Bill Text: FL S1648 | 2018 | Regular Session | Introduced
Bill Title: Chiropractic Medicine
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2018-03-10 - Died in Health Policy [S1648 Detail]
Download: Florida-2018-S1648-Introduced.html
Florida Senate - 2018 SB 1648
By Senator Brandes
24-01120A-18 20181648__
1 A bill to be entitled
2 An act relating to chiropractic medicine; amending s.
3 460.402, F.S.; revising applicability of provisions
4 relating to chiropractic medicine 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
13 medicine to applicants who meet certain requirements,
14 including the payment of a fee; repealing s. 460.4061,
15 F.S., relating to a restricted license; amending s.
16 460.4062, F.S.; revising the educational requirements
17 that must be satisfied by applicants before the
18 department may issue a chiropractic medicine faculty
19 certificate; amending s. 460.413, F.S.; revising
20 grounds for denial of a license or disciplinary action
21 relating to failing to preserve identity of funds and
22 property of a patient; amending s. 460.4165, F.S.;
23 revising continuing education requirements for
24 chiropractic physician’s assistants; amending s.
25 460.4167, F.S.; revising provisions relating to the
26 employment by certain clinical facilities of
27 independent contractors who provide specified
28 chiropractic services; providing an effective date.
29
30 Be It Enacted by the Legislature of the State of Florida:
31
32 Section 1. Section 460.402, Florida Statutes, is amended to
33 read:
34 460.402 Exceptions.—This chapter does The provisions of
35 this chapter shall not apply to:
36 (1) Other duly licensed health care practitioners acting
37 within their authorized scope of practice.
38 (2) Any person furnishing medical assistance in case of an
39 emergency.
40 (3) The domestic administration of recognized family
41 remedies.
42 (4) The practice of the religious tenets of any church.
43 (5) Any massage therapist acting within her or his scope of
44 practice authorized in chapter 480.
45 (6) A chiropractic student who is enrolled in a
46 chiropractic school, college, or program accredited by an
47 accrediting agency recognized by the United States Secretary of
48 Education or in an educational program leading to a degree in
49 chiropractic medicine from an institution located outside the
50 United States which is approved by the board or authorized to
51 operate by the government having jurisdiction over the program
52 chiropractic college accredited by the Council on Chiropractic
53 Education and who is participating in either of the following:
54 (a) A community-based internship under the direct
55 supervision of a doctor of chiropractic medicine who is
56 credentialed as an adjunct faculty member of a chiropractic
57 college in which the student is enrolled.; or
58 (b) A chiropractic college clinical internship under the
59 direct supervision of a doctor of chiropractic medicine who is a
60 full-time, part-time, or adjunct faculty member of a
61 chiropractic college located in this state which is accredited
62 by an accrediting agency recognized by the United States
63 Secretary of Education or of an institution located outside the
64 United States which is approved by the board or authorized to
65 operate by the government having jurisdiction over the program
66 and accredited by the Council on Chiropractic Education and who
67 holds a current, active Florida chiropractor’s license.
68 (7) A chiropractic physician who holds an active license in
69 another state, the District of Columbia, or a possession or
70 territory of the United States and is performing chiropractic
71 procedures or demonstrating equipment or supplies for
72 educational purposes at a board-approved continuing education
73 program.
74 Section 2. Subsection (4) and paragraph (a) of subsection
75 (9) of section 460.403, Florida Statutes, are amended to read:
76 460.403 Definitions.—As used in this chapter, the term:
77 (4)(a) “Community-based internship” means a program in
78 which a student enrolled in the last year of either a
79 chiropractic college accredited by an accrediting agency
80 recognized by the United States Secretary of Education or an
81 educational program leading to a degree in chiropractic medicine
82 from an institution located outside the United States which is
83 approved by the board or authorized to operate by the government
84 having jurisdiction over the program accredited by the Council
85 on Chiropractic Education is approved to obtain required
86 pregraduation clinical experience in a chiropractic clinic or to
87 practice under the direct supervision of a doctor of
88 chiropractic medicine who is approved as an adjunct faculty
89 member of the chiropractic college in which the student is
90 enrolled, in accordance with according to the teaching protocols
91 for the clinical practice requirements of the college.
