1. GEORGIA BOARD OF CHIROPRACTIC EXAMINERS
Board Update

2. Legal Charge of the Georgia Board of Chiropractic Examiners
The board shall possess and exercise such powers to protect the public health, safety and welfare through the regulation of the practice of chiropractic.

3. Board Members Dr. Mary Watkins, D.C., President
Dr. Andy Krantz, D.C., Vice President
Emily Campbell, Consumer Member
Dr. Robert Alpert, D.C.
Dr. Joseph Krzemien, D.C.
Dr. David Wren, D.C.
It is important to note that the consumer member is the only member who is not connected in any way to the practice of chiropractic.

4. Board Staff Board Attorney Adrienne D. Price, Executive Director
Adrienne D. Price, Executive Director
Kathy Osier, Licensing Supervisor
Sonja Glover, Licensing Analyst
Kimberly Candler, Complaints/Compliance Analyst
Michelle Foster, Board Support Specialist
Board Attorney
D. Williams-McNeely, Assistant Attorney General

5. Statistical Data: Georgia licensed Chiropractors (as of 09/07/2017)
3,337
Licenses Issued:
to date

6. Statistical Data Continued… Complaints/Disciplinary
The Board initiated 60 investigations in 2014, 79 in 2015, and 38 in In 2017, there have been 29 investigations related to advertising violations, arrests/convictions/pleas, CE violations, fraud/misrepresentations, malpractice cases, practicing beyond the scope of chiropractic, substandard care/practice, records release violations, and sexual misconduct.
In 2014 the Board issued 9 Disciplinary actions / consent orders; 23 in 2015; and 8 in In 2017, there have been 8 actions related to CE violations, unlicensed practice, and arrests/convictions/pleas.

7. Meeting Dates
All meetings are held at the Professional Licensing Boards Division in Macon, GA unless otherwise specified. The meeting dates are as follows: Macon, GA Friday, November 2, :00 a.m. Macon, GA Friday, January 12, :00 a.m. Macon, GA Friday, March 2, :00 a.m. Macon, GA Friday, May 18, :00 a.m. Macon, GA Friday, July 20, :00 a.m. Macon, GA Friday, September 7, :00 a.m. Macon, GA Friday, November 2, :00 a.m. All Board meetings are open to the public during open session in compliance with the Georgia Open Meetings Act. Matters which are confidential by law are discussed in Executive Session which is closed to the public. Investigative Subcommittee meeting dates are Macon, GA Friday, December 8, :00 a.m. Macon, GA Friday, February 2, :00 a.m. Macon, GA Friday, April 6, :00 a.m. Macon, GA Friday, June 1, :00 a.m. Macon, GA Friday, August 3, :00 a.m. Macon, GA Friday, October 5, :00 a.m. Macon, GA Friday, November 30, :00 a.m. These meetings are not open to the public as complaints and investigations are confidential by law.

8. Board Members must be dedicated to attending the meetings…
but not in the midst of
Snowmagedon or A Family of Hurricanes!
When it becomes necessary to cancel a Board Meeting due to inclement weather, the Board may opt to hold a conference call to discuss cases or attempt to reschedule the meeting as soon as possible.

9. Licensure Process Applicants must submit: Completed Application;
$275 non-refundable application fee;
Transcript showing D.C. from CCE-accredited college;
Parts 1-4 National Board Examination (Pass=375);
Undergraduate transcripts documenting completion of not less than 60 quarter/90 semester hours;
Verification of licensure from all states where applicant holds or has ever held a license;
Passing score on Georgia law examination; and
Applicants wishing to have the Certified in Modalities designation must submit documentation of 120 hours of coursework in therapeutics.
Unexpired Secure and Verifiable Document and Affidavit of Citizenship
Other information as determined by the Board (i.e. verification of employment, a curriculum vitae, continuing education, etc.).
Some military spouses and transitioning service members may qualify for an expedited application process if they or their spouse is active in the military and meet all other requirements of law.

