DAR File No. 27355

Commerce, Occupational and Professional Licensing

R156-73

Chiropractic Physician Practice Act Rules

NOTICE OF PROPOSED RULE

DAR File No.: 27355
Filed: 08/17/2004, 07:47
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

As a result of S.B. 249 passed during the 2004 legislative session, amendments are being proposed to update definitions, clarify continuing education requirements, and update requirements for chiropractic physicians who provide acupuncture services as part of their practice. (DAR NOTE: S.B. 249 is found at UT L 2004 Ch 309, and was effective 05/03/2004.)

Summary of the rule or change:

In Section R156-73-102, added definitions for the following: "Distance learning", "FCLB" (Federation of Chiropractic Licensing Boards), "NBCE" (National Board of Chiropractic Examiners); "PACE" (Providers of Approved Continuing Education sponsored by the Federation of Chiropractic Licensing Boards) and renumbered the remaining subsections. In Section R156-73-103, updated a statute citation reference. In Section R156-73-303b, added Providers of Continuing Education (PACE) of the Federation of Chiropractic Licensing Boards as an additional organization that may approve chiropractic continuing education programs. Also, added that no more than 10 hours of continuing education in each 2-year period may be completed by distance learning and added that as part of the 40 continuing education hours required every 2 years, a chiropractic physician who provides acupuncture services as a part of their practice shall complete 10 hours of acupuncture-related continuing education. In Section R156-73-601, changes are being proposed to clarify what competency, training, and examinations are required for chiropractic physicians to practice clinical acupuncture.

State statutory or constitutional authorization for this rule:

Section 58-73-101, and Subsections 58-1-106(1)(a) and 58-1-202(1)(a)

Anticipated cost or savings to:

the state budget:

The Division will incur costs of approximately $100 to reprint the rule once these proposed amendments are made effective. Any costs incurred will be absorbed in the Division's current budget.

local governments:

Proposed amendments do not apply to local governments. Therefore, no costs or savings are anticipated.

other persons:

Proposed amendments will only apply to licensed chiropractic physicians and or applicants for licensure as a chiropractic physician. The proposed amendment allowing no more than 10 continuing education hours in distance learning may result in a potential savings to licensed chiropractic physicians. Usually, distance learning continuing education programs are more expensive than in-person programs and if a chiropractic physician is only allowed 10 hours out of the total 40 hours required, the remaining 30 hours must be obtained through continuing education programs that may cost less money. The Division is unable to determine any exact savings amount since the cost of continuing education programs is so varied. Licensed chiropractic physicians who begin providing clinical acupuncture services as a part of their practice on or after January 1, 2005, will be required to meet the requirements to take and receive a passing score on one of two acupuncture examinations. The cost of either examination is $300 in addition to costs to obtain the required training, which costs are unknown to the Division. The Division is unable to determine how many chiropractic physicians will begin providing clinical acupuncture services after January 1, 2005.

Compliance costs for affected persons:

Proposed amendments will only apply to licensed chiropractic physicians and or applicants for licensure as a chiropractic physician. Licensed chiropractic physicians who begin providing clinical acupuncture services as a part of their practice on or after January 1, 2005, will be required to meet the requirements to take and receive a passing score on one of two acupuncture examinations. The cost of either examination is $300 in addition to costs to obtain the required training, which costs are unknown to the Division. The Division is unable to determine how many chiropractic physicians will begin providing clinical acupuncture services after January 1, 2005.

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule change requires a chiropractic physician to obtain continuing education in acupuncture, 10 credit hours for each 2-year period, in order to practice acupuncture. The rule also adds an examination requirement in acupuncture for chiropractic physicians who begin providing acupuncture services on or after January 1, 2005. There are currently 712 chiropractic physician licensees; approximately 30% already practice acupuncture. The cost of each credit of continuing education is approximately $20; the cost of each examination is approximately $300. Thus, the rule change will impact 30% of the current chiropractic physicians as to the continuing education requirement. It is difficult to determine how many of the remaining 70% will begin practicing acupuncture after January 1, 2005, and will incur the cost of the examinations. The rule filing also contains some technical changes, including definitions, which do not create any fiscal impact to businesses. Klarice A. Bachman, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Direct questions regarding this rule to:

Daniel T. Jones at the above address, by phone at 801-530-6767, by FAX at 801-530-6511, or by Internet E-mail at dantjones@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

10/15/2004

Interested persons may attend a public hearing regarding this rule:

10/14/2004 at 9:00 AM, Heber Wells Building, 160 E 300 S, Conference Room 4A (Fourth Floor), Salt Lake City, UT

This rule may become effective on:

10/16/2004

Authorized by:

J. Craig Jackson, Director

RULE TEXT

R156. Commerce, Occupational and Professional Licensing.

R156-73. Chiropractic Physician Practice Act Rules.

R156-73-102. Definitions.

In addition to the definitions in Title 58, Chapters 1 and 73, as used in Title 58, Chapters 1 and 73, or these rules:

(1) "Clinical acupuncture" means the application of mechanical, thermal, manual, and/or electrical stimulation of acupuncture points and meridians, including the insertion of needles, by a chiropractic physician that has demonstrated competency and training by completing a recognized course that is sponsored by an institution or organization approved to sponsor continuing education, as defined in Section R156-73-303b.

(2) "Distance learning" means the acquisition of knowledge and skills through information and instruction encompassing all technologies and other forms of learning at a distance, including internet, audio/visual recordings, mail or other correspondence.

(3) "FCLB" means the Federation of Chiropractic Licensing Boards.

([2]4) "Indirect supervision" means the supervising licensed chiropractic physician shall be available for immediate voice contact by telephone, radio, or other means and shall provide daily face to face consultation and review of cases at the chiropractic facility for the chiropractic intern, temporarily licensed or unlicensed person being supervised.

(5) "NBCE" means the National Board of Chiropractic Examiners.

(6) "PACE" means Providers of Approved Continuing Education sponsored by the Federation of Chiropractic Licensing Boards.

([3]7) "Preceptor" means a licensed chiropractic physician who is a supervisor of interns and externs in the professional practice of chiropractic.

([4]8) "Preceptorship" means a supervised training program established by a written contract between a chiropractic college or university whose program or institution is accredited by the Council on Chiropractic Education, Inc., and a licensee for the purpose of providing chiropractic training to a student enrolled in the chiropractic college or university while under the supervision of a licensee.

([5]9) "Unprofessional conduct", as defined in Title 58, Chapters 1 and 73, is further defined in accordance with Subsection 58-1-203(5), in Section R156-73-501.

R156-73-103. Authority - Purpose.

These rules are adopted by the division under the authority of Subsection 58-1-106(1)(a) to enable the division to administer Title 58, Chapter 73.

R156-73-303b. Continuing Education - Standards.

(1) The standards for continuing education are as follows:

(a) the content must be relevant to chiropractic practice and consistent with the laws and rules of this state;

(b) the course must be under the sponsorship of or approved by:

(i) a chiropractic college or university whose doctor of chiropractic program is accredited by the Council on Chiropractic Education, Inc.;

(ii) a professional association or nonprofit organization representing a licensed profession whose program objectives relate to the practice of chiropractic;[ or]

(iii) the licensing agency of another state; or

(iv) PACE;

(c) learning objectives must be reasonably and clearly stated;

(d) teaching methods must be clearly stated and appropriate;

(e) faculty must be qualified, both in experience and in teaching expertise;

(f) documentation of attendance must be provided;[ and]

(g) there shall be no more than four clock hours related to chiropractic practice marketing or practice building;

(h) no more than 10 hours of continuing education, in each two year period of licensure, may be by distance learning.

(2) A licensee shall be responsible for maintaining competent records of completed continuing education for a period of two years after close of the two year period to which the records pertain.

(3) The board may, after review, waive the continuing education requirements for a licensee presenting sufficient evidence of hardship or illness or other reason making it impossible or highly impractical for the licensee to attend or have attended a sufficient number of continuing education classes.

(4) As part of the 40 continuing education hours required every two years, a chiropractic physician, who provides acupuncture services as a part of their practice, shall complete 10 hours of acupuncture related continuing education.

R156-73-601. Scope of Practice.

The requirements to demonstrate competency and training to perform clinical acupuncture include:

(1) Licensees who provided acupuncture services as a part of their practice prior to January 1, 2002 are not required to meet the requirements of Subsections (2) or (3), but are required to complete[completing] a recognized clinical acupuncture course sponsored by an institution or organization approved to sponsor continuing education, as defined in Section R156-73-303b, consisting of at least 100 classroom hours of instruction and passing a certifying examination in order to continue to provide clinical acupuncture as a part of their practice after January 1, 2002.

(2) [Beginning January 1, 2002, for licensees who have not previously met the requirements listed in Subsection (1), the requirements to demonstrate competency and training to perform clinical acupuncture shall be]Licensees who begin providing clinical acupuncture as a part of their practice on or after January 1, 2002 and prior to January 1, 2005 shall:

(a) [completing]complete a recognized clinical acupuncture course sponsored by an institution or organization approved to sponsor continuing education, as defined in Section R156-73-303b, consisting of at least 200 classroom hours of instruction and passing a certifying examination; or

(b) [completing]complete a recognized clinical acupuncture course sponsored by an institution or organization approved to sponsor continuing education, as defined in Section R156-73-303b, consisting of at least 100 classroom hours of instruction, passing a certifying examination, and completing 100 hours of clinical experience under the indirect supervision of a licensed health care provider who has met the requirements in Subsection (1) or (2)(a), and has practiced clinical acupuncture for at least two years.

(3) Licensees who begin providing clinical acupuncture as a part of their practice on or after January 1, 2005 shall:

(a) meet the requirements to take and receive a passing score on the NBCE Acupuncture Examination; or

(b) meet the requirements to take and receive a passing score on the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) Examination.

KEY: chiropractors, licensing, chiropractic physician

[September 5, 2002]2004

Notice of Continuation July 5, 2001

58-73-101

58-1-106(1)(a)

58-1-202(1)(a)

ADDITIONAL INFORMATION

PLEASE NOTE:

• Text to be deleted is struck through and surrounded by brackets (e.g., [example]). Text to be added is underlined (e.g., example). Some browsers may not depict some or any of these attributes on the screen or when the document is printed.
• Please see the DISCLAIMER regarding information available from state web pages.

For questions regarding the content or application of this rule, please contact Daniel T. Jones at the above address, by phone at 801-530-6767, by FAX at 801-530-6511, or by Internet E-mail at dantjones@utah.gov

For questions about the rulemaking process, please contact the Division of Administrative Rules (801-538-3764). Please Note: The Division of Administrative Rules is NOT able to answer questions about the content or application of these administrative rules.