Assigned to RAGE AS PASSED BY COW
ARIZONA STATE SENATE
Fifty-Seventh Legislature, First Regular Session
AMENDED
FACT SHEET FOR S.B. 1588
naturopathic physicians; board; investigations
(NOW: naturopathic physicians; chiropractors; board; conduct)
Purpose
Outlines various actions that constitute unprofessional conduct for the purpose of
disciplining a doctor of chiropractic (DC). Outlines causes for termination of the Executive
Director of the Arizona Board of Chiropractic Examiners (Chiropractic Board). Modifies the
powers and duties of the Chiropractic Board and the Naturopathic Physicians Medical Board
(Naturopathic Board).
Background
The Chiropractic Board is charged with protecting the health, welfare and safety of the
public through the enforcement of the laws governing chiropractic practice. The Chiropractic
Board's duties include: 1) adopting necessary rules to protect the public regarding chiropractic
practice; 2) determining the qualifications and regulation of chiropractic assistants who are not
otherwise licensed by law; and 3) reviewing the amount of each authorized fee in a public hearing
at least once each fiscal year and before establishing the amount of a fee for the subsequent fiscal
year (A.R.S. § 32-904).
Current statute outlines what actions constitute grounds for disciplinary action of a DC by
the Chiropractic Board. The Chiropractic Board on its own motion, or on receipt of a complaint,
may investigate any information that appears to show that a DC is or may be in violation of the
laws and Chiropractic Board rules that govern the practice of chiropractic in Arizona, or that
indicates the DC may be mentally or physically unable to safely engage in the practice of
chiropractic. The Chiropractic Board must notify the licensee of the complaint as soon as is
reasonable. If the Chiropractic Board believes the allegation is of such magnitude as to warrant
suspension or revocation of the license, the Chiropractic Board must immediately initiate formal
revocation or suspension proceedings. The Chiropractic Board must notify the licensee of the
complaint and hearing by certified mail addressed to the licensee's last known address on record
in the Chiropractic Board's files. The notice of the complaint and hearing is effective on the date
of its deposit in the mail. The Chiropractic Board must then hold a formal hearing within 180 days
after the date the notice is deposited in the mail. (A.R.S. § 32-924).
The Naturopathic Board oversees the licensing and practice of naturopathic medicine in
Arizona including administering and enforcing all provisions of the naturopathic medicine statutes
and rules adopted by the Naturopathic Board (A.R.S. § 32-1504).
There is no anticipated fiscal impact to the state General Fund associated with this
legislation. FACT SHEET – Amended
S.B. 1588
Page 2
Provisions
Unprofessional Conduct
1. Prescribes that the following actions, occurring in Arizona or elsewhere, constitute
unprofessional conduct for the purpose of disciplining a DC:
a) failure to disclose, in writing, to a patient or third-party payor that the DC has a financial
interest in a diagnostic or treatment facility, test, good or service when referring a patient
for various services, as prescribed;
b) knowingly providing a false or misleading statement or information to a patient or
third-party payor;
c) failure to create and maintain adequate patient records as prescribed;
d) failure to provide a copy of requested patient records, free of charge, to a patient, patient's
authorized agent or a licensed physician;
e) misrepresentation of the DC's certification in a specialty area, academic or professional
credentials;
f) failure to provide documentation of the DC's specialty certification, academic or
professional credentials to a patient who requests such documentation;
g) practicing or billing for services under any name other than the name by which the DC is
licensed by the Chiropractic Board, including a corporate, business or other licensed
health care provider's name, without first notifying the Chiropractic Board in writing;
h) suggesting or having sexual contact in the course of patient treatment, or within three
months of the last chiropractic service, with an individual with whom a consensual sexual
relationship did not exist prior to becoming a patient;
i) intentionally viewing a disrobed patient, not related to the patient's complaint, diagnoses
or treatment;
j) intentionally misrepresenting the effectiveness of a treatment, diagnostic test or device;
k) performing prohibited diagnostic procedures as prescribed;
l) promoting or using diagnostic testing or treatment for research or experimental purposes
without obtaining informed consent and conforming to generally accepted research or
experimental criteria;
m) having a professional connection with an unlawful practitioner; misrepresenting oneself
as current or past Chiropractic Board personnel or claiming superiority in the practice of
chiropractic;
n) having an action taken against the DC's license in another jurisdiction or having a license
renewal denied due to unprofessional conduct;
o) directly or indirectly dividing a professional fee for patient referrals as prescribed;
p) violating any federal or state law, rule or regulation applicable to the practice of
chiropractic;
q) habitually using or having habitually used alcohol, narcotics or stimulants to the extent of
incapacitating the DC in performing professional duties; and
r) filing an anonymous complaint against another DC.
