SB232: Bill Text

SB232,1,12 An Act to renumber and amend 446.02 (7) (a), 446.02 (7) (d) 1. and 446.02 (7) (d) 2.; to amend 440.05 (intro.), 441.001 (3) (a), 441.001 (4) (b), 446.02 (1) (b), 446.026 (1) (a), 446.03 (intro.), 446.03 (1), 446.04 (2), 446.04 (4), 446.05 (1) and 451.02 (1); to repeal and recreate 440.05 (intro.); and to create 36.24, 38.235, 118.294, 440.08 (2) (a) 23k., 446.01 (1b), 446.01 (1f), 446.01 (1g), 446.01 (1v), 446.02 (2) (d), 446.02 (2) (dm), 446.02 (7) (a) 2., 446.02 (10m), 446.023, 446.04 (6) and 632.87 (3) (d) of the statutes; relating to: physical examinations conducted by chiropractors; performance of medical examinations by chiropractors for the Federal Motor Carrier Safety Administration; chiropractic acupuncture and chiropractic dry needling; delegation of certain services by a chiropractor; modifying various administrative rules promulgated by the Chiropractic Examining Board; and granting rule-making authority.

Analysis by the Legislative Reference Bureau

This bill makes changes to the laws relating to chiropractors, including all of the following:

Motor Carrier Safety Administration medical examinations

The bill provides that a licensed chiropractor who has a valid Federal Motor Carrier Safety Administration medical examiner certification credential may conduct medical examinations for the Federal Motor Carrier Safety Administration.

Physical examinations

If a school requires a pupil to have a physical examination as a condition of participating in a youth athletic activity or an extracurricular activity, the bill requires the school to accept a physical examination completed by a chiropractor who holds a certificate in health or physical examinations in the same manner that the school accepts a physical examination completed by a licensed physician. A youth athletic activity is any organized athletic activity in which the participants, a majority of whom are under 19 years of age, are engaged in an athletic game or competition against another team, club, or entity, and includes practice or preparation for such a game or competition. In addition, the bill allows a school district to contract with an interscholastic association only if, for purposes of determining whether a pupil may participate in a youth athletic activity or an extracurricular activity, the association accepts a physical examination completed by a chiropractor who holds a certificate in health or physical examinations in the same manner that the association accepts a physical examination completed by a licensed physician.

If a technical college within the Technical College System or a two-year college campus within the University of Wisconsin System (UW college) requires a student to have a physical examination as a condition of participating in an athletic activity, the bill requires the technical college or UW college to accept, in the same manner that it accepts a physical examination completed by a licensed physician, a physical examination completed by a chiropractor who holds a certificate in health or physical examinations.

Chiropractic acupuncture and dry needling

Under the bill, a chiropractor who is licensed by the examining board may practice chiropractic acupuncture, as defined in the bill, without being an acupuncturist certified by the Department of Safety and Professional Services if the examining board registers the licensed chiropractor to practice chiropractic acupuncture. Under the bill, the examining board may register a licensed chiropractor to practice chiropractic acupuncture if, among other requirements, the chiropractor does the following:

1. Submits evidence satisfactory to the examining board that the licensed chiropractor has completed at least 200 hours of instruction in chiropractic acupuncture at a college of chiropractic approved by the examining board or at an accredited college or university.

2. Successfully completes the acupuncture examination administered by the National Board of Chiropractic Examiners.

3. Pays a one-time registration fee of $100.

The bill also establishes standards for the certification of and authorizes the examining board to certify a licensed chiropractor to practice chiropractic dry needling, which is defined in the bill as puncturing the skin of the human body with needles at trigger points to treat neuromusculoskeletal pain and performance.

Delegation of services

The bill authorizes a chiropractor to delegate certain services that are preparatory or complementary to chiropractic adjustments to various licensed health care professionals if the services are performed under the direct, on-premises supervision of the chiropractor. Currently, a chiropractor may delegate such services only to a chiropractic technician.

Administrative rules

Finally, the bill makes several changes to the administrative rules promulgated by the Chiropractic Examining Board, including the following:

1. Provides that a chiropractic student need not be in his or her last academic quarter, semester, or trimester in order to qualify for a preceptorship, provided the student is eligible for graduation.

2. Specifies that a licensed chiropractor is not prohibited from using cold laser therapy and that a licensed chiropractor may practice acupuncture at the same location as the chiropractor practices chiropractic if the chiropractor is also a certified acupuncturist.

For further information see the state and local fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

SB232,1 Section 1 . 36.24 of the statutes is created to read:

SB232,3,6 36.24 Physical examinations for athletics at college campuses. (1) In this section, “athletic activity” means an organized athletic activity in which the participants are engaged in an athletic game or competition against another team, club, or entity, or in practice or preparation for an organized athletic game or competition against another team, club, or entity.

SB232,4,2 (2) If a college campus requires a student to have a health or physical examination as a condition of participating in an athletic activity, the college campus shall accept a health or physical examination completed by a certificate holder under s. 446.02 (2) (dm) in the same manner it accepts a health or physical examination completed by an individual licensed to practice medicine and surgery under ch. 448.

