By Carter                                             H.B. No. 2426
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the practice of physical therapy.
    1-3        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-4        SECTION 1.  Article 4512e, Revised Statutes, is amended to
    1-5  read as follows:
    1-6        Article 4512e.  Board of Physical Therapy Technician
    1-7  Examiners
    1-8        Sec. 1.  In this Act:
    1-9              (1)  "Physical therapy" means a form of health care
   1-10  that prevents, identifies, corrects, and alleviates acute or
   1-11  prolonged movement dysfunction or pain of anatomic or physiologic
   1-12  origin.  Physical therapy includes the testing and measurement of
   1-13  the function of the musculoskeletal, neurological, pulmonary, and
   1-14  cardiovascular systems and rehabilitative treatment concerned with
   1-15  the restoration of function and prevention of disability caused by
   1-16  illness, injury, or birth defect.  Physical therapy includes
   1-17  treatment, consultative, educational, and advisory services for the
   1-18  purpose of reducing the incidence and severity of disability and
   1-19  pain to enable, train, or retrain an individual to perform the
   1-20  independent skills and activities of daily living.   Physical
   1-21  therapy also includes the delegation of selective forms of
   1-22  treatment to supportive personnel with retention by a physical
   1-23  therapy technician <therapist> of the responsibilities for the care
    2-1  of the patient and continuing direction and supervision of the
    2-2  supportive personnel.  The use of manipulation, use of roentgen
    2-3  rays and radium for diagnostic and therapeutic purposes, and the
    2-4  use of electricity for surgical purposes, including cauterization,
    2-5  are not authorized under the term "physical therapy" as used
    2-6  herein, and a license issued hereunder shall not authorize the
    2-7  diagnosis of diseases or the practice of medicine as defined by
    2-8  law.
    2-9              (2)  "Physical therapy technician" <therapist> means a
   2-10  person who practices physical therapy and is licensed by the Texas
   2-11  Board of Physical Therapy Examiners.  <"Hydrotherapist,"
   2-12  "physiotherapist," "mechano-therapist," "functional therapist,"
   2-13  "physical therapy practitioner,"> "Physical <physical> therapy
   2-14  technician <therapist> specialist," <"physical therapy specialist,"
   2-15  "physiotherapy practitioner," "kinesiotherapist,"> "physical
   2-16  rehabilitation specialist," and "myofunctional therapist" are
   2-17  equivalent terms; any derivation of the above terms or any
   2-18  reference to any one of them in this Act includes the others.
   2-19              (3)  "Physical therapy technician <therapist>
   2-20  assistant" means a person licensed by the Texas Board of Physical
   2-21  Therapy Examiners who assists and is supervised by a licensed
   2-22  physical therapy technician <therapist> in the practice of physical
   2-23  therapy and whose activities require an understanding of physical
   2-24  therapy.
   2-25              (4)  "Physical therapy technician aide" <or "physical
    3-1  therapy technician"> means a person who aids in the practice of
    3-2  physical therapy under the on-site supervision of a physical
    3-3  therapy technician <therapist or a physical therapist assistant>
    3-4  and whose activities require on-the-job training.
    3-5              (5)  "Board" means the Texas Board of Physical Therapy
    3-6  Technician Examiners.
    3-7              (6)  "Discipline" means the revocation or suspension of
    3-8  a license, the placing on probation of a licensee, the reprimand of
    3-9  a licensee, the levying of fines, or other actions imposed on the
   3-10  licensee or other person for a violation of this Act and rules
   3-11  adopted by the board.
   3-12              (7)  "Practice of physical therapy" means:
   3-13                    (A)  performing, offering to perform, or
   3-14  attempting to perform health care that prevents, identifies,
   3-15  corrects, and alleviates acute or prolonged movement dysfunction or
   3-16  pain of anatomic or physiologic origin, the proper application of
   3-17  which requires education, training, and experience in physical
   3-18  therapy; or
   3-19                    (B)  publicly professing to be or holding oneself
   3-20  out to be a physical therapy technician <therapist> or as providing
   3-21  physical therapy.
   3-22              (8)  "Physical therapy facility" is a physical site,
   3-23  such as a building, office, or protable facility, where the
   3-24  practice of physical therapy takes place.  A physical therapy
   3-25  facility must be under the direction of a physical therapy
    4-1  technician <therapist> licensed by the board and meet any
    4-2  additional requirements as may be established by the board.
    4-3              (9)  "Accredited program" means a physical therapy
    4-4  educational program that is currently accredited by the Commission
    4-5  on Accreditation in Physical Therapy Education and is associated
    4-6  with an institution of higher education.
    4-7              (10)  "Person" means an individual, a partnership, an
    4-8  association of individuals, or a corporation.
    4-9        Sec. 2.  (a)  There is created a Texas Board of Physical
   4-10  Therapy Technician Examiners.  The board's purpose is to regulate
   4-11  the practice of physical therapy in this state to safeguard the
   4-12  health and welfare of the public.  The board shall consist of nine
   4-13  members appointed by the governor with the advice and consent of
   4-14  the senate for staggered terms of six years.  Six members must be
   4-15  licensed physical therapy technicians <therapists> and three
   4-16  members must be members of the general public.  Two of the physical
   4-17  therapy technicians <therapists> members' terms and one of the
   4-18  public members' terms end on January 31 of each odd-numbered year.
   4-19        (b)  A vacancy on the board shall be filled by appointment by
   4-20  the governor with the advice and consent of the senate for the
   4-21  remainder of the term.
   4-22        (c)  Appointments to the board shall be made without regard
   4-23  to the race, creed, sex, religion, disability, age, or national
   4-24  origin of the appointees.
