Current through Reg. 50, No. 187; September 24, 2024
Unless otherwise approved by the Board or its designee, or
addressed by the Final Order, the following are the terms applicable to all
Final Orders rendered by the Board in disciplinary proceedings.
(1) Payment of Fines and Costs. All fines and
costs shall be paid by check or money order made payable to the Board and sent
to DOH/Compliance Management Unit, Bin #C76, P.O. Box 6320, Tallahassee,
Florida 32314-6320, within thirty (30) days of the filing of the Order unless
another date is negotiated between the Department and the Respondent, and
approved by the Board.
(2)
Addresses. Respondent must keep current residence and practice addresses on
file with the Board. Respondent shall notify the Compliance Office, in writing,
within ten (10) days of any changes of those addresses. Furthermore, if the
Respondent's license is on probation, the Respondent shall notify the
Compliance Office within ten (10) days in the event that Respondent leaves the
active practice of chiropractic medicine in Florida.
(3) Compliance Address. All reports,
correspondence and inquiries shall be sent to: DOH, Compliance Management Unit,
Bin #C76, 4052 Bald Cypress Way, Tallahassee, Florida 32399-3251, Attn:
Chiropractic Medicine Compliance Officer.
(4) Continuing Education.
(a) Continuing education imposed by Board
Order shall be in addition to those hours required for biennial renewal of
licensure. The Board confers authority on the Compliance Committee Chair
("Chair") to approve or disapprove continuing education courses. The Respondent
is required to submit a course syllabus for all continuing education courses
Respondent seeks to have approved. The courses shall be live in-person format;
online/virtual live courses will not be approved.
(b) The time frame for completing such
continuing education is twelve (12) months from the date the Order is
filed;
(5) PRN
Conditions. Should the Board determine that a contract by the Professionals
Resource Network (PRN) is appropriate, Respondent shall participate and comply
with the PRN contract.
(a) Respondent shall
enter into a with PRN, shall comply with all its terms, and shall be
responsible for assuring that the medical director of PRN sends the Compliance
Office a copy of said contract.
(b)
Respondent shall execute a release that authorizes PRN to release information
and medical records (including psychiatric records and records relating to
treatment for drug dependence and alcoholism) to the Board of Chiropractic
Medicine as needed to monitor the progress of Respondent in the PRN
program.
(c) Respondent shall
authorize the director of PRN to report to the Board of Chiropractic Medicine
any problems that may occur with Respondent and any violations of Chapter 456
or 460, F.S. Such a report shall be made within thirty (30) days of the
occurrence of any problems, or violations of Chapter 456 or 459,
F.S.
(6) Restriction of
the authorized scope of practice or license. Whether or not the action also
involves placing Respondent on probation or monitoring, or imposing any
penalty, the Board may impose restrictions on Respondent's practice that
include, but are not limited to the following:
(a) Requiring remedial education as a
requirement of continued practice,
(b) Restricting the licensee from practicing
in certain settings,
(c)
Restricting the licensee to work in only certain settings or under designated
conditions,
(d) Restrictions on
Treating Female, Minor, and Vulnerable Person Patients. Should the Board
determine there should be a restriction on treating female, minor, or
vulnerable person patients, Respondent shall not examine or treat female,
minor, or vulnerable person patients without a chaperone who is a health care
practitioner licensed by the Florida Department of Health present in the room
in any examination or treatment setting. The Respondent is required to maintain
a log of each such patient contact, and the name of the chaperone present. The
log shall be immediately available to a Department of Health inspector,
monitor, Board Compliance Officer or the Board Chair upon request.
(e) Restricting the licensee from performing
or providing designated clinical and administrative services,
(f) Restricting the licensee from practicing
above a designated number of hours,
(g) Any other restriction found to be
necessary for the protection of the public health, safety, and welfare and is
reasonably related to the specific violation for which discipline is being
imposed.
(7) Continuity
of Practice.
