| 1 | A bill to be entitled | 
| 2 | An act relating to chiropractic medicine; amending s. | 
| 3 | 460.4062, F.S.; authorizing the Department of Health to | 
| 4 | issue a chiropractic medicine faculty certificate to | 
| 5 | faculty who perform research; amending s. 460.4165, F.S.; | 
| 6 | limiting the locations where certified chiropractic | 
| 7 | physician's assistants may perform chiropractic services; | 
| 8 | deleting restrictions on the minimum time permitted for | 
| 9 | completing the curriculum of a training program for | 
| 10 | certified chiropractic physician's assistants; amending s. | 
| 11 | 460.4166, F.S.; requiring chiropractic assistants who | 
| 12 | perform certain services to register with the Board of | 
| 13 | Chiropractic Medicine after a specified date; requiring a | 
| 14 | registered chiropractic assistant to notify the board of a | 
| 15 | change of employment; requiring the supervision of | 
| 16 | registered chiropractic assistants by chiropractic | 
| 17 | physicians approved by the board; providing that the | 
| 18 | board's approval of supervising chiropractic physicians | 
| 19 | and registration applications shall apply retroactively; | 
| 20 | providing for a fee; requiring the board to prescribe | 
| 21 | forms; amending s. 460.4167, F.S.; revising restrictions | 
| 22 | on the ownership of entities that employ chiropractic | 
| 23 | physicians; authorizing additional persons to possess | 
| 24 | ownership interests in entities that employ chiropractic | 
| 25 | physicians; authorizing the surviving spouse of a deceased | 
| 26 | chiropractic physician to keep an ownership interest in | 
| 27 | the chiropractic practice for a specified period after the | 
| 28 | chiropractic physician's death; providing penalties for | 
| 29 | violations of provisions prohibiting ownership of a | 
| 30 | chiropractic practice by persons other than licensed | 
| 31 | chiropractic physicians; voiding contracts entered into or | 
| 32 | renewed before a specified date that violate provisions | 
| 33 | prohibiting ownership of a chiropractic practice by | 
| 34 | persons other than licensed chiropractic physicians; | 
| 35 | providing effective dates. | 
| 36 | 
 | 
| 37 | Be It Enacted by the Legislature of the State of Florida: | 
| 38 | 
 | 
| 39 | Section 1.  Paragraph (e) of subsection (1) of section | 
| 40 | 460.4062, Florida Statutes, is amended to read: | 
| 41 | 460.4062  Chiropractic medicine faculty certificate.-- | 
| 42 | (1)  The department may issue a chiropractic medicine | 
| 43 | faculty certificate without examination to an individual who | 
| 44 | remits a nonrefundable application fee, not to exceed $100 as | 
| 45 | determined by rule of the board, and who demonstrates to the | 
| 46 | board that he or she meets the following requirements: | 
| 47 | (e)1.  Has been offered and has accepted a full-time | 
| 48 | faculty appointment to teach in a program of chiropractic | 
| 49 | medicine or perform research at a publicly funded state | 
| 50 | university or college or at a college of chiropractic located in | 
| 51 | the state and accredited by the Council on Chiropractic | 
| 52 | Education; and | 
| 53 | 2.  Provides a certification from the dean of the | 
| 54 | appointing college acknowledging the appointment. | 
| 55 | Section 2.  Paragraph (b) of subsection (2) and subsection | 
| 56 | (5) of section 460.4165, Florida Statutes, are amended to read: | 
| 57 | 460.4165  Certified chiropractic physician's assistants.-- | 
| 58 | (2)  PERFORMANCE BY CERTIFIED CHIROPRACTIC PHYSICIAN'S | 
| 59 | ASSISTANT.--Notwithstanding any other provision of law, a | 
| 60 | certified chiropractic physician's assistant may perform | 
| 61 | chiropractic services in the specialty area or areas for which | 
| 62 | the certified chiropractic physician's assistant is trained or | 
| 63 | experienced when such services are rendered under the | 
| 64 | supervision of a licensed chiropractic physician or group of | 
| 65 | chiropractic physicians certified by the board. Any certified | 
| 66 | chiropractic physician's assistant certified under this section | 
| 67 | to perform services may perform those services only: | 
| 68 | (b)  Under indirect supervision if the indirect supervision | 
| 69 | occurs at the supervising chiropractic physician's address of | 
| 70 | record or place of practicerequired by s. 456.035, other than | 
| 71 | at a clinic licensed under part X of chapter 400, of the | 
| 72 | chiropractic physician to whom she or he is assigned as defined | 
| 73 | by rule of the board; | 
| 74 | (5)  PROGRAM APPROVAL.--The department shall issue | 
| 75 | certificates of approval for programs for the education and | 
| 76 | training of certified chiropractic physician's assistants which | 
| 77 | meet board standards. Any basic program curriculum certified by | 
| 78 | the board shall cover a period of 24 months. The curriculum must  | 
