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STATE OF MICHIGAN

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

BUREAU OF PROFESSIONAL LICENSING

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PUBLIC HEARING

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TUESDAY, JANUARY 19, 2021

AT ABOUT 1:00 P.M.

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HELD VIA ZOOM CONFERENCE

LANSING, MICHIGAN

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RE: Chiropractic - General Rules

(MOAHR #2019-84 LR)

Pharmacy Technicians - General Rules

(MOAHR #2020-29 LR)

Speech-Language Pathology - General Rules

(ORR 2018-107 LR)

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HEARING FACILITATOR:

WESTON MacINTOSH

Bureau of Professional Licensing

611 W. Ottawa Street

Lansing, Michigan 48909

21 ALSO PRESENT: Kerry Przybylo

Andria Ditschman

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LeAnn Payne

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24 REPORTED BY: Lori Anne Penn, CSR-1315

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I N D E X

2 Opening Statement - Weston MacIntosh

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4 COMMENTS:

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MARTIN BROWN

KRIS FETTERMAN

ERIC DiMARTINO

GARTH AAMODT

DONALD RENO

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ROBERT FENELL

KRIS FETTERMAN

ROBYN PEAKE

LARRY KAPLAN

ROYANN HASSINGER

LEWIS SQUIRES

LEIGHIA WELLS

DONALD RENO

GARTH AAMODT

MARTIN BROWN

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21 Closing Statement by Mr. MacIntosh

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Tuesday, January 19, 2021

At 1:00 p.m.

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MR. MacINTOSH: Good afternoon. My name

is Weston MacIntosh, and I am an analyst for the Bureau

of Professional Licensing in the Department of Licensing

and Regulatory Affairs, and I will be conducting the

hearing today.

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This is a public hearing on proposed

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administrative rules entitled "Chiropractic - General

Rules", "Pharmacy Technicians - General Rules", and

"Speech-Language Pathology - General Rules". We are

conducting the hearing as required by the Administrative

Procedures Act to allow the public to comment on the

proposed to changes to these rule sets. As with all

other public hearings on draft rule sets, the only items

discussed during this hearing will be proposed changes to

the rule sets. This hearing will not be covering any

questions or discussions on any other issues, such as

reopening businesses, as this is not the proper platform.

We are calling this hearing to order at

1:00 o'clock p.m. on January 19, 2021, via Zoom, to

follow measures designed to help prevent the spread of

Coronavirus Disease 2019 (COVID-19). The notice of

public hearing was published in three newspapers of

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general circulation, the Grand Rapids Press, the Flint

Journal, and the Mining Journal, on January 5, 2021, as

well as the Michigan Register, Issue #24, published on

January 15, 2021.

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All comments should relate directly to

the proposed rules. If you have questions about the

rules, you may place your comments on the record and the

Department will review and consider them. If you have

suggested changes to the proposed rules, please include

the specific reasons why the changes would be in the

public interest.

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We'll take comments in the following

manner.

• For those using the Video Conference Portion,

i.e., not calling on the telephone, please use

the "Raise Your Hand" feature in Zoom. I will

call on individuals to speak and they will be

unmuted at that time.

• For participants that are available only by

telephone, we'll ask if you wish to make a

comment after the video participants have

finished.

• If you have a comment but do not wish to speak,

please note that the Department will also accept

written statements e-mailed or postmarked to

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BPL-BoardSupport@Michigan.gov until 5:00 o'clock

p.m. today.

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Those making comments should clearly and

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slowly say and spell your name and advise if you are

speaking on behalf of an organization. We will limit

comments to three minutes per person. Please remember

that only one person should speak at a time.

The Department staff from the Bureau of

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Professional Licensing includes Kerry Przybylo, Andria

Ditschman, and LeAnn Payne, as well as myself.

We will group the comments by rule set so

that we can group the comments together. And I'm not

going to go alphabetically, I'm going to actually start

with the first rule set we'll look at is taking comments

for Speech-Language Pathology - General Rules. Is there

anyone who wishes to speak on the Speech-Language

Pathology - General Rules?

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MS. PRZYBYLO: Wes, I don't see anybody's

hands up.

MR. MacINTOSH: I'm just looking at the

second page. Okay. Yeah, I'm not seeing anyone either.

Okay. So the next rule set we'll look at

is comments for Pharmacy Technicians - General Rules. Do

we have anyone who would like to make comments on the

Pharmacy Technicians - General Rules?

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MS. PRZYBYLO: Wes, this is Kerry. I

don't see anybody's hands up for the Pharmacy Technician

Rules.

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MR. MacINTOSH: I don't either.

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So next we'll take the third set, which

is the Chiropractic - General Rules. Is there anyone who

would like to make a comment on the Chiropractic -

General Rules? And again, please, if you wish to make a

comment, please raise Your hand under the participants'

tab in Zoom.

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MS. PRZYBYLO: Wes, it looks like Martin

Brown has a comment.

