CR 19-100 Rule Text

Plain language analysis:

The Board conducted an evaluation and update of ch. Chir 12 to ensure the definitions under s. Chir 12.01, the criteria for granting a certificate for nutritional counseling under s. Chir 12.02, and the criteria for approval of nutritional counseling educational programs under s. Chir 12.03 are consistent with current professional and academic practices and applicable Wisconsin statutes. As a result, the following updates have been made:

- A definition of “patient” is added to the definitions under s. Chir 12.01.

- The requirement under s. Chir 12.03 (2) (a) 5. that program subject matter is generally taught at the undergraduate or postgraduate level of a chiropractic college and relates to improving the clinical skills of a chiropractor is revised. The revised requirement is that program subject matter contributes to the advancement, extension, and enhancement of the clinical skills of a chiropractor and fosters the enhancement of general or specialized practice and values.

- Other provisions throughout ch. Chir 12 have been revised to provide clarity and conform to current drafting standards.

Summary of, and comparison with, existing or proposed federal regulation:

None.

Comparison with rules in adjacent states:

Illinois: Illinois does not certify chiropractors in nutritional counseling. The statutory definition of chiropractic physician provides a chiropractor is not prohibited from providing advice regarding the use of non-prescription products (225 ILCS 60/2).

Iowa: Iowa does not certify chiropractors in nutritional counseling. Iowa statutes provide that licensed chiropractors who make dietetic or nutritional assessments or give dietetic or nutritional advice in the normal practice of their profession are exempted from the requirement to be licensed to practice dietetics (Iowa Code 2017, section 152A.3).

Michigan: Michigan does not certify chiropractors in nutritional counseling. By statutory definition, the practice of chiropractic includes the use of nutritional advice (MCL 333.16401).

Minnesota: Minnesota does not certify chiropractors in nutritional counseling. Minnesota statutes provide no person may engage in dietetics or nutrition practice unless the person is licensed as a dietitian or nutritionist (Minnesota Statutes 2016, section 148.630).

Summary of factual data and analytical methodologies:

The proposed rules were developed by reviewing the provisions of ch. Chir 12 to ensure the rules are consistent with current professional and academic practices and applicable Wisconsin statutes. No additional factual data or analytical methodologies were used to develop the proposed rules.

Analysis and supporting documents used to determine effect on small business or in preparation of economic impact analysis:

The proposed rules were posted for a period of 14 days to solicit public comment on economic impact, including how the proposed rules may affect businesses, local government units, and individuals. No comments were received.

Fiscal Estimate and Economic Impact Analysis:

The Fiscal Estimate and Economic Impact Analysis document is attached.

Effect on small business:

These proposed rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department’s Regulatory Review Coordinator may be contacted by email at [e-mail], or by calling [phone].

Agency contact person:

Dale Kleven, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, Wisconsin 53708-8366; telephone [phone]; email at [e-mail].

Place where comments are to be submitted and deadline for submission:

Comments may be submitted to Dale Kleven, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, WI 53708-8366, or by email to [e-mail]. Comments must be received at or before the public hearing to be held at 8:30 a.m. on August 29, 2019, to be included in the record of rule-making proceedings.

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TEXT OF RULE

Section 1.   Chir 12.01 (1) (intro.) is renumbered Chir 12.01 (1) and amended to read:

  Chir 12.01 (1) “Administering" “Administer” means the direct application of a product to directly apply a nutritional supplement or direct the self-application of a nutritional supplement, whether by ingestion or any other means, to the body of a patient or research subject. by any of the following:

Section 2.   Chir 12.01 (1) (a) and (b) are repealed.

Section 3.   Chir 12.01 (2) and (3) are amended to read:

  Chir 12.01 (2) “Dispensing" “Dispense” means delivering a product to deliver a nutritional supplement to an ultimate user or research subject by a chiropractor.

  (3) “Nutritional counseling" means providing counsel, direction, guidance, advice, or a recommendation to a patient regarding the health effects of vitamins, herbs or nutritional supplements.

 

Section 4.   Chir 12.01 (4) is renumbered Chir 12.01 (4) (intro.) and amended to read:

  Chir 12.01 (4) (intro.) “Nutritional supplement" means a product, other than tobacco, that is labeled as a nutritional or dietary supplement or intended to supplement the diet and that contains or is a concentrate, metabolic, constituent, or extract of one or more of the following dietary ingredients: a vitamin, a mineral, an herb or other botanical, an amino acid, a dietary substance for use by man to supplement the diet by increasing the total daily intake, or concentrate, metabolics, constituent, extract or combination of these ingredients; or is labeled as a nutritional or dietary supplement.

