Since January 1, 1994, Wisconsin has permitted use of limited liability companies and since December 1995, limited liability partnerships. The law regulating the practice of chiropractic in Wisconsin does not specifically prohibit or authorize a chiropractor to organize a chiropractic practice as a limited liability company or limited liability partnership. The rule proposed is intended to provide a clear statement of the Board's position as to whether it is permissible for a chiropractor to organize a practice under any of the limited liability organizations recognized in current state law.
Under the rule a chiropractor may practice with or in a business that is organized as a limited liability organization under Wisconsin law with certain restrictions that are based on current statutory practice requirements. The chiropractor shall not practice with or in a business organized so that a person other than a chiropractor has the right to direct or control the professional judgment of the chiropractor. The chiropractor shall have in effect professional liability insurance in the amounts required by the Board in s. Chir 3.07.
The rule explicitly recognizes legal principle that chiropractic practice with or in a business that is organized as a limited liability organization does not relieve the chiropractor from personal liability for any acts, errors or omissions of the chiropractor arising out of the performance of professional services.
Text of Rule
SECTION 1. Chir 3.08 is created to read:
Chir 3.08 Limited liability entities. (1) A chiropractor may practice with or in a business that is organized as a limited liability organization under the laws of this state, including a limited liability partnership, a service corporation, and limited liability company.
(2) A chiropractor may not practice with or in a business organized so that a person other than a chiropractor has the right to direct or control the professional judgment of the chiropractor. This restriction does not prohibit a chiropractor from working with or in a business organized so that someone other than the patient pays the chiropractor's fee or salary, provided the fee or salary arrangements do not modify the chiropractor's obligation to his or her patient.
(3) Nothing in this section shall relieve a chiropractor from personal liability for any acts, errors or omissions of the chiropractor arising out of the performance of professional services.
(4) Nothing in this section shall relieve a chiropractor from the requirement that every practicing chiropractor shall have in effect professional liability insurance in the amounts required by the board in s. Chir 3.07.
Fiscal Estimate
1. The anticipated fiscal effect on the fiscal liability and revenues of any local unit of government of the proposed rule is: $0.00.
2. The projected anticipated state fiscal effect during the current biennium of the proposed rule is: $0.00.
3. The projected net annualized fiscal impact on state funds of the proposed rule is: $0.00.
Initial Regulatory Flexibility Analysis
These proposed rules will have no significant economic impact on small businesses, as defined in s. 227.114 (1) (a), Stats.
Copies of Rule and Contact Information
Copies of this proposed rule are available without cost upon request to:
Pamela Haack
Department of Regulation and Licensing
Office of Administrative Rules
1400 East Washington Ave., Room 171
P.O. Box 8935
Madison, WI 53708
Telephone (608) 266-0495
Notice of Hearing
Chiropractic Examining Board
Notice is hereby given that pursuant to authority vested in the Chiropractic Examining Board in ss. 15.08 (5) (b) and 227.11 (2), Stats., and interpreting ss. 446.01 (2) and 446.03 (5), Stats., the Chiropractic Examining Board will hold a public hearing at the time and place indicated below to consider an order to amend s. Chir 4.03; and to create s. Chir 6.03, relating to referral of patients to other health care practitioners.
Hearing Information
May 20, 1999 Room 179A
Thursday 1400 East Washington Ave.
10:00 a.m. MADISON, WI
Written Comments
Interested persons are invited to present information at the hearing. Persons appearing may make an oral presentation but are urged to submit facts, opinions and argument in writing as well. Facts, opinions and argument may also be submitted in writing without a personal appearance by mail addressed to the Department of Regulation and Licensing, Office of Administrative Rules, P.O. Box 8935, Madison, Wisconsin 53708. Written comments must be received by May 30, 1999 to be included in the record of rule-making proceedings.
Analysis Prepared by the Dept. of Regulation and Licensing
Statutes authorizing promulgation: ss. 15.08 (5) (b) and 227.11 (2), Stats.
Statutes interpreted: ss. 446.01 (2) and 446.03 (5), Stats.
A chiropractor has a responsibility recognized under common law to determine whether a patient presents a problem that is treatable through chiropractic means and refrain from further chiropractic treatment if the patient's condition will not be responsive to chiropractic treatment. This responsibility was recognized in Kerkman v. Hintz, 142 Wis. 2d 404, 418 N.W.2d 795 (1988) and is codified in this rule.
In the Kerkman decision and more recently in
Goldstein v. Janusz Chiropractic Clinics, S.C., 218 Wis. 2d 683, 582 N.W.2d 78, (Ct. App. 1998) rev. den. 220 Wis. 2d 364 (1998) the courts have relied on the description of the practice of chiropractic in s. Chir 4.03, Wis. Adm. Code, to limit the responsibility and liability of a chiropractor who does not refer a patient to a medical doctor. In this rule the description of the practice of chiropractic is amended to recognize:
1) That chiropractors treat body tissues other than those adjacent to the spine; and
2) That diagnosis by a chiropractor involves using chiropractic science and the principles of education and training common to the chiropractic and medical professions.
