Florida Senate - 2019                                    SB 1242
       
       
        
       By Senator Rouson
       
       
       
       
       
       19-01544-19                                           20191242__
    1                        A bill to be entitled                      
    2         An act relating to chiropractors; amending s. 460.402,
    3         F.S.; revising an exemption from regulation under ch.
    4         460, F.S., for certain chiropractic students; amending
    5         s. 460.403, F.S.; conforming definitions to changes
    6         made by the act; amending s. 460.406, F.S.; revising
    7         application requirements for licensure by examination;
    8         conforming cross-references to changes made by the
    9         act; amending s. 460.4062, F.S.; revising requirements
   10         for the issuance of a chiropractic medicine faculty
   11         certificate without examination; conforming a
   12         provision to changes made by the act; amending ss.
   13         460.4061, 460.4165, 460.4167, and 400.9905, F.S.;
   14         conforming provisions to changes made by the act;
   15         providing an effective date.
   16          
   17  Be It Enacted by the Legislature of the State of Florida:
   18  
   19         Section 1. Subsection (6) of section 460.402, Florida
   20  Statutes, is amended to read:
   21         460.402 Exceptions.—The provisions of this chapter shall
   22  not apply to:
   23         (6) A chiropractic student enrolled in a chiropractic
   24  school, college, or program accredited by an accrediting agency
   25  recognized by the United States Secretary of Education or a
   26  course of study leading to a degree in chiropractic from an
   27  institution of higher education located outside the United
   28  States which is approved by the board as reasonably comparable
   29  to that of similar accredited institutions in the United States
   30  based on information that includes evaluations by third parties
   31  with experience in evaluating the comparability of educational
   32  programs the Council on Chiropractic Education and participating
   33  in either:
   34         (a) A community-based internship under the direct
   35  supervision of a doctor of chiropractic medicine who is
   36  credentialed as an adjunct faculty member of a chiropractic
   37  college in which the student is enrolled; or
   38         (b) A chiropractic college clinical internship under the
   39  direct supervision of a doctor of chiropractic medicine who is a
   40  full-time, part-time, or adjunct faculty member of a
   41  chiropractic college located in this state and accredited by an
   42  accrediting agency recognized by the United States Secretary of
   43  Education or an institution of higher education located outside
   44  the United States which is approved by the board as reasonably
   45  comparable to that of similar accredited institutions in the
   46  United States based on information that includes evaluations by
   47  third parties with experience in evaluating the comparability of
   48  educational programs the Council on Chiropractic Education and
   49  who holds a current, active Florida chiropractor’s license.
   50         Section 2. Subsection (4) and paragraph (a) of subsection
   51  (9) of section 460.403, Florida Statutes, are amended to read:
   52         460.403 Definitions.—As used in this chapter, the term:
   53         (4)(a) “Community-based internship” means a program in
   54  which a student enrolled in the last year of a chiropractic
   55  college accredited by an accrediting agency recognized by the
   56  United States Secretary of Education or a course of study
   57  leading to a degree in chiropractic from an institution of
   58  higher education located outside the United States which is
   59  approved by the board as reasonably comparable to that of
   60  similar accredited institutions in the United States based on
   61  information that includes evaluations by third parties with
   62  experience in evaluating the comparability of educational
   63  programs the Council on Chiropractic Education is approved to
   64  obtain required pregraduation clinical experience in a
   65  chiropractic clinic or practice under the direct supervision of
   66  a doctor of chiropractic medicine approved as an adjunct faculty
   67  member of the chiropractic college in which the student is
   68  enrolled, according to the teaching protocols for the clinical
   69  practice requirements of the college.
   70         (b) “Chiropractic college clinical internship” means a
   71  program in which a student enrolled in a chiropractic college
   72  located in this state and accredited by an accrediting agency
   73  recognized by the United States Secretary of Education or a
   74  course of study leading to a degree in chiropractic from an
   75  institution of higher education located outside the United
   76  States which is approved by the board as reasonably comparable
   77  to that of similar accredited institutions in the United States
   78  based on information that includes evaluations by third parties
   79  with experience in evaluating the comparability of educational
   80  programs the Council on Chiropractic Education obtains clinical
   81  experience pursuant to the chiropractic college’s curriculum in
   82  a classroom or chiropractic clinic operated by the chiropractic
   83  college, according to the teaching protocols for the clinical
   84  practice requirements of the college.
