Sunset Commission Issues TBCE Report – Summary
Written by Editor   
Sunday, October 09, 2016 12:05 PM

While opening with the customary provocative language, “the Texas Board of Chiropractic Examiners has long been dogged by litigation and a reputation for using its authority to expand chiropractors’ scope of practice in lieu of focusing on protecting the public,” the Sunset Advisory Commission Staff Report does report, however Sunset staff found no evidence that the board continues to engage in practices that would merit this reputation.

The full report may be found here but this article will briefly provide the overview recommendations made by the Sunset staff. Other articles will be linked to these overview points to provide quotations from the report for further explanation.  You are encouraged to review the articles related to the issue to clearly understand them.

The Sunset Commission staff have identified five specific issues and made key recommendations for each issue.  They are:

Issue 1: slow complaint resolution and misplaced focus on low-risk enforcement activities.

  • Develop a plan to improve TBCE’s investigative process and reduce complaint resolution timeframes.
  • Prioritize investigations by risk to the public.
  • Revise the penalty matrix to more closely align the severity of penalties with the risk a violation poses to the public.
  • Maintain complainants’ confidentiality.

Issue 2: chiropractic facility registration is unnecessary to protect the public.

  • Discontinue registration of chiropractic facilities.

Issue 3: the board lack formal mechanisms to ensure chiropractic expertise in its enforcement process.

  • Repeal the local and executive peer review requirements from statute.
  • Require the board to develop an expert review process in rule to ensure chiropractic expertise in its enforcement process.

Issue 4: key elements of the board’s licensing and regulatory functions do not conform to common licensing standards.

  • Require the board to conduct fingerprint-based background checks of ALL licensees and applicants.
  • Authorize the board to check for disciplinary actions in other states or from other licensing boards for license applications and renewals.
  • Remove the limitation on the number of times an applicant can take the board’s jurisprudence exam.
  • Direct the board to stop requiring letters of recommendation as a part of the initial application process.

Issue 5: Texas should continue regulating chiropractors, but decisions on the structure of the TBCE await further review.

  • Postpone the decision on continuation of the TBCE until completion of the Sunset reviews of other health licensing agencies.

The Sunset Commission staff say "the recommendation to discontinue the registration of chiropractic facilities would result in the loss of approximately $242,055 per year to the General Revenue Fund. However, due to the reduction in workload from not investigating facility-related violations, this loss of general revenue would be offset by salary savings of $22,880 per year from a reduction of one half of a full-time position," which they estimate would result in a net loss of some $219,000 to the state.

This staff report is the first of three phases in the Sunset process.  In this phase the Sunset Staff Report identifies problem areas and makes specific recommendations for positive change, either to the laws governing an agency or in the form of management directives to agency leadership.   The next phase is a public hearing to take testimony on the staff report and the agency overall. Later, the commission meets again to vote on which changes to recommend to the full Legislature. The next step in the process is the legislative session itself, after which the Sunset Commission staff will summarize the changes proposed, recommended, adopted, and any new provisions added by the legislature.