Thursday, September 18, 2014 08:30 AM

(a) Purpose. The purpose of these guidelines is to:


 (1) provide guidance and a framework of analysis for board staff, the enforcement committee and the administrative law judges to promote consistency in the making of recommendations on sanctions to the board in disciplinary cases;

  (2) promote consistency in the exercise of sound discretion by the board in the imposition of sanctions in disciplinary cases; and

  (3) provide guidance for the enforcement committee and other members of the board for the informal resolution of potentially contested matters. 

(b) Limitations. This section shall be construed and applied so as to preserve the board's discretion in the imposition of sanctions and remedial measures pursuant to the Chiropractic Act, Occupations Code, Chapter 201. This section shall be further construed and applied so as to be consistent with the Act, and shall be limited to the extent as otherwise proscribed by statute and board rule.

(c) Board action. The board may take disciplinary action against a licensee who is found in violation of the Chiropractic Act, another state law for which disciplinary action may be taken or a rule or order of the board. A disciplinary action may be composed of any one or a combination of the following sanctions:

  (1) revocation of license;

  (2) suspension of license for a definite period of time; 

  (3) suspension with probation for a definite period of time;

  (4) formal reprimand;

  (5) administrative penalty;

  (6) additional continuing education.

(d) Practicing without a license. A person, not a licensee, who is found to be practicing without a license in violation of the Chiropractic Act, Occupations Code, Chapter 201, shall be assessed an administrative penalty as provided by §78.10 of this title (relating to Schedule of Sanctions).

(e) Additional conditions. The Board may impose, as a condition of probation or as a term of a sanction, additional conditions or restrictions upon the license of the licensee that the Board deems necessary to facilitate the rehabilitation and education of the licensee and to protect the public, including but not limited to: 

  (1) completion of a specified number of continuing education hours on specified topics approved in advance by the board in addition to the minimum number required of all licensees as a condition of renewal;

  (2) taking and passing with the minimum required score of an examination required by the board; 

  (3) restrictions on the type of treatment, treatment procedures, and/or class of patients to be treated;

  (4) restrictions on the licensee's supervision of others in the practice of chiropractic;

  (5) undergoing a psychological and/or medical evaluation by a qualified professional approved in advance by the board and undergoing any treatment recommended pursuant to the evaluation;

  (6) regular reporting to the board as a means of monitoring the licensee's compliance with a board order.

(f) Down-time. A licensee whose license has been suspended shall not during the period of suspension realize any remuneration from his or her chiropractic practice; be in attendance in his or her office when it is open to serve patients; or provide chiropractic services to any person at any location. The licensee may arrange with another licensee to provide care and treatment to patients during the period of down-time so long as the suspended licensee does not receive any form of payment for chiropractic services rendered, including fee sharing with the treating licensee.

(g) Aggravation. The following may be considered as aggravating factors so as to merit more severe or restrictive sanction by the board:

  (1) seriousness of the violation, including the nature, circumstances, extent, or gravity of the prohibited conduct and the harm or potential harm to a patient;

  (2) economic harm to any individual or entity, to property or the environment; 

  (3) hazard or potential hazard created to the health, safety, or economic welfare of the public;

  (4) attempted concealment of misconduct; 

  (5) premeditated conduct; 

  (6) intentional misconduct;

  (7) disciplinary history, including prior violations of a similar or related nature;

  (8) likelihood of future misconduct of a similar nature;

  (9) failure to implement remedial measures to correct or alleviate harm arising from the misconduct;

  (10) lack of rehabilitative potential; 

  (11) motive;

  (12) the type of sanction, including the amount of any administrative penalty, necessary to deter future violations; and

  (13) any relevant circumstances or facts increasing the seriousness of the misconduct.

(h) Extenuation and mitigation. The absence of the circumstances listed as subsection (g)(1) - (13) of this section, as well as the presence of the following factors, may be considered as extenuating and mitigating factors so as to merit less severe or less restrictive sanctions by the board: 

  (1) self-reported and voluntary admissions of misconduct;

  (2) implementation of remedial measures to correct or mitigate harm arising from the misconduct;

  (3) motive;

  (4) rehabilitative potential; 

  (5) relevant facts and circumstances reducing the seriousness of the misconduct;

  (6) relevant facts and circumstances lessening responsibility for the misconduct.

(i) The board shall consider the factors listed in subsections (g) and (h) of this section in determining the amount of an administrative penalty under §78.10 of this title (relating to Schedule of Sanctions).

(j) Upon a finding that a violation of the Act, another state law, or a rule or order of the board has occurred and that disciplinary action is warranted, the enforcement committee shall determine and recommend the type and amount of sanction in accordance with this section and §78.10 of this title. 

(k) All disciplinary actions issued by the board will take the form of a board order. All disciplinary actions shall be recorded and made available upon request as public information. All disciplinary actions shall be published in the TBCE newsletter, may be released in a press release, and shall be transmitted to the Chiropractic Information Network-Board Action Data Bank (CIN-BAD) or other national data bank as required by law.