92 (b) “Chiropractic college clinical internship” means a
93 program in which a student enrolled in either a chiropractic
94 college accredited by an accrediting agency recognized by the
95 United States Secretary of Education or an educational program
96 leading to a degree in chiropractic medicine from an institution
97 located outside the United States which is approved by the board
98 or authorized to operate by the government having jurisdiction
99 over the program located in this state and accredited by the
100 Council on Chiropractic Education obtains clinical experience
101 pursuant to the chiropractic college’s curriculum in a classroom
102 or chiropractic clinic operated by the chiropractic college, in
103 accordance with according to the teaching protocols for the
104 clinical practice requirements of the college.
105 (9)(a) “Practice of chiropractic medicine” means a
106 noncombative principle and practice consisting of the science,
107 philosophy, and art of the adjustment, manipulation, and
108 treatment of the human body in which vertebral subluxations and
109 other malpositioned articulations and structures that are
110 interfering with the normal generation, transmission, and
111 expression of nerve impulse between the brain, organs, and
112 tissue cells of the body, thereby causing disease, are adjusted,
113 manipulated, or treated, thus restoring the normal flow of nerve
114 impulse which produces normal function and consequent health by
115 chiropractic physicians using specific chiropractic adjustment
116 or manipulation techniques taught in a chiropractic college
117 accredited by an accrediting agency recognized by the United
118 States Secretary of Education or in an educational program
119 leading to a degree in chiropractic medicine from an institution
120 located outside the United States which is approved by the board
121 or authorized to operate by the government having jurisdiction
122 over the program colleges accredited by the Council on
123 Chiropractic Education. No person other than a licensed
124 chiropractic physician may render chiropractic services,
125 chiropractic adjustments, or chiropractic manipulations.
126 Section 3. Section 460.406, Florida Statutes, is amended to
127 read:
128 460.406 Licensure by examination; licensure by
129 endorsement.—
130 (1) Any person desiring to be licensed as a chiropractic
131 physician must apply to the department to take the licensure
132 examination. There shall be an application fee set by the board
133 not to exceed $100 which shall be nonrefundable. There shall
134 also be an examination fee not to exceed $500 plus the actual
135 per applicant cost to the department for purchase of portions of
136 the examination from the National Board of Chiropractic
137 Examiners or a similar national organization, which may be
138 refundable if the applicant is found ineligible to take the
139 examination. The department shall examine each applicant who the
140 board certifies has:
141 (a) Completed the application form and remitted the
142 appropriate fee.
143 (b) Submitted proof satisfactory to the department that he
144 or she is not less than 18 years of age.
145 (c) Submitted proof satisfactory to the department that he
146 or she is a graduate of a chiropractic college accredited by an
147 accrediting agency recognized by the United States Secretary of
148 Education or of an educational program leading to a degree in
149 chiropractic medicine from an institution located outside the
150 United States which is approved by the board or authorized to
151 operate by the government having jurisdiction over the program
152 which is accredited by or has status with the Council on
153 Chiropractic Education or its predecessor agency. However, any
154 applicant who is a graduate of a chiropractic college that was
155 initially accredited by the Council on Chiropractic Education in
156 1995, who graduated from such college within the 4 years
157 immediately preceding such accreditation, and who is otherwise
158 qualified is shall be eligible to take the examination. An No
159 application for a license to practice chiropractic medicine may
160 not shall be denied solely because the applicant is a graduate
161 of a chiropractic college that subscribes to one philosophy of
162 chiropractic medicine as distinguished from another.
163 (d)1. For an applicant who has matriculated in a
164 chiropractic college prior to July 2, 1990, completed at least 2
165 years of residence college work, consisting of a minimum of one
166 half the work acceptable for a bachelor’s degree granted on the
167 basis of a 4-year period of study, in a college or university
168 accredited by an accrediting agency recognized and approved by
169 the United States Department of Education. However, prior to
170 being certified by the board to sit for the examination, each
171 applicant who has matriculated in a chiropractic college after
172 July 1, 1990, shall have been granted a bachelor’s degree, based
173 upon 4 academic years of study, by a college or university
174 accredited by a regional accrediting agency which is a member of
175 the Commission on Recognition of Postsecondary Accreditation.