   4-25        (d)  A member of the board is not liable to civil action for
    5-1  any act performed in good faith in the execution of the member's
    5-2  duties in this capacity.
    5-3        Sec. 2A.  A member of the board is entitled to a per diem as
    5-4  set by the General Appropriations Act for each day that the member
    5-5  engages in the business of the board.  A member may not receive any
    5-6  reimbursement for travel expenses, including expenses for meals and
    5-7  lodging, other than transportation expenses as provided by the
    5-8  General Appropriations Act.
    5-9        Sec. 2B.  A person is not eligible for appointment as a
   5-10  public member of the board if the person or the person's spouse:
   5-11              (1)  is registered, certified, or licensed by an
   5-12  occupational regulatory agency in the field of health care;
   5-13              (2)  is employed by or participates in the management
   5-14  of a business entity or other organization regulated by the
   5-15  executive council or the board or receiving funds from the
   5-16  executive council or the board;
   5-17              (3)  owns or controls, directly or indirectly, more
   5-18  than a 10 percent interest in a business entity or other
   5-19  organization regulated by the executive council or the board or
   5-20  receiving funds from the executive council or the board; or
   5-21              (4)  uses or receives a substantial amount of tangible
   5-22  goods, services, or funds from the executive council or the board,
   5-23  other than compensation or reimbursement authorized by law for
   5-24  executive council or board membership, attendance, or expenses.
   5-25        Sec. 2C.  (a)  An officer, employee, or paid consultant of a
    6-1  Texas trade association in the field of health care may not be a
    6-2  board member.
    6-3              (b)  A person who is the spouse of an officer, manager,
    6-4  or paid consultant of a Texas trade association in the field of
    6-5  health care may not be a board member.
    6-6              (c)  For the purposes of this section, a Texas trade
    6-7  association is a nonprofit, cooperative, and voluntarily joined
    6-8  association of business or professional competitors in this state
    6-9  designed to assist its members and its industry or profession in
   6-10  dealing with mutual business or professional problems and in
   6-11  promoting their common interest.
   6-12        Sec. 2D.  A person may not serve as a board member if the
   6-13  person is required to register as a lobbyist under Chapter 305,
   6-14  Government Code, and its subsequent amendments, because of the
   6-15  person's activities for compensation on behalf of a profession
   6-16  related to the operation of the board.
   6-17        Sec. 2E.  (a)  It is a ground for removal from the board if a
   6-18  member:
   6-19              (1)  does not have at the time of appointment the
   6-20  qualifications required by Section 2(a) of this Act;
   6-21              (2)  does not maintain during service on the board the
   6-22  qualifications required by Section 2(a) of this Act;
   6-23              (3)  violates a prohibition established by Section 2C
   6-24  or 2D of this Act;
   6-25              (4)  cannot discharge the member's duties for a
    7-1  substantial part of the term for which the member is appointed
    7-2  because of illness or disability; or
    7-3              (5)  is absent from more than half of the regularly
    7-4  scheduled board meetings that the member is eligible to attend
    7-5  during a calendar year unless the absence is excused by majority
    7-6  vote of the board.
    7-7        (b)  The validity of an action of the board is not affected
    7-8  by the fact that it is taken when a ground for removal of a board
    7-9  member exists.
   7-10        (c)  If the coordinator of physical therapy programs has
   7-11  knowledge that a potential ground for removal exists, the
   7-12  coordinator shall notify the presiding officer of the board of the
   7-13  ground.  The presiding officer shall then notify the governor that
   7-14  a potential ground for removal exists.
   7-15        Sec. 2F.  (a)  The board may request the executive council to
   7-16  assign administrative and clerical employees as necessary to carry
   7-17  out the board's functions.
   7-18        (b)  The board shall develop and implement policies that
   7-19  clearly define the respective responsibilities of the board and the
   7-20  staff of the executive council.
   7-21        Sec. 2G.  Except as provided by other statutes, the board
   7-22  shall administer and enforce this Act.
   7-23        Sec. 2H.  The board shall prepare information of public
   7-24  interest describing the functions of the board and the board's
   7-25  procedures by which complaints are filed with and resolved by the
    8-1  board.  The board shall make the information available to the
    8-2  public and appropriate state agencies.
    8-3        Sec. 2I.  The board shall develop and implement policies that
    8-4  provide the public with a reasonable opportunity to appear before
    8-5  the board and to speak on any issue under the jurisdiction of the
    8-6  board.
    8-7        Sec. 2J.  The board shall prepare and maintain a written plan
    8-8  that describes how a person who does not speak English can be
    8-9  provided reasonable access to the board's programs.  The board
   8-10  shall also comply with federal and state laws for program and
   8-11  facility accessibility.
   8-12        Sec. 2K.  (a)  The board shall establish a training program
   8-13  for the members of the board.
   8-14        (b)  Before a member of the board may assume the member's
   8-15  duties, the member must complete at least one course of the
   8-16  training program established under this section.
   8-17        (c)  A training program established under this section shall
   8-18  provide information to a participant regarding:
   8-19              (1)  the enabling legislation that created the board to
   8-20  which the member is appointed;
   8-21              (2)  the programs operated by the agency;
   8-22              (3)  the role and functions of the agency;
   8-23              (4)  the rules of the agency with an emphasis on the
   8-24  rules that relate to disciplinary and investigatory authority;
   8-25              (5)  the current budget for the agency;
    9-1              (6)  the results of the most recent formal audit of the
    9-2  agency;
    9-3              (7)  the requirements of the:
    9-4                    (A)  open meetings law, Chapter 271, Acts of the
    9-5  60th Legislature, Regular Session, 1967 (Article 6252-17, Vernon's
    9-6  Texas Civil Statutes), and its subsequent amendments;
    9-7                    (B)  open records law, Chapter 424, Acts of the
    9-8  63rd Legislature, Regular Session, 1973 (Article 6252-17a, Vernon's
    9-9  Texas Civil Statutes), and its subsequent amendments; and
   9-10                    (C)  Administrative Procedure and Texas Register
   9-11  Act (Article 6252-13a, Vernon's Texas Civil Statutes) and its
   9-12  subsequent amendments;
   9-13              (8)  the requirements of the conflict of interest laws
   9-14  and other laws relating to public officials; and
   9-15              (9)  any applicable ethics policies adopted by that
   9-16  state agency or the Texas Ethics Commission.
