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Vision Statement: The FCLB is the premier international resource for information and consolidated services for ensuring the safe, ethical practice of chiropractic
Mission Statement: Protecting the public by promoting excellence in chiropractic regulation through service to our member boards.

 

Mission Bay, California
May 4, 2019

 

RESOLUTION #1-19

Submitted for Consideration by FCLB Board of Directors 

Chiropractic Licensing Boards’ Support of Temporary Licensure for Chiropractors

Whereas, the Federation of Chiropractic Licensing Boards (FCLB) is comprised of member chiropractic licensing boards throughout the United States, Canada and across the globe; and

Whereas, the public health is enhanced by improving practitioner mobility which allows for continuity of patient care services across different jurisdictions and realistic processes for learning clinical practice techniques from outside experts; and

Whereas, Temporary Licensure is a common regulatory construct used by government to license professionals engaged in limited practice scenarios; and

Whereas, Temporary Licensure is most applicable to definitively limited travel-to-treat and travel-to-teach practice scenarios; and

Whereas, twenty-one (21) FCLB members currently have some form of Temporary Licensing available to chiropractic professionals entering into their jurisdiction; and

Whereas, the FCLB Model Practice Act has sample statutory and regulatory language for enacting and administering Temporary Licensure for chiropractic professionals; and

Whereas, the FCLB PASSPORT program is available to member jurisdictions with Temporary Licensure to help lower the administrative burdens and costs of assessing the credentials of actively-licensed chiropractic professionals seeking inter-jurisdictional mobility to engage in limited practice scenarios; and

Whereas, the FCLB delegate assembly has previously resolved to promote chiropractic practitioner mobility among its FCLB member jurisdictions through processes that include Temporary Licensure; now therefore be it

Resolved, that the Federation of Chiropractic Licensing Boards (FCLB) recognizes the public health benefits to travel-to-treat and travel-to-teach limited practice scenarios; supports the regulatory construct of Temporary Licensure for promoting practitioner mobility; and encourages the prospect of every FCLB member board establishing a Temporary Licensure provision for chiropractic professionals in its jurisdiction.

Adopted by the delegate body 
93rd Annual Congress
May 4, 2019 • Mission Bay, California

 
RESOLUTION #2-19A
Submitted for Consideration by FCLB Board of Directors

Action Steps to Combat the Opioid Prescription Drug Epidemic for NMS Pain Management

Whereas, the United States Department of Health and Human Services, Centers for Disease Control and Prevention CDC Guideline for Prescribing Opioids for Chronic Pain, United States 2016 states: “non-pharmacologic therapy and non-opioid pharmacologic therapy are preferred for chronic pain. Clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient. If opioids are used, they should be combined with non-pharmacologic therapy and non-opioid pharmacologic therapy, as appropriate”;

Whereas, the American College of Physicians, April 2017, Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of

Physicians states: “[for patients with acute or sub acute low back pain] clinicians and patients should select non-pharmacologic treatment with superficial heat, massage, acupuncture, or spinal manipulation; [and] for patients with chronic low back pain, clinicians and patients should initially select non-pharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation”;

Whereas, The Joint Commission for Accreditation and Certification of Healthcare Organizations & Programs, January 2015, Revision to Pain Management Standard (PC.01.02.07) states: “The identification and management of pain is an important component of patient-centered care. Patients can expect that their health care providers will involve them in their assessment and management of pain. Both pharmacologic and non-pharmacologic strategies have a role in the management of pain. The following examples are not exhaustive, but strategies may include the following non-pharmacologic strategies: physical modalities (for example, acupuncture therapy, chiropractic therapy, osteopathic manipulative treatment, massage therapy, and physical therapy), relaxation therapy, and cognitive behavioral therapy”;

Whereas, the State of Rhode Island amended their insurance laws Coverage for the treatment of mental health and substance use disorders (Ch.27-38.2), in January 2017, to require: “a group health plan and an individual or group health insurance plan shall provide coverage for the treatment of mental health and substance-use disorders under the same terms and conditions as that coverage is provided for other illnesses and disease; [and that] coverage shall not impose non-quantitative treatment limitations for the treatment of mental health and substance-use disorders; [and] patients with substance use disorders shall have access to evidence-based non-opioid treatment for pain, therefore coverage shall apply to medically necessary chiropractic care, and osteopathic manipulative treatment”; and

Whereas, the American Public Health Association, November 2015, Prevention and Intervention Strategies to Decrease Misuse of Prescription Pain Medication (policy #20154) includes the following evidence-based strategies and recommended corrective actions:

 Prioritize and implement provider training programs on non-pharmacological pain treatment alternatives, substance abuse, and overdose prevention for license renewal education;

 Health providers becoming more knowledgeable about identifying and treating pain with alternative modalities, such as physical medicine & acupuncture, and to coordinate pain management with complementary and integrative care providers;

 Promote state legislation requiring individuals to undergo physical and mental examinations before they are prescribed controlled pain medications;

Now therefore be it -

Resolved, that the Federation of Chiropractic Licensing Boards (FCLB) supports the following strategies for our member boards’ consideration to help curb the current public health epidemic relating to the overprescribing and misuse of pain medication:

(1) Approving continuing education credit courses for chiropractic license renewal on pain-management, substance abuse awareness, and drug-free health counseling;

(2) Updating its state’s chiropractic standards to facilitate better interdisciplinary cooperation by codifying the primary health care services performed by chiropractors which in addition to the examining, diagnosing and treating of patients, also includes managing, coordinating, referring and delegating patient care functions within scope of practice; and

(3) Advocating the development of state guidelines and/or standards that recommend or even require that patients with non-carcinogenic neuromusculoskeletal pain undergo an assessment, by a licensed health practitioner skilled in neuromusculoskeletal conditions and the therapeutic application of manual services, prior to their having extended any treatment program that relies on pharmaceutical pain management through the use of controlled (addictive) medications.

Adopted by the delegate body 
93rd Annual Congress
May 4, 2019 • Mission Bay, California

 
RESOLUTION #4-19C
Submitted for Consideration by Dr. Robert G. Frieman (Maryland Delegate)

Whereas the term “physician” refers to a healer or one who tends to the ills, sicknesses, well-being and maintenance of well-being in human health, dating back through the ages, and is not strictly related to or owned by a particular treatment philosophy or profession, and

Whereas the practice of chiropractic since its founding has been a member of the healing arts that addresses the human state of health through natural and wholistic methods, providing an approach seeking the promotion of optimal health and wellness, and

Whereas chiropractic is a licensed health care profession and chiropractors are recognized and accepted as portal of entry, primary care doctors, responsible for proper decision-making regarding diagnosis, treatment and referral to other providers when appropriate, and

Whereas chiropractors are employed in the Veterans Administration, Accepted in Medicare, Medicaid, accepted in third-party health insurance and HMOs, and

Whereas chiropractors are educated and in many states licensed to order or perform diagnostic testing including x-rays, laboratory blood and urine, MRI, and other standard diagnostic testing, and

Whereas patients may seek chiropractic care for diagnosis and treatment from a licensed chiropractor without the requirement of a referral or “pre-screening” by a medical or other physician, and

Whereas chiropractors are

Included in the category of providers such as MDs, DOs, podiatrists, oral surgeons, and Nurse Practitioners, considered “physicians” by Medicare, and

Whereas the term “physician” when used with “chiropractic” as in “chiropractic physician” is an appropriate description of the role carried out by a chiropractor as they accept patients directly and make clinical decisions regarding diagnosis and treatment. 

Therefore we resolve that the Federation of Chiropractic Licensing Boards fully supports the use of the term  “Chiropractic Physician” to further standardize our position and describe the chiropractor in his/her role within the ever changing  healthcare arena.

Adopted by the delegate body 
93rd Annual Congress
May 4, 2019 • Mission Bay, California