A BILL TO BE ENTITLED
AN ACT to update various laws of the practice and licensure of chiropractic.
The General Assembly of North Carolina enacts:
SECTION 1.(a)  Article 8 of Chapter 90 of the General Statutes reads as rewritten:
"Article 8.
"Chiropractic.
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"§ 90‑142.  Powers; duties.
The North Carolina State Board of Chiropractic Examiners shall have the following powers and duties:
(1)	Administer and enforce the provisions of this Article.
(2)	Adopt, amend, or repeal rules as may be necessary to carry out and enforce the provisions of this Article.
(3)	Issue position statements and other interpretative guidelines.
(4)	Require an applicant or licensee to submit to the Board evidence of the applicant's or licensee's continuing competence to practice chiropractic.
(5)	Establish substantial equivalency under G.S. 90‑143(b) and G.S. 90‑143.1.
(6)	Set the passing scores for approved examinations under G.S. 90‑143(b).
(7)	Establish certain reasonable fees as authorized by this Article for applications for examination, licensure, provisional licensure, renewal of licensure, and other services provided by the Board. When the Board uses a testing service for the preparation, administration, or grading of examination, the Board may charge the applicant the actual cost of the examination services and a prorated portion of the examination fee for administration and processing of the examination. Examination fees are not refundable.
(8)	Establish certification standards for diagnostic imaging technicians.
(9)	Establish certification standards for chiropractic clinical assistants.
(10)	Employ and fix the compensation of personnel and legal counsel that the Board deems necessary to carry out the provisions of this Article.
(11)	Establish by rule a schedule and access civil penalties pursuant to G.S. 90‑158.
(12)	Take disciplinary action pursuant to G.S. 90‑154.2, 90‑154.3, and 90‑154.4.
(13)	Seek injunctive relief through a court of competent jurisdiction for violations of this Article.
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"§ 90‑144.  Meetings of Board of Examiners.
The North Carolina Board of Chiropractic Examiners shall meet at least once a year at such time and place as the Board shall determine and advertise. Applicants for licensure under this Article shall comply with G.S. 90‑143(b).
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"§ 90‑148.  Records of Board.
(a)	The secretary of the Board of Chiropractic Examiners shall keep a record of the proceedings of the Board, giving the name of each applicant for license, and the name of each applicant licensed and the date of such license. The Board may order that any records concerning the practice of chiropractic and relevant to a complaint received by the Board or an inquiry or investigation conducted by or on behalf of the Board shall be produced by the custodian of the records to the Board or for inspection and copy by representatives of or counsel to the Board. A chiropractor licensed by the Board or an establishment employing a chiropractor licensed by the Board shall maintain records for a minimum of seven years from the date the chiropractor terminates services to the patient and the patient services record is closed. A chiropractor licensed by the Board or a chiropractic assistant certified by the Board shall cooperate fully and in a timely manner with the Board and its designated representatives in an inquiry or investigation of the records conducted by or on behalf of the Board.
(b)	Except as otherwise provided, all records, papers, and documents containing information collected and compiled by or on behalf of the Board shall be public records, provided that any information that identifies a patient who has not consented to the public disclosure of services rendered to him or her shall be deleted or redacted, as appropriate. Records, papers, and other documents containing information collected or compiled by or on behalf of the Board as a result of an investigation, inquiry, or interview conducted in connection with certification, licensure, or a disciplinary matter shall not be considered public records as defined in G.S. 132‑1. Any notice or statement of charges, notice of hearing, or decision rendered in connection with a hearing shall be a public record provided that information identifying a patient who has not consented to the public disclosure of his or her services by a person licensed or certified under this Article shall be redacted from the public record.
(c)	The names and office addresses of members of the Board shall be a public record as defined in G.S. 132‑1. The Board members' home addresses and email addresses shall not be a public record, unless a Board member consents to the disclosure in writing.
(d)	The names and office addresses of all licensees of the Board shall be a public record as defined in G.S. 132‑1. Home addresses and email addresses of licensees of the Board shall not be a public record, unless a licensee member consents to the disclosure in writing.
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"§ 90‑154.  Grounds for professional discipline.
(a)	The Board of Chiropractic Examiners may impose any of the following sanctions, singly or in combination, when it finds that a practitioner or applicant is guilty of any offense described in subsection (b):
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(7)	A civil penalty as allowed by this section.
(b)	Any one of the following is grounds for disciplinary action by the Board under subsection (a):
	
(2)	Conviction of a felony or of a crime involving moral turpitude.
(3)	Physical, mental, emotional infirmity, including addiction to or severe dependency upon alcohol or any other drug that impairs the ability to practice safely.
	
