Legislature(2015 - 2016)BARNES 124
04/13/2016 03:15 PM House LABOR & COMMERCE
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SB 69-BD OF CHIROPRACTIC EXAMINERS; PRACTICE 5:18:20 PM CHAIR OLSON announced that the next order of business would be CS FOR SENATE BILL NO. 69(FIN), "An Act relating to the Board of Chiropractic Examiners and the practice of chiropractic." 5:18:40 PM SENATOR BILL STOLTZE informed the committee his interest in the proposed legislation began with the issue of sports pre- participation physicals and the need to provide more opportunity for rural youth to have better access to said physicals. The bill is a product of the work of the Board of Chiropractic Examiners, Division of Corporations, Business, and Professional Licensing, Department of Commerce, Community & Economic Development, as well as the chiropractic trade organization, the Alaska Chiropractic Society. Regarding pre-participation physicals, the bill places Alaska along with 22 other states which have provided patients the opportunity to use chiropractic services. School districts and the Alaska School Activities Association have been cautious in this regard, and although not officially supporting the bill, have welcomed the clarification of the acceptability of pre-participation physicals performed by chiropractic practitioners. 5:21:24 PM BRANDON BREFCZYNSKI, Staff, Senator Bill Stoltze, paraphrased from the following sectional analysis: Section 1: Amends AS 08.20.055 by adding new language that allows the board to adopt regulations for the following: - Training and scope of practice of chiropractic interns and chiropractic preceptors; - Designation of a nationally recognized certification program for chiropractic clinical assistants; - Performance of patient examinations. Section 2: Amends AS 08.20.100(b) clarifying how chiropractors can accept referrals, authorizes chiropractors to perform school physicals, and allows the employment of certified chiropractic clinical assistants, chiropractic interns, and chiropractic preceptors. Section 3: Amends AS 08.20.100 by adding a new subsection (d) that exempts chiropractic interns from this section. Section 4: Amends AS 08.20.160 regarding the requirements for temporary permits. Section 5: Amends AS 08.20 by adding a new section (AS 08.20.168 Chiropractic clinical assistant) providing qualifications and allowed duties of chiropractic clinical assistants. Section 6: Amends 08.20.185 by changing name of "peer review committee" to "utilization review committee" to better reflect the purpose of the committee. Also, the change is intended to assist in determining what complaints warrant a referral to investigative staff. Section 7: Amends AS 08.20 by adding a new section (AS 08.20.195 Limitation of practice) requiring chiropractic clinical assistants, interns, and preceptors to act within the scope of practice as authorized by the board of chiropractic examiners. Section 8: Amends AS 08.20.200 by updating penalties for unlicensed practice. Section 9: Amends AS 08.20.210 by updating penalties for fraudulent licenses and certificates. Section 10: Amends definition of "chiropractic examination" located in AS 08.20.900(7). Section 11: Amends AS 08.20.900 by adding new definitions for "chiropractic clinical assistant," chiropractic intern," and "chiropractic preceptor." 5:26:02 PM SENATOR STOLTZE stated the bill's attached fiscal note Identifier SB069CS(FIN)-DCCED-CBPL-04-06-16 is a onetime expenditure of $2,500. REPRESENTATIVE HUGHES directed attention to page 4, [beginning on line 3] which read: Sec. 7. AS 08.20 is amended by adding a new section to article 2 to read: Sec. 08.20.195. Limitation of practice. A person licensed under this chapter or a person who is practicing as a chiropractic intern, chiropractic clinical assistant, or chiropractic preceptor under this chapter may only act within the scope of practice authorized by the board. REPRESENTATIVE HUGHES asked whether the above section gives the board authority to broaden the scope of practice in any way. 5:27:35 PM SENATOR STOLTZE stated the foregoing section is a good faith effort between the medical and chiropractic professions, and his office, to accomplish the bill's goals without overly expanding the scope. MR. BREFCZYNSKI said that Legislative Legal Services, Legislative Affairs Agency, advised that AS 08.20.100, AS 08.20.230, and AS 08.20.900 are related to the practice of chiropractic and outline the scope of chiropractic practice. REPRESENTATIVE HUGHES expressed concern regarding sports pre- examinations of children with health challenges, although expanding the scope and availability of providers makes health care more affordable and accessible. She directed attention to page 2, lines 7 and 8 which read: (2) accept referrals for [CHIROPRACTIC] treatment by chiropractic core methodology or by ancillary methodology; REPRESENTATIVE HUGHES asked for the meaning of core methodology and ancillary methodology. [The chair asked that she hold her question.] 