1. The CTA Experience: Standards Advancing a Profession

2. The Need for Standardization Re-active vs. Pro-active Our experience – BC/BS Policy Change Some steps are the same Pro-active – determine own timelines, etc.

3. Building the Case for Standardization Strategy to Delay Payer and Assess Needs of the Profession Research available CA training resources Survey physicians and staff as to current training methods Survey patients - perception

4. Choice to Ensure Chiropractic Guides Chiropractic Taking the Legislative Course SAMPLE LEGISLATION SOURCE: Tennessee Code/TITLE 63 PROFESSIONS OF THE HEALING ARTS/CHAPTER 4 CHIROPRACTORS 63-4-123. Minimum educational standards and criteria. a)(1) The board shall adopt rules and regulations that shall establish minimum educational standards and criteria for persons performing physical agent modalities and physical treatment in a chiropractic physician's office. (2) These regulations shall include, but not be limited to, provisions for grandfathering, waiver, reciprocity, renewal, continuing education, fees, examination and hardship cases. (b) No person shall perform therapeutic procedures in a chiropractic physician's office who does not meet these standards and who has not received a certificate of proficiency from the board. [Acts 1999, ch. 306, § 1.]

5. Board of Chiropractic Examiners Rules and Regulations General Rules Governing Chiropractic Therapy Assistants (key sections): A person must comply with the following procedures and requirements prior to submitting an application: be at least eighteen (18) years of age; be of good moral character; and be a high school graduate or equivalent. Also requires that individuals seeking licensure as a CTA complete three key components of education. These three components in order of required completion are: CTA 50 Hour Distance Learning Program CTA State Examination CTA 1200 Hour Clinical Internship Post-Course Completion Hours – Six (6) hours of continuing education (CE) credits each calendar year for all licensed CTAs (not in the year they are licensed) One-time, two (2) hour course covering sexual boundaries, risk management, and jurisprudence is mandated in addition to the six hours of CE the first year that continuing education is required.

6. Standardization in CA Training Be Proactive - Things to Consider Commitment from the profession Dedicated Staff to Oversee Start up cost Committee to Create/Update Exam Proctors and Testing Locations Speakers for Continuing Education Distance Learning Issues Licensed to Individuals, Not Clinic Affidavit Policy Transfer Policy

7. CTA Program Curriculum The Professional CTA Principles of Chiropractic Healthcare Terminology for Healthcare Professionals Documentation & Recordkeeping Common Duties of the CTA Anatomy & Physiology Treatment Principles and Procedures Spinal Rehabilitation Fundamentals Professional Boundaries and Ethics Emergency Procedures

8. CTA 50 Hour Distance Learning Program Textbook Practical Workbook Video Component Affidavit of Completion documentation Completion Exam and Certificate

9. Making It Work in Your State……

10. Licensing Verification Insurance Claim Denials Practicing Without a License – Affects Doctor and CTA Standardization in CA Training Be Proactive - Things to Consider Licensing Matters

11. Standardization in CA Training Be Proactive - Benefits to Profession Parity of training, applicable in all chiropractic practices Pool of licensed professionals with potential for reciprocity among states Annual CE keeping CTAs current with the latest research and technology Knowledgeable patient education leading to increased retention Higher level of professional CTAs = increased quality to patient care

12. The CTA Experience: Standards Advancing a Profession