WSR 06-02-088

PERMANENT RULES

DEPARTMENT OF HEALTH


(Chiropractic Quality Assurance Commission)

[ Filed January 4, 2006, 10:50 a.m. , effective February 4, 2006 ]


Effective Date of Rule: Thirty-one days after filing.

Purpose: This rule adds 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 adds 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.

Citation of Existing Rules Affected by this Order: Amending WAC 246-808-190 and 246-808-535.

Statutory Authority for Adoption: RCW 18.25.0171.

Other Authority: RCW 18.25.190.

Adopted under notice filed as WSR 05-20-102 on October 5, 2005.

A final cost-benefit analysis is available by contacting Karen Kelley, Program Manager, P.O. Box 47869, Olympia, WA 98504-7869, phone (360) 236-4856, fax (360) 236-4918, e-mail karen.kelley@doh.w.gov.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 1, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 2, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 2, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 2, Repealed 0.

Date Adopted: November 17, 2005.

Nancy McCown, DC

Vice Chair

Chiropractic Quality

Assurance Commission

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.]