10. Licensure Process Continued…
Standard processing time may take up to 25 business days.
Processing time may be extended in the following instances:
Application is Incomplete, i.e. missing documentation, failure to complete forms accurately, insufficient funds for the application fee
Criminal history is revealed
History of Disciplinary Action by another jurisdiction or Board is identified.
Submission of a Petition for Rule Waiver or Variance regarding certain regulatory requirements.
Questions concerning qualifications.

11. Responsibilities of license holder
1. Renew your license PRIOR to the expiration date of your license.
2. Notify the board if your name changes and send in supporting documentation.
3.Keep your and mailing address up to date.
4. Keep current with Georgia Law and Board Rules
5.Notify the board of any criminal convictions within 10 days of the conviction.
6. Display license in a conspicuous location in place of business

12. Complaint / Investigative Case File is received by the Board
Determination is made as to whether or not the allegation would be a violation of Board laws, rules and policies
If allegation is within the Board's jurisdiction, the complaint is referred to the SOS Investigations Division
The investigative findings are returned to the Investigative Subcommittee of the Board to make a recommendation regarding an action by the Board
Investigative Committee makes recommendations to the Board & the Board renders a decision on the case and/or begins the process again if more investigation is necessary.
The Complaint Process
A detailed explanation of the complaint process may be located on home page of the Secretary of State website.

13. Average Timeframes For Case Resolution
As it is in criminal law, there are a number of reasons for the delay in the resolution of some cases. The variance in timeframes are directly related to whether or not the alleged act falls within the jurisdiction of the Board; the available resources to investigate the case (i.e. number of available enforcement officers per case load); responsiveness of witnesses when gathering evidence; receipt of a preponderance of evidence (convincing evidence and its probable truth or accuracy) in order to proceed to action; and each licensee’s constitutional right to due process (i.e. fair treatment with no deprivation of life, liberty, or property without first giving adequate notice under the law and an opportunity to defend themselves).
YEAR
MONTHS
DAYS
2017
4.5
128
2016
5.17
155
2015
6.1
183
2014
8.63
259

14. Status of Complaints
As of September 21, 2017, the Board had 74 open cases which fell within the following categories:
Action in Another Jurisdiction 2
Prescribing Violation 1
Advertising 7
Quality of Care/Substandard 4
Arrest, Conviction & Plea 3
Records Release Violation
CE Violation
Sexual Misconduct 5
Drug Diversion / Impairment
Solicitation by Runner
Failure to Meet Qualifications
Unlicensed Practice 11
Fraud/Misrepresentation
Unprofessional / Unethical Conduct 13
Malpractice
Violation of Board Order
Practicing Beyond Scope
Other: Failure to meet licensure qualifications / chiropractor’s dog attacked complainant

15. Complaint Categories Organized by Relevant Statutes (O. C. G. A
Complaint Categories Organized by Relevant Statutes (O.C.G.A. §§ & O.C.G.A )
Action in Another Jurisdiction [O.C.G.A. § (a)(5)]
Advertising [O.C.G.A. § (7)]
Criminal [O.C.G.A. § (a)(3) & (4)(A-5)]
Arrest/Conviction/Plea/Nolo
Failure to Demonstrate Qualifications for License [O.C.G.A. § (a)(1)]
CE Violation
Failure to meet exam or education requirements
Failure to submit a complete application
Unlicensed practice & aiding and abetting unlicensed practice [O.C.G.A. § (a)(7)]
Fraudulent, Deceptive Representations [O.C.G.A. § (a)(2)]
Drug Diversion
Prescribing Violation
Inappropriate interactions with patients/staff
Unprofessional Conduct [O.C.G.A. § (a)(6 - 11)]
Impairment
Inability to practice with reasonable skill and safety
Malpractice
Practicing Beyond Scope
Quality of Care/Substandard Care
Records Release Violations
Sexual Misconduct
Solicitation by Runner
Substance abuse
Unethical Conduct
Violation of Board Order

16. How To File An Online Complaint
Visit & Select the “Licensing” link at the top of the page

17. How to File An Online Complaint
Locate the “Submit a Complaint” button on the page and select it.

18. How to File An Online Complaint
You will select a link based on whether or not you are submitting a complaint against a licensed person, an unlicensed person or a facility.
CLICK HERE

19. How to File An Online Complaint
You will then need to search for the individual by entering information into the available search fields. Once you have entered information, select “Search.”
The next page that comes up gives you the option to select “Submit Complaint” beside the name of the individual or facility on which you are complaining.