| 79 | consist of a curriculum of at least 200 didactic classroom hours | 
| 80 | during those 24 months. | 
| 81 | (a)  In developing criteria for program approval, the board | 
| 82 | shall give consideration to, and encourage, the utilization of | 
| 83 | equivalency and proficiency testing and other mechanisms whereby | 
| 84 | full credit is given to trainees for past education and | 
| 85 | experience in health fields. | 
| 86 | (b)  The board shall create groups of specialty | 
| 87 | classifications of training for certified chiropractic | 
| 88 | physician's assistants. These classifications shall reflect the | 
| 89 | training and experience of the certified chiropractic | 
| 90 | physician's assistant. The certified chiropractic physician's | 
| 91 | assistant may receive training in one or more such | 
| 92 | classifications, which shall be shown on the certificate issued. | 
| 93 | (c)  The board shall adopt and publish standards to ensure | 
| 94 | that such programs operate in a manner which does not endanger | 
| 95 | the health and welfare of the patients who receive services | 
| 96 | within the scope of the program. The board shall review the | 
| 97 | quality of the curricula, faculties, and facilities of such | 
| 98 | programs; issue certificates of approval; and take whatever | 
| 99 | other action is necessary to determine that the purposes of this | 
| 100 | section are being met. | 
| 101 | Section 3.  Subsection (3) of section 460.4166, Florida | 
| 102 | Statutes, is amended, and subsections (4) and (5) are added to | 
| 103 | that section, to read: | 
| 104 | 460.4166  Registered chiropractic assistants.-- | 
| 105 | (3)  REGISTRATION.-- | 
| 106 | (a)  A registered chiropractic assistant assistantsmay | 
| 107 | register with be registered bythe board for a biennial fee not | 
| 108 | to exceed $25. Effective April 1, 2010, a person must register | 
| 109 | with the board as a chiropractic assistant if the person | 
| 110 | performs therapeutic services or administers therapeutic agents | 
| 111 | related to a chiropractic physician's treatment of a patient, | 
| 112 | unless the person is otherwise certified or licensed to perform | 
| 113 | those services or administer those agents. | 
| 114 | (b)  A person employed as a registered chiropractic | 
| 115 | assistant, if required to register under this section, must | 
| 116 | submit an initial application for registration to the board | 
| 117 | within 30 days after employment. Upon the board's approval of | 
| 118 | the application, the effective date of the registration shall | 
| 119 | apply retroactively to the date of employment. | 
| 120 | (c)  A registered chiropractic assistant, within 30 days | 
| 121 | after a change of employment, must notify the board of the new | 
| 122 | place of employment and the name of the chiropractic physician | 
| 123 | or group of chiropractic physicians under whose supervision the | 
| 124 | registered chiropractic assistant performs the duties described | 
| 125 | in subsection (2). | 
| 126 | (d)  A person who exclusively performs nontherapeutic | 
| 127 | services is not required to register under this section. | 
| 128 | (4)  APPROVAL OF SUPERVISING CHIROPRACTIC PHYSICIANS.-- | 
| 129 | (a)  A chiropractic physician or group of chiropractic | 
| 130 | physicians under whose supervision a registered chiropractic | 
| 131 | assistant performs the duties described in subsection (2) must | 
| 132 | be approved by the board. If a registered chiropractic assistant | 
| 133 | performs those duties under the direct supervision of a | 
| 134 | certified chiropractic physician's assistant, the chiropractic | 
| 135 | physician or group of chiropractic physicians under whose | 
| 136 | supervision the certified chiropractic physician's assistant | 
| 137 | provides direct supervision for the registered chiropractic | 
| 138 | assistant must be approved by the board. | 
| 139 | (b)  If a registered chiropractic assistant changes | 
| 140 | employment, the supervising chiropractic physician or group of | 
| 141 | chiropractic physicians at the new place of employment must be | 
| 142 | approved by the board. | 
| 143 | (c)  Upon approval of a supervising chiropractic physician | 
| 144 | or group of chiropractic physicians, the effective date of the | 
| 145 | board's approval shall apply retroactively to the date of | 
| 146 | employment. The board shall assess a fee for approval of a | 
| 147 | supervising chiropractic physician or group of chiropractic | 
| 148 | physicians not to exceed $75. | 
| 149 | (5)  APPLICATION FORMS.--The board shall prescribe by rule | 
| 150 | application forms for the initial registration of a registered | 
| 151 | chiropractic assistant, the board's approval of a supervising | 
| 152 | chiropractic physician or group of chiropractic physicians, and | 
| 153 | the registered chiropractic assistant's notice of a change of | 
| 154 | employment. | 
