BILL ANALYSIS �
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THIRD READING
Bill No: SB 352
Author: Huff (R)
Amended: 1/11/12
Vote: 21
SENATE BUSINESS, PROF & ECON DEVELOP COMM : 7-0, 1/9/12
AYES: Price, Emmerson, Corbett, Correa, Negrete McLeod,
Vargas, Walters
NO VOTE RECORDED: Hernandez, Wyland
SENATE APPROPRIATIONS COMMITTEE : 7-1, 01/19/12
AYES: Kehoe, Walters, Emmerson, Lieu, Pavley, Price,
Steinberg
NOES: Alquist
NO VOTE RECORDED: Runner
SUBJECT : Chiropractors
SOURCE : Author
DIGEST : This bill prohibits the treatment of
hypersensitivity to foods, medications, environmental
allergens, or venoms by a chiropractor, and prohibits a
chiropractor from advertising that he or she provides or is
able to provide those services, as specified.
ANALYSIS : Existing law:
1.Establishes the Chiropractic Initiative Act of California
(Act), approved by voters on November 7, 1922, and became
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effective on December 21, 1922.
2.Establishes, under the Act, the State Board of
Chiropractic Examiners (BCE) that shall consist of seven
members appointed by the Governor, with five licensee
members and two public members, and specifies that the
BCE shall license and regulate the chiropractic practice,
and prescribes the licensing and renewal fees for
chiropractors.
3.Provides that the BCE may adopt from time to time such
rules and regulations as the BCE may deem proper and
necessary for the performance of its work, the effective
enforcement and administration of the Act, the
establishment of educational requirements for license
renewal, and the protection of the public.
4.Provides that the BCE shall approve chiropractic schools
and colleges and specifies what chiropractic schools and
colleges may be eligible for approval.
5.Specifies the schedule of minimum educational
requirements to enable any person to practice
chiropractic in this state and provides that prior to
issuance of a certificate to practice chiropractic a
person must submit to the BCE an application, as
specified, and payment of license fee and proof of
graduation from an approved chiropractic school or
college.
6.Provides that the BCE shall issue a certificate
designated as a "License to practice chiropractic," which
shall authorize the holder thereof to practice
chiropractic in the state of California as taught in
chiropractic schools or colleges; and, also, to use all
necessary mechanical, and hygienic and sanitary measures
incident to the care of the body, but shall not authorize
the practice of medicine, surgery, osteopathy, dentistry
or optometry, nor the use of any drug or medicine now or
hereafter included in material medica.
7.Provides that the BCE may by rule or regulation adopt,
amend, or repeal rules of professional conduct
appropriate to the establishment and maintenance of a
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high standard of professional service and the protection
of the public.
8.Prohibits a chiropractor, among other healing arts
practitioners, from disseminating any form of public
communications containing a false, fraudulent,
misleading, or deceptive statement for the purpose of
inducing the rendering of professional services, as
specified.
9.Specifies that it is unprofessional conduct for a
chiropractor to employ runners, cappers, steerers, or
other persons to procure patients, unless otherwise
allowed by law.
10.Provides that provisions of the Business and Professions
Code which have general application to other healing arts
practitioners shall also be applicable to persons
licensed by the BCE.
This bill:
1.Provides findings and declarations that the scope of
practice authorized by the Chiropractic Act does not
extend beyond the scope of the term "chiropractic" as it
was understood and defined in 1922, upon the adoption of
the Chiropractic Act. In addition, the Chiropractic Act
prohibits a chiropractor from engaging in the practice of
medicine. As it was understood in 1922, the term
"chiropractic" did not include the treatment of
hypersensitivity to foods, medications, environmental
allergens, or venoms. Furthermore, those services
constitute the practice of medicine. Therefore, the
Chiropractic Act does not authorize licensees to provide
those services.
2.Specifies that the practice of chiropractic does not
include the treatment of hypersensitivity to foods,
medications, environmental allergens, or venoms,
including, but not limited to, the use of laser therapy
for those purposes.
3.Provides that it shall constitute a cause for discipline
by the BCE to violate the provision in Item # 2 above in
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accordance with the initiative measure.
4.Prohibits a chiropractor from advertising that he or she
provides or is able to provide the services as specified
in Item # 2 above, unless that person holds another
license that authorizes the person to provide such
services.
5.Defines what "advertise" includes and also includes
business solicitations communicated by radio or
television broadcasting.
6.Provides that it shall constitute a cause for discipline
by the BCE to violate the provision in Item # 4 above in
accordance with the initiative measure.
7.Provides that provisions of this measure are severable.
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. The BCE oversees approximately 14,000 licensees
and has an annual budget of approximately $3 million,
funded exclusively by the profession through licensing fees
and other regulatory fees.
The BCE was created on December 21, 1922, as the result of
an initiative measure approved by California voters on
November 7, 1922. The BCE 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 BCE was created by an initiative that does not permit
amendment by the Legislature, the Legislature is without
the power to sunset the BCE, 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 BCE'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 BCE enforces laws and regulations pertaining to
the practice of chiropractic in California.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2012-13 2013-14
2014-15 Fund
Investigation of Chiropractic unknown,
likely minor annually Special*
Act violations
Ballot pamphlet one time costs
of General
approx. $264
*Chiropractic Examiners Fund
SUPPORT : (Verified 1/19/12)
California Medical Association
The Joint Council of Allergy, Asthma & Immunology
Capital Allergy & Respiratory Disease Center
North Bay Allergy & Asthma Medical Associates
Allergy & Asthma Associates of Southern California
OPPOSITION : (Verified 1/19/12)
Board of Chiropractic Examiners
California Chiropractic Association
Southern California University of Health Sciences
ARGUMENTS IN SUPPORT : The Capital Allergy & Respiratory
Disease Center (CARDC), a Medical Corporation in
Sacramento, is in support of this measure, and brought this
issue to the attention of the Author. The CARDC indicates
that a significant number of their patients with food
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allergies have come to them stating that they have been
approached by chiropractors who espouse "laser therapy" for
the diagnosis and treatment of food allergies. The CARDC
has raised the same concerns of the Author, in that 4
million patients in the United States suffer from food
allergies and that these reactions are from mild to life
threatening and that "there is no known cure for food
allergies at this time other than avoidance." The CARDC
points out that the allergy scientific community and
Federal government are actively working on a consensus
document regarding the diagnosis and treatment of food
allergies. "It is expected that statement will
specifically warn patients of the dangers relating to
alternative therapies including electrodermal and laser
treatments."
The CARDC understands that the Author has been working with
the BCE on regulations and although they appreciate any
regulatory reform on the issue, they strongly support the
measure as they feel that it will help define an area of
medicine that should remain under the care of physicians.
ARGUMENTS IN OPPOSITION : The California Chiropractic
Association (CCA) is opposed to this bill and argues that
it seeks to limit a doctor of chiropractic's scope of
practice relating to the treatment and diagnosis, as well
as the use of light in treating patients. "In addition to
the measure being unnecessary, it represents a threat to
public safety."
According to CCA, doctors of chiropractic are licensed to
diagnose and differentially diagnose all conditions
affecting the entire human body. Restricting a doctor of
chiropractic's professional duty to diagnose could
jeopardize public safety by limiting a doctor's ability to
diagnose potentially life-threatening conditions that, as
warranted by the situation, should be referred to other
licensed health care providers. Also, CCA argues the
proposed limitation would prevent many other appropriate
diagnoses, for example, lactose intolerance, in which a
doctor of chiropractic could offer patient dietary changes
to resolve symptoms associated with the condition.
The CCA further states that they believe the bill is
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unnecessary since the BCE has undertaken the development of
regulations to govern the use of lasers by chiropractors
and reports they have not received any complaints related
to a chiropractors use of laser for treatment purposes or
the treatment of allergies, and that laws already exist to
govern advertising by chiropractors.
JJA:nl 1/23/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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