SB762,32,1820
343.51
(1) Any person who qualifies for registration plates of a special design
21under s. 341.14 (1), (1a), (1m), or (1q) or any other person with a disability that limits
22or impairs the ability to walk may request from the department a special
23identification card that will entitle any motor vehicle parked by, or under the
24direction of, the person, or a motor vehicle operated by or on behalf of the
25organization when used to transport such a person, to parking privileges under s.
1346.50 (2), (2a), and (3). The department shall issue the card at a fee to be determined
2by the department, upon submission by the applicant, if the applicant is an
3individual rather than an organization, of a statement from a physician licensed to
4practice medicine in any state, from an advanced practice nurse licensed to practice
5nursing in any state, from a public health nurse certified or licensed to practice in
6any state, from a physician assistant licensed or certified to practice in any state,
7from a podiatrist licensed to practice in any state,
from a primary spinal care
8practitioner licensed to practice spinal medicine in any state, from a chiropractor
9licensed to practice chiropractic in any state, or from a Christian Science practitioner
10residing in this state and listed in the Christian Science journal that the person is
11a person with a disability that limits or impairs the ability to walk. The statement
12shall state whether the disability is permanent or temporary and, if temporary, the
13opinion of the physician, advanced practice nurse, public health nurse, physician
14assistant, podiatrist,
primary spinal care practitioner, chiropractor, or practitioner
15as to the duration of the disability. The department shall issue the card upon
16application by an organization on a form prescribed by the department if the
17department believes that the organization meets the requirements under this
18subsection.
SB762,71
19Section
71. 343.62 (4) (a) 4. of the statutes is amended to read:
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343.62
(4) (a) 4. The applicant submits with the application a statement
21completed within the immediately preceding 24 months, except as provided by rule,
22by a physician licensed to practice medicine in any state, from an advanced practice
23nurse licensed to practice nursing in any state, from a physician assistant licensed
24or certified to practice in any state, from a podiatrist licensed to practice in any state,
25from a primary spinal care practitioner licensed to practice spinal medicine in any
1state, from a chiropractor licensed to practice chiropractic in any state, or from a
2Christian Science practitioner residing in this state, and listed in the Christian
3Science journal certifying that, in the medical care provider's judgment, the
4applicant is physically fit to teach driving.
SB762,72
5Section
72. 440.03 (13) (b) 53s. of the statutes is created to read:
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440.03
(13) (b) 53s. Primary spinal care practitioner.
SB762,73
7Section
73. 440.08 (2) (a) 60s. of the statutes is created to read:
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440.08
(2) (a) 60s. Primary spinal care practitioner: December 15 of each
9even-numbered year.
SB762,74
10Section
74. 441.001 (3) (a) of the statutes is amended to read:
SB762,33,1911
441.001
(3) (a) "Practical nursing" means the performance for compensation
12of any simple acts in the care of convalescent, subacutely or chronically ill, injured
13or infirm persons, or of any act or procedure in the care of the more acutely ill, injured
14or infirm under the specific direction of a nurse, physician, podiatrist
or primary
15spinal care practitioner licensed under ch. 448, dentist licensed under ch. 447 or
16optometrist licensed under ch. 449, or under an order of a person who is licensed to
17practice medicine, podiatry,
spinal medicine, as defined in s. 448.971 (5), dentistry
18or optometry in another state if that person prepared the order after examining the
19patient in that other state and directs that the order be carried out in this state.
SB762,75
20Section
75. 441.001 (4) (b) of the statutes is amended to read:
SB762,34,321
441.001
(4) (b) The execution of procedures and techniques in the treatment
22of the sick under the general or special supervision or direction of a physician,
23podiatrist
, or primary spinal care practitioner licensed under ch. 448, dentist
24licensed under ch. 447, or optometrist licensed under ch. 449, or under an order of
25a person who is licensed to practice medicine, podiatry,
spinal medicine, as defined
1in s. 448.971 (5), dentistry, or optometry in another state if the person making the
2order prepared the order after examining the patient in that other state and directs
3that the order be carried out in this state.
SB762,76
4Section
76. 446.02 (6m) of the statutes is amended to read:
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446.02
(6m) No chiropractor may provide counsel, direction, guidance, advice,
6or a recommendation to a patient regarding the health effects of vitamins, herbs, or
7nutritional supplements unless the chiropractor has been issued a certificate under
8sub. (2) (c). This subsection does not apply to a chiropractor licensed under this
9chapter who is certified as a dietician under subch. V of ch. 448
or who is a primary
10spinal care practitioner licensed under s. 448.9725.
