Florida Senate - 2023 SB 378
By Senator Garcia
36-00872-23 2023378__
1 A bill to be entitled
2 An act relating to the practice of chiropractic
3 medicine; amending s. 400.9905, F.S.; revising the
4 definition of the term “clinic” as it relates to the
5 regulation of health care clinics; amending s.
6 460.402, F.S.; revising applicability of ch. 460,
7 F.S.; amending s. 460.403, F.S.; revising definitions;
8 amending s. 460.406, F.S.; revising licensure
9 requirements for chiropractic physicians; amending s.
10 460.4061, F.S.; revising requirements for restricted
11 licenses for chiropractic physicians; amending s.
12 460.4062, F.S.; revising requirements for chiropractic
13 medicine faculty certificates; amending s. 460.4165,
14 F.S.; revising certification requirements for
15 certified chiropractic assistants; amending s.
16 460.4167, F.S.; revising criteria for clinical
17 facilities that may employ or engage chiropractic
18 physicians to provide chiropractic services; providing
19 an effective date.
20
21 Be It Enacted by the Legislature of the State of Florida:
22
23 Section 1. Paragraph (j) of subsection (4) of section
24 400.9905, Florida Statutes, is amended to read:
25 400.9905 Definitions.—
26 (4) “Clinic” means an entity where health care services are
27 provided to individuals and which tenders charges for
28 reimbursement for such services, including a mobile clinic and a
29 portable equipment provider. As used in this part, the term does
30 not include and the licensure requirements of this part do not
31 apply to:
32 (j) Clinical facilities affiliated with a college of
33 chiropractic accredited by an accrediting agency recognized by
34 the United States Department of Education the Council on
35 Chiropractic Education at which training is provided for
36 chiropractic students.
37
38 Notwithstanding this subsection, an entity shall be deemed a
39 clinic and must be licensed under this part in order to receive
40 reimbursement under the Florida Motor Vehicle No-Fault Law, ss.
41 627.730-627.7405, unless exempted under s. 627.736(5)(h).
42 Section 2. Subsection (6) of section 460.402, Florida
43 Statutes, is amended to read:
44 460.402 Exceptions.—The provisions of this chapter shall
45 not apply to:
46 (6) A chiropractic student enrolled in a chiropractic
47 college accredited by an accrediting agency recognized by the
48 United States Department of Education the Council on
49 Chiropractic Education and participating in either:
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; or
54 (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 and accredited by an
58 accrediting agency recognized by the United States Department of
59 Education the Council on Chiropractic Education and who holds a
60 current, active Florida chiropractor’s license.
61 Section 3. Subsection (4) and paragraph (a) of subsection
62 (9) of section 460.403, Florida Statutes, are amended to read:
63 460.403 Definitions.—As used in this chapter, the term:
64 (4)(a) “Community-based internship” means a program in
65 which a student enrolled in his or her the last year of a
66 chiropractic college accredited by an accrediting agency
67 recognized by the United States Department of Education the
68 Council on Chiropractic Education is approved to obtain required
69 pregraduation clinical experience in a chiropractic clinic or
70 practice under the direct supervision of a doctor of
71 chiropractic medicine approved as an adjunct faculty member of
72 the chiropractic college in which the student is enrolled,
73 according to the teaching protocols for the clinical practice
74 requirements of the college.
75 (b) “Chiropractic college clinical internship” means a
76 program in which a student enrolled in a chiropractic college
77 that is located in this state and accredited by an accrediting
78 agency recognized by the United States Department of Education
79 the Council on Chiropractic Education obtains clinical
80 experience pursuant to the chiropractic college’s curriculum in
81 a classroom or chiropractic clinic operated by the chiropractic
82 college, according to the teaching protocols for the clinical
83 practice requirements of the college.
84 (9)(a) “Practice of chiropractic medicine” means a
85 noncombative principle and practice consisting of the science,
86 philosophy, and art of the adjustment, manipulation, and
87 treatment of the human body in which vertebral subluxations and
88 other malpositioned articulations and structures that are
89 interfering with the normal generation, transmission, and
90 expression of nerve impulse between the brain, organs, and
91 tissue cells of the body, thereby causing disease, are adjusted,
92 manipulated, or treated, thus restoring the normal flow of nerve
93 impulse which produces normal function and consequent health by
94 chiropractic physicians using specific chiropractic adjustment
95 or manipulation techniques taught in chiropractic colleges
96 accredited by an accrediting agency recognized by the United
97 States Department of Education the Council on Chiropractic
98 Education. No person other than a licensed chiropractic
99 physician may render chiropractic services, chiropractic
100 adjustments, or chiropractic manipulations.