(5)	Negligence, incompetence, or malpractice in the practice of chiropractic.
(6)	Repealed by Session Laws 1995, c. 188, s. 1.
	
(8)	Lewd or immoral conduct toward a patient.
(9)	Committing or attempting to commit fraud, deception, or misrepresentation.

	

	

	
(19)	Concealing information from the Board or failing to respond truthfully and completely to an inquiry from the Board concerning any matter affecting licensure.
(20)	Failing to comply with a decision of the Board that is final.
	
(22)	Engaging in any act or practice violative of any of the provisions of this Article or of any of the rules and regulations adopted by the Board, or aiding, abetting, or assisting any other person in the violation of any of the provisions of this Article.
(c)	If a licensee is found guilty in a contested case arising under subsection (b) of this section, the Board may assess the licensee the reasonable cost of the hearing held to make such a determination if the Board finds that the licensee's defense at the hearing was dilatory or not asserted in good faith.
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"§ 90‑154.3.  Acceptable care in the practice of chiropractic.
(a)	It shall be unlawful for a doctor of chiropractic to examine, treat, or render any professional service to a patient that does not conform to the standards of acceptable care.
(b)	For purposes of disciplinary action, the Board of Chiropractic Examiners may adopt rules that establish and define standards of acceptable care.

	

	
	
(d)	Nothing in this section shall alter the lawful scope of practice of chiropractic as defined in G.S. 90‑143 or the limitation of license as defined in G.S. 90‑151.
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"§ 90‑155.  Annual fee for renewal of license.
(a)	Licensees must renew their license each year on or before December 31 of each year following the year in which a license is first issued, and shall pay to the Board of Chiropractic Examiners a renewal license fee as prescribed and set by the said Board which fee shall not be more than three hundred dollars ($300.00), and shall furnish the Board evidence of having attended two days of educational sessions or programs approved by the Board during the preceding 12 months, provided the Board may waive this educational requirement due to sickness or other hardship of the applicant.

(b)	A licensee who is not actively engaged in the practice of chiropractic in this State and who does not wish to renew his or her license may direct the Board to place the licensee on inactive status.
(c)	A licensee who fails to renew his or her license as required by this section shall pay an additional fee of twenty‑five dollars ($25.00) to the Board. The license of any licensee who fails to renew by January 30 of each year shall automatically be placed on inactive status.
(d)	A licensee with an inactive license shall not practice chiropractic in this State. The Board shall retain jurisdiction over an inactive license, including licenses placed on inactive status by retirement of the licensee, a request by the licensee for inactivation, the surrendering of a license, or by operation of an order entered by the Board.
(e)	Upon payment of all accumulated fees and penalties, the license of the licensee may be reinstated, subject to the Board requiring the licensee to appear before the Board for an interview to prove the licensee's competency in a manner as may be reasonably determined by the Board and to comply with other licensing requirements.
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SECTION 1.(b)  Article 8 of Chapter 90 of the General Statutes is amended by adding a new section to read:
"§ 90‑157.4.  Civil penalty; disciplinary costs.
(a)	The Board may assess a civil penalty not to exceed five hundred dollars ($500.00) per violation of this Article or any rule adopted by the Board. The clear proceeds of any civil penalty assessed under this section shall be remitted to the Civil Penalty and Forfeiture Fund in accordance with G.S. 115C‑457.2.
(b)	The Board shall consider the following factors before imposing or assessing a civil penalty under this section:
(1)	The nature, gravity, and persistence of the particular violation.
(2)	The appropriateness of the imposition of a civil penalty when considered alone or in combination with other punishment.
(3)	Whether the violation was willful and malicious.
(4)	Any other factors that would tend to mitigate or aggravate the violations found to exist.
(c)	The Board shall establish a schedule of civil penalties for violations of this Article and rules adopted by the Board.
(d)	The Board may charge costs in a disciplinary proceeding, including reasonable attorneys' fees, to the licensee against whom the proceedings were brought.
(e)	If the Board imposes a civil penalty under this section, the party against whom the civil penalty has been assessed may file a petition for judicial review under Article 4 of Chapter 150B of the General Statutes."
SECTION 2.  This act becomes effective October 1, 2021.