MR. MacINTOSH: Yes, Martin, it looks

like you're unmuted. Go ahead.

MARTIN BROWN: Are asking me to begin my

comment?

MR. MacINTOSH: Yeah. Can you please

just state and -- state your name and first and last and

just spell it, because we do have a court reporter, just

so she has a record.

MARTIN BROWN: Okay. Thank you. My name

is Martin Brown, M-a-r-t-i-n B-r-o-w-n, and I'm president

of Macomb County Chiropractic Association, M-a-c-o-m-b,

County Chiropractic Association.

Is the reporter, stenographer ready for

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me to begin?

MR. MacINTOSH: Go ahead, Martin, yeah.

MARTIN BROWN: I oppose the Board of

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Chiropractic granting authority over the review and

approval of continuing education to the Michigan

Association of Chiropractors, MAC for short. This is not

a common standard in other professions here, nor is it

common in other states' chiropractic boards. This option

is very questionable and controversial.

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I am a loyal, longstanding, dues-paid

member of MAC and its predecessor since the early '80s.

I have consistently attended MAC events for over 35

years. I recognize MAC's fine efforts in serving its

members and promoting the profession, but there are

limits on MAC's organizational role.

MAC is a non-regulatory, nongovernmental

membership trade organization and should not be given a

regulatory role. Chiropractors are not required to join

MAC. The State board's primary obligation is to protect

the health, safety, and welfare of the public. MAC's

role is to serve its members. These are different and

separate roles and the distinction should remain.

MAC holds continuing ed programs and

derives significant income from these. There is a clear

conflict of interest if MAC were to oversee all other

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providers of continuing ed. The proposed rules provide

no oversight, no checks or balances on MAC whatsoever.

In fact, MAC has been placed above the rules with no

application, review, or approval required for their own

programs. MAC courses should be impartially reviewed. I

do not doubt the validity of MAC programs, but I oppose

an unequal review process.

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The Federation of Chiropractic Licensing

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Boards established PACE, Providers of Approved Continuing

Ed, with an well-accepted rigorous review process

utilized by the vast majority, some 80 percent of state

boards, for impartial review. PACE is perfectly suitable

for Michigan.

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Another issue, chiropractic college

courses given on campus are currently automatically board

approved. Off-campus and online courses should also be

automatically approved in the new rules. There are no

chiropractic colleges in the State of Michigan. The same

course taught in-state for the doctors' safety and

convenience of course warrants automatic approval if

taught on campus, likewise for online courses. The

pandemic has taught us about valid flexible options. All

universities offer online courses to protect from COVID,

and chiropractic CEs should become more accessible, not

further encumbered.

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The State must preserve fair government

authority. The Board of Chiropractic must always focus

on its role of protecting the public. I speak in the

name of fairness, equal justice, and ethical principles.

And I've also submitted written documents personally and

as president of the Macomb County Chiropractic

Association providing reasonable options for a just and

fair alternative to serve the board and the public.

Thank you very much.

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MR. MacINTOSH: Thank you, Dr. Brown.

And I'll just also remind folks, we

already have received a lot of written comments. If you

sent in a written comment, you don't have to basically

say the same thing. You know, if we have your written

comment, we have your written comment and we'll obviously

pass it along to the board, just for everybody's

clarification. So if you've already submitted something

and it would be basically the same thing that you would

say otherwise, you don't need to say it again for the

sake of the record.

Who else would like to make a comment on

Chiropractic - General Rules?

MS. PRZYBYLO: Wes, Kris Fetterman has a

comment. She was unable to raise her hand.

MR. MacINTOSH: Okay. Kris, go ahead.

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KRIS FETTERMAN: Thank you. I'm Kris

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Fetterman with Fetterman Events, spelled K-r-i-s, last

name is F- as in Frank e-t-t-e-r-m-a-n. And I sent each

board member of a packet of information a few weeks ago

that explained my thoughts and opinions on the issue; if

you didn't receive it, I can e-mail the information

again. But I sent it because I had heard the board

members were given incorrect information that weighed in

on your decision to move in the direction you were

taking.

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My company provides CE seminars for about

38 states right now, and we've interacted with state

boards for each of these states and have seen firsthand

the differences in state boards that use their state

associations for some aspect of their business. In each

of these states, the chiropractors in the state feel as

if their state board is controlled by the state

association, the transparency of the board disappears,

and the impropriety of the board increases. There's a

lot of distrust between the doctors and the board. It

also builds a great divide between the chiropractors and

the association.

Now, I have always, have always and

always will encourage doctors to join their state

association, and specifically the Michigan one because

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they do a lot of great things for the chiropractors. We

only do continuing education, but the state association

does a lot more with legal and legislative issues

specifically. But so saying that, it's -- this is not to

just go against state association, this is actually

something that should be kept separate.