101 Section 4. Subsections (1), (2), and (5) of section
102 460.406, Florida Statutes, are amended to read:
103 460.406 Licensure by examination.—
104 (1) Any person desiring to be licensed as a chiropractic
105 physician must apply to the department to take the licensure
106 examination. There is shall be an application fee set by the
107 board not to exceed $100 which is shall be nonrefundable. There
108 is shall also be an examination fee not to exceed $500 plus the
109 actual per applicant cost to the department for purchase of
110 portions of the examination from the National Board of
111 Chiropractic Examiners or a similar national organization, which
112 may be refundable if the applicant is found ineligible to take
113 the examination. The department shall examine each applicant
114 whom the board certifies has met all of the following criteria:
115 (a) Completed the application form and remitted the
116 appropriate fee.
117 (b) Submitted proof satisfactory to the department that he
118 or she is not less than 18 years of age.
119 (c) Submitted proof satisfactory to the department that he
120 or she is a graduate of a chiropractic college which is
121 accredited by or has status with an accrediting agency
122 recognized by the United States Department of Education the
123 Council on Chiropractic Education or its predecessor agency.
124 However, any applicant who is a graduate of a chiropractic
125 college that was initially accredited by the Council on
126 Chiropractic Education in 1995, who graduated from such college
127 within the 4 years immediately preceding such accreditation, and
128 who is otherwise qualified is eligible to take the examination.
129 An application for a license to practice chiropractic medicine
130 may not be denied solely because the applicant is a graduate of
131 a chiropractic college that subscribes to one philosophy of
132 chiropractic medicine as distinguished from another.
133 (d)1. For an applicant who has matriculated in a
134 chiropractic college before July 2, 1990, completed at least 2
135 years of residence college work, consisting of a minimum of one
136 half the work acceptable for a bachelor’s degree granted on the
137 basis of a 4-year period of study, in a college or university
138 accredited by an institutional accrediting agency recognized and
139 approved by the United States Department of Education. However,
140 before being certified by the board to sit for the examination,
141 each applicant who has matriculated in a chiropractic college
142 after July 1, 1990, must have been granted a bachelor’s degree,
143 based upon 4 academic years of study, by a college or university
144 accredited by an institutional accrediting agency that is a
145 member of the Commission on Recognition of Postsecondary
146 Accreditation.
147 2. Effective July 1, 2000, completed, before matriculation
148 in a chiropractic college, at least 3 years of residence college
149 work, consisting of a minimum of 90 semester hours leading to a
150 bachelor’s degree in a liberal arts college or university
151 accredited by an institutional accrediting agency recognized and
152 approved by the United States Department of Education. However,
153 before being certified by the board to sit for the examination,
154 each applicant who has matriculated in a chiropractic college
155 after July 1, 2000, must have been granted a bachelor’s degree
156 from an institution holding accreditation for that degree from
157 an institutional accrediting agency that is recognized by the
158 United States Department of Education. The applicant’s
159 chiropractic degree must consist of credits earned in the
160 chiropractic program and may not include academic credit for
161 courses from the bachelor’s degree.
162 (e) Successfully completed the National Board of
163 Chiropractic Examiners certification examination in parts I, II,
164 III, and IV, and the physiotherapy examination of the National
165 Board of Chiropractic Examiners, with a score approved by the
166 board.
167 (f) Submitted to the department a set of fingerprints on a
168 form and under procedures specified by the department, along
169 with payment in an amount equal to the costs incurred by the
170 Department of Health for the criminal background check of the
171 applicant.
172
173 The board may require an applicant who graduated from an
174 institution accredited by an accrediting agency recognized by
175 the United States Department of Education the Council on
176 Chiropractic Education more than 10 years before the date of
177 application to the board to take the National Board of
178 Chiropractic Examiners Special Purposes Examination for
179 Chiropractic, or its equivalent, as determined by the board. The
180 board shall establish by rule a passing score.
