Here is a brief explanation of the disciplinary process:
• •
When a complaint is received, it is processed by an intake specialist and then transferred to the Commission Office.
The complaint is then brought to a panel made up of half of the Commission members via a teleconference, where they decide whether or not the case should be opened. If there isn’t an allegation of a violation of law, the case is closed. If the case alleges a violation and the panel determines it meets the threshold to investigate, it is opened and assigned to a DOH investigator. The investigator gathers evidence and submits their report to the panel.
• Then, the case is assigned to a Commission member and a staff attorney for review. The Commissioner writes up a summary giving options for proceeding, and the case is presented at the next teleconference. The case will either be closed, sent to the Early Remediation Program (ERP – discussed below), or go forward to resolve the case informally or formally. If a chiropractor refutes allegations, they can request a hearing, similar to a trial.
• Hearing costs can escalate quickly, depending on expert witness testimonies and assistant attorney general fees. Even if the case is settled before a hearing, significant attorney costs can still be incurred.
Our budgetary costs have continued to rise in the aftermath of COVID-19 complaints and the ongoing boundary and sexual misconduct allegation cases. Our Commission has sought analyses and advice from DOH to determine if licensure fees need to be increased to stay solvent.
After an analysis, we are in the red and will continue to go negative unless we have a licensure fee increase. Three options were given, but until our January 301
meeting, nothing will be recommended
to DOH, the agency that actually makes final decisions regarding fee changes.
It is our fervent hope that the increased disciplinary costs of the last few years were an outlier and that we’ll see them lower but nothing is certain. The budget committee is working hard to highlight possible ways to cut costs, including meeting remotely for meetings and getting a more detailed analysis from DOH on attorney fees and necessary expenses.
Another significant and unforeseen expenditure is something called HELMS. This is the new computer system that all DOH licensing programs must transition to for licensing and disciplinary processes. It was initially set to roll out a few years ago but due to several unforeseen setbacks, the new system’s licensing portion is now being implemented. The original budget for the project has increased significantly. DOH and all the professional boards and commissions have invested funds in the new system and our Commission continues to be responsible for our prorated portion.
One thing that is unique to our Commission and saves money is the Early Remediation Program (ERP). This program is utilized when the chiropractor has been investigated and found to have made an error but where no patient harm resulted. Instead of the chiropractor and Commission going through a lengthy and costly disciplinary process that could result in a hearing, they enter an agreement, and the chiropractor starts the ER program. The chiropractor may, for example, be tasked with completing some extra continuing education, taking and passing our jurisprudence examination, or composing an essay. Upon successful completion of the program, the chiropractor is released with no disciplinary record on their license. It is both cost-saving and keeps the chiropractors’ records clean where appropriate.
Generally, our Commission has been able to cover these costs; however, during the COVID-19 pandemic, our complaints skyrocketed. There were some teleconferences I would be on where we had over fifty complaints to review and determine if a warning letter would be sent or if there was a need to open and investigate the claims.
At the same time, we also seemed to have more boundary and sexual misconduct complaints coming in. Allegations of a chiropractor touching or treating a patient inappropriately are taken very seriously and we must always investigate to determine if such violations occurred.
Our Commission and staff are dedicated to protecting the public and helping enhance the delivery of chiropractic care. HELMS is beginning its rollout in mid-February, increasing our efficiency; the ERP continues to save money; and our budget committee will continue to work hard to cut expenditures where possible.
Chiropractic is a wonderful career that I am proud to be a part of and I will continue to serve the public and the Commission to make our profession even better.
Footnote:
1. This article was written prior to the January 30 Commission meeting. Due to our production timeline, we could not include an update on that meeting in this issue of Plexus. Stay tuned to your WSCA newsletters for more on that.
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