   9-17        (d)  In developing the training requirements provided for in
   9-18  this section, the board shall consult with the governor's office,
   9-19  the attorney general's office, and the Texas Ethics Commission.
   9-20        (e)  In the event that another state agency or entity is
   9-21  given the authority to establish the training requirements, the
   9-22  board shall allow that training in lieu of developing its own
   9-23  program.
   9-24        Sec. 2L.  The board is subject to:
   9-25              (1)  the open meetings law, Chapter 271, Acts of the
   10-1  60th Legislature, Regular Session, 1966 (Article 6252-17, Vernon's
   10-2  Texas Civil Statutes), and its subsequent amendments; and
   10-3              (2)  the Administrative Procedure and Texas Register
   10-4  Act (Article 6252-13a, Vernon's Texas Civil Statutes) and its
   10-5  subsequent amendments.
   10-6        Sec. 2M.  The Texas Board of Physical Therapy Technician
   10-7  Examiners is subject to Chapter 325, Government Code (Texas Sunset
   10-8  Act), and its subsequent amendments.  Unless continued in existence
   10-9  as provided by that chapter, the board is abolished and this Act
  10-10  expires September 1, 2005.
  10-11        Sec. 3.  (a)  The board shall examine applicants for licenses
  10-12  at least once each year at such reasonable places and times as
  10-13  shall be designated by the board in its discretion.
  10-14        (b)  The examination shall cover those subjects generally
  10-15  taught by accredited programs and may include the content areas of
  10-16  clinical decision-making and evaluation, treatment program planning
  10-17  and implementation, administration, education, consultation, and
  10-18  research in physical therapy.
  10-19        (c)  Not later than the 30th day after the date a licensing
  10-20  examination is administered under this Act, the board shall notify
  10-21  each examinee of the results of the examination.   However, if an
  10-22  examination is graded or reviewed by a national testing service,
  10-23  the board shall notify each examinee of the results of the
  10-24  examination not later than the 14th day after the date the board
  10-25  receives the results from the testing service.  If the notice of
   11-1  the examination results graded or reviewed by a national testing
   11-2  service will be delayed for more than 90 days after the examination
   11-3  date, the board shall notify each examinee of the reason for the
   11-4  delay before the 90th day.
   11-5        (d)  The board by rule may establish procedures for the
   11-6  administration of the examination, including the conditions under
   11-7  which and the number of times an applicant may retake an
   11-8  examination.
   11-9        (e)  The board shall have the written portion of the
  11-10  examination, if any, validated by an independent testing entity.
  11-11        (f)  If requested in writing by a person who fails a
  11-12  licensing examination administered under this Act, the board shall
  11-13  furnish the person with an analysis of the person's performance on
  11-14  the examination.
  11-15        (g) to (l)  Deleted by Acts 1993, 73rd Leg., ch. 352, Sec.
  11-16  2.03, eff.  Sept. 1, 1993.
  11-17        (m)  The board may request and, if necessary, compel by
  11-18  subpoena the attendance of witnesses for examination under oath and
  11-19  the production for inspection and copying of books, accounts,
  11-20  records, papers, correspondence, documents, and other evidence
  11-21  relevant to the investigation of alleged violations of this Act.
  11-22  If a person fails to comply with a subpoena issued under this
  11-23  subsection, the board, acting through the attorney general, may
  11-24  file suit to enforce the subpoena in a district court in Travis
  11-25  County or in the county in which a hearing conducted by the board
   12-1  may be held.  The court, if it determines that good cause exists
   12-2  for the issuance of the subpoena, shall order compliance with the
   12-3  requirements of the subpoena.  Failure to obey the order of the
   12-4  court may be punished by the court as contempt.
   12-5        Sec. 4.  (a)  The members of the board shall, on appointment,
   12-6  elect from their number a presiding officer, secretary, and other
   12-7  officers required for the conduct of business.  Special meetings of
   12-8  the board shall be called by the presiding officer and secretary,
   12-9  acting jointly, or on the written request of any two members.  The
  12-10  board may adopt bylaws and rules necessary to govern its
  12-11  proceedings and to implement the purposes of this Act.
  12-12        (b)  The secretary shall keep a record of each meeting of the
  12-13  board and maintain a register containing the names of all physical
  12-14  therapy technicians <therapists> licensed under this Act, which
  12-15  shall be at all times open to public inspection.  On March 1 of
  12-16  each year, the coordinator of physical therapy programs shall
  12-17  transmit an official copy of the list of the licensees to the
  12-18  executive council and the secretary of state for permanent record,
  12-19  a certified copy of which shall be admissible as evidence in any
  12-20  court of this state.
  12-21        (c)  The board shall assist the proper legal authorities in
  12-22  the prosecution of all persons violating any provisions of this
  12-23  Act.
