Bill Text: FL S0994 | 2019 | Regular Session | Introduced
Bill Title: Practice of Chiropractic
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2019-02-20 - Withdrawn prior to introduction [S0994 Detail]
Download: Florida-2019-S0994-Introduced.html
Florida Senate - 2019 SB 994 By Senator Harrell 25-01266-19 2019994__ 1 A bill to be entitled 2 An act relating to the practice of chiropractic; 3 amending s. 460.402, F.S.; revising applicability of 4 provisions relating to chiropractic with regard to 5 certain chiropractic students; amending s. 460.403, 6 F.S.; revising definitions; amending s. 460.406, F.S.; 7 revising the educational requirements that must be 8 satisfied by applicants before examination by the 9 Department of Health; removing the authority of the 10 board to require certain applicants to take a certain 11 examination; requiring the department to issue a 12 license by endorsement to practice chiropractic to 13 applicants who meet certain requirements; amending s. 14 460.4062, F.S.; revising the educational requirements 15 that must be satisfied by applicants before the 16 department may issue a chiropractic medicine faculty 17 certificate; amending s. 460.4165, F.S.; revising 18 continuing education requirements for chiropractic 19 physician’s assistants; amending s. 460.4167, F.S.; 20 revising provisions relating to the employment by 21 certain clinical facilities of independent contractors 22 who provide specified chiropractic services; providing 23 an effective date. 24 25 Be It Enacted by the Legislature of the State of Florida: 26 27 Section 1. Section 460.402, Florida Statutes, is amended to 28 read: 29 460.402 Exceptions.—This chapter doesThe provisions of30this chapter shallnot apply to: 31 (1) Other duly licensed health care practitioners acting 32 within their authorized scope of practice. 33 (2) Any person furnishing medical assistance in case of an 34 emergency. 35 (3) The domestic administration of recognized family 36 remedies. 37 (4) The practice of the religious tenets of any church. 38 (5) Any massage therapist acting within her or his scope of 39 practice authorized in chapter 480. 40 (6) A chiropractic student who is enrolled in a 41 chiropractic school, college, or program accredited by an 42 accrediting agency recognized by the United States Secretary of 43 Education or in an educational program leading to a degree in 44 chiropractic from an institution located outside the United 45 States which is approved by the board or authorized to operate 46 by the government having jurisdiction over the program 47chiropractic college accredited by the Council on Chiropractic48Educationand the student is participating in either of the 49 following: 50 (a) A community-based internship under the direct 51 supervision of a doctor of chiropractic medicine who is 52 credentialed as an adjunct faculty member of a chiropractic 53 college in which the student is enrolled.; or54 (b) A chiropractic college clinical internship under the 55 direct supervision of a doctor of chiropractic medicine who is a 56 full-time, part-time, or adjunct faculty member of a 57 chiropractic college located in this state which is accredited 58 by an accrediting agency recognized by the United States 59 Secretary of Education or of an institution located outside the 60 United States which is approved by the board or authorized to 61 operate by the government having jurisdiction over the program 62and accredited by the Council on Chiropractic Educationand the 63 doctor of chiropractic medicinewhoholds a current, active 64 Florida chiropractor’s license. 65 (7) A chiropractic physician who holds an active license in 66 another state, the District of Columbia, or a possession or 67 territory of the United States and is performing chiropractic 68 procedures or demonstrating equipment or supplies for 69 educational purposes at a board-approved continuing education 70 program. 71 Section 2. Subsection (4) and paragraph (a) of subsection 72 (9) of section 460.403, Florida Statutes, are amended to read: 73 460.403 Definitions.—As used in this chapter, the term: 74 (4)(a) “Community-based internship” means a program in 75 which a student enrolled in the last year of either a 76 chiropractic college accredited by an accrediting agency 77 recognized by the United States Secretary of Education or an 78 educational program leading to a degree in chiropractic from an 79 institution located outside the United States which is approved 80 by the board or authorized to operate by the government having 81 jurisdiction over the programaccredited by the Council on82Chiropractic Educationis approved to obtain required 83 pregraduation clinical experience in a chiropractic clinic or to 84 practice under the direct supervision of a doctor of 85 chiropractic medicine who is approved as an adjunct faculty 86 member of the chiropractic college in which the student is 87 enrolled, in accordance withaccording tothe teaching protocols 88 for the clinical practice requirements of the college. 89 (b) “Chiropractic college clinical internship” means a 90 program in which a student enrolled in either a chiropractic 91 college accredited by an accrediting agency recognized by the 92 United States Secretary of Education or an educational program 93 leading to a degree in chiropractic from an institution located 94 outside the United States which is approved by the board or 95 authorized to operate by the government having jurisdiction over 96 the programlocated in this state and accredited by the Council97on Chiropractic Educationobtains clinical experience pursuant 98 to the chiropractic college’s curriculum in a classroom or 99 chiropractic clinic operated by the chiropractic college, in 100 accordance withaccording tothe teaching protocols for the 101 clinical practice requirements of the college. 