South Carolina General Assembly
116th Session, 2005-2006

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S. 612

STATUS INFORMATION

General Bill
Sponsors: Senator Fair
Document Path: l:\council\bills\nbd\11168ac05.doc
Companion/Similar bill(s): 3409

Introduced in the Senate on March 10, 2005
Currently residing in the Senate Committee on Labor, Commerce and Industry

Summary: Chiropractor licensure and regulation

HISTORY OF LEGISLATIVE ACTIONS

     Date      Body   Action Description with journal page number
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   3/10/2005  Senate  Introduced and read first time SJ-4
   3/10/2005  Senate  Referred to Committee on Labor, Commerce and Industry 
                        SJ-4

View the latest legislative information at the LPITS web site

VERSIONS OF THIS BILL

3/10/2005

(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

A BILL

TO AMEND CHAPTER 9, TITLE 40, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE LICENSURE AND REGULATION OF CHIROPRACTORS, SO AS TO CONFORM THIS CHAPTER TO THE STATUTORY AND ORGANIZATIONAL FRAME WORK ESTABLISHED FOR PROFESSIONAL AND OCCUPATIONAL BOARDS IN CHAPTER 1, TITLE 40 UNDER THE ADMINISTRATION OF THE DEPARTMENT OF LABOR, LICENSING, AND REGULATION, AND TO FURTHER PROVIDE FOR THE LICENSURE AND REGULATION OF CHIROPRACTORS, INCLUDING AUTHORIZING THE TREATMENT OF ARTICULATION AND EXTREMITIES AND THE USE OF ACUPUNCTURE UNDER CERTAIN CONDITIONS, CLARIFYING THAT ONLY CHIROPRACTORS MAY PERFORM SPINAL ADJUSTMENT AND EXAMINATIONS TO EVALUATE FOR TREATMENT, PROVIDING FOR PRECEPTORSHIP TRAINING, AUTHORIZING DELEGATION OF CERTAIN TREATMENT, ALLOWING OUT-OF-STATE CHIROPRACTORS TO OBTAIN LICENSURE BY ENDORSEMENT AND TO SERVE AS CONSULTANTS, REQUIRING MALPRACTICE INSURANCE, AUTHORIZING THE BOARD TO OBTAIN CERTAIN MEDICAL AND PSYCHOLOGICAL RECORDS ON APPLICANTS, AND ESTABLISHING BOARD IMMUNITY FROM LIABILITY.

Be it enacted by the General Assembly of the State of South Carolina:

SECTION    1.    Chapter 9, Title 40 of the 1976 Code is amended to read:

"CHAPTER 9

Chiropractors and Chiropractic

Section 40-9-10.    As used in this chapter:

(a) "Chiropractic" is defined as that science and art which utilizes the inherent recuperative powers of the body and deals with the relationship between the nervous system and the spinal column, including its immediate articulations and the role of this relationship in the restoration and maintenance of health.

(b) "Chiropractic practice" is defined as the spinal analysis of any interference with normal nerve transmission and expression, and by adjustment to the articulations of the vertebral column and its immediate articulations for the restoration and maintenance of health and the normal regimen and rehabilitation of the patient without the use of drugs or surgery.

(c) "Analysis" is defined as physical examination, the use of x-ray and procedures generally used in the practice of chiropractic.

(d) Any machine used in "chiropractic practice" or "analysis" must first be approved by the South Carolina Board of Chiropractic Examiners.

Section 40-9-20.    No person may practice chiropractic in this State without a license issued by the South Carolina Board of Chiropractic Examiners as provided in this chapter, except that senior students of any chiropractic college chartered by the State may perform without a license chiropractic procedures under the supervision of a chiropractor licensed in South Carolina on the college staff. These procedures and this supervision must be practiced within the confines of the appropriate chiropractic college. However, no charges for professional service may be made to any patient or to his insurance company for any work performed on the patient by the senior students or by the licensed chiropractor on the college staff while supervising the senior students. The chiropractic college may charge the patient for the actual costs and expenses it incurs for the use of its clinical property or facilities by the patient. However, this section does not apply to any chiropractic college which has failed to attain accredited status from the Council on Chiropractic Education or its successors or from the Commission on Accreditation of the Straight Chiropractic Academic Standards Association.

Section 40-9-30.    (A) There is hereby created the South Carolina Board of Chiropractic Examiners consisting of eight members. One licensed chiropractor must be appointed by the Governor from each congressional district and must be a chiropractor residing and practicing in the district the chiropractor represents. The board shall certify in writing to the Governor the names of the two nominees who received the highest number of votes in each district's election conducted pursuant to Section 40-9-37. The Governor may reject any or all of the nominees upon satisfactory showing of the unfitness of those rejected. If the Governor declines to appoint any of the nominees submitted, additional nominees must be submitted in the same manner. One member of the board, who must be a licensed and practicing chiropractor, must be appointed by the Governor from the State at large, and one member, who may not be a member of the chiropractic or medical profession, must be appointed by the Governor. The conduct of the balloting for the nominees for the board from the respective congressional districts is the responsibility of the Board of Chiropractic Examiners. Each chiropractic member must be a licensed and practicing chiropractor in South Carolina in good standing for a period of five years preceding the date of appointment to the board.

(B) All terms are for four years and until their successors are appointed and qualify. The Governor may remove a member of the board who is guilty of continued neglect of board duties, guilty of a misdemeanor or a felony, or who is found to be incompetent. No member may be removed without first giving the member an opportunity to refute the charges filed against that member who must be given a copy of the charges at the time they are filed.

(C) The South Carolina Board of Chiropractic Examiners shall meet at least twice a year at a time and place as determined by the board. The board shall hold elections for its officers each year. The board may call additional meetings when necessary for the transaction of board business. The board shall adopt regulations for its government, for judging the professional and ethical competence of chiropractors, including compliance with the code of chiropractic ethics, and for the discipline of chiropractors. A majority of the board constitutes a quorum for the transaction of business.

(D) The board may:

(1) establish suitable procedures for carrying out its duties pursuant to this chapter;

(2) execute certificates which must be accepted in the courts of this State and by an administrative law judge as provided under Article 5 of Chapter 23 of Title 1 as the best evidence of the minutes of the board and the best evidence of whether a person is registered under the requirements of this chapter;

(3) adopt and revise regulations not inconsistent with the law as may be necessary to carry out this chapter including, but not limited to, regulations concerning patient care and treatment, solicitation of patients, and advertising; however, the board may not prohibit or discriminate against advertising in any particular media;

(4) conduct investigations and cause the prosecution of all persons violating this chapter and have power to incur necessary expenses for this;

(5) keep a record of all its proceedings;

(6) (reserved);

(7) fix the time for holding its meetings;

(8) examine, license, and renew the licenses of qualified applicants and certify applicants as to their ability and as to the degree of their practice of chiropractic as authorized under the laws of this State; however, the nonchiropractic member of the board may not participate in the examination of a license applicant on matters of technical or professional nature; the board shall use the National Board Examination of the National Board of Chiropractic Examiners in lieu of the state written examination for persons graduating from an approved chiropractic college pursuant to Section 40-9-40 after July 1, 1982;

(9) judge the professional and ethical competence of chiropractors, establish a code of chiropractic ethics, and provide for the discipline of chiropractors;

(10) order the revocation, suspension, or restriction of the license of a licensee to practice chiropractic or take other disciplinary action, including assessing a civil fine for a violation of this chapter;

(11) assess and collect costs from a licensee for investigating a complaint and conducting proceedings pursuant to this chapter.

Section 40-9-31. (A) An action of the board relating to the revocation or suspension of a license or other action restricting a license or disciplining a licensee must be taken only after a written complaint of misconduct has been filed with the board in accordance with regulations promulgated by the board. After receiving a complaint a closed hearing must be held by an examiner selected by the board after thirty days' notice to the complainant and the licensee or their counsel. The Attorney General's office, upon request of the board, shall present the case for the complainant before the examiner. Upon receipt of the examiner's report, the board shall notify the complainant and the licensee and the licensee's counsel of the time and place at which the board will consider the report for the purpose of determining its action on the report; the notice must be given not less than ten days before the meeting. The complainant and the licensee and the licensee's counsel have the right to appear before the board at the meeting, submit briefs, and be heard in oral argument in opposition to or in support of the recommendations of the board. The Attorney General's office also has the right to appear before the board and submit briefs and be heard in oral argument. Upon its final review the board may either dismiss the complaint or find that the licensee is guilty of misconduct meriting sanction. The board shall file a final certified report of the proceedings before it with the secretary of the board who shall notify the complainant and the licensee and the licensee's counsel of this action. A decision of the board to revoke, suspend, or restrict a license or to limit or discipline a person engaging in the practice of chiropractic requires a majority vote of the membership of the board. The board's decision may be appealed to an administrative law judge as provided under Article 5 of Chapter 23 of Title 1, which shall hear the matter upon petition filed by the licensee with an administrative law judge as provided under Article 5 of Chapter 23 of Title 1, and served upon the secretary of the board within ten days from the date of delivery of the board's decision to the licensee. A decision by the board to revoke, suspend, or restrict a license or to limit or discipline a licensee or one who is found to be practicing chiropractic without complying with this chapter is not effective until the tenth day following the date of delivery of a written copy of the decision to the licensee. Service of a petition for a review of the decision stays the board's decision pending completion of the appellate process.

(B) If a licensee is found to have violated this chapter or a regulation promulgated under this chapter, in addition to or instead of taking action to revoke, suspend, or restrict the license of the licensee, the board may assess a civil fine of up to two thousand dollars for each violation, but the total fine may not exceed ten thousand dollars.

Section 40-9-35.    Members of the Board and persons authorized by the Board, engaged in business for the Board, shall receive for their services a per diem as determined by the Board, and travel expenses as provided by law for state boards, committees and commissions. Such compensation shall be paid from board funds.

Section 40-9-36.    The Director of the Department of Labor, Licensing, and Regulation, pursuant to Section 40-73-15 may appoint and employ a qualified person to serve as executive director, and shall fix his compensation and define his duties. The executive director of the board shall have the power to make contracts, with board approval, for the furtherance of the board's functions and the management of the office. The Director of the Department of Labor, Licensing, and Regulation may employ such other persons as may be necessary to carry on its work. The salaries of employees and necessary expenses incurred in the performance of their duties shall be paid out of funds held by the board.

Section 40-9-37.    Each chiropractor, licensed pursuant to Title 40, Chapter 9, Code of Laws of South Carolina, 1976, and residing within the congressional district from which the appointment is to be made, shall be entitled to vote in the advisory election. A ballot shall be sent by certified mail to each licensed chiropractor residing in that congressional district from which the appointment is to be made. The ballot shall contain the name of each chiropractor licensed pursuant to this chapter and residing within the congressional district from which the appointment is to be made, as indicated by the records of the Board of Chiropractic Examiners or its predecessor. For the initial election the records used shall be the records of the South Carolina Board of Chiropractic Examiners on May 10, 1978. A space shall be provided for write-in votes for qualified candidates whose names do not appear on the ballot. The ballot shall specify the date by which the returned ballot must be received by the agency conducting the advisory election. The ballots shall be opened at 9:00 A.M. on the day following the date specified for the receipt of the ballots and the results shall be tabulated. The tabulated results shall be immediately forwarded to the Governor.

Section 40-9-38.    Vacancies on the Board shall be filled in the manner of the original appointment for the unexpired term.

