Audit fiinds violations by state chiropractic board

A sweeping audit released Tuesday found the state board that licenses 15,000 chiropractors broke open meeting and conflict-of-interest laws and failed to aggressively pursue wayward practitioners.

The state Board of Chiropractic Examiners' delays in disciplinary cases could have allowed chiropractors accused of fraud or sexual abuse to continue to endanger the public, State Auditor Elaine Howle said in the 115-page report. Violations of open meeting laws, meanwhile, kept the public from participating in decision-making.

"This board has functioned very poorly, and it's inexcusable," Sen. Mark Ridley-Thomas, D-Los Angeles, said in response to the audit. Ridley-Thomas has held hearings and written legislation addressing the board's shortcomings.

The board said it had started to make many of the reforms suggested in the audit before the auditors even arrived.

The audit "reflects what was, but not what it is in the current day," Executive Director Brian Stiger said.

That view was echoed by Gov. Arnold Schwarzenegger, who appointed all seven members of the board, including two friends from his body-building days.

"I am pleased to learn that the board concurs with the majority of the (audit's) recommendations and has already taken action on many of them," Schwarzenegger wrote in a letter released by the board.

The board found itself in the spotlight a year ago after it took several legally questionable actions, including firing its executive director without due notice and failing to adhere to the Bagley-Keene Open Meetings Act.

That led to legislative hearings and a bill to strip the board of some of the autonomy granted by voters in 1922 when they approved an initiative to regulate the profession.

An ensuing Sacramento Bee investigation found that the board's passive approach to policing chiropractors had caused it to overlook civil cases that alleged fraud or sexual abuse. A follow-up described the case of a Los Angeles chiropractor who continued to practice for two years after the board first learned that a woman had accused him of rape. He was later convicted of sexually assaulting five women – including the initial accuser and four later victims.

The audit released Tuesday delved into that passive approach. It found that when the board got notification of a malpractice settlement against a chiropractor, it made little effort to find out what happened or whether the doctor should be disciplined. Instead, the board merely sent letters to plaintiffs notifying them of their right to complain.

This represents a stark contrast to other state licensing boards, which make an effort to get the details of malpractice claims to see if discipline is warranted.

The audit found inexplicable delays in the board's investigations. It took 68 days to open a case against a chiropractor accused of gross negligence, for instance, even though that kind of conduct is supposed to be a high priority. In two other cases, one involving sexual misconduct and the other fraud, the board took more than a year to refer the case to an investigator.

The delays "allow licensees who may pose a threat to the public to continue practicing," the audit says.

"Virtually all boards take only a matter of weeks" to investigate complaints, said Assemblyman Mike Eng, D-Monterey Park. "This particular board takes a matter of months and that is completely and wholly unacceptable."

He said the state attorney general's office should be involved in investigating complaints from the beginning, instead of waiting for the board to put together a disciplinary case.

The report uncovered instances when the board invited improper communication between members and chiropractors facing discipline. It held a closed session in December 2006 that did not meet the legal criteria for a closed session. And board members engaged in "serial communications," such as e-mails sent out to colleagues, that might have led to violations of the state open meeting law.

Board members and top management are required to fill out annual conflict-of-interest forms disclosing their financial holdings. But the process was in such disarray at the chiropractic board, the audit found, that the woman in charge of the annual filings did not know she had been assigned that role.

Board members and top management did not fill out the forms correctly – two, for instance, did not disclose business income. Some filed late, and two did not file the statements at all.

Despite the board's claim that it already has embarked on reforms, legislators said they want to make sure the audit recommendations are being followed before restoring the board's budget.

Last year, the Legislature cut the $3 million budget in half, making the full amount contingent on passage of a bill that would have stripped the board of some of its historic autonomy. Schwarzenegger vetoed the bill, leaving the board with half its money.

"We do mean business," Ridley-Thomas said. "Consumer protection has to be first and foremost in the consciousness of this board."

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