SB 69-BD OF CHIROPRACTIC EXAMINERS; PRACTICE  1:35:57 PM CHAIR COSTELLO reconvened the meeting and announced the consideration of SB 69. "An Act relating to the Board of Chiropractic Examiners and the practice of chiropractic." She noted that this was the first hearing. 1:36:25 PM SENATOR BILL STOLTZE, sponsor of SB 69, introduced SB 69 speaking to the following sponsor statement: Healthcare and wellness have developed and progressed over the years, and patient preferences have changed along with them. In some cases, state laws have not kept up with this progress. Senate Bill 69 endeavors to update and clarify the statutes guiding chiropractic care in Alaska. SB 69 addresses training and utilization of chiropractic clinical assistants and interns; strengthens current law allowing chiropractors to perform school physicals; revises penalties for fraudulent practices; and updates definitions and modernizes terminology. SB 69 makes timely changes to our statutes guiding chiropractic care, resulting in chiropractic physicians being able to treat patients more efficiently and affordably. 1:41:57 PM SENATOR GIESSEL pointed out that in addition to physicians, nurse practitioners and physician assistants are qualified to perform pre-participation sports physicals. She questioned whether the education statutes needed to be updated to include chiropractors for performing those physicals. SENATOR STOLTZE admitted he didn't know. 1:43:36 PM CHAIR COSTELLO asked for a sectional analysis. 1:43:48 PM BRANDON BREFCZYNSKI, Staff, Senator Bill Stoltze, provided the following sectional analysis for SB 69: Section 1: Amends AS 08.20.055 by adding new language allowing the board to adopt regulations for chiropractic interns and preceptors, chiropractic clinical assistants, and performance of patient examinations. Section 2: Amends AS 08.20.100(b) clarifying how chiropractors can accept referrals, allowing chiropractors to perform school physicals, and allowing the employment of certified chiropractic clinical assistants, interns, and preceptors. Section 3: Adds new subsection to AS 08.20.100 exempting from this section chiropractic interns under certain conditions. Section 4: Amends AS 08.20.160 regarding the requirements for temporary permits. Section 5: Adds new section to AS 08.20 regarding chiropractic clinical assistants. Section 6: Amends 08.20.185 to modernize terminology. Section 7: Amends AS 08.20.200 by updating penalties for unlicensed practice. 1:46:31 PM SENATOR GIESSEL noted that her question was answered; AS 14.30.070 and 14.30.120 identify chiropractors as being able to perform physical examinations for students and education programs. CHAIR COSTELLO asked what chiropractors are not qualified to diagnose. SENATOR STOLTZE deferred the question. SENATOR COSTELLO asked if the bill provides further clarification that chiropractors are able to perform pre- participation physicals because that's not universally understood. SENATOR STOLTZE replied that's one reason, and he hopes to hear from one of the organizations. CHAIR COSTELLO requested a general statewide overview of which schools districts do and do not accept physicals from chiropractors. SENATOR STOLTZE agreed to provide the information. CHAIR COSTELLO asked Mr. Parady to review the fiscal note. 1:50:09 PM FRED PARADY, Deputy Commissioner, Department of Commerce, Community and Economic Development (DCCED), said SB 69 adds new licensure requirements for chiropractic assistants and will require additional administrative procedures to authorize chiropractic interns and preceptors. The fiscal note requests one part time licensing examiner for up to 14 hours per week to manage the estimated additional 200 plus chiropractic assistants and new intern preceptor approval processes. Professional licensing programs within the Division of Corporations, Business and Professional Licensing are entirely receipt supported so the fiscal note includes no undesignated general funds. He noted that the estimated cost of $750 per license likely will be lower based on FY2014 data that shows the 314 licensees paid $450 per license. Responding to an earlier question, he relayed that when he worked for the North Slope Borough School District, chiropractors performed pre-performance sports physicals. CHAIR COSTELLO asked if public health nurses are able to do sports physicals. SENATOR GIESSEL answered no. 1:53:10 PM CHAIR COSTELLO opened public testimony. 1:53:40 PM SHARI RYAN, Executive Administrator, Alaska Chiropractic Society, introduced herself. CHAIR COSTELLO asked about the difference in training for a medical doctor and a chiropractic doctor. MS. RYAN replied the educational requirements are comparable and she would follow up with specifics. SENATOR STEVENS asked about chiropractic clinical assistants and interns. MS. RYAN explained that a chiropractic clinical assistant does therapy and assists the chiropractor. Their training ranges from a two year program at the Palmer College of Chiropractic to online programs. A chiropractic intern has completed the required training and education and wants on-the-job training supervised by a preceptor. 1:56:08 PM CHAIR COSTELLO asked how many chiropractors are performing school physicals across the state. MS. RYAN offered to follow up with the information. CHAIR COSTELLO asked what a physical costs. MS. RYAN offered to follow up with the information. SENATOR MEYER asked if other states allow chiropractors to perform pre-participation sports physicals. MS. RYAN replied 35 states allow that. 1:57:47 PM PATRICIA CONNERS ALLEN, D.C., Chair, Board of Trustees, University of Western States, said she has practiced chiropractic medicine in Juneau since 1984 and previously served on the Board of Chiropractic Examiners. She explained that the bill allows the Board of Examiners to establish a process so that chiropractic interns can come to Alaska and be supervised by a preceptor doctor. 1:59:23 PM EDWARD J. BARRINGTON, D.C., representing himself, reported that he serves on the Board of Chiropractic Examiners and is chair of two committees in the Alaska Chiropractic Society. He explained that chiropractors practice in primary care and their training and diagnostic capabilities exceeds their practice statute. SB 69 will update the statutes to bring the law closer to the current training and education of chiropractic physicians. It also clarifies that chiropractic physicians are able to perform pre-participation sports physicals. The Alaska School Athletic Association (ASAA) has requested that the statute specifically include the pre-participation language. Chiropractors are currently authorized to perform physicals on children before they enter school and to keep them out of sports activities. It makes sense that they should also be authorized to perform pre- participation sports physicals. SB 69 will also help regulate the training and certification of chiropractic clinical assistants. Medical assistants are trained and often work in chiropractic offices but they are not under the auspices of the Board of Chiropractic Examiners. The bill also provides a name change for the peer review committee. 2:05:39 PM JAMES F. HESTON, member, Board of Chiropractic Examiners, described SB 69 as basic housekeeping that has been discussed for years. However, the $700 licensing fee described in the fiscal note misrepresents the intention, which was simply to get statutory authority to adopt regulations to regulate chiropractic assistants. The board would like to use a national certification program provided through an organization such as the Federation of Chiropractic Licensing Boards for training, testing, and two-year certification. He noted that the board had yet to vote to support this in a resolution but it was likely. CHAIR COSTELLO said she didn't intend to move the bill today so there was time for the resolution to pass before the committee took any action. 2:07:37 PM TODD CURZIE D.C., President, Alaska Chiropractic Society (ACS), stated that ACS coordinates continuing education and training for its members, many of whom are also active in other national organizations. ACS supports SB 69 as a responsible way to modernize chiropractic practices and protect the public. 2:09:06 PM CHAIR COSTELLO announced that she would keep public testimony open and hold SB 69 for further consideration.