SB762,77
11Section
77. 446.02 (7d) (d) of the statutes is created to read:
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446.02
(7d) (d) This subsection does not apply to a primary spinal care
13practitioner licensed under subch. VIII of ch. 448 with respect to treatment of a
14condition within the scope of that license.
SB762,78
15Section
78. 446.026 (1) (a) of the statutes is amended to read:
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446.026
(1) (a) No person may provide adjunctive services unless the person
17is a chiropractic technician and is under the direct, on-premises supervision of a
18chiropractor licensed under this chapter
or a primary spinal care practitioner
19licensed under subch. VIII of ch. 448.
SB762,79
20Section
79. 446.05 (1) of the statutes is renumbered 446.05 (1) (a).
SB762,80
21Section
80. 446.05 (1) (b) of the statutes is created to read:
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446.05
(1) (b) The examining board shall refer an allegation of a violation of
23subch. VIII of ch. 448 to the spinal medicine affiliated credentialing board for
24investigation, unless the alleged conduct also involves a violation of this chapter, in
1which case the examining board and the spinal medicine affiliated credentialing
2board shall consult concerning the investigation.
SB762,81
3Section
81. 448.03 (2) (a) of the statutes is amended to read:
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448.03
(2) (a) Any person lawfully practicing within the scope of a license,
5permit, registration, certificate or certification granted to practice midwifery under
6subch. XIII of ch. 440, to practice professional or practical nursing or
7nurse-midwifery under ch. 441, to practice chiropractic under ch. 446, to practice
8dentistry or dental hygiene under ch. 447,
to practice spinal medicine under subch.
9VIII, to practice optometry under ch. 449, to practice acupuncture under ch. 451 or
10under any other statutory provision, or as otherwise provided by statute.
SB762,82
11Section
82. 448.21 (1) (f) of the statutes is created to read:
SB762,35,1312
448.21
(1) (f) The practice of spinal medicine within the meaning of s. 448.971
13(5).
SB762,83
14Section
83. 448.52 (2m) (a) of the statutes is amended to read:
SB762,35,1815
448.52
(2m) (a) Except as provided in par. (b), a chiropractor licensed under ch.
16446
or a primary spinal care practitioner under subch. VIII claiming to render
17physical therapy, if the physical therapy is provided by a physical therapist employed
18by the chiropractor
or primary spinal care practitioner.
SB762,84
19Section
84. 448.52 (2m) (b) of the statutes is amended to read:
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448.52
(2m) (b) A chiropractor licensed under ch. 446
or a doctor of chiropractic
21licensed under subch. VIII claiming to render physical therapy modality services.
SB762,85
22Section
85. 448.56 (1) of the statutes is amended to read:
SB762,36,1223
448.56
(1) Written referral. Except as provided in this subsection and s.
24448.52, a person may practice physical therapy only upon the written referral of a
25physician, physician assistant, chiropractor, dentist, podiatrist,
primary spinal care
1practitioner, or advanced practice nurse prescriber certified under s. 441.16 (2).
2Written referral is not required if a physical therapist provides services in schools to
3children with disabilities, as defined in s. 115.76 (5), pursuant to rules promulgated
4by the department of public instruction; provides services as part of a home health
5care agency; provides services to a patient in a nursing home pursuant to the
6patient's plan of care; provides services related to athletic activities, conditioning, or
7injury prevention; or provides services to an individual for a previously diagnosed
8medical condition after informing the individual's physician, physician assistant,
9chiropractor, dentist, podiatrist,
primary spinal care practitioner, or advanced
10practice nurse prescriber certified under s. 441.16 (2) who made the diagnosis. The
11examining board may promulgate rules establishing additional services that are
12excepted from the written referral requirements of this subsection.
SB762,86
13Section
86. 448.56 (1m) (b) of the statutes is amended to read:
SB762,36,1914
448.56
(1m) (b) The examining board shall promulgate rules establishing the
15requirements that a physical therapist must satisfy if a physician, physician
16assistant, chiropractor, dentist, podiatrist,
primary spinal care practitioner, or
17advanced practice nurse prescriber makes a written referral under sub. (1). The
18purpose of the rules shall be to ensure continuity of care between the physical
19therapist and the health care practitioner.
SB762,87
20Section
87. 448.956 (1m) of the statutes is amended to read:
SB762,37,221
448.956
(1m) Subject to sub. (1) (a), a licensee may provide athletic training
22to an individual without a referral, except that a licensee may not provide athletic
23training as described under s. 448.95 (5) (d) or (e) in an outpatient rehabilitation
24setting unless the licensee has obtained a written referral for the individual from a
1practitioner licensed or certified under subch. II, III, IV, V,
or, VII
, or VIII of this
2chapter; under ch. 446; or under s. 441.16 (2).