   85         (9)(a) “Practice of chiropractic medicine” means a
   86  noncombative principle and practice consisting of the science,
   87  philosophy, and art of the adjustment, manipulation, and
   88  treatment of the human body in which vertebral subluxations and
   89  other malpositioned articulations and structures that are
   90  interfering with the normal generation, transmission, and
   91  expression of nerve impulse between the brain, organs, and
   92  tissue cells of the body, thereby causing disease, are adjusted,
   93  manipulated, or treated, thus restoring the normal flow of nerve
   94  impulse which produces normal function and consequent health by
   95  chiropractic physicians using specific chiropractic adjustment
   96  or manipulation techniques taught in chiropractic colleges
   97  accredited by an accrediting agency recognized by the United
   98  States Secretary of Education or a course of study leading to a
   99  degree in chiropractic from an institution of higher education
  100  located outside the United States which is approved by the board
  101  as reasonably comparable to that of similar accredited
  102  institutions in the United States based on information that
  103  includes evaluations by third parties with experience in
  104  evaluating the comparability of educational programs the Council
  105  on Chiropractic Education. No person other than a licensed
  106  chiropractic physician may render chiropractic services,
  107  chiropractic adjustments, or chiropractic manipulations.
  108         Section 3. Section 460.406, Florida Statutes, is amended to
  109  read:
  110         460.406 Licensure by examination.—
  111         (1) Any person desiring to be licensed as a chiropractic
  112  physician must apply to the department to take the licensure
  113  examination. There shall be an application fee set by the board
  114  not to exceed $100 which shall be nonrefundable. There shall
  115  also be an examination fee not to exceed $500 plus the actual
  116  per applicant cost to the department for purchase of portions of
  117  the examination from the National Board of Chiropractic
  118  Examiners or a similar national organization, which may be
  119  refundable if the applicant is found ineligible to take the
  120  examination. The department shall examine each applicant who the
  121  board certifies has:
  122         (a)1. Completed the application form and remitted the
  123  appropriate fee.
  124         2.(b) Submitted proof satisfactory to the department that
  125  he or she is not less than 18 years of age.
  126         3.(c) Submitted proof satisfactory to the department that
  127  he or she is a graduate of a chiropractic college which is
  128  accredited by an accrediting agency recognized by the United
  129  States Secretary of Education or a course of study leading to a
  130  degree in chiropractic from an institution of higher education
  131  located outside the United States which is approved by the board
  132  as reasonably comparable to that of similar accredited
  133  institutions in the United States based on information that
  134  includes evaluations by third parties with experience in
  135  evaluating the comparability of educational programs or has
  136  status with the Council on Chiropractic Education or its
  137  predecessor agency. However, any applicant who is a graduate of
  138  a chiropractic college that was initially accredited by the
  139  Council on Chiropractic Education in 1995, who graduated from
  140  such college within the 4 years immediately preceding such
  141  accreditation, and who is otherwise qualified shall be eligible
  142  to take the examination. No application for a license to
  143  practice chiropractic medicine shall be denied solely because
  144  the applicant is a graduate of a chiropractic college that
  145  subscribes to one philosophy of chiropractic medicine as
  146  distinguished from another.
