Current through Register Vol. 47, No. 12, December 22, 2023
A. Lapsed or Expired South Carolina
Licenses.
(1) A chiropractor whose
license has been expired for more than twelve (12) months but four
(4) years or less, may reactivate the license by submitting an
Application for Reinstatement, satisfactory evidence of CE for each
lapsed or expired renewal cycle, if applicable, and each renewal
cycle's license fee plus the applicable penalty.
(2) A chiropractor whose license
has been expired for more than four (4) years must complete a new
application and take and pass the SPEC examination, or meet
requirements in effect at the time of the new application.
B. Continuing Education
(CE). As a pre-requisite for biennial renewal of a practitioner's
license, the licensee must complete a minimum of thirty-six (36)
hours of approved professional CE, no more than half of which may be
online. "One continuing education (CE) hour" shall mean a minimum of
fifty (50) minutes of interactive instruction or organized learning.
Of the thirty-six (36) CE hours, two (2) hours are required in rules
and regulations of the S.C. Board of Chiropractic Examiners (limited
to four (4) hours per renewal period) and two (2) hours in risk
management which include, but are not limited to, boundary or public
health issues.
(1) Acceptable
educational programs or courses are those that are:
(a) presented and/or sponsored by
accredited chiropractic colleges;
(b) taught by post-graduate level
instructors of an accredited college or school approved by the Board;
or
(c) presented and/or
sponsored by other individuals or organizations approved by the
Board.
(2) In
addition, CE may also be granted by:
(a) administering Part IV of the
National Board of Chiropractic Examination, which may count toward
fifteen (15) hours of CE per administration, including risk
management and boundary issues credit;
(b) attendance at Federation of
Chiropractic Licensing Boards/National Board of Chiropractic
Examiners (FCLB/NBCE) meetings, which may be accepted as twelve (12)
hours of CE per meeting;
(c) teaching a course at an
accredited chiropractic college, which may provide the number of CE
hours commensurate with the hours earned by the students taking the
course;
(d) serving as a
teaching assistant for a course at an accredited chiropractic
college, which can earn one-half of the hours earned by students
taking the course;
(e)
out-of-state licensees meeting their home state's CE requirements,
which will satisfy the Board's CE requirements;
(f) teaching an approved CE
seminar, which may provide the number of CE hours equal to the number
of hours taught in the course limited to eighteen (18) hours per
renewal period; and
(g)
attending a test committee of NBCE, which may be accepted as twelve
(12) hours of CE per meeting.
(3) CE Exemption. Chiropractors who
graduate from an accredited chiropractic college and become licensed
to practice chiropractic within the same biennial license renewal
period are exempted from the thirty-six (36) hour CE requirement
during that same biennial renewal period. Their senior year
chiropractic college classes and their license examination
preparation and testing are deemed to adequately fulfill the aims of
the CE requirement during this time period. This exemption is allowed
only for those who graduate and are licensed within the same renewal
period; chiropractic college graduates who become licensed during a
renewal period other than that of their graduation are not eligible
for this exemption.
(4)
Sponsor Requirements. All sponsors seeking approval for educational
programs must submit a written request to the Board Administrator at
least ninety (90) days prior to the scheduled date of the
presentation, be PACE (Providers of Approved Continuing
Education)-approved (provided it is within the scope of chiropractic
practice), South Carolina Chiropractic Association, Palmetto State
Chiropractic Association, or other associations or organizations
approved by the Board in its discretion. Non-PACE-approved providers
shall:
(a) have a mechanism for the
maintenance of records for no fewer than three (3) years;
(b) have a method of monitoring and
verifying attendance;
(c)
provide each participant adequate documentation of participation in
the program to include:
(i) name
and license number of participant;
(ii) name and address of the
sponsoring individual(s) or organization;
(iii) name of program;
(iv) number of hours
completed;
(v) date and
location of program;
(vi)
authorized signature.
(d) not present sales promotions
during the CE seminar or presentation. Sales promotions are
appropriate by sponsors or instructors outside the seminar or
presentation, or outside the room during a seminar or
presentation.
