The Board of Chiropractic Examiners consists of seven Board members appointed by the Governor; five Board members must be doctors of chiropractic, and two members must be public members. A public member cannot be a licensee of any of the other health care regulatory boards.
The Board regulates doctors of chiropractic only. The Board approves licenses or registrations for these individuals, and also decides when to impose disciplinary or corrective action.
B. Board Staff
The staff of the Board of Chiropractic Examiners are employees of the State of Minnesota who handle the day to day operations of the Board. Approximately five people are employed to gather licensing and complaint information for the Board's review and to handle administrative functions.
II. PROTOCOL FOR COMPLAINT PROCESSING
A. Complaints and Report
Information regarding doctors of chiropractic who may be in violation of the Minnesota Chiropractic Practice Act (Minn. Stat. 148.01-148.108, or Minnesota Administrative Rules 2500.0100-2500.6050,) comes to the attention of the Board through submission of a complaint. Complaints or reports may be filed by anyone and are typically submitted on a complaint form, although the Board may act on complaints submitted by phone, letter or other format. Complaints and reports are not public information and may not be discussed with anyone except the respondent (subject of the investigation) and the complainant (person filing the complaint.) The Board is mandated to pursue all jurisdictional complaints against individuals it regulates. In other words, if the complaint alleges a violation of the Chiropractic Practice Act by a doctor of chiropractic, the complaint will be investigated. An example of a non-jurisdictional complaint is one which alleges that the patient did not get better after treatment. Health care professionals, courts and others are required by law to report conduct which may be grounds for disciplinary action under the Chiropractic Practice Act. Minnesota Statute 148.102 describes the reporting obligations for licensed health professionals. Minn. Stat. `
B. File Set up and Assignment
Set Up: When a jurisdictional complaint is received, a file is assigned to a Panel which will have responsibility for that file until no further action is required.
Beginning the Investigation: For most complaints, the board staff will obtain a response from the respondent including all pertinent health care and billing records. Complaints alleging sexual misconduct must, by law, be investigated by the Minnesota Attorney General's Office which may also provide investigative and legal services for other types of complaints. The completed investigation will be returned to the Board for appropriate follow up.
C. Complaint Panel Review Meetings
The Complaint Panel:
A Complaint Panel is comprised of three members; two are members of the board, and the third is the Boards Executive Director.
Because of the number of complaints received and processed by the Board each year, it is typical that three complaint Panels are operating at any given time.
Each Panel meets once per month (usually) to decide triage, discuss pending disciplinary offers and petitions, discuss the next appropriate step in any given case, and to meet with respondents who have been asked to appear before the Panel.
Outcomes of Discussions and Appearances:
Dismissal. The Panel may choose to dismiss the complaint and so inform the respondent and complainant. A dismissal requires the agreement of at least two Panel members.
Continue, pending further investigation or some other specified action.
Corrective Action. The Panel may recommend that the respondent enter into an Agreement for Corrective Action. This Agreement is a contract between the Panel and the respondent in which the respondent agrees to take certain remedial action, often educational, to correct problems identified in the Complaint Review process. Corrective action is not disciplinary action, but it is a public action. This action will be described in an official document referred to as an Agreement for Corrective Action. The Agreement does not require action by the full Board.
D. Disciplinary Action:
The Panel may recommend that the respondent's license be disciplined. Formal Discipline may include such things as a reprimand, conditions, limitations or restrictions, suspension, or revocation. Should the Panel determine that the respondent's license be disciplined, it will generally first offer to impose the disciplinary action by Stipulation and Order. (See below) Failure to come to an agreement, may result in the need for a contested case hearing. (See below.)
The Panel may recommend that the respondent's license be immediately suspended, known as a summary suspension. In this case, it requires a nearly immediate convening of the board. If the Board approves the summary suspension, based on a finding that the respondent has violated the Chiropractic Practice Act and that the respondent's continued practice creates an immediate and serious risk of harm to the public, the respondent is entitled to a hearing within 30 days of the issuance of the suspension order.
III. DISCIPLINARY RESOLUTION
A. Stipulation And Order
The Stipulation is an agreement between the respondent and the Complaint Review Panel in which the respondent agrees that certain disciplinary action should be imposed on their chiropractic license as a result of the Panel having identified areas in which the respondent violated the Chiropractic Practice Act.
The Order is issued by the full Board when it has reviewed and ratified the Stipulation between the Panel and the respondent. The Order implements the terms of the Stipulation. The Stipulation and Order are incorporated into one written instrument. This document is public and may be obtained by anyone upon proper request.
When the Panel finds the respondent is in violation of the Chiropractic Practice Act, it will ask the respondent to voluntarily enter into a Stipulation and Order to place restrictions on their chiropractic license.
Should the respondent refuse to agree to stipulate to the restrictions offered by the Panel, or, if the full Board rejects the proposed Stipulation and Order, the matter may proceed to a contested case hearing initiated under the Administrative Procedures Act.
B. Contested Case Hearing
The Administrative Hearing is held before an Administrative Law Judge (ALJ) and involves the presentation of testimony and submission of exhibits in a manner similar to a civil trial.
If the Panel is successful at the Contested Case Hearing, the ALJ will indicate that the Board's position is correct and make a recommendation which will be limited to discipline is warranted or discipline is not warranted. After reviewing an ALJ report stating that discipline is warranted, the Board may issue a Findings of Fact, Conclusions of Law, and a Final Order which describes the disciplinary action taken against the respondent.
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