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A04706 Summary:

BILL NOA04706B
 
SAME ASSAME AS S05860-B
 
SPONSORClark
 
COSPNSRLupardo
 
MLTSPNSR
 
Rpld §6556, amd §§6551, 6552, 6553, 6554 & 6555, add §§6556 & 6557, Ed L
 
Expands the scope of chiropractic practice; authorizes chiropractic clinical assistants.
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A04706 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         4706--B
 
                               2025-2026 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 4, 2025
                                       ___________
 
        Introduced  by  M. of A. CLARK, LUPARDO -- read once and referred to the
          Committee on Higher Education -- committee discharged,  bill  amended,
          ordered  reprinted  as  amended  and  recommitted to said committee --
          committee discharged, bill amended, ordered reprinted as  amended  and
          recommitted to said committee

        AN  ACT  to  amend  the  education  law,  in relation to modernizing the
          chiropractic scope of practice; and to repeal  certain  provisions  of
          such law relating thereto
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Section 6551 of the education law, as added by chapter  987
     2  of  the  laws of 1971, paragraphs a and b of subdivision 2 as amended by
     3  chapter 450 of the laws of 1983, and subdivision 3 as amended by chapter
     4  683 of the laws of 1991, is amended to read as follows:
     5    § 6551. Definition of practice of chiropractic.   1. The  practice  of
     6  the  profession  of chiropractic is defined as [detecting and correcting
     7  by manual or  mechanical  means  structural  imbalance,  distortion,  or
     8  subluxations  in the human body for the purpose of removing nerve inter-
     9  ference and the effects thereof, where such interference is  the  result
    10  of  or  related  to distortion, misalignment or subluxation of or in the
    11  vertebral column. 2.] the examination, evaluation, diagnosis,  detection
    12  and/or  correction by manual, mechanical or other means, subluxations in
    13  the vertebral column and other articulations and  the  effects  thereof;
    14  and/or the ability to treat soft tissue or neuromusculoskeletal dysfunc-
    15  tion for the restoration and maintenance of health.
    16    2.  a.  The  practice of chiropractic includes physical and functional
    17  examination of patients, health assessment, work capability  assessment,
    18  handicap  eligibility  assessment,  school  and other sports assessment,
    19  school attendance assessment, and spinal health assessment, analysis, or
    20  to give consultation, advice, recommendations and  counseling  regarding
    21  anatomy,  physiology,  neurology,  general  health matters, wellness and
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05767-04-5

        A. 4706--B                          2
 
     1  health optimization by any means of communication, the use of x-ray  and
     2  diagnostic imaging studies using ionizing and non-ionizing imaging meth-
     3  ods,   adjustment,  mobilization,  manipulation,  traction,  and  decom-
     4  pression,  and  other procedures consisting of but not limited to, heat,
     5  cold, light, air, water, sound, electricity, massage, manual  therapies,
     6  therapeutic  exercise  with or without assistive devices.  Chiropractors
     7  may use diagnostic clinical laboratory methods directly related  to  the
     8  diagnosis  and  monitoring of neuromusculoskeletal conditions, including
     9  those assessing nutritional or metabolic factors that impact  musculosk-
    10  eletal health, as approved by the department.
    11    b. Chiropractic examination, diagnostic and treatment methods may also
    12  include electrodiagnostic testing and manipulation under anesthesia when
    13  appropriate  education  standards  have  been met and as approved by the
    14  department as being appropriate to the practice of chiropractic.
    15    c. The practice of the profession of chiropractic  allows  a  licensed
    16  chiropractor who has successfully completed a registered doctoral, post-
    17  doctoral  or  continuing  education  certification  program  of a higher
    18  education credential by an accrediting agency, which contains courses of
    19  study in wellness care methods, nutrition, and dietary advice  satisfac-
    20  tory  to the department; use of wellness care methods and the ability to
    21  engage in nutritional  counseling  and  dietary  advice,  including  the
    22  dispensing  of  food  concentrates, food extracts, nutraceuticals, vita-
    23  mins, minerals,  and  other  nutritional  supplements  approved  by  the
    24  department  as  being  appropriate to, and as a part of, the practice of
    25  chiropractic, as the above relates to the definition of the practice  of
    26  chiropractic in subdivision one of this section.
    27    3.  a.  A license to practice as a chiropractor shall permit a chirop-
    28  ractic practitioner in their  professional  discretion  the  ability  to
    29  take,  order  and use x-ray and diagnostic imaging studies but shall not
    30  permit the holder thereof to use  [radio-therapy,  fluoroscopy,  or  any
    31  form  of  ionizing  radiation  except  X-ray which shall be used for the
    32  detection of structural imbalance, distortion, or  subluxations  in  the
    33  human body] ionizing radiation sources for the purposes of radiotherapy.
    34    b. The requirements and limitations with respect to the use of [X-ray]
    35  diagnostic  imaging  studies  by  chiropractors shall be enforced by the
    36  state commissioner of health and [he] the commissioner is authorized  to
    37  promulgate  rules  and  regulations  after  conferring  with the [board]
    38  department to carry out the purposes of this subdivision.
    39    c. Chiropractors shall retain for a period of three years  all  [X-ray
    40  films] diagnostic images taken in the course of their practice, together
    41  with  the records pertaining thereto, and shall make such [films] images
    42  and records available to the state commissioner of health or [his] their
    43  representative on demand.
    44    [3.] 4. Chiropractors may use diagnostic clinical  laboratory  methods
    45  involving  chemical  or  biological  means  which  particular  tests and
    46  services shall be approved by the department as appropriate to the prac-
    47  tice of chiropractic as defined in this section.
    48    5. A license to practice chiropractic  shall  not  permit  the  holder
    49  thereof  to  treat  for  any  infectious diseases such as pneumonia, any
    50  communicable diseases listed in the sanitary code of the  state  of  New
    51  York, any of the cardio-vascular-renal or cardio-pulmonary diseases, any
    52  surgical  condition  [of  the  abdomen  such  as  acute appendicitis, or
    53  diabetes], or any benign or malignant neoplasms; to operate;  to  reduce
    54  fractures  [or  dislocations]; to prescribe, administer, dispense or use
    55  in [his] their practice drugs or medicines[; or  to  use  diagnostic  or
    56  therapeutic  methods involving chemical or biological means except diag-

