Bill Text: AZ SB1008 | 2015 | Fifty-second Legislature 1st Regular | Chaptered
Bill Title: Chiropractic board; licensure; regulation; fees
Spectrum: Partisan Bill (Republican 1-0)
Status: (Passed) 2015-04-01 - Chapter 134 RFE [SB1008 Detail]
Download: Arizona-2015-SB1008-Chaptered.html
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Senate Engrossed |
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State of Arizona Senate Fifty-second Legislature First Regular Session 2015
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CHAPTER 134
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SENATE BILL 1008 |
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AN ACT
Amending sections 32-904, 32-921, 32-922 and 32-922.02, Arizona Revised Statutes; amending title 32, chapter 8, article 2, Arizona Revised Statutes, by adding section 32-922.03; amending sections 32-923 and 32-924, Arizona Revised Statutes; relating to the state board of chiropractic examiners.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Section 32-904, Arizona Revised Statutes, is amended to read:
32-904. Powers and duties
A. The board may administer oaths, summon witnesses and take testimony on matters within its powers and duties.
B. The board shall:
1. Adopt a seal, which shall be affixed to licenses issued by the board.
2. Adopt rules which that are necessary and proper for the enforcement of this chapter.
3. Adopt rules regarding chiropractic assistants who assist a doctor of chiropractic, and the board shall determine the qualifications and regulation of chiropractic assistants who are not otherwise licensed by law.
4. At least once each fiscal year and before establishing the amount of a fee for the subsequent fiscal year, review the amount of each fee authorized in this chapter in a public hearing.
C. A copy of the rules shall be filed with the secretary of state upon adoption as provided by law.
Sec. 2. Section 32-921, Arizona Revised Statutes, is amended to read:
32-921. Application for license; qualifications of applicant; fee; background investigations
A. A person who wishes to practice chiropractic in this state shall submit a complete application to the board at least forty‑five days before the next scheduled examinations on a form and in the manner prescribed by the board.
B. To be eligible for an examination and licensure, the applicant shall:
1. Be a person of good character and reputation.
2. Be a graduate of a chiropractic college that both:
(a) Is accredited by or has status with the council on chiropractic education or is accredited by an accrediting agency recognized by the United States department of education or the council on postsecondary accreditation.
(b) Teaches a resident course of four years of not less than nine months each year, or the equivalent of thirty‑six months of continuous study, and that comprises not less than four thousand credit hours of resident study required to receive a degree of doctor of chiropractic (D.C.).
3. Be physically and mentally able to practice chiropractic skillfully and safely.
4. Have a certificate of attainment for part I and part II and a score of three hundred seventy‑five or more on part III or IV of the examination conducted by the national board of chiropractic examiners.
C. The board may refuse to give an examination or may deny licensure to an applicant who:
1. Fails to qualify for an examination or licensure under subsection B of this section.
2. Has had a license to practice chiropractic refused, revoked, suspended or restricted by a regulatory board in this or any other jurisdiction for any act that constitutes unprofessional conduct pursuant to this chapter.
3. Is currently under investigation by a regulatory board in this or any other jurisdiction for an act that constitutes unprofessional conduct pursuant to this chapter.
4. Has surrendered a license to practice chiropractic in lieu of disciplinary action by a regulatory board in this or any other jurisdiction for an act that constitutes unprofessional conduct pursuant to this chapter.
5. Has been convicted of criminal engaged in any conduct that constitutes grounds for disciplinary action pursuant to section 32‑924 or board rules.
D. On making application, the applicant shall pay to the executive director of the board a nonrefundable fee of two hundred fifty not more than three hundred twenty‑five dollars as established by the board. The board shall keep a register of all applicants and the result of each examination.
E. In order to determine an applicant's eligibility for examination and licensure, the board may require the applicant to submit a full set of fingerprints to the board. The board shall submit the fingerprints to the department of public safety for the purpose of obtaining a state and federal criminal records check pursuant to section 41‑1750 and Public Law 92‑544. The department of public safety may exchange this fingerprint data with the federal bureau of investigation. The board shall charge each applicant a fee that is necessary to cover the cost of the investigation. The board shall forward this fee to the department of public safety.