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Many states, almost all states in fact,

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use PACE to handle the CE approvals in some manner. Some

states rely solely on PACE and use their approval as the

board's approval, and other states use a PACE precheck to

sort through the applications and make it less lengthy

for their time, so there's an option of control for the

state boards. PACE is a part of the Federation of

Chiropractic Licensing Board, they're the ones who

control the national board testing. They are an unbiased

organization that's designed to ensure that CE programs

are of the highest quality and that providers adhere to

strict guidelines, and there's an extensive application

process to even become a PACE provider, which weeds out

individuals or companies that try to get CE approval for

seminars that don't enhance the doctors' knowledge or

education.

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Now, I understand there are more and more

CE applications coming into the board for review and that

this is taking a lot of the board's resources of staff

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and member time, however, to give this duty to the state

association will dissolve any transparency of fairness

and ethical morality that the board has. It will also

give the appearance of impropriety, whether real or

imagined. So I'm asking the board members to reconsider

this option and look into the possibility of using PACE

instead to handle this duty. They're equipped to do this

and already handle this for the majority of state boards.

Members of the FCLB receive annual

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benefits, such as free access to online reporting,

reporting agent service, polls, poll surveys regarding

scope or practice issues, and several more benefits that

help govern, towards govern their state professional.

Michigan is only -- is one of only three states that are

not members of the Federation, all other states are.

One of the most attractive benefits for

regulatory boards is the retention of authority. The

boards that are a part of the FCLB retain their authority

and they can choose to implement PACE as a means of

delegating some of the workload associated with that

authority.

Another big benefit, and this is one of

the largest ones I've been told, is their CIN-BAD

program. Members, board members can look up licensed

applicants to make sure they don't have board actions in

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other states. CIN-BAD also sends out monthly

notification on any board action so that state licensing

boards can request get a heads up. That way if a doctor

who's licensed in Tennessee has his Oklahoma license

revoked for unprofessional conduct, the Tennessee board

will be able to act before that doctor hurts a patient in

their state. So, and all boards, all licensing boards

are required to report actions to the National

Practitioner Databank; FCLB handles that via the CIN-BAD.

So it can be a huge cost savings, and that's one of the

things I am presenting, presenting this information so

you can make an informed decision and encourage you to

consider the FCLB's PACE program as a better option.

Thank you.

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MR. MacINTOSH: Do we have any other

comments on the Chiropractic --

MS. PRZYBYLO: Eric DiMartino has a

comment.

MR. MacINTOSH: Okay. Eric, go ahead.

And again, please, you know, state your first and last

name, and please spell it.

ERIC DiMARTINO: Thank you. Good

afternoon. My name is Dr. Eric DiMartino, that's E-r-i-c

D-i-M-a-r-t-i-n-o, and I currently serve as chairman of

the board for the Michigan Association of Chiropractors.

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I'm here today to speak in support of the

proposed Administrative Rule, the change regarding

Chiropractic continuing education, as well as discuss a

potential change to the current rule regarding

chiropractic relicensure.

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First, regarding the proposed rule

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governing continue education, this solution was arrived

at after a member of the Michigan Board of Chiropractics

continuing education committee contacted the MAC

regarding the intense administrative burden faced by

their committee. In researching models across the

country and keeping in mind their desire to keep the

approval process within the State of Michigan, the rules

committee work group arrived at this solution.

MAC programs are already approved for

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continuing education without going through the

application process; this is the result of the recent

changes to the Administrative Rules that were approved

and went through the public hearing process years ago,

this again is acknowledging the MAC's years of

high-quality programs that consistently meet State of

Michigan requirements. The MAC has the nonprofit legal

structure, expertise, experience, and well-informed staff

to provide a professional evaluation that strictly

follows the guidelines for approved continuing education

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outlined in the current State of Michigan Administrative

Rules. As long as the current guidelines are followed,

programs will be approved.

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As I mentioned, there are precedents

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among other states for taking such action, including the

chiropractic licensing boards of Kansas and Tennessee,

both of which delegate the authority for the review and

approval of chiropractic continuing education programs to

their chiropractic state associations. Also, other

professional membership organizations in Michigan, such

as the realtors and CPAs, have taken on this critical

responsibility.

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The MAC board of directors, leadership

and education programs committee are confident that the

model proposed by the rules committee work group and

passed by the full Board of Chiropractic solves the

administrative issues faced by the Board of Chiropractic

and ensures that CE programs continue to count for the

Michigan chiropractic scope of practice as well as

current trends in Michigan's chiropractic practice, while

continuing to allow only the highest quality programs for

continuing education. I firmly believe that the proposed

change to the rule governing acceptable chiropractic

continuing education will greatly benefit the licensed

chiropractors in our state and the State of Michigan

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itself.

Next I'd like to talk about the

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Administrative Rule governing chiropractic relicensure --

THE REPORTER: Can you slow down a little

bit, please. I'm sorry.

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ERIC DiMARTINO: Am I speaking too fast?

THE REPORTER: You're getting faster and

faster. Thank you.

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ERIC DiMARTINO: You can't keep up.

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Okay.