        A. 4706--B                          3

     1  nostic services performed by clinical laboratories which services  shall
     2  be approved by the board as appropriate to the practice of chiropractic;
     3  or  to  utilize  electrical devices except those devices approved by the
     4  board  as  being  appropriate  to  the practice of chiropractic. Nothing
     5  herein shall be construed to prohibit a licensed  chiropractor  who  has
     6  successfully  completed  a  registered doctoral program in chiropractic,
     7  which contains courses of study in nutrition satisfactory to the depart-
     8  ment, from using nutritional counseling,  including  the  dispensing  of
     9  food  concentrates,  food extracts, vitamins, minerals, and other nutri-
    10  tional supplements approved by the board as being appropriate to, and as
    11  a part of, his or her practice of chiropractic. Nothing herein shall  be
    12  construed  to prohibit an individual who is not subject to regulation in
    13  this state as a licensed chiropractor from engaging in nutritional coun-
    14  seling.] or controlled substances or to administer or  use  anesthetics.
    15  Chiropractors may use topical analgesic substances and anesthetic balms,
    16  salves or emollients or advise on over the counter substances.
    17    § 2. Section 6552 of the education law, as added by chapter 987 of the
    18  laws of 1971, is amended to read as follows:
    19    § 6552. Practice  of  chiropractic  and use of title "chiropractor" or
    20  "doctor of chiropractic".  Only a person licensed [or exempt] or  other-
    21  wise authorized under this article [shall] to practice chiropractic [or]
    22  may use the title "chiropractor" or "doctor of chiropractic".
    23    § 3. Section 6553 of the education law, as added by chapter 987 of the
    24  laws of 1971, is amended to read as follows:
    25    § 6553. State  board for chiropractic.  A state board for chiropractic
    26  shall be appointed by the board of  regents  on  recommendation  of  the
    27  commissioner  for  the purpose of assisting the board of regents and the
    28  department on matters of professional licensing and professional conduct
    29  in accordance with section sixty-five hundred eight of this title.   The
    30  board  shall be composed of not less than [seven] eight members, includ-
    31  ing [at least four licensed] seven chiropractors[, one  licensed  physi-
    32  cian who is a doctor of medicine, one licensed physician who is a doctor
    33  of  osteopathy,  and  one  educator  who holds a doctorate or equivalent
    34  degree in either anatomy, physiology, pathology, chemistry or microbiol-
    35  ogy] licensed in this state and one public member.  An executive  secre-
    36  tary  to  the board shall be appointed by the board of regents on recom-
    37  mendation of the commissioner.
    38    § 4. Section 6554 of the education law, as added by chapter 987 of the
    39  laws of 1971, subdivision 3 as amended by chapter 994  of  the  laws  of
    40  1971,  subdivision  6 as amended by chapter 669 of the laws of 2022, and
    41  subdivision 8 as amended by chapter 62 of the laws of 1989,  is  amended
    42  to read as follows:
    43    § 6554. Requirements  for  a  professional  license.  To qualify for a
    44  license as a chiropractor, an  applicant  shall  fulfill  the  following
    45  requirements:
    46    (1) Application: file an application with the department;
    47    (2) Education: have received an education, including [two] three years
    48  or  ninety  semester  hours of credit or equivalent trimester or quarter
    49  hours of credit of preprofessional college study  and  completion  of  a
    50  [four-year  resident  program  in chiropractic,] program of chiropractic
    51  education of not less than four academic years, or the equivalent there-
    52  of in accordance with the commissioner's regulations;
    53    (3) Experience: have experience  satisfactory  to  the  board  and  in
    54  accordance with the commissioner's regulations[:];
    55    (4)  Examination:  pass  examinations satisfactory to the board and in
    56  accordance with the commissioner's regulations[, in clinical  chiroprac-

