Regular Session 2021-2022 House Bill 2267 P.N. 2630

PRINTER'S NO. 2630

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

No.

2267

Session of

2022

INTRODUCED BY LAWRENCE, R. BROWN, SCHLEGEL CULVER, JAMES,

JOZWIAK, NEILSON, ROZZI, RYAN, SCHMITT AND SHUSTERMAN,

JANUARY 21, 2022

REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE,

JANUARY 21, 2022

AN ACT

Amending the act of December 16, 1986 (P.L.1646, No.188),

entitled "An act providing for the licensing of chiropractors

and the regulation of the practice of chiropractic;

establishing the State Board of Chiropractic in the

Department of State and providing for its powers and duties;

providing for the supervision of colleges of chiropractic,

for the examination of applicants, for enforcement and for

disciplinary actions; providing penalties; and making

repeals," providing for certified chiropractic assistants; in

supportive personnel, further providing for supportive

personnel; and making editorial changes.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1. The act of December 16, 1986 (P.L.1646, No.188),

known as the Chiropractic Practice Act, is amended by adding a

chapter to read:

CHAPTER 5A

CERTIFIED CHIROPRACTIC ASSISTANTS

Section 5A01. Chiropractic assistant certifications.

(a) Eligibility.--To be eligible for certification by the

board as a chiropractic assistant, an applicant shall:

(1) be at least 18 years of age unless otherwise

determined by the board;

(2) has proved to the satisfaction of the board that the

individual is of good moral character and is not unfit or

unable to practice as a chiropractic assistant by reason of

physical or mental impairment. In assessing the moral

character of an individual with a criminal conviction, the

board shall conduct an individualized assessment in

accordance with 63 Pa.C.S. § 3113 (relating to consideration

of criminal convictions);

(3) successfully complete a certified chiropractic

assistant program adopted by the board that has been approved

for the education and training of certified chiropractic

assistants by the appropriate nationally recognized

accrediting agency; and

(4) successfully pass an examination approved by the

board, subject to rules and regulations established by the

board and administered in accordance with section 812.1 of

the act of April 9, 1929 (P.L.177, No.175), known as The

Administrative Code of 1929. An applicant may not be

certified as a certified chiropractic assistant unless the

applicant has attained passing scores on the examination

under this paragraph as published prior to the administration

of the examination.

(b) Temporary certification.--Upon the submission of an

application for certification as a chiropractic assistant as

provided by the board, the board shall issue a temporary

certificate to the applicant who meets the requirements under

subsection (a)(1) and (3) and is eligible to take the

examination under subsection (a)(4) . The board shall issue only

20220HB2267PN2630 - 2 -

one temporary certificate under this subsection to an applicant.

A temporary certificate under this subsection shall expire upon

the applicant's failure of the first examination under

subsection (a)(4), or six months after the date of issuance of

the temporary certificate, whichever occurs first. Issuance of a

temporary certificate under this subsection shall permit the

applicant to engage in the practice of chiropractic assistance

only while under the direct on-premises supervision of a

licensed chiropractor. Upon the expiration a temporary

certificate under this subsection, the applicant shall promptly

return the temporary certificate to the board.

examination under subsection (a)(4), the applicant for

certification shall, after the expiration of 60 days from the

date of the first examination and no later than one year after

the first examination, have the opportunity to take the

examination a second time. The board may adopt regulations

governing the eligibility of applicants who have failed to pass

two examinations under subsection (a)(4) in order to be admitted

to subsequent examinations.

(d) Use of title.-- Only an individual who has been properly

certified as a chiropractic assistant with the board, in

accordance with this chapter and the rules and regulations

promulgated by the board, shall assist a licensed chiropractor

in the practice of chiropractic as a certified chiropractic

assistant and use the title "certified chiropractic assistant"

and the abbreviation "CCA." Until such time as the board

promulgates rules and regulations governing the certification of

chiropractic assistants, an individual who is properly

registered with the board shall be deemed certified for the

20220HB2267PN2630 - 3 -

purposes of this section.

(e) Actions.--The board shall issue, renew, revoke or

suspend the certification of a chiropractic assistant in

accordance with the rules and regulations promulgated by the

board. All actions of the board under this subsection shall be

taken subject to the right of notice, hearing and adjudication

and the right of appeal in accordance with 2 Pa.C.S. (relating

to administrative law and procedure).

(f) Reinstatement.--Unless ordered by a court of competent

jurisdiction, the board shall not reinstate the certification of

an individual to practice as a chiropractic assistant that has

been revoked under subsection (e). The individual may apply for

certification as a chiropractic assistant after five years have

elapsed since the date of revocation in accordance with this

chapter.

(g) Renewals.--For each certificate renewal, a chiropractic

assistant shall complete within the preceding two-year period at

least 16 hours of continuing chiropractic education, including

eight hours of in-person learning, as approved by the board in

accordance with standards and criteria established by the board

by rules and regulations. A certified chiropractic assistant

shall provide the board with evidence of the completion of the

continuing chiropractic education under this subsection. The

board's rules and regulations shall remain in effect until such

time as the board establishes by regulations, standards and

criteria relating to continuing chiropractic education for

certified chiropractic assistants.

Section 5A02. Performance of chiropractic acts and services.

While providing assistance to a licensed chiropractor, a

certified chiropractic assistant shall only perform patient-

20220HB2267PN2630 - 4 -

related chiropractic acts and services that are assigned or

delegated by and under the supervision of a licensed

chiropractor. A certified chiropractic assistant may provide

therapeutic exercise under the supervision of a licensed

chiropractor. A certified chiropractic assistant may not perform

evaluations, adjustments, test interpretations or the planning

or modification of a plan of care for a patient. A licensed

chiropractor shall be responsible for the performance of acts

and services by a certified chiropractic assistant.

Section 5A03. Supervision of certified chiropractic assistants.

(a) Supervision.--

(1) A licensed chiropractor shall provide direct, on-

premises supervision of a certified chiropractic assistant

until the certified chiropractic assistant submits

satisfactory evidence to the board of any of the following:

(i) The certified chiropractic assistant has at

least 2,000 hours of experience providing patient-related

acts and services verified by the supervising

licensed chiropractor.

(ii) The certified chiropractic assistant has been

employed as a certified chiropractic assistant for at

least three of the prior five years.

(2) If a certified chiropractic assistant submits

evidence satisfactory to the board under paragraph (1), a

licensed chiropractor shall provide direct, on-premises

supervision of the certified chiropractic assistant for at

least 50% of the hours worked by the certified chiropractic

assistant during the calendar week.

(3) A certified chiropractic assistant shall consult

with the supervising licensed chiropractor in the event of a

20220HB2267PN2630 - 5 -

change in the patient's condition that may require the

assessment of a licensed chiropractor.

(4) In all practice settings, the initial patient

contact shall be made by a licensed chiropractor for

evaluation of the patient and establishment of a plan of

care.

(b) Limitation.--A licensed chiropractor shall not supervise

more than three certified chiropractic assistants at any time.

If there is a change of the licensed chiropractor supervising a

certified chiropr actic assistant, the succeeding licensed

chiropractor shall be responsible for the ongoing supervision of

the certified chiropractic assistant and shall be considered the

supervising licensed chiropractor for the purpose of this

section.

immediately available by telecommunication if not providing

direct on-premises supervision.

(d) Emergency situations.--

(1) In an emergency situation, including a serious

illness or death of a family member, which causes the

unanticipated absence of a supervising licensed chiropractor

for not more than two days per month, a certified

chiropractic assistant may continue to render services only

to the patients for which the certified chiropractic

assistant has previously participated in the intervention for

an established plan of care. A certified chiropractic

assistant may continue to render services under this

paragraph for a period not to exceed the regularly scheduled

operational hours of each day the supervising licensed

chiropractor is absent. A supervising licensed chiropractor

20220HB2267PN2630 - 6 -

or certified chiropractic assistant shall make every effort

to obtain the supervision of care specified under this

paragraph. A supervising licensed chiropractor may only

utilize the emergency provisions of this paragraph for no

more than 10 days per year.

(2) A supervising licensed chiropractor who experiences

an unanticipated absence under paragraph (1) shall have all

of the following duties:

(i) Maintain a written record noting the date and

the emergency, which shall be available for board review.

(ii) Submit a report to the board on a biennial

basis stating each day the supervising licensed

chiropractor is absent and the reason for the absence.

Section 2. The heading of Chapter 6 of the act is amended to

read:

CHAPTER 6

UNLICENSED OR UNCERTIFIED SUPPORTIVE PERSONNEL

Section 3. Section 601 of the act is amended to read:

Section 601. Supportive personnel.

(a) Construction.--Nothing in this act shall prohibit a

licensed chiropractor from utilizing the assistance of

unlicensed or uncertified supportive personnel performing under

the direct on-premises supervision of a licensed chiropractor or

certified chiropractic assistant, provided that a chiropractor

may not delegate any activity or duty to such unlicensed or

uncertified individuals which requires formal education or

training in the practice of chiropractic or the knowledge and

skill of a licensed chiropractor or certified chiropractic

assistant.

(b) Definitions.--As used in this section, the term "d irect

20220HB2267PN2630 - 7 -

on-premises supervision" means supervision conducted while being

physically present onsite and immediately available for

direction.

Section 4. This act shall take effect in 60 days.

20220HB2267PN2630 - 8 -