1. Federation of Chiropractic Licensing Boards Draft Model Practice Act May 7, 2011

2. MPA Task Force Kirk Shilts, D.C., Massachusetts, chair Hank Hulteen, D.C., South Carolina Karen Mathiak, D.C., Georgia Michael Massey, D.C., Tennessee Gary Pennebaker, D.C., Minnesota Bill Rademacher, D.C., Illinois Ian Yamane, D.C., Nevada

3. MPA Task Force Purpose: “To provide contemporary structure as well as sample statutory & regulatory language for reference, use, or adaptation by existing or emerging chiropractic regulatory authorities”

4. Task Force Activity MPA concept under discussion since late 1990’s Commissioned in 2004 2009: adopted documentation/ recordkeeping section of MPA May 2010: focused on definitions, including chiropractic ‘subluxation’ Oct. 2010: sought input at FCLB District Mtgs. Dec. 2010: invited add’l stakeholder involvement

5. MPA Examples o Federation of Associations of Regulatory Boards “Generic Model Practice Act” o Association of Social Work Boards “Model Social Work Practice Act” o National Council of State Boards of Nursing “NCSBN Model Nursing Practice Act & Model Nursing Administrative Rules”

6. MPA Examples o Federation of State Medical Boards “Essentials of a Modern Medical & Osteopathic Practice Act” (12 th edition) o Federation of State Boards of Physical Therapists “The Model Practice Act for Physical Therapists: A tool for public protection and legislative change” o American Association of Veterinary State Boards “Veterinary Medicine & Veterinary Technology Practice Act Model with comments”

7. What constitutes a profession?  Profession: (1) a vocation or calling, especially one that involves some branch of advanced learning or science. (2) a body of people engaged in a profession.  Distinguishing attributes/characteristics  Legal recognition

8. What are the standards of a profession? Legal: Statutes, rules/regulations, practice guidelines Educational: Accreditation standards, program curricula Practical: Recognized experts, professional associations, consensus of actual practitioners Philosophical doctrine (although important) is not a standard

9. Legal Standards STATUTE:  Enacted by legislature / jurisdictional authority  Geared toward public RULE/ REGULATION:  Promulgated by governmental body (Board, licensing admin., oversight & parent agencies)  Requires connection to a statute  Geared toward licensees

10. Legal Standards (cont.) PRACTICE GUIDELINE:  Board policy  Much less legal weight as a rule / regulation  Issues that could use additional clarification

11. How is an MPA developed? Information from Existing FCLB Jurisdictions: Establish overall structure Look for commonalities, 64 independent member jurisdictions over history of FCLB Select clear and established language Concept of a “best practice” document (evidence-based) is not applicable

12. How is a MPA developed? Other Information: Material from non-member jurisdictions & other professions Ideas that address recognized deficiencies: * Recordkeeping, Electronic Health Records * Temporary licensure (travel/treat, disaster declarations, student preceptorships) * Delegation of certain board processes (CE- approvals, accreditations, monitoring, exams)

13. Current Discussion Topics? Complete Government Oversight Format:  Centralized licensing & disciplinary functions  Limited / no control over funding & revenue Semi-autonomous Oversight Formats  Coupled with the professional association  Independent hiring & management authority

14. Current Discussion Topics? Scope of Practice Info.: Statutory (broad) vs. regulatory (specific) Full vs. limited scope (limited to certain body- areas and/or physiological systems?) Listing of allowed vs. prohibited activities Tangential health services (e.g., acupuncture, drug testing, venipuncture, allergy testing, cosmetic procedures?)

15. Current Discussion Topics? Provider Status Info.: Physician vs. practitioner Primary care vs. specialist Recognition of diplomat-board credentials Specialized training * Regulatory: (e.g., peer review work, MUA) * Statutory: (tiered scope, not recommended)

16. Sample MPA Sections (Draft) o Statutory and Regulatory Definitions o Board Structure, Indemnification o Chiropractic Clinical Assistants o Delegation of CE Application Process o Peer Review o Compliance Programs o Grounds for Disciplinary Actions o Board Advisory Rulings & Practice Guidelines

17. Future Committee Tasks Differentiate statutory vs. regulatory concepts Develop consensus of core definitions “Chiropractic” (statutory) “Scope of practice” (regulatory) “Chiropractic subluxation” (regulatory) Identify / insert essential key words Establish comprehensive table of contents

18. Future Committee Tasks Fast-track certain sections: Inter-jurisdictional mobility items Chiropractic assistants Frame MPA for use by emerging jurisdictions Condense / consolidate information Release updated draft for ongoing discussion

19. For More Information www.FCLB.org contact any task force member My information: drshilts@verizon.net (617) 277-1344