BACKGROUND PAPER FOR THE BOARD OF CHIROPRACTIC …

BACKGROUND PAPER FOR THE BOARD OF CHIROPRACTIC EXAMINERS

Joint Oversight Hearing, March 11, 2013, Senate Committee on Business, Professions and Economic

Development and

Assembly Committee on Business, Professions and Consumer Protection

IDENTIFIED ISSUES, BACKGROUND AND RECOMMENDATIONS REGARDING THE BOARD OF CHIROPRACTIC EXAMINERS

BRIEF OVERVIEW OF THE BOARD OF CHIROPRACTIC EXAMINERS

The Board of Chiropractic Examiners, (Board), is responsible for regulating the practice of licensed chiropractors in California. The Board was created on December 21, 1922, through an initiative measure approved on November 7, 1922. The Board's mission statement, as stated on the Board's website is as follows:

"The mission of the Board of Chiropractic Examiners is to protect consumers from fraudulent, negligent, or incompetent chiropractic practice."

The Board achieves this mission through its educational requirements, Licensing and Continuing Education Programs, and its Enforcement Program

The Board's educational requirements are designed to gage the demonstrated entry-level competence of a chiropractor prior to licensure, while the continuing education function of the Board ensures licensees maintain up-to-date knowledge of the chiropractic profession.

Through its Enforcement Program, the Board disciplines licensees who violate the laws and regulations governing the practice of chiropractic. Discipline imposed can range from warning letters to citations to formal disciplinary action by way of accusation, with the ultimate discipline being license revocation.

In FY 2010/11, the Board had a license base of 13,810 active and 1,272 inactive licenses. The Board also oversees 19 chiropractic schools and colleges located throughout the United States and Canada.

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The Board is a seven member policy-making body, consisting of five professional members and two public members. Each member is appointed by the Governor to serve a four year term. All Board meetings are subject to the Bagley-Keene Open Meetings Act.

The following table lists all members of the Board including background on each member, appointment date, term expiration date and appointing authority.

Board Members

Francesco Columbu, D.C., professional member)

Appointment Term Member Appointing Date Expiration Type Authority Date

(Chair, 02/10/06 02/10/14 Professional Governor

Francesco Columbu, D.C., of Los Angeles has been a practicing chiropractor in West Los Angeles since 1978. In January 2013, Dr. Columbu was elected Chairman of the Board.

Sergio Azzolino, D.C., (Vice-Chair, professional member)

05/24/12 02/10/16 Professional Governor

Sergio F. Azzolino, D.C., of San Francisco, has been the director at Azzolino Chiropractic Inc. since 1995. He served as faculty at Life Chiropractic College West from 1996 to 1999, and currently is an assistant professor of Clinical Neurology at the Carrick Institute for Graduate Studies. Dr. Azzolino earned a Doctor of Chiropractic degree from Life Chiropractic College West. He is a diplomate and Vice President of the American Chiropractic Neurology Board, diplomate in pain management through the American Academy of Pain Management, a Fellow of the American College of Functional Neurology and Fellow of the American Board of Childhood Development Disorders. He serves on the editorial board of journal of Functional Neurology, Rehabilition, and Ergonomics (FNRE). He was voted the Chiropractic Neurologist of the year in 1999 by the American Chiropractic Association

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Council on Neurology and Clinician of the year in 2010 at the International Conference of Functional Neurology. From 2008 - 2010, Dr. Azzolino served as the Northern California Delegate to the American Chiropractic Association. He is a Qualified Medical Evaluator and serves as an expert witness for disputes in workers' compensation system, personal injury and malpractice cases.

Julie Elginer, Dr. PH, (Secretary, public member)

Julie Elginer, Dr. PH of Calabasas, has been a lecturer at the University of California, Los Angeles School of Public Health and founder of Elginer Advocacy Group since 2011. She was a graduate student researcher at the UCLA Center for Health Policy Research from 2008 to 2010 and senior marketing manager at Amgen from 1999 to 2007. Elginer served as adjunct faculty for the Advisory Board Company at the Johns Hopkins School of Nursing in 2002 and was a financial analyst for Abbott Laboratories from 1995 to 1997. She earned a Doctor of Public Health degree in health services from the University of California, Los Angeles and a Master of Business Administration degree in marketing and strategy from the University of Maryland.

