The chiropractic board, one year later

It was just over a year ago that the Board of Chiropractic Examiners burst out of obscurity and onto the front pages of newspapers covering California state government. Members of the board and the staff leveled charges of corruption and mismanagement at each other, numerous lawsuits were filed, and legislators moved to reign in the board's autonomy. But with the board set to meet Thursday at its headquarters in Natomas, most of the people involved say it is well on its way to putting these problems behind it.

On Tuesday, the Bureau of State Audits released a 119-page report on the board, with plenty of blame to go around. It found serious problems with both the staff and the board members. This included Open Meeting Act violations and improper communications between board members. But it also found that the board had taken significant steps to address problems around management, procedures and enforcement actions against problem chiropractors.

Those problems had led the Legislature to cut the board budget in half last year, from $3.1 million to $1.5 million. This forced the board to cut its staff from 17 people to 6. On Monday, a bill to restore that funding – AB450 by Assemblyman Bill Emmerson, R-Redlands – cleared the Senate Business and Professions Committee by a unanimous vote.

The committee's chair, Sen. Mark Ridley-Thomas, D-Los Angeles, was the legislator who had the board's budget cut in the first place. He and Emmerson made an agreement that Ridley-Thomas could recall AB450 to his committee if the state auditors report found anything unexpected. Now that the report is out, Emmerson said he expects his bill to have a clear path.

"The audit confirms my belief that the Board and certain appointed members have been derelict in their responsibilities and duties," Ridley-Thomas said in a statement on Tuesday.

He said restoration of the board's funding would be dependent on them following the legal counsel they're given by their DCA attorney. He also called for a follow-up of the audit in six months. Contacted Wednesday morning, Ridley-Thomas' office could not confirm whether the bill would be recalled to committee or not.

"I don't believe he will (recall the bill)," Emmerson said. "I think the new administration at the chiropractic board is taking care of the issues and resolving their problems." 

The centerpiece of that new administration is Brian Stiger. Formerly a staffer with the Department of Consumer Affairs, Stiger has made a career as a "fixer" for troubled state boards. He was brought in last year and eventually become the board's executive director. He welcomed the committee vote, saying it would allow the board to comply with the recommendations from the state auditors report. Part of this effort would be hiring some new staff. With one possible exception, Stiger said, any former staffers would need to reapply if they wanted to come back to the board.

"We're very pleased and hopeful that this bill will make it all the way through to restore our budget," Stiger said, adding, "It's pretty difficult to initiate all the reforms without all of our funding."

At the time, disputes within the board largely pitted staff against board members and chiropractic professional organizations. By this measure, the chiropractors appear to have won. The two most controversial board members, Richard Tyler and Franco Columbu, remain in place. Both are friends of Gov. Arnold Schwarzenegger from his bodybuilding days. Tyler did step down from the board's chairmanship last year and is currently in a one-year grace period after the expiration of his first four-year term; he is eligible to be confirmed to a second four-year term.

Meanwhile, all of the board staffers at the center of the controversy have moved on. Former Executive Director Catherine Hayes is now a staff services manager at the DCA. Jana Tuton, the deputy attorney general once assigned to the board, is no longer listed in state salary databases; according to several people familiar with the board, she has retired from state service.

Maggie Craw, the board's chiropractic consultant since 2002, resigned in August and reportedly moved out of state. The auditors report contained language that appeared to back up claims by some chiropractic groups that Craw did not meet the official qualifications for the consultant position:

"Employee B did not include any information regarding experience working as a practicing chiropractor. Because the minimum qualifications do not clearly define the phrase ‘practice of chiropractic,' we were unable to determine whether the applicant met the minimum qualifications."

The board and staff have been working closely with chiropractic organizations to establish procedures for disciplining chiropractors who break professional rules or are subjected to patient complaints. Stiger said this process should be complete by July 1. On Tuesday, Schwarzenegger sent a letter to new chair, Fred Lerner, praising the board for making improvements.

"Things are a lot better than they were in the past," said Charles Davis, president of the International Chiropractors Association of California, which has been highly critical of the now-departed board staffers. "There needs to be a regulatory agency with enforcement, but it needs to be proper enforcement. No one is against that. We don't have the final say on anything, but at least they know our concerns."

The board has also appears to have put to bed one of the most contentious issues around the practice of chiropractic. In December, Stiger signed off on an opinion from the legal affairs department at the DCA finding that the manipulation under anesthesia is legal for chiropractors as long as they have the proper help from an anesthesiologist.

There is still the matter of three pending lawsuits that the board will discuss in closed session. Hayes sued the board for allegedly illegally firing her a year ago; the auditors report found that board members did take illegal actions in trying to dismiss her during the contentious board meeting that landed them in headlines.

David Hinchee, a former board staffer who was laid off in January, has a suit pending against Hayes, alleging she engaged in harassing behavior toward him for not going along with numerous actions she took as director. Finally, Bryan Meredith, a chiropractor who was disciplined by the board for allegedly illegally practicing MUA, has a suit pending against Craw and the board for taking action against him without reason. His attorney, Roger Calton, said he has been working with the board toward a settlement.

"I think it will be resolved," Calton said. "We don't have the settlement finalized yet. But I do expect that it will be resolved."

According to some people close to the situation, the problems experienced by the board have deep roots and won't necessarily be resolved in the next few months. These go back to the establishment of the board via a poorly drafted 1922 voter initiative – and to a rivalry between doctors and chiropractors that some say has been going on far longer than that.

"I think it was appropriate to have a dentist step in when there was a problem between the doctors and chiropractors," joked Emmerson, who is an orthodontist.