2. Prohibits the Chiropractic Board from adopting any rule that may alter or amend
unprofessional conduct, as outlined. FACT SHEET – Amended
S.B. 1588
Page 3
Removal of the Executive Director
3. Requires the Chiropractic Board to terminate the Executive Director for any of the following:
a) subpoenaing information that is unrelated to a complaint allegation;
b) failing to refer to the appropriate law enforcement agency a complaint or information
indicating that a DC may have committed a misdemeanor or felony within two business
days after receiving the compliant or information; or
c) advocating in support or against a legislative proposal in the Executive Director's official
capacity before the Chiropractic Board has taken a formal position on the proposal in a
public meeting.
Conflict of Interest
4. Requires each Chiropractic Board member and employee to complete on appointment or hire
a conflict-of-interest disclosure form, including an attestation that no conflict exists, if
applicable.
5. Requires the disclosure form be updated annually.
6. Requires the Chiropractic Board retain all conflict-of-interest disclosure forms and make the
disclosure forms and meeting minutes available to the public on request.
7. Requires each Chiropractic Board member and employee to complete on hire or appointment
an annual training approved by the Attorney General's Office on the following:
a) conflict-of-interest requirements, processes and disclosure forms, including how
Arizona's conflict-of-interest requirements relate to their individual roles and
responsibilities;
b) open meetings law requirements; and
c) the Chiropractic Board's authority to investigate complaints and issue subpoenas.
Executive Director Duties
8. Requires the executive director of the Chiropractic Board to:
a) ensure that the Chiropractic Board follows all applicable laws and rules and complies with
all reporting requirements;
b) advise the Chiropractic Board of any contemplated actions that are outside of the
Chiropractic Board's authority and to state the Executive Director's concern in open
session if the Chiropractic Board disregards the advice provided;
c) prepare and maintain a discipline matrix to ensure all licensees are treated consistently
based on the specific allegations at issue that:
i. briefly outlines material facts of all past cases in which discipline was imposed without
identifying any specific DC or complainant other than by potential file number or other
reference;
ii. specifies the level of discipline imposed; and
iii. is available to any DC against whom a complaint has been filed and a formal
investigation has been opened, including the DC's counsel; and
d) classify complaints pursuant to Chiropractic Board policies to prioritize the allocation of
Chiropractic Board resources and the investigation and adjudication of complaints. FACT SHEET – Amended
S.B. 1588
Page 4
9. Prohibits the Executive Director of the Chiropractic Board from:
a) advocating in support of or against a legislative proposal in the Executive Director's
official capacity until the Chiropractic Board has taken a formal position on the proposal
in a public meeting; or
b) encouraging DC's or the public to support or oppose any legislation.
Investigations and Initial Review
10. Limits the scope of an investigation to the information contained in the initial complaint or
the information that the Chiropractic Board has in its possession at the time of the
Chiropractic Board's motion to investigate.
11. Prohibits the Chiropractic Board from subpoenaing information related to a licensee's
personal finances during an investigation.
12. Requires the Chiropractic Board, if a disciplinary or nondisciplinary order requires a DC to
complete continuing education requirements, to provide at least two choices of continuing
education provider organizations, boards or associations that can satisfy the required courses.
13. Requires the Chiropractic Board to complete an investigation and initial review within 90
days of receiving a complaint unless it extends the time to investigate.
14. Allows the Chiropractic Board to extend the time to investigate a licensee if:
a) the complaint relates to the improper sexual conduct of a DC; or
b) the DC agrees to the proposed extension and the Chiropractic Board has diligently pursued
investigations within the allotted timeframe, as prescribed, for complaints involving
allegations or violations of unprofessional conduct or malpractice that implicates patient
safety.
15. Requires the Chiropractic Board to make a final decision regarding a complaint of misconduct
within 220 days after the complaint is filed if a formal hearing is required.
16. Deems, if the Chiropractic Board has not made a final decision after the 220 days, the
complaint administratively closed.
17. Entitles a licensee to restitution for all costs incurred relating to an investigation and formal
hearing process if the Chiropractic Board acted capriciously against the licensee.
Criminal Complaint Referrals
18. Requires the Chiropractic Board to refer complaints or information indicating that a DC may
have committed a misdemeanor or felony offense to the appropriate law enforcement agency
within two business days after receiving the complaint or information.
19. Allows the Chiropractic Board to refer the complaint to law enforcement without obtaining
the complainant's consent or substantiating the complaint. FACT SHEET – Amended
S.B. 1588
Page 5
20. Allows the Chiropractic Board to restrict, limit or order a summary suspension of the DC's
license pending action by the law enforcement agency if the complaint or information
received requires that emergency action be taken to protect public health, safety or welfare.