(a) Tolling Provisions. In the
event the Respondent leaves the State of Florida for a period of sixty (60)
days or more or otherwise does not or may not engage in the active practice of
chiropractic medicine in the State of Florida due to location out of the state,
license suspension, incarceration or inability to safely practice due to PRN
restrictions, then certain provisions of the requirements in the Board's Order
shall be tolled and shall remain in a tolled status until Respondent returns to
the active practice of chiropractic medicine in the State of Florida.
Respondent shall notify the Compliance Officer ten (10) days prior to his or
her return to practice in the State of Florida. The following requirements
shall be tolled until the Respondent returns to active practice:
1. The time period of probation shall be
tolled.
2. The provisions regarding
supervision, whether direct or indirect, by the monitor/supervisor and required
reports from the monitor/supervisor shall be tolled.
3. The requirement for quality assurance
review of Respondent's practice shall be tolled.
(b) Active Practice. In the event that
Respondent leaves the active practice of chiropractic medicine for a period of
one year or more, the Respondent may be required to appear before the Board and
demonstrate the ability to practice chiropractic medicine with reasonable skill
and safety to patients prior to resuming the practice of chiropractic medicine
in the State of Florida, which may include but not be limited to passage of the
National Board of Chiropractic Examiners SPEC Examination, EBAS Examination, or
additional CE coursework.
(8) Definitions of Probation / Supervision /
Monitoring Terms.
(a) Probation is any ongoing
requirement relating to Respondent's practice, including but not limited to,
direct or indirect supervision, records review, remedial education, PRN
compliance, or reporting.
(b)
Monitoring is indirect supervision by a monitoring physician (monitor), as set
forth in the Board's Order. Monitoring does not require that the monitor
practice on the same premises as the Respondent. However, the monitor shall
practice within a reasonable geographic proximity to Respondent, which shall be
within fifty (50) miles and shall be readily available for
consultation.
(c) Supervision is
direct supervision by a supervising physician (supervisor), as set forth in the
Order. Direct supervision requires that the supervisor and Respondent work in
the same office.
(d) Immediate
Supervision is supervision by a supervising physician (supervisor), as set
forth in the Board's order. Immediate Supervision requires that the supervisor
be physically located in the same room when supervising the
Respondent.
(e) Records Review is
indirect supervision of the patient charts/logs/records of Respondent and
Respondent's practice by the monitor or Board's compliance officer. The Board
shall set forth the percentage of the records and type of records to be
reviewed. The patient records shall be selected by the monitoring physician on
a random basis at least once every month. In order to comply with this
responsibility of random review, the monitoring physician shall go to
Respondent's office once every month unless a different time frame is set forth
in the Board's Order. At that time, the monitoring physician shall be
responsible for making the random selection of the records to be reviewed by
the monitoring physician.
(9) Probation.
(a) Probation Term. Unless otherwise
specified within each individual offense guideline, or unless a lesser period
of time is stated in the order imposing probation, the period of probation will
be for a period of five (5) years,
(b) Probation Conditions. Probation
conditions may include, but not be limited to, the following; and may be
imposed regardless of whether the term "conditions" is referenced in an
individual offense guideline:
1. Requiring the
licensee to attend additional continuing education courses or remedial
education;
2. Requiring the
licensee to pass an examination on the content and requirements of Chapters 456
and 460, F.S., and Division 64B2, F.A.C.;
3. Requiring the licensee to work under the
supervision of another licensee, including the submission of documents and
reports from the supervisor and licensee;
4. Tolling of the running of the probationary
period when the licensee ceases to practice in Florida, or fails to maintain
compliance with the probation requirements;
5. Compliance with all terms of the order
that imposes probation;
6.
Evaluation by PRN and entering or maintaining compliance with a recommended
impaired practitioners program contract;
7. Submitting to a continuing education audit
for the next two consecutive biennial licensure renewal periods beginning with
the date of the order imposing probation;
8. Corrective action related to the
violation, including but not limited to the repayment of any fees billed and
collected from a patient or third party on behalf of the patient.
9. Passage of the SPEC or EBAS Examinations
conducted by the National Board of Chiropractic
Examiners.
