute a quorum.






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        11)Clarifies that the PTB shall comply with the Bagley-Keene Open  
          Meeting Act.

        12)Revises and clarifies the scope of practice for PTs.

        13)Conforms the requirements for maintaining patient records with  
          regulations adopted by the PTB, and grants authority to the PTB to  
          establish other requirements as necessary.

        14)Provides that the Act does not authorize a PT to  diagnose disease  ,  
          practice medicine, surgery, or any other form of healing except as  
          authorized under the PTs scope of practice.

        15)Provides that a PT shall be responsible for managing all aspects of  
          the care of each patient as set forth in regulation and the  
          supervision of physical therapist assistants and aides, as  
          specified.

        16)Authorizes the PTB by regulation to prescribe, amend, or repeal any  
          rules contained within the code of professional conduct appropriate  
          to the establishment and maintenance of integrity and dignity in the  
          profession of physical therapy and provides that every licensee  
          shall be governed and controlled by the rules and standards adopted  
          by the PTB. 

        17)Clarifies and conforms the requirements for a licensed physical  
          therapy assistant and supervision of assistants with current  
          regulations of the PTB.

        18)Clarifies and conforms the requirements for an unlicensed physical  
          therapy aide and supervision of aides with current regulations of  
          the PTB.

        19)Adds authority for the PTB to provide for licensure exemptions for  
          specific purposes for a limited period of time for physical  
          therapists or physical therapist assistants from another  
          jurisdiction of the United States, from another country, or in  
          consultation with a licensed physical therapist within California.

        20)Grants general authority for the PTB to establish specific  
          application and licensure requirements in regulation.

        21)Allows for the PTB to define what a "complete application" is in  
          regulation and adds requirements for the supervision of a PT or PTA  
          applicant, and adds other requirements applicable to the license for  
          which is being applied.





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        22)Reorganizes and consolidates renewal requirements and exemptions or  
          waivers for renewal and provides regulatory authority for the PTB to  
          define a completed renewal application.

        23)Specifies education requirements for both PTs and PTAs and provides  
          that curriculum requirements shall be those as prescribed by the  
          CAPTE of the APTA or the Accreditation Council of Canadian  
          Physiotherapy (ACCP) and shall include a combination of didactic and  
          clinical experiences; clinical experience shall include at least 18  
          weeks of full-time experience with a variety of patients.

        24)Provides that the PTB shall approve those PT  and PTA  education  
          programs that prove to the satisfaction of the PTB that they comply  
          with the minimum PT  or PTA  educational requirements as approved by  
          the PTB, and provides that those education programs that are  
          accredited by the CAPTE of the APTA  or the ACCP  shall be deemed  
          approved by the PTB unless the PTB determines otherwise.

        25)Provides that nothing shall prohibit the PTB from disapproving any  
          foreign PT or PTA educational program, or denying an applicant, if  
          in the opinion of the PTB, the instruction received was not  
          equivalent to that required under the Act.

        26)Reorganizes provisions related to licensing applicants who have  
          been issued a diploma by a PT education program that is not approved  
          by the PTB and is not located in the United States as long as they  
          meet other specified requirements and allows the PTB to establish  
          application requirements in regulation.

        27)Revises and specifies additional grounds for unprofessional conduct  
          and for the PTB to either cite, discipline, deny a license, suspend  
          or revoke a license, or impose probationary conditions upon a  
          licensee.

        28)Allows the PTB to issue a public letter of reprimand and to require  
          specified training or education for the licensee.

        29)Specifies that if a licensee fails or refuses to comply with a  
          request for medical records of a patient, that is accompanied by a  
          patient's written authorization for release of the records, within  
          15 days, shall pay to the PTB a civil penalty of $1,000 per day,  
          unless the licensee is unable to provide the documents for good  
          cause.  

        30)Provides that the PTB is within the jurisdiction of the Health  





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          Quality Enforcement Section of the Attorney General and the Medical  
          Quality Hearing Panel of the Office of Administrative Hearings.

        31)Renames the "Diversion Program" as the "Substance Abuse  
          Rehabilitation Program" and makes conforming name changes.

        FISCAL EFFECT:  Unknown.  This bill is keyed "fiscal" by Legislative  
        Counsel.

        COMMENTS:
        
        1.Purpose.  The PTB is the sponsor of this measure.  According to the  
          PTB, in response to public and licensee concerns that the Physical  
          Therapy Practice Act was complex and difficult to use, the PTB  
          established the Physical Therapy Practice Act Review Task Force  
          (Task Force) in 2004.  The Task Force was charged with reviewing the  
          Act for accuracy and currency.  The Task Force referenced the Model  
          Practice Act developed by the Federation of State Boards of Physical  
          Therapy (FSBPT) and the American Physical Therapy Association's  
          (APTA) revised Guide to Physical Therapist Practice in developing  
          the proposed revisions to recommend to the PTB.

        The Task Force was comprised of various individual licensees and  
          representatives from the California Physical Therapy Association  
          (CPTA), as well as PTB staff and legal counsel.  As noted, the CPTA  
          was involved in drafting the proposed revisions initially, and  
          recently has stated it supports the updated proposed revisions.  In  
          addition to collaboration with the profession, the PTB also  
          exercised all available efforts to ensure public access.  The PTB  
          conducted all business regarding the proposed revisions in a public  
          forum.  Therefore, Task Force meetings were public and noticed as  
          such, and discussions and decisions, including adoption of all  
          versions of the proposed revisions to the Act, occurred at meetings  
          publically noticed in accordance with the Bagley-Keene Open Meeting  
          Act.  The PTB also opens all agenda items for public comment at  
          every meeting, and, within the last few years, webcasts meetings and  
          posts all meeting materials online, including the proposed revisions  
          to the Act.

        The proposed revisions that were adopted by the PTB primarily  
          reorganize the provisions within the Act for clarity, and clean-up  
          outdated provisions.  Consequently, the proposed revisions need to  
          be taken together as they are intended to coincide; if some of the  
          proposed revisions are taken without the others, in most cases, this  
          may result in duplicative or lost provisions.






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        2.Background.  
        
           a)   Physical Therapy Board of California.  The Physical Therapy  
             Practice Act (Act) was established in 1953, Chapter 1823 (AB 17)  
             and Chapter 1826 (AB 1001), Statutes of 1953, creating the  
             Physical Therapy Examining Committee (PTEC) under the auspices of  
             the Medical Board of California (MBC).  The Physical Therapy  
             Practice Act mandates the regulation of physical therapy by the  
             Physical Therapy Examining Committee.  A "practice act"  
             safeguards the public by regulating a defined scope of practice  
             vs. a "title act" which merely restricts action to revoking a  
             title with no restriction of practice.

             The evolution of PTECs' structure is as follows:  1953, PTEC was  
             comprised of three physical therapists, one physician, and one  
             public member; 1968, increased its physical therapist member  
             positions from three to four with one physician and one public  
             member remaining; and, in 1976, changed to three professional and  
             three public members eliminating the physician member position.   
             Chapter 991, Statutes of 1998 (SB 1980) again increased the  
             number of PT members by one for a total of seven members.   The  
             current composition of the Board remains as four PT members and  
             three public members  .  As a result of the 1997 sunset review  
             legislation, one of the PT member's is required to be involved in  
             the education of physical therapists.  The Governor appoints all  
             professional members as well as one public member; the Senate  
             Rules Committee appoints one public member; and the Speaker of  
             the Assembly appoints one public member.  The Board meets about  
             four times per year.  All Board meetings are subject to the  
             Bagley-Keene Open Meeting Act. 

             Initially, the PTEC regulated two forms of licensure; one  
             required PTs to work under the direction of a physician, while  
             the other permitted PTs to work independently.  Chapter 1284,  
             Statutes of 1968 (SB 1006) unified the two forms of licensure  
             resulting in the PT license.  This licensure permitted all PTs to  
             work independently. 

             Beginning in 1971, PTs were authorized to utilize assistive  
             personnel if properly supervised by a PT.  That same year PTAs  
             became licensed and were permitted to assist in the practice of  
             physical therapy under the supervision of a licensed PT.   
             However, PTAs did not gain title protection until 1997.  In 1973,  
             PTs were also granted authority to utilize the services of a  
             physical therapy aide, an unlicensed person who performs patient  
             related tasks under the direct and immediate supervision of a PT.





