Florida Senate - 2024 COMMITTEE AMENDMENT
Bill No. CS for SB 1474
Ì698850>Î698850
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
02/27/2024 .
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The Committee on Rules (Trumbull) recommended the following:
1 Senate Amendment (with title amendment)
2
3 Delete lines 44 - 155
4 and insert:
5 acupuncture; by the use of monofilament intramuscular
6 stimulation treatment, also known as dry needling, for trigger
7 points or myofascial pain; or by the administration of foods,
8 food concentrates, food extracts, and items for which a
9 prescription is not required and may apply first aid and
10 hygiene, but chiropractic physicians are expressly prohibited
11 from prescribing or administering to any person any legend drug
12 except as authorized under subparagraph 2., from performing any
13 surgery except as stated herein, or from practicing obstetrics.
14 2. Notwithstanding the prohibition against prescribing and
15 administering legend drugs under subparagraph 1. or s.
16 499.83(2)(c), pursuant to board rule chiropractic physicians may
17 order, store, and administer, for emergency purposes only at the
18 chiropractic physician’s office or place of business,
19 prescription medical oxygen and may also order, store, and
20 administer the following topical anesthetics in aerosol form:
21 a. Any solution consisting of 25 percent ethylchloride and
22 75 percent dichlorodifluoromethane.
23 b. Any solution consisting of 15 percent
24 dichlorodifluoromethane and 85 percent
25 trichloromonofluoromethane.
26
27 However, this paragraph does not authorize a chiropractic
28 physician to prescribe medical oxygen as defined in s.
29 499.82(10) chapter 499.
30 (d) Chiropractic physicians shall have the privileges of
31 services from the department’s laboratories.
32 (e) The term “chiropractic medicine,” “chiropractic,”
33 “doctor of chiropractic,” or “chiropractor” shall be synonymous
34 with “chiropractic physician,” and each term shall be construed
35 to mean a practitioner of chiropractic medicine as the same has
36 been defined herein. Chiropractic physicians may analyze and
37 diagnose the physical conditions of the human body to determine
38 the abnormal functions of the human organism and to determine
39 such functions as are abnormally expressed and the cause of such
40 abnormal expression.
41 (f) Any chiropractic physician who has complied with the
42 provisions of this chapter is authorized to analyze and diagnose
43 abnormal bodily functions and to adjust the physical
44 representative of the primary cause of disease as is herein
45 defined and provided. As an incident to the care of the sick,
46 chiropractic physicians may advise and instruct patients in all
47 matters pertaining to hygiene and sanitary measures as taught
48 and approved by recognized chiropractic schools and colleges. A
49 chiropractic physician may not use acupuncture until certified
50 by the board. Certification shall be granted to chiropractic
51 physicians who have satisfactorily completed the required
52 coursework in acupuncture and after successful passage of an
53 appropriate examination as administered by the department. The
54 required coursework shall have been provided by a college or
55 university which is recognized by an accrediting agency approved
56 by the United States Department of Education.
57 Section 2. Paragraph (d) of subsection (1) of section
58 460.406, Florida Statutes, is amended to read:
59 460.406 Licensure by examination.—
60 (1) Any person desiring to be licensed as a chiropractic
61 physician must apply to the department to take the licensure
62 examination. There shall be an application fee set by the board
63 not to exceed $100 which shall be nonrefundable. There shall
64 also be an examination fee not to exceed $500 plus the actual
65 per applicant cost to the department for purchase of portions of
66 the examination from the National Board of Chiropractic
67 Examiners or a similar national organization, which may be
68 refundable if the applicant is found ineligible to take the
69 examination. The department shall examine each applicant whom
70 the board certifies has met all of the following criteria:
71 (d)1. For an applicant who has matriculated in a
72 chiropractic college before July 2, 1990, completed at least 2
73 years of residence college work, consisting of a minimum of one
74 half the work acceptable for a bachelor’s degree granted on the
75 basis of a 4-year period of study, in a college or university
76 accredited by an institutional accrediting agency recognized and
77 approved by the United States Department of Education. However,
78 before being certified by the board to sit for the examination,
79 each applicant who has matriculated in a chiropractic college
80 after July 1, 1990, must have been granted a bachelor’s degree,
81 based upon 4 academic years of study, by a college or university
82 accredited by an institutional accrediting agency that is a
83 member of the Commission on Recognition of Postsecondary
84 Accreditation or have produced a credentials evaluation report
85 from a board-approved organization that deems the applicant’s
86 education equivalent to a bachelor’s degree.
87 2. Effective July 1, 2000, completed, before matriculation
88 in a chiropractic college, at least 3 years of residence college
89 work, consisting of a minimum of 90 semester hours leading to a
90 bachelor’s degree in a liberal arts college or university
91 accredited by an institutional accrediting agency recognized and
92 approved by the United States Department of Education or have
93 produced a credentials evaluation report from a board-approved
94 organization that deems the applicant’s education equivalent to
95 a bachelor’s degree. However, before being certified by the
96 board to sit for the examination, each applicant who has
97 matriculated in a chiropractic college after July 1, 2000, must
98 have been granted a bachelor’s degree from an institution
99 holding accreditation for that degree from an institutional
100 accrediting agency that is recognized by the United States
101 Department of Education or have produced a credentials
102 evaluation report from a board-approved organization that deems
103 the applicant’s education equivalent to a bachelor’s degree. The
104 applicant’s chiropractic degree must consist of credits earned
105 in the chiropractic program and may not include academic credit
106 for courses from the bachelor’s degree.