181 (2) For those applicants applying for the certification
182 examination who have matriculated prior to July 1, 1996, in a
183 chiropractic college, the board shall waive the provisions of
184 paragraph (1)(c) if the applicant is a graduate of a
185 chiropractic college which has been denied accreditation or
186 approval on the grounds that its curriculum does not include the
187 training in acupuncture necessary for the completion of the
188 certification examination or is a graduate of a chiropractic
189 college where acupuncture is not taught or offered if the
190 college is accredited by or has status with an accrediting
191 agency recognized by the United States Department of Education
192 the Council on Chiropractic Education or its predecessor.
193 (5) A student enrolled in a school or college of
194 chiropractic accredited by an accrediting agency recognized by
195 the United States Department of Education the Council on
196 Chiropractic Education or its successor in the final year of the
197 program may file an application pursuant to subsection (1), take
198 all examinations required for licensure, submit a set of
199 fingerprints, and pay all fees required for licensure. A
200 chiropractic student who successfully completes the licensure
201 examinations and who otherwise meets all requirements for
202 licensure as a chiropractic physician during the student’s final
203 year must have graduated before being certified for licensure
204 pursuant to this section.
205 Section 5. Paragraph (a) of subsection (1) of section
206 460.4061, Florida Statutes, is amended to read:
207 460.4061 Restricted license.—
208 (1) An applicant for licensure as a chiropractic physician
209 may apply to the department for a restricted license without
210 undergoing a state or national written or clinical competency
211 examination for licensure if the applicant initially applies not
212 later than October 31, 1994, for the restricted license and:
213 (a) Holds a degree from a college of chiropractic
214 accredited by an accrediting agency recognized by the United
215 States Department of Education the Council on Chiropractic
216 Education or its predecessor agency and holds a bachelor’s
217 degree.
218 Section 6. Paragraphs (a) and (e) of subsection (1) of
219 section 460.4062, Florida Statutes, are amended to read:
220 460.4062 Chiropractic medicine faculty certificate.—
221 (1) The department may issue a chiropractic medicine
222 faculty certificate without examination to an individual who
223 remits a nonrefundable application fee, not to exceed $100 as
224 determined by rule of the board, and who demonstrates to the
225 board that he or she meets the following requirements:
226 (a) Is a graduate of an accredited school or college of
227 chiropractic accredited by an accrediting agency recognized by
228 the United States Department of Education the Council on
229 Chiropractic Education.
230 (e)1. Performs research or has been offered and has
231 accepted a full-time or part-time faculty appointment to teach
232 in a program of chiropractic medicine at a publicly funded state
233 university or college or at a college of chiropractic located in
234 this the state and accredited by an accrediting agency
235 recognized by the United States Department of Education the
236 Council on Chiropractic Education; and
237 2. Provides a certification from the dean of the appointing
238 college acknowledging the appointment.
239 Section 7. Paragraph (b) of subsection (13) of section
240 460.4165, Florida Statutes, is amended to read:
241 460.4165 Certified chiropractic physician’s assistants.—
242 (13) CERTIFIED CHIROPRACTIC ASSISTANT CERTIFICATION
243 RENEWAL.—The certification must be renewed biennially.
244 (b) Each certified chiropractic physician’s assistant shall
245 biennially complete 24 hours of continuing education courses
246 sponsored by chiropractic colleges accredited by an accrediting
247 agency recognized by the United States Department of Education
248 the Council on Chiropractic Education and approved by the board.
249 The board shall approve those courses that build upon the basic
250 courses required for the practice of chiropractic medicine, and
251 the board may also approve courses in adjunctive modalities. The
252 board may make exception from the requirements of this section
253 in emergency or hardship cases. The board may adopt rules within
254 the requirements of this section which are necessary for its
255 implementation.
256 Section 8. Paragraph (d) of subsection (1) of section
257 460.4167, Florida Statutes, is amended to read:
258 460.4167 Proprietorship by persons other than licensed
259 chiropractic physicians.—
260 (1) A person may not employ a chiropractic physician
261 licensed under this chapter or engage a chiropractic physician
262 licensed under this chapter as an independent contractor to
263 provide services that chiropractic physicians are authorized to
264 offer under this chapter, unless the person is any of the
265 following:
266 (d) A clinical facility that is affiliated with a college
267 of chiropractic accredited by an accrediting agency recognized
268 by the United States Department of Education the Council on
269 Chiropractic Education at which training is provided for
270 chiropractic students.
271 Section 9. This act shall take effect upon becoming a law.