  147         4.a.(d)1. For an applicant who has matriculated in a
  148  chiropractic college before prior to July 2, 1990, completed at
  149  least 2 years of residence college work, consisting of a minimum
  150  of one-half the work acceptable for a bachelor’s degree granted
  151  on the basis of a 4-year period of study, in a college or
  152  university accredited by an accrediting agency recognized and
  153  approved by the United States Department of Education. However,
  154  before prior to being certified by the board to sit for the
  155  examination, each applicant who has matriculated in a
  156  chiropractic college after July 1, 1990, shall have been granted
  157  a bachelor’s degree, based upon 4 academic years of study, by a
  158  college or university accredited by a regional accrediting
  159  agency which is a member of the Commission on Recognition of
  160  Postsecondary Accreditation.
  161         b.(I)2. Effective July 1, 2000, completed, before prior to
  162  matriculation in a chiropractic college, at least 3 years of
  163  residence college work, consisting of a minimum of 90 semester
  164  hours leading to a bachelor’s degree in a liberal arts college
  165  or university accredited by an accrediting agency recognized and
  166  approved by the United States Department of Education. However,
  167  before prior to being certified by the board to sit for the
  168  examination, each applicant who has matriculated in a
  169  chiropractic college after July 1, 2000, shall have been granted
  170  a bachelor’s degree from an institution holding accreditation
  171  for that degree from a regional accrediting agency which is
  172  recognized by the United States Department of Education. The
  173  applicant’s chiropractic degree must consist of credits earned
  174  in the chiropractic program and may not include academic credit
  175  for courses from the bachelor’s degree; or
  176         (II)Completed an educational program located outside of
  177  the United States, if the board finds the educational program is
  178  reasonably comparable to the requirement of this paragraph based
  179  on information that includes evaluations by third parties with
  180  experience in evaluating the comparability of educational
  181  programs.
  182         5.(e) Successfully completed the National Board of
  183  Chiropractic Examiners certification examination in parts I, II,
  184  III, and IV, and the physiotherapy examination of the National
  185  Board of Chiropractic Examiners, with a score approved by the
  186  board.
  187         6.(f) Submitted to the department a set of fingerprints on
  188  a form and under procedures specified by the department, along
  189  with payment in an amount equal to the costs incurred by the
  190  Department of Health for the criminal background check of the
  191  applicant; or
  192         (b)For an applicant who holds a valid license to practice
  193  chiropractic in another state or territory of the United States,
  194  demonstrated that he or she:
  195         1.Has actively practiced chiropractic in another state or
  196  territory of the United States for the preceding 10 years
  197  without having his or her license acted against by the licensing
  198  authority of any jurisdiction.
  199         2.Meets the requirements of subparagraphs (a)1., 2., 3.,
  200  4., and 6.
  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 prior to July 1, 1996, in a
  211  chiropractic college, the board shall waive the provisions of
  212  subparagraph (1)(a)3. paragraph (1)(c) if the applicant is a
  213  graduate of a chiropractic college which has been denied
  214  accreditation or approval on the grounds that its curriculum
  215  does not include the training in acupuncture necessary for the
  216  completion of the certification examination or is a graduate of
  217  a chiropractic college where acupuncture is not taught or
  218  offered if the college is accredited by or has status with the
  219  Council on 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 subparagraphs (1)(a)1.-5. paragraphs (1)(a)-(e)
  232  and who have successfully passed the state licensure
  233  examination. An applicant who is notified in writing by the
  234  department of the successful completion of requirements in
  235  subparagraphs (1)(a)1.-5. paragraphs (1)(a)-(e) and who has
  236  successfully passed the state licensure examination may lawfully
  237  practice pending receipt of the certificate of licensure, and
  238  the written notification shall act as evidence of licensure
  239  entitling the chiropractic physician to practice for a maximum
  240  period of 45 days or until the licensing fee is received by the
  241  department whichever is sooner.
  242         (5) A student in a school or college of chiropractic
  243  accredited by an accrediting agency recognized by the United
  244  States Secretary of Education or a course of study leading to a
  245  degree in chiropractic from an institution of higher education
  246  located outside the United States which is approved by the board
  247  as reasonably comparable to that of similar accredited
  248  institutions in the United States based on information that
  249  includes evaluations by third parties with experience in
  250  evaluating the comparability of educational programs the Council
  251  on Chiropractic Education or its successor in the final year of
  252  the program may file an application pursuant to subsection (1),
  253  take all examinations required for licensure, and submit a set
  254  of fingerprints, and pay all fees required for licensure. A
  255  chiropractic student who successfully completes the licensure
  256  examinations and who otherwise meets all requirements for
  257  licensure as a chiropractic physician during the student’s final
  258  year must have graduated before being certified for licensure
  259  pursuant to this section.
  260         Section 4. Subsection (1) of section 460.4062, Florida
  261  Statutes, is amended to read:
  262         460.4062 Chiropractic medicine faculty certificate.—
  263         (1) The department may issue a chiropractic medicine
  264  faculty certificate without examination to an individual who
  265  remits a nonrefundable application fee, not to exceed $100 as
  266  determined by rule of the board, and who demonstrates to the
  267  board that he or she meets the following requirements:
  268         (a) Is a graduate of a an accredited school or college of
  269  chiropractic accredited by an accrediting agency recognized by
  270  the United States Secretary of Education or a course of study
  271  leading to a degree in chiropractic from an institution of
  272  higher education located outside the United States which is
  273  approved by the board as reasonably comparable to that of
  274  similar accredited institutions in the United States based on
  275  information that includes evaluations by third parties with
  276  experience in evaluating the comparability of educational
  277  programs the Council on Chiropractic Education.