102 (9)(a) “Practice of chiropractic medicine” means a 103 noncombative principle and practice consisting of the science, 104 philosophy, and art of the adjustment, manipulation, and 105 treatment of the human body in which vertebral subluxations and 106 other malpositioned articulations and structures that are 107 interfering with the normal generation, transmission, and 108 expression of nerve impulse between the brain, organs, and 109 tissue cells of the body, thereby causing disease, are adjusted, 110 manipulated, or treated, thus restoring the normal flow of nerve 111 impulse which produces normal function and consequent health by 112 chiropractic physicians using specific chiropractic adjustment 113 or manipulation techniques taught in a chiropractic college 114 accredited by an accrediting agency recognized by the United 115 States Secretary of Education or in an educational program 116 leading to a degree in chiropractic from an institution located 117 outside the United States which is approved by the board or 118 authorized to operate by the government having jurisdiction over 119 the programcollegesaccredited by the Council on Chiropractic120Education. No person other than a licensed chiropractic 121 physician may render chiropractic services, chiropractic 122 adjustments, or chiropractic manipulations. 123 Section 3. Section 460.406, Florida Statutes, is amended to 124 read: 125 460.406 Licensure by examination; licensure by 126 endorsement.— 127 (1) Any person desiring to be licensed as a chiropractic 128 physician must apply to the department to take the licensure 129 examination. There shall be an application fee set by the board 130 not to exceed $100 which shall be nonrefundable. There shall 131 also be an examination fee not to exceed $500 plus the actual 132 per applicant cost to the department for purchase of portions of 133 the examination from the National Board of Chiropractic 134 Examiners or a similar national organization, which may be 135 refundable if the applicant is found ineligible to take the 136 examination. The department shall examine each applicant who the 137 board certifies has: 138 (a) Completed the application form and remitted the 139 appropriate fee. 140 (b) Submitted proof satisfactory to the department that he 141 or she is not less than 18 years of age. 142 (c) Submitted proof satisfactory to the department that he 143 or she is a graduate of a chiropractic college accredited by an 144 accrediting agency recognized by the United States Secretary of 145 Education or of an educational program leading to a degree in 146 chiropractic from an institution located outside the United 147 States which is approved by the board or authorized to operate 148 by the government having jurisdiction over the programwhich is149accredited by or has status with the Council on Chiropractic150Education or its predecessor agency. However, any applicant who 151 is a graduate of a chiropractic college that was initially 152 accredited by the Council on Chiropractic Education in 1995, who 153 graduated from such college within the 4 years immediately 154 preceding such accreditation, and who is otherwise qualified is 155shall beeligible to take the examination. AnNoapplication for 156 a license to practice chiropractic medicine may notshallbe 157 denied solely because the applicant is a graduate of a 158 chiropractic college that subscribes to one philosophy of 159 chiropractic medicine as distinguished from another. 160(d)1. For an applicant who has matriculated in a161chiropractic college prior to July 2, 1990, completed at least 2162years of residence college work, consisting of a minimum of one163half the work acceptable for a bachelor’s degree granted on the164basis of a 4-year period of study, in a college or university165accredited by an accrediting agency recognized and approved by166the United States Department of Education. However, prior to167being certified by the board to sit for the examination, each168applicant who has matriculated in a chiropractic college after169July 1, 1990, shall have been granted a bachelor’s degree, based170upon 4 academic years of study, by a college or university171accredited by a regional accrediting agency which is a member of172the Commission on Recognition of Postsecondary Accreditation.1732. Effective July 1, 2000, completed, prior to174matriculation in a chiropractic college, at least 3 years of175residence college work, consisting of a minimum of 90 semester176hours leading to a bachelor’s degree in a liberal arts college177or university accredited by an accrediting agency recognized and178approved by the United States Department of Education. However,179prior to being certified by the board to sit for the180examination, each applicant who has matriculated in a181chiropractic college after July 1, 2000, shall have been granted182a bachelor’s degree from an institution holding accreditation183for that degree from a regional accrediting agency which is184recognized by the United States Department of Education. The185applicant’s chiropractic degree must consist of credits earned186in the chiropractic program and may not include academic credit187for courses from the bachelor’s degree.188 (d)(e)Successfully completed the National Board of 189 Chiropractic Examiners certification examination in parts I, II, 190 III, and IV, and the physiotherapy examination of the National 191 Board of Chiropractic Examiners, with a score approved by the 192 board. 