Moving on, I'd like to talk about the

Administrative Rule governing chiropractic relicensure

for chiropractors whose Michigan license has been expired

for three years or more. Prior to the rewrite of the

rules that became effective in 2019, all applicants for

relicensure were required to satisfy either of the

following: Either 45 hours of continuing education in

the preceding three years with all the outlined

requirements, or have been licensed as a chiropractor in

another state of the United States during the three-year

period immediately preceding the applications for

relicensure. This was changed in the most recent rewrite

of the rules.

Currently, doctors seeking Michigan

relicensure after their license has been elapsed for

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three years or more are now required to have the 45 hours

of continuing education and either have been licensed in

another state for three years preceding the application

or have passed a National Board of Chiropractic Examiners

special purposes examination for chiropractic. We feel

that this is overly burdensome on doctors seeking

relicensure in that if a doctor has been continuously

licensed in another state for the three years immediately

preceding applications for relicensure, has been

following the state's continuing education rules, and has

no sanction against his or her license in that other

state, they are presumed to have the skills to practice

chiropractic in the State of Michigan. We also do not

believe that passing the NBCE SPEC exam is necessary to

establish the presumption of having the skills and

ability to practice chiropractic in the State of

Michigan.

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It is also important to note that if a

doctor had never been licensed in Michigan at all, the

process to get a license is much less cumbersome, but

because someone may have gotten a Michigan license right

out of school, but then moved to another state to

practice and now wants to come back to Michigan, they

must follow a completely different and more stringent set

of rules. We would like to see the rule rewritten to be

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more in line with the rule prior to the previous rewrite

in which chiropractors have access to two methods in

which to gain relicensure: (1) through continuing

education, or (2) having been continuously licensed in

another state for the immediate past three years. This

change will continue to protect both the general public

and the profession itself while easing a burdensome

requirement on applicants for relicensure whose license

has been expired for three years or more. Thank you for

your time and your consideration of these comments.

MR. MacINTOSH: The next hand I see

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raised is (inaudible) --

THE REPORTER: I'm sorry, Wes, I could

not hear you.

MR. MacINTOSH: Sorry. The next hand I

see raised is Garth Aamodt. Hopefully I pronounced that

correctly. Garth.

GARTH AAMODT: You were close.

MR. MacINTOSH: And then please, again,

just state your first and last name and please spell it.

Thank you.

GARTH AAMODT: Okay. Can you hear me

now?

MR. MacINTOSH: Yes.

GARTH AAMODT: My name is Dr. Garth

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Aamodt, and that's spelled A-a-m-o-d-t, pronounce it

Aamodt.

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I actually don't represent anyone here

except my own opinion. I have sent in a letter from

January 12 to the board, so I won't repeat anything I've

said there. I have just a couple of things I didn't

bring up in my letter that I think pertain here, some of

them from been brought up by the previous speakers. I'll

keep it real brief.

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My chief concern is the wording, which I

think is new wording, about how approved university

seminars must be on campus for automatic approval. That

bothers me. One reason is because every year I

participate in an annual conference held in Chicago,

Illinois, it's sponsored by National University of

Chiropractic, it's also sponsored by the ACA Council on

Orthopedics, but as I understand it, because they draw

chiropractors from all over the country, often all 50

states, or at least contiguous states, they hold it off

campus, they hold it at the Marriott Hotel; it's

convenient, you can book your room there, and it's a

three-day conference. I'm concerned that because it's

off campus, even though it's sponsored by a university,

does that mean that they or the other sponsors or the ACA

are going to have to add to their burden to apply for

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sponsorship or approval for their CE hours. I don't know

that they have to do that with other states, but I

presume that since they are automatically included in

most other provisions being sponsored by the University

and the ACA, that that would be a formality that I would

think would not be necessary under normal circumstances.

My other concern is the conflict of

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interest. We have not always had the best continuing

education seminars in Michigan, sorry. I'm not saying

those were sponsored by the MAC, we've had other

organizations before the MAC, but I have actually seen

some pretty bad things sponsored by various previous

trade organizations, so I'm concerned that if the

ideology becomes farther leaning one way or another,

we're going to find an unintentional bias in what they

may approve or not approve, so that concerns me. Also,

I'm concerned that conflict of interest, if they're doing

a seminar on one topic and Fetterman, say, for example,

or someone else, Macomb, applies for a similar topic you

might say, will they prefer theirs since theirs are

automatically approved. That's not a bonus that you're

automatically approved and are above the, I guess you'd

say the vetting process.

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So those are my main contentions. It

could be that I have a misunderstanding, I have read the

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rule change and I've tried to stay informed, but my main

concern is one of conflict of interest and the additional

burden that would come upon organizations that right now

know that they're already vetted by I would assume almost

all other states, so why are we adding to their burden.

And we're just spreading out the burden in this state,

we're need not really improving it. I personally think

that PACE is a great way to go. I have no ax to grind

either way, I'm a private practitioner, but these are my

concerns, and I appreciate the opportunity to express

them.

