1. Presentation on Chiropractic Assistants
Salvatore LaRusso, D.C, Chairman Board of Chiropractic Medicine

2. What is a chiropractic assistant?
The Florida Legislature created section , Florida Statutes to encourage the more effective utilization of the skills of chiropractic physicians by enabling them to delegate health care tasks to qualified assistants when such delegation is consistent with the patient's health and welfare and to allow for innovative development of programs for the education of physician's assistants.
There are two categories of chiropractic assistants: Registered Chiropractic Assistants (RCA) and Certified Chiropractic Physician’s Assistants (CCPA).

3. Definitions Registered Chiropractic Assistant direct supervision
patient care management
executes administrative and clinical procedures
performs managerial and supervisory functions.
Certified Chiropractic Physician’s Assistant
24 month Chiropractic Education
performing tasks traditionally performed by the Chiropractic physician
indirect supervision
case histories, diagnostic testing, physical examinations, and therapeutic procedures
cannot perform adjustive procedures, diagnostic testing interpretations, treatment advice, or the taking of x-rays unless properly certified.

4. More Definitions
Supervising physician - licensed DC approved by the Board, may supervise more than one CCPA.
Responsible supervision - ability to responsibly exercise control and provide direction

5. Responsible Supervision
In determining responsible supervision the following factors must be considered:
background and training
skill of the assistant
adequacy of the direction in terms of form
the setting where tasks are performed
availability of the supervising physician
the necessity for immediate attention
the number of other persons the DC supervises

6. More Definitions
Direct supervision requires the physical presence of the licensed supervising DC on the premises
Indirect supervision responsible supervision and control and easy availability of the supervising DC for consultation and direction
Easy availability means either physically present or within 30 minutes of the treatment location. Supervising DC must be available by communication devices such as telephone, two-way radio, medical beeper or other electronic means

7. Laws and Rules
Chapter 460, Florida Statutes is the law that governs the chiropractic profession.
Rule 64B2, Florida Administrative Code are the rules of the Board of Chiropractic Medicine.

8. Registered Chiropractic Assistants
DUTIES.--Under the direct supervision and responsibility of a licensed DC or licensed CCPA, an RCA may:
prepare patients for the DC care
take vital signs
observe and report patients' signs or symptoms
administer basic first aid
assist with patient examinations or treatments
operate office equipment.
collect routine laboratory specimens
administer nutritional supplements
perform office procedures
RCAs may register for a biennial fee of $25.

9. CCPA Duties CCPAs may perform services only:
In the primary practice location of the supervising DC
Under indirect supervision
In a hospital in which the supervising DC is a member of the staff
On calls outside the primary practice location on the direct order of the supervising DC

10. Certification of Supervisors
Any chiropractic physician desiring to supervise, employ or work with a CCPA shall make application to the Board on forms provided by the Board.
The Board shall certify the physician or group of physicians to supervise a CCPA.
Certifications to supervise shall remain valid for one year and must be renewed annually.
A fee of $ is required for authorization to supervise a CCPA.

11. Method of Performance
An assistant must clearly identify himself or herself by appropriate identification as a CCPA or RCA to insure that he or she is not mistaken for a licensed physician (for example, a name tag).
The assistant must generally function in reasonable proximity to the supervising physician. If he or she is to perform away from the supervising physician, these duties must be clearly specified in the supervising physician’s application to the Board.

12. Pending Rule Changes Definitions:
supervising physician at a ratio no greater than 2 CCPAs to one supervisor
indirect supervision only in a practice that is exempt from licensure under Part X, Chapter 400, F.S., and wholly owned by one or more chiropractic physicians or by a chiropractic physician and the spouse, parent, child, or sibling of that chiropractic physician.

13. Application for Certification as a Chiropractic Physician’s Assistant
As part of the application process, the Board shall interview the supervising chiropractic physician and the applicant about the work arrangement proposed in the application.
Applicants must successfully complete 24 months of chiropractic education which is accredited by, or has status with the Council on Chiropractic Education or its predecessor agency.
The application shall be accompanied by a diploma, written verification of completion of the 24 months of chiropractic education from the educational institution
Successful completion is deemed to mean obtaining a raw score of 75% on a comprehensive examination covering the entire education and training program.