Section 40-9-39.    Notwithstanding any other provision of law, no appointive member of the above Board shall be allowed to serve more than two full consecutive terms on the Board; provided, however, that an appointive member who has served for the remainder of a former member's unexpired term shall be allowed to then serve two additional full terms.

Section 40-9-40.    No person may be granted a license to engage in the practice of chiropractic unless he presents proof that he has at least two years of pre-professional college credits from a college or university accredited by the Southern Association of Colleges and Schools or an accrediting agency of equal status and recognition and that he is a graduate of a chiropractic college which is accredited by or has recognized candidate status with the Council on Chiropractic Education or with the Commission on Accreditation of the Straight Chiropractic Academic Standards Association or meets equivalent standards.

Section 40-9-45.    All students of any chiropractic college chartered by the State shall have two years of preprofessional college credits from a college or university accredited by the Southern Association of Colleges and Secondary Schools or an accrediting agency of equal status and recognition prior to enrollment. Provided, that the educational qualifications required of students entering chiropractic colleges shall not apply to students enrolled prior to July 1, 1974.

Section 40-9-50.     All applicants for a license examination shall file with the Secretary of the Board, on or before a specified date to be determined by the Board, a completed application to be provided by the Board, supported by proper credentials and the payment of a fee to be set by the Board.

Section 40-9-60.    In case the applicant fails in the first examination, he shall be entitled to a second examination at the next regular meeting of the Board.

Section 40-9-70.    The Board shall have authority to grant licensure in accordance with item (8) of Section 40-9-30 by reciprocity to applicants from states having commensurate requirements as provided in this chapter and which also grant reciprocal privileges to licensees of this State provided that an applicant shall have been in practice in that state for at least one year.

Section 40-9-80.    (a)    The Board may set and charge annually a fee for the renewal of a license and set the renewal fee for license holders not practicing in the State or for those inactive at a lower fee than for those practicing in the State. The Board may waive the renewal fee for all licensees who are serving on active duty in the Armed Services of the United States at the time the fee is due.

(b) If the license renewal fee is not paid by the first of July of each year, or within sixty days from the mailing of notice by the Board, whichever is later, the license shall automatically expire and be forfeited. Such license can only be reinstated upon payment of all sums due, and the Board may assess such delinquent holder an additional sum not to exceed twenty-five percent of the amount due as a penalty.

Section 40-9-85.    (A) The South Carolina Board of Chiropractic Examiners is authorized to issue a special volunteer license for chiropractors who wish to devote their expertise exclusively to providing chiropractic care to the needy and indigent in South Carolina. The board will waive all application fees, examination fees, and annual registration fees for any chiropractor licensed in accordance with this section.

(B) The board shall promulgate regulations outlining the qualifications for the issuance of a special volunteer license.

Section 40-9-90.    Misconduct which constitutes grounds for a revocation, suspension or other restriction of a license or other discipline of a licensee shall be based upon a satisfactory showing to the Board of any of the following:

(1) That any false, fraudulent or forged statement has been used, or any fraudulent, deceitful or dishonest act has been practiced by the holder of a license in connection with any of the licensing requirements.

(2) That the holder of a license is addicted to alcohol or drugs to such a degree as to render him unfit to practice chiropractic.

(3) That the holder of a license has been convicted of the illegal or unauthorized practice of chiropractic.

(4) That the holder of a license has knowingly performed any act which in any way assists an unlicensed person to practice chiropractic.

(5) That the holder of a license has sustained any physical or mental disability which renders further practice by him dangerous to the public.

(6) That the holder of a license has violated the code of ethics or regulations as adopted by the State Board of Chiropractic Examiners.

(7) That the holder of a license is guilty of engaging in any dishonorable, unethical or unprofessional conduct that is likely to deceive or harm the public.

(8) That the holder of a license is guilty of the use of any false or fraudulent statement in any document connected with the practice of chiropractic.

(9) That the holder of a license is guilty of obtaining fees or assisting in obtaining such fees under dishonorable, false or fraudulent circumstances.

(10) That the holder of a license has intentionally violated or attempted to violate, directly or indirectly, or is assisting in or abetting the violation or conspiring to violate any provisions or terms of the laws of chiropractic practice.

(11) That the holder of a license is guilty of the commission of any act, during the course of practice conducted pursuant to a license issued under this chapter, that constitutes fraud, dishonest dealing, illegality, incompetence or gross negligence.

In addition to all other remedies and actions provided for in this chapter, the license of any chiropractor adjudged mentally incompetent by any court of competent jurisdiction shall be automatically suspended by the Board until he is adjudged by the court or in any other manner provided by law as being restored to mental competency.

Section 40-9-95.    For the purpose of any investigation or proceeding under the provisions of this chapter, the board or any person designated by it may administer oaths and affirmations, subpoena witnesses, take testimony, and require the production of any documents or records which the board deems relevant to the inquiry. In the case of contumacy by, or refusal to obey a subpoena issued to any person, an administrative law judge as provided under Article 5 of Chapter 23 of Title 1, upon application by the board, may issue an order requiring the person to appear before the board or the person designated by it and produce documentary evidence and to give other evidence concerning the matter under inquiry.

Whenever the board has sufficient evidence that any person is violating any provision of this chapter, it may, in addition to all other remedies, order such person to immediately desist and refrain from such conduct. The board may apply to an administrative law judge as provided under Article 5 of Chapter 23 of Title 1 for an injunction restraining the person from such conduct. An administrative law judge as provided under Article 5 of Chapter 23 of Title 1 may issue a temporary injunction ex parte, and upon notice and full hearing may issue any other order in the matter it deems proper. No bond shall be required of the board by an administrative law judge as provided under Article 5 of Chapter 23 of Title 1 as a condition to the issuance of any injunction or order contemplated by the provisions of this section.

