Practice Rights Threatened in California

A small but potentially deadly legislative bill proposes to strip the chiropractic profession of its autonomy and protection. California Senate Bill 2034 ("Healing Arts: Chiropractic Act, Osteopathic Act") is the most disastrous piece of legislation for chiropractic put forth in recent years. SB 2034, authored by Senator Liz Figueroa (D-Fremont), would place control of the scope of practice and every other aspect of chiropractic law in the hands of the California legislature and the Department of Consumer Affairs (DCA). As we go to press, there is a hearing on the bill set for April 24. It if goes to the voters, it will be via an initiative on the November ballot.

The chiropractic scope of practice, composition and authority of the California Board of Chiropractic Examiners (BCE), basic educational requirements and other aspects of chiropractic law have been under the Chiropractic Initiative Act that was passed by the California voters in 1922. SB 2034 seeks to amend the act. Liz Figueroa proposes to:

• decrease the number of licensed chiropractor board members from five to four;

• increase the number of public board members from two to three;

• allow the legislature to amend, revise, or supplement the Chiropractic Act;

• not permit the legislature to eliminate the licensing of chiropractic practitioners in the state; and

• provide for the termination of the operation of the board on an unspecified date.

Chiropractic is not the only victim on the chopping block. SB 2034 also seeks to give the legislature the same authority over the osteopathic profession.

SB 2034 arose out of a routine review of the California Board of Chiropractic Examiners (BCE) and other consumer boards by California's Joint Legislative Sunset Review Committee (JLSRC). Many boards are subject to "sunset" provisions - i.e., boards must justify their existence to the legislature on a periodic basis. The chiropractic board cannot be "sunsetted" as long as the Chiropractic Act remains intact.

The JLSRC recommended that the BCE be treated as all other state boards, i.e., to place the BCE under oversight of the department of consumer affairs and give the legislature the authority to "amend, revise or supplement the Chiropractic Act," though "not eliminate the licensing of practitioners of chiropractic." It also means subjecting the BCE to a sunset provision, which could result in the demise of the chiropractic board in favor of regulation from another state agency. Although the JLSRC's concept of uniformity for state boards sounds equitable, it is not benign and could result in the virtual destruction of the chiropractic profession in California.

Under the authority of the Chiropractic Act, the BCE handles all of the licensing, discipline and regulation of the chiropractic profession. Under SB 2034, the BCE would lose the protection of the Act and would fall under the oversight of the DCA. The DCA has statutory authority to veto regulations made by boards under its auspices, to assess fees and impact budgets.

The California Chiropractic Association (CCA), International Chiropractors Association of California (ICAC), and representatives from the four chiropractic colleges in California have met to discuss the bill, how it could affect the profession and what action should be taken. A representative of the California Board of Chiropractic Examiners was also present at the meeting. The CCA was designated as the coordinator of the political effort for the colleges and associations.

Both the ICAC and the CCA are working together to solicit support in opposition to SB 2034. "It took an act of the people in 1922 to unite chiropractors under the umbrella of one regulatory authority and assure a uniform scope of practice," observed California Chiropractic Association President Wayne Whalen,DC. "Given our past, it will not serve us to turn over control of our very existence to the legislature and the DCA."

The ICAC Board met April 2 and passed a motion opposing SB 2034. "We are supporting the Chiropractic Board of Examiners (CBE) position to remain under the California Constitution and the initiative or referendum process," declared ICAC President Dr. James Musick. "The ICAC has agreed to coordinate our grass roots activities with the CCA and the CBE."

The CCA has met with Senator Figueroa to convey the profession's alarm about the language of her bill. The CCA indicates she "has promised to work with CCA to attempt to craft language that CCA and the profession can live with." A compromise seems dubious. Given the high stakes, it would seem that the only thing the chiropractic profession in California could live with is a quick death for the bill.

One thing is certain. If the bill goes forward as written, the CCA and ICAC will stage an all-out war against SB 2034. This would include a massive grass roots effort in Sacramento and a public campaign against any anti-chiropractic initiative on the ballot in November.

Participation by every chiropractor and student will be absolutely critical. In the coming weeks and months, all California chiropractors may be asked to enter the fight.

The following is a motion passed by the California Board of Chiropractic Examiners:

California Chiropractic Board Opposes SB 2034

At its meeting on March 23, the California Board of Chiropractic Examiners discussed the potential devastating effects of SB 2034 and adopted the following resolutions: Whereas, the people of California passed the Chiropractic Initiative Act in November, 1922 (reprinted in West's Annotated California Codes, Business & Professions Code, Division 2, Section 1000 et seq.) (as amended, the "Act"), which established the Board of Chiropractic Examiners (the "Board") and a category of licensed healing arts professionals known as chiropractors; and

Whereas, the Act was necessary to protect the public from confusing, conflicting and sometimes unreasonable interpretations of existing law and regulation concerning chiropractic practice and to bring various categories of drugless practitioners under the umbrella of one state regulatory authority; and Whereas, before the Act, many chiropractors were arrested or prosecuted by the Medical Board for the unlicensed practice of medicine; and

Whereas the scope of chiropractic practice is set forth in the Act and clarified in a regulation codified as Section 302 of Title 16 of the California Code of Regulations ("Rule 302"); and Whereas, as recently as the 1980s, the Board was sued by the Medical Board and the Physical Therapy Licensing Committee and other medical entities with respect to appropriate chiropractic scope of practice and this litigation was settled with the adoption by the Board of Rule 302; and

Whereas, since 1996 the Board has greatly improved its operating efficiency and has demonstrated its commitment to consumer protection by increasing the average annual number of enforcement decisions against chiropractic licentiates [nearly threefold];

and Whereas, the potential for chaos, litigation, intra-governmental strife and consumer harm would be created if the delicate balance between legal chiropractic practice and the practice of medicine and other healing arts established by the adoption of Rule 302 is disturbed, such as might be expected to occur if the chiropractic scope of practice is placed in the authority of the legislature or any state agency other than the Board; and

Whereas, the members of the Board believe that the consumers of California are best served by a stable set of professional standards and scope of practice as currently exists today; and

Whereas placing control of the Act in the hands of the Legislature and/or any other government agency, including the Department of Consumer Affairs, could disturb the stability of the chiropractic profession by removing ultimate control of the regulations, including Rule 302, personnel, budget and other managerial and substantive elements of the Board's authority from the Board; and

Whereas, the unique history surrounding the adoption of the Act, the many anti-chiropractic actions by other state agencies and other aspects of chiropractic history set the chiropractic profession and the Board apart from other healing arts professions and their respective boards; Therefore, be it resolved, that the Board opposes SB 2034 as introduced; and

Further resolved, the Board opposes any action which would remove the chiropractic scope of practice from The People and/or the Board or in any way jeopardizes the chiropractic scope of practice directly or indirectly and any action which would impede the effectiveness of the Board in protecting the public; and

Further resolved, the Board hereby authorizes and directs the Chairman of the Board to take any and all actions he deems necessary or desirable to effectuate the intent of these resolutions and directs the Chairman to report to this Board his actions with respect to this issue.