This rule establishes a duty requiring a chiropractor to advise a patient to consult another appropriate health care provider if the chiropractor determines that correct treatment for the patient is outside the practice of chiropractic or if the chiropractor knows or should know that he or she does not have the skill, knowledge or facilities to treat the patient's condition. As established in this rule, the responsibility of a chiropractor to advise a patient to consult another appropriate health care provider is broader than the duty recognized in the Kerkman decision.
Text of Rule
SECTION 1. Chir 4.03 is amended to read:
Chir 4.03 Practice. The practice of chiropractic is the application of chiropractic science in the adjustment of the spinal column, skeletal articulations and adjacent tissue
other body tissues which includes diagnosis and analysis to determine the existence of spinal subluxations and associated nerve energy expression and the use of procedures and instruments preparatory and complementary to treatment of the spinal column, skeletal articulations and
adjacent tissue other body tissues. Diagnosis and analysis involves the use of chiropractic science as described in s. Chir 4.02 and the principles of education and training common to the chiropractic and medical professions and may include physical examination, specimen analysis, drawing of blood, blood-analysis and the use of x-ray and other instruments.
SECTION 2. Chir 6.03 is created to read:
Chir 6.03 Duty to evaluate and refer. (1) A chiropractor shall determine whether a patient presents a condition which is treatable by the practice of chiropractic and refrain from chiropractic treatment if the chiropractor knows, or should know, that a patient's condition will not be responsive to chiropractic treatment.
(2) A chiropractor shall advise his or her patient to consult another appropriate health care provider if the chiropractor determines during diagnosis and analysis or treatment of a patient that the correct treatment for the patient's condition is outside the practice of chiropractic as described in s. Chir 4.03.
(3) A chiropractor shall advise his or her patient to consult another appropriate health care provider if the chiropractor knows, or should know, that he or she does not have the skill, knowledge, or facilities to treat the patient's condition.
Fiscal Estimate
1. The anticipated fiscal effect on the fiscal liability and revenues of any local unit of government of the proposed rule is: $0.00.
2. The projected anticipated state fiscal effect during the current biennium of the proposed rule is: $0.00.
3. The projected net annualized fiscal impact on state funds of the proposed rule is: $0.00.
Initial Regulatory Flexibility Analysis
These proposed rules will have no significant economic impact on small businesses, as defined in s. 227.114 (1) (a), Stats.
Copies of Rule and Contact Information
Copies of this proposed rule are available without cost upon request to:
Pamela Haack
Department of Regulation and Licensing
Office of Administrative Rules
1400 East Washington Ave., Room 171
P.O. Box 8935
Madison, WI 53708
Telephone (608) 266-0495
Notice of Hearing
Commerce
(Wisconsin Development Zone
Program, Ch. Comm 112)
Notice is hereby given that pursuant to s. 560.875, Stats., the Department of Commerce announces that it will hold public hearings on proposed rules relating to the Wisconsin Development Zone Program and the emergency rule adopted on the same subject.
Hearing Information
May 12, 1999 Conference Room 3C
Wednesday 201 W. Washington Ave.
9:00 a.m. Madison, WI
Interested persons are invited to appear at the hearing and present comments on the proposed rules. Persons making oral presentations are requested to submit their comments in writing. Persons submitting comments will not receive individual responses. The hearing record on this proposed rulemaking will remain open until May 17, 1999, to permit submittal of written comments from persons who are unable to attend a hearing or who wish to supplement testimony offered at a hearing.
This hearing is held in an accessible facility. If you have special needs or circumstances that may make communication or accessibility difficult at the hearing, please call (608) 266-8741 or TTY at (608) 264-8777 at least 10 days prior to the hearing date. Accommodations such as interpreters, English translators, or materials in audio tape format will, to the fullest extent possible, be made available upon request by a person with a disability.
A copy of the proposed rules may be obtained without cost from Richard Meyer, Department of Commerce, Program Development Bureau, P.O. Box 2689, Madison, Wisconsin 53701, telephone (608) 266-3080 or (608) 264-8777 (TTY). Copies will also be available at the public hearings.
Analysis of Rules
Statutory Authority: ss. 560.70 through 560.797
Statutes Interpreted: ss. 560.70 through 560.797
Pursuant to ss. 560.70 through 560.797, Stats., the Department of Commerce is responsible for administering Wisconsin Development Zone Program. These rules are being adopted to incorporate in the administrative code the recent amendments contained in 1997 Wisconsin Act 27 that entirely changed the eligibility and the criteria for certified development zone businesses and the process for the verification and the claiming of tax credits. Section 560.785, Stats., directs the Department of Commerce to develop rules and exceptions to those rules concerning the eligibility for tax benefits. After a review and evaluation of all the certified businesses and their projects a number of exceptions have been identified in order to meet the needs of different areas of the state and to fulfill our commitments to businesses that were made prior to this legislation. In order to process claims for tax years beginning on or after January, 1, 1998, these rules must be made available immediately.
