FINAL BILL REPORT

                 SHB 1629

                         C 320 L 91

                     Synopsis As Enacted

Brief Description:  Redefining the practice of chiropractic.

Sponsor(s):  By House Committee on Health Care (originally sponsored by Representatives Prentice, Wood, R. Meyers, Franklin, Day, Miller, Ludwig, Morris, Pruitt, Brough, Braddock, Anderson, Betrozoff, Cooper, Fuhrman, R. King, McLean, Cantwell, Leonard, Kremen, Nealey, Phillips, P. Johnson, Wynne and Dorn).

House Committee on Health Care

Senate Committee on Health & Long-Term Care

Background:  The State regulates and licenses chiropractors.  Chiropractors primarily detect and correct neuronal disturbances of the spine by adjusting and manipulating the vertebral column and its immediate articulations.

There is no peer review process established by law for evaluating the quality, utilization and cost of chiropractic services provided to the public.

Chiropractors may identify themselves as "chiropractors," "D.C.," "D.C.Ph.C.," or "Dr." in conjunction with the word chiropractic or chiropractor.  The use of the title "chiropractic physician" is not presently authorized.  However, the use of the title of "physician" is not prohibited by law if it is employed in connection with a description of another branch of the healing arts.

Chiropractors licensed in other states may be granted a license to practice in this state, if their states of origin have standards equal to those in Washington, and they complete examinations in chiropractic, x-ray and adjustment.

There is no exemption from the requirement of licensure provided for chiropractors licensed in other states practicing temporarily in this state, students, clinical postgraduate trainees, or eligible applicants for the examination practicing chiropractic in this state.

Summary:  A peer review committee is established, composed of eight chiropractors, a member of the Chiropractic Disciplinary Board who serves as chair, a representative of the insurance industry, and a member representing the state Department of Labor and Industries.  The members of the committee are appointed by the Chiropractic Disciplinary Board.

Peer review may be requested by a patient, a state agency or a chiropractor.  Peer review includes an evaluation of appropriate quality, utilization and the cost of chiropractic services provided to a patient.  It excludes issues associated with licensure, scope of practice and discipline.  The Chiropractic Disciplinary Board determines each request for review as appropriate for either review by the Peer Review Committee, voluntary mediation or discipline.  The costs associated with peer review proceedings are to be borne by the chiropractic profession as general regulatory costs, except that the board must assess a fee if the requesting party is a chiropractor or third party.

Findings and recommendations of the Peer Review Committee must be submitted to the board for approval, and are appealable to the board.  The committee may file complaints with the board in those cases involving any alleged unprofessional conduct.

The board is required to report to the Legislature on a biennial basis summarizing its peer review activities.

Chiropractors may refer to themselves as "chiropractic physicians" in addition to other titles authorized by law.

Chiropractors licensed in US territories, the District of Columbia, Puerto Rico, and Canada, as well as in other states, may be granted a license to practice in this state if those jurisdictions have qualifications substantially equivalent to those in Washington, and if applicants complete any examinations required by the board.

Exemptions from licensure are provided for chiropractors from other jurisdictions practicing temporarily in this state, for regular senior students enrolled in accredited chiropractic schools, for clinical postgraduate trainees, and for eligible applicants for the licensing examination who practice under the direct supervision of a licensed chiropractor.  Persons exempted from licensure are subject to disciplinary procedures provided by law.

Votes on Final Passage:

House  75   21

Senate 43   3   (Senate amended)

House  94   0   (House concurred)

Effective:  July 28, 1991