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H0377.................................................by HEALTH AND WELFARE CHIROPRACTIC MEDICAL FORMULARY COUNCIL - Adds to and amends existing law to clarify chiropractic practices that are not allowed; to establish the Chiropractic Medical Formulary Council; and to provide additional rulemaking authority for the State Board of Chiropractic Physicians. 01/21 House intro - 1st rdg - to printing 01/22 Rpt prt - to Health/Wel
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]] Fifty-ninth Legislature Second Regular Session - 2008IN THE HOUSE OF REPRESENTATIVES HOUSE BILL NO. 377 BY HEALTH AND WELFARE COMMITTEE 1 AN ACT 2 RELATING TO THE CHIROPRACTIC PRACTICE ACT; AMENDING SECTION 54-704, IDAHO 3 CODE, TO CLARIFY CHIROPRACTIC PRACTICES THAT ARE NOT ALLOWED AND TO MAKE 4 TECHNICAL CORRECTIONS; AMENDING CHAPTER 7, TITLE 54, IDAHO CODE, BY THE 5 ADDITION OF A NEW SECTION 54-704A, IDAHO CODE, TO ESTABLISH THE CHIROPRAC- 6 TIC MEDICAL FORMULARY COUNCIL; AND AMENDING SECTION 54-707, IDAHO CODE, TO 7 PROVIDE ADDITIONAL RULEMAKING AUTHORITY FOR THE BOARD. 8 Be It Enacted by the Legislature of the State of Idaho: 9 SECTION 1. That Section 54-704, Idaho Code, be, and the same is hereby 10 amended to read as follows: 11 54-704. CHIROPRACTIC PRACTICE. Chiropractic practice and procedures which 12 may be employed by physicians are as follows: 13 (1) The system of specific adjustment or manipulation of the 14 articulations and tissues of the body; the investigation, examination and 15 clinical diagnosis of conditions of the human body and the treatment of the 16 human body by the application of manipulative, manual, mechanical, 17 physiotherapeutic or clinical nutritional methods and may include the use of 18 diagnostic X-rays. 19 (a) "Adjustment" means the application of a precisely controlled force 20 applied by hand or by mechanical device to a specific focal point on the 21 anatomy for the express purpose of creating a desired angular movement in 22 skeletal joint structures in order to eliminate or decrease interference 23 with neural transmission and correct or attempt to correct subluxation 24 complex; "chiropractic adjustment" utilizes, as appropriate, short lever 25 force, high velocity force, short amplitude force, or specific line-of- 26 correction force to achieve the desired angular movement, as well as low 27 force neuromuscular, neurovascular,neuro-cranialneurocranial, orneuro-28lymphaticneurolymphatic reflex technique procedures. 29 (b) "Manipulation" means an application of a resistive movement by apply- 30 ing a nonspecific force without the use of a thrust, that is directed into 31 a region and not into a focal point of the anatomy for the general purpose 32 of restoring movement and reducing fixation. 33 (c) "Massage therapy," also called massology, means the systematic manual 34 or mechanical mobilization of the soft tissue of the body by such move- 35 ments as rubbing, kneading, pressing, rolling, slapping and tapping, for 36 the purpose of promoting circulation of the blood and lymph, relaxation of 37 muscles, release from pain, restoration of metabolic balance, and the 38 other benefits both physical and mental. 39 (2) Nothing herein contained shall allow any physician to: 40 (a) Perform surgical operations or practice obstetrics; 41 (b) Except as approved by the chiropractic medical formulary council for 42 use by chiropractic physicians as a clinical nutritional method, dDirect, 43orsuggest or administer tothea patientthat such patient shall usea 2 1substancedrug which, under federal law is required, prior to being dis- 2 pensed or delivered, to be labeled witheitherone (1) of the following 3 statements: (i) "Caution: Federal Law Prohibits Dispensing Without Pre- 4 scription"; or (ii) "Caution: Federal Law Restricts This Drug To Use By or 5 On The Order Of A Licensed Veterinarian"; or (iii) "Rx Only"; or (iv) a 6 product which is required by any applicable federal or state law regula- 7 tion to be dispensed on prescription only or is restricted to use by prac- 8 titioners only. 9 (3) Chiropractic practice, as herein defined, is hereby declared not to 10 be the practice of medicine within the meaning of the laws of the state of 11 Idaho defining the same, and physicians licensed pursuant to this chapter 12 shall not be subject to the provisions of chapter 18, title 54, Idaho Code, 13 nor liable to any prosecution thereunder, when acting within the scope of 14 practice as defined in this chapter. 15 SECTION 2. That Chapter 7, Title 54, Idaho Code, be, and the same is 16 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 17 ignated as Section 54-704A, Idaho Code, and to read as follows: 18 54-704A. CHIROPRACTIC MEDICAL FORMULARY COUNCIL ESTABLISHED -- MEMBERSHIP 19 -- DUTIES. (1) There is hereby established a chiropractic medical formulary 20 council, which is separate and distinct from the board of chiropractic physi- 21 cians, to be composed of five (5) members appointed by the board of chiroprac- 22 tic physicians as follows: 23 (a) Two (2) members shall be chiropractic physicians licensed under this 24 chapter; 25 (b) One (1) member shall be a pharmacist licensed under chapter 17, title 26 54, Idaho Code, appointed from a list of nominees provided by the Idaho 27 state board of pharmacy; 28 (c) One (1) member shall be a physician licensed under chapter 18, title 29 54, Idaho Code, appointed from a list of nominees provided by the Idaho 30 state board of medicine; 31 (d) One (1) member shall be a public member appointed from a list of nom- 32 inees from any source. 33 (2) The initial council shall be appointed as follows: 34 (a) One (1) chiropractic physician shall be appointed to a term of one 35 (1) year and one (1) chiropractic physician shall be appointed to a term 36 of three (3) years; 37 (b) The pharmacist member and the physician member shall each be 38 appointed to a term of two (2) years; and 39 (c) The public member shall be appointed to a term of three (3) years. 40 Thereafter, the term of office shall be three (3) years. A quorum shall con- 41 sist of three (3) members and shall be required for any vote to be taken. 