193 (e)(f)Submitted to the department a set of fingerprints on 194 a form and under procedures specified by the department, along 195 with payment in an amount equal to the costs incurred by the 196 departmentof Healthfor the criminal background check of the 197 applicant. 198 199The board may require an applicant who graduated from an200institution accredited by the Council on Chiropractic Education201more than 10 years before the date of application to the board202to take the National Board of Chiropractic Examiners Special203Purposes Examination for Chiropractic, or its equivalent, as204determined by the board. The board shall establish by rule a205passing score.206 (2) For those applicants applying for the certification 207 examination who have matriculated beforeprior toJuly 1, 1996, 208 in a chiropractic college, the board shall waive the provisions 209 of paragraph (1)(c) if the applicant is a graduate of a 210 chiropractic college thatwhichhas been denied accreditation or 211 approval on the grounds that its curriculum does not include the 212 training in acupuncture necessary for the completion of the 213 certification examination or is a graduate of a chiropractic 214 college where acupuncture is not taught or offered if the 215 college is accredited by or has status with the Council on 216 Chiropractic Education or its predecessor. 217 (3) An applicant for the licensure examination may elect 218 not to take the certification examination to use acupuncture. 219 The department shall, in addition to the licensing exam, offer 220 an examination for certification to use acupuncture. An 221 applicant may elect to take the certification examination at the 222 time of taking the licensure examination. Passage of the 223 certification examination shall not grant any applicant the 224 right to practice chiropractic medicine absent the passage of 225 the licensing examination. 226 (4) The department shall submit written notification within 227 5 working days to applicants who have successfully completed the 228 requirements of paragraphs (1)(a)-(d)(1)(a)-(e)and who have 229 successfully passed the state licensure examination. An 230 applicant who is notified in writing by the department of the 231 successful completion of requirements in paragraphs (1)(a)-(d) 232(1)(a)-(e)and who has successfully passed the state licensure 233 examination may lawfully practice pending receipt of the 234 certificate of licensure, and the written notification shall act 235 as evidence of licensure entitling the chiropractic physician to 236 practice for a maximum period of 45 days or until the licensing 237 fee is received by the department whichever is sooner. 238 (5) A student in a school or college of chiropractic 239 accredited by an accrediting agency recognized by the United 240 States Secretary of Education or in an educational program 241 leading to a degree in chiropractic from an institution located 242 outside the United States which is approved by the board or 243 authorized to operate by the government having jurisdiction over 244 the programby the Council on Chiropractic Education or its245successorin the final year of the program may file an 246 application pursuant to subsection (1), take all examinations 247 required for licensure, submit a set of fingerprints, and pay 248 all fees required for licensure. A chiropractic student who 249 successfully completes the licensure examinations and who 250 otherwise meets all requirements for licensure as a chiropractic 251 physician during the student’s final year must have graduated 252 before he or she may bebeingcertified for licensure pursuant 253 to this section. 254 (6) The department shall issue a license by endorsement to 255 practice chiropractic to an applicant who submits an application 256 to the department, pays the application fee described in 257 subsection (1), and provides proof that he or she has satisfied 258 all of the following requirements: 259 (a) Holds a valid license to practice chiropractic in 260 another state or territory of the United States. 261 (b) Has actively practiced chiropractic in another state or 262 territory of the United States for the preceding 10 years 263 without having his or her license acted against by the licensing 264 authority of any jurisdiction. 265 (c) Meets the requirements in paragraphs (1)(a), (b), (c), 266 and (e). 267 Section 4. Subsection (1) of section 460.4062, Florida 268 Statutes, is amended to read: 269 460.4062 Chiropractic medicine faculty certificate.— 270 (1) The department may issue a chiropractic medicine 271 faculty certificate without examination to an individual who 272 remits a nonrefundable application fee, not to exceed $100 as 273 determined by board ruleof the board, and who demonstrates to 274 the board that he or she meets the following requirements: 275 (a) Is a graduate of aan accreditedschool or college of 276 chiropractic accredited by an accrediting agency recognized by 277 the United States Secretary of Education or of an educational 278 program leading to a degree in chiropractic from an institution 279 located outside the United States which is approved by the board 280 or authorized to operate by the government having jurisdiction 281 over the school or collegethe Council on Chiropractic282Education. 