(5) Program Approval Requirements.
Requests for program approval must include the following information:
(a) name and address of the
sponsoring individual(s) or organization;
(b) instructors' name and
credentials;
(c) outline
of program content;
(d)
the number of actual hours of instruction;
(e) the method of monitoring and
certifying attendance;
(f) location at which the program
will be presented;
(g)
the dates on which the program will be presented;
(h) course approval is valid for
two (2) renewal periods.
(6) Program approval will be based
on the following criteria:
(a) The
program will enhance the practitioner's knowledge and skill in the
practice of chiropractic as defined by state law.
(b) The instructors are
sufficiently qualified in the field of instruction either by
practical or academic experience or both.
(c) The program will be held in a
suitable setting, conducive to learning.
(d) Adequate monitoring or
certifying measures are provided.
(7) Practice-building subject
matter (administration, finance, etc.) will not be approved for
license renewal.
(8)
Comprehensive Approval. A comprehensive approval allows the provider
or sponsor to submit an application indicating all course offerings
for a given calendar year. Requests for a comprehensive approval may
be submitted to the Board office at least ninety (90) days prior to
the beginning of each year or ninety (90) days prior to the beginning
of a scheduled program. Providers and sponsors shall be responsible
for renewal approval.
C. Retention and Audit. Licensees
must maintain copies of attendance certificates for four (4) years
from the last renewal date. The Board may conduct random audits of
licensees on an annual or biennial basis to certify compliance with
CE requirements.
D.
Waiver During Period of Temporary Medical Disability. The Board
reserves the right to waive CE requirements for individual cases
involving extraordinary hardship or incapacitating illness. A
licensee may be eligible for waiver or extension who, upon written
application to the Board and for good cause shown, demonstrates that
the applicant is unable to participate in a sufficient number of
regular continuing education programs for license renewal.
E. Therapeutic Modalities. Usage of
therapeutic modalities is permitted only by those chiropractors who
have passed the National Board of Chiropractic Examiners (NBCE)
physiotherapy exam or a substantially equivalent future NBCE
examination. Chiropractors licensed in South Carolina prior to June
1, 1986, are exempt from this examination. Therapeutic modalities are
limited to those modalities within the chiropractic scope of
practice.
(1) Permitted Machines.
The following machines are approved for use in therapeutic
modalities:
(a) high Frequency
Diathermy: Shortwave diathermy, Microwave diathermy,
Ultrasound;
(b) low
Frequency Direct current: Low voltage galvanism, High voltage
galvanism;
(c)
alternating Current: Sine Wave, Faradic, Transcutaneous
Stimulation;
(d) medium
Frequency Current: Interferential;
(e) combination currents:
Ultrasound with sine, Ultrasound with high voltage, Sine with
galvanism;
(f) cold laser
and intense pulse light (IPL) therapy;
(g) such other machines as may be
approved by the Board, in its discretion.
(2) The following therapy
procedures are approved for use in therapeutic modalities:
(a) heat: hot moist packs, heating
pads, infrared, paraffin, ultraviolet;
(b) cold: cold packs, ice massages,
ice therapy;
(c)
hydrotherapy: whirlpool, hubbard tanks;
(d) nutritional
therapies;
(e) exercise
and massage;
(f)
rehabilitation and rehabilitative procedures;
(g) manipulation under
anesthesia.
(3) The following traction
therapies are approved for use in therapeutic modalities: cervical,
thoracic, lumbar, pelvic, intersegmental.
(4) Use of Diagnostic Equipment and
Testing Procedures. A chiropractor may request diagnostic and testing
procedures, consistent with all other applicable laws and
regulations, and may perform those tests which are consistent with
the chiropractic scope of practice as approved by the Board in its
discretion.
F.
Terms and Definitions.
(1) Accepted
terms are Chiropractic Physician, D.C., Chiropractor, Doctor of
Chiropractic.
(2)
Chiropractors may not refer to themselves as physical therapists or
physiotherapists.
