On Friday, October 21, NYSCA Board member, Lynn Pownall, DC, DACBN presented a letter to the New York State Board for Chiropractic addressed to the State Board chair, Ali M. Jafari, DC on behalf of NYSCA President, Mariangela Penna, DC. The letter addressed a number of professional issues that have an impact on the State Education Department’s mission “[t]o protect the public by fostering high standards of professional . . . practice.” The Association stated that it “believes that public protection and patient safety are not being served by the current state of professional practice by any state agency, including the State Education Department, and such altruistic sentiments as contained in the SED mission statement and goals are not being met.” “Patient protection and the standards of practice for chiropractic and the other licensed professions generally, are within the purview of the State Education Department,” Dr. Penna noted, “but the professions are not only affected by the laws and regulations of the SED, but by all of laws and all of regulations of all of the state agencies combined. In view of the current state of professional practice, the NYSCA submits that SED’s attitude in view of its stated mission to ‘protect the public’ by ‘fostering high standards of professional . .. practice’ without looking at the totality of the laws and regulation that affect patient safety and professional practice is agency-centric -- more inclined to protect the status quo rather than being patient-centered/ public safety conscious or concerned about establishing ‘high standards of professional . . . practice.’ As laudable as they are, patient protection/public safety and standards of professional practice are missions and goals that cannot be met or compartmentalized solely the province of the SED without an examination of all areas of law and regulation of the state in their totality. The NYSCA submits that the SED, as well as the other state agencies, have surrendered important regulatory and standards setting responsibilities collectively to the whims of the market place.” The NYSCA letter noted that the utilization review practices of health plans, insurers, HMOs and MCOs, Individual Practice Associations (IPAs) and independent Utilization Review agents based on proprietary guidelines not open to public scrutiny amounted to a “defacto regulation of the profession” by self-interested, private enterprises – entities raking in record profits and whose only interest is their own financial bottom for the benefit of their shareholders and does not represent “quality” health care or “high standards of professional practice.” “Who is minding the fox?,” Penna asked. The NYSCA also charged that the termination practices by plans amounted to a constructive, albeit financial, delicensing of chiropractic professionals. “Health care is everyone’s responsibility – patient, provider, employer, insurer, government and governmental agency,” Penna noted. “Health care needs to be patient-centered, evidence-based, efficacious, efficient, cost-effective, patient-responsible and transparent for everyone’s benefit. Presently, this is not the case. But the State Boards can help, including the State Board for Chiropractic," Penna said. “The development of practice guidelines and standards and written review criteria are within the ambit of the regulatory functions of a disinterested State Education Department charged with establishing and maintaining “high standards of professional . . . practice” for the public’s protection, and that the promulgation of these guidelines and standards, Penna stated, should be developed and disseminated in concert with all interested parties.” Dr. Penna’s statement was joined by a statement expressing similar sentiments by the American Chiropractic Association (ACA) given by ACA downstate delegates, H. William Wolfson, DC who is also the NYSCA District 7 President (Suffolk County).