283 (b) Holds a valid current license to practice chiropractic 284 medicine in another jurisdiction in the United States. 285 (c) Is at least 21 years of age and of good moral 286 character. 287 (d) Has not committed any act or offense in any 288 jurisdiction which would constitute the basis for discipline 289 under this chapter or chapter 456. 290 (e)1. Performs research or has been offered and has 291 accepted a full-time or part-time faculty appointment to teach 292 in a program of chiropractic medicine at a publicly funded state 293 university or college or at a college of chiropractic located in 294 the state and accredited by an accrediting agency recognized by 295 the United States Secretary of Educationthe Council on296Chiropractic Education; and 297 2. Provides a certification from the dean of the appointing 298 college acknowledging the appointment. 299 Section 5. Paragraph (b) of subsection (13) of section 300 460.4165, Florida Statutes, is amended to read: 301 460.4165 Certified chiropractic physician’s assistants.— 302 (13) CERTIFIED CHIROPRACTIC ASSISTANT CERTIFICATION 303 RENEWAL.—The certification must be renewed biennially. 304 (b) Each certified chiropractic physician’s assistant shall 305 biennially complete 24 hours of continuing education courses 306 approved by the board and sponsored by an accrediting agency 307 recognized by the United States Secretary of Education 308chiropractic colleges accredited bythe Council on Chiropractic309Education and approved by the board. The board shall approve 310 those courses that build upon the basic courses required for the 311 practice of chiropractic medicine, and the board may also 312 approve courses in adjunctive modalities. The board may exempt a 313 chiropractic physician’s assistantmake exceptionfrom the 314 requirements of this section in the case of an emergency or 315 hardshipcases. The board may adopt rules within the 316 requirements of this section which are necessary for its 317 implementation. 318 Section 6. Subsection (1) of section 460.4167, Florida 319 Statutes, is amended to read: 320 460.4167 Proprietorship by persons other than licensed 321 chiropractic physicians.— 322 (1) A person may not employ a chiropractic physician 323 licensed under this chapter or engage a chiropractic physician 324 licensed under this chapter as an independent contractor to 325 provide services that chiropractic physicians are authorized to 326 offer under this chapter,unless the person is any of the 327 following: 328 (a) A sole proprietorship, group practice, partnership, 329 corporation, limited liability company, limited partnership, 330 professional association, or any other entity that is wholly 331 owned by: 332 1. One or more chiropractic physicians licensed under this 333 chapter; 334 2. A chiropractic physician licensed under this chapter and 335 the spouse or surviving spouse, parent, child, or sibling of the 336 chiropractic physician; or 337 3. A trust whose trustees are chiropractic physicians 338 licensed under this chapter and the spouse, parent, child, or 339 sibling of a chiropractic physician. 340 341 If the chiropractic physician described in subparagraph 2. dies, 342 notwithstanding part X of chapter 400, the surviving spouse or 343 adult children may hold, operate, pledge, sell, mortgage, 344 assign, transfer, own, or control the chiropractic physician’s 345 ownership interests for so long as the surviving spouse or adult 346 children remain the sole proprietors of the chiropractic 347 practice. 348 (b) A sole proprietorship, group practice, partnership, 349 corporation, limited liability company, limited partnership, 350 professional association, or any other entity that is wholly 351 owned by a physician or physicians licensed under this chapter, 352 chapter 458, chapter 459, or chapter 461. 353 (c) An entity that is wholly owned, directly or indirectly, 354 by an entity licensed or registered by the state under chapter 355 395. 356 (d) A clinical facility that is affiliated with a college 357 of chiropractic accredited by an accrediting agency recognized 358 by the United States Secretary of Educationby the Council on359Chiropractic Educationat which training is provided for 360 chiropractic students. 361 (e) A public or private university or college. 362 (f) An entity wholly owned and operated by an organization 363 that is exempt from federal taxation under s. 501(c)(3) or (4) 364 of the Internal Revenue Code, a community college or university 365 clinic, or an entity owned or operated by the Federal Government 366 or by state government, including any agency, county, 367 municipality, or other political subdivision thereof. 368 (g) An entity owned by a corporation whosethestockof369whichis publicly traded. 370 (h) A clinic licensed under part X of chapter 400 which 371 provides chiropractic services by a chiropractic physician 372 licensed under this chapter and other health care services by 373 physicians licensed under chapter 458 or chapter 459, the 374 medical director of which is licensed under chapter 458 or 375 chapter 459. 376 (i) A state-licensed insurer. 377 (j) A health maintenance organization or prepaid health 378 clinic regulated under chapter 641. 379 Section 7. This act shall take effect upon becoming a law.