20. How to File An Online Complaint
Complete the online submission form in its entirety with as much information as you have available and select “Submit.”

21. Additional Methods For Filing a Complaint
A complaint may also be submitted via:
US Mail
Phone - Please be aware that if a complaint is submitted via the phone, pertinent information will be documented; however, the complaint process may not begin if the complainant does not submit the substance of the complaint in a written format.
Anonymous complaints are accepted; however, they may or may not be acted upon by the Board if the complainant fails to submit enough detail on which the Board may initiate an investigation
A Complainant’s information is confidential during the course of the investigation; however, should the case proceed to hearing it is possible that the Complainant’s identity may be realized. It is also possible for the Licensee/Respondent to surmise the identity of the Complainant based on the information that is provided to them in order for the Board to illicit a response.

22. The Board Decision
When considering information relevant to a complaint investigation, the Board may either:
Close the case
Conduct an additional investigation
Issue a non-disciplinary action through:
A Mitigating Letter – a settlement agreement between the Board and the Licensee/Respondent, i.e. if the individual meets certain conditions established by the Board, no public action will be taken and the case will be closed.
A Letter of Concern – a statement from the Board that the allegations are of concern to the Board but the evidence does not rise to the level of a sanction or disciplinary action.
Sanction or discipline a license by:
A Private Order/Agreement – not available to the public but may be released to law enforcement agencies or lawful licensing authorities
A Public Order/Agreement – is available for public review and is typically posted on the license verification site. Public actions are also reportable to the National Practitioner Databank (NPDB) and The Chiropractic Information Network/Board Action Databank (CIN-BAD).
Deny the issuance of a license (which is also an action reportable to NPDB and CIN-BAD).

23. What is NPDB & CIN-BAD
National Practitioner Databank (NPDB) The National Practitioner Data Bank (NPDB), or "the Data Bank," is a confidential information clearinghouse created by Congress with the primary goals of improving health care quality, protecting the public, and reducing health care fraud and abuse in the U.S. See Table 1 for information on who can query and report to the Data Bank. -
The Chiropractic Information Network/Board Action Databank (CIN-BAD) is an inter-jurisdictional chiropractic board action database of information on public actions taken by chiropractic regulatory licensing boards and/or exclusions from Medicare/Medicaid reimbursement by the U.S. Department of Health & Human Services with regard to individual chiropractors. It is maintained by the Federation of Chiropractic Licensing Boards as a service to its member boards, to the health care community, and to the general public. -
Both databanks house public actions and help the Board to protect the public health, safety and welfare by enabling the Board to track those individuals who have violated the law and/or engaged in unsafe or unauthorized practices in other states.

24. What About Chiropractic Assistants?
Georgia law does not allow an unlicensed individual (C.A.) to work under a D.C.’s license to provide massage therapy services.
C.A.’s can still perform other duties under the direct supervision of the D.C. to include but not be limited to:
Physiological Therapeutics
Patient history
X-Rays with certification