(10)
Requirements for Monitors/Supervisors.
(a) If
the terms of the Order include indirect supervision/monitoring of the
licensee's practice (monitoring) or direct monitoring of the licensee's
practice (supervision), the Respondent shall not practice chiropractic medicine
without an approved monitor/supervisor, as specified by the Final
Order.
(b) The monitor/supervisor
must be licensed under Chapter 460, F.S., in good standing, in active status
for a minimum of five (5) years, without restriction or limitation on his or
her license, must be qualified by training and experience, and must not have
any conflicts of interest that would prohibit him or her from impartially
performing his or her duties as a monitor/supervisor. Specific grounds for
rejecting a proposed monitor/supervisor by the Board or its designee shall
include but are not limited to the following:
1. The proposed monitor/supervisor has
previously been subject to disciplinary action against his/her license in this
or any other jurisdiction,
2. The
proposed monitor/supervisor is currently under investigation, or is the subject
of a pending disciplinary action,
3. The proposed monitor/supervisor is not
actively engaged in the practice of chiropractic medicine or the management of
a chiropractic or related clinic/office,
4. The proposed monitor/supervisor is not
practicing within a distance of no more than fifty (50) one hundred (100) miles
from the Respondent's practice location,
5. The proposed monitor/supervisor is a
relative or employee of the Respondent.
(c) Temporary Approval. The Board confers
authority on the Chair to temporarily approve Respondent's monitor/supervisor.
To obtain this temporary approval, Respondent shall submit to the Compliance
Officer the name and curriculum vitae of the proposed monitor/supervisor, and
letter from the proposed monitor/supervisor stating that he or she is willing
to serve as a monitor/supervisor, that he or she has received a copy of the
Administrative Complaint and Final Order, that he or she is aware of his or her
duties and responsibilities as a monitor/supervisor, that he or she discloses
any conflicts of interests, specifies distance to the Respondent's practice
location, and that he or she agrees to appear before the Board for formal
approval at the next meeting of the Board. This information shall be furnished
to the Chair by way of the Compliance Officer. Should Respondent's
monitoring/supervising physician be temporarily approved, said approval shall
only remain in effect until the next meeting of the Board. Absent said
approval, Respondent shall not practice chiropractic medicine until a
monitoring/supervising physician is approved.
(d) Formal Approval. Unless waived by the
Board, Respondent shall have the monitor/supervisor with him or her at the
first probation appearance before the Board. Prior to consideration of the
monitor/supervisor by the Board, the Respondent shall provide the
monitor/supervisor a copy of the Administrative Complaint and the Board's Order
in this case. Respondent shall submit a current curriculum vitae, a description
of current practice, and a letter agreeing to serve from the proposed
monitor/supervisor to the Compliance Officer no later than twenty-one (21) days
before the Respondent's first scheduled probation appearance. Respondent's
monitor/supervisor shall also appear before the Board at such times as directed
by the Board. It shall be the Respondent's responsibility to ensure the
appearance of his or her monitor/supervisor as directed. Failure of the
monitor/supervisor to appear as directed shall constitute a violation of the
terms of the Board's Order and shall render the Respondent subject to
additional disciplinary action.
(e)
Change in Monitor/Supervisor. In the event that Respondent's monitor/supervisor
is unable or unwilling to fulfill his/her responsibilities as a
monitor/supervisor as described above, the Respondent shall advise the
Compliance Office of this fact within twenty-four (24) hours of becoming aware
of the situation. Respondent shall submit to the Compliance Office the name of
a temporary monitor/supervisor for consideration. Respondent shall not practice
pending approval of this temporary monitor/supervisor by the Chair.
Furthermore, Respondent shall make arrangements with his or her temporary
monitor/supervisor to appear before the Board at its next regularly scheduled
meeting for consideration of the monitor/supervisor. Respondent shall only
practice under the supervision of the temporary monitor/supervisor (approved by
the Chair) until the next regularly scheduled meeting of the Board where at the
issue of the Respondent's new monitor/supervisor shall be addressed.