107
108 The board may require an applicant who graduated from an
109 institution accredited by the Council on Chiropractic Education
110 more than 10 years before the date of application to the board
111 to take the National Board of Chiropractic Examiners Special
112 Purposes Examination for Chiropractic, or its equivalent, as
113 determined by the board. The board shall establish by rule a
114 passing score.
115 Section 3. Section 460.4085, Florida Statutes, is created
116 to read:
117 460.4085 Performance of dry needling by chiropractic
118 physicians.—
119 (1) The board shall establish minimum standards of practice
120 for the performance of dry needling by chiropractic physicians,
121 including, at a minimum, all of the following:
122 (a) Completion of 40 hours of in-person continuing
123 education on the topic of dry needling for chiropractic
124 physicians not certified in chiropractic acupuncture and 24
125 hours of such in-person continuing education for chiropractic
126 physicians certified in chiropractic acupuncture, and passage of
127 a written and practical examination. Online or distance-based
128 courses do not qualify as approved hours to meet the dry
129 needling certification requirements.
130 1. Course content must be approved by one or more of the
131 following entities before a chiropractic physician may take such
132 course for purposes of meeting the continuing education
133 requirements of this paragraph:
134 a. An entity accredited in accordance with s. 460.408.
135 b. The board.
136 c. The American Chiropractic Association.
137 d. The International Chiropractic Association.
138 e. Providers of Approved Continuing Education.
139 f. The American Medical Association.
140 g. The American Osteopathic Association.
141 2. The course instructor must be a licensed chiropractic
142 physician, allopathic or osteopathic physician, or physical
143 therapist holding a Doctor of Physical Therapy degree who has
144 practiced dry needling for at least 5 years, either by
145 instructing dry needling coursework at an accredited institution
146 of higher education or treating patients using dry needling
147 treatment in a professional office setting.
148 3. The continuing education must include instruction in all
149 of the following areas:
150 a. Theory of dry needling.
151 b. Selection and safe handling of needles and other
152 apparatus or equipment used in dry needling, including
153 instruction on the proper handling of biohazardous waste.
154 c. Indications and contraindications for dry needling.
155 d. Psychomotor skills needed to perform dry needling.
156 e. Postintervention care, including adverse responses,
157 adverse event recordkeeping, and any reporting obligations.
158 (b) Completion of at least 10 patient sessions of dry
159 needling performed under the supervision of a licensed
160 chiropractic physician, allopathic or osteopathic physician, or
161 physical therapist holding a Doctor of Physical Therapy degree
162 who has actively performed dry needling for at least 1 year. A
163 chiropractic physician must provide satisfactory documentation
164 to the board demonstrating that he or she has met the
165 supervision and competency requirements of this paragraph and
166 does not need additional supervised sessions to perform dry
167 needling.
168 (c) A requirement that dry needling may not be performed
169 without patient consent and education on the risks and adverse
170 events that could occur. Such patient consent and education must
171 be included as part of the patient’s documented plan of care.
172 (d) A requirement that dry needling may not be delegated to
173 any person other than a chiropractic physician who is authorized
174 to engage in dry needling under this chapter.
175 (2) At the request of a licensee, the board may do any of
176 the following:
177 (a) Review coursework completed before July 1, 2024, to be
178 approved to satisfy the coursework requirements of this section.
179 (b) Waive some or all of the hours or requirements of
180 subsection (1) if the licensee presents satisfactory proof of
181 completing coursework that constitutes adequate training of dry
182 needling or of the components of education and training required
183 for dry needling.
184 (c) Determine whether the licensee has received adequate
185 training to be eligible to perform dry needling.
186 (3) When a chiropractic physician submits documentation to
187 the board verifying completion of the required hours of
188 education and training under this section, the board must issue
189 the chiropractic physician a letter certifying that the he or
190 she is authorized to practice dry needling under this chapter.
191 Section 4. This act shall take effect upon becoming a law.
192
193 ================= T I T L E A M E N D M E N T ================
194 And the title is amended as follows:
195 Delete lines 5 - 10
196 and insert:
197 specified treatment; amending s. 460.406, F.S.;
198 revising education requirements for licensure as a
199 chiropractic physician; creating s. 460.4085, F.S.;
200 requiring the Board of Chiropractic Medicine to
201 establish minimum standards of practice for the
202 performance of dry needling by chiropractic
203 physicians, including specified education and training
204 requirements and restrictions on such practice;
205 authorizing the board to take specified actions at the
206 request of a chiropractic physician; requiring the
207 board to issue a chiropractic physician a letter
208 certifying that he or she is authorized to perform dry
209 needling if the chiropractic physician submits certain
210 documentation to the board; providing an effective
211 date.