42 (3) It shall be the duty of the chiropractic medical formulary council to 43 establish a formulary for use by chiropractic physicians, and immediately upon 44 adoption or revision of the formulary, the council shall transmit the approved 45 formulary to the board, which shall adopt the formulary by temporary rule. The 46 formulary shall be reviewed annually by the council, or at any time at the 47 request of the board. The formulary list shall not go beyond the scope of pre- 48 scription medicines and medical devices covered by approved chiropractic edu- 49 cation and training and such specialty standards and certifications as 50 required by board rule. 51 (4) Nothing herein shall allow a chiropractic physician to dispense, 52 administer or prescribe any prescription drug as defined in section 53 54-1705(28), Idaho Code, or medical device unless such prescription drug or 3 1 medical device is specifically included in the chiropractic medical formulary. 2 SECTION 3. That Section 54-707, Idaho Code, be, and the same is hereby 3 amended to read as follows: 4 54-707. POWERS AND DUTIES. The board shall have the authority to: 5 (1) Hire or appoint employees, including an executive director, investi- 6 gators, attorneys, consultants and independent hearing examiners; 7 (2) Establish, pursuant to the provisions of chapter 52, title 67, Idaho 8 Code, rules for the administration of the provisions of this chapter; 9 (3) Conduct investigations and examinations and hold hearings; 10 (4) Revoke or suspend licenses to practice chiropractic after providing 11 the licensee with an opportunity for an appropriate contested case in accor- 12 dance with the provisions of chapter 52, title 67, Idaho Code; 13 (5) In any disciplinary proceeding pursuant to this chapter to administer 14 oaths, take depositions of witnesses within or without the state in the manner 15 provided by law in civil cases, and shall have the power throughout the state 16 of Idaho to require the attendance of such witnesses and the production of 17 such books, records, and papers as it may desire at any hearing and, for that 18 purpose, the board may issue a subpoena for any witnesses or subpoena duces 19 tecum to compel the production of any books, records or papers, directed to 20 the sheriff of any county in the state of Idaho, where such witness resides or 21 may be found, which shall be served and returned in the same manner as a sub- 22 poena in a criminal case is served and returned. The fees and mileage of the 23 witnesses shall be the same as that allowed in the district courts in criminal 24 cases, which fees and mileage shall be paid from any funds in the state trea- 25 sury in the same manner as other expenses of the board are paid. The licensee 26 accused in such proceedings shall have the same right of subpoena upon making 27 application to the board therefor. In any case of disobedience to, or neglect 28 of, any subpoena or subpoena duces tecum, served upon any person, or the 29 refusal of any witness to testify to any matter regarding which he may law- 30 fully be interrogated, it shall be the duty of the district court of any 31 county in this state in which this disobedience, neglect or refusal occurs, on 32 application by the board to compel compliance with the subpoena, to issue its 33 order directing compliance with such subpoena, and in the event of a violation 34 of such order, to compel compliance with such order by proceedings for con- 35 tempt as in the case of disobedience of the requirement of a subpoena issued 36 from such court or for refusal to testify therein; 37 (6) Seek injunctive relief prohibiting the unlawful practice of chiro- 38 practic; 39 (7) Make and enter into contracts in the necessary performance of its 40 duties pursuant to this chapter; 41 (8) Develop and submit a proposed budget setting forth the amount neces- 42 sary to perform its functions; 43 (9) Perform such other duties as set forth in the laws of this state; 44 (10) Provide such other services and perform such other functions as are 45 necessary to fulfill its responsibilities; 46 (11) Adopt rules to provide for reasonable fees and for administrative 47 costs and to assess costs reasonably and necessarily incurred in the enforce- 48 ment of this chapter when a licensee has been found to be in violation 49 thereof; 50 (12) Adopt a rule requiring continuing education as a condition of contin- 51 ued licensure;and52 (13) Adopt rules pursuant to chapter 52, title 67, Idaho Code, to estab- 53 lish and operate a system of peer review for chiropractic physicians which 4 1 shall include, but not be limited to, the appropriateness, quality, utiliza- 2 tion, and cost of chiropractic services and the ethical performance of chiro- 3 practic care; 4 (14) Adopt rules to create and establish standards and specialty certifi- 5 cations for the use of intravenous and injectable substances as approved by 6 the chiropractic medical formulary council; and 7 (15) Adopt rules to create and establish standards and specialty certifi- 8 cations for chiropractic adjustments provided under anesthesia.
STATEMENT OF PURPOSE
RS 17440
This bill will create a chiropractic formulary council that will
consist of five members; two licensed chiropractic physicians,
one licensed pharmacist, one licensed physician, and one public
member. The purpose of this council is to establish a formulary
for use by chiropractic physicians, but shall not go beyond the
scope of prescription medicines and medical devices covered by
chiropractic education, training, and such specialty standards
and certifications as required by board rule. This bill will
give the board the authority to adopt rules to create standards
and specialty certifications for intravenous, injectable
substances, and adjustments provided under anesthesia.
FISCAL NOTE
There is no fiscal impact on the General Fund. There would be
an impact on dedicated funds. The formulary council would need
to meet two or three times at the onset which would require
reimbursement of expenses for the council members. This cost
could be absorbed in their current budget.
CONTACT
Name: TANA CORY
Agency: Occupational License, Bureau
Phone: (208) 334-3233
STATEMENT OF PURPOSE/FISCAL NOTE H 377