TITLE 22.EXAMINING BOARDS

Part 3. TEXAS BOARD OF CHIROPRACTIC EXAMINERS

Chapter 71. APPLICATIONS AND APPLICANTS

22 TAC §71.9

The Texas Board of Chiropractic Examiners adopts new §71.9, relating to applicants who fail to appear at a scheduled examination, without changes to the proposed text as published in the October 12, 2001, issue of the Texas Register (26 TexReg 7972) and will not be republished.

The new section will allow an applicant who gives prior notice of the inability to take an examination or who provides the board with an acceptable excuse to re-take the examination without repaying another examination fee. Currently, an applicant is required to submit a non-refundable examination fee for the jurisprudence examination. If the applicant does not take the examination regardless of the reason, it has been the practice of the board to apply the fee to a subsequent application for examination. Under the new §71.9, if an applicant simply fails to appear and has no acceptable excuse, the applicant will be required to submit another examination fee for taking the examination. In fiscal year 2001, there was an average of three applicants per exam who failed to appear for the scheduled exam, giving no advance notice to the board. Some applicants failed to appear on more than one occasion. The board hopes that the rule will significantly reduce the number of no shows at the jurisprudence examinations, by providing an incentive to show up or to give the board notice of non-appearance prior to the exam in order to avoid paying multiple examination fees.

No comments were received regarding adoption of the rule.

The new section is adopted under the Occupations Code §201.152, which the board interprets as authorizing it to adopt rules necessary for the performance of its duties, and specifically, for the examination of an applicant for a license to practice chiropractic.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 14, 2002.

TRD-200200156

Gary K. Cain, Ed.D.

Executive Director

Texas Board of Chiropractic Examiners

Effective date: February 3, 2002

Proposal publication date: October 12, 2001

For further information, please call: (512) 305-6709


Chapter 73. LICENSES AND RENEWALS

22 TAC §73.2

The Texas Board of Chiropractic Examiners adopts an amendment to §73.2, relating to renewal of a chiropractic license, without changes to the proposed text as published in the November 2, 2001, issue of the Texas Register (26 TexReg 8656) and will not be republished.

S.B. 171, as enacted by the 77th Legislature, and effective September 1, 2001, allows a person whose chiropractic license has been expired for more than one year but not more than three years to renew without reexamination and compliance with the requirements and procedures for an original license if the board determines that good cause exists for the nonrenewal. The board, by rule, is required to establish criteria to use in making this determination. The adoption amends §73.2(d) by adding new paragraphs (6) and (7), which set out the requirements for renewal in this situation and the criteria that the board will use in considering applications. Good cause is defined basically as extenuating circumstances beyond the control of the applicant. Example are provided. A licensee who practices with an expired license is not eligible.

No comments were received regarding adoption of the rule.

The amendment is adopted under the Occupations Code §201.152, which the board interprets as authorizing it to adopt rules necessary for the performance of its duties; and §201.354(g), which the board interprets as requiring it to adopt criteria, by rule, for determining whether or not certain licensees who has failed to renew their chiropractic licenses timely, may renew without examination.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 14, 2002.

TRD-200200157

Gary K. Cain, Ed.D.

Executive Director

Texas Board of Chiropractic Examiners

Effective date: February 3, 2002

Proposal publication date: November 2, 2001

For further information, please call: (512) 305-6709


22 TAC §73.3

The Texas Board of Chiropractic Examiners adopts an amendment to §73.3, relating to continuing education, without changes to the proposed text as published in the November 23, 2001, issue of the Texas Register (26 TexReg 9501). The text of the rule as amended will not be republished. The amendment limits the number of continuing education hours that a licensee may take through online courses over the Internet to four hours each year. The Board, at its September 13 meeting, approved the University of Bridgeport College of Chiropractic as an approved sponsor for online courses, through its online program. The Board desires to make online courses available to enhance the choice of courses available. At the same time, it is the opinion of the Board that the majority of continuing education should be obtained through attendance at live seminars or conferences where in-person interaction with instructors and other participants occurs. The amendments provide greater flexibility to licensees in selecting the subject matter and format of courses while still requiring the majority of hours of continuing education to be through in-person attendance. The amendments also allow a person who is medically unable to attend courses to acquire all continuing education credits through online courses. Lastly, the amendments make changes in format and update statutory references.

The board received comments from 16 individuals, opposing the proposed amendment. The commenters were all chiropractors, except one. The commenters expressed opinions generally that attending seminars does not increase the value of the information, although one commenter did agree that some topics are not suited for online education and favored requiring live attendance. He also asked that if the board instituted the limitation, additional time be given for compliance since he had been planning on doing all of his continuing education in December online. The commenters felt that online courses were more convenient and more instructive than traditional conferences or seminars for a variety of reasons, including the social distractions surrounding professional conferences, and that distance learning was acceptable method of education throughout the country's educational system. One commenter, while acknowledging that she was not aware of the reasons the board was changing its requirements, expressed the belief that attendance at seminars was not a preferred method of obtaining continuing education credit, and online instruction was a better learning model. It was noted by several commenters that M.D.'s and D.O.'s can subscribe to a journal in their specialty and self test or take unlimited online courses for continuing education credits, and felt this same opportunity should be available to chiropractors. Some commenters expressed their opinion that the restriction was motivated by those who provide on-site seminars. Commenters also stated that cost and convenience considerations favored online instruction. One commenter favored making the total continuing education requirement open to online courses because of the convenience provided to a full-time practicing chiropractor with a family. Another commenter favored no restriction because of the financial and physical difficulty in attending weekend seminars due to a disability. She felt that four hours was worthless, because she would still have to attend an overnight session to obtain the remaining hours. Lastly, she felt that Texas was behind other states that allowed their licensees to utilize online courses totally and asked the board to change the proposed four hour limitation. One other commenter expressed the need for more online courses due to difficulty in air traveling because of a heart condition and recent September 11 attack.

The board disagrees with the comments that were generally in opposition to the proposed restrictions for online courses. This restriction was not motivated by any desire to protect existing continuing education providers. As stated elsewhere in the preamble, the board feels that the majority of continuing education should be obtained through attendance at live seminars or conferences where in-person interaction with instructors and other participants occurs. The benefit of live interaction with the instructor and other participants is a valuable exercise, not only in exchanging comments and questions about the subject matter being taught, but also in simply interacting socially with peers. In-person communication is an essential tool of a practitioner and attendance at live courses provides an opportunity for licensees to interact, face-to-face, with fellow licensees, that is not available online. For these reasons, the board declines to make any changes in the proposed amendment at this time. The board agrees with the commenters, who expressed difficulty in attending courses in person because of a disability. Current board rules allow other continuing education opportunities that do not require travel and attendance at a seminar. If a licensee is disabled and unable to attend continuing education courses, rule §73.3(b)(5) allows a licensee to acquire continuing education by audio or video tapes, upon submission of the required doctor's statement. The amendments add online courses to the list of alternative methods for acquiring credits, and the proposed four hour restriction for online courses does not apply. This amendment does not take effect until 20 days after filing with the Texas Register, and will be applied to licensees whose compliance is due, beginning May 1, 2002, giving all licensees a reasonable period of time to comply.

The amendment is adopted under Occupations Code §201.152, which the board interprets as authorizing it to adopt rules necessary for the performance of its duties, the regulation of the practice of chiropractic, and the enforcement of the Chiropractic Act, and §201.356, which the board interprets as requiring it to adopt rules providing for a continuing education program for its licensees.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 14, 2002.

TRD-200200159

Gary K. Cain, Ed.D.

Executive Director

Texas Board of Chiropractic Examiners

Effective date: February 3, 2002

Proposal publication date: November 23, 2001

For further information, please call: (512) 305-6709


Chapter 80. MISCELLANEOUS

22 TAC §80.1

The Texas Board of Chiropractic Examiners adopts an amendment to §80.1(c)(5), relating to tasks and procedures that may be delegated by a licensee, without changes to the proposed text as published in the October 12, 2001, issue of the Texas Register (26 TexReg 7972). The text of the rule as amended will not be republished. The amendment adds the words "procedures and activities" to subsection (c)(5), clarifying the types of tasks or procedures relating to physical therapy that may be delegated.

The board received one comment from the executive director of the Texas Physical Therapy Association (TPTA). The TPTA opposes the amendment, because, in its opinion, the change is "overly broad and ambiguous as to what specific 'procedures and activities' may be properly delegated." The TPTA also feels, in spite of express language in subsection (c) that limits delegation to qualified and properly trained persons, that the amendment would allow delegation to unqualified persons, and that such a consequence makes the adoption of the amendment beyond the scope of the rulemaking authority of the TBCE. The TPTA feels that the language should be revised to "more specifically enumerate the procedures and activities that may be properly delegated . . . to avoid improper delegation and confusion about delegation." The board disagrees with the comments of the TPTA and its interpretation of this amendment and the scope of the board's rulemaking power. The board declines to revise the amendment. The Chiropractic Act, Occupations Code §201.451, required the board to develop guidelines on tasks and procedures that a chiropractor may delegate. Subsection (c) of §80.1 expressly limits delegation of tasks and procedures to those persons that are qualified and properly trained. Violation of the rule will subject a licensee to disciplinary action. The TPTA gives no reason why it feels that licensed chiropractors, in effect, will disobey the rule and delegate to unauthorized staff, or how this rule as a whole, or the amendment singly, will lead to confusion among licensed chiropractors. The board believes the rule as drafted is sufficiently specific to provide guidance to its licensees as to the types of tasks and procedures they may delegate to others. Prior to subsection (c) being adopted, licensees had to determine, without any guidance from the board, the tasks or procedures that could be delegated. The board adopted subsection (c) to provide guidance to chiropractors to avoid the very consequences the TPTA is charging will happen with this minor amendment to the subsection. The list of tasks and procedures in subsection (c) is not exclusive; it contains examples of the types of activities that may be delegated. Licensees may determine that other tasks or procedures not enumerated may be delegated under this section. With or without the amendments, a licensee would not necessarily be precluded from delegating a task or procedure that was a physical therapy activity or procedure to a qualified and properly trained person. If confusion occurs or complaints are received relating to improper delegation, the board will re-examine this rule and consider other changes. At present, it has no evidence that the rule will not operate as intended.

The amendment is adopted under the Occupations Code §201.152, which the board interprets as authorizing it to adopt rules necessary for the performance of its duties, the regulation of the practice of chiropractic, and the enforcement of the Chiropractic Act, and §201.451, which the board interprets as requiring it to establish guidelines relating to the tasks and procedures that a chiropractor may delegate to an assistant.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on January 14, 2002.

TRD-200200160

Gary K. Cain, Ed.D.

Executive Director

Texas Board of Chiropractic Examiners

Effective date: February 3, 2002

Proposal publication date: October 12, 2001

For further information, please call: (512) 305-6709