G. Licensees must report CE hours
to the electronic tracking system designated by the South Carolina
Department of Labor, Licensing and Regulation for CE compliance and
monitoring. Licensees who fail to meet the CE requirements will be
notified in writing of their deficit, ordered to cease practice, and
advised to obtain CE. Failure of the CE audit results in a lapsed
license. After the Board is in receipt of the approved CE credits,
the Board staff will reinstate the license to active status.
The following sanctions will be imposed:
(1) First Offense: Private
Reprimand and $2000 fine.
(2) Second Offense: Hearing
scheduled before the Board.
If evidence is received that the licensee continued to
practice after an order to cease and desist from practice, the matter
will be scheduled for a hearing before the Board, and the licensee
will not be permitted to resume practice pending hearing and until
further order of the Board.
H. Manipulation Under Anesthesia
(MUA)
(1) For purposes of this
regulation, Manipulation Under Anesthesia (MUA) means a manipulation
of the spinal column and its immediate articulations by a licensed
practitioner (DC, MD or DO) of a patient who is under the
administration of anesthesia performed by a physician licensed in
this state who is Board certified or Board eligible in anesthesiology
by the American Board of Medical Specialties or American Osteopathic
Association.
(2)
Manipulation under anesthesia (MUA) may be performed by a DC in
collaboration with an MD or DO, as long as the MUA is performed in
accordance with this regulation. MUA shall be performed by two
practitioners (a doctor of chiropractic, "DC," and a medical
physician, "MD," or doctor of osteopathic medicine, "DO") who
constitute the collaborative treatment team and have attained their
certificates of training in MUA as described in this regulation. The
two MUA practitioners must be in addition to the anesthesiologist.
One practitioner must be designated primary practitioner; the second
practitioner will serve as the first assistant. Practitioners,
including MDs and DOs, performing MUA must be appropriately trained
through a course of instruction approved by their respective
boards.
(3) The
practitioners must have proper training demonstrated by successful
completion of a postgraduate educational course approved by their
respective boards.
(4)
The DC must have proper training demonstrated by successful
completion of a postgraduate educational course approved by the Board
or which has been approved by a Council on Chiropractic Education
(CCE) accredited chiropractic college prior to performing the
procedure.
(5) MUA must
be performed in an appropriately licensed hospital or ambulatory
surgical center or office based surgical facility approved by
American Association of Ambulatory Surgery Facilities (AAASF);
Accreditation Association for Ambulatory Health Care (AAAHC); the
Joint Commission on Accreditation of Healthcare Organizations
(JCAHO); or the Healthcare Facilities Accreditation Program (HFAP), a
division of the American Osteopathic Association; or any other agency
approved by the South Carolina Board of Medical Examiners in statute
or regulation.
(6) The
patient must receive a medical evaluation and clearance prior to
undergoing MUA. It is the responsibility of the MD or DO to conduct
an appropriate medical evaluation regarding the patient's ability to
undergo the procedure. A physician licensed and Board certified or
Board eligible as a medical specialist in anesthesiology must
complete an evaluation of the patient's suitability for undergoing
anesthesia in accordance with American Society of Anesthesiologists
(ASA) standards of care for Monitored Anesthesia Care
(MAC).
(7) It shall be
the responsibility of the practitioners (DC, MD or DO) to submit
their documentation of appropriate training in MUA to their
respective boards in accordance with the established parameters of
this regulation.
(8)
Patient safety shall be of paramount concern, and shall be regulated
by proper training, patients' selection criteria, medical clearance
for anesthesia, and by following the standards and protocols for the
performance of MUA.
(9)
Failure of a practitioner to follow the standard of care contained in
this section while performing MUA shall constitute unprofessional
conduct.
Amended by State Register Volume
17, Issue No. 4, eff April 23, 1993; State Register Volume 23, Issue
No. 6, eff June 25, 1999; State Register Volume 27, Issue No. 6, Part
2, eff June 27, 2003; State Register Volume 33, Issue No. 4, eff
April 24, 2009; State Register Volume 37, Issue No. 6, eff June 28,
2013;
State
Register Volume 44, Issue No. 06, eff.
6/26/2020.