Section 40-9-97.     Every communication, whether oral or written made by or on behalf of any person or firm to the Board or any person designated by it to investigate or otherwise hear matters relating to the revocation, suspension or other restriction on a license or other discipline of a licensee, whether by way of complaint or testimony, shall be privileged; and no action or proceeding, civil or criminal, shall lie against any such person or firm by or on whose behalf such communication shall have been made by reason thereof, except upon proof that such communication was made with malice.

No provision of this chapter shall be construed as prohibiting the respondent or his legal counsel from exercising the respondent's constitutional right of due process under the law, nor to prohibit the respondent from normal access to the charges and evidence filed against him as a part of due process under the law.

Section 40-9-110.     It shall be unlawful for any person to practice chiropractic in violation of the provisions of this chapter, and any person violating any provisions thereof shall upon conviction be fined not more than five hundred dollars or imprisoned for a period not to exceed thirty days, or both, at the discretion of the court. Each violation shall constitute a separate offense. The provisions of this section shall apply to any person or firm aiding or abetting in any violation of this chapter.

Section 40-9-05.    Unless otherwise provided for in this chapter, Article 1, Chapter 1 of Title 40 applies to licensed chiropractors regulated by the Department of Labor, Licensing and Regulation. If there is a conflict between this chapter and Article 1, Chapter 1 of Title 40, the provisions of this chapter control.

Section 40-9-10.    (A)    There is created the South Carolina Board of Chiropractic Examiners consisting of eight members. One licensed chiropractor must be appointed by the Governor from each congressional district who must be a chiropractor residing in the district the chiropractor represents. The board shall conduct an election to nominate two chiropractors for each congressional district and shall certify in writing to the Governor the names of the two nominees who received the highest number of votes in each district's election. The Governor may reject any or all of the nominees upon satisfactory showing of the unfitness of those rejected. If the Governor declines to appoint any of the nominees submitted, additional nominees must be submitted in the same manner. One member of the board, who must be a licensed and practicing chiropractor, must be appointed by the Governor from the State at large, and one member, who must not be a member of the chiropractic or medical profession, must be appointed by the Governor. Each chiropractic member must be a licensed and practicing chiropractor in this State in good standing for a period of five years preceding the date of appointment to the board.

(B)    All terms are for four years and until their successors are appointed and qualify. The Governor may remove a member of the board in accordance with Section 1-3-240. A member must not be removed without being given a copy of the charges at the time they are filed and without first giving the member an opportunity to refute the charges.

(C)    Notwithstanding any other provision of law, a member of the board must not serve more than two full consecutive terms on the board; however, a member who has served for the remainder of a former member's unexpired term may serve two additional full terms consecutively.

Section 40-9-20.    As used in this chapter:

(1)    'Active license' means the status with the board of a license that has been renewed for the current period and that authorizes the licensee to practice chiropractic in this state.

(2)    'Adjustment or manipulation' means, upon proper diagnosis, the skillful and dexterous treatment whereby a corrective force or passive movement of the joint is made to realign vertebrae or articulations to their normal juxtapositioning to decrease nerve interference, to increase circulation, to increase range of motion, or to reduce interosseous disrelationship.

(3)    'Analysis' is defined as physical examination, the use of x-ray and procedures generally used in the practice of chiropractic. Any machine used in 'chiropractic practice' or 'analysis' must first be approved by the board.

(4)    'Chiropractic' is defined as that science and art which utilizes the inherent recuperative powers of the body and deals with the relationship between the nervous system and the spinal column, including its articulations and extremities, and the role of these relationships in the restoration and maintenance of health and function.

(5)    'Chiropractic intern or resident' means a chiropractic student enrolled and in good standing in an approved college of chiropractic who is participating in a preceptorship or residency training program.

(6)    'Chiropractic practice' is defined as the spinal analysis of any interference with normal nerve transmission and expression, and as adjustment to the articulations of the vertebral column and its articulations for the restoration and maintenance of health and the normal regimen and rehabilitation of the patient without the use of prescription drugs or surgery. Any machine used in 'chiropractic practice' or 'analysis' must first be approved by the board. Chiropractic practice also includes the use of acupuncture when the licensee is trained and certified as provided for in this chapter.

(7)    'Consultant' means a chiropractor licensed in this or another state who gives expert or professional advice to a chiropractor licensed in this State.

(8)    'Department' means the South Carolina Department of Labor, Licensing and Regulation.

(9)    'Direct supervision' means the physical presence of a licensed chiropractor in the immediate area where a patient is being provided chiropractic services. The licensed chiropractor must be on the premises and available to provide immediate and personal assistance and direction.

(10)    'Licensed healthcare practitioner' means a person licensed in this State to practice as a physician, dentist, podiatrist, veterinarian, or nurse practitioner.

(11)    'Preceptor' means a supervising licensed chiropractor.

(12)    'Preceptorship or residency training program' means a clinical program of an approved college of chiropractic in which a chiropractic intern or resident practices chiropractic under the direct supervision of a licensed chiropractor.

Section 40-9-30. (A)    A person may not practice chiropractic without an active license issued in accordance with this chapter. A person whose license has been suspended or revoked, or who uses in connection with the person's name the words or letters 'D.C.', 'Doctor of Chiropractic', 'Chiropractic Physician', 'Chiropractor', or other letters, words or insignia indicating or implying that the person is a licensed chiropractor or who in any other way, orally or in writing or in print or by sign directly or by implication, represents the person as a licensed chiropractor without being licensed by the board is subject to the penalties provided for in this chapter.

(B)    Only a licensed chiropractor may perform a specific spinal adjustment or manipulation on a patient or perform an independent examination for evaluating chiropractic treatment. A licensed chiropractor may delegate tasks to other persons in the chiropractor's office and under the chiropractor's supervision only when the task does not require the skill and judgment of a licensed chiropractor and when the task, if improperly performed, would not result in significant injury to the patient.

(C)    A chiropractor may not refer to himself or herself as a physical therapist or physiotherapist.

(D) Nothing in this chapter may be construed to prohibit:

(1)    a person who is a regular student, technician, or instructor in a lawfully chartered chiropractic educational institution from the performance of those duties and actions conducted as a responsibility in teaching and research or as a requirement for an academic degree or for participation in a preceptorship training program under the direct supervision of a licensed chiropractor;

(2)    a chiropractor holding a current and valid license in another state from acting as a consultant with a licensed chiropractor of this State.

(E)    Nothing in this chapter limits or affects the practice of a person who is licensed in this State who is acting within the scope of the person's licensed practice or profession.

(F)    Nothing in this chapter affects the practice of qualified persons, including licensed chiropractors, to whom a licensed healthcare practitioner has delegated the performance of procedures, therapeutic options, and alternate therapies. The delegating practitioner shall verify the qualifications of these persons and their competencies and is responsible for the care of the patient.

Section 40-9-31.    (A)    An applicant for a license examination shall file with the board, before a specified date to be determined by the board, a completed application to be provided by the board, supported by proper credentials and the payment of a fee established by the board in regulation.

(B)    Before entering a chiropractic college a student must have two years of pre-professional college credits from a college or university accredited by the Southern Association of Colleges and Secondary Schools or an accrediting agency of equal status; however this requirement does not apply to students who entered a chiropractic college before July 1, 1974.

(C)    An applicant shall provide satisfactory evidence of graduation from a chiropractic college accredited by the Council on Chiropractic Education or its successors.

(D)    The board shall use the National Board Examination of the National Board of Chiropractic Examiners in lieu of a state written and practical examination. The board may administer an additional examination to determine an applicant's familiarity with applicable state law.

(E)(1)    It is unlawful for a person to practice chiropractic in this State unless the person purchases and maintains professional liability insurance from an acceptable insurer in an amount not less than one million dollars for each occurrence against liability for injury to persons arising out of the licensee's practice of chiropractic. This liability insurance must be maintained continuously during the entire licensing period if the person engages in the practice of chiropractic in this State. The amount of the deductible provision in the policy of insurance is dependent upon the licensee's proof of financial responsibility and must be established by the board on a case-by-case basis.

For purposes of this subsection, an 'acceptable insurer' is an insurer that is either licensed by the Department of Insurance in this State or approved by the Department of Insurance as a nonadmitted surplus lines carrier for risks located in this State.

(2)    Each policy, by its original terms or an endorsement, must provide that the insurer will not cancel, suspend, or nonrenew the policy without thirty days' written notice of the proposed cancellation, suspension, or nonrenewal and a complete report of the reasons for the cancellation, suspension, or nonrenewal must be provided to the board. If the liability insurance is canceled, suspended, or nonrenewed, the insurer immediately shall notify the board. This section must not be construed to expand any of the rights granted the employees of the applicant under the workers' compensation laws of this State.

(F)    At or prior to the time of renewal, each licensee shall certify to the board proof that liability insurance is in effect, the effective dates of the policy, the policy number, policy limits, and the name and address of the insurance agent and insurance carrier. Failure to provide this information or failure to continuously maintain the required liability insurance results in denial or cancellation of licensure until the doctor of chiropractic provides proof of compliance to the board.

(G)    Within thirty days of initial licensure in this State, initial licensees must certify to the board proof that the required liability insurance is in effect, the effective dates of the policy, the policy number, policy limits, and the name and address of the insurance agent and insurance carrier. Failure to provide this information or failure to continuously maintain the required liability insurance results in denial or cancellation of licensure until the doctor of chiropractic provides proof of compliance to the board.

Section 40-9-32.    (A)    Licenses issued pursuant to this chapter are valid for up to two years and renewable on dates established by the department with the consent of the board and payment of a renewal fee and fulfillment of all other requirements for continued licensure. Late fees must be added for renewals received after the last day of the designated renewal period. Failure to renew, including payment of any late fees, within thirty days after the last day of the designated renewal period renders all authorization to practice void, and the doctor of chiropractic shall cease practice. To resume practice the doctor of chiropractic shall apply for reinstatement of licensure.

(B)    A licensee who allows his or her license to lapse by failing to renew the license as provided in this section, or as may be provided for in regulation, may be reinstated by the board upon payment of renewal fees and fulfillment of continuing education and other requirements, if any, provided for in regulation. The board may assess a reinstatement fee and impose additional requirements for reinstatement as may be provided for in regulation.

(C)    The board may issue a duplicate license to replace a license that has been lost or destroyed upon payment of a reasonable fee established by the department. A duplicate license must have the word 'Duplicate' typed or printed across the face of the license.

(D)    A person licensed under this chapter shall display his or her license in a prominent and conspicuous place in the person's primary place of practice.

(E)    A licensee shall notify the board within thirty days of a change in name or mailing address. When requesting a name change on a license, the licensee shall submit legal documentation, satisfactory to the board, indicating the name change.

Section 40-9-33.    The board may issue a license to a person who has been in the active practice of chiropractic in another state, territory, or country upon certification by the proper licensing authority that the applicant has been licensed for a minimum of five years immediately preceding application to this board and that the applicant's license has not been limited, suspended, revoked, or censured, or the applicant has not otherwise been disciplined. The board may establish requirements in regulation for licensure pursuant to this section.

Section 40-9-34. A person licensed to practice chiropractic in this State is entitled to practice acupuncture as part of chiropractic practice upon submission to the board of satisfactory proof of completion of one hundred hours of training in acupuncture/meridian therapy from a college accredited by the Council on Chiropractic Education and successful completion of the National Board of Chiropractic Examiners Acupuncture Examination.

