BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 163|
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THIRD READING
Bill No: AB 163
Author: Eng (D)
Amended: 9/7/07 in Assembly
Vote: 21
PRIOR SENATE VOTES NOT RELEVANT
ASSEMBLY FLOOR : Not available
SUBJECT : Chiropractic Initiative Act
SOURCE : Author
DIGEST : This bill places a legislative proposition on
the statewide ballot for approval by the voters to amend
the Chiropractic Initiative Act of California to bring the
State Board of Chiropractic Examiners under the Department
of Consumer Affairs.
ANALYSIS :
Existing law:
1.Consists of the Chiropractic Initiative Act, which
prescribes the terms upon which licenses may be issued to
practitioners of chiropractic, creates the State Board of
Chiropractic Examiners (Board), declares the Board's
powers and duties, and prescribes penalties for violation
of the Act. The Act can only be amended by initiative.
CONTINUED
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2.States that the Board shall consist of seven members
appointed by the Governor, with five licensee members and
two public members, and specifies the requirements for
board members
3.Requires the Board to employ an executive officer and fix
his salary with the approval of the Director of Finance.
4.Authorizes the Board to employ investigators, clerical
assistants, commissioners on examination and other
employees as it may deem necessary to carry into effect
the provisions of the Act, and prescribe the duties of
such employees.
This bill places a legislative proposition on the statewide
ballot for approval by the voters to amend the Chiropractic
Initiative Act of California (Act) to bring the State Board
of Chiropractic Examiners (BCE) under the Department of
Consumer Affairs (DCA).
This bill:
1. Provides that the provisions of this bill become
effective only if they are approved by a vote of the
electorate on the June 3, 2008 statewide ballot.
2. Requires that protection of the public shall be the
highest priority of BCE in exercising its licensing,
regulatory and disciplinary functions. Whenever the
protection of the public is inconsistent with other
interests sought to be promoted, the protection of the
public shall be paramount.
3. Provides that BCE shall become part of DCA similar to
the 39 other boards and bureaus currently specified as
within DCA.
4. Provides that the Director of DCA shall not have the
authority to disapprove any rule or regulation
pertaining to the legal scope of professional practice
or the current minimum educational requirements for
doctors of chiropractic.
5. States that BCE rulemaking shall be in compliance
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with current law applicable to other boards and that
such rulemaking is subject to review by the Office of
Administrative Law.
6. Provides that BCE shall consist of seven members:
five appointed by the Governor, one appointed by the
Speaker of the Assembly, and one appointed by the
Senate Rules Committee. The gubernatorial appointees
shall consist of four "professional" members
(chiropractors) and one "public" member
(non-chiropractors). Both legislative appointees
shall be public members.
7. Requires that the five BCE members appointed by the
Governor shall be subject to Senate confirmation.
8. Provides that the Legislature may "reconstitute" BCE
(through legislation signed by the Governor).
(Reconstitution results in the removal of BCE members
that are then followed by new replacement
appointments.)
9. Provides that the DCA Director shall have the
authority to approve BCE's appointment of an Executive
Director who is exempt from civil service
requirements.
10. Requires all BCE meetings to be conducted in
accordance with the provisions of the Bagley-Keene
Open Meeting Act.
11. Provides that employees of BCE (excluding the
Executive Director) shall be subject to the state's
civil service requirements.
12. Clarifies that the employment of legal counsel by BCE
is subject to the requirements in current law
applicable to other boards within DCA.
13. Provides that BCE shall comply with specified
Business and Professions and Government code section
that have general application to other health care
related boards within DCA.
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14. Requires that appropriations for BCE shall be made by
the Legislature in the annual Budget Act.
15. Requires, in addition to the appropriation made in
the Budget Act of 2007, an appropriation over $1.5
million from the revenue in the State Board of
Chiropractic Examiners' Fund for the support of the
Board of Chiropractic Examiners.
16. Includes intent language to appropriate revenues from
the State Board of Chiropractic Examiners' Fund in the
amount of $300,000 to reimburse the Secretary of State
for the printing costs incurred to place a proposition
on the June 3, 2008 statewide ballot.
17. Includes double-jointing language with SB 534
(Perata) to avoid conflict with an affected code
section contained in both bills.
Background
Chiropractors provide non-drug, non-surgical health care
through treatment of the musculoskeletal and nervous
systems and manipulation of the spinal column and bony
tissues. In FY 2004/05 the Board had a license base of
15,412 -- 14,206 active and 1,206 inactive licensees. Its
budget was approximately $2.25 million.
The Board was created on December 21, 1922, as the result
of an initiative measure approved by California voters on
November 7, 1922. The Board is a seven-member
policy-making body. Five professional members and two
public members appointed by the Governor to serve four-year
terms. Because the Board was created by an initiative that
does not permit amendment by the Legislature, the
Legislature is without the power to sunset the Board, or
repeal the state's regulation of the chiropractic
profession. The Legislature could, however, place proposed
reform statutes before the electorate by a two-thirds vote
and seek the electorate's approval.
The Board's mission is to protect consumers from fraudulent
or incompetent chiropractic practice, examine applicants
for licensure in order to evaluate entry level competence,
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and enforce the Act, statutes, and regulations relating to
the practice of chiropractic. The Board's regulatory
program also approves chiropractic schools and colleges
whose graduates may apply for licensure in California and
approves continuing education. As a law enforcement
agency, the Board enforces laws and regulations pertaining
to the practice of chiropractic in California.
Joint Hearing of the Chiropractic Board by this Committee
and the Assembly Business and Professions Committee . On
March 28, 2007 a joint hearing was held in response to
several actions that were taken by the Board over the past
few months. In particular, it was alleged that some of the
actions taken by the Board at its March 1, 2007 meeting
were inappropriate and illegal. Since that hearing, the
Board chairman has taken the blame for those actions and
two of them have been rescinded. In addition, the Board is
scheduled to reconsider two more of its actions from the
March 1, 2007 meeting at the next meeting scheduled for
April 19, 2007.
During the Joint Hearing, the evidence gathered indicated
that the Board and its members had potentially violated the
law or administrative procedures in several areas,
including: (1) communications between Board members illegal
under the Bagley Keene Open Meeting Act, (2) not following
or ignoring proper civil service employee procedures and
requirements in an attempt to make personnel decision about
non-exempt civil service employees, (3) attempts by certain
Board members to interfere with ongoing enforcement actions
of the Board enforcement staff and the Attorney General's
Office, (4) making an improper attempt to influence or
impede ongoing criminal prosecution against chiropractors
involved in insurance fraud and who provided manipulation
under anesthesia, (5) proposing to dismiss the Attorney
General as counsel for the Board, ejecting the Deputy
Attorney General from the March 1st Board Meeting; and
removal of a Deputy Attorney General as Board counsel, (6)
failure to follow required procedures for approving a
chiropractic college and allowing its graduates to practice
in California, and (7) firing of the Executive Officer
without following appropriate procedures and self
appointment of the Board Chair as Executive Officer.
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In addition to the above, some serious concerns have
recently been raised regarding the mission of the Board and
some of its newest members. In fact, some of those
involved, including the appointing authority, have made
statements that may lead one to believe that the primary
purpose of the Board is to represent the profession's
viewpoints. The official mission of the Board is to: ( 1)
protect Californians from fraudulent or incompetent
practice of chiropractic, (2) examine applicants for
licensure in order to evaluate entry level competence,
and,( 3) enforce the Chiropractic Initiative Act and
regulations relating to the practice of chiropractic. It
has appeared on more than one occasion that the Board
members may have lost sight of this objective.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 9/10/07)
Center for Public Interest Law
California Primary Care Association
ARGUMENTS IN SUPPORT : The Center for Public Interest Law
(CPIL) strongly supports this measure because it would
subject the Board to the same oversight and supervision by
the Legislature and the Administration that applies to
other state agencies that regulate health care
professionals. CPIL believes that an attempt to bring the
Board in line with the mainstream of California government
is long overdue. In addition, the urgency of SB 801 is
illustrated by the several recent controversies relating to
the actions of the Board, which were well-reported in the
media and occurred because the Board is not subject to any
meaningful oversight, training, and/or accountability by
either the Legislature or the Administration.
As noted by CPIL, the Board lacks accountability to the
Legislature because it can't amend or repeal the Act. The
Board lacks accountability to the Administration because it
doesn't reside within any larger agency or department that
reviews its regulations, monitors its budget, or provides
it with services. The statutes of all other agencies that
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regulate health care professionals are codified in the
Business and Professions Code, and are able to be amended
by the Legislature. All of these agencies have been placed
under the jurisdiction of the DCA. This Board should be
treated the same as all of these other agencies that
regulate health care professionals.
Finally, according to CPIL, SB 801 is necessary to affirm
the validity of recent legislation that has been applied to
the Board and to chiropractors, and the practice of
chiropractic merits the same level of executive and
legislative branch oversight as the practices of the other
health professions.
JJA:nl 9/10/07 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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