S.B. No. 304

AN ACT

relating to the continuation and functions of the Texas Board of Chiropractic Examiners; authorizing a reduction in fees.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 201.002(b), Occupations Code, is amended to read as follows:

(b) A person practices chiropractic under this chapter if the person:

(1) uses objective or subjective means to diagnose, analyze, examine, or evaluate the biomechanical condition of the spine and musculoskeletal system of the human body;

(2) performs nonsurgical, nonincisive procedures, including adjustment and manipulation, to improve the subluxation complex or the biomechanics of the musculoskeletal system;

(3) represents to the public that the person is a chiropractor; or

(4) uses the term "chiropractor," "chiropractic," "doctor of chiropractic," "D.C.," or any derivative of those terms or initials in connection with the person's name.

SECTION 2. Section 201.004, Occupations Code, is amended to read as follows:

Sec. 201.004. APPLICATION OF SUNSET ACT. The Texas Board of Chiropractic Examiners is subject to Chapter 325, Government Code (Texas Sunset Act). Unless continued in existence as provided by that chapter, the board is abolished and this chapter expires September 1, 2029 [2017].

SECTION 3. Section 201.061, Occupations Code, is amended by amending Subsection (b) and adding Subsection (d) to read as follows:

(b) The training program must provide the person with information regarding:

(1) this chapter;

(2) [and] the board's programs, functions, rules, and budget;

(3) the scope of and limitations on the board's rulemaking authority;

(4) the types of board rules, interpretations, and enforcement actions that may implicate federal antitrust law by limiting competition or impacting prices charged by persons engaged in a profession or business the board regulates, including rules, interpretations, and enforcement actions that:

(A) regulate the scope of practice of persons in a profession or business the board regulates;

(B) restrict advertising by persons in a profession or business the board regulates;

(C) affect the price of goods or services provided by persons in a profession or business the board regulates; and

(D) restrict participation in a profession or business the board regulates;

(5) [(2)] the results of the most recent formal audit of the board;

(6) [(3)] the requirements of:

(A) laws relating to open meetings, public information, administrative procedure, and disclosure of conflicts of interest; and

(B) other laws applicable to members of the board in performing their duties; and

(7) [(4)] any applicable ethics policies adopted by the board or the Texas Ethics Commission.

(d) The executive director of the board shall create a training manual that includes the information required by Subsection (b). The executive director shall distribute a copy of the training manual annually to each board member. On receipt of the training manual, each board member shall sign and submit to the executive director a statement acknowledging receipt of the training manual.

SECTION 4. Section 201.153(a), Occupations Code, is amended to read as follows:

(a) The board by rule shall set fees in amounts reasonable and necessary to cover the costs of administering this chapter. [The board may not set a fee in an amount that is less than the amount of that fee on September 1, 1993.]

SECTION 5. The heading to Section 201.206, Occupations Code, is amended to read as follows:

Sec. 201.206. CONFIDENTIALITY OF COMPLAINTS, INVESTIGATION FILES, AND OTHER INFORMATION.

SECTION 6. Section 201.206, Occupations Code, is amended by amending Subsection (a) and adding Subsections (c-1) and (f) to read as follows:

(a) Each complaint, adverse report, investigation file, and other investigation report and all other investigative information in the possession of or received or gathered by the board or the board's employees or agents relating to a license holder, an application for a license, or a criminal investigation or proceeding is privileged and confidential and is [The board's investigation files are confidential, privileged, and] not subject to discovery, subpoena, or any other means of legal compulsion for release to anyone other than [to] the board or an employee or agent of the board involved in any disciplinary action relating to a license holder.

(c-1) The board's providing of information under Subsection (c) does not constitute a waiver of a privilege or confidentiality under this chapter or any other law.

(f) The board shall protect the identity of a complainant to the extent possible.

SECTION 7. Subchapter E, Chapter 201, Occupations Code, is amended by adding Section 201.2065 to read as follows:

Sec. 201.2065. REQUIREMENTS FOR CERTAIN COMPLAINTS. (a) In this section:

(1) "Anonymous complaint" means a complaint that lacks sufficient information to identify the source or the name of the person who filed the complaint.

(2) "Insurance agent" means a person licensed under Chapter 4054, Insurance Code.

(3) "Insurer" means an insurance company or other entity authorized to engage in the business of insurance under Subtitle C, Title 6, Insurance Code.

(4) "Third-party administrator" means a person required to have a certificate of authority under Chapter 4151, Insurance Code.