SB232,2 Section 2 . 38.235 of the statutes is created to read:

SB232,4,8 38.235 Physical examinations for athletics at technical colleges. (1) In this section, “athletic activity” means an organized athletic activity in which the participants are engaged in an athletic game or competition against another team, club, or entity, or in practice or preparation for an organized athletic game or competition against another team, club, or entity.

SB232,4,14 (2) If a technical college requires a student to have a health or physical examination as a condition of participating in an athletic activity, the technical college shall accept a health or physical examination completed by a certificate holder under s. 446.02 (2) (dm) in the same manner it accepts a health or physical examination completed by an individual licensed to practice medicine and surgery under ch. 448.

SB232,3 Section 3 . 118.294 of the statutes is created to read:

SB232,4,17 118.294 Physical examination for youth athletics and extracurricular activities; chiropractors. (1) In this section:

SB232,4,18 (a) “School” means a public, private, or tribal school.

SB232,4,19 (b) “Youth athletic activity” has the meaning given in s. 118.293 (1) (c).

SB232,4,25 (2) If a school requires a pupil to have a health or physical examination as a condition of participating in a youth athletic activity or an extracurricular activity, the school shall accept a health or physical examination completed by a certificate holder under s. 446.02 (2) (dm) in the same manner it accepts a health or physical examination completed by an individual licensed to practice medicine and surgery under ch. 448.

SB232,5,6 (3) A school district may contract with an interscholastic association only if, for the purpose of determining whether a pupil may participate in a youth activity or an extracurricular activity, the interscholastic association accepts a health or physical examination completed by a certificate holder under s. 446.02 (2) (dm) in the same manner it accepts a health or physical examination completed by an individual licensed to practice medicine and surgery under ch. 448.

SB232,4 Section 4 . 440.05 (intro.) of the statutes is amended to read:

SB232,5,10 440.05 Standard fees. (intro.) The following standard fees apply to all initial credentials, except as provided in ss. 440.51, 444.03, 444.11, 446.02 (2) (c) and (dm), 447.04 (2) (c) 2., 448.07 (2), 449.17 (1m) (d), and 449.18 (2) (d):

SB232,5 Section 5 . 440.05 (intro.) of the statutes, as affected by 2015 Wisconsin Act 116, section 7m, and 2017 Wisconsin Act .... (this act), is repealed and recreated to read:

SB232,5,16 440.05 Standard fees. (intro.) The following standard fees apply to all initial credentials, except as provided in ss. 440.51, 444.03, 444.11, 446.02 (2) (c) and (dm), 447.04 (2) (c) 2., 449.17 (1m) (d), and 449.18 (2) (d):

SB232,6 Section 6 . 440.08 (2) (a) 23k. of the statutes is created to read:

SB232,5,19 440.08 (2) (a) 23k. Chiropractor acupuncturist: December 15 of each even-numbered year.

SB232,7 Section 7 . 441.001 (3) (a) of the statutes is amended to read:

SB232,6,4 441.001 (3) (a) “Practical nursing" means the performance for compensation of any simple acts in the care of convalescent, subacutely or chronically ill, injured or infirm persons, or of any act or procedure in the care of the more acutely ill, injured or infirm under the specific direction of a nurse, physician, podiatrist licensed under ch. 448, chiropractor licensed under ch. 446, dentist licensed under ch. 447 or optometrist licensed under ch. 449, or under an order of a person who is licensed to practice medicine, podiatry, chiropractic, dentistry or optometry in another state if that person prepared the order after examining the patient in that other state and directs that the order be carried out in this state.

SB232,8 Section 8 . 441.001 (4) (b) of the statutes is amended to read:

SB232,6,13 441.001 (4) (b) The execution of procedures and techniques in the treatment of the sick under the general or special supervision or direction of a physician, podiatrist licensed under ch. 448, chiropractor licensed under ch. 446, dentist licensed under ch. 447, or optometrist licensed under ch. 449, or under an order of a person who is licensed to practice medicine, podiatry, chiropractic, dentistry, or optometry in another state if the person making the order prepared the order after examining the patient in that other state and directs that the order be carried out in this state.

SB232,9 Section 9 . 446.01 (1b) of the statutes is created to read:

SB232,6,15 446.01 (1b) “Acupuncturist" has the meaning given in s. 451.01 (2).

SB232,10 Section 10 . 446.01 (1f) of the statutes is created to read:

SB232,6,21 446.01 (1f) “Chiropractic acupuncture” means to promote, maintain, or restore health or to diagnose, prevent, or treat disease by treating specific areas of the human body, known as acupuncture points or meridians, by the insertion of needles or by the application of manual, thermal, or electrical stimulation or any other secondary therapeutic technique.

SB232,11 Section 11 . 446.01 (1g) of the statutes is created to read:

SB232,6,25 446.01 (1g) “Chiropractic dry needling” means puncturing the skin of the human body with needles at trigger points to treat neuromusculoskeletal pain and performance.

SB232,12 Section 12. 446.01 (1v) of the statutes is created to read:

SB232,7,3 446.01 (1v) “Health care professional" means an individual who is licensed, registered, or certified by any of the following:

SB232,7,4 (a) Board of nursing under ch. 441.