  12-24        Sec. 6.  (a)  This Act does not restrict a licensee of
  12-25  another state agency from performing health-care services within
   13-1  the scope of the applicable licensing act if:
   13-2              (1)  the licensee does not represent to others that the
   13-3  licensee is a physical therapy technician <therapist> and does not
   13-4  use the term "physical therapy," "physical therapy technician,"
   13-5  <therapist> "physiotherapy," "physiotherapist," "licensed physical
   13-6  therapy technician," <therapist> "registered physical therapy
   13-7  technician," <therapist> or assistant thereto, or the letters
   13-8  "PTT," "PhT," "LPTT" or "RPTT" or any derivative of those terms in
   13-9  connection with the licensee's name or practice; and
  13-10              (2)  the licensee practices strictly in conformity with
  13-11  applicable laws and regulations relating to the licensure and
  13-12  observes all prohibitions of Section 7 of this Act.
  13-13        (b)  This Act does not apply to:
  13-14              (1)  a physical therapy technician aide;
  13-15              (2)  a physical therapy technician student or physical
  13-16  therapy technician <therapist> assistant student participating in
  13-17  an accredited physical therapy or physical therapy technician
  13-18  <therapist> assistant educational program if the student is under
  13-19  the supervision of a licensee under this Act; or a student
  13-20  participating in an accredited allied health science program
  13-21  leading to licensure by another state agency if the student is
  13-22  under the supervision of properly licensed, certified, or
  13-23  registered personnel;
  13-24              (3)  a physical therapy technician <therapist> doing
  13-25  special projects in patient care while working toward an advanced
   14-1  degree from an accredited college or university; or
   14-2              (4)  a physical therapy technician <therapist> who does
   14-3  not live in this state and is licensed by the appropriate
   14-4  authorities who comes into this state to attend educational
   14-5  activities.  The duration of this exemption shall be no more than
   14-6  six months.
   14-7        Sec. 7.  (a)  A person may not practice physical therapy,
   14-8  offer to practice physical therapy, or in any way hold the person
   14-9  out as being able to practice physical therapy, including practice
  14-10  as a physical therapy technician <therapist> or physical therapy
  14-11  technician <therapist> assistant, unless the individual holds a
  14-12  valid license issued by the board under this Act.
  14-13        (b)  It is unlawful for any person or for any business, its
  14-14  employees, or other agents or representatives to use in connection
  14-15  with its name or business activity the words "physical therapy,"
  14-16  "physical therapy technician," <therapist> "physiotherapy,"
  14-17  "physiotherapist," "licensed physical therapy technician,"
  14-18  <therapist> "registered physical therapy technician," <therapist>
  14-19  or physical therapy technician <therapist> assistant or the letters
  14-20  "PTT," "PhT," "LPTT," "RPTT," or "PTTA" or any other words,
  14-21  letters, abbreviations, or insignia indicating or implying orally
  14-22  or in writing, in print or by sign, or in any other way, directly
  14-23  or by implication, that physical therapy is provided or supplied,
  14-24  or to extend or provide physical therapy services unless the
  14-25  services are provided by a physical therapy technician <therapist>
   15-1  licensed under this Act.
   15-2        (c)  It is a violation of this Act to advertise the ability
   15-3  to provide physical therapy unless the individual providing the
   15-4  physical therapy is licensed under this Act.
   15-5        (d)  It is a violation of this Act for an individual licensed
   15-6  by the board to violate the provisions of Section 161.091, Health
   15-7  and Safety Code.
   15-8        (e)  A violation of any provision of this section will
   15-9  subject the violator to the penalties of Section 18 of this Act.
  15-10        Sec. 8.  (a)  An applicant for a license as a physical
  15-11  therapy technician <therapist> must file a written application, on
  15-12  a form provided by the board, accompanied by an examination fee
  15-13  prescribed by the board, which is refundable if the applicant does
  15-14  not take the examination, and an application fee prescribed by the
  15-15  board, which is not refundable.  The applicant must present
  15-16  evidence satisfactory to the board that the applicant has completed
  15-17  an accredited program or equivalent program in physical therapy
  15-18  education. "Equivalent program" means that the applicant shall
  15-19  provide official documentation from a board-approved educational
  15-20  credentials review agency, certifying completion of a program
  15-21  equivalent to a Commission on Accreditation of Physical Therapy
  15-22  Education accredited program and completion of a minimum of 60
  15-23  academic semester credits or the equivalent from an accredited
  15-24  institution of higher learning.
  15-25        (b)  The board shall issue a license to each applicant who
   16-1  passes the examination, meets the qualifications prescribed by
   16-2  Subsection (a) of this section, and has not committed an act that
   16-3  constitutes grounds for denial of a license under Section 19 of
   16-4  this Act.
   16-5        (c)  The applicant must meet all other requirements and
   16-6  qualifications set forth by the board.
   16-7        Sec. 9.  (a)  An applicant for a physical therapy technician
   16-8  <therapist> assistant license must file a written application with
   16-9  the board, on a form provided by the board, accompanied by an
  16-10  examination fee prescribed by the board, which is refundable if the
  16-11  applicant does not take the examination, and an application fee
  16-12  prescribed by the board, which is not refundable.  The applicant
  16-13  must present evidence satisfactory to the board that the applicant
  16-14  has completed an accredited physical therapy technician <therapist>
  16-15  assistant program or an accredited physical therapy program,
  16-16  including courses in the anatomical, biological, and physical
  16-17  sciences, and clinical procedures as prescribed and approved by the
  16-18  board.
  16-19        (b)  The board shall issue a license to each applicant who
  16-20  passes the examination, meets the qualifications prescribed by
  16-21  Subsection (a) of this section, and has not committed an act that
  16-22  constitutes grounds for denial of a license under Section 19 of
  16-23  this Act.
  16-24        (c)  The applicant must meet all other requirements and
  16-25  qualifications established by the board.