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             Several legislative amendments occurred between 1971 and 1996  
             transferring administrative oversight previously designated to  
             the Medical Board to the PTEC.  One of those amendments, Chapter  
             829, Statutes of 1996 (AB 3473), renamed the "Physical Therapy  
             Examining Committee" the "Physical Therapy Board of California." 

             The PTB took steps to remove itself from the oversight of the  
             Medical Board.  In 2004 the PTB began utilizing the services of  
             the Department of Consumer Affair's Division of Investigation  
             (DOI) and subsequently absorbed its own probation monitoring  
             responsibilities.  In 2007, the PTB, through a budget change  
             proposal, was authorized staff for its cashiering function.

             The PTB protects the public from the incompetent, unprofessional,  
             and fraudulent practice of physical therapy.  The mission of the  
             PTB is to promote and protect the interests of the people of  
             California by the effective and consistent administration and  
             enforcement of the Act.  To meet this mission, the PTB does the  
             following:

                   Promotes legal and ethical standards of professional  
               conduct.
                   Conducts background checks for all applicants.
                   Promotes a national examination reflective of the current  
               practice of physical therapy, in addition to a jurisprudence  
               examination focused specifically on the laws and regulations of  
               the State.
             "      Licenses PTs, and PTAs, and provides certification to  
               qualified licensees to perform electromyography.
                   Investigates complaints on PTs, PTAs, and unlicensed  
               physical therapy practice.
                   Takes disciplinary action and issues citations when  
               appropriate.
                   Conducts various outreach activities to provide the  
               public, licensees, and potential licenses the most  
               comprehensive and current information.
                   Routinely develops a Strategic Plan to establish goals and  
               objectives for the PTBC. 

             The PTB regulates approximately  21,863  active PT licensees and  
              5,381  active PTA licensees.  The Board has issued over 40,000 PT  
             licenses and over 10,000 PTA licenses since its inception.  The  
             active licensee population has stayed somewhat constant for the  
             past four years.  






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             The requirements for licensure as a PT generally includes  
             graduation from a professional degree program of an accredited  
             postsecondary institution or institutions approved by the PTB and  
             passing a national physical therapy examination and an  
             examination provided by the PTB to test the knowledge of the laws  
             and regulations related to the practice of physical therapy in  
             California (California Law Examination).  The requirements for  
             licensure as a PTA includes graduation from a PTA education  
             program approved by the PTB, or have training or experience or a  
             combination of training and experience which in the opinion of  
             the PTB is equivalent to that obtained in an approved educational  
             program, and successfully passing an examination provided by the  
             PTB.  As for out-of-state and foreign applicants, the PTB has  
             wide discretion in determining whether the applicant's education  
             and training qualifies the applicant to become licensed in  
             California.  They must determine whether the training and/or  
             education is either equal to or greater than that provided in  
             California and that the examination taken by the applicant is  
             comparable to the (national) examination required in California.   
             They must also pass the California Law Examination.  A PTA must  
             be under the supervision of a PT and a PT may generally not  
             supervise more than two PTAs unless the PTB determines otherwise.  
              A PT may also utilize the services of one aide engaged in  
             patient-related tasks to assist the PT in his or her practice  
             under specified conditions.

             The PTB ensures continuing competency by requiring continuing  
             competency hours.  This program began October 31, 2010.   
             Continuing competency hours must be obtained in subjects related  
             to either the professional practice of physical therapy or  
             patient/client management.

           a)   Physical Therapy Practice.  Physical therapy provides services  
             to individuals and populations, from pediatric to geriatric, to  
             develop, maintain and restore maximum movement and functional  
             ability.  This includes providing services in circumstances where  
                                                                                    movement and function are threatened by aging, injury, diseases,  
             disorders, conditions or environmental factors.  Functional  
             movement is crucial to maintaining a healthy body. 