25. Statutory Changes
There were no statutory changes which directly effected the chiropractic board during the 2017 Session of the Georgia General Assembly; however, the Board is operating under the following statutory changes which went into effect in 2016.
O.C.G.A. § 43-1C “Georgia Professional Regulation Reform Act” – Became effective July 1, 2016 and provides for executive oversight of the Professional Licensing Boards to the office of the Governor of the State of Georgia.
O.C.G.A. § 43-1C-2(3); “Military Spouses and Veterans Licensure Act” – Became effective July 1, 2016 and requires professional licensing boards and other boards to adopt rules and regulations implementing a process by which military spouses and transitioning service members may qualify for licenses.
O.C.G.A. § “General Provisions of Law” – Became effective July 1, 2016 and requires professional licensing boards to consider certain factors relating to felonies before denying a license to an applicant or revoking a license and to provide for probationary licenses for participants in accountability courts.
O.C.G.A. § 38-3 “Uniform Emergency Volunteer Health Practitioners Act” – Became effective July 1, 2016 and provides for regulation of volunteer health practitioners during a declared emergency
O.C.G.A. § “The Consumer Information and Awareness Act” - signed
into law by Governor Nathan Deal on May 12, The new statute requires
that licensed health care practitioners provide for certain identification,
educational identifiers and signage in the workplace and in advertisements.
It also identifies the penalties for intentional violation of the provisions of the law.

26. Rules Amended and/or Adopted in 2017
Board Rule Diplomate Status and Certifications
Board Rule Standards of Practice
Board Rule Review Agent
NEW RULE: Board Rule Guidelines for the Chiropractic Peer Reviewer
If you are interested in being notified of proposed rule amendments, it is suggested that you subscribe to the interested parties list by visiting selecting the link for subscriptions on the home page and following the instructions to subscribe.
Proposed Rules that have been posted for public comment can be found at
These rules were adopted by the Board during the May 19, 2017 Board meeting; however, they have not yet been approved by the Governor Oversight Committee. As a result, the revised or new rules are not yet in effect.

27. Policy Amendments of 2017
Policy # 4 – Updated procedural guidelines and requirements for the reactivation.
Policy # 5 – Authorizes staff to administratively process reinstatement applications under specified conditions and if application falls outside of those terms and conditions, staff is to prepare it for review by the Board.
Policy # 7 – Provides procedural guidelines by which staff may conduct an audit of continuing education each renewal cycle.
These policy revisions were approved during the May 19, 2017 Board meeting; however, they have not yet been approved by the Governor Oversight Committee. As a result, the revised versions are not yet in effect.

28. Patient Records Law O.C.G.A. §31-33 Health Records
Georgia Patients Records laws can be found under the
Laws, Policies & Rules on the Board’s website where O.C.G.A. § is references.
The law requires providers to maintain patient records for not less than 10 years from the date the patient was last treated.
Further provides for charging a fee for copying and mailing patient records.
A practitioner cannot refuse to release patient records if the patient has an outstanding balance. Per Board Policy #3, records must be released within 3-5 working days from receipt of a properly signed and executed request from a patient or legal designee.

29. Patient Records continued…
The minimum, reasonable standard of care must be evident within the patient records and reflect that the chiropractor is practicing within the scope, is practicing ethically, insurance requisitions(if applicable), consent forms and notes which include examination results, treatments, diagnostics and clinical impressions.
The minimum, reasonable standard includes but is not limited to documentation of:
Subjective - The subjective component is the client’s report of how he or she has been doing since the last visit, and this includes the current visit.
Objective - The objective component is straightforward and includes vital signs (temperature, blood pressure, pulse, respiration), documentation of the physical examination that was done, and results of laboratory or other studies that may be done during the course of this visit.
Assessment - the clinician pulls together the subjective information gathered during the interview with the client and the objective findings of the physical exam (and, possibly, laboratory or other study results) and consolidates them into a short assessment in order to formulate a diagnosis
Plan - The plan should include anything that will be done as a consequence of the assessment and may include recommendations for treatment.

30. Minimum Reasonable Standards
The minimum reasonable standards of care not only include what is reflected within the patient record but it also extends to the chiropractors conduct, behavior and the ways in which chiropractors interact with their clients or potential clients (See Board Rules Chapter 7).
Question:
1) Is this an appropriate
advertisement?
2) Why or Why Not?