   17-1        (d)  The board may grant licensure as a physical therapy
   17-2  technician <therapist> assistant to an individual who has not
   17-3  completed an accredited program for physical therapy technician
   17-4  <therapist> assistants if the individual meets all requirements of
   17-5  Section 8 of this Act and has had no disciplinary action in any
   17-6  other state or nation.
   17-7        Sec. 10.  (a)  The board may grant an provisional license to
   17-8  an applicant who presents proof of current licensure in another
   17-9  state, the District of Columbia, or territory of the United States
  17-10  that maintains professional standards considered by the board to be
  17-11  equivalent to those set forth in this Act.  An applicant for a
  17-12  provisional license under this section must:
  17-13              (1)  be licensed in good standing as a physical therapy
  17-14  technician <therapist> or physical therapy technician <therapist>
  17-15  assistant in another state, the District of Columbia, or a
  17-16  territory of the United States that has licensing requirements that
  17-17  are substantially equivalent to the requirements of this Act;
  17-18              (2)  have passed a national or other examination
  17-19  recognized by the board relating to the practice of physical
  17-20  therapy; and
  17-21              (3)  be sponsored by a person licensed by the board
  17-22  under this Act with whom the provisional licensee may practice
  17-23  under this section.
  17-24        (b)  An applicant for a provisional license may be excused
  17-25  from the requirement of Subsection (a)(3) of this section if the
   18-1  board determines that compliance with that subsection constitutes a
   18-2  hardship to the applicant.
   18-3        (c)  A provisional license is valid until the date the board
   18-4  approves or denies the provisional licensee's application for a
   18-5  license.  The board shall issue a license under this Act to the
   18-6  holder of a provisional license under this section if:
   18-7              (1)  the provisional licensee passes a jurisprudence
   18-8  examination, if required;
   18-9              (2)  the board verifies that the provisional licensee
  18-10  has the academic and experience requirements for a license under
  18-11  this Act; and
  18-12              (3)  the provisional licensee satisfies any other
  18-13  license requirements under this Act.
  18-14        (d)  The board must complete the processing of a provisional
  18-15  licensee's application for a license not later than the 180th day
  18-16  after the date the provisional license is issued.  The board may
  18-17  extend the 180-day limit if the results on an examination have not
  18-18  been received by the board.
  18-19        Sec. 10A.  Foreign-trained physical therapy technicians
  18-20  <therapists> or physical therapy technician <therapist> assistants
  18-21  shall satisfy the examination requirements of Section 8 or 9 of
  18-22  this Act.  The board shall require foreign-trained applicants to
  18-23  furnish proof of good moral character and completion of
  18-24  requirements substantially equal to those contained in Section 8 or
  18-25  9 of this Act before taking the examination.
   19-1        Sec. 11.  (a)  The board by rule may provide for the issuance
   19-2  of a temporary license.  A holder of a temporary license shall
   19-3  practice under the supervision of a licensed physical therapy
   19-4  technician <therapist>.  Rules adopted under this subsection shall
   19-5  include a time limit for a licensee to remain on temporary status.
   19-6        (b)  The board by rule may provide for a person who holds a
   19-7  license under this Act to be placed on inactive status.  Rules
   19-8  adopted under this subsection shall include a time limit for a
   19-9  licensee to remain on inactive status.
  19-10        Sec. 12.  (a)  A licensed physical therapy technician
  19-11  <therapist> may use the title "Physical Therapy Technician
  19-12  <Therapist>."   No other person may be so designated or permitted
  19-13  to use the term "Physical Therapy Technician <Therapist>."  The
  19-14  license as a physical therapy technician <therapist> does not
  19-15  authorize the use of any affix indicating or implying that the
  19-16  licensed person is a physician.
  19-17        (b)  A licensed physical therapy technician <therapist>
  19-18  assistant may use the title "Physical Therapy Technician
  19-19  <Therapist> Assistant."  No other person may be so designated or
  19-20  permitted to use the term "Physical Therapy Technician <Therapist>
  19-21  Assistant."   The license as a physical therapy technician
  19-22  <therapist> assistant does not authorize the use of any affix
  19-23  indicating or implying that the licensed person is a physician.
  19-24        Sec. 13.  (a)  An applicant who fails to pass a one-part
  19-25  examination or any part or parts of a divided examination given by
   20-1  the board may take another one-part examination or the part or
   20-2  parts of the divided examination that he failed on payment of an
   20-3  additional examination fee.
   20-4        (b)  On the failure of an applicant to pass a second or
   20-5  subsequent examination, the board, shall require him to complete
   20-6  additional courses of study designated by the board, in which case
   20-7  the applicant shall be required to present to the board
   20-8  satisfactory evidence of having completed the required additional
   20-9  courses before taking subsequent examinations and shall pay
  20-10  additional fees equal to the fee required for filing the original
  20-11  application.
  20-12        (c)  If requested in writing by a person who fails the
  20-13  licensing examination administered under this Act, the board shall
  20-14  furnish the person with an analysis of the person's performance on
  20-15  the examination.
  20-16        Sec. 14.  (a)  Each licensee under this Act shall display his
  20-17  license and renewal certificate in a conspicuous place in the
  20-18  principal office where he practices physical therapy.
  20-19        (b)  There shall at all times be prominently displayed in the
  20-20  place of business of each licensee under this Act a sign containing
  20-21  the name, mailing address, and telephone number of the board and a
  20-22  statement informing consumers that complaints against licensees can
  20-23  be directed to the board.
  20-24        Sec. 15.  (a)  A license issued under this Act expires two
  20-25  years after the date of issuance.
   21-1        (b)  A person may renew an unexpired license by paying to the
   21-2  executive council before the expiration date of the license the
   21-3  required renewal fee.
   21-4        (c)  If a person's license has been expired for 90 days or
   21-5  less, the person may renew the license by paying to the executive
   21-6  council the required renewal fee and a fee that is one-half of the
   21-7  examination fee for the license.