        A. 4706--B                          4

     1  tic  analysis,  the  practice  of  chiropractic,  X-ray as it relates to
     2  chiropractic analysis, and examinations satisfactory to  the  department
     3  in  anatomy,  physiology, pathology, chemistry, microbiology, diagnosis,
     4  and the use and effect of X-ray] for the practice of chiropractic;
     5    (5) Age: be at least twenty-one years of age;
     6    (6) Citizenship or immigration status: be a United States citizen or a
     7  noncitizen  lawfully  admitted  for  permanent  residence  in the United
     8  States;
     9    (7) Character: be of good moral character as determined by the depart-
    10  ment; and
    11    (8) Fees: pay a fee of one hundred seventy-five dollars to the depart-
    12  ment for [admission to a department conducted examination  and  for]  an
    13  initial license, [a fee of eighty-five dollars for each reexamination, a
    14  fee  of  one  hundred fifteen dollars for an initial license for persons
    15  not requiring admission to a department conducted  examination,]  and  a
    16  fee  of  one  hundred fifty-five dollars for each triennial registration
    17  period.
    18    § 5. Section 6555 of the education law, as amended by chapter  537  of
    19  the laws of 1983, is amended to read as follows:
    20    § 6555. Exempt  persons.   [Nothing in this article shall be construed
    21  to affect or prevent a student enrolled in a college of chiropractic  in
    22  this state from engaging in all phases of clinical practice under super-
    23  vision  of  a  licensed chiropractor or physician in a curriculum regis-
    24  tered by the department.] The  following  persons  under  the  following
    25  limitations  may  practice  chiropractic  within  the  state  without  a
    26  license:
    27    1. A student enrolled in any accredited college of chiropractic engag-
    28  ing in all phases of clinical practice under supervision of  a  licensed
    29  chiropractor  or physician in a curriculum registered by the department;
    30  or
    31    2. A student who is performing a clinical externship or  preceptorship
    32  in  a  chiropractic  office  or  clinic setting and who is enrolled in a
    33  chiropractic school  which  meets  the  standards  satisfactory  to  the
    34  department,  provided such practice is under the direct supervision of a
    35  licensed chiropractor for a maximum period of twelve months; or
    36    3. Any chiropractor authorized to practice chiropractic while  travel-
    37  ling  from  another  state  or  country  in  which  such chiropractor is
    38  licensed, to provide chiropractic services during any emergency services
    39  associated with any  rescue,  recovery  or  humanitarian  relief  effort
    40  provided  such  practice  is  pursuant  to  a  state  disaster emergency
    41  declared by the governor pursuant to section twenty-eight of the  execu-
    42  tive law; or
    43    4.  A  chiropractor who is not a resident of this state who is legally
    44  qualified to practice in their state and who is travelling from  another
    45  state  for the purpose of providing chiropractic services for a specific
    46  purpose or event provided that such duration  shall  not  exceed  thirty
    47  days or the duration of the specified event; or
    48    5.  Any  chiropractor  who is licensed in another state or country and
    49  who is meeting or communicating with a  chiropractor  licensed  in  this
    50  state,  for  purposes of consultation, provided such practice is limited
    51  to such consultation; or
    52    6. Any chiropractor who is licensed in another state or  country,  who
    53  is  visiting a chiropractic school or teaching facility in this state to
    54  receive chiropractic instruction for a period not to exceed  six  months
    55  or to conduct chiropractic instruction, provided such practice is limit-

        A. 4706--B                          5
 
     1  ed  to  such  instruction  and  is  under  the  general supervision of a
     2  licensed chiropractor; or
     3    7. Any chiropractor who is authorized by a foreign government to prac-
     4  tice  in  relation  to  its  diplomatic,  consular  or  maritime staffs,
     5  provided such practice is limited to such staffs; or
     6    8. Any commissioned chiropractic officer who is serving in the  United
     7  States  armed forces or public health service or any chiropractor who is
     8  employed in the United States  Veterans  Administration,  provided  such
     9  practice is limited to such service or employment.
    10    §  6.  Section 6556 of the education law is REPEALED and a new section
    11  6556 is added to read as follows:
    12    § 6556. Limited permits. Permits limited as to  eligibility,  practice
    13  and  duration, shall be issued by the department to eligible applicants,
    14  as follows:
    15    1. Eligibility: The following persons shall be eligible for a  limited
    16  permit:
    17    a.  A  person  who fulfills all requirements for a license as a chiro-
    18  practor except those relating to the examination;
    19    b. A licensed foreign chiropractor who meets guidelines  developed  in
    20  accordance with the commissioner's regulations;
    21    c.  A licensed foreign chiropractor or a foreign intern who is in this
    22  country on a non-immigration visa for the continuation  of  chiropractic
    23  study  who meets guidelines developed in accordance with the commission-
    24  er's regulations and has received two years  of  training  at  a  United
    25  States accredited chiropractic school;
    26    d.  Any graduate of a chiropractic school which meets standards satis-
    27  factory to the department, provided such practice is under  the  general
    28  supervision  of  a  licensed chiropractor for a maximum period of twelve
    29  months from date of graduation.
    30    2. Limit of practice. A permittee  shall  be  authorized  to  practice
    31  chiropractic  only  under the supervision of a licensed chiropractor and
    32  only in a licensed chiropractic office or clinical setting.
    33    3. Duration. A limited permit shall be valid for one year.  A  limited
    34  permit may be renewed annually at the discretion of the department.
    35    4. Fees. The fee for each limited permit and for each renewal shall be
    36  one hundred five dollars.
    37    § 7. The education law is amended by adding a new section 6557 to read
    38  as follows:
    39    § 6557. Special provisions. 1. Non-liability of licensed chiropractors
    40  for  first aid or emergency treatment.  Notwithstanding any inconsistent
    41  provision of any general, special or local law, any licensed  chiroprac-
    42  tor who voluntarily and without the expectation of monetary compensation
    43  renders  first aid or emergency treatment at the scene of an accident or
    44  other emergency, outside a hospital, doctor's office or any other  place
    45  having  proper  and necessary chiropractic equipment, to a person who is
    46  unconscious, ill or injured, shall not be liable for damages  for  inju-
    47  ries  alleged  to  have been sustained by such person or for damages for
    48  the death of such person alleged to have occurred by reason of an act or
    49  omission in the rendering of  such  first  aid  or  emergency  treatment
    50  unless  it  is  established  that  such  injuries were or such death was
    51  caused by gross negligence on the part of such chiropractor. Nothing  in
    52  this  section  shall be deemed or construed to relieve a licensed chiro-
    53  practor from liability for damages for injuries or death  caused  by  an
    54  act  or  omission  on the part of a chiropractor while rendering profes-
    55  sional services in the normal and ordinary course of their practice.

        A. 4706--B                          6
 
     1    2. This article shall not  be  construed  to  affect  or  prevent  the
     2  following:
     3    a. The furnishing of any assistance in an emergency;
     4    b.  The  chiropractor  from being a primary portal of entry healthcare
     5  provider.
     6    3. There shall be no monetary liability on the part of, and  no  cause
     7  of  action  for  damages  shall  arise against, any person, partnership,
     8  corporation, firm, society, or other entity on account of  the  communi-
     9  cation  of information in the possession of such person or entity, or on
    10  account of any recommendation or evaluation,  regarding  the  qualifica-
    11  tions,  fitness, or professional conduct or practices of a chiropractor,
    12  to any governmental agency, chiropractic society, a hospital as  defined
    13  in  article twenty-eight of the public health law, a hospital as defined
    14  in subdivision ten of section 1.03 of  the  mental  hygiene  law,  or  a
    15  health  maintenance  organization  organized under article forty-four of
    16  the public health law or  article  forty-three  of  the  insurance  law,
    17  including  a  committee of an individual practice association or medical
    18  group acting pursuant to a contract with a health maintenance  organiza-
    19  tion.  The  foregoing shall not apply to information which is untrue and
    20  communicated with malicious intent.
    21    § 8.  This act shall take effect eighteen months after it  shall  have
    22  become a law.
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