Legislature(1999 - 2000)
04/04/2000 01:40 PM Senate L&C
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 297-BOARD OF CHIROPRACTIC EXAMINERS
CHAIRMAN MACKIE announced SB 297 to be up for consideration.
MS. SHARON CLARK, Aide to Senator Miller, said this bill was
introduced on behalf of the chiropractors. She said that SB 297 is
an act relating to licensing of chiropractors. It amends the
licensing statute for Alaskan chiropractors.
Section 1 allows for a temporary permit to practice chiropractic in
Alaska. It is for fifty days initially and may be extended by the
Board of Chiropractic Examiners. It is subject to the same terms
and conditions of a regular license.
This section also provides for a licensee who does not practice in
the State to hold an inactive license. It also provides for a
retired licensee. A person holding a retired license may not
practice chiropractic in the State. They may apply for an active
license subject to terms and conditions set by the Board.
Section 2 provides new reasons why the Board of Chiropractic
Examiners may refuse to issue a license in the State. These
include a conviction of a felony or other crime that would affect
the person's ability to practice competently and safely.
Commission of crime involving the unlawful procurement, sales,
prescription or dispensing of drugs, and attempting to practice
after becoming unfit due to an infectious or contagious disease.
Ms. Mary Vaele, American Physical Therapy Association, said the
bill is fine. They don't have any complaints with registering
local chiropractors, but have one question on the first page on
lines 21 - 22 and the use of the term "physiotherapy." She
explained that many other English speaking countries a
physiotherapist is a physical therapist. So they would like to
keep that terminology out of the chiropractic legislation.
She said that she understands that this is an optional exam for the
chiropractors. She doesn't think it is required for the rest of
the chiropractors in the State.
MS. CATHERINE REARDON, Director, Division of Occupational
Licensing, explained the exams are set in regulation (under
statute) for the regular full licenses. Therefore, the Board has
the authority to chose the exam. There are five parts to the
chiropractic exam; the physical therapy exam is one of those parts.
The current regulations on exams do require for people who passed
after a certain date..."12 AC16.037: An applicant must pass each
subject of the following parts of the examination: the National
Board of Chiropractic Examiners and the elected physiotherapy
examination." Her understanding is that it is not regulation that
they are requiring that physiotherapy examination section now. It
doesn't appear in the statute because that just says, "The Board
can adopt by regulation...."
CHAIRMAN MACKIE asked if that should be in the proposed statute or
not.
MS. REARDON said her personal opinion was that it should appear as
it appears in the bill.
SENATOR KELLY asked what physiotherapy was. He asked if it was
addressed in statute.
MS. REARDON responded that it is addressed in statute in that the
definition of the practice of chiropractic in AS 08.20.900 includes
the employment of physiological therapeutic procedures preparatory
to and complimentary with the correction of the subluction. A
further definition defines physiological therapeutic goes on for
several paragraphs. She said it looks like it is the pushing,
massaging, and maneuvering of someone to result in the subluction,
which is out of alignment, being corrected.
SENATOR KELLY asked Ms. Veale if she has training in this area.
MS. VEALE said yes and added that her definition of physical
therapy is different from a chiropractic definition of physical
therapy. It's semantics, but the terminology concerns her.
Number 2306
DR. LORAN MORGAN, President, Chiropractic Society, said there is
concern with the use of the word "physiotherapy." In AS 08.20.120
the term "physiotherapy" is used by the National Board of
Chiropractic Examiners as the name of the test. To be synonymous
across the board, they use the same terminology so when someone
from Washington D.C., for instance, comes to Alaska and takes the
test, they know what exact test they need to take. It's being
consistent with the Board of Chiropractic Examiners terminology.
He said it is now in Alaska statutes as a National Board of
Examiners requirement - 12AAC16.037.
CHAIRMAN MACKIE asked him if he supports the bill.
DR. MORGAN said yes.
CHAIRMAN MACKIE asked Ms. Clark if the proposed CS in their packet
was the one that Senator Miller was offering.
MS. CLARK responded that it is the CS that came about this morning
on behalf of the Department. She said that Senator Miller has no
problem with it.
TAPE 00-13, SIDE B
Number 2300
MR. DAVE GRAY, Aide to Senate Labor and Commerce, informed the
Committee that a letter from Catherine Reardon suggested "clean-up"
language. There was also a letter from the Attorney General
suggesting taking out one phrase. The CS deals with those concerns
which seemed legitimate.
SENATOR LEMAN moved to adopt the CS version G/Lauterbach4/4. There
were no objections and it was so ordered.
