Certified Chiropractic Therapy AssistantsClinical

Public Protection Perspective

• Boards do NOT hear complaints – reluctant to change

• Why isn’t this covered by delegation clauses?– Doctor’s license is responsible

• 5.1% of malpractice claims involve patient injuries

• NINE US boards currently have some type of regulatory authority over CAs who help with therapies

• Ranges from little or no defined training hours to fairly robust programs

Public Protection Perspective

At a Glance

• Vacuum cleaners are coming: $93,000 removed from AZ DC last month

• Without a national certificationprogram, boards and insurance companies will create their ownrequirements

Insurance regulators are demanding that insurance companies only allow credentialed people to touch patients

Building a National Program• Post grad deans developed core curriculum

components• Task force built on core: – clinical competencies– model statute and regs

• Discussions with stakeholders– Summits– FCLB regional meetings– COCSA, ACA, CCE– FCLB Baltimore meetings

Core Program Values

• Credible• Affordable• Gets CA to work quickly• Portable credentials

At a Glance

Certified to assist

with Therapies (CCCA)

BillingFront Desk

SuppliesCustomer RelationsBusiness

Management

Certified to assist

with X-rays

(ACCRT)

NBCE 2009 Practice Analysis

• 55% of respondents employ 1 or more CAs who have direct patient contact

• Previous surveys (2003 and 1998) showed 41% delegate therapies to assistants

• 44% think their state requires licensure or certification– These CAs are full-time in 28.8% of offices

NBCE 2009 Practice Analysis

NBCE 2009 Practice Analysis

At a Glance

Program Components

• Eligibility Criteria – 18 yrs, High school or equiv– Criminal background check

• Didactic Training – 20 to 40 hrs– On-line, in person, combination OK– Offered by PACE Approved Providers– Providers may offer short refresher course– CE hours

Program Components

• Examination– Offered by NBCE– Available frequently– Modest cost– Available to new trainees, those out of practice for

a while, or grandfathering experienced people

Program Components

• Clinical Internship– Register with the board– Log progress regularly on website– Minimum # hours– Doctor certifies specific competencies– Billable services while training

Regulation

• Experience with violations – what do CCTAs do wrong?– Exceed scope of authority– On own initiative or at direction of DC

• Additional revenue source for boards• Possible resistance to regulating additional

group of people

National / International Registry

• Web-based• Facilitates mobility

Grandfathering Provision

• Based on NBCE exam• How much previous background to qualify• How to reinstate status after absence

• Boards’ regulatory authority over clinical CAs

– Which boards have authority now?– Which boards can get authority in the future?– Which boards will never be able to have

authority?• Insurance companies will regulate by contract

Today’s Issue

Comments Welcome

• Materials posted on FCLB website– Brochure• Expanded handout

– Clinical competencies– Model statute and regulation

We must changeWe can change

We are not alone