           Physical therapy is concerned with identifying and maximizing  
             quality of life and movement potential within the spheres of  
             promotion, prevention, treatment/intervention, habilitation and  
             rehabilitation.  This encompasses physical, psychological,  
             emotional, and social well-being.  Physical therapy involves the  
             interaction between the PT, patients/clients, other health  





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             professionals, families, care givers and communities in a process  
             where movement potential is assessed and goals are agreed upon,  
             using knowledge and skills unique to PTs.

           PTs are qualified and professionally required to:

                   Undertake a comprehensive examination/assessment of the  
               patient/client or needs of a client group. 
                   Evaluate the findings from the examination/assessment to  
               make clinical judgments regarding patients/clients. 
                   Formulate a prognosis and treatment plan. 
                   Provide consultation within their expertise and determine  
               when patients/clients need to be referred to another health  
               care professional. 
                   Implement a physical therapist intervention/treatment  
               program. 
                   Determine the outcomes of any interventions/treatments.
                   Make recommendations for self-management. 

             The PT's extensive knowledge of the body and its movement needs  
             and potential is central to determining strategies for  
             intervention.  The practice settings will vary according to  
             whether the physical therapy is concerned with health promotion,  
             prevention, treatment/intervention, habilitation or  
             rehabilitation.

             Physical therapy is an essential part of the health and  
             community/welfare services delivery systems.  PTs practice  
             independently of other health care service providers and also  
             within interdisciplinary rehabilitation/habilitation programs  
             that aim to prevent movement disorders or maintain/restore  
             optimal function and quality of life in individuals with movement  
             disorders.

           b)   Review of the Physical Therapy Board.  In 2013, this  
             Committee conducted oversight hearings to review 14 regulatory  
             boards within the Department of Consumer Affairs.  The Committee  
             began its review of these licensing agencies in March and  
             conducted three days of hearings.  The PTB was last reviewed by  
             the former Joint Legislative Sunset Review Committee (JLSRC) in  
             2005.  At that time, the JLSRC identified 10 issues for  
             discussion.  On November 1, 2011, the PTBC submitted its  
             required Sunset Report to this Committee.  However, because of  
             an audit of the PTB, which was to be completed by the Bureau of  
             Audits in 2012, it was decided to put over the review of the PTB  
             until the audit was finalized.  The PTB provided an update and  





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             addendum to its original report to this Committee on December 1,  
             2012.  In its 2011 report and its 2012 addendum the PTB  
             described actions it had taken (including both regulatory and  
             legislative) since its last sunset review.
           
           The PTB also indicated both in its report to this Committee and  
             during its review the need to revise the Physical Therapy  
             Practice Act.  According to the PTB, some of the proposed  
             revisions have been codified; however, the PTB attempted each  
             year, since 2006, to get all the revisions of the Act introduced  
             without success.  The PTB continued to pursue this issue because  
             the PTB believed that the Act is such a crucial document, and as  
             a consumer agency, it is essential for consumers to easily  
             access and understand the functions of the PTB; the scope and  
             qualifications of PTs and PTAs; the requirements and  
             restrictions of the profession; and, the consequences for  
             violating the Act.  Moreover, the PTB stated, consumers also  
             benefit from licentiates having a clear understanding of the  
             Act.

             The PTB outlined the revisions to the Act as follows:

                   Overall reorganizes, clarifies and updates current  
               statute.
                   Explicitly states the responsibilities of the Board.
                   Specifically defines terms directly related to physical  
               therapy care providers and clarifies the scope in plain  
               English. 
                   Adds who may qualify for licensure exemptions and defines  
               the requirements of each qualifying method.
                   Removes all specific details of the licensing, renewal and  
               documentation requirements and processes with the intent of  
               moving them to regulation.
                   Adds license renewal exemptions for specified  
               circumstances.
                   Adds authority for the Board to determine ethical  
               standards.
                   Clearly defines specific violations which constitute  
               unprofessional conduct.
                   Provides authority for the Board to impose a fee on  
               approval agencies to support the Continuing Competency Services  
               program. 
                   Adds the authority for the Board to impose a fine for  
               licensees refusing to produce records requested by the Board.
                   Adds the Board to the list of agencies under the  
               jurisdiction of the Department of Justice Health Quality  





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               Enforcement Section.
                   Removes authority relating to physical therapy from the  
               Medical Practice Act
                   Adds authority to impose a condition requiring additional  
               training and/or education when issuing a public letter of  
               reprimand.
                   Replaces the term "diversion" with "substance abuse  
               rehabilitation program" to accurately describe the PTBC's  
               program, which does not divert from discipline. 