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MR. MacINTOSH: Thank you, Garth.

Next we'll do Don Reno. And again,

please state your first and last name and spell them.

DONALD RENO: Well, good afternoon,

everybody. My name is Dr. Donald Reno, D-o-n-a-l-d,

middle initial M., last name Reno, R-e-n-o. And I'm here

today to speak in support of the proposed changes to the

Michigan Board of Chiropractics Administrative Rules.

There's been some awesome points that

have been made by all parties. And I speak as the former

BOC chairman, served eight years on the Michigan board,

and there's a couple things I think I can help to clarify

here.

Administratively, the State of Michigan

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deals with its boards maybe a little bit differently than

some other states; I think it's an extremely great system

that the State of Michigan has utilized over the years.

Many states have boards with budgets and directors and

heavy, cumbersome internal organization factors. The

State of Michigan does not allow for board budgets and

secretaries that are private to the members of the board

per se, which is a very good way to keep the board in

line without being a sheriff in town.

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PACE is also -- or FCLB is an

organization that does specialize in continuing education

through their PACE program. Due to the fact that

Michigan does not participate in the FCLB -- the reason

why that is is it's a cost pay-for-play organization --

since there's no budget for the board to pay FCLB dues,

the board had always navigated the world of CEs through

volunteer. Yes, it's a cumbersome situation. I believe

the MAC is stepping up in great faith to take on a burden

that will have no financial redeeming qualities to it,

they are not going to be paid for the work that they're

going to do, and there is no new conflict because most of

these chair of the CE committee on the board has always

been a MAC member, so there is no new introduction to any

kind of conflict of interest whatsoever in my opinion.

The members of the Association are dues

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paid, it is not incumbent upon the MAC to pay the FCLB to

pay for the approval of the continuing education credits.

Especially in a pandemic period where obviously cost

containment is is very, very important, I think it would

be unfair for us to put additional costs on the shoulders

of the doctors for the MAC or -- not the MAC, but for the

board to participate with the FCLB. It's just, it's an

additional cost that's not really in the best interest of

the public.

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And in my eight years as, or disciplined

in the Board of Chiropractic, I've always observed

nothing but the utmost integrity in the review of the CEs

with no conflict, and if there was any disapproval of a

CE, it was over something that just simply didn't appear

in the paperwork or the quality of the program. So I

speak in support of this, and I can't imagine a better

organization to review the CEs for the State of Michigan

and offer the best and highest quality of public

protection.

MR. MacINTOSH: Thank you for your

comments. Next I see Robert Fenell. Robert.

ROBERT FENELL: Good afternoon. My name

is Dr. Robert Fenell, and that's spelled R-o-b-e-r-t

F-e-n-e-l-l, and I'm here representing nobody other than

myself right now.

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I'm a practicing chiropractor and

licensed in the State of Oklahoma, and I am speaking here

today to oppose the rule under consideration which would

give the Michigan Association of Chiropractors, or MAC,

sole authority over continuing education.

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We have a different, but somewhat

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similar, process here in Oklahoma. You may or may not

know that we have two state associations, and as a

practicing chiropractor, we are required to take one of

the handful of seminars that are made available to us

each year by either/or of the different state

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associations. It makes for -- and I'm speaking for let's

just say nearly a hundred percent of the chiropractors in

the State of Oklahoma because I personally have met most

of the chiropractors through my affiliations with either

one or other of those associations. So, and it is a

disadvantageous environment for us to practice in. The

speakers that are chosen for either/or of the two

associations, in many opinions of the doctors, we'd

rather have other presenters. Speaking to colleagues of

ours who practice in other states, they have a plethora

of seminars and speakers they can gain their CE hours

through, and they may travel, some of them come to other

states, and what have you. But in Oklahoma, it's very

limited.

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A colleague of mine who practices in

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Michigan mentioned this to me recently, and I said, oh,

no, please, I hope that doesn't happen to you guys, that

sounds like it could even be potentially worse because

there's one association and they'll have full control

versus we have two associations and there's some shared

control there of course. But it's very, very limiting,

the DCs here wish that we had similarities of other

states, possibly, for example, PACE certified or able to

get a seminar that's certified through a chiropractic

college, but that's not the case, unfortunate for the

Oklahoma chiropractors, and it sounds like this would be

the more unfortunate for doctors practicing chiropractic

in the State of Michigan. So I greatly oppose that

consideration, and hopefully Michigan can remain how they

have been. I'm just speaking from the love of

chiropractic and a fellow chiropractor. That's all I

have to say.

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MR. MacINTOSH: Thank you for your

comment.

MS. PRZYBYLO: Weston, Kris Fetterman was

next on the list. She had an additional comment to make

and messaged me before the other people put their hand

up.

MR. MacINTOSH: Oh, okay. Go ahead,

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Kris.

