BILL ANALYSIS
C.S.S.B. 718
By: Moncrief
Health and Human Services
04-18-95
Committee Report (Substituted)
BACKGROUND
In 1992, the Sunset Commission reviewed the Texas Board of
Chiropractic Examiners, and reported on problems the board had with
certain provisions, especially the review and readoption of rules.
In 1995, at a joint hearing on the board's progress toward
addressing issues raised by the Sunset Commission in 1992, board
members and the attorney general's office testified that
legislative intent regarding scope of practice was unclear. Other
testimony indicated problems with enforcement and the extent of the
board's authority.
PURPOSE
As proposed, C.S.S.B. 718 requires a person regarded as practicing
chiropractic to use non-surgical, non-invasive procedures to
improve the subluxation complex and biomechanical condition of the
spine and appendicular skeleton and the muscles of the spine and
appendicular skeleton; creates an advisory commission to the Texas
Board of Chiropractic Examiners (board); limits the membership of
the enforcement committee appointed by the board; and requires the
board to keep an information file for complaints filed with the
board and referred to the enforcement committee.
RULEMAKING AUTHORITY
It is the committee's opinion that rulemaking authority is granted
to the Texas Board of Chiropractic Examiners under SECTION 7
(Section 14.c.1., Article 4512b, V.T.C.S.) of this bill.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 1, Article 4512b, V.T.C.S., as follows:
Sec. 1. (a) Requires a person to be regarded as practicing
chiropractic if the person:
(1) analyzes, examines, or evaluates the subluxation
complex and biomechanical condition of the spine and
appendicular skeleton and muscles of the spine and
appendicular skeleton; or
(2) performs non-surgical, non-invasive procedures, rather
than uses adjustment, manipulation, to improve the
subluxation complex and biomechanical condition of the
spine and appendicular skeleton and the muscles of the
spine and appendicular skeleton.
(b) Prohibits the practice of chiropractic from being
construed to include invasive or surgical procedures,
prescribing of controlled substances or dangerous drugs.
(c) Defines "invasive procedure."
SECTION 2. Amends Section 4(c), Article 4512b, V.T.C.S., to require
the Texas Board of Chiropractic Examiners (board) to adopt
guidelines for educational preparation and acceptable practices
which are within the scope of chiropractic practice as defined in
Section 1 of this Act.
SECTION 3. Amends Section 5a, Article 4512b, V.T.C.S., by adding
Subsection (c), to provide that a person in violation of this
section commits an offense classified as a Class A misdemeanor, or,
if the person was previously convicted under this section, a felony
of the third degree. Provides that each day of violation
constitutes a separate offense.
SECTION 4. Amends Article 4512b, V.T.C.S., by adding Section 12b,
as follows:
Sec. 12b. (a) Creates the advisory commission (commission) to
the board.
(b) Sets forth the composition of the commission.
(c) Provides that each member serves at the pleasure of the
authority that appointed the member.
(d) Requires the president of the board to appoint the chair
of the commission.
(e) Prohibits members from being compensated for their
services, but entitles members to reimbursement for expenses
incurred in service to the commission.
(f) Considers all expenses of the commission to be expenses
necessary to the administration of this Act and requires
them to be defrayed under Section 2.
(g) Requires the commission to meet at least once each year
at the call of the chair.
(h) Provides that the commission serves to review new and
experimental procedures, therapies, and tests which would be
within the scope of the practice of chiropractic to
determine the safety and efficacy of such procedures,
therapies, and tests.
SECTION 5. Amends Article 4512b, V.T.C.S., by adding Section 13b,
as follows:
Sec. 13b. (a) Requires the board to adopt a process to
certify chiropractors to perform manipulation under
anesthesia. Requires the process to include a requirement
that the chiropractor demonstrate competence by submitting
proof of successful completion of a postgraduate course in
manipulation under anesthesia offered by a chiropractic
college accredited by the Council on Chiropractic Education.
(b) Requires a chiropractor certified by the board to
perform manipulation under anesthesia to perform the
procedure in a setting which provides immediate access to
emergency medical care in the event of adverse reaction of
the patient to the anesthesia. Requires anesthesia to be
administered only by a medical or osteopathic doctor
licensed by the Texas State Board of Medical Examiners to
administer anesthesia and who shall be present throughout
the chiropractic procedure.
SECTION 6. Amends Section 14a, Article 4512b, V.T.C.S., to
authorize the board to refuse to admit for examination and to
cancel, revoke, suspend, or place on probation licensees for
advertising or representing in the use of a professional name or
title the term "physician," "chiropractic physician," or any
combination or derivation of the term "physician."
SECTION 7. Amends Section 14b, Article 4512b, V.T.C.S., to require
the board to implement any federal and state law requirements
relating to radiologic training of a chiropractor's employees.
Makes nonsubstantive changes.
SECTION 8. Amends Section 14c, Article 4512b, V.T.C.S., as follows:
Sec. 14c. (a) Requires the enforcement committee appointed by
the board to be composed of three board members, two of whom
are doctors of chiropractic and one of whom is a
representative of the general public. Deletes from membership
the executive director of the board and a representative of
the attorney general's office.
(b) Authorizes the board to contract with a private attorney
to advise the enforcement committee concerning complaints
and other enforcement matters, if funds are available.
Sec. 14c.1. (a) Created from existing text.
(b) and (c) Redesignate existing Subsections (c) and (d).
SECTION 9. Amends Section 19, Article 4512b, V.T.C.S., to make a
conforming change.
SECTION 10. Sets forth requirements for term limits under the
Texas Board of Chiropractic Examiners.
SECTION 11. (a) Requires any rule adopted or proposed by the
Texas Board of Chiropractic Examiners on or after September 1,
1994, to be reviewed and amended in conformance with this Act,
except for a rule relating to procedures for the conduct of a
contested case under Chapter 2001, Government Code, or internal
operating procedures.
(b) Requires the board, not later than December 1, 1996, to
submit a report to the governor, lieutenant governor, and
speaker of the house of representatives on the results of the
review and rulemaking actions under Subsection (a) of this
section.
SECTION 12. Requires the comptroller to review and analyze the
effectiveness and efficiency of the policy, management, fiscal
affairs, and operation of the Texas Board of Chiropractic
Examiners. Requires the report to be made before January 10, 1997.
SECTION 13. Emergency clause.
Effective date: upon passage.