Enforcement committee recommends defining 'chiropractic assistant' and a 2,000‑hour pathway for indirect supervision

The Board of Chiropractic Examiners Enforcement Committee on Dec. 13 recommended that the full board consider regulatory language to define and set minimum supervision and training requirements for chiropractic assistants, including an experience pathway equal to roughly one year (2,000 supervised clinical hours).

Miss Walker, enforcement staff, told the committee the draft seeks to clarify that a "chiropractic assistant is somebody that's assisting the licensee in a clinical care type component," and that "at the end of the day, it's up to the licensee to ensure that the person is competent to perform a specific service." The draft also distinguishes direct supervision (licensee available to assist immediately) from indirect supervision (licensee may not be on the premises) and would require assistants to consult the supervising licensee before departing from a written treatment plan when a patient presents new symptoms.

Why it matters: The committee said the rules are intended to protect patients by ensuring unlicensed staff working without a license under indirect supervision have a minimum, verifiable level of training or experience. Staff signaled the proposal aims to reduce safety risk from improperly delegated clinical tasks and to make enforcement expectations clearer.

Key details: Staff proposed three qualification pathways for indirect supervision: passing a recognized certification exam, completing specified education, or meeting an experience standard (proposed at 2,000 supervised clinical hours). Miss Walker said the 2,000‑hour figure was adopted to align with the Federation of Chiropractic Licensing Boards (FCLB) certification benchmark but noted the committee could set a different number. The draft excludes 24 hours of continuing education as a standalone path, though 24 hours could be combined with certification.

Committee discussion and action: Committee members urged adding broader "equivalency" language to allow other nationally recognized certification programs in the future and discussed whether the 2,000‑hour threshold might be excessive for some small practices. Members also asked for clearer definitions of direct and indirect supervision and for tighter language about when an assistant may or may not modify a treatment plan. After discussion, the committee voted to recommend the draft language to the full board with non‑substantive edits to be handled by staff and legal counsel. The motion carried 3–0.

Next steps: Staff will work with legal counsel to finalize the regulatory text and present it to the full Board at a future meeting for consideration. The committee flagged preceptorships for chiropractic students and exceptions for licensees acting under other healing‑arts boards as areas to preserve in the final language.

Quote: "The chiropractic assistant is somebody that's assisting the licensee in a clinical care type component," Miss Walker said, adding that the supervising licensee "is ultimately responsible for anything that occurs under their supervision." The committee approved forwarding the proposal to the Board.

Procedure note: The committee's recommendation does not itself change the regulations; it asks the Board to consider the proposed language and the final regulatory text will be subject to formal rule‑making procedures.