Sec. 3. Section 32-922, Arizona Revised Statutes, is amended to read:
32-922. Examinations; licensure
A. The examination for a license to practice chiropractic required of applicants shall be conducted at a time and place designated by the board at least semiannually. Each applicant to be examined shall first file a completed application found to be true and correct and shall be given at least twenty days' written notice of the time and place of the examination.
B. The examination shall be in English, practical in character and designed to include subjects that are necessary to ascertain the applicant's knowledge of and fitness to practice chiropractic safely and skillfully as authorized in this state. Examinations shall include material relating to chiropractors and Arizona jurisprudence and the following subjects as taught by accredited chiropractic colleges:
1. Anatomy.
2. Physiology.
3. Pathology.
4. Bacteriology.
5. Symptomatology.
6. Diagnosis, including physical, clinical, x‑ray and laboratory subjects.
7. Chiropractic orthopedics.
8. Principles of chiropractic and adjusting.
9. Neurology.
10. Chemistry, including biochemistry and nutrition.
11. Public health and hygiene.
12. Chiropractic spinal analysis.
C. The board may waive examination in those subjects that the applicant passed previously with the percentage of correct answers prescribed in subsection D of this section in an examination conducted by the national board of chiropractic examiners.
D. The board shall grant a license to an applicant who meets all of the following requirements:
1. Correctly answers at least seventy‑five per cent percent of all questions asked on the subjects identified in subsection B of this section or attains a board approved passing score on all questions asked on the subjects identified in subsection B of this section in an examination administered by a board approved testing facility.
2. Correctly answers at least seventy‑five per cent percent of the questions on jurisprudence.
3. Meets all other licensing requirements of this chapter.
4. Pays the original license fee of not more than one hundred twenty‑five dollars as established by the board.
E. An applicant who fails the examination for the first time may retake the examination within one year if the applicant submits an updated application that meets the requirements of section 32‑921.
F. An applicant shall reapply for licensure if the applicant does not pay the original license fee within one year after having been notified by the board that the applicant is eligible to receive a license.
Sec. 4. Section 32-922.02, Arizona Revised Statutes, is amended to read:
32-922.02. Specialties; certification; fees
A. In order to practice a chiropractic specialty a licensee shall be certified in that specialty by the board.
B. An applicant who wishes to be certified to perform acupuncture shall submit the following to the board:
1. Documentation of successful completion of a minimum of one hundred hours of study in acupuncture at an accredited chiropractic college or postgraduate study with an instructor on the active or postgraduate staff of an accredited chiropractic college.
2. A complete application as prescribed by the board.
3. Documentation of having passed a board-approved acupuncture examination.
C. An applicant who wishes to be certified to perform physical medicine modalities and therapeutic procedures shall submit the following to the board:
1. A complete application as prescribed by the board.
2. Documentation of successful completion of a minimum of one hundred twenty hours of study in physical medicine modalities and therapeutic procedures at an accredited chiropractic college or postgraduate study with an instructor on the active or postgraduate staff of an accredited chiropractic college.
3. Documentation of having passed an examination in physical medicine modalities and therapeutic procedures that is approved by the board.
D. The board shall issue a certificate to any applicant who meets the requirements of this section, who correctly answers at least seventy‑five per cent percent of all questions asked on the specialty examination and who pays a certificate fee of not more than one hundred twenty‑five dollars as established by the board.
E. On making application, the applicant shall pay to the executive director of the board a nonrefundable fee of not more than one hundred twenty‑five dollars as established by the board. The board shall keep a register of all applicants and the result of each examination.
F. A chiropractor who is certified in a specialty pursuant to subsection C to perform physiotherapy before the effective date of this amendment to this section July 29, 2010 is deemed to be certified in physical medicine modalities and therapeutic procedures.
Sec. 5. Title 32, chapter 8, article 2, Arizona Revised Statutes, is amended by adding section 32-922.03, to read:
32-922.03. Licensure by endorsement; requirements
A. The board may issue a license to practice chiropractic pursuant to this chapter by endorsement to an applicant who meets all of the following requirements:
1. Has actively practiced chiropractic in another state or jurisdiction for at least five of the immediately preceding seven years.
