SB762,33,66 440.03 (13) (b) 53s. Primary spinal care practitioner.
SB762,73 7Section 73. 440.08 (2) (a) 60s. of the statutes is created to read:
SB762,33,98 440.08 (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:
SB762,34,105 446.02 (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:
SB762,34,1412 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:
SB762,34,1916 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:
SB762,35,222 446.05 (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:
SB762,35,104 448.03 (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:
SB762,35,2120 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).
SB762,38,4 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.
SB762,38,9 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:
SB762,38,1010 (a) Surgery.
SB762,38,1211 (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.
SB762,39,206 (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:
SB762,39,24 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.
SB762,40,7 6(4) A person performing the gratuitous domestic administration of family
7remedies.
SB762,40,9 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).
SB762,40,1816 (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.
SB762,41,324 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.
SB762,42,88 (b) Case management and coordination of care in spinal pain patients.
SB762,42,99 (c) Spinal injuries, correlated with diagnostic imaging.
SB762,42,1010 (d) Public health issues and epidemiology of spinal pain conditions.
SB762,42,1111 (e) Pharmacology.
SB762,42,1212 (f) Nutrition for musculoskeletal health.
SB762,42,1313 (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).
SB762,43,1
12. Proof of completion of continuing education requirements in s. 448.975.
SB762,43,42 3. Proof of current licensure by the chiropractic examining board under ch. 446,
3unless the affiliated credentialing board waives that requirement under s. 448.9725
4(2).
SB762,43,11 5(3) A licensee whose license is lost, stolen, or destroyed may apply to the
6department for a duplicate license. Duplicate license applications shall be submitted
7to the department on a form provided by the department and shall be accompanied
8by the fee specified under s. 440.05 (7) and an affidavit describing the circumstances
9of the loss, theft, or destruction of the license. Upon receipt of an application under
10this subsection, the department shall issue a duplicate license bearing on its face the
11word "duplicate".
SB762,43,14 12448.974 Malpractice liability insurance. (1) Each licensee shall annually
13submit to the affiliated credentialing board evidence satisfactory to the affiliated
14credentialing board that the licensee satisfies any of the following:
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