(b) The board may not accept anonymous complaints.

(c) Notwithstanding any confidentiality requirements under Chapter 552, Government Code, or this chapter, a complaint filed with the board by an insurance agent, insurer, pharmaceutical company, or third-party administrator against a license holder must include the name and address of the insurance agent, insurer, pharmaceutical company, or third-party administrator filing the complaint.

(d) Not later than the 15th day after the date the complaint is filed with the board, the board shall notify the license holder who is the subject of the complaint of the name and address of the insurance agent, insurer, pharmaceutical company, or third-party administrator who filed the complaint, unless the notice would jeopardize an investigation.

SECTION 8. Subchapter E, Chapter 201, Occupations Code, is amended by adding Section 201.210 to read as follows:

Sec. 201.210. EXPERT REVIEW PROCESS. (a) The board by rule shall develop an expert review process to assist the board with the investigation of complaints filed with the board that require additional chiropractic expertise.

(b) The board shall:

(1) determine the type of complaints that require potential expert review, including standard of care complaints;

(2) create a list of qualified experts to review complaints that require additional chiropractic expertise; and

(3) establish a method for assigning an expert to a complaint that ensures unbiased assignments of complaints, maintains confidentiality of complaints, and avoids conflicts of interest related to complaints.

(c) The rules adopted under this section must address:

(1) the qualifications of the experts who may review complaints;

(2) the grounds for removal of an expert who is assigned to review a complaint;

(3) the time in which a complaint that requires expert review must be resolved; and

(4) the content and format of expert review documents.

(d) The board may contract with a qualified expert on the list created under this section to assist the board in the investigation of a complaint that requires additional chiropractic expertise.

SECTION 9. Section 201.302(a), Occupations Code, is amended to read as follows:

(a) An applicant for a license by examination must present satisfactory evidence to the board that the applicant:

(1) is at least 18 years of age;

(2) [is of good moral character;

[(3)] has completed 90 semester hours of college courses other than courses included in a doctor of chiropractic degree program; and

(3) [(4)] is either a graduate or a final semester student of a bona fide reputable doctor of chiropractic degree program.

SECTION 10. Section 201.303(d), Occupations Code, is amended to read as follows:

(d) A bona fide reputable doctor of chiropractic degree program that satisfies Section 201.302(a)(3) [201.302(a)(4)] is one that:

(1) has entrance requirements and a course of instruction as high as those of a better class of doctor of chiropractic degree programs in the United States;

(2) maintains a resident course of instruction equivalent to:

(A) not less than four terms of eight months each; or

(B) not less than the number of semester hours required by The University of Texas for a bachelor of arts or bachelor of science degree;

(3) provides a course of instruction in the fundamental subjects listed in Section 201.305(b); and

(4) has the necessary teaching staff and facilities for proper instruction in all of the fundamental subjects listed in Section 201.305(b).

SECTION 11. Section 201.307(b), Occupations Code, is amended to read as follows:

(b) The board by rule shall establish the number of times an applicant may retake the examination required by Section 201.304(a)(1) or (b), as applicable. [An applicant must pass the examination required by Section 201.304(a)(2) within three attempts.] The board by rule shall establish the conditions under which an applicant may retake an examination. The board may require an applicant to fulfill additional educational requirements.

SECTION 12. Subchapter G, Chapter 201, Occupations Code, is amended by adding Sections 201.313 and 201.314 to read as follows:

Sec. 201.313. CRIMINAL HISTORY RECORD INFORMATION FOR LICENSE ISSUANCE. (a) The board shall require that an applicant for a license submit a complete and legible set of fingerprints, on a form prescribed by the board, to the board or to the Department of Public Safety for the purpose of obtaining criminal history record information from the Department of Public Safety and the Federal Bureau of Investigation.

(b) The board may not issue a license to a person who does not comply with the requirement of Subsection (a).

(c) The board shall conduct a criminal history record information check of each applicant for a license using information:

(1) provided by the individual under this section; and

(2) made available to the board by the Department of Public Safety, the Federal Bureau of Investigation, and any other criminal justice agency under Chapter 411, Government Code.

(d) The board may:

(1) enter into an agreement with the Department of Public Safety to administer a criminal history record information check required under this section; and

(2) authorize the Department of Public Safety to collect from each applicant the costs incurred by the Department of Public Safety in conducting the criminal history record information check.

