AN ACT Relating to practice rights for chiropractors; amending RCW 18.25.005; and adding new sections to chapter 18.25 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. A new section is added to chapter 18.25 RCW to read as follows:

The legislature finds that the purpose of this chapter is to ensure that every chiropractic physician practicing in this state meets minimum requirements for safe practice, in order to promote the public safety and welfare, to protect the public from being misled by unauthorized persons, and to assure the highest degree of professional conduct and competency. It is the intent of the legislature that chiropractic physicians who fall below minimum competency or who otherwise present a danger to the public health be prohibited from practicing in this state.

Sec. 2. Section 7, chapter 97, Laws of 1974 ex. sess. and RCW 18.25.005 are each amended to read as follows:

For the purpose of chapters 18.25 and 18.26 RCW, the term "chiropractic" as a science and healing arts profession that deals with health and disease shall mean and include that practice of health care which ((deals with the detection of subluxations, which shall be defined as any alteration of the biomechanical and physiological dynamics of contiguous spinal structures which can cause neuronal disturbances, the chiropractic procedure preparatory to, and complementary to the correction thereof, by adjustment or manipulation of the articulations of the vertebral column and its immediate articulations for the restoration and maintenance of health; it includes the normal regimen and rehabilitation of the patient, physical examination to determine the necessity for chiropractic care, the use of x-ray and other analytical instruments generally used in the practice of chiropractic)) concerns the detection and treatment of articular dysfunction, including subluxation, and related neuromuscular disorders for the restoration and maintenance of health. Subluxation shall be defined as any functional defect, alteration of the biomechanical and physiological dynamics, in a joint, with or without displacement detectable on x-ray, which may be attended by any of the following: Fixation, hypomobility, hypermobility, periarticular muscle spasm edema, and inflammation; and which may cause neuronal disturbances. It emphasizes the use of manipulative and physiological therapeutic procedures to relieve aberrations of the neuromusculoskeletal system which may cause neuronal disturbances, thereby disrupting innate control over body function. It includes examination, analysis, and diagnosis of the human body and its diseases by the use of any physical, clinical, thermal, laboratory, x-ray, or other generally accepted diagnostic analytical methods, and includes the use of common domain procedures and devices of patient examination and treatment which it employs and shares with other primary health care providers. It further includes the use of ancillary treatment procedures such as heat, cold, light, water, traction, sound, electricity, exercise, and the provision of dietary advise and recommendation and oral administration of nutritional supplementation, which is defined as any vitamins, minerals, food, food concentrates, or food extracts. It further includes the normal regimen and rehabilitation of the patient, and the use of emergency procedures and first aid and counseling on hygiene, sanitation, and preventive measures. The terms "doctors of chiropractic," "chiropractic physician," and "chiropractor" shall be synonymous, and each term shall mean a practitioner of chiropractic as defined in this section: PROVIDED, That no chiropractor shall prescribe or dispense any medicine or drug nor practice obstetrics or surgery nor use x-rays for therapeutic purposes: PROVIDED, HOWEVER, That the term "chiropractic" as defined in this ((~~act~~)) chapter shall not prohibit a practitioner licensed under chapter 18.71 RCW from performing accepted medical procedures and a practitioner licensed under chapter 18.74 RCW from performing accepted physical therapy procedures, except such procedures shall not include the ((~~adjustment by hand of any articulation of the spine: AND PROVIDED FURTHER, That nothing herein shall be construed to prohibit the rendering of dietary advice~~)) manual or mechanical adjustment or grade 5 manipulation of any skeletal articulation.

NEW SECTION. Sec. 3. A new section is added to chapter 18.25 RCW to read as follows:

(1) The board shall certify qualified licensees to use adjunctive procedures. To obtain such certification, a licensee shall submit an application to the board on a form provided by the board showing to the satisfaction of the board that the licensee has accomplished at least one of the following: (a) Passed a state licensure examination which included successful completion of a section on adjunctive procedures; or (b) passed the written physiotherapy examination administered by the national board of chiropractic examiners, with a minimum score of seventy-six percent.

(2) Any chiropractic physician practicing prior to the effective date of this section, who wishes to utilize adjunctive procedures shall complete a minimum of one hundred hours of study in the use of adjunctive procedures as approved by the board and shall demonstrate proficiency by passing an examination conducted, or caused to be conducted, by the board.

(3) The board shall adopt rules required to implement this section.

(4) The requirement for certification to use adjunctive procedures is effective upon the effective date of this section.