Dr. Hugh Lubkin, D.C., (professional member)

Dr. Hugh Lubkin, D.C., of Elk Grove, has owned and works out of Laguna Chiropractic Clinic, located in Elk Grove since 1991. In addition to his clinical practice, Dr. Lubkin is appointed as a Qualified Medical Evaluator (QME) for Workers' Compensation cases. He is a graduate of the Chiropractic Orthopedics Program (WSCC) and he works as a medical legal expert for both injury cases

05/24/12

02/28/07, 02/25/10

11/03/16 Public

Governor

02/10/14 Professional Governor

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and professional malpractice cases. Dr. Lubkin is a former Vice-President of the International Chiropractors Association of California (ICAC). Dr. Lubkin has worked as a Professional Member, Vice-Chair and Chair of the Board.

Heather Dehn, D.C., (professional member)

05/24/12

Heather Dehn, D.C., of Sacramento, has been the owner of Dehn Chiropractic since 1995. She earned a Doctor of Chiropractic degree from Palmer Chiropractic College. Dr. Dehn has previously worked as Vice-Chair of the Board.

Frank Ruffino, (public member)

Frank Ruffino is the Community Partnership Manager at the Richard J. Donovan Correctional Facility. He was Regional Administrative Officer at the California Department of Fish and Game from 2004 to 2008, and Hospital General Services Administrator at the California Department of Veterans Affairs from 2000 to 2004. Mr. Ruffino has served in multiple positions at the California Department of Corrections and Rehabilitation from 1985 to 2000. Also, Mr. Ruffino serves as the Vice President for Governmental Affairs for the Association of California State Supervisors. Additionally, he served as a member of the City of Chula Vista Civil Service Commission and the Coalinga City Planning Commission. Mr. Ruffino has dedicated all of his life to community service and has been a volunteer with many community organizations.

02/21/12

02/10/16 Professional Governor

11/03/16 Public

Governor

The Board is comprised of three units: the Administrative/Licensing Unit (ALU), the Compliance Unit (CU), and the Field Investigations Unit (FIU). The ALU is responsible for processing license applications and renewals, continuing education, and the administrative and

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policy functions for the Board. The CU and the FIU are primarily responsible for enforcement. The CU handles complaint intake, conducts administrative investigations, recommends case dispositions to the executive officer and/or the compliance manager, including those to be forwarded to the Attorney General for disciplinary action, issues letters of admonishment as well as citations and fines. The CU also serves as probation monitor to chiropractors whose licenses are on probation due to prior disciplinary action. The CU continues to refer approximately a quarter of its complaints received to the FIU. The FIU consists of non-sworn investigators who conduct field administrative investigations to complete cases.

As of the 2011 report, the Board has eight standing committees including:

1. Continuing Education 2. Enforcement 3. Government Relations 4. Legislative/Regulation 5. Licensing 6. Public Relations 7. Strategic Planning 8. Scope of Practice

Each committee is made up of at least two members appointed by the Board Chair. The committees must meet during open session meetings held three times a year. The committees may also meet on an as needed basis, but they have no authority independent of the Board.

The Board maintains a single office in Sacramento. The Board's Executive Officer presently oversees a staff of 18 permanent full-time employees and one part-time employee.

PRIOR SUNSET REVIEW: CHANGES AND IMPROVEMENTS

The Committee last reviewed the Board of Chiropractic Examiners in 2005. At that time, the Committee identified issues for the Board and directed the Board to address the issues and implement a number of recommended changes.

On November 1, 2011, the Board of Chiropractic Examiners submitted its required Sunset Report to this Committee. In its 2011 report, the Board described actions it has taken since its last sunset review. Below are the prior issues raised by the JLSRC in its Background Paper of 2005 and in its final recommendations, and the Board's responses to how the issues or recommendations of the JLSRC were addressed. (The prior "Board of Chiropractic Examiners Background Paper of 2005" which details these issues and the JLSRC Recommendations regarding the Board can be obtained from this Committee.)

1. The JLSRC recommended that the Board 1) identify those statutes that were enacted without a vote of the people that could be considered amendments to the Chiropractic Act; 2) determine if additional amendment of the Chiropractic Act is necessary to ensure

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