176 2. Effective July 1, 2000, completed, prior to
177 matriculation in a chiropractic college, at least 3 years of
178 residence college work, consisting of a minimum of 90 semester
179 hours leading to a bachelor’s degree in a liberal arts college
180 or university accredited by an accrediting agency recognized and
181 approved by the United States Department of Education. However,
182 prior to being certified by the board to sit for the
183 examination, each applicant who has matriculated in a
184 chiropractic college after July 1, 2000, shall have been granted
185 a bachelor’s degree from an institution holding accreditation
186 for that degree from a regional accrediting agency which is
187 recognized by the United States Department of Education. The
188 applicant’s chiropractic degree must consist of credits earned
189 in the chiropractic program and may not include academic credit
190 for courses from the bachelor’s degree.
191 (d)(e) Successfully completed the National Board of
192 Chiropractic Examiners certification examination in parts I, II,
193 III, and IV, and the physiotherapy examination of the National
194 Board of Chiropractic Examiners, with a score approved by the
195 board.
196 (e)(f) Submitted to the department a set of fingerprints on
197 a form and under procedures specified by the department, along
198 with payment in an amount equal to the costs incurred by the
199 department of Health for the criminal background check of the
200 applicant.
201
202 The board may require an applicant who graduated from an
203 institution accredited by the Council on Chiropractic Education
204 more than 10 years before the date of application to the board
205 to take the National Board of Chiropractic Examiners Special
206 Purposes Examination for Chiropractic, or its equivalent, as
207 determined by the board. The board shall establish by rule a
208 passing score.
209 (2) For those applicants applying for the certification
210 examination who have matriculated before prior to July 1, 1996,
211 in a chiropractic college, the board shall waive the provisions
212 of paragraph (1)(c) if the applicant is a graduate of a
213 chiropractic college that which has been denied accreditation or
214 approval on the grounds that its curriculum does not include the
215 training in acupuncture necessary for the completion of the
216 certification examination or is a graduate of a chiropractic
217 college where acupuncture is not taught or offered if the
218 college is accredited by or has status with the Council on
219 Chiropractic Education or its predecessor.
220 (3) An applicant for the licensure examination may elect
221 not to take the certification examination to use acupuncture.
222 The department shall, in addition to the licensing exam, offer
223 an examination for certification to use acupuncture. An
224 applicant may elect to take the certification examination at the
225 time of taking the licensure examination. Passage of the
226 certification examination shall not grant any applicant the
227 right to practice chiropractic medicine absent the passage of
228 the licensing examination.
229 (4) The department shall submit written notification within
230 5 working days to applicants who have successfully completed the
231 requirements of paragraphs (1)(a)-(d) (1)(a)-(e) and who have
232 successfully passed the state licensure examination. An
233 applicant who is notified in writing by the department of the
234 successful completion of requirements in paragraphs (1)(a)-(d)
235 (1)(a)-(e) and who has successfully passed the state licensure
236 examination may lawfully practice pending receipt of the
237 certificate of licensure, and the written notification shall act
238 as evidence of licensure entitling the chiropractic physician to
239 practice for a maximum period of 45 days or until the licensing
240 fee is received by the department whichever is sooner.
241 (5) A student in a school or college of chiropractic
242 accredited by an accrediting agency recognized by the United
243 States Secretary of Education or in an educational program
244 leading to a degree in chiropractic medicine from an institution
245 located outside the United States which is approved by the board
246 or authorized to operate by the government having jurisdiction
247 over the program by the Council on Chiropractic Education or its
248 successor in the final year of the program may file an
249 application pursuant to subsection (1), take all examinations
250 required for licensure, submit a set of fingerprints, and pay
251 all fees required for licensure. A chiropractic student who
252 successfully completes the licensure examinations and who
253 otherwise meets all requirements for licensure as a chiropractic
254 physician during the student’s final year must have graduated
255 before he or she may be being certified for licensure pursuant
256 to this section.
257 (6) The department shall issue a license by endorsement to
258 practice chiropractic medicine to an applicant who submits an
259 application to the department, pays an application fee
260 determined by the board, which may not exceed $100, and provides
261 proof that he or she has satisfied all of the following
262 requirements:
263 (a) Holds a valid license to practice chiropractic medicine
264 in another state or territory of the United States.
265 (b) Has actively practiced chiropractic medicine in another
266 state or territory of the United States for the preceding 10
267 years without having his or her license acted against by the
268 licensing authority of any jurisdiction.
269 (c) Meets the requirements in paragraphs (1)(a), (b), (c),
270 and (e).
271 Section 4. Section 460.4061, Florida Statutes, is repealed.
272 Section 5. Subsection (1) of section 460.4062, Florida
273 Statutes, is amended to read:
274 460.4062 Chiropractic medicine faculty certificate.—
275 (1) The department may issue a chiropractic medicine
276 faculty certificate without examination to an individual who
277 remits a nonrefundable application fee, not to exceed $100 as
278 determined by board rule of the board, and who demonstrates to
279 the board that he or she meets the following requirements:
280 (a) Is a graduate of a an accredited school or college of
281 chiropractic accredited by an accrediting agency recognized by
282 the United States Secretary of Education or of an educational
283 program leading to a degree in chiropractic medicine from an
284 institution located outside the United States which is approved
285 by the board or authorized to operate by the government having
286 jurisdiction over the school or college by the Council on
287 Chiropractic Education.
288 (b) Holds a valid current license to practice chiropractic
289 medicine in another jurisdiction in the United States.
290 (c) Is at least 21 years of age and of good moral
291 character.
292 (d) Has not committed any act or offense in any
293 jurisdiction which would constitute the basis for discipline
294 under this chapter or chapter 456.
295 (e)1. Performs research or has been offered and has
296 accepted a full-time or part-time faculty appointment to teach
297 in a program of chiropractic medicine at a publicly funded state
298 university or college or at a college of chiropractic located in
299 the state and accredited by an accrediting agency recognized by
300 the United States Secretary of Education the Council on
301 Chiropractic Education; and
302 2. Provides a certification from the dean of the appointing
303 college acknowledging the appointment.
304 Section 6. Present paragraphs (z) through (ff) of
305 subsection (1) of section 460.413, Florida Statutes, are
306 redesignated as paragraphs (y) through (ee), respectively, and
307 present paragraph (y) of that subsection is amended, to read:
308 460.413 Grounds for disciplinary action; action by board or
309 department.—
310 (1) The following acts constitute grounds for denial of a
311 license or disciplinary action, as specified in s. 456.072(2):
312 (y) Failing to preserve identity of funds and property of a
313 patient, the value of which is greater than $501. As provided by
314 rule of the board, money or other property entrusted to a
315 chiropractic physician for a specific purpose, including
316 advances for costs and expenses of examination or treatment
317 which may not exceed the value of $1,500, is to be held in trust
318 and must be applied only to that purpose. Money and other
319 property of patients coming into the hands of a chiropractic
320 physician are not subject to counterclaim or setoff for
321 chiropractic physician’s fees, and a refusal to account for and
322 deliver over such money and property upon demand shall be deemed
323 a conversion. This is not to preclude the retention of money or
324 other property upon which the chiropractic physician has a valid
325 lien for services or to preclude the payment of agreed fees from
326 the proceeds of transactions for examinations or treatments.
327 Controversies as to the amount of the fees are not grounds for
328 disciplinary proceedings unless the amount demanded is clearly
329 excessive or extortionate, or the demand is fraudulent. All
330 funds of patients paid to a chiropractic physician, other than
331 advances for costs and expenses, shall be deposited into one or
332 more identifiable bank accounts maintained in the state in which
333 the chiropractic physician’s office is situated, and funds
334 belonging to the chiropractic physician may not be deposited
335 therein except as follows:
336 1. Funds reasonably sufficient to pay bank charges may be
337 deposited therein.
338 2. Funds belonging in part to a patient and in part
339 presently or potentially to the physician must be deposited
340 therein, but the portion belonging to the physician may be
341 withdrawn when due unless the right of the physician to receive
342 it is disputed by the patient, in which event the disputed
343 portion may not be withdrawn until the dispute is finally
344 resolved.
345
346 Every chiropractic physician shall maintain complete records of
347 all funds, securities, and other properties of a patient coming
348 into the possession of the physician and render appropriate
349 accounts to the patient regarding them. In addition, every
350 chiropractic physician shall promptly pay or deliver to the
351 patient, as requested by the patient, the funds, securities, or
352 other properties in the possession of the physician which the
353 patient is entitled to receive.
