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  1. 1. Presentation on Chiropractic Assistants Salvatore LaRusso, D.C, Chairman Board of Chiropractic Medicine
  2. 2. What is a chiropractic assistant? <ul><li>The Florida Legislature created section 460.4165, Florida Statutes to encourage the more effective utilization of the skills of chiropractic physicians by enabling them to delegate health care tasks to qualified assistants when such delegation is consistent with the patient's health and welfare and to allow for innovative development of programs for the education of physician's assistants. </li></ul><ul><li>There are two categories of chiropractic assistants: Registered Chiropractic Assistants (RCA) and Certified Chiropractic Physician’s Assistants (CCPA). </li></ul>
  3. 3. Definitions <ul><li>Registered Chiropractic Assistant </li></ul><ul><li>direct supervision </li></ul><ul><li>patient care management </li></ul><ul><li>executes administrative and clinical procedures </li></ul><ul><li>performs managerial and supervisory functions. </li></ul><ul><li>Certified Chiropractic Physician’s Assistant </li></ul><ul><li>24 month Chiropractic Education </li></ul><ul><li>performing tasks traditionally performed by the Chiropractic physician </li></ul><ul><li>indirect supervision </li></ul><ul><li>case histories, diagnostic testing, physical examinations, and therapeutic procedures </li></ul><ul><li>cannot perform adjustive procedures, diagnostic testing interpretations, treatment advice, or the taking of x-rays unless properly certified. </li></ul>
  4. 4. More Definitions <ul><li>Supervising physician - licensed DC approved by the Board, may supervise more than one CCPA. </li></ul><ul><li>Responsible supervision - ability to responsibly exercise control and provide direction </li></ul>
  5. 5. Responsible Supervision <ul><li>In determining responsible supervision the following factors must be considered: </li></ul><ul><li>background and training </li></ul><ul><li>skill of the assistant </li></ul><ul><li>adequacy of the direction in terms of form </li></ul><ul><li>the setting where tasks are performed </li></ul><ul><li>availability of the supervising physician </li></ul><ul><li>the necessity for immediate attention </li></ul><ul><li>the number of other persons the DC supervises </li></ul>
  6. 6. More Definitions <ul><li>Direct supervision requires the physical presence of the licensed supervising DC on the premises </li></ul><ul><li>Indirect supervision responsible supervision and control and easy availability of the supervising DC for consultation and direction </li></ul><ul><li>Easy availability means either physically present or within 30 minutes of the treatment location. Supervising DC must be available by communication devices such as telephone, two-way radio, medical beeper or other electronic means </li></ul>
  7. 7. Laws and Rules <ul><li>Chapter 460, Florida Statutes is the law that governs the chiropractic profession. </li></ul><ul><li>Rule 64B2, Florida Administrative Code are the rules of the Board of Chiropractic Medicine. </li></ul>
  8. 8. Registered Chiropractic Assistants <ul><li>DUTIES.--Under the direct supervision and responsibility of a licensed DC or licensed CCPA, an RCA may: </li></ul><ul><li>prepare patients for the DC care </li></ul><ul><li>take vital signs </li></ul><ul><li>observe and report patients' signs or symptoms </li></ul><ul><li>administer basic first aid </li></ul><ul><li>assist with patient examinations or treatments </li></ul><ul><li>operate office equipment. </li></ul><ul><li>collect routine laboratory specimens </li></ul><ul><li>administer nutritional supplements </li></ul><ul><li>perform office procedures </li></ul><ul><li>RCAs may register for a biennial fee of $25. </li></ul>
  9. 9. CCPA Duties <ul><li>CCPAs may perform services only: </li></ul><ul><li>In the primary practice location of the supervising DC </li></ul><ul><li>Under indirect supervision </li></ul><ul><li>In a hospital in which the supervising DC is a member of the staff </li></ul><ul><li>On calls outside the primary practice location on the direct order of the supervising DC </li></ul>
  10. 10. Certification of Supervisors <ul><li>Any chiropractic physician desiring to supervise, employ or work with a CCPA shall make application to the Board on forms provided by the Board. </li></ul><ul><li>The Board shall certify the physician or group of physicians to supervise a CCPA. </li></ul><ul><li>Certifications to supervise shall remain valid for one year and must be renewed annually . </li></ul><ul><li>A fee of $100.00 is required for authorization to supervise a CCPA. </li></ul>
  11. 11. Method of Performance <ul><li>An assistant must clearly identify himself or herself by appropriate identification as a CCPA or RCA to insure that he or she is not mistaken for a licensed physician (for example, a name tag). </li></ul><ul><li>The assistant must generally function in reasonable proximity to the supervising physician. If he or she is to perform away from the supervising physician, these duties must be clearly specified in the supervising physician’s application to the Board. </li></ul>
  12. 12. Pending Rule Changes <ul><li>Definitions: </li></ul><ul><li>supervising physician at a ratio no greater than 2 CCPAs to one supervisor </li></ul><ul><li>indirect supervision only in a practice that is exempt from licensure under Part X, Chapter 400, F.S., and wholly owned by one or more chiropractic physicians or by a chiropractic physician and the spouse, parent, child, or sibling of that chiropractic physician. </li></ul>
  13. 13. Application for Certification as a Chiropractic Physician’s Assistant <ul><li>As part of the application process, the Board shall interview the supervising chiropractic physician and the applicant about the work arrangement proposed in the application. </li></ul><ul><li>Applicants must successfully complete 24 months of chiropractic education which is accredited by, or has status with the Council on Chiropractic Education or its predecessor agency. </li></ul><ul><li>The application shall be accompanied by a diploma, written verification of completion of the 24 months of chiropractic education from the educational institution </li></ul><ul><li>Successful completion is deemed to mean obtaining a raw score of 75% on a comprehensive examination covering the entire education and training program. </li></ul>