21. Requires the law enforcement agency that received the complaint or information to inform
the Chiropractic Board of the outcome of the law enforcement agency's investigation and
whether charges are filed against the DC.
22. Allows the Chiropractic Board to investigate the referred complaint or information to
determine if it constitutes a violation of unprofessional conduct.
Licensure
23. Requires the Chiropractic Board develop policies and procedures for determining when the
Chiropractic Board will require a DC to undergo psychosexual evaluations and how the
Chiropractic Board will use the evaluation results.
24. Requires, rather than allows, the Chiropractic Board to require an applicant for licensure to
submit a full set of fingerprints to the Chiropractic Board.
25. Stipulates that, after 90 days, the Chiropractic Board must automatically suspend a license if
the licensee does not submit a complete application for renewal and pay the renewal fee.
26. Requires the licensee's renewal license to be backdated to the expiration date of the license if
the licensee completes the renewal application and pays the renewal fee within 90 days after
the due date.
27. Allows a facility, business entity, partnership or other form of business in which the majority
of ownership is owned by a licensed DC to submit bills under the controlling licensee's
individual name or business name without notification to the Chiropractic Board.
Naturopathic Board
28. States that, for the purposes of implementing or enforcing the naturopathic medicine statutes,
the Naturopathic Board is not entitled to a naturopathic doctor's proprietary formula or trade
secret.
29. Requires the Naturopathic Board to conform its rule to be consistent with the requirement
relating to a naturopathic doctor's proprietary formula or trade secret.
30. States that the requirement relating to a naturopathic doctor's proprietary formula or trade
secret does not prevent a patient from having access to the list of ingredients for any method
of treatment provided to the patient.
Miscellaneous
31. Defines chiropractic physician, member, patient safety and trade secret.
32. Contains a statement of legislative intent. FACT SHEET – Amended
S.B. 1588
Page 6
33. Makes technical and conforming changes.
34. Becomes effective on the general effective date.
Amendments Adopted by Committee of the Whole
1. Prescribes certain actions, occurring in Arizona or elsewhere, that constitute unprofessional
conduct for the purpose of disciplining a DC.
2. Prohibits the Chiropractic Board from adopting any rule that may alter or amend
unprofessional conduct, as outlined.
3. Requires the Chiropractic Board to terminate the Executive Director under prescribed
circumstances.
4. Requires each Chiropractic Board member and employee to complete on appointment or hire
a conflict-of-interest disclosure form, including an attestation that no conflict exists, if
applicable.
5. Requires the disclosure form be updated annually.
6. Requires the Chiropractic Board retain all conflict-of-interest disclosure forms and make the
disclosure forms and meeting minutes available to the public on request.
7. Requires each Chiropractic Board member and employee to complete on hire or appointment
an annual training approved by the Attorney General's Office as prescribed.
8. Requires the Executive Director of the Chiropractic Board to:
a) ensure the Chiropractic Board follows all applicable laws and rules, and complies with all
reporting requirements;
b) advise the Chiropractic Board of any contemplated actions that are outside of the
Chiropractic Board's authority and to state the executive director's concern in open session
if the Chiropractic Board disregards the advice provided;
c) prepare and maintain a discipline matrix to ensure all licensees are treated consistently
based on the specific allegations at issue that:
i. briefly outlines material facts of all past cases in which discipline was imposed without
identifying any specific DC or complainant other than by potential file number or other
reference;
ii. specifies the level of discipline imposed; and
iii. is available to any DC against whom a complaint has been filed and a formal
investigation has been opened, including the DC's counsel; and
d) prepare and maintain a discipline matrix to ensure all licensees are treated consistently
based on the specific allegations at issue; and
e) classify complaints pursuant to Chiropractic Board policies to prioritize the allocation of
Chiropractic Board resources and the investigation and adjudication of complaints.
9. Prohibits the executive director of the Chiropractic Board from: FACT SHEET – Amended
S.B. 1588
Page 7
a) advocating in support of or against a legislative proposal in the executive director's official
capacity until the Chiropractic Board has taken a formal position on the proposal in a
public meeting; and
b) encouraging DC's or the public to support or oppose any legislation.
10. Limits the scope of an investigation to the information contained in the initial complaint or
the information that the Chiropractic Board has in its possession at the time of the Chiropractic
Board's motion to investigate.
11. Prohibits the Chiropractic Board from subpoenaing information related to a licensee's
personal finances during an investigation.
12. States that if a disciplinary or nondisciplinary order requires a DC to complete continuing
education requirements, the Chiropractic Board is required to provide at least two choices of
continuing education provider organizations, boards or associations that can satisfy the
required courses.
13. Allows the Chiropractic Board to request an extension of time to investigate a licensee for
prescribed reasons.