354 Section 7. Paragraph (b) of subsection (13) of section
355 460.4165, Florida Statutes, is amended to read:
356 460.4165 Certified chiropractic physician’s assistants.—
357 (13) CERTIFIED CHIROPRACTIC ASSISTANT CERTIFICATION
358 RENEWAL.—The certification must be renewed biennially.
359 (b) Each certified chiropractic physician’s assistant shall
360 biennially complete 24 hours of continuing education courses
361 approved by the board and sponsored by a chiropractic college
362 colleges accredited by an accrediting agency recognized by the
363 United States Secretary of Education or by an institution
364 located outside the United States which is approved by the board
365 or authorized to operate by the government having jurisdiction
366 over the college or institution the Council on Chiropractic
367 Education and approved by the board. The board shall approve
368 those courses that build upon the basic courses required for the
369 practice of chiropractic medicine, and the board may also
370 approve courses in adjunctive modalities. The board may exempt a
371 chiropractic physician’s assistant make exception from the
372 requirements of this section in the case of an emergency or
373 hardship cases. The board may adopt rules within the
374 requirements of this section which are necessary for its
375 implementation.
376 Section 8. Subsection (1) of section 460.4167, Florida
377 Statutes, is amended to read:
378 460.4167 Proprietorship by persons other than licensed
379 chiropractic physicians.—
380 (1) A person may not employ a chiropractic physician
381 licensed under this chapter or engage a chiropractic physician
382 licensed under this chapter as an independent contractor to
383 provide services that chiropractic physicians are authorized to
384 offer under this chapter, unless the person is any of the
385 following:
386 (a) A sole proprietorship, group practice, partnership,
387 corporation, limited liability company, limited partnership,
388 professional association, or any other entity that is wholly
389 owned by:
390 1. One or more chiropractic physicians licensed under this
391 chapter;
392 2. A chiropractic physician licensed under this chapter and
393 the spouse or surviving spouse, parent, child, or sibling of the
394 chiropractic physician; or
395 3. A trust whose trustees are chiropractic physicians
396 licensed under this chapter and the spouse, parent, child, or
397 sibling of a chiropractic physician.
398
399 If the chiropractic physician described in subparagraph 2. dies,
400 notwithstanding part X of chapter 400, the surviving spouse or
401 adult children may hold, operate, pledge, sell, mortgage,
402 assign, transfer, own, or control the chiropractic physician’s
403 ownership interests for so long as the surviving spouse or adult
404 children remain the sole proprietors of the chiropractic
405 practice.
406 (b) A sole proprietorship, group practice, partnership,
407 corporation, limited liability company, limited partnership,
408 professional association, or any other entity that is wholly
409 owned by a physician or physicians licensed under this chapter,
410 chapter 458, chapter 459, or chapter 461.
411 (c) An entity that is wholly owned, directly or indirectly,
412 by an entity licensed or registered by the state under chapter
413 395.
414 (d) A clinical facility that is affiliated with a college
415 of chiropractic accredited by an accrediting agency recognized
416 by the United States Secretary of Education or with an
417 institution located outside the United States which is approved
418 by the board or authorized to operate by the government having
419 jurisdiction over the college or institution by the Council on
420 Chiropractic Education at which training is provided for
421 chiropractic students.
422 (e) A public or private university or college.
423 (f) An entity wholly owned and operated by an organization
424 that is exempt from federal taxation under s. 501(c)(3) or (4)
425 of the Internal Revenue Code, a community college or university
426 clinic, or an entity owned or operated by the Federal Government
427 or by state government, including any agency, county,
428 municipality, or other political subdivision thereof.
429 (g) An entity owned by a corporation whose the stock of
430 which is publicly traded.
431 (h) A clinic licensed under part X of chapter 400 which
432 provides chiropractic services by a chiropractic physician
433 licensed under this chapter and other health care services by
434 physicians licensed under chapter 458 or chapter 459, the
435 medical director of which is licensed under chapter 458 or
436 chapter 459.
437 (i) A state-licensed insurer.
438 (j) A health maintenance organization or prepaid health
439 clinic regulated under chapter 641.
440 Section 9. This act shall take effect upon becoming a law.