SB762,88
3Section
88. 448.956 (3) (c) of the statutes is amended to read:
SB762,37,84
448.956
(3) (c) Treat or rehabilitate an employee with an injury or illness that
5has resulted from an employment activity as directed, supervised, and inspected by
6a physician, as defined in s. 448.01 (5), or by a person licensed
under subch. VIII or 7under s. 446.02, who has the power to direct, decide, and oversee the implementation
8of the treatment or rehabilitation.
SB762,89
9Section
89. 448.956 (4) of the statutes is amended to read:
SB762,37,1510
448.956
(4) If a licensee or the consulting physician of the licensee determines
11that a patient's medical condition is beyond the scope of practice of the licensee, the
12licensee shall, in accordance with the protocol established under sub. (1) (a), refer the
13patient to a health care practitioner who is licensed under ch. 446 or 447 or subch.
14II, III
or, IV
, or VIII of ch. 448 and who can provide appropriate treatment to the
15patient.
SB762,90
16Section
90. Subchapter VIII of chapter 448 [precedes 448.971] of the statutes
17is created to read:
SB762,37,1818
chapter 448
SB762,37,1919
subchapter viii
SB762,37,2120
spinal medicine affiliated
21
credentialing board
SB762,37,22
22448.971 Definitions. In this subchapter:
SB762,37,24
23(1) "Affiliated credentialing board" means the spinal medicine affiliated
24credentialing board.
SB762,37,25
25(2) "Licensee" means a person who is licensed under s. 448.9725.
SB762,38,1
1(3) "Practice of chiropractic" has the meaning given in s. 446.01 (2).
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2(4) "Primary spinal care practitioner" means an individual possessing the
3degree of doctor of spinal medicine or equivalent degree as determined by the
4affiliated credentialing board.
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5(5) "Spinal medicine" means the integration and application of the practice of
6chiropractic and the practice of medicine and surgery that is limited to conditions of
7the spine and of the musculoskeletal, neuromuscular, and nervous systems and
8includes prescribing and administering drugs. The practice of spinal medicine does
9not include all of the following:
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(a) Surgery.
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(b) Administering a general anesthetic, except under the direction of a person
12licensed to practice medicine and surgery under subch. II.
SB762,38,18
13448.9715 License required. (1) Except as provided in ss. 257.03 and
14448.972, no person may practice spinal medicine, designate himself or herself as a
15primary spinal care practitioner, use or assume the title "primary spinal care
16practitioner," or append to the person's name the letters "P.S.C.P.," or any other title,
17letters, or designation that represents or may tend to represent the person as a
18primary spinal care practitioner unless the person is a licensee.
SB762,38,22
19(2) (a) A primary spinal care practitioner shall evaluate each patient before
20commencing treatment of the patient to determine whether the patient has a
21condition that is treatable by the practice of spinal medicine. The evaluation shall
22be based upon an examination that is appropriate to the patient.
SB762,39,523
(b) A primary spinal care practitioner shall discontinue the practice of spinal
24medicine on a patient if, at any time after the evaluation under par. (a) or during or
25following treatment of the patient, the primary spinal care practitioner determines
1or reasonably believes that the patient's condition is not treatable by the practice of
2spinal medicine, or will not respond to further practice of spinal medicine by the
3primary spinal care practitioner, except that a primary spinal care practitioner may
4provide maintenance, supportive, and wellness care to the patient if the patient is
5being treated by another health care professional.
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(c) A primary spinal care practitioner who discontinues the practice of spinal
7medicine as required in par. (b) shall inform the patient of the reason for
8discontinuing the practice of spinal medicine and shall refer the patient to a
9physician. A primary spinal care practitioner may continue to provide maintenance,
10supportive, and wellness care to a patient referred under this paragraph who
11requests these services from the doctor of spinal medicine. A referral under this
12paragraph shall describe the primary spinal care practitioner's findings. If the
13referral is written, the primary spinal care practitioner shall provide the patient
14with a copy and shall maintain a copy in the patient's records. If the referral is oral,
15the primary spinal care practitioner
shall communicate the referral directly to the
16physician, shall notify the patient about the referral, and shall make a written record
17of the oral referral. The written record of the oral referral shall include the name of
18the physician to whom the patient was referred and the date of the referral. The
19primary spinal care practitioner shall maintain a copy of the written record of the
20oral referral in the patient's records.
SB762,39,22
21448.972 Applicability. This subchapter does not require a license for any of
22the following:
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23(1) A person lawfully practicing within the scope of a license, permit,
24registration, or certification granted by this state or the federal government.
