BILL NUMBER: AB 721	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 13, 2009

INTRODUCED BY   Assembly Member Nava
   (Coauthors: Assembly Members Adams, Chesbro, Emmerson, Galgiani,
Knight, Niello, and Silva)
   (  Coauthor:   Senator  
Walters   Coauthors:   Senators  
Strickland   and Walters  )

                        FEBRUARY 26, 2009

   An act to amend Section  2620   2660 of, and
to add Section 2620.1 to,  of the Business and Professions Code,
relating to physical therapists.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 721, as amended, Nava. Physical therapists:  scope of
practice.   direct access to services. 
   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 and 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," would authorize a physical therapist to initiate treatment
of conditions within the scope of physical therapist practice
  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,  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 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 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 2620.1 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, a person may initiate physical
therapy treatment directly from a licensed physical therapist
provided that the treatment is within the scope of practice of
physical therapists as defined in Section 2620, and that all 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, 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 disclose to the patient any
financial interest he or she has in treating the patient.
   (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.
   (b) The conditions in paragraphs (1), (2), and (3) of subdivision
(a) do not apply to a physical therapist when providing evaluation or
wellness physical therapy services to a patient as described in
subdivision (a) of Section 2620.
   (c) Nothing in this section shall be construed to 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) Nothing in this section shall be construed to require a health
care service plan or insurer to provide coverage for direct access
to treatment by a physical therapist. 
   SEC. 3.    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 blood-borne 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 blood-borne 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 blood-borne
infectious diseases.
   (m) The commission of verbal abuse or sexual harassment. 
   (n) Failure to comply with the provisions of Section 2620.1. 

  SECTION 1.    Section 2620 of the Business and
Professions Code is amended to read:
   2620.  (a) Physical therapy means examining, evaluating, and
testing a person with mechanical, physiological, and developmental
movement-related impairments, functional limitations, and
disabilities or other health and movement-related conditions in order
to develop a plan of therapeutic intervention and to initiate
treatment. Physical therapy is the art and science of physical or
corrective rehabilitation or of physical or corrective treatment of a
bodily or mental condition of a 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 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.

   (b) A physical therapist may initiate treatment of conditions
within the scope of practice of a physical therapist. If at any time,
the physical therapist has reason to believe that the patient he or
she is treating has signs or symptoms of a condition that requires
treatment or services beyond the scope of practice of a physical
therapist, 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 by a person licensed to practice dentistry, podiatric medicine,
or chiropractic.
   (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.   SEC. 4. 
   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.