First Regular Session
Sixty-first General Assembly
LLS NO. 970075.01 JLB
HOUSE BILL 971017
STATE OF COLORADO
BY REPRESENTATIVE Salaz
WELFARE & INSTITUTIONS
A BILL FOR AN ACT
CONCERNING LIMITED PRESCRIPTIVE AUTHORITY FOR CHIROPRACTORS,
AND, IN CONNECTION THEREWITH, ESTABLISHING QUALIFICATION REQUIREMENTS.
(Note: This summary applies to this bill as introduced
and does not necessarily reflect any amendments which may be subsequently
Authorizes chiropractors who satisfactorily complete qualification requirements to prescribe, administer, and inject noncontrolled legend drugs. Expressly prohibits chiropractors from prescribing, administering, or injecting controlled substances. Authorizes the state board of chiropractic examiners to promulgate rules for the administration of a limited prescription program which authorizes chiropractors with limited prescriptive authority to prescribe noncontrolled legend drugs. The program expressly prohibits chiropractors from prescribing controlled substances.
Requires applicants for limited prescriptive authority to complete 6,000 hours of fulltime chiropractic practice, 24 hours of course work in injections and injectables approved by an accredited chiropractic college, and 96 hours of course work in pharmacology and pharmacotherapy taught by an accredited school of pharmacy. Includes a continuing education requirement.
Includes the following acts within "unprofessional conduct":
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. 1233102, Colorado Revised Statutes, 1991 Repl. Vol., is amended to read:
1233102. Definitions. As used in this article, unless the context otherwise requires:
(1) "ACUPUNCTURE" MEANS THE PUNCTURE OF THE SKIN WITH FINE NEEDLES FOR DIAGNOSTIC AND THERAPEUTIC PURPOSES.
(2) "ADMINISTER" MEANS TO GIVE A DRUG VIA METHODS THAT INCLUDE, BUT ARE NOT LIMITED TO, INJECTIONS.
(1) (3) "Chiropractic"
means that branch of the healing arts which
THAT is based on the premise that disease is attributable to the
abnormal functioning of the human nervous system. It includes
the diagnosing and analyzing of human ailments and seeks the elimination
of the abnormal functioning of the human nervous system by the
adjustment or manipulation, by hand, of the articulations and
adjacent tissue of the human body, particularly the spinal column,
and the usage as indicated of procedures which
THAT facilitate and make the adjustment or manipulation more effective,
and the use of sanitary, hygienic, nutritional, and physical remedial
measures necessary to such practice. "Chiropractic"
includes the use of venipuncture for diagnostic purposes. "Chiropractic"
does not include colonic irrigation therapy. "Chiropractic"
includes treatment by acupuncture AND THE USE OF NONCONTROLLED
LEGEND DRUGS when performed by an appropriately trained chiropractor
as determined by the Colorado state board of chiropractic examiners.
Nothing in this section shall apply to persons using acupuncture
not licensed by the board.
means the puncture of the skin with fine needles for diagnostic
and therapeutic purposes.
(2) (4) "Chiropractic
adjustment" means the application, by hand, by a trained
chiropractor who has fulfilled the educational and licensing requirements
of this article, of adjustive force to correct subluxations, fixations,
structural distortions, abnormal tensions, and disrelated structures,
or to remove interference with the transmission of nerve force.
The application of the dynamic adjustive thrust is designed and
intended to produce and usually elicits audible and perceptible
release of tensions and movement of tissues or anatomical parts
for the purpose of removing or correcting interference to nerve
transmission and expression.
(3) (5) "Electrotherapy"
means the application of any radiant or current energies of high
or low frequency, alternating or direct, except surgical cauterization,
electrocoagulation, the use of radium in any form, and Xray
(6) "LIMITED PRESCRIPTIVE AUTHORITY" MEANS THE AUTHORITY TO PRESCRIBE AND ADMINISTER NONCONTROLLED LEGEND DRUGS.
(7) "NONCONTROLLED LEGEND DRUGS" MEANS A LEGEND DRUG THAT IS AN ANALGESIC, ANTIINFLAMMATORY, MUSCLE RELAXANT, OR NUTRITIONAL THERAPY. "NONCONTROLLED LEGEND DRUG" DOES NOT MEAN A CONTROLLED SUBSTANCE, AS DEFINED IN SECTION 1818102 (5), C.R.S.
(4) (8) "Venipuncture"
means the puncture of a vein for the withdrawal of blood for the
purpose of diagnosis through blood analysis. Any blood analysis
shall be done by a chiropractor or by a commercial laboratory.
SECTION 2. 1233107 (1), Colorado Revised Statutes, 1991 Repl. Vol., as amended, is amended BY THE ADDITION OF A NEW PARAGRAPH to read:
1233107. Board powers. (1) The board is authorized to and shall:
(i) ADOPT SUCH RULES AS ARE NECESSARY TO ADMINISTER THE APPLICATION PROCEDURES AND QUALIFICATION REQUIREMENTS OF CHIROPRACTORS SEEKING TO ACQUIRE AND MAINTAIN LIMITED PRESCRIPTIVE AUTHORITY PURSUANT TO SECTION 1233111.7.