2. Has not had an adverse disciplinary action taken against a professional license issued by another state or jurisdiction.
3. Receives a grade of at least seventy‑five percent on the Arizona jurisprudence examination.
4. On making application, pays to the executive director of the board a nonrefundable fee of not more than five hundred dollars as established by the board.
5. Pays the original license fee as prescribed by section 32‑922.
B. The applicant shall present proof satisfactory to the board that:
1. A professional license of the applicant issued by any other state or jurisdiction has not been sanctioned for any cause that may be a basis of a sanction imposed by the board pursuant to this chapter, except for failure to pay fees.
2. The applicant has not previously failed to pass the examination in this state.
3. The applicant qualifies for licensure as prescribed in section 32‑921, except the applicant is not required to submit proof of obtaining a passing score on part III or IV of the examination conducted by the national board of chiropractic examiners.
C. An applicant under this section is not required to pay the fee prescribed in section 32-921, subsection D.
Sec. 6. Section 32-923, Arizona Revised Statutes, is amended to read:
32-923. Change of address; annual renewal fee; failure to renew; waivers; definition
A. Every person who is licensed pursuant to this chapter shall notify the board in writing of any change in residence or office address and telephone number within thirty days after that change. The board shall impose a penalty of fifty dollars on a licensee who does not notify the board as required by this subsection.
B. Except as provided in section 32‑4301, every person who is licensed to practice chiropractic in this state shall annually make a renewal application to the board before January 1 after original issuance of a license and shall pay a renewal license fee prescribed by the board of not more than one hundred seventy two hundred twenty-five dollars as established by the board. The renewal application shall be made on a form and in a manner prescribed by the board. At least thirty days before the renewal application and renewal fee are due, the board shall send by first class mail a renewal application and notice requiring license renewal and payment of the renewal fee.
C. The board shall automatically administratively suspend a license automatically if the licensee does not submit a complete application for renewal and pay the renewal license fee as required by this section.
D. The board may reinstate a license if the person completes an application for reinstatement as prescribed by the board, complies with the continuing education requirements for each year that the license was suspended, pays the annual renewal license fee for each year that the license was suspended and pays an additional fee of one two hundred dollars. An applicant who does not request reinstatement within two years of the date of suspension shall apply for a license as a new candidate pursuant to section 32‑921 or 32-922.01.
E. The board may waive the annual renewal license fee if a licensee presents evidence satisfactory to the board that the licensee has permanently retired from the practice of chiropractic and has paid all fees required by this chapter before the waiver.
F. During the period of waiver the retired licensee shall not engage in the practice of chiropractic. A violation of this subsection subjects the retired licensee to the same penalties as are imposed in this chapter on a person who practices chiropractic without a license.
G. The board may reinstate a retired licensee to active practice on payment of the annual renewal license fee and presentation of evidence satisfactory to the board that the retired licensee is professionally able to engage in the practice of chiropractic and still possesses the professional knowledge required. After a hearing, the board may refuse to reinstate a retired licensee to active practice under this subsection on any of the grounds prescribed in section 32‑924.
H. For the purposes of this section, "administratively suspend" means a nondisciplinary action that is imposed for failure to renew a license and that requires the licensee to suspend practice until renewal requirements are met.
Sec. 7. Section 32-924, Arizona Revised Statutes, is amended to read:
32-924. Grounds for disciplinary action; hearing; civil penalty; definition
A. The following are grounds for disciplinary action, regardless of where they occur:
1. Employment of fraud or deception in securing a license.
2. Practicing chiropractic under a false or assumed name.
3. Impersonating another practitioner.
4. Habitual use of alcohol, narcotics or stimulants to the extent of incapacitating the licensee for the performance of professional duties.
5. Unprofessional or dishonorable conduct of a character likely to deceive or defraud the public or tending to discredit the profession.
6. Conviction of a misdemeanor involving moral turpitude or of a felony.
7. Gross malpractice, repeated malpractice or any malpractice resulting in the death of a patient.
8. Representing that a manifestly incurable condition can be permanently cured, or that a curable condition can be cured within a stated time, if this is not true.
