HB 1106 — An Act amending the act of December 16, 1986 (P.L.1646, No.188), known as the Chiropractic Practice Act, in preliminary provisions, further providing for definitions; in licensure and regulation, further providing for refusal, suspension or revocation of license and for reporting of multiple licensure; providing for certified chiropractic assistants; in supportive personnel, further providing for supportive personnel; in penalty provisions, further providing for violation of other provisions and for civil penalty; and making an editorial change.

PRINTER'S NO.   1231

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                         HOUSE BILL
                         No. 1106
                                                Session of
                                                  2025

     INTRODUCED BY BOROWSKI, BRENNAN, CERRATO, FREEMAN, GIRAL, HILL-
        EVANS, JAMES, LAWRENCE, MADDEN, MALAGARI, MALONEY, MULLINS,
        O'MARA, PIELLI, SANCHEZ, RADER, SCHMITT, STRUZZI, PICKETT,
        BENNINGHOFF, KAUFFMAN, E. NELSON, GILLEN AND WEBSTER,
        APRIL 3, 2025

     REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, APRIL 3, 2025


                                    AN ACT
 1   Amending the act of December 16, 1986 (P.L.1646, No.188),
 2      entitled "An act providing for the licensing of chiropractors
 3      and the regulation of the practice of chiropractic;
 4      establishing the State Board of Chiropractic in the
 5      Department of State and providing for its powers and duties;
 6      providing for the supervision of colleges of chiropractic,
 7      for the examination of applicants, for enforcement and for
 8      disciplinary actions; providing penalties; and making
 9      repeals," providing for certified chiropractic assistants; in
10      supportive personnel, further providing for supportive
11      personnel; and making an editorial change.
12      The General Assembly of the Commonwealth of Pennsylvania
13   hereby enacts as follows:
14      Section 1.    The act of December 16, 1986 (P.L.1646, No.188),
15   known as the Chiropractic Practice Act, is amended by adding a
16   chapter to read:
17                                CHAPTER 5-A
18                     CERTIFIED CHIROPRACTIC ASSISTANTS
19   Section 501-A.    Chiropractic assistant certifications.
20      (a)   Eligibility.--To be eligible for certification by the
21   board as a chiropractic assistant, an applicant shall:
 1            (1)   be at least 18 years of age unless otherwise
 2      determined by the board;
 3            (2)   possess a high school diploma or its equivalent;
 4            (3)   prove to the satisfaction of the board that the
 5      individual is of good moral character and is not unfit or
 6      unable to practice as a chiropractic assistant by reason of
 7      physical or mental impairment. In assessing the moral
 8      character of an individual with a criminal conviction, the
 9      board shall conduct an individualized assessment in
10      accordance with 63 Pa.C.S. § 3113 (relating to consideration
11      of criminal convictions);
12            (4)   be a graduate of a nationally recognized
13      chiropractic assistant program approved by the board; and
14            (5)   successfully pass an examination approved by the
15      board, subject to rules and regulations established by the
16      board and administered in accordance with section 812.1 of
17      the act of April 9, 1929 (P.L.177, No.175), known as The
18      Administrative Code of 1929. An applicant may not be
19      certified as a certified chiropractic assistant unless the
20      applicant has attained passing scores on the examination
21      under this paragraph as published prior to the administration
22      of the examination.
23      (b)   Temporary certification.--Upon the submission of an
24   application for certification as a chiropractic assistant as
25   provided by the board, the board shall issue a temporary
26   certificate to the applicant who meets the requirements under
27   subsection (a)(1) and (4) and is eligible to take the
28   examination under subsection (a)(5). The board shall issue only
29   one temporary certificate under this subsection to an applicant.
30   A temporary certificate under this subsection shall expire upon

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 1   the applicant's failure of the first examination under
 2   subsection (a)(5), or six months after the date of issuance of
 3   the temporary certificate, whichever occurs first. Issuance of a
 4   temporary certificate under this subsection shall permit the
 5   applicant to engage in the practice of chiropractic assistance
 6   only while under the direct on-premises supervision of a
 7   licensed chiropractor. Upon the expiration of a temporary
 8   certificate under this subsection, the applicant shall promptly
 9   return the temporary certificate to the board.
10      (c)   Second examination.--If an applicant fails the first
11   examination under subsection (a)(5), the applicant for
12   certification, after the expiration of 60 days from the date of
13   the first examination and no later than one year after the first
14   examination, shall have the opportunity to take the examination
15   a second time. The board may adopt regulations governing the
16   eligibility of applicants who have failed to pass two
17   examinations under subsection (a)(5) in order to be admitted to
18   subsequent examinations.
19      (d)   Use of title.--Only an individual who has been properly
20   certified as a chiropractic assistant with the board, in
21   accordance with this chapter and the rules and regulations
22   promulgated by the board, shall assist a licensed chiropractor
23   as a certified chiropractic assistant and use the title
24   "certified chiropractic assistant" and the abbreviation "CCA."
25      (e)   Actions.--The board shall issue, renew, revoke or
26   suspend the certification of a chiropractic assistant in
27   accordance with the rules and regulations promulgated by the
28   board. All actions of the board under this subsection shall be
29   taken subject to the right of notice, hearing and adjudication
30   and the right of appeal in accordance with 2 Pa.C.S. (relating