KRIS FETTERMAN: Oh, thanks. I just

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wanted to mention Dr. Reno had mentioned -- no, no, it

wasn't Dr. Reno, it was Dr. DiMartino, that Tennessee

uses their state association. They actually switched two

years ago and are with PACE. Their association still is

automatically approved, but they do go through PACE, you

have to be a PACE provider to be approved there, and I

wanted to mention that.

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And I also mentioned -- wanted to say

something about verbiage being given to people to speak

here which is in the chat box, that doesn't quite seem

right, but I just thought I'd bring that up. That's all.

Thank you.

MR. MacINTOSH: Just as a heads-up, no

one should be commenting in the chat box, comments are

supposed to be made orally for the purpose of this

hearing.

Let's see here. Next I see Robyn Peake.

Go ahead, Robyn.

ROBYN PEAKE: I am sorry for the comment

that ended up in the public chat, I thought I was

responding to somebody privately and it did not respond

to that individual, and my apologies for that. I

recognized that after the fact, and I did make that

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apology on chat for any disruption. That was certainly

not my intent.

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I have a love of chiropractic,

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chiropractic is my first go-to for healthcare for myself

and my family. And it's important to me that we have

doctors and continuing ed that are efficient, that are

effective. One of the concerns that I have as an

individual is what's the value of online coursework that

can -- that has no supervision. Somebody could set up a

program to play and then walk back in two to three hours

later when it's complete. How much value has that served

for the chiropractor, and what does that translate to for

care of patients.

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Just because something comes in does not

mean that it needs to be approved. I think that running

it through the MAC would streamline the process, I think

it would help for both doctors as well as the providers

of the coursework. There's certain standards that I

expect out of my chiropractor, there's certain standards

that I would hope would be followed with the continuing

ed programs. To resist those standards I think puts the

public at risk. I think there needs to be the programs

that have the proper supervision that can verify that the

doctors have in fact completed the coursework, that can

have a positive result on how they practice and

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protecting the public. Thank you very much.

MR. MacINTOSH: Thank you for your

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comments. Is there anyone -- I'm not seeing any other

hands right now. Is there anyone else who would like to

make a comment? Let me just really quick circle back

because I'm not seeing any hands right now.

Was there anyone else who would want to

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make a comment on either the Speech-Language Pathology -

General Rules or the Pharmacy Technician - General Rules?

Okay. I'm not seeing anyone.

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And again, sort of last call, is there

anyone else who would like to make a comment on the

Chiropractic - General Rules?

MS. PRZYBYLO: Weston, Larry Kaplan is

physically raising his hand.

MR. MacINTOSH: Okay. Larry, go ahead.

Again, please state your first and last name and spell

them for the record.

LARRY KAPLAN: Okay. My name is Larry

Kaplan, L-a-r-r-y K-a-p-l-a-n.

I strongly oppose this measure. I've

been a MAC member for many years, I was an MCC member, I

was a Society member. They put, the MAC puts on great

seminars, but I think there has to be a regulatory part

of it. I think there's a conflict of interest here both

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financially on both sides. The MAC, from what I

understand, is more of a membership association, and it

even says in its bylaws that it's not a regulatory

agency, and I think that's a conflict there. The state

board, they might be overwhelmed and maybe they need help

in doing it, but they're the ones who can give a fair

maybe assessment of the continuing ed, and I never

understood why this came to where it is.

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Not everyone in the State here is a

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member of the MAC, so now, arbitrarily now they have to

become a member or they have to abide by their rules, and

there's no regulation, they're just being handed over

this priority of regulating the continuing ed program.

And everything else has been said.

I've been to many seminars, the MAC puts

on great seminars, Macomb puts on, I've been to Omni,

I've been to Fetterman, I've been all over, and they're

all really good, and I just think right now, I just think

it would be a conflict of interest, and that's my input.

Everything else has been said. So that's it, and I thank

you for the opportunity.

MR. MacINTOSH: Thank you for your

comments. I see a hand, Royann Hassinger. Royann, can

you hear me? You're on mute.

ROYANN HASSINGER: Yes. Okay. I'm

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sorry. I'm Royann Hassinger, I'm a chiropractor in

Ortonville. I have been a member of MAC --

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MR. MacINTOSH: First of all, can you

please spell your first and last name.

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ROYANN HASSINGER: I'm sorry. My first

name is Royann, R-o-y-a-n-n, Hassinger, H-a-s-s- like in

Sam i-n-g-e-r. I'm in Ortonville, Michigan.

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There are several of us in my little,

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tiny community, and I believe we all practice

differently; that is one of my concerns with MAC being

the primary or having authority over all the continuing

education.

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I've attended MAC seminars, I've attended

other seminars. If I want an in-depth seminar, if I want

to learn a new program, it is very difficult to get that

at seminars sponsored by larger organizations.

I'm concerned about the conflict of

interest. I want to be able to practice the way the laws

say I can, but are different from the person down the

street from me. That is what gives our patients the

freedom of choosing a particular doctor. Unfortunately,

because I turned 65 and had to get Medicare, I went to a

medical doctor. I didn't really get a choice as to who I

got, and they're all the same so it really didn't matter.

Nothing wrong. But now I really, really appreciate the

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fact that I can choose the doctor who I want as a

chiropractor, my patients can choose me as opposed to

Dr. Brown. He doesn't live near me so it's not a

problem. But we can choose who we want because of how we

practice, and I am afraid that MAC will restrict what my

continuing education credits are.

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I did like what Dr. Eric had said about

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licensing. I agree, if you've been practicing out of

state, you should be able to come to Michigan if you

qualify. Dr. Reno made a comment that the chiropractic

board has always had an MAC president; that does kind of

seem strange to me. But I just think that from an

individual chiropractor not associated with any

organization, that PACE or some non-biased organization

would be a better supplier for our continuing education

credits. Thank you.

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MR. MacINTOSH: Thank you for your

comments. Squires.

LEWIS SQUIRES: There we go. Thank you,

Weston. I'm Dr. Lou Squires, S-q-u-i-r-e-s. I'm the

immediate past chairman of the board.

MR. MacINTOSH: (Inaudible).

THE REPORTER: I'm sorry, I didn't hear

you, Weston.

MR. MacINTOSH: I asked for him to spell

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his first name for the record as well.

THE REPORTER: Thank you.

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LEWIS SQUIRES: Sorry, Weston. First

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name Lewis, L-e-w-i-s, last name Squires, S-q-u-i-r-e-s.

I'm speaking in favor of these rule changes as a person

that has been on this board for eight years, appointed by

Governor Snyder at the time.

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We have seen a lot of situations occur

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within Michigan on the CE, and within the last two years

we have had an overabundance of CE credits turned in,

some positive, some negative, some outside our scope, and

some within our scope. It has been extremely challenging

for the doctors that review these CE credits to keep up

with all those situations that they're faced. I'm urging

the State to understand that the importance of doing all

this is to safeguard the public, but also to be able to

present the best educational seminars for CEs. This not

to criticize any of the CEs put on by other organizations

or universities, this is to help us in the process. That

doesn't mean that other organizations and universities

sponsored or entrepreneurs are going to not receive their

credits, this is just a starting point for this, this is

something that's vitally important on behalf of the Board

of Chiropractic to safeguard the public and to provide

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quality educational situations for our doctors. I think

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there's a little confusion going on with some of the

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people that have spoke about exactly what the rules are

intended to do, so I just wanted to say that, and I do

support this. Thank you very much.

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MR. MacINTOSH: Thanks for your comments.

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Next I see Leighia Wells.

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LEIGHIA WELLS: Hi. My name is Leighia

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Wells, L-e-i-g-h-i-a, Wells, W-e-l-l-s. I'm a provider

in Portage, Michigan, and I've been a part of the MAC in

the past and enjoyed my time very much there.

I think the MAC does a very good job with

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other endeavors, legislative, and also with supporting

changes in, governmental changes that are needed and with

legalized changes that we also need implemented. I

don't, however, agree with having the MAC be in charge of

continuing education. I think that is a conflict of

interest. I do appreciate that they want to help with

it, but I am concerned about what courses would be

automatically agreed to, and we're spending money on that

instead of other endeavors, and I think that that should

be separated and not combined into two.

Many times I do not attend the

conferences that occur at -- for the State for the MAC

because, or I only attend a few of classes that happen

because I don't agree with the information that's being

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presented, and I don't necessarily agree with many of the

courses being presented on a very large scale, and so I

often take classes in other states and don't even get the

continuing education credits from Michigan applied

because these other organizations don't go through the

rigorous process to get it applied for Michigan because

if they only have me there, I'm not going to ask them to

make sure that that gets applied.

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So I want to make sure that classes,

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also, if they're off campus for a university, they should

automatically count just as much as if they're on campus.

I completely disagree with that rule. I saw that come up

a year or so ago and I couldn't even believe it, it makes

no sense to me that suddenly the same teachers that are

putting the presentation on, you know, down the street,

no longer is automatically in. That's more work for

whoever is approving these courses, so that should be

automatically taken care of.

I see no reason why we don't use PACE.

I've looked into other states, and that's what they're

using. That seems a legitimate way, an effective and

efficient way of completing some of these courses.

And I'm also curious, I started to do

some digging but it was very hard to find, is what are

other healthcare professional boards doing for continuing

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education. Do they have a state-run organization like

we're considering, the MAC, in control of all of the

courses? I don't know the answer to that, but I want to

make sure that we're in alignment with what other

professions are doing in our State. If we are to be

considered legitimate, we need to make sure that we're in

alignment with all other health professions.

So in conclusion, I disagree with the MAC

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being in charge, not because I don't think they're

capable, but I think there could be some bias, and I

think there is a conflict of interest, and I do think we

should consider other options. Obviously the State board

is having difficulty running through all of this

information for all of these submissions, but I think we

need another alternative, and I don't think it should be

the MAC unfortunately controlling this. And that's all I

have to say. Thank you.

