WSR 14-22-106
(Chiropractic Quality Assurance Commission)
[Filed November 5, 2014, 6:59 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 09-09-031.
Title of Rule and Other Identifying Information: WAC 246-808-150 Commission approved continuing education, amending the continuing education (CE) requirements for Washington state licensed chiropractors.
Hearing Location(s): Department of Health, Point Plaza East, Rooms 152/153, 310 Israel Road, Tumwater, WA 98504, on December 11, 2014, at 10:00 a.m.
Date of Intended Adoption: December 11, 2014.
Submit Written Comments to: Billie Jo Dale, Program Representative, Department of Health, Chiropractic Program, P.O. Box 47858, Olympia, WA 98504-7858, e-mail, fax (360) 236-2901, by December 1, 2014.
Assistance for Persons with Disabilities: Contact Leann Yount by December 1, 2014, TTY (800) 833-6388, or 711.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: ESHB 2315 (chapter 71, Laws of 2014), requires chiropractors to obtain one-time training of three or six hours in suicide assessment, screening, and referral. The commission has determined that the training should include only screening and referral elements as appropriate based on the chiropractic scope of practice, so only three hours of CE in suicide training should be required. The commission has also reviewed the current CE requirements against the current practice standards and determined that additional changes are needed to the rule. The commission is proposing amendments to the rule to add CE categories, describe acceptable documentation to verify completion, and expand the mutlimedia options for obtaining CE. The proposed rules also amend the number of CE hours that may be obtained for some categories.
Reasons Supporting Proposal: The proposed rule implements ESHB 2315 within the chiropractic profession. Based on the chiropractic scope of practice, which does not allow treating patients to manage suicidal thoughts or ideation, the commission chose to require three hours of CE instead of six hours. The commission has also reviewed the current continuing education requirements and determined that changes and updates are needed to keep current with practice standards and enhance competency.
Statutory Authority for Adoption: RCW 18.25.0171, 18.25.070; ESHB 2315 (chapter 71, Laws of 2014).
Statute Being Implemented: RCW 18.25.070; ESHB 2315 (chapter 71, Laws of 2014).
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of health, chiropractic quality assurance commission, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Billie Jo Dale, 111 Israel Road S.E., Tumwater, WA 98501, (360) 236-2868.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rule would not impose more than minor costs on businesses in an industry.
A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Billie Jo Dale, Program Representative, Department of Health, Chiropractic Program, P.O. Box 47858, Olympia, WA 98504-7858, phone (360) 236-2868, fax (360) 236-2901, e-mail
November 5, 2014
Leann Yount
Program Manager
AMENDATORY SECTION (Amending WSR 06-03-057, filed 1/11/06, effective 2/11/06)
WAC 246-808-150 Commission approved continuing education.
(1) Chiropractors must complete twenty-five hours of continuing education per year under RCW 18.25.070 and chapter 246-12 WAC, Part 7.
(2) The commission approves the following subject material for continuing chiropractic education credit:
(a) Diagnosis and treatment of the spine or ((immediate)) extremity articulations within the scope of practice;
(b) X-ray/diagnostic imaging;
(c) Adjustive technique;
(d) Detection of a subluxation;
(e) Physical examination;
(f) Hygiene;
(g) Symptomatology;
(h) Neurology;
(i) Pathology;
(j) Orthopedics;
(k) Patient/case management, documentation, coding;
(l) Impairment within the scope of practice;
(m) CPR (not to exceed a total of four hours);
(n) Dietary and nutrition advice; ((and))
(o) Chiropractic philosophy ((and business management (not to exceed a total of eight hours))); and
(p) Governmental regulations relevant to chiropractic and public health (not to exceed a total of twelve hours).
(3) Beginning June 12, 2014, as part of the continuing education, chiropractors are required to obtain three hours in suicide screening and referral from a qualified suicide prevention training program. This is a one-time suicide prevention training that must be completed no later than the first full reporting period after June 12, 2014 or the first full continuing education reporting period after initial licensure, whichever is later.
(a) A qualified training program in suicide screening and referral must be at least three hours in length which may be provided in one or more sessions.
(b) The hours spent completing a training program in suicide screening and referral under this section count toward meeting any applicable continuing education requirements.
(c) Nothing in this subsection is intended to expand or limit the chiropractic scope of practice.
(4) Subject matter not approved for continuing education credit:
(a) Subject matter not directly relating to the chiropractic clinical scope of practice; and
(b) Conduct prohibited by Washington state statutes or rules governing chiropractic practice.
(((4))) (5) A chiropractor may earn a maximum of twelve hours for:
(a) Completing a multimedia chiropractic education program, which includes, but is not limited to, the internet, teleseminars, employer led training offering continuing education hours, and video presentations.
(b) Serving as teachers or lecturers in continuing education programs approved under subsection (2) of this section. A chiropractor may receive credit on the same basis as ((the doctors)) those attending the program.
(((5) The individual or organization responsible for a continuing education presentation must provide documentation of attendance to participants, including course content and number of hours.))
(6) A chiropractor must provide acceptable documentation of attendance upon commission request or audit. Acceptable forms of documentation include:
(a) Transcripts;
(b) Letters from the course instructors;
(c) Certificate of completion; or
(d) Other formal documentation which includes:
(i) Participant's name;
(ii) Course title;
(iii) Course content;
(iv) Date(s) of course;
(v) Provider's name(s); and
(vi) Signature of the program sponsor or course instructor. Multimedia courses are exempt from the signature requirement.
(7) Chiropractors in active status who reside and practice outside Washington must meet all the requirements ((of this section)).