First Regular Session
Sixty-second General Assembly
LLS NO. 99-0528.01 Robert Neill SENATE BILL 99-158
STATE OF COLORADO
BY SENATORS Hernandez, Hillman, and Musgrave;
also REPRESENTATIVES Dean, Alexander, and McKay.
HEALTH, ENVIRONMENT, WELFARE & INSTITUTIONS
APPROPRIATIONS
A BILL FOR AN ACT
101 CONCERNING ADEQUATE TRAINING TO PERFORM SPINAL MANIPULATION,
102 AND, IN CONNECTION THEREWITH, SANCTIONING VIOLATIONS OF
103 THE TRAINING REQUIREMENTS.
Bill Summary
(Note: This summary applies to this bill as introduced and does
not necessarily reflect any amendments that may be subsequently
adopted.)
Declares that adequate training is necessary to protect the people
of the state from the unauthorized, unqualified, and improper application
of spinal adjustment. Defines spinal adjustment as treatment whereby a
health care provider uses directed, brief, and sudden impulsion, thrust, or
leverage to move or mobilize a joint or joints of a patient's spine.
Requires that anyone performing spinal adjustment must be a
doctor of medicine, doctor of osteopathy, or doctor of chiropractic, with
adequate training as prescribed by their respective board of examiners or
as required by this article. Provides that a health care provider must not
perform or authorize any spinal adjustment without having first received
at least 500 hours of classroom instruction and at least 900 hours of
supervised clinical training.
Provides that claiming to be able to diagnose or perform spinal
adjustment without adequate training is a deceptive trade practice under
the "Colorado Consumer Protection Act". Makes it unlawful to
fraudulently hold oneself out to the public as licensed to perform spinal
adjustment, to fraudulently sell a license, to obtain or furnish a fraudulent
license, or to aid or abet therein. Provides that violations of this article
are grounds for suspension or revocation of an offender's license,
nonrenewal of an offender's license, or other disciplinary action
authorized by law.
[ ] denotes HOUSE amendment. { } denotes SENATE amendment.
Capital letters indicate new material to be added to existing statute.
Dashes through the words indicate material to be deleted from existing statute.
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Provides that the state boards of chiropractic and medical
examiners may apply for an injunction to enjoin any person from
committing any act prohibited by this article.
1 Be it enacted by the General Assembly of the State of Colorado:
2 SECTION 1. Title 12, Colorado Revised Statutes, is amended BY
3 THE ADDITION OF A NEW ARTICLE to read:
4 ARTICLE 43.2
5 Spinal Adjustment
12-43.2-101. Legislative declaration. THE GENERAL ASSEMBLY
6 HEREBY FINDS AND DECLARES THAT, IN ORDER TO SAFEGUARD THE PUBLIC
7 HEALTH, SAFETY, AND WELFARE OF THE PEOPLE OF THIS STATE AND IN
8 ORDER TO PROTECT THE PEOPLE OF THIS STATE AGAINST THE
9 UNAUTHORIZED, UNQUALIFIED, AND IMPROPER APPLICATION OF SPINAL
10 MANIPULATION OR ADJUSTMENT, ADEQUATE TRAINING IS NECESSARY AND
11 SHOULD BE REQUIRED.
12 12-43.2-102. Definitions. AS USED IN THIS ARTICLE, UNLESS THE
13 CONTEXT OTHERWISE REQUIRES:
14 (1) "SPINAL MANIPULATION" AND "SPINAL ADJUSTMENT" ARE
15 INTERCHANGEABLE TERMS THAT MEAN A METHOD OF SKILLFUL DIAGNOSIS
16 AND TREATMENT WHEREBY A HEALTH CARE PROVIDER USES DIRECTED,
17 BRIEF, AND SUDDEN IMPULSION, THRUST, OR LEVERAGE TO MOVE OR
18 MOBILIZE A JOINT OR JOINTS OF A PATIENT'S SPINE BEYOND ITS PASSIVE
19 RANGE OF MOTION BUT WITHOUT EXCEEDING THE LIMITS OF ANATOMICAL
20 INTEGRITY. FOR PURPOSES OF THIS SECTION, "SPINAL MANIPULATION" AND
21 "SPINAL ADJUSTMENT" DO NOT INCLUDE EITHER THE ORTHOPEDIC
22 REDUCTION OF FRACTURES AND DISLOCATIONS OR JOINT MOBILIZATION IN
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1 WHICH NO SUDDEN IMPULSION, THRUST, OR LEVERAGE IS USED AND THE
2 PATIENT'S JOINT IS NOT MOVED BEYOND ITS NORMAL PASSIVE RANGE OF
3 MOTION.
4 12-43.2-103. Spinal manipulation or adjustment prohibited
5 unless performed by a doctor or a person with adequate training.