9. Offering, undertaking or agreeing to cure or treat a condition by a secret means, method, device or instrumentality.
10. Refusing to divulge to the board on demand the means, method, device or instrumentality used in the treatment of a condition.
11. Giving or receiving or aiding or abetting the giving or receiving of rebates, either directly or indirectly.
12. Acting or assuming to act as a member of the board if this is not true.
13. Advertising in a false, deceptive or misleading manner.
14. Having had a license refused, revoked or suspended by any other state or country, unless it can be shown that the action was not taken for reasons that relate to the ability to safely and skillfully practice chiropractic or to any act of unprofessional conduct.
15. Any conduct or practice contrary to recognized standards in chiropractic or any conduct or practice that constitutes a danger to the health, welfare or safety of the patient or the public or any conduct, practice or condition that impairs the ability of the licensee to safely and skillfully practice chiropractic.
16. Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate any of the provisions of this chapter or any board order.
17. Failing to sign the physician's name, wherever required, in any capacity as "chiropractic doctor", "chiropractic physician" or "doctor of chiropractic" or failing to use and affix the initials "D.C." after the physician's name.
18. Failing to place or cause to be placed the word or words "chiropractic", "chiropractor", "chiropractic doctor" or "chiropractic physician" in any sign or advertising media.
19. Using physical medicine modalities and therapeutic procedures without passing an examination in that subject and without being certified in that specialty by the board.
20. Using acupuncture without passing an examination in that subject and without being certified in that specialty by the board.
21. Engaging in sexual intercourse or oral sexual contact with a patient in the course of treatment.
22. Billing or otherwise charging a patient or third-party payor for services, appliances, tests, equipment, an x‑ray examination or other procedures not actually provided.
23. Intentionally misrepresenting to or omitting a material fact from the patient or third-party payor concerning charges, services, appliances, tests, equipment, an x‑ray examination or other procedures offered or provided.
24. Advertising chiropractic services, appliances, tests, equipment, x‑ray examinations or other procedures for a specified price without also specifying the services, procedures or items included in the advertised price.
25. Advertising chiropractic services, appliances, tests, equipment, x‑ray examinations or other procedures as free without also disclosing what services or items are included in the advertised service or item.
26. Billing or charging a patient or third-party payor a higher price than the advertised price in effect at the time the services, appliances, tests, equipment, x‑ray examinations or other procedures were provided.
27. Advertising a specialty or procedure that requires a separate examination or certificate of specialty, unless the licensee has satisfied the applicable requirements of this chapter.
28. Solicitation by the licensee or by the licensee's compensated agent of any person who is not previously known by the licensee or the licensee's agent, and who at the time of the solicitation is vulnerable to undue influence, including any person known to have experienced any of the following within the last fifteen days:
(a) Involvement in a motor vehicle accident.
(b) Involvement in a work‑related accident.
(c) Injury by, or as the result of actions of, another person.
B. The board on its own motion or on receipt of a complaint may investigate any information that appears to show that a doctor of chiropractic is or may be in violation of this chapter or board rules or is or may be mentally or physically unable to safely engage in the practice of chiropractic. The board shall notify the licensee as to the content of the complaint as soon as is reasonable. Any person who reports or provides information to the board in good faith is not subject to civil damages as a result of that action.
C. The board may require a licensee under investigation pursuant to this section to be interviewed by the board or its representatives. The board may require a licensee who is under investigation pursuant to this section to undergo, at the licensee's expense, any combination of medical, physical or mental examinations that the board finds necessary to determine the licensee's competence.
D. If the board finds based on the information it receives under subsections B and C of this section that the public health, safety or welfare imperatively requires emergency action, and incorporates a finding to that effect in its order, the board may order a summary suspension of a license pending proceedings for revocation or other action. If the board takes this action, it shall also serve the licensee with a written notice that states the charges and that the licensee is entitled to a formal hearing within sixty days.
E. If, after completing its investigation, the board finds that the information provided pursuant to this section is not of sufficient seriousness to merit disciplinary action against the licensee, it may take any of the following actions:
1. Dismiss the complaint if in the board's opinion the information is without merit or does not warrant sanction of the licensee.