Section 40-9-40.    In addition to the powers and duties enumerated in Section 40-1-60, the board shall, at the first board meeting in each calendar year, elect from its membership a chairman, vice chairman, and any other officers it considers necessary. The board shall meet at least twice a year and upon the call of the chairman or any two members of the board. A majority of the members of the board serving constitutes a quorum for the transaction of business.

Section 40-9-50.    The board must be administered by the Department of Labor, Licensing and Regulation in accordance with Section 40-1-50.

Section 40-9-60.    The board may adopt rules governing its proceedings and internal operations, and may promulgate regulations necessary to carry out the provisions of this chapter.

Section 40-9-70.    The board shall regulate the issuance of licenses and shall discipline chiropractors in any manner authorized by this chapter and Section 40-1-70.

Section 40-9-71.    The board may adopt by regulation a code of ethics governing the practice of chiropractic in this State.

Section 40-9-80.    As provided in Section 40-1-80, for the purposes of conducting an investigation or proceeding under this chapter, the board or a person designated by the board may subpoena witnesses, take evidence, and require the production of any documents or records that the board considers relevant to the inquiry.

Section 40-9-90.    (A)    In addition to the powers and duties enumerated in Section 40-1-90, the board may receive complaints by any person against a licensee and may require a complaint to be submitted in writing, and signed by the complainant, specifying the exact charge or charges. Upon receipt of a complaint, the board administrator shall refer the complaint to a designated investigator of the Department of Labor, Licensing and Regulation, who shall investigate the allegations in the complaint and make a report to the board concerning the investigation. If further proceedings are indicated, a formal accusation must be filed charging the licensee with a violation of this chapter or a regulation promulgated pursuant to this chapter. When the accusation is filed, the administrator shall notify the licensee in writing not less than thirty days before the hearing and a copy of the accusation must be attached to the notice. The notice must be served personally or sent to the accused by registered mail, return receipt requested, to the last mailing address furnished to the board. The post office registration receipt signed by the licensee, the licensee's agent, or a responsible member of the licensee's household or office staff, or, if not accepted by the person to whom addressed, the postal authority stamp showing the notice refused, is prima facie evidence of service of the notice.

(B)    The licensee has the right to be present and present evidence and argument on all issues involved, to present and to cross-examine witnesses, and to be represented by counsel, at the licensee's expense. For the purpose of these hearings, the board may require by subpoena the attendance of witnesses and the production of documents and other evidence and may administer oaths and hear testimony, either oral or documentary, for and against the accused. All investigations, inquiries, and proceedings conducted pursuant to this chapter are confidential, except as otherwise provided for in this chapter.

(C)    Every communication, whether oral or written, made by or on behalf of a person to the director or board to investigate or hear matters relating to the investigation or discipline of a licensee, whether by way of complaint or testimony, is privileged and exempt from disclosure for any reason whatsoever, except to the extent disclosed in the course of the proceedings before the board. An action or proceeding, civil or criminal, may not be brought against any person by whom or on whose behalf the communication is made, except upon other proof that the communication was made with malice.

(D)    A person connected with any complaint, investigation, or other proceeding before the board including, but not limited to, a witness, counsel, counsel's secretary, board member, department, court reporter, or investigator, must not disclose any information tending to identify the initial complainant or any witness or party to the complaint, investigation, or proceeding, except to persons directly involved and except as necessary for the proper disposition of the complaint, investigation, or other proceeding. However, if the board receives information in any complaint, investigation, or other proceeding before it indicating a violation of a state or federal law, the board may provide that information, to the extent the board considers necessary, to the appropriate state or federal law enforcement agency or regulatory body. Nothing contained in this section may be construed to prevent the board from making public a copy of its final order in any proceeding, as authorized or required by law.

Section 40-9-100.    (A)    The board may issue a cease and desist order or may petition an administrative law judge for a temporary restraining order or other equitable relief to enjoin a violation of this chapter, as provided for in Section 40-1-100. An administrative law judge may issue a temporary injunction ex parte and upon notice and full hearing may issue any other order in the matter it considers proper. A bond must not be required of the board as a condition to the issuance of any injunction or order contemplated by the provisions of this section.

(B)    A member of the board or its committees, special examiners, the director of the department, or other department employees or representatives are not liable for acts performed in the course of official duties, except where actual malice is shown.

Section 40-9-110.    (A)    In addition to other grounds provided in Section 40-1-110, the board, after notice and a hearing conducted in accordance with the Administrative Procedures Act, may restrict or refuse to grant a license to an applicant or may refuse to renew the license of a person or may suspend, revoke, or otherwise restrict a chiropractor who:

(1)    has violated this article or a regulation promulgated by the board;

(2)    has used a false, fraudulent or forged statement, or any fraudulent, deceitful or dishonest act in connection with any of the licensing requirements or in connection with professional practice;

(3)    has sustained a physical or mental impairment or disability that renders practice dangerous to the public;

(4)    has engaged in the illegal or unauthorized practice of chiropractic or medicine;

(5)    knowingly has performed an act that in any way assists an unlicensed person to practice chiropractic;

(6)    is addicted to alcohol or drugs to such a degree as to render the person unfit to practice chiropractic;

(7)    has violated a section of this chapter or a regulation or order of the board;

(8)    has failed to cooperate with an investigation or other proceeding of the board;

(9)    has failed to comply with a directive or order of the department or board;

(10)    has disseminated a patient's health or personal information acquired during the course of practice to persons not entitled by law or hospital or agency policy to disclosure of this information;

(11)    has violated the code of ethics or regulations adopted by the board;

(12)    has engaged in any dishonorable, unethical, or unprofessional conduct that is likely to deceive or harm the public;

(13)    has made a false or fraudulent statement in a document connected with the practice of chiropractic;

(14)    is guilty of obtaining fees or assisting in obtaining fees under dishonorable, false, or fraudulent circumstances;

