Bill Summary – FastDemocracy

       Florida Senate - 2023                                     SB 378



       By Senator Garcia





       36-00872-23                                            2023378__
                      A bill to be entitled                      
       An act relating to the practice of chiropractic
       medicine; amending s. 400.9905, F.S.; revising the
       definition of the term âclinicâ as it relates to the
       regulation of health care clinics; amending s.
       460.402, F.S.; revising applicability of ch. 460,
       F.S.; amending s. 460.403, F.S.; revising definitions;
       amending s. 460.406, F.S.; revising licensure
       requirements for chiropractic physicians; amending s.
       460.4061, F.S.; revising requirements for restricted
       licenses for chiropractic physicians; amending s.
       460.4062, F.S.; revising requirements for chiropractic
       medicine faculty certificates; amending s. 460.4165,
       F.S.; revising certification requirements for
       certified chiropractic assistants; amending s.
       460.4167, F.S.; revising criteria for clinical
       facilities that may employ or engage chiropractic
       physicians to provide chiropractic services; providing
       an effective date.
        
Be It Enacted by the Legislature of the State of Florida:

       Section 1.âParagraph (j) of subsection (4) of section
400.9905, Florida Statutes, is amended to read:
       400.9905âDefinitions.â
       (4)ââClinicâ means an entity where health care services are
provided to individuals and which tenders charges for
reimbursement for such services, including a mobile clinic and a
portable equipment provider. As used in this part, the term does
not include and the licensure requirements of this part do not
apply to:
       (j)âClinical facilities affiliated with a college of
chiropractic accredited by an accrediting agency recognized by
the United States Department of Education the Council on
Chiropractic Education at which training is provided for
chiropractic students.