Section 5.   Chir 12.01 (4) (a) to (e) and (5) are created to read:

  Chir 12.01 (4) (a)  A vitamin.

  (b) A mineral.

  (c) An herb or other botanical.

  (d) An amino acid.

  (e) A dietary substance for use by an individual to supplement the diet by increasing total daily intake. 

  (5) “Patient” means an individual with whom a chiropractor has an established chiropractor-patient relationship or who, based on the actions of the chiropractor, has a reasonable belief that an established chiropractor-patient relationship exists.

Section 6.   Chir 12.02 (1) (intro.), (a), (a) (Note), (b), and (c) are renumbered Chir 12.02 (intro.), (1), (1) (Note), (2), and (3) and amended to read:

  Chir 12.02 (intro.)  The board shall grant a certificate for nutritional counseling to a licensed chiropractor licensed under ch. 446, Stats., who does all of the following:

  (1) Submits an application for a certificate to the department on a form provided by the department.

  (Note) Application forms are available on the department’s website at dsps.wi.gov, or by request to from the board office located at 1400 East Washington Avenue Department of Safety and Professional Services, P.O. Box 8935, Madison, Wisconsin 53708, or from the department's website at: http://dsps.wi.gov call [phone].

  (2) Pays the fee specified in under s. 446.02 (2) (c), Stats.

  (3) Submits evidence satisfactory to the board that he or she the applicant has completed received any of the following:

  (a) Received a A postgraduate degree in human nutrition, nutrition education, food and nutrition, or dietetics conferred by a college or university that is accredited by an accrediting body listed as nationally recognized by the secretary of the federal United States department of education.

  (b) Received diplomate Diplomate status in human nutrition conferred by a college of chiropractic accredited by the Council on Chiropractic Education, (CCE) or approved by the board, or accredited by an accrediting agency approved recognized by the United States office department of education or its successor.

  (c) Received a A postgraduate degree in human nutrition conferred by a foreign school determined to be equivalent to an accredited college of chiropractic by the CCE Council on Chiropractic Education or approved by the board or another board approved accrediting agency, indicating that the applicant has graduated from a program that is substantially equivalent to a postgraduate or diplomate program under subd. 1. or 2. par. (a) or (b).

  (d) Received a A degree from or otherwise successfully completed other recognition of successful completion of a postgraduate program after December 1, 2006 consisting of a minimum of 48 hours in human nutrition that is approved by the board as provided in under s. Chir 12.03, after December 1, 2006 at the time the program is completed.

Section 7.   Chir 12.03 (1) (intro.) is amended to read:

  Chir 12.03 (1) (intro.) To qualify for board approval as a nutritional counseling education program under s. Chir 12.02 (1) (c) 4., a program shall meet all of the following minimum requirements:

Section 8.   Chir 12.03 (1) (am) is created to read:

  Chir 12.03 (1) (am) The program consists of a minimum of 48 hours in human nutrition.

Section 9.   Chir 12.03 (1) (b) 3., 4., 5., 9., and 10. are amended to read:

  Chir 12.03 (1) (b) 3. Analysis of laboratory data including hair, saliva, urine, and blood samples.

  4. Symptoms of severe vitamin and nutritional deficiencies, and the toxicity of excess vitamin and mineral supplementation, herbals, or other nutritional supplements.

  5. Protein, carbohydrates, and fat macronutrient needs, and symptoms of deficiencies of any of these nutrients.

  9. The Codex Alimentarius Commission.

  10. The Dietary supplement health Supplement Health and education act Education Act of 1994, P.L. 103-417 and related regulations.

Section 10.   Chir 12.03 (1) (b) 10. (Note) is created to read:

  Chir 12.03 (1) (b) 10. (Note) The Dietary Supplement Health and Education Act of 1994 is also known as Public Law 103-417.

Section 11.   Chir 12.03 (1) (b) 11., 13., 15., 17., 19., 21., 22., 24., and 25. are amended to read:

  Chir 12.03 (1) (b) 11. Etiology of organ system dysfunction, and internal medicine diseases and conditions.

  13. The efficacy, safety, risks, and benefits of glandular products, chelation therapy, and therapeutic enzymes.

  15. Sports nutrition, endurance, body building, and exercise physiology.