SB762,40,2
1(2) A person assisting a primary spinal care practitioner under the direct,
2on-premises supervision of the primary spinal care practitioner.
SB762,40,5
3(3) A student enrolled in a spinal medicine program approved by the affiliated
4credentialing board under s. 448.973 if the student is engaged in activities required
5under that program.
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6(4) A person performing the gratuitous domestic administration of family
7remedies.
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8(5) A person furnishing medical assistance or first aid at the scene of an
9emergency.
SB762,40,12
10448.9725 Licensure of primary spinal care practitioners. (1) The
11affiliated credentialing board shall grant a license as a primary spinal care
12practitioner to a person who does all of the following:
SB762,40,1413
(a) Submits an application for the license to the department on a form provided
14by the department.
SB762,40,1515
(b) Pays the fee specified in s. 440.05 (1).
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(c) Subject to ss. 111.321, 111.322, and 111.335, submits evidence satisfactory
17to the affiliated credentialing board that the applicant does not have an arrest or
18conviction record.
SB762,40,2019
(d) Submits evidence satisfactory to the affiliated credentialing board
20establishing all of the following:
SB762,40,2321
1. That the applicant has practiced as a licensed chiropractor in good standing
22with the chiropractic examining board for at least two years and remains a licensed
23chiropractor in good standing with the chiropractic examining board under ch. 446.
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2. That the applicant is a graduate of a master of science degree program in
25spinal medicine approved by the affiliated credentialing board under s. 448.973 and
1possesses a diploma from that program conferring the degree of primary spinal care
2practitioner or equivalent degree as determined by the affiliated credentialing
3board.
SB762,41,6
4(2) The affiliated credentialing board may waive the requirements under sub.
5(1) (d) for an applicant who establishes, to the satisfaction of the affiliated
6credentialing board, all of the following:
SB762,41,77
(a) That the applicant is a graduate of a spinal medicine school or program.
SB762,41,98
(b) That the applicant is licensed as a primary spinal care practitioner or its
9equivalent by another licensing jurisdiction in the United States.
SB762,41,1310
(c) That the jurisdiction in which the applicant is licensed required the
11applicant to be a graduate of a school or program approved by the licensing
12jurisdiction or of a school or program that the licensing jurisdiction evaluated for
13education equivalency.
SB762,41,1714
(d) That the applicant has actively practiced spinal medicine, under the license
15issued by the other licensing jurisdiction in the United States, for at least 3 years
16immediately preceding the date of his or her application for a license under this
17subchapter.
SB762,41,19
18(3) The affiliated credentialing board may promulgate rules providing for
19various classes of temporary licenses to practice spinal medicine.
SB762,41,24
20(4) If the affiliated credentialing board finds, based upon considerations of
21public health and safety, that an applicant has not demonstrated adequate
22education, training, or performance on examinations or in past practice, if any, to
23qualify for full licensure under sub. (1), the board may grant the applicant a limited
24license and shall so notify the applicant.
SB762,42,4
1448.973 Education. The affiliated credentialing board shall approve a master
2of science degree program in spinal medicine that is accredited by the Higher
3Learning Commission or an equivalent accrediting body, as determined by the
4affiliated credentialing board, and that includes all of the following:
SB762,42,6
5(1) At least 60 hours of instruction, including classroom instruction, in the
6following subjects:
SB762,42,77
(a) Causes of spinal pain and differential diagnosis.
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(b) Case management and coordination of care in spinal pain patients.
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(c) Spinal injuries, correlated with diagnostic imaging.
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(d) Public health issues and epidemiology of spinal pain conditions.
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(e) Pharmacology.
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(f) Nutrition for musculoskeletal health.
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(g) Interpreting research and applying evidence in spinal care practice.
SB762,42,14
14(2) At least 500 clinical rotation hours under the supervision of a physician.
SB762,42,16
15(3) An examination in spinal medicine approved by the affiliated credentialing
16board.
SB762,42,19
17448.9735 Issuance of license; expiration and renewal; duplicate
18license. (1) The department shall issue a certificate of licensure to each person who
19is licensed under this subchapter.
SB762,42,22
20(2) (a) The renewal date for a license granted under this subchapter, other than
21a temporary license granted under rules promulgated under s. 448.9725 (3), is
22specified under s. 440.08 (2) (a).
SB762,42,2423
(b) Renewal applications shall be submitted to the department on a form
24provided by the department and shall be accompanied by all of the following:
SB762,42,2525
1. The renewal fee determined by the department under s. 440.03 (9) (a).