17.1 Authority

1. These regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws § 5-30-2 for the purpose of adopting minimum standards for the licensure of chiropractic physicians practicing in this state.

17.2 Definitions

1. A. Wherever used in these rules and regulations, the following terms shall be construed as follows:

   1. 1. "Act" means R.I. Gen. Laws Chapter 5-30, entitled "Chiropractic Physicians."
   2. 2. "Board" means the state Board of Chiropractic Physicians within the Rhode Island Department of Health, established pursuant to the provisions of R.I. Gen. Laws § 5-30-1.1.
   3. 3. "Practice of chiropractic medicine" means as defined pursuant to R.I. Gen. Laws § 5-30-1.
   4. 4. "Chiropractic physician" means an individual licensed to practice chiropractic medicine pursuant to the provisions of the Act and the rules and regulations of this Part.
   5. 5. “Department” means the Rhode Island Department of Health.
   6. 6. "Director" means the Director of the Rhode Island Department of Health.
   7. 7. "Division" means the Division of Professional Licensing, Boards & Commissions, Rhode Island Department of Health.

   8. 8. "Hour of instruction" means a documentable unit of participation in a learning experience in a chiropractic medicine-related subject as:

      1. a. Approved by the Council on Chiropractic Education; or
      2. b. Conducted by the Chiropractic Society of Rhode Island (C.S.R.I., Inc.) or by the major chiropractic society or association in another state or jurisdiction and approved by the Division; or
      3. c. Approved courses and programs by the FCLB Providers of Approved Chiropractic Education (PACE); or
      4. d. Completion of post-graduate study at an educational session or institution approved by the Division.
      5. e. For the purposes of approval by the Division, an educational session(s) may be audited by a Board member without charge. Provided, however, said educational session may not be applied toward the Board member's own continuing education requirement as described of this Part.
   9. 9. "Licensure" is synonymous with the term "certification" for the purposes of the rules and regulations of this Part.
   10. 10. "Physiotherapist" means an individual licensed to practice physiotherapy/ chiropractic medicine in this state pursuant to the provisions of the Act and the regulations of this Part.
   11. 11. "Physiotherapy" means the treatment and instruction of human beings within the scope of chiropractic medical practice as defined in R.I. Gen. Laws § 5-30-1, to prevent, correct, alleviate and limit physical disability, physical dysfunction, and pain from injury, disease and any other bodily conditions, including the use of physical measures, activities, and devices, for prevention and therapeutic purposes; and the provision of consultative, educational, and other advisory services for the purpose of reducing the incidence and severity of physical disability, physical dysfunction and pain. No person licensed to practice physiotherapy shall represent him/herself out as practicing physical therapy as defined in R.I. Gen. Laws Chapter 5-40, and the regulations adopted thereunder.

17.3 Licensure Requirements

1. A. No person shall practice chiropractic medicine or any of its branches without a license issued in accordance with the provisions of R.I. Gen. Laws § 5-30-3 and this Part.
2. B. No person licensed to practice chiropractic medicine issued under the provisions of R.I. Gen. Laws § 5-30-3 and this Part shall practice physiotherapy or any of its branches without a license authorizing him/her to practice physiotherapy in accordance with the provisions of R.I. Gen. Laws §§ 5-30-8 and § 17.5.1 of this Part.

17.3.1 Chiropractic Medicine

17.4 Qualifications for Licensure

1. A. In addition to the qualifications for licensure to practice chiropractic medicine in this state as defined in R.I. Gen. Laws § 5-30-6, an applicant shall present evidence that he/she:

   1. 1. Has three (3) letters from three (3) licensed chiropractic physicians attesting to the applicant's moral character, including one (1) letter from a faculty member at a college of chiropractic medicine if the applicant has graduated within five (5) years of application;
   2. 2. Has successfully graduated from a school or college of chiropractic medicine accredited by the Council on Chiropractic Education and approved by the Division;

   3. 3. Has successfully passed:

      1. a. Parts I and II examinations of the National Board of Chiropractic Examiners; and
      2. b. The Written Clinical Competency Examination (WCCE) or Part III of the National Board of Chiropractic Examiners; and

      3. c. Part IV of the National Board of Chiropractic Examiners.

         17.4.2 Physiotherapy

2. A. In addition to the qualifications for licensure to practice physiotherapy in this state as defined in R.I. Gen. Laws § 5-30-8 an applicant must:

   1. 1. Hold a certificate of completion of a physiotherapy program from a college or school of chiropractic medicine accredited by the Council of Chiropractic Education and;
   2. 2. Have successfully passed the examination of the National Board of Chiropractic Examiners section in physiotherapy.

17.4.1 Chiropractic Medicine

17.5 Application for Licensure and Fee

1. A. Application for licensure to practice chiropractic medicine and/or physiotherapy in this state shall be made on forms provided by the Division. Such application shall be accompanied by the following:

   1. 1. Supporting official transcript of education credentials as set forth in § 17.4.1 of this Part.
   2. 2. Official notification of the national examination(s) results submitted directly to the Board by the National Board of Chiropractic Examiners;

   3. 3. A non-returnable, non-refundable license fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title)

      17.5.2 Application by Endorsement

2. A. In addition to the requirements of R.I. Gen. Laws § 5-30-7, an application for licensure by endorsement in this state to practice chiropractic medicine and/or physiotherapy by endorsement shall be made on forms provided by the Department. Such application shall be accompanied by the following:

   1. 1. A non-returnable, non-refundable license fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title);
   2. 2. Official notification of the national examination(s) results submitted directly to the Board by the National Board of Chiropractic Examiners;
   3. 3. A statement from the board of chiropractic medicine in each state in which the applicant has held or holds licensure or registration to be submitted to the Department attesting to the licensure status of the applicant during the time period applicant held licensure or registration in said state;
   4. 4. Documented evidence that continuing education requirements in the jurisdictions in which continuing education is required have been met by the applicant during the five (5) years prior to application for licensure in Rhode Island.

17.5.1 Application

17.6 Licensing of Chiropractic Physicians with the Practice of Physiotherapy

1. A. Applicants shall be required to successfully pass such examination(s) as established by the Division to determine the applicant's qualifications to practice chiropractic medicine and physiotherapy.

2. B. For Chiropractic Physicians: Written Examinations:

   1. 1. The Division shall utilize for the examination in the basic sciences, subjects of microbiology, anatomy, physiology, chemistry and pathology, vertebral palpation and adjusting, the National Board of Chiropractic Examiners' examinations (Parts I and II) and the Written Clinical Competency Examination (WCCE or Part III) and Part IV of the National Board of Chiropractic Examiners, or such other examination that, in the opinion of the Division, is substantially equivalent thereto.

3. C. For Physiotherapists:

   1. 1. The applicant shall qualify for licensure based upon the requirements of § 17.4.2 of this Part.

4. D. Passing Score:

   1. 1. The Division shall accept the recommended passing score for Parts I, II, III, IV and the Special Purposes Examination for Chiropractic (SPEC) examinations of the National Board of Chiropractic Examiners as acceptable for applicants seeking licensure in Rhode Island.

      17.6.2 Continuing Education

5. A. Continuing education requirements are in accordance with R.I. Gen. Laws § 5-30-13. Every chiropractic physician licensed to practice chiropractic medicine in Rhode Island under the provisions of the Act and this Part, on or before the thirtieth (30th) day of October of every third year, shall apply to the Board for certification of triennial registration of continuing education.

   1. 1. The application shall include satisfactory evidence to the Board of completion of at least sixty (60) hours of instruction as defined in § 17.2 of this Part, and completed over the three (3) year period preceding recertification. No less than fifty (50) hours of this 60-hour requirement shall be in clinically-related courses.
   2. 2. The Board may designate that course work in specific practice areas in specific amounts be included in the time period above. Notification of specific requirements, if any, will be made to each licensee prior to the start of the three (3) year cycle. In addition, within a given three (3) year cycle, the Board may designate that licensees attend programs in specific content areas in response to emerging public health concerns or other immediate concerns identified by the Board. Adequate notice shall be given to allow all licensees the opportunity to attend any specific content area courses so designated.
   3. 3. At least thirty (30) hours of instruction in the three (3) year continuing education cycle shall be obtained in live, didactic learning experiences. Such live learning experiences shall include hours of instruction acquired through attendance or participation at programs that provide for direct interaction between faculty and participants and may include lectures, symposia, live teleconferences, or workshops.