   21-8        (d)  If a person's license has been expired for more than 90
   21-9  days but less than one year, the person may renew the license by
  21-10  paying to the executive council all unpaid renewal fees and a fee
  21-11  that is equal to the examination fee for the license.
  21-12        (e)  If a person's license has been expired for one year or
  21-13  more, the person may not renew the license.  The person may obtain
  21-14  a new license by submitting to reexamination and complying with the
  21-15  requirements and procedures for obtaining an original license.
  21-16  However, the board may renew without examination an expired license
  21-17  of a person who was licensed in this state, moved to another state,
  21-18  and is currently licensed and has been in practice in the other
  21-19  state for the two years preceding application.  The person must pay
  21-20  to the executive council a fee that is equal to the examination fee
  21-21  for the license.
  21-22        (f)  At least 30 days before the expiration of a person's
  21-23  license, the executive council shall send written notice of the
  21-24  impending license expiration to the person at the licensee's last
  21-25  known address according to the records of the executive council.
   22-1        Sec. 16.  The board may adopt a system under which licenses
   22-2  expire on various dates during the year.  For the year in which the
   22-3  license expiration date is changed, license fees payable on the
   22-4  date of issuance shall be prorated on a monthly basis so that each
   22-5  licensee shall pay only that portion of the license fee that is
   22-6  allocable to the number of months during which the license is
   22-7  valid.  On renewal of the license on the new expiration date, the
   22-8  total license renewal fee is payable.
   22-9        Sec. 16A.  (a)  The board by rule shall adopt requirements
  22-10  for mandatory continuing education for licensees under this Act in
  22-11  subjects pertaining to the practice of physical therapy.  The board
  22-12  by rule shall establish a minimum number of hours of continuing
  22-13  education required to renew a license.  The board ma assess the
  22-14  continuing education needs of licensees and may require licensees
  22-15  to attend continuing education courses specified by the board.  The
  22-16  board by rule shall develop a process to evaluate and approve
  22-17  continuing education courses.
  22-18        (b)  The board shall identify the key factors for the
  22-19  competent performance by a licensee of the licensee's professional
  22-20  duties.  The board shall adopt a procedure to assess a licensee's
  22-21  participation and performance in continuing education programs.
  22-22        Sec. 17.  The board ma recommend to the executive council
  22-23  reasonable and necessary fees for licenses issued or services
  22-24  performed under this Act so that the fees, in the aggregate,
  22-25  produce sufficient revenue to cover the cost of administering this
   23-1  Act.  The board may not recommend a fee to the executive council
   23-2  for an amount less than the amount of that fee on September 1,
   23-3  1993.
   23-4        Sec. 18.  (a)  A person who knowingly or intentionally
   23-5  violates a provision of this Act commits a Class A misdemeanor.
   23-6        (b)  Each day of violation constitutes a separate offense.
   23-7        (c)  The attorney general, a district attorney, a county
   23-8  attorney, or any other person or any group of persons may institute
   23-9  injunction proceedings or any other proceedings to enforce this Act
  23-10  and to enjoin or restrain a physical therapy technician <therapist>
  23-11  assistant, or any other person from the practice of physical
  23-12  therapy without having complied with this Act.  A physical therapy
  23-13  technician <therapist>, physical therapy technician <therapist>
  23-14  assistant, or any other person found by a court of competent
  23-15  jurisdiction to have violated a provision of this Act shall forfeit
  23-16  to the State of Texas the sum of $200 per day as a penalty for each
  23-17  day's violation, the sums to be recovered in a suit by the attorney
  23-18  general, a district attorney, a county attorney, or any other
  23-19  person or any group of persons.  A person other than the attorney
  23-20  general, a district attorney, or a county attorney who brings an
  23-21  action for injunction or to enforce this Act may recover his court
  23-22  costs and attorney's fees.
  23-23        Sec. 19.  (a)(1)  A license may be denied, or after hearing,
  23-24  suspended or revoked, or a licensee otherwise disciplined if the
  23-25  applicant or licensee has:
   24-1                    (A)  provided physical therapy to a person,
   24-2  except as provided by Subdivision (2) of this subsection, without
   24-3  the referral from a physician licensed to practice medicine by a
   24-4  state Board of Medical Examiners, or by a dentist licensed by a
   24-5  state Board of Dental Examiners, or a doctor licensed to practice
   24-6  chiropractic by a state Board of Chiropractic Examiners or a
   24-7  podiatrist licensed by a state Board of Podiatry Examiners, or by
   24-8  any other qualified, licensed health-care professional who within
   24-9  the scope of the professional licensure is authorized to refer for
  24-10  health care services.  The professional taking an action under this
  24-11  subdivision is a referring practitioner;
  24-12                    (B)  in the case of a physical therapy technician
  24-13  <therapist> assistant, treated a person other than under the
  24-14  direction of a licensed physical therapy technician <therapist>;
  24-15                    (C)  used drugs or intoxicating liquors to an
  24-16  extent that affects the licensee's or applicant's professional
  24-17  competence;
  24-18                    (D)  been convicted of a felony in this state or
  24-19  in any other state, territory, or nation; conviction as used in
  24-20  this subdivision includes a finding or verdict of guilty, an
  24-21  admission of guilt, or a plea of nolo contendere;
  24-22                    (E)  obtained or attempted to obtain a license by
  24-23  fraud or deception;
  24-24                    (F)  been grossly negligent in the practice of
  24-25  physical therapy or in acting as a physical therapy technician
   25-1  <therapist> assistant;
   25-2                    (G)  been adjudged mentally incompetent by a
   25-3  court of competent jurisdiction;
   25-4                    (H)  practiced physical therapy in a manner
   25-5  detrimental to the public health and welfare; or
   25-6                    (I)  had the licensee's or applicant's license to
   25-7  practice physical therapy revoked or suspended or had other
   25-8  disciplinary action taken against the licensee or applicant or had
   25-9  the licensee's or applicant's application for a license refused,
  25-10  revoked, or suspended by the proper licensing authority of another
  25-11  state, territory, or nation.