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 1   to administrative law and procedure).
 2      (f)     Reinstatement.--Unless ordered by a court of competent
 3   jurisdiction, the board shall not reinstate the certification of
 4   an individual to practice as a chiropractic assistant that has
 5   been revoked under subsection (e). The individual may apply for
 6   certification as a chiropractic assistant after five years have
 7   elapsed since the date of revocation in accordance with this
 8   chapter.
 9      (g)     Renewals.--For each certificate renewal, a chiropractic
10   assistant shall complete within the preceding two-year period at
11   least 16 hours of continuing chiropractic education, including
12   eight hours of in-person learning, as approved by the board in
13   accordance with standards and criteria established by the board
14   by rules and regulations. A certified chiropractic assistant
15   shall provide the board with evidence of the completion of the
16   continuing chiropractic education under this subsection. The
17   board's rules and regulations shall remain in effect until such
18   time as the board establishes by regulations, standards and
19   criteria relating to continuing chiropractic education for
20   certified chiropractic assistants.
21   Section 502-A.    Performance of chiropractic acts and services.
22      (a)     Supervision.--While providing assistance to a licensed
23   chiropractor, a certified chiropractic assistant shall only
24   perform patient-related chiropractic acts and services that are
25   assigned or delegated by and under the direct on-premises
26   supervision of a licensed chiropractor.
27      (b)     Scope.--A certified chiropractic assistant may provide,
28   demonstrate, administer or observe therapeutic exercise under
29   the direct on-premises supervision of a licensed chiropractor. A
30   certified chiropractic assistant may not perform evaluations,

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 1   adjustments, test interpretations, other therapeutic procedures
 2   or the planning or modification of a plan of care for a patient.
 3      (c)     Responsibility.--A licensed chiropractor shall be
 4   responsible for the performance of acts and services by a
 5   certified chiropractic assistant. In all practice settings, the
 6   initial patient contact shall be made by a licensed chiropractor
 7   for evaluation of the patient and establishment of a plan of
 8   care.
 9      (d)     Consultation.--A certified chiropractic assistant shall
10   consult with the supervising licensed chiropractor in the event
11   of a change in the patient's condition that may require the
12   assessment of a licensed chiropractor.
13      (e)     Limitation.--A licensed chiropractor shall not supervise
14   more than three certified chiropractic assistants at any time.
15   If there is a change of the licensed chiropractor supervising a
16   certified chiropractic assistant, the succeeding licensed
17   chiropractor shall be responsible for the ongoing supervision of
18   the certified chiropractic assistant and shall be considered the
19   supervising licensed chiropractor for the purpose of this
20   section.
21      (f)     Definitions.--As used in this section, the term
22   "therapeutic exercise" shall mean a therapeutic procedure of
23   using exercise to develop strength, endurance, range of motion
24   and flexibility.
25      Section 2.    Chapter 6 heading and section 601 of the act are
26   amended to read:
27                                 CHAPTER 6
28               UNLICENSED OR UNCERTIFIED SUPPORTIVE PERSONNEL
29   Section 601.    Supportive personnel.
30      (a)     Construction.--Nothing in this act shall prohibit a

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 1   licensed chiropractor from utilizing the assistance of
 2   unlicensed or uncertified supportive personnel performing under
 3   the direct on-premises supervision of a licensed chiropractor,
 4   provided that a chiropractor may not delegate any activity or
 5   duty to such unlicensed or uncertified individuals which
 6   requires formal education or training in the practice of
 7   chiropractic or the knowledge and skill of a licensed
 8   chiropractor.
 9      (b)   Definitions.--As used in this section, the term "direct
10   on-premises supervision" shall mean supervision conducted while
11   being physically present in the office suite or facility, but
12   not necessarily in the same room and immediately available.
13      Section 3.   This act shall take effect in 60 days.




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