MS. KAREN GRAFTON, President, Alaska Physical Therapy Association,
said one of their main concerns is line 21 which says
"physiotherapy examination." In April 1999, the State of Alaska
Physical Therapy Board and Occupational Therapy Board resolved that
the Board declared its unanimous opinion that physical therapy and
physiotherapy were identical in meaning and that physical therapist
and physiotherapist are identical in meaning.
To name an exam "physiotherapy examination" within the chiropractic
statutes opens up the door to confusion for the public. Worldwide,
physiotherapy is physical therapy. The United State is the only
country where they are titled physical therapists. Austria,
Australia, New Zealand, Germany, and Italy are all
physiotherapists. She asked that the word "physiotherapy" be
removed.
In addition, AS 18.20.120, qualifications for a license, says "to
have completed the exam by the National Board of Chiropractors".
Her concern is that the locumpentum section is different than the
permanent licensure section. She asked that the word
"physiotherapy" be removed from line 21.
SENATOR LEMAN noted that it was line 23 on the current version.
SENATOR KELLY commented that they were getting caught up in
semantics and asked if this door hadn't been open for years
already. Haven't we been referring the physiotherapy examinations
for several years in statute.
CHAIRMAN MACKIE responded that was what the Department tells them.
SENATOR KELLY asked Ms. Reardon if this wasn't just a status quo.
MS. REARDON said it wasn't.
MS. GRAFTON responded that she didn't see the word "physiotherapy
examination" in the Chiropractic Practice Act. Currently, in her
book page 3, says "the exam from the National Board of
Chiropractors" which she has no problem with. She asked if the
National Association changes the name of their exam, are they going
to have to reopen the Practice Act to retitle the exam.
MS. REARDON responded that was what the previous witness said about
the standard license - "the exam of the National Association in
regulation". So the word does not appear in statute, but it
appears in regulations. But sprinkled through the actual statute,
there are references to physiologic therapy. All that they achieve
by removing this reference, is leaving the other four references to
physiological therapy that are in the core definition of what is
chiropractic. It doesn't fully resolve the issue.
Also, if the committee chose to eliminate the term in this bill,
she asked that they not take out the exam, because she thought the
committee would want them to pass the exam. She supported saying,
"the exams identified by the Board in regulations."
SENATOR KELLY asked how long regulations have required passing a
physiotherapy exam.
MS. REARDON replied she thought that was relatively new, but the
other references in statute have been there for years.
MS. GRAFTON inserted that they have no problem with physiologic
therapeutics as written in the current Act. They have a problem
with the term "physiotherapy" which our State Board has stated and
resolved is the same thing as physical therapy.
SENATOR LEMAN said the examination of the National Board of
Chiropractic Examiners probably has within it as physiologic
therapeutics. The next section says, "...has passed to the
satisfaction of the Board parts 1 and 2 of the examination." He
asked whether a part of that examination deals with physiological
therapeutics and, if so, could that part of the examination be
referenced.
MS. REARDON explained the problem is that part is called the
physiotherapy examination. That is why it is capitalized on line
23. There are five parts of the National Board. Part 1 covers
basic science subjects, part 2 covers clinical subjects, part 3 is
the written competency exam, part 4 is the practical exam, and the
physiotherapy exam.
SENATOR LEMAN asked if part 5 is the physiotherapy exam.
MS. REARDON replied the information she has does not refer to the
physiotherapy exam as a part. Again, that is why it is capitalized
because they do not have a good name for it.
SENATOR LEMAN asked what she thought of suggesting to them that
they call it part 5.
SENATOR TIM KELLY asked who had the name first, the chiropractors
or the physical therapists. He said he thought the chiropractors
did, and that seems to be the problem.
CHAIRMAN MACKIE asked if it changes the scope of the work anyone
does.
MS. REARDON said it does not but the very important concept that
anyone else can call him/herself a physical therapist or
physiotherapist still holds. This bill does not allow
chiropractors to call themselves physiotherapists.
CHAIRMAN MACKIE asked if that issue was addressed a few years ago.
MS. REARDON said she thinks that was the origin of the Alaska
Boards of Physical Therapy and Occupational Therapy's positions but
those terms are synonymous to make sure nobody could call
themselves a physiotherapist who was not a licensed physical
therapist. She pointed out that is important to the Board.
MS. BERNADETTE GILLET, representing the Providence Medical Center,
made the following comment. "Just speaking in terms of differences
between physiotherapy - physical therapy, that we have resolved
that two are synonymous and, in speaking directly about that
statement, it says the physiotherapy examination, as Karen just
discussed, can be congruent with our language that describes about
our profession of physical therapy. You ask who came first - the
chiropractor or the physical therapist - but PT's came up in 1926
with the term 'physical therapist'. Chiropractic medicine started
in 1895 with the 'chiropractor.' Those two differences split us
and it maintains that with the way that this is stated. That's why
we prefer to have this wording struck from that line."