Notwithstanding this subsection, an entity shall be deemed a
clinic and must be licensed under this part in order to receive
reimbursement under the Florida Motor Vehicle No-Fault Law, ss.
627.730-627.7405, unless exempted under s. 627.736(5)(h).
       Section 2.âSubsection (6) of section 460.402, Florida
Statutes, is amended to read:
       460.402âExceptions.âThe provisions of this chapter shall
not apply to:
       (6)âA chiropractic student enrolled in a chiropractic
college accredited by an accrediting agency recognized by the
United States Department of Education the Council on
Chiropractic Education and participating in either:
       (a)âA community-based internship under the direct
supervision of a doctor of chiropractic medicine who is
credentialed as an adjunct faculty member of a chiropractic
college in which the student is enrolled; or
       (b)âA chiropractic college clinical internship under the
direct supervision of a doctor of chiropractic medicine who is a
full-time, part-time, or adjunct faculty member of a
chiropractic college located in this state and accredited by an
accrediting agency recognized by the United States Department of
Education the Council on Chiropractic Education and who holds a
current, active Florida chiropractorâs license.
       Section 3.âSubsection (4) and paragraph (a) of subsection
(9) of section 460.403, Florida Statutes, are amended to read:
       460.403âDefinitions.âAs used in this chapter, the term:
       (4)(a)ââCommunity-based internshipâ means a program in
which a student enrolled in his or her the last year of a
chiropractic college accredited by an accrediting agency
recognized by the United States Department of Education the
Council on Chiropractic Education is approved to obtain required
pregraduation clinical experience in a chiropractic clinic or
practice under the direct supervision of a doctor of
chiropractic medicine approved as an adjunct faculty member of
the chiropractic college in which the student is enrolled,
according to the teaching protocols for the clinical practice
requirements of the college.
       (b)ââChiropractic college clinical internshipâ means a
program in which a student enrolled in a chiropractic college
that is located in this state and accredited by an accrediting
agency recognized by the United States Department of Education
the Council on Chiropractic Education obtains clinical
experience pursuant to the chiropractic collegeâs curriculum in
a classroom or chiropractic clinic operated by the chiropractic
college, according to the teaching protocols for the clinical
practice requirements of the college.
       (9)(a)ââPractice of chiropractic medicineâ means a
noncombative principle and practice consisting of the science,
philosophy, and art of the adjustment, manipulation, and
treatment of the human body in which vertebral subluxations and
other malpositioned articulations and structures that are
interfering with the normal generation, transmission, and
expression of nerve impulse between the brain, organs, and
tissue cells of the body, thereby causing disease, are adjusted,
manipulated, or treated, thus restoring the normal flow of nerve
impulse which produces normal function and consequent health by
chiropractic physicians using specific chiropractic adjustment
or manipulation techniques taught in chiropractic colleges
accredited by an accrediting agency recognized by the United
States Department of Education the Council on Chiropractic
Education. No person other than a licensed chiropractic
physician may render chiropractic services, chiropractic
adjustments, or chiropractic manipulations.
       Section 4.âSubsections (1), (2), and (5) of section
460.406, Florida Statutes, are amended to read:
       460.406âLicensure by examination.â
       (1)âAny person desiring to be licensed as a chiropractic
physician must apply to the department to take the licensure
examination. There is shall be an application fee set by the
board not to exceed $100 which is shall be nonrefundable. There
is shall also be an examination fee not to exceed $500 plus the
actual per applicant cost to the department for purchase of
portions of the examination from the National Board of
Chiropractic Examiners or a similar national organization, which
may be refundable if the applicant is found ineligible to take
the examination. The department shall examine each applicant
whom the board certifies has met all of the following criteria:
       (a)âCompleted the application form and remitted the
appropriate fee.
       (b)âSubmitted proof satisfactory to the department that he
or she is not less than 18 years of age.
       (c)âSubmitted proof satisfactory to the department that he
or she is a graduate of a chiropractic college which is
accredited by or has status with an accrediting agency
recognized by the United States Department of Education the
Council on Chiropractic Education or its predecessor agency.
However, any applicant who is a graduate of a chiropractic
college that was initially accredited by the Council on
Chiropractic Education in 1995, who graduated from such college
within the 4 years immediately preceding such accreditation, and
who is otherwise qualified is eligible to take the examination.
An application for a license to practice chiropractic medicine
may not be denied solely because the applicant is a graduate of
a chiropractic college that subscribes to one philosophy of
chiropractic medicine as distinguished from another.
       (d)1.âFor an applicant who has matriculated in a
chiropractic college before July 2, 1990, completed at least 2
years of residence college work, consisting of a minimum of one
half the work acceptable for a bachelorâs degree granted on the
basis of a 4-year period of study, in a college or university
accredited by an institutional accrediting agency recognized and
approved by the United States Department of Education. However,
before being certified by the board to sit for the examination,
each applicant who has matriculated in a chiropractic college
after July 1, 1990, must have been granted a bachelorâs degree,
based upon 4 academic years of study, by a college or university
accredited by an institutional accrediting agency that is a
member of the Commission on Recognition of Postsecondary
Accreditation.
       2.âEffective July 1, 2000, completed, before matriculation
in a chiropractic college, at least 3 years of residence college
work, consisting of a minimum of 90 semester hours leading to a
bachelorâs degree in a liberal arts college or university
accredited by an institutional accrediting agency recognized and
approved by the United States Department of Education. However,
before being certified by the board to sit for the examination,
each applicant who has matriculated in a chiropractic college
after July 1, 2000, must have been granted a bachelorâs degree
from an institution holding accreditation for that degree from
an institutional accrediting agency that is recognized by the
United States Department of Education. The applicantâs
chiropractic degree must consist of credits earned in the
chiropractic program and may not include academic credit for
courses from the bachelorâs degree.
       (e)âSuccessfully completed the National Board of
Chiropractic Examiners certification examination in parts I, II,
III, and IV, and the physiotherapy examination of the National
Board of Chiropractic Examiners, with a score approved by the
board.
       (f)âSubmitted to the department a set of fingerprints on a
form and under procedures specified by the department, along
with payment in an amount equal to the costs incurred by the
Department of Health for the criminal background check of the
applicant.

The board may require an applicant who graduated from an
institution accredited by an accrediting agency recognized by
the United States Department of Education the Council on
Chiropractic Education more than 10 years before the date of
application to the board to take the National Board of
Chiropractic Examiners Special Purposes Examination for
Chiropractic, or its equivalent, as determined by the board. The
board shall establish by rule a passing score.
       (2)âFor those applicants applying for the certification
examination who have matriculated prior to July 1, 1996, in a
chiropractic college, the board shall waive the provisions of
paragraph (1)(c) if the applicant is a graduate of a
chiropractic college which has been denied accreditation or
approval on the grounds that its curriculum does not include the
training in acupuncture necessary for the completion of the
certification examination or is a graduate of a chiropractic
college where acupuncture is not taught or offered if the
college is accredited by or has status with an accrediting
agency recognized by the United States Department of Education
the Council on Chiropractic Education or its predecessor.
       (5)âA student enrolled in a school or college of
chiropractic accredited by an accrediting agency recognized by
the United States Department of Education the Council on
Chiropractic Education or its successor in the final year of the
program may file an application pursuant to subsection (1), take
all examinations required for licensure, submit a set of
fingerprints, and pay all fees required for licensure. A
chiropractic student who successfully completes the licensure
examinations and who otherwise meets all requirements for
licensure as a chiropractic physician during the studentâs final
year must have graduated before being certified for licensure
pursuant to this section.
       Section 5.âParagraph (a) of subsection (1) of section
460.4061, Florida Statutes, is amended to read:
       460.4061âRestricted license.â
       (1)âAn applicant for licensure as a chiropractic physician
may apply to the department for a restricted license without
undergoing a state or national written or clinical competency
examination for licensure if the applicant initially applies not
later than October 31, 1994, for the restricted license and:
       (a)âHolds a degree from a college of chiropractic
accredited by an accrediting agency recognized by the United
States Department of Education the Council on Chiropractic
Education or its predecessor agency and holds a bachelorâs
degree.
       Section 6.âParagraphs (a) and (e) of subsection (1) of
section 460.4062, Florida Statutes, are amended to read:
       460.4062âChiropractic medicine faculty certificate.â
       (1)âThe department may issue a chiropractic medicine
faculty certificate without examination to an individual who
remits a nonrefundable application fee, not to exceed $100 as
determined by rule of the board, and who demonstrates to the
board that he or she meets the following requirements:
       (a)âIs a graduate of an accredited school or college of
chiropractic accredited by an accrediting agency recognized by
the United States Department of Education the Council on
Chiropractic Education.
       (e)1.âPerforms research or has been offered and has
accepted a full-time or part-time faculty appointment to teach
in a program of chiropractic medicine at a publicly funded state
university or college or at a college of chiropractic located in
this the state and accredited by an accrediting agency
recognized by the United States Department of Education the
Council on Chiropractic Education; and
       2.âProvides a certification from the dean of the appointing
college acknowledging the appointment.
       Section 7.âParagraph (b) of subsection (13) of section
460.4165, Florida Statutes, is amended to read:
       460.4165âCertified chiropractic physicianâs assistants.â
       (13)âCERTIFIED CHIROPRACTIC ASSISTANT CERTIFICATION
RENEWAL.âThe certification must be renewed biennially.
       (b)âEach certified chiropractic physicianâs assistant shall
biennially complete 24 hours of continuing education courses
sponsored by chiropractic colleges accredited by an accrediting
agency recognized by the United States Department of Education
the Council on Chiropractic Education and approved by the board.
The board shall approve those courses that build upon the basic
courses required for the practice of chiropractic medicine, and
the board may also approve courses in adjunctive modalities. The
board may make exception from the requirements of this section
in emergency or hardship cases. The board may adopt rules within
the requirements of this section which are necessary for its
implementation.
       Section 8.âParagraph (d) of subsection (1) of section
460.4167, Florida Statutes, is amended to read:
       460.4167âProprietorship by persons other than licensed
chiropractic physicians.â
       (1)âA person may not employ a chiropractic physician
licensed under this chapter or engage a chiropractic physician
licensed under this chapter as an independent contractor to
provide services that chiropractic physicians are authorized to
offer under this chapter, unless the person is any of the
following:
       (d)âA clinical facility that is affiliated with a college
of chiropractic accredited by an accrediting agency recognized
by the United States Department of Education the Council on
Chiropractic Education at which training is provided for
chiropractic students.
       Section 9.âThis act shall take effect upon becoming a law.
Statutes affected: 
S 378 Filed: 400.9905, 460.402, 460.4061, 460.4165, 460.4167