14. Requires the Chiropractic Board to complete an investigation and initial review within 90
days of receiving a complaint.
15. Requires a final decision regarding a complaint misconduct to be made within 220 days after
the complaint is filed if a formal hearing is required.
16. Deems, if the Chiropractic Board has not made a final decision after the 220 days, the
complaint administratively closed.
17. Entitles a licensee to restitution for all costs incurred relating to an investigation and formal
hearing process if the Chiropractic Board acted capriciously against the licensee.
18. Requires the Chiropractic Board develop policies and procedures for determining when the
Chiropractic Board will require a DC to undergo psychosexual evaluations and how the
Chiropractic Board will use the evaluation results.
19. Requires, rather than allows, the Chiropractic Board to require an applicant for licensure to
submit a full set of fingerprints to the Chiropractic Board.
20. Stipulates that, after 90 days, the Chiropractic Board must automatically suspend a license if
the licensee does not submit a complete application for renewal and pay the renewal fee.
21. Requires the licensee's renewal license to be backdated to the expiration date of the license if
the licensee completes the renewal application and pays the renewal fee within 90 days after
the due date.
22. Requires the Chiropractic Board refer complaints or information indicating that a DC may
have committed a misdemeanor or felony offense to the appropriate law enforcement agency
within two business days after receiving the complaint or information. FACT SHEET – Amended
S.B. 1588
Page 8
23. Allows the Chiropractic Board to refer the complaint to law enforcement without obtaining
the complainant's consent or substantiating the complaint.
24. Allows the Chiropractic Board to restrict, limit or order a summary suspension of the DC's
license pending action by the law enforcement agency if the complaint or information
received requires that emergency action be taken to protect public health, safety or welfare.
25. Requires the law enforcement agency that received the complaint or information to inform
the Chiropractic Board of the outcome of the law enforcement agency's investigation and
whether charges are filed against the DC.
26. Allows the Chiropractic Board to investigate the referred complaint or information to
determine if it constitutes a violation of unprofessional conduct.
27. Allows a facility, business entity, partnership or other form of business in which the majority
of ownership is owned by a licensed DC to submit bills under the controlling licensee's
individual name or business name without notification to the Chiropractic Board.
28. Defines chiropractic physician, member and patient safety.
29. Adds a statement of legislative intent.
30. Removes the requirement for executive director of the Naturopathic Board to:
a) ensure that the Naturopathic Board follows all applicable laws and rules and complies
with all reporting requirements;
b) advise the Naturopathic Board if any contemplated action is beyond the scope of the
authority granted to the Naturopathic Board in accordance with the naturopathic medicine
statutes;
c) prepare and maintain a discipline matrix for use by the Naturopathic Board to ensure that
all licensees are treated consistently, to the best of the Naturopathic Board's ability, based
on the specific allegation at issue, when the Naturopathic Board contemplates imposing
any form of discipline; and
d) classify, consistent with the naturopathic medicine statutes. each complaint on submission
to the Naturopathic Board according to policies adopted by the Naturopathic Board that
prioritize the allocation of Naturopathic Board resources and the investigation and
adjudication of complaints.
31. Removes the authorization for the executive director of the Naturopathic Board to provide
advice on the scope of the Naturopathic Board's authority in executive session.
32. Removes the requirement for the executive director, if the information about the scope of the
Naturopathic Board's authority is disregarded, to state potential concerns in an open meeting
of the Naturopathic Board.
33. Restores the authorization for the Naturopathic Board to make investigations it deems proper
to adequately advise itself with respect to the qualifications of an applicant for a license to
practice naturopathic medicine. FACT SHEET – Amended
S.B. 1588
Page 9
34. Removes the limitation on the scope of an investigation, in accordance with a disciplinary
action requirement, to the information contained in the initial complaint or the information
that the Naturopathic Board has in its possession at the time of the Naturopathic Board's
motion to investigate.
35. Restores the restitution of fees to a patient after a period and term of probation that the
Naturopathic Board may fix to a naturopathic doctor's license as a disciplinary action after an
investigation.
36. Removes the specification that evidence of a criminal violation uncovered during the course
of a disciplinary investigation by the Naturopathic Board must be made available to the
appropriate criminal justice agency for its consideration within 48 hours after the
determination.
37. Removes the statement that, if a court of competent jurisdiction finds that the Naturopathic
Board acted capriciously against a licensee without merit and in violation of naturopathic
medicine statutes, the adopted rules or the Naturopathic Board's policies or procedures, the
licensee is entitled to restitution for all costs incurred related to the matter in the course of the
investigation or formal hearing process, or both.
Senate Action
RAGE 2/20/25 DP 4-1-2
Prepared by Senate Research
March 4, 2025
JT/KP/ci