(15)    intentionally has violated or attempted to violate, directly or indirectly, or is assisting in or abetting the violation of or conspiring to violate any provision of law of chiropractic practice;

(16)    is guilty of the commission of an act, during the course of practice conducted pursuant to a license issued under this chapter, that constitutes fraud, dishonest dealing, illegality, incompetence, or gross negligence;

(17)    has caused to be published or circulated, directly or indirectly, a fraudulent, false, or misleading statement as to the skill or methods of practice of himself or another licensee;

(18)    has practiced chiropractic while under the influence of alcohol or drugs;

(19)    has been adjudged mentally incompetent by a court of competent jurisdiction; and upon notice of a legal determination of incompetency, an individual's license must be automatically suspended until the individual, in accordance with law, has been restored to mental competency;

(20)    has failed to report, as required by law, or made a false report of a contagious or infectious disease;

(21)    has been convicted of or pled guilty or nolo contendere to a felony or other crime involving moral turpitude; or

(22)    has been disciplined by a licensing or disciplinary authority of another state, country, or nationally recognized professional organization or been convicted or disciplined by a court of a state or country for an act that would be grounds for disciplinary action under this section.

(B)(1)    If the board finds that reasonable grounds exist that a licensee or applicant may be addicted to alcohol or drugs or may have sustained a physical or mental disability that may render practice by the licensee or applicant dangerous to the public, the board, without a formal complaint or opportunity for hearing, may require a licensee or applicant to submit to a mental or physical examination by physicians designated by the board. The results of an examination are admissible in a hearing before the board, notwithstanding a claim of privilege under a contrary rule of law or statute.

(2)    A person who accepts the privilege of engaging in a licensed profession or occupation in this State or who files an application for a license to practice in this State is deemed to have consented to submit to a mental or physical examination and to have waived all objections to the admissibility of the results in a hearing before the board upon the grounds that the same constitutes a privileged communication.

(3)    If a licensee or applicant fails to submit to an examination when properly directed to do so by the board, unless the failure was due to circumstances beyond the person's control, the board shall enter an order automatically suspending or denying the license pending compliance and further order of the board.

(4)    A licensee or applicant who is required to submit to a mental or physical examination may request within twenty-four hours of receipt of the requirement a review by an administrative hearing officer appointed by the board or its designee. A written request filed for a review by an administrative hearing officer does not stay the time directed in which to submit to a mental or physical examination, and a stay must not be issued, except as provided in this subsection. Upon proper written request, a review hearing must be conducted within forty-eight hours of receipt of the request. Failure to provide a review hearing within the prescribed time stays the time required to submit to a mental or physical examination until a decision is issued by the administrative hearing officer. The review hearing for purposes of this subsection must be limited to the issues of whether the person is a licensee or applicant, whether reasonable grounds exist to require a mental or physical examination, and whether the licensee or applicant has been informed that failure to submit to an examination will result in the entry of an order automatically suspending or denying the license pending compliance and further order of the board. The administrative hearing officer's decision is not subject to appeal.

(5)    A licensee or applicant who is prohibited from practicing under this subsection must be afforded at reasonable intervals an opportunity to demonstrate to the board the ability to resume or begin the practice with reasonable skill and safety.

(C)(1)    The board upon reasonable grounds may obtain records relating to the mental or physical condition of a licensee or applicant including, but not limited to, psychiatric records, and these records are admissible in a hearing before the board, notwithstanding any other provision of law.

(2)    A person who accepts the privilege of engaging in a licensed profession or occupation in this State or who files an application to practice in this State is deemed to have consented to the board obtaining these records and to have waived all objections to the admissibility of these records in a hearing before the board upon the grounds that the same constitute a privileged communication.

(3)    If a licensee or applicant refuses to sign a written consent for the board to obtain these records when properly requested by the board, unless the failure was due to circumstances beyond the person's control, the board shall enter an order automatically suspending or denying the license pending compliance and further order of the board. A licensee or applicant who is prohibited from practicing under this subsection must be afforded at reasonable intervals an opportunity to demonstrate to the board the ability to resume or begin the practice of chiropractic with reasonable skill and safety.

(D)    An order requiring a licensee or applicant to submit to a mental or physical examination or an order requiring the submission of records relating to the mental or physical condition of a licensee or applicant is confidential and must not be disclosed, except to the extent necessary for the proper disposition of the matter before the board. An order automatically suspending or denying a license pending compliance and further order of the board is public information under the South Carolina Freedom of Information Act. A decision of an administrative hearing officer is confidential, unless an order automatically suspending or denying a license pending compliance and further order of the board has been issued, in which case the administrative hearing officer's decision and the order requiring an examination or records is public information under the South Carolina Freedom of Information Act.

Section 40-9-111.    (A)    An act or omission by a licensee causing the denial, revocation, suspension, or restriction of a license to practice chiropractic in another state supports the issuance of a formal complaint and the commencement of disciplinary proceedings as described in Section 40-9-110. This provision applies only when the disciplinary action taken in another state is based on grounds that would constitute misconduct under Section 40-9-110.

(B)    Proof of this act or omission may be shown by a copy of the transcript of record of the disciplinary proceedings in another state or a copy of the final order, consent order, or similar order stating the basis for the action taken.

(C)    Upon the filing of an initial complaint alleging that the licensee has been disciplined in another state, the licensee must produce for the board, copies of all transcripts, documents, and orders used, relied upon, or issued by the licensing authority in the other state. Failure to produce these items within ninety days of the board's request for them results in the suspension of the individual's license to practice chiropractic in this State until such time as the items have been supplied to the board.

(D)    The licensee may present mitigating testimony to the board regarding disciplinary action taken in another state or evidence that the acts or omissions committed in another state do not constitute misconduct under Section 40-9-110.

Section 40-9-115.    The board has jurisdiction over the actions of licensees and former licensees as provided for in Section 40-1-115.

Section 40-9-120.    Upon a determination by the board that one or more of the grounds for discipline of a licensee exists, the board may impose sanctions as provided in Section 40-1-120, including imposing a fine of up to ten thousand dollars.

Section 40-9-125.    (A)    The board is authorized to issue a special volunteer license for chiropractors who wish to devote their expertise exclusively to providing chiropractic care without charge to the needy and indigent in this State. The board will waive all application fees, examination fees, and renewal fees for any chiropractor licensed in accordance with this section.

(B)    The board shall promulgate regulations outlining the qualifications for the issue of a special volunteer license.

Section 40-9-130.    As provided for in Section 40-1-130, the board may deny licensure to an applicant based on the same grounds for which the board may take disciplinary action against a licensee.

Section 40-9-140.    A license may be denied based on a person's prior criminal record only as provided for in Section 40-1-140.

Section 40-9-150.    A licensee under investigation for a violation of this chapter or a regulation promulgated under this chapter may voluntarily surrender the license in accordance with Section 40-1-150.

Section 40-9-160.    A person aggrieved by a final action of the board may seek review of the decision in accordance with Section 40-1-160.

Section 40-9-170.    A person found in violation of this chapter or a regulation promulgated under this chapter may be required to pay costs associated with the investigation and prosecution of the case in accordance with Section 40-1-170.

Section 40-9-180.    All costs and fines imposed pursuant to this chapter must be paid in accordance with and are subject to the collection and enforcement provisions of Section 40-1-180.

Section 40-9-190.    (A)(1)    Investigations and proceedings conducted under this chapter are confidential, and all communications are privileged as provided for in Section 40-1-190 and Section 40-9-90.

(2)    All documents filed in a proceeding are public at the time that an answer to the formal complaint or the citation is filed and due.

(3)    Every communication, oral or written, to the board, department, staff, counsel, or any other person acting on behalf of the board or department during the investigation, hearing, or adjudication of disciplinary matters including, among other things, investigative reports concerning interviews and issues under investigation, correspondence, summaries, incident reports, computer printouts, and documents created during peer review proceedings are privileged against liability.

(4)    Information that has been declared confidential or personal under this chapter or other applicable law must not be disclosed, except to the extent necessary for the proper disposition of the matter before the board and must be protected in the same manner as provided in Section 40-71-20 or as otherwise provided by law.

(5)    The identity of the initial complainant and any confidential informants or other witnesses who do not testify must not be disclosed to other parties, entities, or persons, and all information contained in confidential investigative files are privileged from disclosure for any reason whatsoever, except as provided below.

(B)(1)    A party to a proceeding may petition the board or the appropriate hearing officer for an order to close the hearing or the record, or both, in whole or in part, to protect patients or clients or other witnesses from disclosure of personal or confidential information.

(2)    A witness in a disciplinary proceeding may petition the board or the appropriate hearing officer for an order to close the hearing or the record, or both, in whole or in part, to protect the witness from disclosure of personal or confidential information.

(3)    Upon a finding that the health or safety or the personal privacy of a party or a witness would be unreasonably put at risk by the disclosure of identifying information or of other personal information, or if an existing order so provides, the board or the appropriate hearing officer may grant the motion to protect personal privacy.

(4)    Where a motion to protect personal privacy is granted, all public records must refer to that witness, patient, or client by an identifier number.

(C)    If the department receives information indicating a violation of state or federal law, the department may provide that information, to the extent the department considers necessary, to the appropriate state or federal law enforcement or regulatory body.

(D)    Information in investigative files or disciplinary proceedings is not required to be expunged pursuant to any other provision of state law.

Section 40-9-200.    A person who practices or offers to practice chiropractic in this State in violation of this chapter, or who knowingly presents to or files false information for the purpose of obtaining a license, is guilty of a misdemeanor and, upon conviction, must be fined not more than fifty thousand dollars or imprisoned for not more than one year. Each violation constitutes a separate offense. The provisions of this chapter apply to a person or entity aiding and abetting in a violation of this chapter.

Section 40-9-210.    The department, in addition to instituting a criminal proceeding, may institute a civil action through the Administrative Law Court. If the board has reason to believe that a person is violating or intends to violate a provision of this chapter, the board may, in addition to all other remedies, order the person to immediately desist and refrain from that conduct. The board may apply to an administrative law judge as provided under Article 5, Chapter 23, Title 1 for an injunction restraining the person from that conduct. An administrative law judge may issue a temporary injunction ex parte and upon notice and full hearing may issue any other order in the matter as it considers proper. An administrative law judge must not require a bond by the board as a condition to the issuance of an injunction or order contemplated by the provisions of this section.

(B)    A member of the board or its committees, special examiners, agents, and employees may not be held liable for acts performed in the course of official duties, except where actual malice is shown. For the purpose of an investigation or proceeding conducted pursuant to this chapter, the board or a person designated by the board may administer oaths and affirmations, subpoena witnesses, take evidence, and require the production of documents or records that the board considers relevant to the inquiry.

Section 40-9-220.    If any section, subsection, paragraph, subparagraph, sentence, clause, phrase, or word of this act is for any reason held to be unconstitutional or invalid, such holding shall not affect the constitutionality or validity of the remaining portions of this act, the General Assembly hereby declaring that it would have passed this chapter, and each and every section, subsection, paragraph, subparagraph, sentence, clause, phrase, and word thereof, irrespective of the fact that any one or more other sections, subsections, paragraphs, subparagraphs, sentences, clauses, phrases, or words hereof may be declared to be unconstitutional, invalid, or otherwise ineffective."

SECTION    2.    This act takes effect upon approval by the Governor.

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This web page was last updated on Friday, December 4, 2009 at 3:30 P.M.