CHAIRMAN MACKIE asked the two groups if they could get together to
resolve the differences.
MS. GILLET replied yes.
SENATOR TIM KELLY asked if he was referring to the physical
therapists and the chiropractors.
CHAIRMAN MACKIE said yes. He didn't think anyone wanted to change
the scope of what they do, but they need to have consistency in our
statutes.
Number 2006
MR. GEORGE SALMON, Fairbanks Physical Therapist, agreed with Ms.
Grafton's testimony that "physiotherapy" wording be deleted. He
said there is a lot of confusion in the public about what physical
therapists and chiropractors do. It opens the door for the public
to start thinking of chiropractors and physical therapists. He
thought they should call that part of the test "part 5."
MS. CHERYL SACKETT, Fairbanks, agreed with Mr. Salmon and the need
to remove "physiotherapy" and label the exam "part 5."
SENATOR LEMAN said he had additional concerns. One on page 2,
lines 4 - 13, the disqualification section, that they should
consider being consistent throughout with health care providers as
they update statutes. They have similar standards for dentistry,
but he likes the wording in this bill better. It's a little
shorter and has less repetition.
His other concern was on page 3, line 21 where it appears to him
that by deleting "after a hearing" the Board may impose a
disciplinary sanction on a person without having a hearing. But in
AS 18.08.075 it says they can't do it without a hearing. He
thought it should be written so that the Board could refuse to
issue a license without having to have a hearing. He suggested,
"The Board may refuse to issue a license under this chapter, and
after a hearing, impose a disciplinary sanction..."
MS. REARDON responded that what Senator Leman said was fine. It's
correct that the reason they are taking out "after a hearing" is
because they want the Board to be able to deny without having a
hearing first. It was their intention to comply with the
Administrative Procedures Act which does apply to this Board's
activities. It requires a hearing before taking disciplinary
action. Senator Leman's suggestion is fine with her.
CHAIRMAN MACKIE asked if that was a suggestion of the Attorney
General.
MS. REARDON answered yes. She added that this part of the bill is
actually what the Division finds is the most important part. This
increases public protection because it says the Board can deny
licenses if you have done something wrong. As it is now, although
the title of the section includes refuse to issue a license, they
found the substance of this section would not allow them to deny
licenses for very legitimate reasons.
CHAIRMAN MACKIE said without the drafter there, they couldn't
explain the language.
MS. REARDON said probably what Senator Leman is referring to is the
summary suspension option for discipline if there is a clear and
immediate threat to public health.
CHAIRMAN MACKIE asked her to have her legal people look at Senator
Leman's wording. Ms. Reardon indicated her agreement. He said the
only issue remaining is the physical therapist's concern with the
language. Senator Leman suggested using the wording "part 5" and
eliminating "physiotherapy examination." He asked for comments
from the Department.
MS. REARDON replied that would be a wonderful solution except that
it's not called "part 5" by the National Board, so that wording
would not actually have a meaning.
SENATOR LEMAN corrected her saying that he suggested part 5 in a
note to the chairman and then put (physiotherapy examination).
That really doesn't do much more than give a nod to the
physiotherapist that their's is a separate entity different from
chiropractors and not confuse the public.
CHAIRMAN MACKIE asked what Senator Miller's thoughts were on this.
MS. CLARK replied he agreed with what the chiropractors want and
whatever Occupational Licensing thinks should be in statute. He is
in agreement with the CS.
SENATOR MACKIE asked them to work together and resolve the issue
when it goes to the floor.
DR. MORGAN inserted that the Chiropractic Board has already said
that physical therapy, physiotherapy, and physiological therapeutic
are all synonymous terms. He thought the physical therapists had
said that as well. It is a name given by the National Board of
Chiropractors, not of physical therapists, to fulfill that basic
requirement in the State. If the term changes, he didn't know how
to change it on a national level.
SENATOR MACKIE said there is obviously a conflict and that's why he
has asked people to get together and work it out. Otherwise it
will most likely remain like the sponsor has it.
SENATOR KELLY said he was sympathetic to the arguments of the
physical therapists, but he thought that was irrelevant to the bill
in front of them. They will continue to struggle through that
until they can reach an agreement.
SENATOR KELLY moved to pass CSSB 297 (L&C) with individual
recommendations. There were no objections and it was so ordered.
CHAIRMAN MACKIE adjourned the meeting at 2:50 p.m.
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