2. Issue an advisory letter. An advisory letter is a nondisciplinary action and is a public document.
3. Issue a nondisciplinary order requiring the licensee to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee with the necessary understanding of current developments, skills, procedures or treatment. Failure to complete a nondisciplinary order requiring continuing education is a violation of subsection A, paragraph 16 of this section.
F. The board may request a formal interview with the licensee concerned. At a formal interview the board may receive and consider pertinent documents and sworn statements of persons who may be called as witnesses in a formal hearing. Legal counsel may be present and participate in the formal interview. If the licensee refuses the request or if the licensee accepts the request and the results of the interview indicate suspension or revocation of the license may be in order, the board shall issue a complaint and order that a hearing be held pursuant to title 41, chapter 6, article 10. If, after the formal interview, the board finds that the information provided pursuant to this section is true but is not of sufficient seriousness to merit suspension or revocation of the license, it may take any of the following actions:
1. Dismiss the complaint if in the board's opinion the information is without merit or does not warrant sanction of the licensee.
2. Issue an advisory letter. An advisory letter is a nondisciplinary action and is a public document.
3. Issue an order to cease and desist.
4. Issue a letter of concern.
5. Issue an order of censure. An order of censure is an official action against the licensee and may include a requirement for restitution of fees to a patient resulting from a violation of this chapter or board rules.
6. Fix a period and terms of probation best adapted to protect the public health and safety and to rehabilitate or educate the licensee. Any costs incidental to the terms of probation are at the licensee's own expense. Probation may include restrictions on the licensee's license to practice chiropractic.
7. Impose a civil penalty of not more than one thousand dollars for each violation of this chapter.
8. Refuse to renew a license.
9. Issue a disciplinary or nondisciplinary order requiring the licensee to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee with the necessary understanding of current developments, skills, procedures or treatment.
G. If the board believes the charge is of such magnitude as to warrant suspension or revocation of the license, the board shall immediately initiate formal revocation or suspension proceedings pursuant to title 41, chapter 6, article 10. The board shall notify a licensee of a complaint and hearing by certified mail addressed to the licensee's last known address on record in the board's files. The notice of a complaint and hearing is effective on the date of its deposit in the mail. The board shall hold a formal hearing within one hundred eighty days after that date.
H. If the licensee wishes to be present at the formal hearing in person or by representation, or both, the licensee shall file with the board an a written answer to the charges in the complaint. The answer shall be in writing, verified under oath and filed within twenty days after service of the complaint. A licensee who has been notified of a complaint pursuant to this section shall file with the board a written response not more than twenty days after service of the complaint and the notice of hearing. If the licensee fails to file an answer in writing, it is deemed an admission of the act or acts charged in the complaint and notice of hearing and the board may take disciplinary action pursuant to this chapter without a hearing.
I. Any licensee who, after a hearing, is found to be in violation of this chapter or board rules or is found to be mentally or physically unable to safely engage in the practice of chiropractic is subject to any combination of those disciplinary actions identified in subsection F of this section or suspension or revocation of the license. In addition, the board may order the licensee to pay restitution or all costs incurred in the course of the investigation and formal hearing in the matter, or both.
J. The board shall report allegations of evidence of criminal wrongdoing to the appropriate criminal justice agency.
K. The board may accept the surrender of an active license from a licensee who admits in writing to having violated this chapter or board rules.
L. For the purposes of this section, "solicitation" includes contact in person, by telephone, telegraph or telefacsimile or by other communication directed to a specific recipient and includes any written form of communication directed to a specific recipient.
Sec. 8. Requirements for enactment; two-thirds vote
Pursuant to article IX, section 22, Constitution of Arizona, this act is effective only on the affirmative vote of at least two-thirds of the members of each house of the legislature and is effective immediately on the signature of the governor or, if the governor vetoes this act, on the subsequent affirmative vote of at least three-fourths of the members of each house of the legislature.
APPROVED BY THE GOVERNOR APRIL 1, 2015.
FILED IN THE OFFICE OF THE SECRETARY OF STATE APRIL 2, 2015.
