HI Chiro Juris cheat sheet

Chiropractic licensure in Hawaii is governed by HRS Chapter 442, administered by the Hawaii Board of Chiropractic Examiners within the Department of Commerce and Consumer Affairs (DCCA).

HAR Title 16, Chapter 71 contains the Board's administrative rules, covering licensure, practice standards, continuing education, and disciplinary procedures.

The Board consists of five members appointed by the Governor: three licensed chiropractors and two public members; terms are four years, with a maximum of two consecutive terms.

Licensure by examination requires graduation from a Council on Chiropractic Education (CCE)-accredited chiropractic college, passage of all four parts of the NBCE exam plus the physiotherapy (PT) examination, and a jurisprudence examination.

License renewal is biennial (every two years) on a schedule set by the DCCA; failure to renew results in forfeiture of the license, and practice during forfeiture is unlicensed practice.

Continuing education: 24 hours per two-year licensing cycle, including at least 2 hours in ethics and 2 hours in Hawaii jurisprudence; courses must be Board-approved or from Board-recognized providers.

Grounds for discipline under HRS §442-9 include fraud in obtaining a license, gross negligence, incompetence, substance abuse, and violation of Board rules; penalties range from reprimand to license revocation and fines.

The Board may issue cease-and-desist orders and impose administrative fines for unlicensed practice; unlicensed practice is also a misdemeanor under Hawaii law.

Licensees must report address changes to the DCCA within 30 days; failure to maintain current contact information can result in missed notices and default disciplinary action.

Hawaii defines chiropractic as the diagnosis and treatment of human ailments by adjustment of the spinal column and articulations, including the use of physiotherapy modalities and nutritional counseling.

Chiropractors may order and interpret X-rays and other imaging necessary for diagnosis; they may not perform surgery or prescribe legend drugs, but may recommend nutritional supplements.

Licensure requires: (1) graduation from a CCE-accredited college, (2) NBCE Parts I-IV plus PT, (3) jurisprudence exam, (4) good moral character, and (5) no disqualifying criminal history.

A chiropractor may not practice beyond the scope of chiropractic, such as performing acupuncture without separate certification or providing obstetrical care.

Temporary licenses may be issued to chiropractors licensed in another state who are in Hawaii for a limited educational or charitable purpose, at the Board's discretion.

A chiropractor must display the license conspicuously at the practice location and carry a wallet-sized license when practicing at multiple locations.

Continuing education must include at least 2 hours in recordkeeping and 2 hours in informed consent per renewal cycle under recent rule updates.

Unprofessional conduct includes practicing while impaired, failing to refer a patient when indicated, and aiding unlicensed practice; each is a basis for discipline.

HRS §442-9 authorizes the Board to revoke, suspend, or refuse to renew a license, and to impose fines up to $1,000 per violation, for causes including gross negligence, fraud, and unethical conduct.

The disciplinary process begins with a complaint filed with the DCCA Regulated Industries Complaints Office (RICO), which investigates and may issue a citation or forward the matter to the Board.

Due process requires notice of charges and a hearing before the Board; the licensee may be represented by counsel, present evidence, and cross-examine witnesses.

The Board may impose interim suspension without a prior hearing if there is an immediate danger to the public health, safety, or welfare, followed by a prompt post-suspension hearing.

Mandatory reporting: licensees must report to the Board any known violation of the chiropractic statutes or rules by another licensee, including impairment or sexual misconduct.

Sexual contact with a patient is expressly prohibited and constitutes grounds for permanent revocation; no patient consent is a defense.

A chiropractor must not abandon a patient; termination of the provider-patient relationship requires written notice, an opportunity to obtain records, and referral if needed.

Disciplinary sanctions are reported to the National Practitioner Data Bank and may be considered by other states in licensure decisions.

Hawaii requires chiropractors to maintain patient records for at least seven years from the date of the last treatment, or until the patient reaches age 25 if the patient was a minor.

Records must include: patient identification, chief complaint, history, examination findings, diagnosis, treatment plan, informed consent documentation, and progress notes for each visit.

Informed consent must be documented in writing before initiating care; it should describe the nature of the condition, proposed treatment, risks and benefits, alternatives, and the right to refuse.

Patients have the right to access their records and to obtain copies; a reasonable copying fee may be charged, and records must be provided within 30 days of a written request.

Confidentiality: patient information may not be disclosed without written authorization except as required by law, such as mandatory reporting of child abuse or a court order.

A chiropractor must post a notice of the patient's rights, including the right to file a complaint with the DCCA, in a conspicuous location in the office.

Termination of practice or relocation requires public notice and arrangements for record custody; patients must be notified how to obtain their records.

Billing records must accurately reflect services rendered; upcoding and billing for services not performed are fraudulent and grounds for discipline.