6. B. It shall be the sole responsibility of the individual practitioner to obtain documentation from the sponsoring organization, agency, institution or other as approved by the Division, of his/her participation in a learning experience or course and the number of dated hours of instruction earned.

   1. 1. The documents shall be safeguarded by the individual practitioner for review by the Board as may be requested. These documents shall be retained by each licensee for no less than two (2) years (i.e., from the date of license renewal) and are subject to random audit by the Department.

7. C. A chiropractic physician failing to comply with the requirements of this Part shall be subject to the sanctions of the Act, except when the educational requirements for a practitioner are waived by the Division for due cause such as an applicant has suffered hardship or for any sufficient reason which prevented the applicant from meeting the continuing educational requirements and said reasons are found acceptable to the Division.

   17.6.3 Issuance and Renewal of License and Fee

8. A. Upon recommendation of the Board, the Director shall issue an initial license to applicants who have satisfactorily met the licensure requirements of this Part. Subsequent to the initial license issuance, license renewals shall be issued upon recommendation of the Board to the Director for those applicants who meet the licensure requirements of this Part, including the continuing education requirements. Said license to practice chiropractic medicine and/or chiropractic medicine with physiotherapy, unless sooner suspended or revoked shall expire on the following October 30th following the date of issuance of the original license and annually on November 1st thereafter.
9. B. Every licensed person who wishes to renew his/her license shall file a renewal application with the Division, during the month of October, together with the renewal fee as set forth in the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title).

10. C. Any person who allows his/her license to lapse by failing to renew it on or before the first of November annually as provided in this Part, may be reinstated by the Director upon submission of an application and on payment of the current renewal fee, unless the license has been suspended or revoked.

    17.6.4 Rights and Duties of Chiropractic Physicians

11. The Rights and Duties of Chiropractic Physicians are set forth in R.I. Gen. Laws § 5-30-11.

    17.6.5 Advertisement.

12. A. The name of the licensed chiropractic physician shall be included in any advertisement, sign, stationery or other means which identifies the offering of chiropractic medical treatment.

    1. 1. Any person practicing pursuant to the provisions of R.I. Gen. Laws Chapter 5-30, shall be required to post his/her name on the premises where the services are being offered in such a manner as to be clearly visible to the public at the entrance to the premises and on any sign visible outside of the premises which offers the delivery of chiropractic medical services.
    2. 2. Any chiropractic physician or group of chiropractic physicians who advertise in print media shall state the name(s) of the chiropractic physician(s) responsible for said advertisement.

13. B. Chiropractic medical records shall be legible and contain the identity of the chiropractic physician or physician extender and supervising chiropractic physician by name and professional title who is responsible for rendering, ordering, supervising or billing each diagnostic or treatment procedure. The records shall contain sufficient information to justify the course of treatment, including, but not limited to, patient histories, including medications, examination results, and test results leading to a differential diagnosis; and reports of consultations and hospitalizations.

    17.6.6 Grounds for Denial, Revocation or Suspension of License

14. A. Pursuant to the provisions of R.I. Gen. Laws § 5-30-13 of the Act, the Division may, after due notice and hearing, deny, revoke or suspend the license of a chiropractic physician. In addition to the definition of “gross unprofessional conduct” as set forth in R.I. Gen. Laws § 5-30-13(b), the following activities are grounds for denial, revocation or suspension of a license:

    1. 1. The practice of chiropractic medicine under a false or assumed name that shall include the practice of chiropractic medicine under a fictitious name that does not include the name of a chiropractic physician in its advertising;
    2. 2. The advertising for the practice of chiropractic medicine in a deceptive or unethical manner which shall include soliciting professional patronage by agents or persons or profiting from acts of those representing themselves to be agents of the licensed chiropractic physician;

    3. 3. Sexual misconduct: any violation of the chiropractic physician-patient relationship in which the licensed chiropractic physician engages in, or attempts to induce a patient who is not the chiropractic physician's spouse to engage in any sexual activity, whether consensual or non-consensual, while such a physician-patient relationship exists;

       17.6.7 Rules Governing Practices and Procedures

15. All hearings and reviews required under the provisions of the Act shall be held in accordance with the provisions of the Act and the rules and regulations regarding Practices and Procedures before the Department of Health (Part 10-05-4 of this Title) and Access to Public Records (Part 10-05-1).

17.6.1 By Examination: