Report of the Annual Meeting of the Congress of Chiropractic State Associations

State chiropractic leaders gathered in Baltimore over November 8-12, 2006 for the annual meeting of the Congress of Chiropractic State Associations. Set to the theme "Sailing into the Future with a New Vision," over 120 delegates from 50 state chiropractic associations participated in round table discussions and workshops aimed at improving their operations and overall effectiveness in serving their members and advancing the chiropractic profession. In addition to providing association management training for state elected leaders and staff, the meeting covered chiropractic's hottest issues, the introduction of new COCSA programs and policies, and the election of COCSA leaders for 2007. Sponsors of the 2006 meeting were Airpacks, Breakthrough Coaching, CBG, ChiroCode, Chiropractic America, Chiropractor Monthly, Foot Levelers, Interactive Health, Lippincott Williams and Wilkins, Maryland Chiropractic Association, NCMIC, Now You Know, Palmer College of Chiropractic, Parker Chiropractic College, Standard Process, Texas Chiropractic College, Dr. Terry Yochum, and Voice for Health. Following is a brief summary of the primary activities and issues of the 2006 Congress. CCGPP Best Practices Recommendations Over eight hours of the program was spent in intense discussion with CCGPP about their efforts to develop a best practices document. Despite heated debate and disagreement, the meeting was conducted very professionally and allowed for a true exchange of ideas with the final outcome being that COCSA members unanimously approved the following recommendations to CCGPP: • Consider the written recommendations received and make the appropriate revisions to the current draft to allow for the concerns, additions and omissions to be considered and follow this procedure for future drafts. • Change the name of the document to truly reflect the intent and use of the document. • Ensure expanded input allowing the duly elected CCGPP representatives to truly act as liaisons between the member associations and the CCGPP Board. • Consider redrafting the document's overview and introduction to make it easier to read and understand, including a shorter more concise narrative, written in non-academic language with bullet points for better understanding. • The process will remain open to allow other organizations and researchers and concerned stakeholders to be included in the process. • Consider rewriting the research compilation to make it more user-friendly to those affected. • Ensure that the commentary process will be well advertised in advance so that the stakeholders will be fully engaged. • In the absence of higher levels of evidence and research, consider the use of the clinical experience and case studies/course studies. In response, CCGPP unanimously agreed to "resubmit the low back draft to stakeholders for comment on the 'user-friendly' status, format and for consideration of responses to stakeholder comments." The chiropractic profession, as well as all other stakeholders, will receive 45 days notice before release of this new draft and an additional 45 days to respond to the draft when it is released. Furthermore, CCGPP agreed to adopt the title "Chiropractic Clinical Compass" for the CCGPP Best Practice process and defined the process as follows: "The Chiropractic Clinical Compass, which is an iterative process, shall include but not be limited to the research literature synthesis and stratification, the application of and utilization of this process in practice, and the dissemination, implementation, evaluation, and revision process applied to the various aspects of our profession: to include the experiential, experimental and clinical orientation of practitioners in order to promote Best Practices and improve the quality of patient care within our profession." Mr. Russ Leonard, executive director of the Wisconsin Chiropractic Association, an outspoken critic of the initial CCGPP draft prefaced the COCSA vote by applauding the CCGPP's patient-centered model. "The willingness of CCGPP to consider this broad set of recommendations should be commended. This is a significant step towards producing a practice document that reflects a broad consensus within the profession. Should that occur, the chiropractic profession will take a giant leap forward in its ability to attract new patients to the profession". Similarly, Dr. Don Hirsh, President of the Maryland Chiropractic Association and one of the more vocal participants in the debate, praised those involved on both sides of the discussion for their professionalism and willingness to work together towards a common goal. COCSA President Dr. Jerry DeGrado applauded the efforts of everyone involved. "Our profession took a huge step forward. We did not circle the wagons but instead chose the high road and ended the weekend with mutual concessions and respect for one another. There were points throughout the weekend at which both sides had to agree to disagree, but we did not let those disagreements kill the spirit of unity or prevent us from reaching an acceptable conclusion. I have tremendous hope for the future of our great profession---that we can, even in the midst of disagreement, move forward." However, he warned, "We must be mindful that this is only the first chapter in the book, and the rest of our story is yet to be told. As the plot thickens, it is imperative that we continue to consider the destiny of the chiropractic profession and work together for the betterment of our chiropractic family. " Resolution on Proper Documentation and Record Keeping As a participating member of the OIG Task Force, COCSA approved the following resolution emphasizing COCSA's support of the OIG Task Force Action Plan. Other members of the Task Force are the Association of Chiropractic Colleges, the American Chiropractic Association, and the Federation of Chiropractic Licensing Boards: RESOLUTION ON DOCUMENTATION AND RECORKEEPING Whereas, the 2005 report from the US Office of Health and Human Services= Office of the Inspector General extrapolates from a review of records from 2001 that a number of chiropractic claims submitted to Medicare were flawed, and Whereas, the same report noted 2/3 of all chiropractic claims failed to document medical necessity, and Whereas, the public interest is best served by all health care providers maintaining accurate records of patient visits, including appropriate documentation of medial necessity; and Whereas, chiropractic state associations are empowered to provide appropriate training on documentation and recordkeeping practices for their member doctors of chiropractic, and Whereas, it is anticipated that chiropractic colleges may soon add documentation and recordkeeping to the chiropractic curriculum, and Whereas, it is anticipated that chiropractic licensing board may soon require approved continuing education in documentation and recordkeeping as a condition for relicensure; and Whereas, the Congress of Chiropractic State Associations (COCSA) is participating in the OIG Task Force with the Association of Chiropractic Colleges, the American Chiropractic Association, and the Federation of Chiropractic Licensing Board on developing appropriate documentation and recordkeeping curriculum; and Whereas, the OIG Task Force will also develop and offer "train the trainer" sessions to familiarize instructors on appropriate documentation and recordkeeping curricula; now therefore be it Resolved, that COCSA encourages member state associations to provide approved training seminars for their member doctors; and be it Further resolved, that COCSA will work with state associations to ensure proper training of their documentation and recordkeeping instructors, and be it Further resolved, that COCSA will continue to work with the OIG Task Force to represent the interests of all state associations to ensure that their member doctors develop proper documentation and recordkeeping practices. Focus on COCSA Programs COCSA leaders reviewed the successes of the past year and announced several new programs for 2007. Among those introduced were World Class Conferencing, CERV Team, the new National Backpack Safety Program offered in affiliation with Core Products, and the development of implementation kits for the Quit for Life smoking cessation program. During the Saturday luncheon, Yolanda Davis of Foot Levelers presented a $14,250 check to Drs. Steve Simonetti and Jerry DeGrado, representing state association use of the Foot Levelers Speakers Grant Program. Checks were also presented to COCSA from NCMIC, Eclipse/Chiromatic, and TPK Backsaver Wallet. Congress members also received an update on the advances and successes during the past year of the Straighten Up America program. Information on all these programs can be found on the COCSA website. COCSA's New Mission, Vision and Leaders During the planning meeting held earlier in the year, the COCSA board approved changes to its mission statement and adopted a vision statement. At the Baltimore meeting, the board presented and received unanimous approval from the COCSA membership for the following policy statements: Mission Statement: The mission of the Congress of Chiropractic State Associations is to provide an open, nonpartisan forum for the advancement of the chiropractic profession through service to member state associations. Vision Statement: The Congress of Chiropractic State Associations is the forum for unifying the profession and inspiring the achievement of universal understanding and utilization of chiropractic. Elected to lead the Congress in 2007 are: • President - Dr. Jerry DeGrado of Kansas • 1st Vice President - Dr. Jeff Fedorko of Ohio • 2nd Vice President - Dr. John Galbreath of Illinois • Treasurer - Dr. Kate Rufalo of Pennsylvania • Secretary – Dr. Walt Engle of Pennsylvania • Past President – Dr. Stephen Simonetti of New York • District 1 Director - Dr. Don Hirsh of Maryland • District 2 Director - Dr. Ken Hughes of Michigan • District 3 Director - Ms. Lili Montoya of Florida • District 4 Director - Dr. David Kassmeier of Nebraska • District 5 Director – Mr. Bill Howe of California • At Large Director – Ms. Kathy Chittom of Louisiana Dr. Kevin Donovan of Rhode Island, the outgoing Past President, was voted an Honorary Member of the Congress for his many years of service on the COCSA board. Several districts elected representatives to serve on the Council on Chiropractic Guidelines and Practice Parameters (CCGPP). COCSA representatives to CCGPP for 2007 are: • District 1 – Dr. Tom Augat, Maine Chiropractic Association • District 2 – Dr. David Radford, Ohio State Chiropractic Association • District 3 – Dr. Robert Hayden, Georgia Chiropractic Association • District 4 – Dr. Jeff Askew, North Dakota Chiropractic Association • District 5 – vacant • At Large – Dr. Len Suiter, Missouri State Chiropractors Association. The next meeting of the Congress will be held on November 7-11, 2007 in Nashville, Tennessee. For additional information about the Congress, visit: