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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:
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(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. ยง 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
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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.
(c) Second examination.--If an applicant fails the first
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
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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-
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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
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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.
(c) Telecommunication.--A licensed chiropractor shall be
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
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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
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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.
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