             It was recommended that the revisions to the Physical Therapy  
             Practice Act should be included in a separate bill so that the  
             continuation of the PTB in a sunset bill will not be jeopardized  
             if there is any controversy surrounding changes to the Practice  
             Act.  It was also stated that the PTB should assure the  
             Committee that all concerned individuals and interested parties  
             have had an opportunity to express any concerns regarding the  
             changes proposed to the Act and have been addressed, to the  
             extent possible, by the PTB.

        1.Related Legislation.   SB 306  (Price, 2013).  Extends until January  
          1, 2018, the provisions establishing the State Board of Chiropractic  
          Examiners, Speech Language Pathology and Audiology and Hearing Aid  
          Dispensers Board, the Physical Therapy Board of California, and the  
          California Board of Occupational Therapy and extends the terms of  
          the executive officers of the  Physical Therapy Board of California   
          and the Speech Language Pathology and Audiology and Hearing Aid  
          Dispensers Board.  This bill also subjects the boards to be reviewed  
          by the appropriate policy committees of the Legislature.  (  Note  :   
          This bill will also be heard before the BP&ED Committee during  
          today's hearing)

         2.Policy Issue  :  Revisions Regarding Scope of Practice for Physical  
          Therapists.  The PTB has indicated that in its changes to the scope  
          of practice provision for PTs (BPC § 2620) that it is clarifying the  
          scope language and not its content.  In other words, this is not to  
          be considered as an expansion of practice for PTs.  The PTB stated  
          that the language is confusing for consumers as well as licensees  
          and that the proposed revisions make this provision consistent with  
          the FSBPT's Model.  Section 2620 as amended reads as follows:

             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,  





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             and resistive exercise, and shall include physical therapy  
             evaluation, treatment planning, instruction and consultative  
             services. 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.  
              
             Physical therapy includes all of the following:  
              (a) Examining, evaluating, and testing persons with mechanical,  
             physiological, and developmental impairments, functional  
             limitations, and disabilities or other health and  
             movement-related conditions in order to develop a plan of  
             therapeutic intervention.
             (b) Alleviating impairments, functional limitations, and  
             disabilities by designing, implementing, and modifying  
             therapeutic interventions that may include, but are not limited  
             to, therapeutic exercise; functional training in self-care and  
             in-home, community, or work integration or reintegration; manual  
             therapy; therapeutic massage; prescription, application, and, as  
             appropriate, fabrication of assistive, adaptive, orthotic,  
             prosthetic, protective, and supportive devices and equipment;  
             airway clearance techniques; integumentary protection and repair  
             techniques; debridement and wound care; physical agents or  
             modalities; mechanical and electrical therapeutic modalities; and  
             patient-related instruction.
             (c) Reducing the risk of injury, impairment, functional  
             limitation, and disability.
             (d) Promoting and maintaining physical fitness to enhance the  
             bodily movement-related health and wellness of individuals  
             through the use of physical therapy interventions. 
               (b) 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.
         
          The prohibition regarding  diagnosis of a disease  by a PT was  
          provided in amendments to Section 2621: 

             2621.  Nothing in this chapter shall be construed as authorizing   
              This chapter does not authorize  a physical therapist to  diagnose  





                                                                         SB 198
                                                                         Page 15



             disease  , practice medicine, surgery, or any other form of healing  
             except as authorized by § 2620.

           The Author has indicated that if there are concerns with the changes  
          to § 2620 by other health professional groups, that § 2620 will be  
          removed from the bill until such concerns can be addressed.
           

        SUPPORT AND OPPOSITION:
        
         Support:  

        Physical Therapy Board of California (Sponsor)

         Opposition:  

        None on file as of April 24, 2013.



        Consultant:  Bill Gage