(f) Appearances. The Respondent shall appear
before the Board at the first Board meeting after probation commences, at the
last meeting of the Board preceding scheduled termination of probation, and at
such other times as requested by the Board, Board Chair, or Compliance
Chair.
(g) Reports. If directed by
Board Order, probation reports, in affidavit form, shall be submitted by the
Respondent and shall contain the following:
1.
Brief statement of why Respondent is on probation.
2. Practice location.
3. Describe current practice (type and
composition).
4. Brief statement of
compliance with probationary terms.
5. Describe relationship with
monitoring/supervising physician.
6. Advise Compliance Officer of any problems
including office incident reports filed; loss or restriction of hospital/clinic
staff privileges; or any Medicare/Medicaid program exclusions, restrictions or
limitations.
(h)
Monitor/Supervisor Reports. If directed by Board Order, monitor/supervisor
reports, in affidavit form, shall include the following:
1. Brief statement of why Respondent is on
probation.
2. Description of
probationer's practice.
3. Brief
statement of probationer's compliance with terms of probation.
4. Brief description of probationer's
relationship with monitoring physician.
5. Detail any problems which may have arisen
with probationer.
(i)
Monitor/Supervisor Records Review. Should the Board determine that the
Respondent's records need to be reviewed, the Board shall set forth the
percentage of the records and type of records to be reviewed by the
monitoring/supervising physician. The patient records shall be selected by the
supervising physician on a random basis at least once every month. A separate
report shall be completed for each record reviewed.
(j) Investigative Reports. Respondent
understands that during the period of probation, at a minimum, semi-annual
investigative reports will be compiled with the Department of Health concerning
compliance with the terms and conditions of probation and the rules and
statutes regulating the practice of chiropractic medicine.
(k) For purposes of determining the dates
when reports are due, the date the Final Order is filed shall constitute the
beginning of the quarter.
1. All quarterly
reports shall be provided to the Board office no later than three (3) months
from the filing date of the Final Order.
2. All semiannual reports shall be provided
to the Board office no later than six (6) months from the filing date of the
Final Order.
3. All annual reports
shall be provided to the Board office no later than twelve (12) months from the
filing date of the Final Order.
(10) Appearances Required. Respondent shall
appear before the Board at the first meeting after said probation commences and
at the last meeting of the Board preceding termination of probation. Respondent
shall be noticed by Board staff of the date, time and place of the Board's
meeting whereat Respondent's appearance is required. Failure of the Respondent
to appear as requested or directed shall be considered a violation of the terms
of probation, and shall subject the Respondent to disciplinary action,
including but not limited to extension of the term of probation, monitoring, or
supervision.
(11) Costs of
Compliance. Respondent shall pay all costs necessary to comply with the terms
of the Board's Order. Such costs include, but are not limited to, the costs of
preparation of the investigative reports detailing compliance with the terms of
the Order, the cost of analysis of any blood or urine specimens submitted
pursuant to the Order, and administrative costs directly associated with
Respondent's probation. See Section
460.413(2),
F.S.
(12) License Expiration. In
the event that a Respondent's license expires during the period that the
license is suspended, this action shall not relieve the Respondent of the
responsibility to renew the license at the end of each licensure period. If the
Respondent fails to renew the license at the end of any licensure period, all
normal conditions and consequences imposed by statute or rule of the Board for
failure to timely and properly renew a license shall apply. Renewal of a
suspended license during the period of suspension shall not affect the
suspension of the license and the suspension shall continue until all
requirements for reinstatement have been met.
(13) Return of License. Any Order which
suspends a license, revokes a license, or accepts a Respondent's offer to
voluntarily relinquish his or her license shall require the Respondent to
return the license to the Department within thirty (30) days from the date the
Final Order is filed. This shall not apply to instances where the Board or a
court has granted the Respondent a stay of the suspension.
Rulemaking Authority
460.405,
456.072(2),
456.079(1),
460.413(4) FS
Law Implemented 456.072(2),
456.079(1),
460.413(2), (4)
FS.
New 11-16-21.