Sec. 201.314. SEARCH OF NATIONAL PRACTITIONER DATABASE. The board shall establish a process to search at least one national practitioner database to determine whether another state has taken any disciplinary action against an applicant or license holder before issuing an initial or renewal license under this chapter.

SECTION 13. The heading to Subchapter H, Chapter 201, Occupations Code, is amended to read as follows:

SUBCHAPTER H. [ANNUAL] REGISTRATION AND LICENSE RENEWAL

SECTION 14. Section 201.351, Occupations Code, is amended to read as follows:

Sec. 201.351. [ANNUAL] REGISTRATION. A chiropractor may not practice chiropractic in this state unless the chiropractor [annually] registers with the board [not later than January 1 of each year].

SECTION 15. The heading to Section 201.352, Occupations Code, is amended to read as follows:

Sec. 201.352. APPLICATION FOR [ANNUAL] REGISTRATION.

SECTION 16. Section 201.352, Occupations Code, is amended by amending Subsections (a) and (d) and adding Subsection (c-1) to read as follows:

(a) A person required to register shall:

(1) file [annually] with the board a written application for registration; and

(2) pay, with the application, a [an annual] registration fee to the board.

(c-1) On receipt of a renewal application, the board shall check the national practitioner database with respect to the license holder as provided by Section 201.314.

(d) If the board determines that the applicant is licensed to practice chiropractic in this state, the board shall issue a [an annual] registration receipt certifying that the applicant has filed an application and paid the registration fee.

SECTION 17. Section 201.353, Occupations Code, is amended by amending Subsection (a) and adding Subsection (a-1) to read as follows:

(a) A license under this chapter is valid for a term of two or more years as determined by board rule.

(a-1) The board by rule may adopt a system under which licenses expire on various dates during the year.

SECTION 18. Sections 201.354(c), (d), (f), and (g), Occupations Code, are amended to read as follows:

(c) The [annual] renewal fee applies to each person licensed by the board, even if the person is not practicing chiropractic in this state.

(d) A person whose license has been expired for 90 days or less may renew the license by paying to the board a renewal fee that is equal to 1-1/2 times the [annual] renewal fee set by the board under Section 201.153(a). If a person's license has been expired for more than 90 days but less than one year, the person may renew the license by paying to the board a renewal fee that is equal to two times the [annual] renewal fee set by the board under Section 201.153(a).

(f) A person who practices chiropractic without a [an annual] renewal receipt for the current year practices chiropractic without a license.

(g) A person may renew a license that has been expired for at least one year but not more than three years if:

(1) the board determines according to criteria adopted by board rule that the person has shown good cause for the failure to renew the license; and

(2) the person pays to the board:

(A) the [annual] renewal fee set by the board under Section 201.153(a) for each year in which the license was expired; and

(B) an additional fee in an amount equal to the sum of:

(i) the [annual] renewal fee set by the board under Section 201.153(a), multiplied by the number of years the license was expired, prorated for fractional years; and

(ii) two times the [annual] renewal fee set by the board under Section 201.153(a).

SECTION 19. Subchapter H, Chapter 201, Occupations Code, is amended by adding Section 201.3545 to read as follows:

Sec. 201.3545. CRIMINAL HISTORY RECORD INFORMATION REQUIREMENT FOR LICENSE RENEWAL. (a) An applicant renewing a license issued under this chapter shall submit a complete and legible set of fingerprints for purposes of performing a criminal history record information check of the applicant as provided by Section 201.313.

(b) The board may administratively suspend or refuse to renew the license of a person who does not comply with the requirement of Subsection (a).

(c) A license holder is not required to submit fingerprints under this section for the renewal of the license if the license holder has previously submitted fingerprints under:

(1) Section 201.313 for the initial issuance of the license; or

(2) this section as part of a prior license renewal.

