PHILADELPHIA, Pennsylvania -- Louis Sportelli,DC, president of the NCMIC and the World Federation of Chiropractic, asked the audience at the 73rd annual Congress of the Federation of Chiropractic Licensing Boards (April 14-18):"Look to your left and to your right. In a few years, none of you may be here."
No, he wasn't a latter-day Nostradamus predicting the end of the world, but speaking on "Licensing -- Does it Have a Future?" and challenging the regulatory boards to remodel professional regulation.
The conference theme, appropriate to the host city, "Evolution or Revolution: The Future of Chiropractic Regulation," hammered home the challenges of regulating the chiropractic profession. The keynote address was by attorney Randolph Reaves, executive director of the Federation of Associations of Regulatory Boards. He outlined the legislative pressures to turn licensing and discipline over to state agencies and consumer groups if the health professions aren't up to the task.
"Every regulated vocation is under siege today," said David Brown,DC, FCLB's newly elected president, but noted that "our boards are constantly evolving in their role of protecting the public."
The HIP Databank
This is not the "hip" that the beat generation spoke of, but the federal Healthcare Integrity and Protection Databank (HIP Databank) to which chiropractic will be required to report. Final regulations have not yet been distributed governing the HIP.
While all the information in the HIP is included in various public records, the public will not have access to the HIP Databank, and fees will be assessed for boards to access the information they have put into the system. This federal program, at the earliest, will be on line in fall 1999.
The FCLB stressed the importance for state boards to continue to report to the chiropractic profession's own databank -- CIN-BAD (Chiropractic Information Network/Board Action Databank). Access to CIN-BAD is free to member boards.
With support from NCMIC, the "Official Actions Database" of CIN-BAD shifted to internet access last year. The Official Actions Database includes the sanctions of public boards and the U.S. Department of Health and Human Services.
The Federation also presented a demonstration of a prototype database -- ALLDoCS (All Legally Licensed Doctors of Chiropractic). ALLDoCS will eventually offer on-line primary source level verification on the licenses held by every chiropractor. The database currently contains 39,000 licenses.
The Federation envisions this as a highly efficient way for managed care to expedite approval of chiropractors to participate in health plans, and to help regulatory boards verify licensure for faster relocation or travel-to-treat options where permitted by law.
The FCLB was pleasantly surprised to receive the announcement from Dr. Louis Sportelli that the NCMIC Board of Directors has approved a two-year grant totaling $120,000 to support the development of the ALLDoCS database to assist the field practitioners and licensing boards.
Education
Representatives of the U.S. Council on Chiropractic Education described the CCE's plans for a streamlined governing structure and new admissions standards.
The FCLB conference offered an impressive array of educational sessions and faculty. In the area of continuing education (CE) credits, the Canadian Memorial Chiropractic College presented a powerful demonstration of the technology available today for online learning.
Conference attendees and speakers strongly encouraged the FCLB to explore hosting a central registry for approving core CE programs. If implemented, the individual boards would maintain the right to approve additional CE programs which meet their particular regulatory requirements. Programs which would clearly qualify in all jurisdictions would no longer need to apply individually to multiple jurisdictions for approval.
Media
Representatives from the Pennsylvania Department of State and Virginia Board of Medicine presented "offense and defense" models for working with the media to ensure appropriate coverage of board issues, including hearings, legislative proposals, and consumer involvement.
Rebuilding a Regulatory Board
The California Board shared a candid assessment of the strengths and weaknesses of its board and how it is implementing an improvement program. Consumer responsiveness was a focal issue.
Professional Standards
In a team discussion program prior to the main conference, board members explored practice standards and made recommendations to the Council on Chiropractic Guidelines and Practice Parameters (CCGPP).
Annual Business Meeting
Guidelines for the Development of a Model Disciplinary Code and Model Code of Ethics for Members of Regulatory Boards for the Licensed Professions were accepted as official FCLB publications. These documents are not stagnant codes, but will continue to evolve as changes in regulations are brought to the attention of the FCLB.
New legislative proposals include: defining the doctor/patient privilege; providing a limited license for travel-to-treat; increasing the penalty for unlicensed practice to a felony; adopting Part IV of the NBCE exams; and expanding the range of sanctions available to the board.
Awards
The award for "Outstanding Chiropractic Regulatory Board" was presented to the Ohio State Board of Chiropractic.
Other awards included "Special Presidential Recognition" for retiring regulatory board members Drs. Richard Plummer (SC) and Earl Barbour (NC).
World View
World Federation of Chiropractic Secretary-General David Chapman-Smith,LLB, closed the conference by urging boards to look at expanding the borders of regulation to a world-wide understanding. That there are more chiropractic colleges outside the U.S. than within its borders was surprising to many in the audience.
The Leadership
The slate of officers is complete for 1999-2000:
| President: | Dr. David Brown (VA) |
| Vice President: | Dr. Wayne Wolfson (FL) |
| Treasurer: | Dr. Richard Cole (TN) |
| Imm. Past President: | Dr. Lawrence Gerstein (MO) |
| Executive Board Chair and District III Director: | Dr. Vernon Temple (VT) |
| District I Director: | Dr. Patricia Conners-Allen (AK) |
| District II Director: | Dr. James Powell (OH) |
| District IV Director: | Dr. Ronald Zoeller (KS) |
| District V Director: | Dr. Linda Steele Denham |
Drs. William Swanson (ND) and Linda Steele Denham (GA) were approved by the membership to serve on the 1999-2000 nominating committee.
Dr. Glenn Moldenhauer (ID) was approved by the membership to serve a four-year term on the long©range planning committee.
Effective in 2000, the annual member dues will be increased, the first increase in five years,
Regional meetings take place August-October. Next year's annual conference is scheduled for May 3-7, 2000 in Seattle, Washington.
For more information about the Philadelphia meeting, please contact the FCLB at (970) 356-3500 or by e-mail: fclb@fclb.org Readers may also click on the FCLB website at www.fclb.org to obtain copies of major lectures and handouts.
Editor's note: We'd like to thank Donna Liewer, executive director of the FCLB, for providing us with an extensive report of the FCLB meeting that was the basis for this article.
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