SB232,7,5 (b) Dentistry examining board under ch. 447.

SB232,7,6 (c) Medical examining board under subch. II of ch. 448.

SB232,7,7 (d) Physical therapy examining board under subch. III of ch. 448.

SB232,7,8 (e) Podiatry affiliated credentialing board under subch. IV of ch. 448.

SB232,7,9 (f) Dietitians affiliated credentialing board under subch. V of ch. 448.

SB232,7,10 (g) Athletic trainers affiliated credentialing board under subch. VI of ch. 448.

SB232,7,12 (h) Occupational therapists affiliated credentialing board under subch. VII of ch. 448.

SB232,7,13 (i) Optometry examining board under ch. 449.

SB232,7,14 (j) Pharmacy examining board under ch. 450.

SB232,7,15 (k) The department of safety and professional services under ch. 451.

SB232,7,16 (L) Psychology examining board under ch. 455.

SB232,7,18 (m) Marriage and family therapy, professional counseling, and social work examining board under ch. 457.

SB232,7,19 (n) Hearing and speech examining board under subch. II of ch. 459.

SB232,7,21 (o) The massage therapy and bodywork therapy affiliated credentialing board under ch. 460.

SB232,13 Section 13 . 446.02 (1) (b) of the statutes is amended to read:

SB232,8,14 446.02 (1) (b) Submits evidence satisfactory to the examining board that the person meets the requirements of continuing education for license renewal as the examining board may require, which requirements shall include current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction. Hours of continuing education completed under subs. (2) (dm) and (4) (b) shall count toward any hours required under this paragraph. The person shall include the approval number assigned under sub. (5) (b) to each educational program completed by the person to satisfy the requirements of this paragraph. During the time between initial licensure and commencement of a full 2-year licensure period new licensees shall not be required to meet continuing education requirements. Any person who has not engaged in the practice of chiropractic for 2 years or more, while holding a valid license under this chapter, and desiring to engage in such practice, shall be required by the examining board to complete a continuing education course at a school of chiropractic approved by the examining board or pass a practical examination administered by the examining board or both.

SB232,14 Section 14 . 446.02 (2) (d) of the statutes is created to read:

SB232,8,17 446.02 (2) (d) 1. No person may practice chiropractic dry needling unless he or she is a chiropractor who is licensed under this chapter and certified under subd. 2.

SB232,8,18 1m. No certification is required under subd. 2. for any of the following:

SB232,8,19 a. A licensed chiropractor who is registered under s. 446.023.

SB232,8,20 b. An acupuncturist who is certified under ch. 451.

SB232,9,2 2. The examining board shall issue a certificate to practice dry needling to a chiropractor who is licensed under this chapter, who submits satisfactory evidence that the chiropractor has completed 50 hours of postgraduate study in chiropractic dry needling that is approved by the examining board, and who pays a one-time certification fee of $25, except that no certification fee is required under this subdivision for an individual who is eligible for the veterans fee waiver program under s. 45.44.

SB232,9,4 3. Subject to subd. 4., the examining board shall promulgate rules implementing the postgraduate education requirement under subd. 2.

SB232,9,8 4. Each program sponsor of an education program required to be completed by a chiropractor as a condition of certification under subd. 2. shall submit the program to the examining board for approval. Under this subdivision, “program sponsor” has the meaning given in s. 446.028.

SB232,15 Section 15 . 446.02 (2) (dm) of the statutes is created to read:

SB232,9,20 446.02 (2) (dm) The examining board shall issue a certificate to a chiropractor who is licensed under this chapter and who submits satisfactory evidence that the chiropractor has completed postgraduate study in performing health or physical examinations for participation in school or college athletic activities. The chiropractor shall pay a one-time certification fee of $25, except that no fee is required under this paragraph for an individual who is eligible for the veterans fee waiver program under s. 45.44. The examining board shall promulgate rules that establish minimum requirements or standards for the postgraduate study that shall be completed in order to obtain a certificate under this paragraph. The examining board shall also promulgate rules that require continuing education in order to maintain the certificate.

SB232,16 Section 16. 446.02 (7) (a) of the statutes is renumbered 446.02 (7) (a) (intro.) and amended to read:

SB232,9,24 446.02 (7) (a) (intro.) Except as provided in pars. (b) and (d), a chiropractor who is licensed under this chapter may delegate to a person who is not licensed under this chapter the performance of adjunctive services if the services are performed by any of the following under the direct, on-premises supervision of the chiropractor.:

SB232,17 Section 17. 446.02 (7) (a) 2. of the statutes is created to read:

SB232,10,4 446.02 (7) (a) 2. A health care professional.

SB232,18 Section 18 . 446.02 (7) (d) 1. of the statutes is renumbered 446.02 (7) (d) and amended to read:

SB232,10,9 446.02 (7) (d) Beginning on July 1, 2010, a A chiropractor may delegate X-ray services only to a chiropractic radiological technologist technician or a health care professional acting within the scope of his or her license, registration, or certification.