SECTION 20. Section 201.502, Occupations Code, is amended by amending Subsection (a) and adding Subsection (c) to read as follows:

(a) The board may refuse to admit a person to examinations and may revoke or suspend a license or place a license holder on probation for a period determined by the board for:

(1) violating this chapter or a rule adopted under this chapter, including committing an act prohibited under Section 201.5025;

(2) engaging in deception or fraud in the practice of chiropractic;

(3) presenting to the board or using a license, certificate, or diploma or a transcript of a license, certificate, or diploma that was illegally or fraudulently obtained, counterfeited, or materially altered;

(4) presenting to the board an untrue statement or a document or testimony that was illegally used to pass the examination;

(5) being convicted of a crime involving moral turpitude or a felony;

(6) procuring or assisting in the procuring of an abortion;

(7) engaging in grossly unprofessional conduct or dishonorable conduct of a character likely to deceive or defraud the public;

(8) having a habit of intemperance or drug addiction or another habit that, in the opinion of the board, endangers the life of a patient;

(9) using an advertising statement that is false or that tends to mislead or deceive the public;

(10) directly or indirectly employing or associating with a person who, in the course of the person's employment, commits an act constituting the practice of chiropractic when the person is not licensed to practice chiropractic;

(11) advertising professional superiority, or advertising the performance of professional services in a superior manner, if that advertising is not readily subject to verification;

(12) purchasing, selling, bartering, using, or offering to purchase, sell, barter, or use a chiropractic degree, license, certificate, or diploma or transcript of a license, certificate, or diploma in or relating to an application to the board for a license to practice chiropractic;

(13) altering with fraudulent intent a chiropractic license, certificate, or diploma or transcript of a chiropractic license, certificate, or diploma;

(14) impersonating or acting as proxy for another in an examination required by this chapter for a chiropractic license;

(15) impersonating a licensed chiropractor;

(16) allowing one's chiropractic license to be used by another person to practice chiropractic;

(17) being proved insane by a person having authority to make that determination;

(18) failing to use proper diligence in the practice of chiropractic or using gross inefficiency in the practice of chiropractic;

(19) failing to clearly differentiate a chiropractic office or clinic from another business or enterprise;

(20) personally soliciting a patient or causing a patient to be solicited by the use of a case history of another patient of another chiropractor;

(21) using for the purpose of soliciting patients an accident report prepared by a peace officer in a manner prohibited by Section 38.12, Penal Code; [or]

(22) advertising using the term "physician" or "chiropractic physician" or any combination or derivation of the term "physician"; or

(23) failing to submit fingerprints to the board or Department of Public Safety to enable the board to obtain criminal history record information as required by Section 201.313. ["physician."]

(c) The board may refuse to admit a person to an examination and may revoke or suspend a license or place a license holder on probation for a period determined by the board because of the person's or license holder's violation of a law of this state, other than this chapter, or a rule of another licensing board in this state, or of a statute or rule of another state as determined through a search conducted as provided by Section 201.314, if the violation constitutes a violation of the laws of this state or a board rule.

SECTION 21. The following provisions of the Occupations Code are repealed:

(1) Subchapter F, Chapter 201; and

(2) Section 201.312.

SECTION 22. (a) Not later than March 1, 2018, the Texas Board of Chiropractic Examiners shall adopt rules to establish the expert review process as required by Section 201.210, Occupations Code, as added by this Act.

(b) Not later than September 1, 2019, the Texas Board of Chiropractic Examiners shall obtain criminal history record information on each person who on the effective date of this Act holds a license issued under Chapter 201, Occupations Code, and did not undergo a criminal history record information check based on the license holder's fingerprints on the initial application for the license. The board may suspend the license of a license holder who does not provide the criminal history record information as required by the board and this subsection.

SECTION 23. (a) Except as provided by Subsection (b) of this section, Section 201.061, Occupations Code, as amended by this Act, applies to a member of the Texas Board of Chiropractic Examiners appointed before, on, or after the effective date of this Act.

(b) A member of the Texas Board of Chiropractic Examiners who, before the effective date of this Act, completed the training program required by Section 201.061, Occupations Code, as that law existed before the effective date of this Act, is required to complete additional training only on subjects added by this Act to the training program as required by Section 201.061, Occupations Code, as amended by this Act. A board member described by this subsection may not vote, deliberate, or be counted as a member in attendance at a meeting of the board held on or after December 1, 2017, until the member completes the additional training.

SECTION 24. This Act takes effect September 1, 2017.

______________________________ ______________________________

President of the Senate Speaker of the House

I hereby certify that S.B. No. 304 passed the Senate on April 5, 2017, by the following vote: Yeas 30, Nays 0; and that the Senate concurred in House amendment on May 22, 2017, by the following vote: Yeas 31, Nays 0.

______________________________ Secretary of the Senate

I hereby certify that S.B. No. 304 passed the House, with amendment, on May 18, 2017, by the following vote: Yeas 144, Nays 0, two present not voting.

______________________________ Chief Clerk of the House

Approved:

______________________________

Date

______________________________

Governor