| 155 | Section 4.  Subsections (1) and (5) of section 460.4167, | 
| 156 | Florida Statutes, are amended to read: | 
| 157 | 460.4167  Proprietorship by persons other than licensed | 
| 158 | chiropractic physicians.-- | 
| 159 | (1)  No person other than a sole proprietorship, group  | 
| 160 | practice, partnership, or corporation that is wholly owned by  | 
| 161 | one or more chiropractic physicians licensed under this chapter  | 
| 162 | or by a chiropractic physician licensed under this chapter and  | 
| 163 | the spouse, parent, child, or sibling of that chiropractic  | 
| 164 | physicianmay employ a chiropractic physician licensed under | 
| 165 | this chapter, or engage a chiropractic physician licensed under | 
| 166 | this chapter as an independent contractor, to provide services | 
| 167 | authorized by this chapter to be offered by a chiropractic | 
| 168 | physician licensed under this chapter, unless the person is any | 
| 169 | of the following except for: | 
| 170 | (a)  A sole proprietorship, group practice, partnership, | 
| 171 | corporation, limited liability company, limited partnership, | 
| 172 | professional association, or any other entity that is wholly | 
| 173 | owned by: | 
| 174 | 1.  One or more chiropractic physicians licensed under this | 
| 175 | chapter; | 
| 176 | 2.  A chiropractic physician licensed under this chapter | 
| 177 | and the spouse or surviving spouse, parent, child, or sibling of | 
| 178 | the chiropractic physician; or | 
| 179 | 3.  A trust whose trustees are chiropractic physicians | 
| 180 | licensed under this chapter and the spouse, parent, child, or | 
| 181 | sibling of a chiropractic physician. | 
| 182 | (b) (a)A sole proprietorship, group practice, partnership, | 
| 183 | orcorporation, limited liability company, limited partnership, | 
| 184 | professional association, or any other entity that is wholly | 
| 185 | owned by a physician or physicians licensed under this chapter, | 
| 186 | chapter 458, chapter 459, or chapter 461. | 
| 187 | (c) (b)An entityEntitiesthat is whollyareowned, | 
| 188 | directly or indirectly, by an entity licensed or registered by | 
| 189 | the state under chapter 395. | 
| 190 | (d) (c)A clinical facilityfacilitiesaffiliated with a | 
| 191 | college of chiropractic accredited by the Council on | 
| 192 | Chiropractic Education at which training is provided for | 
| 193 | chiropractic students. | 
| 194 | (e) (d)A public or private university or college. | 
| 195 | (f) (e)An entity wholly owned and operated by an | 
| 196 | organization that is exempt from federal taxation under s. | 
| 197 | 501(c)(3) or (4) of the Internal Revenue Code, a anycommunity | 
| 198 | college or university clinic, and any entity owned or operated  | 
| 199 | bythe Federal Government, orbystate government, including any | 
| 200 | agency, county, municipality, or other political subdivision | 
| 201 | thereof. | 
| 202 | (g) (f)An entity owned by a corporation the stock of which | 
| 203 | is publicly traded. | 
| 204 | (h) (g)A clinic licensed under part X of chapter 400 that | 
| 205 | provides chiropractic services by a chiropractic physician | 
| 206 | licensed under chapter 460 and other health care services by | 
| 207 | physicians licensed under chapter 458 or ,chapter 459,or  | 
| 208 | chapter 460,the medical director of which must beislicensed | 
| 209 | under chapter 458 or chapter 459. | 
| 210 | (i) (h)A state-licensed insurer. | 
| 211 | (j)  A health maintenance organization or prepaid health | 
| 212 | clinic regulated under chapter 641. | 
| 213 | 
 | 
| 214 | If a chiropractic physician described in subparagraph (a)2. | 
| 215 | dies, notwithstanding part X of chapter 400, the deceased | 
| 216 | chiropractic physician's surviving spouse may hold, operate, | 
| 217 | pledge, sell, mortgage, assign, transfer, own, or control the | 
| 218 | deceased chiropractic physician's ownership interests for 1 year | 
| 219 | after the chiropractic physician's death. The chiropractic | 
| 220 | practice must subsequently comply with this section and part X | 
| 221 | of chapter 400. | 
| 222 | (5)  Any person who violates this section commits a felony | 
| 223 | of the third degree, punishable as provided in s. 775.082 | 
| 224 | 775.081, s. 775.083, or s. 775.084s. 775.035. | 
| 225 | Section 5.  Effective July 1, 2010, subsection (6) of | 
| 226 | section 460.4167, Florida Statutes, is amended to read: | 
| 227 | 460.4167  Proprietorship by persons other than licensed | 
| 228 | chiropractic physicians.-- | 
| 229 | (6)  Any contract or arrangement entered into or undertaken | 
| 230 | in violation of this section is shall bevoid as contrary to | 
| 231 | public policy. This section applies to contracts entered into or  | 
| 232 | renewed on or after July 1, 2008. | 
| 233 | Section 6.  Except as otherwise expressly provided in this | 
| 234 | act, this act shall take effect July 1, 2009. |