BILL ANALYSIS Ó SB 198 Page 1 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SUMMARY : Reorganizes and recasts the Physical Therapy Act (Act), eliminates redundant and outdated provisions, updates and clarifies numerous provisions, makes other technical and conforming changes, and renumbers various sections within the Act. Specifically, this bill : 1)Reorganizes and recasts the Act, eliminates redundant and outdated provisions, updates and clarifies numerous provisions, makes other technical and conforming changes, and renumbers various sections within the Act. 2)Clarifies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 SB 198 Page 2 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. SB 198 Page 3 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. SB 198 Page 4 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. SB 198 Page 5 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. SB 198 Page 6 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 SB 198 Page 7 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 SB 198 Page 8