31. Additional Examples of Questionable Advertisements
Is this advertisement
appropriate? Why or Why
Not?

32. Advertising
1.Defined advertising shall mean any information communicated in a manner designed to attract public attention to the public.
2. A licensee shall not make any false, misleading, or deceptive communication.
3. Advertising can not give impression of professional superiority.
4. advertising that has the capacity or tendency to create false or unjustified expectations of beneficial treatment or successful cures.
5. Chiropractors may only use the terms chiropractor, doctor of chiropractic and/or D.C. The term Chiropractic Physician is NOT authorized.
6. Advertised services being offered free or at a discount must be presented in writing to and signed by the patient, clearly explaining that any further treatment will be provided at rates regularly charged by this office.

33. Waiver of deductibles or copayments in healthcare plans; deceptive or misleading advertising
-it shall be considered a deceptive or misleading practice for any person duly licensed and authorized to provide any type of health care services to advertise, as an inducement to attract patients, the waiver of a deductible or copayment required to be made to such person under the patient’s health insurance policy or plan.

34. CE Requirements Board Rule 100-5-.02 20 hours required per year
15 in clinical sciences
4 in ethics and risk management
1 in Georgia laws and rules
Maximum of 3 in philosophy
Maximum of 4 in clinical documentation
No more than twenty (20) hours per biennial renewal period can be taken via audio/visual/electronic media, such as on-line/internet courses.
Each licensed chiropractor shall maintain in his/her own possession certificates of attendance at continuing education meetings for a period of 4 years from the date of the program.
Each doctor of chiropractic is responsible for determining in advance that the courses which he/she proposes to attend are sponsored by an approved provider.
A continuing education audit may be conducted on any licensee during renewal. When the renewal application is completed, all continuing education requirements should also be complete because at that time, each licensee is asked to attest to having met the CE requirements in accordance with the Board rules.
If a licensee has not satisfied the CE requirements at the time he/she applies for renewal, the answer to the CE attestation question should be “NO.” PLEASE NOTE, THAT IF A LICENSEE ANSWERS “NO” TO HAVING MET THE CONTINUING REQUIREMENTS AT THE TIME HE/SHE APPLIES FOR RENEWAL, ALL HOURS MUST BE COMPLETED PRIOR TO THE EXPIRATION DATE OF THE LICENSE. LICENSEES WHO ANSWER “NO” ARE AUTOMATICALLY AUDITED. LICENSEES ARE SUBJECT TO DISCIPLINARY ACTION BY THE BOARD IF THE CE REQUIREMENTS ARE NOT MET IN ACCORDANCE WITH BOARD RULES AND POLICIES.

35. License Renewal
License renewal applications general go live anytime between days prior to the expiration date of the license. Before attempting to renew, visit the Board website to see if there is a statement on the home page announcing that renewal is now live. The deadline to renew is 12/31 of even-numbered years.
Fee $125.
Late Renewal 01/01 – 03/31- Fee $225.
04/01 or later – Reinstatement Required
No licensee can practice after 12/31 until the license has been renewed.
The licensed D.C. is responsible for ensuring that the license is renewed timely; therefore if the licensee allows someone else to apply for the renewal on their behalf, the licensee will still be held accountable for the responses provided. As a result, it is strongly suggested that licensees complete the renewal application themselves. 
IMPORTANT = If you applied for license renewal, always check the license verification page prior to the expiration date of your license to be sure that your license has been renewed and your expiration date has changed.
You do this by visiting and then select the “Search for a Licensee” feature. Enter the search criteria, click “Search,” select your name to open the verifications page and then check the table ensure that the status says “Active” (or “Probation” if you practice under the terms of a public order) and the expiration date has changed. If the expiration date remains the same or there is some other status besides “active,” the renewal application is not complete and you should check your s and/or contact the Board offices to make an inquiry.

36. Georgia Board of Chiropractic Examiners
Contact Information
Georgia Board of Chiropractic Examiners
237 Coliseum Dr.
Macon, GA
(478)
Fax (866)