  278         (b) Holds a valid current license to practice chiropractic
  279  medicine in another jurisdiction in the United States.
  280         (c) Is at least 21 years of age and of good moral
  281  character.
  282         (d) Has not committed any act or offense in any
  283  jurisdiction which would constitute the basis for discipline
  284  under this chapter or chapter 456.
  285         (e)1. Performs research or has been offered and has
  286  accepted a full-time or part-time faculty appointment to teach
  287  in a program of chiropractic medicine at a publicly funded state
  288  university or college or at a college of chiropractic located in
  289  the state and accredited by an accrediting agency recognized by
  290  the United States Secretary of Education the Council on
  291  Chiropractic Education; and
  292         2. Provides a certification from the dean of the appointing
  293  college acknowledging the appointment.
  294         Section 5. Paragraph (a) of subsection (1) of section
  295  460.4061, Florida Statutes, is amended to read:
  296         460.4061 Restricted license.—
  297         (1) An applicant for licensure as a chiropractic physician
  298  may apply to the department for a restricted license without
  299  undergoing a state or national written or clinical competency
  300  examination for licensure if the applicant initially applies not
  301  later than October 31, 1994, for the restricted license and:
  302         (a) Holds a degree from a college of chiropractic
  303  accredited by an accrediting agency recognized by the United
  304  States Secretary of Education the Council on Chiropractic
  305  Education or its predecessor agency and holds a bachelor’s
  306  degree.
  307         Section 6. Paragraph (b) of subsection (13) of section
  308  460.4165, Florida Statutes, is amended to read:
  309         460.4165 Certified chiropractic physician’s assistants.—
  310         (13) CERTIFIED CHIROPRACTIC ASSISTANT CERTIFICATION
  311  RENEWAL.—The certification must be renewed biennially.
  312         (b) Each certified chiropractic physician’s assistant shall
  313  biennially complete 24 hours of continuing education courses
  314  approved by the board and sponsored by an accrediting agency
  315  recognized by the United States Secretary of Education
  316  chiropractic colleges accredited by the Council on Chiropractic
  317  Education and approved by the board. The board shall approve
  318  those courses that build upon the basic courses required for the
  319  practice of chiropractic medicine, and the board may also
  320  approve courses in adjunctive modalities. The board may make
  321  exception from the requirements of this section in emergency or
  322  hardship cases. The board may adopt rules within the
  323  requirements of this section which are necessary for its
  324  implementation.
  325         Section 7. Paragraph (d) of subsection (1) of section
  326  460.4167, Florida Statutes, is amended to read:
  327         460.4167 Proprietorship by persons other than licensed
  328  chiropractic physicians.—
  329         (1) A person may not employ a chiropractic physician
  330  licensed under this chapter or engage a chiropractic physician
  331  licensed under this chapter as an independent contractor to
  332  provide services that chiropractic physicians are authorized to
  333  offer under this chapter, unless the person is any of the
  334  following:
  335         (d) A clinical facility that is affiliated with a college
  336  of chiropractic accredited by an accrediting agency recognized
  337  by the United States Secretary of Education the Council on
  338  Chiropractic Education at which training is provided for
  339  chiropractic students.
  340         Section 8. Paragraph (j) of subsection (4) of section
  341  400.9905, Florida Statutes, is amended to read:
  342         400.9905 Definitions.—
  343         (4) “Clinic” means an entity where health care services are
  344  provided to individuals and which tenders charges for
  345  reimbursement for such services, including a mobile clinic and a
  346  portable equipment provider. As used in this part, the term does
  347  not include and the licensure requirements of this part do not
  348  apply to:
  349         (j) Clinical facilities affiliated with a college of
  350  chiropractic accredited by an accrediting agency recognized by
  351  the United States Secretary of Education the Council on
  352  Chiropractic Education at which training is provided for
  353  chiropractic students.
  354  
  355  Notwithstanding this subsection, an entity shall be deemed a
  356  clinic and must be licensed under this part in order to receive
  357  reimbursement under the Florida Motor Vehicle No-Fault Law, ss.
  358  627.730-627.7405, unless exempted under s. 627.736(5)(h).
  359         Section 9. This act shall take effect upon becoming a law.