Perspective from the Chair Salvatore D. LaRusso, D.C., Chairman Florida Board of Chiropractic Medicine --------------------------------------------------------------------------------------------------------------------- October 2007 It is with great pride and humility that I have served as Chairman of the Florida Board of Chiropractic Medicine for 3 years ending 2007. In nearly 30 years of practice I have been fortunate to gain invaluable experience as an officer in county, state and national Chiropractic organizations and I hope to share some insights with you -- my colleagues and fellow professionals. The Florida legislature established boards to regulate the various professions in our state and together with the legislature, which enacts laws, the boards promulgate rules designed to protect the public and ensure that care is administered safely. The full Florida Board of Chiropractic Medicine meets five times each year at locations throughout the state and not only is the public welcome at all full board meetings, but practitioners can also obtain continuing education credit for attendance. Our board consists of five licensed Chiropractic Physicians and two consumer members, each appointed by the Governor for staggered terms of four years. Mr. Joe Baker, Jr. serves the board as the executive director, Mrs. Vicki Grant, program administrator, board counsel is Deb Loucks, Esq., prosecuting attorneys are Tobey Schultz, Esq. and Cecilia Jefferson Esq. The full staff in Tallahassee who process and coordinate administrative activities for our profession include Sherra Causey, Ann Broome, Keri Meany, Dee Davis and Sharon Guilford, CE program administrator. Common Violations of the Chiropractic Practice Act 460.413 Grounds for disciplinary action Practicing below standards Billing / Insurance Fraud Sexual Misconduct Practicing beyond scope CE Advertising 675 Complaints were received for investigation (2006-2007) 206 Investigations were completed 4 License revocations 6 Voluntarily surrendered licenses 6 License suspensions 76 Licensees had obligations imposed Recent rule issues our board has considered as well as new legislation that impacts our profession 64B2-11.001 Application for Licensure Examination (3) In order that the Board may timely certify to the Department of Health those applicants eligible to take the examination, all applications, fees and supporting documentation including transcripts, NBCE examination results, fingerprint card, licensure verifications from other jurisdictions and any other documents that may be requested by the Board must be on file with the Board no later than March 1st of each year for those candidates applying for the May examination and September 1st for the November examination 64B2-11.004 Special Purposes Examination Passing Score The Board adopts a passing score as set by the National Board of Chiropractic Examiners 64B2-13004 Continuing Education Beginning April 1, 2008 in addition to hours in risk management, six (6) hours of the forty (40) shall be in the area of recordkeeping / documentation and coding; and two (2) hours of the forty (40) must be in the area of ethics and boundaries. Beginning April 1, 2008, when attending an approved course, a licensee must provide photo identification and sign in and out each time they enter or exit the meeting site and the licensee’s attendance must be certified by the course’s registrar and submitted to the board as verification. Five hours of continuing Chiropractic education in the subject area of risk management may be obtained by attending one full day or eight (8) hours (whichever is shorter) of a Board meeting at which disciplinary hearings are conducted by the Board of Chiropractic Medicine in compliance with the following: (a) The licensee must sign in with the Executive Director of the Board or designee before the meeting day begins. (b) The licensee must remain in continuous attendance. (c) The licensee must sign out with the Executive Director of the Board or designee at the end of the day or at such other earlier time as affirmatively authorized by the Board. A licensee may receive CE credit in risk management for attending the Board meeting only if he or she is attending on that date solely for that purpose, he or she may not receive such credit if appearing at the Board meeting for another purpose. 64B2-13.007 Continuing Education during Initial Licensure Period (1) During the first twelve (12) months after initial licensure, practitioners are required to attend one (1) full day at a Florida Board of Chiropractic Medicine meeting at which disciplinary hearings are conducted as provided in subsection 64B2-13004 (8), F.A.C. Beginning April 1, 2008, practitioners are required to attend six (6) hours of recordkeeping / documentation and coding; and two (2) hours of ethics and boundaries. Once the hours required by Rule 64B2-130045, F.A.C. have been met, practitioners shall not be required to complete any other continuing education requirements during the biennium in which they receive initial licensure. 64B2-15.002 Solicitation Rule has been repealed 64B2-16.0075 Citations 1(e) Advertising. A violation of the following shall result in a penalty of $2500, if the citation is accepted by the licensee: 1. Any discounted or free service without including the required statement, Section 456.062, F.S. 2. Failing to include in an advertisement for free x-rays and / or video fluoroscopy that x-rays or video fluoroscopy will be given only if medically necessary, Rule 64B2-15.001 (2) (b). F.A.C. 3. Failing to specifically name each individual Chiropractor participating in a referral service or bureau when advertising a Chiropractic referral service or bureau, Rule 64B2-15.001, F.A.C. 4. Failing to include a reference to the Chiropractor by name and degree in any advertisement generated on behalf of the Chiropractor, Rule 64B2-15.001 (2) (b), F.A.C. 5. Failing to conspicuously identify the Chiropractor(s) listed in the advertisement as a Chiropractor, Rule 64B2-15.001 (2) (f), F.A.C. 6. Disseminating an advertisement that contains a representation that identifies the Chiropractic practice being advertised by a name that fails to include the terms “Chiropractor,” “Chiropractic,” “the initials, D.C.,” “Chiropractic Physician,” “Doctor of Chiropractic Medicine,” or similar derivative, Rule 64B2- 15.001(2)(h), F.A.C. 7. Advertising that a Chiropractor has received a Diplomate status in a specialty area not recognized by the Board, Rule 64B2-15.001(2) (i), F.A.C. (f) Failing to maintain financial responsibility for a period of not more than thirty (30) days, Rule 64B2- 17.009, F.A.C. (g) Failing to identify the type of licensure under which the practitioner is practicing, Section 456.072(1) (t), F.S. Governor Crist signed into law legislation affecting Board of Chiropractic Medicine Licensees 10 year statutory requirement has been deleted for National Board scores For individuals who graduated more than 10 years before the date of their application to take the state board examination, the board may require them to take the NBCE Special Purposes Examination prior to taking the state administered examination. A student in their final year of the Chiropractic program who has completed Parts I, II, and III of the NBCE may file an application and be eligible to sit for the state board examination. They must meet all the requirements with the only exception being the graduation from Chiropractic College. Faculty certificates are available to individuals who have been offered and accepted a full- time faculty appointment to teach in a program of Chiropractic Medicine at a college of Chiropractic Medicine located in Florida. Faculty certificate holders are not required to take and pass the board examination. CCPAs (Certified Chiropractic Physicians Assistants) Indirect supervision may only occur at the supervising physician’s principal place of practice When making application, the application must include a proposed work arrangement and both parties will be interviewed by the chairman of the CCPA committee. The proposed Chiropractic Physician supervisor must not have an encumbered or restricted license. CCPAs working in a licensed clinic may only perform services under direct supervision of the Chiropractic Physician to whom he or she has been assigned. Proprietorship by a person other than licensed Chiropractic physicians Effective July 1, 2008 no person other than a sole proprietorship, group practice, partnership, or corporation that is wholly owned by one or more Chiropractic Physicians licensed under chapter 460, F.S. or by the spouse, parent, child or sibling of that Chiropractic Physician may employ a Chiropractic Physician or engage a Chiropractic Physician as an independent contractor to provide services authorized by chapter 460. Exceptions for the above are: • A practice owned by a physician or physicians licensed under chapter 460, 458, 459, or 461 • Those facilities owned directly or indirectly by an entity licensed or registered by the state under Chapter 395 • A public or private university or college • An entity exempt from federal taxation • An entity owned by a corporation the stock of which is publicly traded • A clinic licensed under part X of Chapter 400 and provides health care services by physicians licensed under 458, 459, and 460 • A state licensed insurer Lease Agreements must contain a provision that the Chiropractic Physician expressly maintains complete care, custody, and control of the equipment or practice Additional areas of concern: Decompression therapy advertising: The Board recommends careful review of all advertising, especially advertising copy produced by the product manufacturer or consultant to ensure the advertisement is truthful and in compliance with Florida Statutes and Board Rule. Although not a requirement the Board recommends that Doctors of Chiropractic register their Chiropractic assistants and maintain documentation of assistant training. Manipulation Under Anesthesia (MUA) and Laser Therapies: When considering issues and complaints related to new technologies such as MUA and Laser Therapy / Treatments the Board will evaluate documentation of patient safety, medical necessity, treatment protocol and practitioner training in the specific procedure or technology. --------------------------------------------------------------------------------------------------------------------------------- Each of our Board members and staff bring many years of experience and their own unique perspective in service to our profession and the residents of Florida. Recently, William Perman, D.C., concluded 10 years of outstanding Board service and Gene Jenkins, Jr. D.C. of Tallahassee was re-appointed by Governor Crist to fill Dr. Perman’s position for a 4 year term 8/30/07 thru 10/31/10. It has been my honor and privilege to serve with the following dedicated and committed board members and staff who strive for regulatory excellence and public protection: Dr. Trudi Vogel (Port Orange) Dr. William Perman (Boca Raton) Mrs. Vicki Kirby (Winter Springs)- consumer member Dr. Kenneth Dougherty, Vice Chair (New Smyrna Beach) Dr. Ronald Wellikoff (Plantation) Mrs. Linda Reynolds (Longwood) -consumer member Mrs. Deborah Loucks, Board Counsel Mrs. Vicki Grant, Program Administrator Mr. Joe Baker Jr., Executive Director I am exceptionally proud of our international recognition as the 2007 “Outstanding Regulatory Board” awarded to the Florida Board of Chiropractic Medicine by the Federation of Chiropractic Licensing Boards in St. Louis, MO. for excellence in regulation. Should you have questions or comments regarding the Board of Chiropractic Medicine, information is available on our website: www.doh.state.fl.us/mqa/chiro/chiro_home.html or by calling the Board office at 850-245-4355 Upcoming meetings, locations and dates are posted on our website and as always, your comments and attendance are welcome.