1. THE ROLE OF EDUCATIONAL ACCREDITATION IN LICENSURE MOBILITY Federation of Chiropractic Licensing Boards Atlanta, Georgia May 2, 2008 Joseph Brimhall, D.C. President, Western States Chiropractic College Past-President, Council on Chiropractic Education (CCE) Director, Councils on Chiropractic Education International (CCEI)

2. “I believe education is the great equalizer. Our children are our hope for the future, so we have an obligation to provide them with the tools to succeed. There is no more powerful tool than knowledge.” --Dave Heineman

3. The principal goal of education is to create people who are capable of doing new things, not simply of repeating what other generations have done. -Jean Piaget (1896-1980) Swiss cognitive psychologist.

4. What is the role of CCE accreditation? CCE VISION STATEMENT  “Promoting Excellence and Assuring Quality in Chiropractic Education”

5. HOW DOES CCE ASSURE QUALITY OF CHIROPRACTIC EDUCATION? by Development of valid criteria (CCE Standards) Direct accreditation of programs & institutions (COA actions) Recognition and Endorsement of actions and standards of other accrediting agencies (formerly via Reciprocal Agreements)

6. ACCREDITATION IN THE UNITED STATES  Accreditation originated in the U.S.— it is an American “invention”  Relies on peer review rather than governmental regulation  Is “voluntary”

7. “Accreditation is voluntary”  Probably essential to a college, but is a choice, not an imposed requirement.  Similar to professional licensure, accreditation is a privilege, not a right.

8. Who Recognizes CCE?  United States Department of Education – in accordance with federal law and regulations  CHEA (Council on Higher Education Accreditation) – adherence to established criteria  ASPA (Association of Specialized and Professional Accreditors) – voluntary compliance with “Code of Good Practice”  CCE-I – conformance with “Model Standards”

9. United States Department of Education recognition  Recognized accrediting agencies act as “gatekeepers” for access to federal funds.  USDE is a “consumer” of accreditation services (one way to view it)

10. CCE accreditation decisions are recognized by: The United States Secretary of Education Other regional and specialized accrediting agencies in the U.S. The Council for Higher Education Accreditation (CHEA) Most United States licensing boards International chiropractic accrediting agencies (via CCE-I mutual recognition and endorsement)

11. Professional Regulation  Professional licensure is the responsibility of jurisdictional regulation  Accreditation may be a resource for licensing bodies, much like professional testing is used by regulators

12. Chiropractic Regulation View

13. PROFESSIONAL REGULATION  Licensing boards have the legal authority to grant licensure and to approve educational programs necessary for licensure  In the U.S., licensure and education are under the authority of state (not federal) government

14. International mobility WHY RECIPROCITY DOES NOT WORK…  Only 2 entities involved, by definition  “Leap frog” phenomenon  Presumes equivalence of the two sets of Standards to each other  Does not consider regional differences

15. WHY RECIPROCITY DOES NOT WORK…(cont.)  Who maintains assurance of equivalence?  What happens when there are substantial differences between the two Standards (i.e. non- equivalence)?

16. Alternatives to Reciprocity Option: Each agency accredits colleges outside its region/country (for example, CCE could directly accredits colleges outside the U.S.) Requires the college’s adherence to multiple different sets of programmatic accreditation Standards. (many institutions in the U.S. already do this with other programmatic agencies)

17. Another alternative….  Mutual recognition and endorsement of other CCE agencies through compliance with CCE-I Core Model Standards Membership of CCE-I is formed by the CCE agencies of the world Each CCE world-wide has approved the Core Model Standards and has representation on CCE-I CCE-I is responsible to assure compliance of each CCE with the Core Model Standards

18. Councils on Chiropractic Education International (CCE-I)  A membership organization comprised of the four CCE agencies worldwide (U.S., Canada, Europe, Australia)  Has established Core Model Standards that all agencies comply with  Such compliance is the basis for “mutual endorsement and recognition”

19. CCEI Core Model Standards are recognized and endorsed by: Council on Chiropractic Education Australasia (CCEA) Canadian Federation of Chiropractic Regulatory and Educational Accrediting Boards (CFCREAB) Council on Chiropractic Education - United States of America (CCE) European Council on Chiropractic Education (ECCE)

20. Benefits of mutual endorsement and recognition:  Transferability of credits among accredited colleges  MAY facilitate licensure mobility in jurisdictions outside the region

21. Mutual Recognition and Endorsement is already in place  There is nothing for the student or licensing board to buy  The Core Model Standards are available to anyone via the CCE-I web site: http://www.cceintl.org/

22. How does this work for regulation?  Licensing bodies and other third parties may rely on the mutual endorsement and recognition provisions as an effective and comparable approach to resolving questions regarding equivalency of international accreditation requirements and actions.

23. However…  International accreditation process and requirements are not exactly like CCE Not all agencies have the same peer- review accreditation process Differing requirements for admission Educational structures vary in other regions and countries

24. Limitations of CCE recognition and endorsement of a foreign agency:  -does not constitute accreditation by CCE  -does not imply eligibility for federal funds, including Title IV funds or federal student loan programs

25. Challenges for regulation  State laws and regulations may include requirements not covered by recognition and endorsement Licensing bodies must assure compliance with applicable laws

26. Also….  The eligibility of a foreign educational program to participate in Title IV financial aid programs does not imply CCE accreditation of that program  Might not meet state requirements for an accredited program

27. Therefore…  Regulatory bodies may choose to rely on the recognition and endorsement of each regional CCE (via compliance with CCEI Model Standards) as an effective means to facilitate international mobility.

28. PLEASE OBSERVE… It should be noted that CCEI endorsement and recognition of equivalency represents compliance and conformity with CCEI Model Standards and does not necessarily express identical equivalence with CCE-US Standards. Determination of compliance with individual jurisdictional requirements may require review on a case-by-case basis.

29. IMPORTANT:  The decision of how much weight, if any, to give CCE’s mutual recognition and endorsement of other CCE agencies must remain with the licensing and regulatory organizations.

30. “The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn.” - ALVIN TOFFLER ALVIN TOFFLER

31. Questions? Thank you.