SENATE BILL REPORT

ESHB 1492

BYHouse Committee on Health Care (originally sponsored by Representatives Ebersole, D. Sommers, Vekich, Cantwell, Chandler, Jones, Morris, Day, May, R. Meyers, Anderson, P. King and Phillips)

Defining chiropractic care.

House Committe on Health Care

Senate Committee on Health & Long-Term Care

Senate Hearing Date(s):February 14, 1990; February 21, 1990

Majority Report:  Do pass and be referred to Committee on Ways & Means.

      Signed by Senators Smith, Vice Chairman; Amondson, Johnson, Kreidler, Niemi.

Senate Staff:Scott Plack (786-7409)

                  February 21, 1990

AS REPORTED BY COMMITTEE ON HEALTH & LONG-TERM CARE, FEBRUARY 21, 1990

BACKGROUND:

Chiropractic is a health care profession licensed through the Chiropractic Practice Act (Chapter 18.25 RCW).  The chiropractic scope of practice involves primarily the detection and correction of neuronal disturbances of the spine by adjustment and manipulation of the vertebral column and its immediate articulations.  It includes physical examinations to determine the necessity for chiropractic care and the use of analytical instruments, such as x-ray.

The Chiropractic Practice Act does not authorize nonspinal procedures, such as the manipulation of extremities, nor does it specifically authorize diagnosis or referral to other health care practitioners.  There are no references in the practice act to permit chiropractors to detect, care for, or manage vertical subluxation complexes, articular dysfunctions, and neuromusculoskeletal disorders.  There are also no references permitting the provision of nutritional supplementations, first aid or counseling.

Chiropractors are prohibited from dispensing any medicine or drugs, practicing obstetrics or surgery, or using x-rays for therapeutic purposes, although dietary advice may be rendered.  There is no prohibition against the use of diathermy or electricity, nor performing colonic irrigations and venipuncture.  Chiropractors may identify themselves as "chiropractors," "D.C.," "D.C.Ph.C." or "Dr." in conjunction with the word chiropractic or chiropractor.  There is no exemption from licensure provided for persons practicing chiropractic in this state.

SUMMARY:

Chiropractic is defined as an alternative health care practice providing a point of entry into the health care system for treatment or referral of patients.

The chiropractic scope of practice is expanded to include nonspinal procedures including manipulation of extremities complementary to, or preparatory to, a chiropractic spinal adjustment.  The scope also authorizes differential diagnosis for determining the nature and appropriateness of chiropractic treatment or for referral to other health care providers.

Chiropractic services are defined to include the care and management of the vertical subluxation complex, articular dysfunction, and neuromusculoskeletal disorders through manipulation, heat, cold, exercise and physiological procedures.

Chiropractic practice also includes recommendation of nutritional supplementation, first aid, and counseling on hygiene and preventive measures.  The use of diathermy or electricity is prohibited.  Chiropractors are also prohibited from performing colonic irrigations and venipuncture.

Practitioners may refer to themselves as chiropractors or chiropractic physicians in addition to their other titles.

Exemptions from licensure are provided for chiropractors from other jurisdictions practicing temporarily in this state, regular senior students enrolled in accredited chiropractic schools, clinical postgraduate trainees, and eligible applicants for the licensing examination who practice under the direct supervision of a licensed chiropractor.  Persons exempted from licensure are subject to the Uniform Disciplinary Act (Chapter 18.130 RCW).

Appropriation:    none

Revenue:    none

Fiscal Note:      available

Effective Date:The bill takes effect immediately.

Senate Committee - Testified: Dr. Lauren McElheran, Dr. Steve Bartsch, Washington Society of Chiropractors (pro); David Bittenbender, Group Health Cooperative (con); Dr. H. T. Hughes, Federation of Straight Chiropractors of Washington (con); Dr. Loren Rex, Washington Osteopathic Medical Association (con); Dr. Dan Labriola, Dr. Joe Pizzarno, Washington Naturopathic Medical Association (con)