5:30:42 PM REPRESENTATIVE KITO directed attention to page 4, [beginning on line 8] which read: * Sec. 8. AS 08.20.200 is amended to read: Sec. 08.20.200. Unlicensed practice [A MISDEMEANOR]. A person who practices chiropractic in the state without a license in violation of AS 08.20.100 is guilty of a class A misdemeanor and may be punished as provided in AS 12.55 [,AND UPON CONVICTION IS PUNISHABLE BY A FINE OF NOT MORE THAN $1,000, OR BY IMPRISONMENT FOR NOT MORE THAN A YEAR, OR BY BOTH]. * Sec. 9. AS 08.20.210 is amended to read: Sec. 08.20.210. Fraudulent licenses and certificates. A person who obtains or attempts to obtain a chiropractic license or provides the board with evidence that the person is nationally certified to practice as a chiropractic clinical assistant [CERTIFICATE] by dishonest or fraudulent means [,] or who forges, counterfeits, or fraudulently alters a chiropractic license or chiropractic clinical assistant certificate issued by a nationally recognized certification program is guilty of a class A misdemeanor and is punishable as provided in AS 12.55 [BY A FINE OF NOT MORE THAN $500, OR BY IMPRISONMENT FOR NOT MORE THAN SIX MONTHS, OR BY BOTH]. REPRESENTATIVE KITO asked what penalty is added by AS 12.55. MR. BREFCZYNSK responded that both of the foregoing sections increase penalties to a class A misdemeanor, which is punishable by up to one year in jail and a fine of up to $10,000. REPRESENTATIVE KITO directed attention to page 5, [beginning on line 8] which read: * Sec. 11. AS 08.20.900 is amended by adding new paragraphs to read: (11) "chiropractic clinical assistant" means a person who works under the general supervision of a person licensed under this chapter and who is (A) enrolled in a nationally recognized certification program that certifies chiropractic clinical assistants; or (B) certified by a national organization that certifies chiropractic clinical assistants; (12) "chiropractic intern" means a person who is engaged in the practice of chiropractic while under the personal supervision of a person licensed under this chapter for the purpose of obtaining practical experience for licensure as a chiropractor; (13) "chiropractic preceptor" means a person who is licensed under this chapter and who participates in the instruction and training of chiropractic interns. REPRESENTATIVE KITO requested further information regarding the requirements to be a chiropractic intern. MR. BREFCZYNSK stated that interns are working to gain experience. REPRESENTATIVE KITO clarified that interns do not have to be currently enrolled in a certification program. MR. BREFCZYNSK deferred. 5:33:15 PM REPRESENTATIVE JOSEPHSON returned attention to Sections 8 and 9 [text previously provided]. He asked for the reason behind the imposition of stricter penalties. SENATOR STOLTZE observed that the penalties are recommendations from the industry and the Board of Chiropractic Examiners. 5:34:17 PM CHAIR OLSON opened public testimony. 5:34:28 PM EDWARD BARRINGTON, DC, said he is chair of the Alaska Chiropractic Society Legislative Committee, and serves on the Board of Chiropractic Examiners. Dr. Barrington said both entities support SB 69. In response to Representative Hughes' previous questions, he explained that chiropractic core methodology is chiropractic treatment, and examples of ancillary methodology are treatments by ultrasound, muscle stimulation, exercise, diet, nutrition, oxygen, heat, and cold. REPRESENTATIVE KITO restated his question on the qualifications and responsibilities of chiropractic interns. DR. BARRINGTON answered that an intern has satisfied all the graduation requirements of chiropractic college, and is seeking a clinical setting for more training and experience. Interns work under a preceptor, who is a supervising doctor. REPRESENTATIVE KITO asked for the qualifications of a chiropractic preceptor. DR. BARRINGTON explained that a preceptor is required to undergo a certain scrutiny in order to host an intern. In further response to Representative Kito, he said the criteria to be a preceptor is established by the Board of Chiropractic Examiners, however, some colleges are unable to send interns to Alaska in the absence of the proposed legislation. REPRESENTATIVE JOSEPHSON restated his question related to the origin of increasing penalties for unlicensed practice. DR. BARRINGTON advised that the recommendations were suggested by state investigators in order to conform to other boards. 5:39:50 PM CHAIR OLSON, after ascertaining no one else wished to testify, closed public testimony. 5:40:05 PM REPRESENTATIVE HUGHES moved to report CSSB 69(FIN), Version 29- LS0704\S, out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSSB 69(FIN) was reported out of the House Labor and Commerce Standing Committee.