6 (1) TO PERFORM SPINAL MANIPULATION OR ADJUSTMENT, THE HEALTH
7 CARE PROVIDER MUST BE A DOCTOR OF MEDICINE, DOCTOR OF
8 OSTEOPATHY, OR DOCTOR OF CHIROPRACTIC, LICENSED PURSUANT TO THIS
9 TITLE WITH ADEQUATE TRAINING AS PRESCRIBED BY THEIR RESPECTIVE
10 BOARD OF EXAMINERS, OR MUST HAVE ADEQUATE TRAINING AS SET FORTH
11 IN SUBSECTION (2) OF THIS SECTION.
12 (2) NO HEALTH CARE PROVIDER SHALL PERFORM SPINAL
13 MANIPULATION OR ADJUSTMENT WITHOUT ADEQUATE TRAINING OR
14 PERMIT, DIRECT, OR AUTHORIZE ANY PERSON UNDER THE PROVIDER'S
15 DIRECT SUPERVISION TO PERFORM SPINAL MANIPULATION OR ADJUSTMENT
16 WITHOUT ADEQUATE TRAINING. ADEQUATE TRAINING MEANS HAVING
17 FIRST RECEIVED A MINIMUM OF FIVE HUNDRED HOURS OF CLASSROOM
18 INSTRUCTION IN DIAGNOSIS AND IN SPINAL MANIPULATION OR
19 ADJUSTMENT, AND A MINIMUM OF NINE HUNDRED HOURS OF SUPERVISED
20 CLINICAL TRAINING AT A FACILITY WHERE SPINAL MANIPULATION OR
21 ADJUSTMENT IS A PRIMARY METHOD OF TREATMENT, OR AT A FACILITY
22 APPROVED BY THE COLORADO STATE BOARD OF MEDICAL EXAMINERS OR
23 THE COLORADO STATE BOARD OF CHIROPRACTIC EXAMINERS, OR THROUGH
24 COURSES APPROVED BY THE COLORADO STATE BOARD OF MEDICAL
25 EXAMINERS OR THE COLORADO STATE BOARD OF CHIROPRACTIC
26 EXAMINERS.
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1 12-43.2-104. Deceptive trade practice. IT SHALL BE A DECEPTIVE
2 TRADE PRACTICE UNDER THE COLORADO CONSUMER PROTECTION ACT,
3 ARTICLE 1 OF TITLE 6, C.R.S., FOR ANY HEALTH CARE PROVIDER TO CLAIM,
4 EITHER ORALLY OR IN WRITING, TO BE ABLE TO DIAGNOSE OR PERFORM
5 SPINAL MANIPULATION OR ADJUSTMENT UNLESS SUCH PERSON IS A
6 LICENSED DOCTOR OF MEDICINE, DOCTOR OF OSTEOPATHY, OR DOCTOR OF
7 CHIROPRACTIC OR HAS RECEIVED ADEQUATE TRAINING AS SET FORTH IN
8 THIS ARTICLE.
9 12-43.2-105. Sanctions. VIOLATIONS OF THE PROVISIONS OF THIS
10 ARTICLE SHALL BE GROUNDS FOR THE SUSPENSION OR REVOCATION OF THE
11 OFFENDING HEALTH CARE PROVIDER'S LICENSE, CERTIFICATE, OR
12 REGISTRATION, FOR THE REFUSAL TO RENEW THE HEALTH CARE PROVIDER'S
13 LICENSE, CERTIFICATE, OR REGISTRATION, OR FOR TAKING ANY OTHER
14 DISCIPLINARY ACTION AUTHORIZED BY LAW.
15 12-43.2-106. Unlawful acts. (1) IT IS UNLAWFUL FOR ANY
16 PERSON:
17 (a) TO VIOLATE THE PROVISIONS OF THIS ARTICLE;
18 (b) TO USE IN CONNECTION WITH HIS OR HER NAME ANY
19 DESIGNATION TENDING TO IMPLY THAT HE OR SHE IS LICENSED PURSUANT
20 TO THIS ARTICLE OR CERTIFIED TO PERFORM SPINAL MANIPULATION OR
21 ADJUSTMENT WITHOUT FIRST BEING A LICENSED DOCTOR OF MEDICINE,
22 DOCTOR OF OSTEOPATHY, OR DOCTOR OF CHIROPRACTIC AND HAVING
23 RECEIVED ADEQUATE TRAINING;
24 (c) TO SELL OR FRAUDULENTLY OBTAIN OR FURNISH A LICENSE OR
25 TO CERTIFY A PERSON AS BEING ABLE TO DIAGNOSE OR PERFORM SPINAL
26 MANIPULATION OR ADJUSTMENT WITHOUT FIRST BEING A LICENSED
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1 DOCTOR OF MEDICINE, DOCTOR OF OSTEOPATHY, OR DOCTOR OF
2 CHIROPRACTIC AND HAVING RECEIVED ADEQUATE TRAINING OR TO AID OR
3 ABET THEREIN.
4 12-43.2-107. Injunctive proceedings. (1) THE COLORADO STATE
5 BOARD OF MEDICAL EXAMINERS OR THE COLORADO STATE BOARD OF
6 CHIROPRACTIC EXAMINERS MAY, IN THE NAME OF THE PEOPLE OF THE
7 STATE OF COLORADO AND THROUGH THE ATTORNEY GENERAL OF THE
8 STATE OF COLORADO, APPLY FOR AN INJUNCTION IN ANY COURT OF
9 COMPETENT JURISDICTION TO ENJOIN ANY PERSON FROM COMMITTING ANY
10 ACT PROHIBITED BY THE PROVISIONS OF THIS ARTICLE.
11 (2) IF IT IS ESTABLISHED THAT THE DEFENDANT HAS BEEN OR IS
12 COMMITTING ANY ACT PROHIBITED BY THIS ARTICLE, THE COURT SHALL
13 ENTER A DECREE PERPETUALLY ENJOINING SAID DEFENDANT FROM
14 FURTHER COMMITTING SAID ACT OR FROM PRACTICING SPINAL
15 MANIPULATION OR ADJUSTMENT.
16 (3) SUCH INJUNCTIVE PROCEEDINGS SHALL BE IN ADDITION TO AND
17 NOT IN LIEU OF ALL PENALTIES AND OTHER REMEDIES PROVIDED IN THIS
18 TITLE.
19 (4) WHEN SEEKING AN INJUNCTION UNDER THIS SECTION, THE
20 BOARD SHALL NOT BE REQUIRED TO ALLEGE OR PROVE EITHER THAT AN
21 ADEQUATE REMEDY AT LAW DOES NOT EXIST OR THAT SUBSTANTIAL OR
22 IRREPARABLE DAMAGE WOULD RESULT FROM A CONTINUED VIOLATION.
23 SECTION 2. 6-1-105 (1), Colorado Revised Statutes, is amended
24 BY THE ADDITION OF A NEW PARAGRAPH to read:
25 6-1-105. Deceptive trade practices. (1) A person engages in a
26 deceptive trade practice when, in the course of such person's business,
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1 vocation, or occupation, such person:
2 (rr) CLAIMS, EITHER ORALLY OR IN WRITING, TO BE ABLE TO
3 DIAGNOSE OR PERFORM SPINAL MANIPULATION OR ADJUSTMENT UNLESS
4 SUCH PERSON IS A LICENSED DOCTOR OF MEDICINE, DOCTOR OF
5 OSTEOPATHY, OR DOCTOR OF CHIROPRACTIC AND HAS RECEIVED
6 ADEQUATE TRAINING PURSUANT TO SECTION 12-43.2-103, C.R.S.
7 SECTION 3. Safety clause. The general assembly hereby finds,
8 determines, and declares that this act is necessary for the immediate
9 preservation of the public peace, health, and safety.