WSR 05-20-102

PROPOSED RULES

DEPARTMENT OF HEALTH


(Chiropractic Quality Assurance Commission)

[ Filed October 5, 2005, 10:05 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 04-02-064.

Title of Rule and Other Identifying Information: WAC 246-808-190 Preceptor or direct supervisory doctor and 246-808-535 Delegation of services to auxiliary staff and graduate doctors of chiropractic.

Hearing Location(s): Department of Health, 310 Israel Road S.E., Tumwater, WA 98501, on November 17, 2005, at 10:00 a.m.

Date of Intended Adoption: November 17, 2005.

Submit Written Comments to: Karen Kelley, P.O. Box 47869, Olympia, WA 98504-7869, e-mail http://www3.doh.wa.gov/policyreview, fax (360) 236-4918, by November 1, 2005.

Assistance for Persons with Disabilities: Contact Karen Kelley by November 1, 2005, TTY 711 or (800) 833-6388.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed rule amendments will add text that conveys more accurately the language in the statute, clarify what tasks regular senior students, clinical postgraduate trainees, and auxiliary staff may perform, and add text that will allow auxiliary staff, regular senior students, and clinical postgraduate trainees to oversee patients during approved therapeutic procedures, rehabilitation exercises or use of therapeutic or rehabilitation equipment as incident to chiropractic services.

Reasons Supporting Proposal: The amendments add clarity, remove redundant language, and add approved tasks for unlicensed personnel.

Statutory Authority for Adoption: RCW 18.25.0171 and 18.25.190.

Statute Being Implemented: Chapter 18.25 RCW.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Chiropractic Quality Assurance Commission, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Karen Kelley, 310 Israel Road S.E., Olympia, WA 98504-7869, (360) 236-4856.

No small business economic impact statement has been prepared under chapter 19.85 RCW. A small business economic impact statement is not necessary under chapter 19.85 RCW. These rules do not impose additional costs on licensed chiropractors.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Karen Kelley, Chiropractic Quality Assurance Commission, P.O. Box 47869, Olympia, WA 98504-7869, phone (360) 236-4856, fax (360) 236-4918, e-mail karen.kelley@doh.wa.gov.

August 29, 2005

Karen Kelley

Program Manager

OTS-8171.3


AMENDATORY SECTION(Amending WSR 96-16-074, filed 8/6/96, effective 9/6/96)

WAC 246-808-190   Preceptor or direct supervisory doctor.   A preceptor is a doctor of chiropractic who is approved by the commission to provide direct supervision to ((an unlicensed chiropractic doctor)), clinical postgraduate trainee, or regular senior student, as set forth in RCW 18.25.190. The commission ((shall)) maintains a list of approved preceptors.

(1) An approved preceptor shall:

(a) Provide direct supervision and control;

(b) Be on the premises any time the ((unlicensed chiropractic doctor)) clinical postgraduate trainee, or regular senior student, treats patients in accordance with WAC 246-808-535; and

(c) Meet with the patient prior to commencement of chiropractic care, and inform the patient in writing of the unlicensed status of the person from whom care is being received.

(2) To apply for commission approval to function as a preceptor, a doctor of chiropractic shall submit to the commission:

(a) Proof of licensure as a Washington chiropractic doctor for the preceding five years, during which time the license has not been suspended, revoked, or otherwise conditioned or restricted;

(b) A completed official application;

(c) Verification of approval to participate in the program by an approved chiropractic college;

(d) Evidence of malpractice insurance for the ((unlicensed chiropractic doctor and)) clinical postgraduate trainee, the preceptor applicant, the regular senior student; and

(e) A fee as specified in WAC 246-808-990.

[Statutory Authority: Chapter 18.25 RCW. 96-16-074, 246-808-190, filed 8/6/96, effective 9/6/96.]


AMENDATORY SECTION(Amending WSR 96-16-074, filed 8/6/96, effective 9/6/96)

WAC 246-808-535   Delegation of services to auxiliary staff, regular senior students, and ((graduate doctors of chiropractic)) clinical postgraduate trainees.   (1) A licensed chiropractor may((, within the confines of this section,)) delegate certain services to auxiliary staff, regular senior students, and ((graduate doctors of chiropractic, provided that)) clinical postgraduate trainees, if these services are performed under the licensed chiropractor's direct supervision and control. The supervising chiropractor shall be responsible for determining that auxiliary staff, regular senior students, and ((graduate doctors of chiropractic)) clinical postgraduate trainees are competent to perform the delegated services. The licensed supervising chiropractor must render adequate supervision so that the patient's health and safety is not at risk.

(2) Auxiliary staff ((and graduate doctors of chiropractic)) shall not perform the following services:

(a) Detection of subluxation;

(b) Adjustment or manipulation of the articulations of the ((spinal column or its immediate articulations)) body;

(c) Interpretation or analysis of radiographs;

(d) Determining the necessity for chiropractic care;

(e) Orthopedic or neurological examinations ((provided, graduate doctors of chiropractic may perform preliminary orthopedic or neurological examinations under the direct supervision of a licensed chiropractor)).

(3) Regular senior students may perform the following under the direct supervision and control of an approved preceptor:

(a) Detection of subluxation;

(b) Expose, interpret or analyze radiographs;

(c) Determine the necessity for chiropractic care;

(d) Orthopedic or neurological examinations.

(4) Clinical postgraduate trainees may perform the following under the direct supervision and control of an approved preceptor:

(a) Detection of subluxation;

(b) Adjustment or manipulation of the articulations of the body;

(c) Expose, interpret or analyze radiographs;

(d) Determine the necessity for chiropractic care;

(e) Orthopedic or neurological examinations.

(5) Auxiliary staff, regular senior students, and ((graduate doctors of chiropractic)) clinical postgraduate trainees may perform the following auxiliary services: Preliminary patient history, height, weight, temperature, blood pressure, pulse rate, ((and)) gross postural observation, ((())active spinal range of motion utilizing a generally accepted measuring device(())), and oversight of patients during approved therapeutic procedures, rehabilitation exercises or use of therapeutic or rehabilitation equipment as incident to chiropractic services.

[Statutory Authority: Chapter 18.25 RCW. 96-16-074, 246-808-535, filed 8/6/96, effective 9/6/96.]

Washington State Code Reviser's Office