BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  SB 198
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          SENATE THIRD READING
          SB 198 (Lieu)
          As Amended  August 5, 2013
          Majority vote 

           SENATE VOTE  :39-0  
           
           BUSINESS & PROFESSIONS 13-0     APPROPRIATIONS      16-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Gordon, Jones, Bocanegra, |Ayes:|Gatto, Harkey, Bigelow,   |
          |     |Campos, Dickinson,        |     |Bocanegra, Bradford, Ian  |
          |     |Bonilla, Hagman, Holden,  |     |Calderon, Campos, Eggman, |
          |     |Maienschein, Mullin,      |     |Gomez, Hall, Holden,      |
          |     |Skinner, Ting, Wilk       |     |Linder, Pan, Quirk,       |
          |     |                          |     |Wagner, Weber             |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Reorganizes and recasts the Physical Therapy Act  
          (Act), eliminates redundant and outdated provisions, updates and  
          clarifies numerous provisions, makes other technical and  
          conforming changes, and renumbers various sections within the  
          Act.  Specifically,  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            outdated provisions, updates and clarifies numerous  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.

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

          3)Specifies that the members of the Physical Therapy Board (PTB)  
            shall consist of four physical therapists, only one of whom  
            shall be involved in physical therapy education, and three  
            public members. 

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

          5)Clarifies and reorganizes provisions regarding board member  








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            appointing authority and specific appointments.

          6)Clarifies and reorganizes provisions regarding the following:

             a)   Qualification of applicants for licensure;

             b)   Examinations of physical therapists (PTs) and physical  
               therapist assistants (PTAs);

             c)   Issuing licenses for the practice of physical therapy in  
               California; and,

             d)   Suspending and revoking licenses, and otherwise  
               enforcing the provisions of the Act.

          7)Requires the PTB to do the following:

             a)   Administer a continuing competency program;

             b)   Participate in Federation of State Boards of Physical  
               Therapy (FSBPT) meetings;

             c)   Publish a newsletter;

             d)   Provide timely orientation and training to new board  
               appointees; and,

             e)   Adopt and administer a program of education in matters  
               relevant to the regulation of physical therapy.

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

          9)Provides additional authority for PTB to employ an executive  
            officer and other individuals to fill specified positions, and  
            allow the PTB to fix compensation to be paid for services and  
            may incur other expenses as it may deem necessary.

          10)Specifies that the Attorney General shall act as legal  
            counsel for the PTB for any judicial and administrative  
            proceedings and his or her services shall be charged against  
            it.









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

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

          13)Requires that PTB comply with the Bagley-Keene Open Meeting  
            Act.

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

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

          16)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 PT's scope of practice.

          17)Requires a PT to be responsible for managing all aspects of  
            the care of each patient as set forth in regulation, and also  
            for the supervision of PTAs and aides, as specified.

          18)Authorizes 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 PTB. 

          19)Clarifies and conforms the requirements for a licensed PTA  
            and supervision of PTAs to current regulations of PTB.

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

          21)Adds authority for PTB to provide for licensure exemptions  
            for specific purposes for a limited period of time for PTs or  
            PTAs from another jurisdiction of the United States, from  
            another country, or in consultation with a licensed PT within  
            California.









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          22)Authorizes PTB to establish specific application and  
            licensure requirements in regulation.

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

          24)Specifies that a person having, in the opinion of the PTB,  
            training or experience or a combination of training and  
            experience equivalent to that obtained in an approved physical  
            therapist assistant education program and who meets specified  
            requirements, may apply for licensure as a physical therapist.

          25)Reorganizes and consolidates renewal requirements and  
            exemptions, or waivers for renewal.

          26)Specifies education requirements for both PTs and PTAs and  
            provides that curriculum requirements shall be those as  
            prescribed by the Commission on Accreditation in Physical  
            Therapy (CAPTE) 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.

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

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

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









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

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

          32)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, the licensee shall pay to PTB a civil  
            penalty of $1,000 per day, unless the licensee is unable to  
            provide the documents for good cause.  

          33)Clarifies that PTB is within the jurisdiction of the Health  
            Quality Enforcement Section of the Attorney General and the  
            Medical Quality Hearing Panel of the Office of Administrative  
            Hearings.

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

          35)Extends the sunset date on PTB to January 1, 2018. 

          36)States that no reimbursement is required by this bill  
            pursuant to Section 6 of Article XIIIB of the California  
            Constitution because the only costs that may be incurred by a  
            local agency or a school district will be incurred because  
            this bill 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 XIIIB of the California  
            Constitution. 


          37)Makes other technical and clarifying amendments.

           FISCAL EFFECT  :   According to Assembly Appropriations Committee:

          1)Approximately $100,000 annually for two years (Physical  
            Therapy Fund) for PTB to revise regulations.









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          2)Potential increased fee revenue of $15,000 annually to the  
            Physical Therapy Fund due to new authority to charge fees to  
            support existing activities related to approving agencies that  
            certify continuing competency courses.  

          3)Potential increased General Fund (GF) revenue in the tens of  
            thousands annually if PTB imposes civil fines for failure to  
            produce requested patient records under new fine authority  
            provided in this bill.

          4)The bill's expanded list of offenses constituting  
            unprofessional conduct increases the likelihood that  
            Department of Justice (DOJ) will incur costs related to  
            prosecution of proceedings against PTB licensees.  Costs are  
            unknown and depend on the number and complexity of any  
            proceedings.  The likelihood of significant costs is low.

          5)Annual fee-supported special fund costs associated with  
            continued operation of PTB of $3.3 million.

           COMMENTS  :   

           1)Purpose of this bill  .  This bill is a non-controversial  
            comprehensive overhaul of the Act.  This revision has been in  
            process since 2004 by PTB, stakeholders, and the public to  
            clarify, update, and align the Act with best practices.  This  
            bill is sponsored by the PTB.  

          2)Author's statement  .  According to the author, this bill  
            "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."  
                 
            3)PTB history  .  The Physical Therapy Examining Committee was  
            created in 1953 and became PTB in 1996.  The PTB is charged  
            with protecting the public from the incompetent,  
            unprofessional and criminal practice of physical therapy.  The  
            PTB underwent Sunset Review in 2013 and was found to be  
            functioning well.   

             The PTB consists of seven members (four PTs and three public  
            members), who serve four-year terms, with a maximum of two  
            terms. The PTB regulates approximately 21,863 active PT  








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            licensees and 5,381 active PTA licensees.  

            The PTB is funded through license and application fees, and  
            receives no General Fund monies.

           4)Act revision  .  According to PTB, in response to public and  
            licensee concerns that the Act was complex and difficult to  
            use, 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 that it supports  
            the updated proposed revisions.  In addition to collaboration  
            with the profession, PTB also exercised all available efforts  
            to ensure public access.  PTB conducted all business regarding  
            the proposed revisions in a public forum, opened all agenda  
            items for public comment at every meeting, and 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.


           Analysis Prepared by  :    Sarah Huchel / B.,P. & C.P. / (916)  
          319-3301 


                                                                FN: 0002146









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