SECTION 3. Article 33 of title 12, Colorado Revised Statutes, 1991 Repl. Vol., as amended, is amended BY THE ADDITION OF A NEW SECTION to read:
1233111.7. Limited prescription authority requirements. (1) AN APPLICATION FOR LIMITED PRESCRIPTIVE AUTHORITY SHALL BE ON A FORM PROMULGATED BY THE BOARD FOR SUCH PURPOSE AND SHALL INCLUDE PROOF OF SATISFACTORY COMPLETION OF THE REQUIREMENTS SET FORTH IN SUBSECTION (2) OF THIS SECTION.
(2) TO QUALIFY FOR LIMITED PRESCRIPTIVE AUTHORITY, A CHIROPRACTOR SHALL HAVE:
(a) COMPLETED A MINIMUM OF SIX THOUSAND HOURS OF FULLTIME CHIROPRACTIC PRACTICE;
(b) SATISFACTORILY COMPLETED TWENTYFOUR HOURS OF COURSE WORK IN INJECTIONS AND INJECTABLES APPROVED BY A CHIROPRACTIC COLLEGE ACCREDITED BY THE COUNCIL ON CHIROPRACTIC EDUCATION; AND
(c) SATISFACTORILY COMPLETED TWENTYFOUR COURSE WORK HOURS IN PHARMACOLOGY AND SEVENTYTWO COURSE WORK HOURS IN PHARMACOTHERAPY, ALL OF WHICH HOURS ARE TAUGHT BY A SCHOOL OF PHARMACY ACCREDITED BY THE AMERICAN COUNCIL ON PHARMACEUTICAL EDUCATION.
(3) A CHIROPRACTOR SHALL NOT MAINTAIN LIMITED PRESCRIPTIVE AUTHORITY OBTAINED PURSUANT TO THIS SECTION UNLESS, EACH YEAR, SUCH CHIROPRACTOR COMPLETES TWELVE COURSE WORK HOURS OF PHARMACOTHERAPY TAUGHT BY A SCHOOL OF PHARMACY ACCREDITED BY THE AMERICAN COUNCIL ON PHARMACEUTICAL EDUCATION. SUCH TWELVE HOURS SHALL NOT BE IN ADDITION TO THE FIFTEEN HOURS REQUIRED PURSUANT TO SECTION 1233116.
SECTION 4. 1233116, Colorado Revised Statutes, 1991 Repl. Vol., is amended to read:
1233116. Continuing education. (1) It is hereby expressly declared to be the purpose of this section to provide for an increase in the annual scientific educational requirements of licensed Colorado chiropractors. Each licensed Colorado chiropractor in active practice within the state of Colorado shall be required annually to attend not less than fifteen hours of scientific clinics, forums, or chiropractic educational study consisting of subjects basic to the field of the healing arts as set forth in section 1233111. Each year at the time of its regular June meeting the board shall prepare an educational schedule of minimum postgraduate requirements of subjects as set forth in section 1233111 that shall be met by any school, clinic, forum, or convention giving such educational work, and such minimum standards must be complied with by such school, clinic, forum, or convention before the board issues a postgraduate attendance certificate. Credit hours shall be determined by the board. Applicants shall apply to the board prior to or after the course and present proof of attendance and synopsis of the course content for approval of credit hours. This provision is made mandatory in the best interest of public health and welfare and to provide progress in the field of chiropractic. If any licensed chiropractor is unable to comply with this section on account of dire emergency and for good cause shown, the board may waive the provisions of this section.
(2) ANY COURSE WORK HOURS COMPLETED IN PHARMACOTHERAPY PURSUANT TO SECTION 1233111.7, FOR THE PURPOSE OF MAINTAINING LIMITED PRESCRIPTIVE AUTHORITY SHALL BE APPLIED TO THE FIFTEEN HOURS REQUIRED UNDER SUBSECTION (1) OF THIS SECTION.
SECTION 5. 1233117 (1) (a) and (1) (v), Colorado Revised Statutes, 1991 Repl. Vol., as amended, are amended to read:
1233117. Discipline of licensees letters of admonition, suspension, revocation, denial, and probation grounds. (1) Upon any of the following grounds, the board may issue a letter of admonition to a licensee or may revoke, suspend, deny, refuse to renew, or impose conditions on such licensee's license:
(a) Using fraud, misrepresentation, or
deceit in applying for, securing, renewing, or seeking reinstatement
of a license,
taking an examination provided for in this article, APPLYING FOR
LIMITED PRESCRIPTIVE AUTHORITY, OR COMPLETING THE QUALIFICATION
REQUIREMENTS SET FORTH IN SECTION 1233111.7;
(v) Engaging in any of the following activities and practices:
and repeated ordering or performance
WILLFULLY AND REPEATEDLY ORDERING OR PERFORMING, without clinical
demonstrably unnecessary laboratory tests or studies;
ADMINISTERING, without clinical justification, of
THAT is demonstrably unnecessary;
failure FAILING to obtain consultations
or perform referrals when failing to do so is not consistent with
the standard of care for the profession; or
(IV) Ordering or performing, without clinical
justification, any service, Xray, or treatment
THAT is contrary to recognized standards of the practice of chiropractic
as interpreted by the board; OR
(V) PRESCRIBING OR ADMINISTERING NONCONTROLLED LEGEND DRUGS WITHOUT HAVING LIMITED PRESCRIPTIVE AUTHORITY, PURSUANT TO SECTION 1233111.7.
SECTION 6. Effective date applicability. This act shall take effect July 1, 1997, and shall apply to acts occurring on or after said date.
SECTION 7. Safety clause. The general assembly hereby finds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, and safety.