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MR. MacINTOSH: Thank you for your

comments. Any other comments at this time? Don Reno, go

ahead.

DONALD RENO: Yeah. This is a process.

What the State of Michigan came to when I was on the

board was the awareness that this was cumbersome indeed,

and with the multiplicity of the number of programs that

have come in, that is where the reason came in. And

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Dr. Wells, your statement about PACE being a great entity

is not to say -- to take anything away from them, but the

structure in your state does not give any participation

because the requirement is that you as an individual

would have to pay for a representative to go to PACE and

the FCLB. With those dollars not being there, I think

it's unfair to shoulder the practitioners with that.

The MAC as an entity will not have the

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ability to deny anything because there's a rule

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structure, and the structure will hold every entity just

as accountable as the other, and as this is a good-faith

gesture, not a gesture, but act by the State of Michigan

to clarify something that became very, very cumbersome.

Volunteer individuals on the board don't see a dime or

get paid for the work that they do to show up in Lansing,

do the hard work behind the scenes, and then show up in

Lansing and ask for an approval of everybody who's shown

up here today to testify against the process. The

process has no conflicts in it. And I know there's

questions and it's cumbersome, but you just have to trust

in the fact that you've got a great group of people

currently on the board right now that have you and your

profession's best interest in mind.

MR. MacINTOSH: Thanks you. Any other

comments?

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MARTIN BROWN: I have a comment.

MR. MacINTOSH: Garth Aamodt.

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GARTH AAMODT: Yeah. Is it possible to

just ask a question so maybe some clarity can be added

here. And my main question -- again, this is Dr. Garth

Aamodt, G-a-r-t-h A-a-m-o-d-t. I'm not making a

statement, I'm just asking, is there clarity or a reason

can be explained by those who support this, like

Dr. Reno, about why the phrase of on-campus classes are

automatically approved if sponsored by a university, but

they're going to require going through the MAC, I assume,

if they're not on campus? Doesn't that add to the

burden? And if the goal is to remove the burden or

lessen the burden, why didn't that phraseology get

changed there? That's all I ask.

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MR. MacINTOSH: Thank you. Do we have

any other comments?

MS. PRZYBYLO: Dr. Martin has a question,

or has a comment, Wes.

MR. MacINTOSH: Dr. Martin Brown, go

ahead.

MARTIN BROWN: The name is Martin Brown,

M-a-r-t-i-n B-r-o-w-n.

Robyn Peake had made a comment about

continuing ed that was offered online and questioned the

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validity of that. I just want to remind the board and

those attending that the board already approves up to 15

hours of online credits, and they're often accompanied

with quizes and so on to ensure the validity of the

program, so it wouldn't be a change in terms of adding

the on-campus or off-campus or online automatic credit

approval to college courses.

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Additionally, I did provide in written

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version a detailed analysis of each of the providers and

a breakdown and did some statistical reporting in a

written document provided for your review, and

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approximately one-third of the programs would fall into

that category and would drop off; in other words, of the

some 300 applications, would reduce it to some 200. In

fact, only two providers make up the vast majority of the

entire block of all of those courses. Eighty-seven

percent of those submitted courses that were reviewed and

approved are online courses, 13 percent are live courses,

only 40 courses out of the some 300. So if the board

opted for direct application for five or fewer

applications per sponsor and maintained a concurrent

option of application to PACE or whomever is chosen, then

the board's workload would decrease by over 90 percent,

they would only have reviewed 21 applications, fewer

applications than have been provided each year for the

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past 6 years. So it's a reasonable thing to look at a

multiple course option in terms of approval where the

board could retain the option with a limit of up to five

applications and the overage could go to PACE as the

authority to review any multitude or quantity of courses.

So I've provided all the details and the breakdowns in my

written report that was sent by e-mail. If you have

questions, I'd be happy to review them as well.

MR. MacINTOSH: Thank you for your

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comment. Are there any other comments? Okay. I'm not

seeing any other comments.

So if there are no other comments or

anyone else who would like to speak at this time, I

hereby declare the hearing closed. The record will

remain open until 5:00 o'clock p.m. for any other

comments you may wish to share about the proposed rules.

Thank you for attending.

(At 1:53 p.m., the public hearing concluded.)

- - -

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1 STATE OF MICHIGAN )

)

2 COUNTY OF MACOMB )

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I, Lori Anne Penn, certify that this

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transcript consisting of 40 pages is a complete, true,

and correct record of the public hearing held in these

matters on Tuesday, January 19, 2021.

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I further certify that I am not

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responsible for any copies of this transcript not made

under my direction or control and bearing my original

signature.

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I also certify that I am not a relative

or employee of or an attorney for a party; or a relative

or employee of an attorney for a party; or financially

interested in the action.

January 21, 2021

_________________ ______________________________________

Date

Lori Anne Penn, CSR-1315

Notary Public, Macomb County, Michigan

My Commission Expires June 15, 2025

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