  25-12              (2)  A licensed physical therapy technician <therapist>
  25-13  may treat a patient for an injury or condition that was the subject
  25-14  of a prior referral if all of the following conditions are met:
  25-15                    (A)  the physical therapy technician <therapist>,
  25-16  within five business days, notifies the referring licensed
  25-17  physician, dentist, chiropractor, podiatrist, or other referring
  25-18  practitioner of the commencement of therapy;
  25-19                    (B)  for all episodes of physical therapy
  25-20  subsequent to that which was initiated by the referral, the
  25-21  physical therapy technician <therapist> treats the patient for not
  25-22  more than 20 treatment sessions or 30 consecutive calendar days,
  25-23  whichever occurs first, whereupon the physical therapy technician
  25-24  <therapist> must confer with the referring practitioner in order to
  25-25  continue the current episode of treatment; and
   26-1                    (C)  the physical therapy technician <therapist>
   26-2  commences any episode of treatment provided pursuant to this
   26-3  subsection within one year of the referral by the referring
   26-4  practitioner.
   26-5              (3)  No physical therapy technician <therapist> may
   26-6  provide treatment pursuant to Subdivision (2) of this subsection
   26-7  without having been licensed to practice physical therapy for at
   26-8  least one year and without satisfying other requirements set by the
   26-9  board.
  26-10              (4)  A licensed physical therapy technician <therapist>
  26-11  may provide physical assessments or instructions to an asymptomatic
  26-12  person without the referral of a referring practitioner.
  26-13              (5)  In emergency circumstances, including minor
  26-14  emergencies, a licensed physical therapy technician <therapist> may
  26-15  provide assistance to a person to the best of the technician's
  26-16  <therapist> ability without the referral of a referring
  26-17  practitioner. For the purposes of this subsection, "emergency
  26-18  circumstances" means instances where emergency medical care is
  26-19  called for. "Emergency medical care" means bona fide emergency
  26-20  services provided after the sudden onset of a medical condition
  26-21  manifesting itself by acute symptoms of sufficient severity,
  26-22  including severe pain, such that the absence of immediate medical
  26-23  attention could reasonably be expected to result in:
  26-24                    (A)  placing the patient's health in serious
  26-25  jeopardy;
   27-1                    (B)  serious impairment to bodily functions; or
   27-2                    (C)  serious dysfunction of any bodily organ or
   27-3  part.
   27-4        (b)  The board may not adopt rules restricting competitive
   27-5  bidding or advertising by a person regulated by the board except to
   27-6  prohibit false, misleading, or deceptive practices by the person.
   27-7  The board may not include in its rules to prohibit false,
   27-8  misleading, or deceptive practices by a person regulated by the
   27-9  board a rule that:
  27-10              (1)  restricts the person's use of any medium for
  27-11  advertising;
  27-12              (2)  restricts the person's personal appearance or use
  27-13  of his voice in an advertisement;
  27-14              (3)  relates to the size or duration of an
  27-15  advertisement by the person; or
  27-16              (4)  restricts the person's advertisement under a trade
  27-17  name.
  27-18        Sec. 20.  (a)  A person whose application for a licensee is
  27-19  denied is entitled to a hearing before the State Office of
  27-20  Administrative Hearings if the applicant submits a written request
  27-21  for a hearing to the board.
  27-22        (b)  Proceedings for the denial, suspension, or revocation of
  27-23  a license or for other discipline of a licensee and appeals from
  27-24  those proceedings are governed by the Administrative Procedure and
  27-25  Texas Register Act, as amended (Article 6252-13a, Vernon's Texas
   28-1  Civil Statutes).
   28-2        (c)  On application, the board may reissue a license to a
   28-3  person whose license has been revoked, but the application may not
   28-4  be made before the 180th day after the date the order of revocation
   28-5  became final, and the application must be made in the manner and
   28-6  form required by the board.
   28-7        (d)  On application, the board may issue a license to a
   28-8  person whose application for license has been denied, but the
   28-9  application may not be made prior to one year after the date of
  28-10  denial.
  28-11        Sec. 20A.  (a)  The board shall revoke or suspend a license,
  28-12  place on probation a licensee whose license has been suspended, or
  28-13  reprimand a licensee for a violation of this Act or a rule adopted
  28-14  by the board.
  28-15        (b)  If a license suspension is probated, the board may
  28-16  require the licensee to:
  28-17              (1)  report regularly to the board on matters that are
  28-18  the basis of the probation;
  28-19              (2)  limit practice to the areas prescribed by the
  28-20  board; or
  28-21              (3)  continue or review continuing professional
  28-22  education until the licensee attains a degree of skill satisfactory
  28-23  to the board in those areas that are the basis of the probation.
  28-24        (c)  The schedule of sanctions adopted by the board by rule
  28-25  shall be used by the State Office of Administrative Hearings for
   29-1  any sanction imposed as the result of a hearing conducted by that
   29-2  office.
   29-3        Sec. 21.  (a)  Fees received by the board under this Act
   29-4  shall be deposited in the State Treasury to the credit of the
   29-5  General Revenue Fund.
   29-6        (b)  The financial transactions of the board are subject to
   29-7  audit by the state auditor in accordance with Chapter 321,
   29-8  Government Code.
   29-9        (c)  On or before January 1 of each year, the board shall
  29-10  make in writing to the governor and the presiding officer of each
  29-11  house of the legislature a complete and detailed report accounting
  29-12  for all funds received and disbursed by the board during the
  29-13  preceding year.
  29-14        Sec. 22.  (a)  The board shall keep an information file about
  29-15  each complaint filed with the executive council and referred to the
  29-16  board.  The board's information file shall be kept current and
  29-17  contain a record for each complaint of:
  29-18              (1)  all persons contacted in relation to the
  29-19  complaint;
  29-20              (2)  a summary of findings made at each step of the
  29-21  complaint process;
  29-22              (3)  an explanation of the legal basis and reason for a
  29-23  complaint that is dismissed; and
  29-24              (4)  other relevant information.
  29-25        (b)  If a written complaint is received by the board that the
   30-1  board has authority to resolve, the board, at least as frequently
   30-2  as quarterly and until final disposition of the complaint, shall
   30-3  notify the parties to the complaint of the status of the complaint
   30-4  unless the notice would jeopardize an undercover investigation.
   30-5        (c)  The board by rule shall adopt a form to standardize
   30-6  information concerning complaints made to the board.  The board by
   30-7  rule shall prescribe information to be provided to a person when
   30-8  the person files a complaint received by the board.
   30-9        (d)  The board shall provide reasonable assistance to a
  30-10  person who wishes to file a complaint.
  30-11        Sec. 23.  (a)  The board shall adopt rules concerning the
  30-12  investigation of a complaint received by the board.  The rules
  30-13  adopted under this subsection shall:
  30-14              (1)  distinguish between categories of complaints;
  30-15              (2)  ensure that complaints are not dismissed without
  30-16  appropriate consideration;
  30-17              (3)  require that the board be advised of a complaint
  30-18  that is dismissed and that a letter be sent to the person who filed
  30-19  the complaint explaining the action taken on the dismissed
  30-20  complaint;
  30-21              (4)  ensure that the person who filed the complaint has
  30-22  an opportunity to explain the allegations made in the complaint;
  30-23              (5)  prescribe guidelines concerning the categories of
  30-24  complaints that require the use of a private investigator and the
  30-25  procedures for the board to obtain the services of a private
   31-1  investigator; and
   31-2              (6)  require the board to advise the executive council
   31-3  of complaints disposed of.
   31-4        (b)  The board shall dispose of all complaints in a timely
   31-5  manner.   The board shall establish a schedule for conducting each
   31-6  phase of a complaint that is under the control of the board not
   31-7  later than the 30th day after the date the complaint is received by
   31-8  the board.  The schedule shall be kept in the information file for
   31-9  the complaint and all parties shall be notified of the projected
  31-10  time requirements for pursuing the complaint.  A change in the
  31-11  schedule must be noted in the complaint information file and all
  31-12  parties to the complaint must be notified not later than the
  31-13  seventh day after the date the change is made.
  31-14        (c)  The coordinator of the physical therapy programs shall
  31-15  notify the board of a complaint that extends beyond the time
  31-16  prescribed by the board for resolving the complaint so that the
  31-17  board may take necessary action on the complaint.
  31-18        Sec. 24.  (a)  The board by rule shall adopt procedure
  31-19  governing:
  31-20              (1)  informal disposition of a contested case under
  31-21  Section 13(e), Administrative Procedure and Texas Register Act
  31-22  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
  31-23  subsequent amendments; and
  31-24              (2)  informal proceedings held in compliance with
  31-25  Section 18(c), Administrative Procedure and Texas Register Act
   32-1  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
   32-2  subsequent amendments.
   32-3        (b)  Rules adopted under this section must provide the
   32-4  complainant and the licensee an opportunity to be heard and must
   32-5  require the presence of a representative of the office of the
   32-6  attorney general or the board's legal counsel to advise the board
   32-7  or board's employees.
   32-8        Sec. 25.  The board by rule shall develop a system for
   32-9  monitoring licensees' compliance with the requirements of this Act.
  32-10  Rules adopted under this section shall include procedures for
  32-11  monitoring a licensee who is ordered by the board to perform
  32-12  certain acts to ascertain that the licensee performs the required
  32-13  acts and to identify and monitor licensees who represent a risk to
  32-14  the public.
  32-15        Sec. 26.  Certain functions relating to the administration of
  32-16  this Act are performed in accordance with Article 4512e-1, Revised
  32-17  Statutes.  To the extent of a conflict between this Act and Article
  32-18  4512e-1, Revised Statutes, this <that> article controls.
  32-19        Sec. 27.  (a)  The board by rule shall adopt requirements for
  32-20  the registration and renewal of a registration of a facility in
  32-21  which the practice of physical therapy is conducted.  A facility
  32-22  licensed under Subtitle B, Title 4, Health and Safety Code, is
  32-23  exempt from the requirements for registration in this section.
  32-24        (b)  If one or more facilities are owned by an individual,
  32-25  partnership, corporation, or other entity, the board may require
   33-1  only one application for the registration of all facilities.
   33-2        (c)  In accordance with Section 6 of this Act, the rules
   33-3  adopted under this section shall not prohibit a licensed individual
   33-4  from practicing in a facility within the scope of such individual's
   33-5  licensure.
   33-6        SECTION 2.  This Act takes effect on September 1, 1995.
   33-7        SECTION 3.  The importance of this legislation and the
   33-8  crowded condition of the calendars in both houses create an
   33-9  emergency and an imperative public necessity that the
  33-10  constitutional rule requiring bills to be read on three several
  33-11  days in each house be suspended, and this rule is hereby suspended,
  33-12  and that this Act take effect and be in force from and after its
  33-13  passage, and it is so enacted.