Our review of certain practices of the Physical Therapy Board of California (physical therapy board) highlighted the following:
The Physical Therapy Board of California (physical therapy board) uses licensed physical therapists, known as expert consultants, to provide expert opinions when it investigates certain types of complaints. One of these expert consultants has served as the physical therapy board's in-house consultant since approximately 2003, performing cursory reviews of these complaints before the physical therapy board may refer them to other expert consultants in the field. Although this individual has served in this capacity for approximately nine years, the physical therapy board has not tried to hire a state employee to fulfill this function at a reduced cost. We believe that the physical therapy board may be able to save approximately $28,000 to $35,000 annually if it can hire a state physical therapy consultant at existing state rates to perform the same work as its current in-house consultant. Conversely, if the physical therapy board continues to pay for the services of its in-house consultant at the current contract rate of $75 per hour for another nine years, we estimate it will spend approximately $251,000 to $311,000 more than if it hires a state physical therapy consultant to perform the same services. The physical therapy board also lacks a process to formally evaluate its in-house or other expert consultants' performance, which limits its ability to demonstrate that it maximized the efficacy of the nearly $95,000 it spent on expert consultants in fiscal year 2010-11.
Board members and other designated employees can also compromise the physical therapy board's effectiveness if they do not receive proper training about their responsibilities, especially those related to conflicts of interest. For this reason, state law requires the board members to attend a board member orientation. State law also requires board members and other designated employees to attend ongoing ethics training. However, the Department of Consumer Affairs (Consumer Affairs) does not ensure that members of its boards participate in required board member orientation, nor does it ensure that board members and other employees designated in its conflict-of-interest code attend ethics training. Although all current members of the board have attended the board member orientation, Consumer Affairs was unable to demonstrate that two current board members, a former board member, and the former executive officer received all required ethics training. Consumer Affairs also has no records of whether another former board member, who is now a member of the Board of Behavioral Sciences, attended any ethics training or board member orientation while serving as a member of the physical therapy board. Consumer Affairs relies on its boards to ensure that board members and other designated employees attend training when required. However, Consumer Affairs retains ethics training certifications as well as the sign-in sheets for the board member orientations; therefore, we believe that Consumer Affairs is better suited than its boards to ensure that board members and other designated employees receive required training.
The Political Reform Act of 1974 (Political Reform Act) also requires employees designated in an agency's conflict-of-interest code, such as physical therapy board members, to disclose certain financial interests, which are specified in that code, in a document called a statement of economic interests, more commonly referred to as Form 700. The Political Reform Act requires each designated employee to file a Form 700 within 30 days of assuming or leaving office. However, two former board members submitted their Form 700s exceptionally late. Specifically, we found that one former board member submitted her Form 700 for assuming office over 130 days after the deadline, and another former board member submitted her Form 700 for leaving office more than a year late. When board members do not submit their Form 700s by the deadlines specified by law, the public and the board members themselves may be unaware of potential conflicts of interest that may disqualify the board members from dealing with particular issues that come before the board.
Our review does indicate that the physical therapy board appropriately investigates complaints and imposes discipline. We reviewed a total of 40 complaints lodged against physical therapy board licensees whom the physical therapy board investigated during fiscal years 2008-09 through 2010-11, and found that it followed the complaint process that it and Consumer Affairs established. In addition, we reviewed the physical therapy board's relationships with professional organizations and found these relationships to be reasonable and appropriate given its role in regulating the practice of physical therapy. Further, the physical therapy board's relationships with professional organizations are similar to those between other licensing boards and related professional organizations. Finally, we found the physical therapy board complies with the agenda, public-comment, and closed-session requirements of the Bagley-Keene Open Meeting Act.
The physical therapy board should explore the feasibility of establishing a state position to perform the duties of its current in-house consultant at a reduced cost.
To make certain that it provides effective services to consumers, the physical therapy board should develop a means of formally evaluating its expert consultants against performance measures and benchmarks. Furthermore, the physical therapy board should conduct these evaluations regularly and document them fully.
Consumer Affairs should establish procedures for ensuring that board members attend the board member orientation and that those individuals and other designated employees receive all required ethics training.
To ensure that board members disclose in a timely manner potential conflicts of interest on their Form 700s, the physical therapy board should notify Consumer Affairs' filing officer promptly when board members are appointed or when they indicate that they intend to leave office.
Consumer Affairs and the physical therapy board agree with our findings and recommendations and provided an overview of the steps they have recently taken or plan to take to implement the recommendations.