Support HB1106 Restore Delegation Rights for Pennsylvania Chiropractors

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Your voice is essential. Stand with PCA to transform chiropractic care and eliminate outdated barriers that hinder patient access and practice efficiency.

In 2018, a judge determined that non-licensed supportive personnel do not have the proper training to provide therapeutic exercise for our patients, which removed our ability to delegate therapeutic exercise.
This ruling has disrupted standard procedures in chiropractic offices regarding the delegation of safe and effective supervised therapeutic exercise, which chiropractors had been delegating for decades before the ruling, with great benefit to the patient.
Without this bill, chiropractors are forced to either reduce services or operate at a disadvantage compared to other states, creating a workforce issue and increasing patient costs.
This has created a unique problem for chiropractors and patients, as Pennsylvania is the only state restricting the delegation of therapeutic exercise.

Number of Licensed Chiropractors in PA

Chiropractic Industry annually in PA

National Ranking for Workforce Growth

What is Therapeutic Exercise?

What Is Therapeutic Exercise Used For?

Therapeutic exercise in chiropractic care involves targeted, controlled physical movements designed to restore function, improve mobility, and reduce pain. Chiropractors use these exercises to support recovery from musculoskeletal injuries, enhance spinal stability, correct postural imbalances, and prevent future injury. They are often prescribed as part of a broader treatment plan following chiropractic adjustments.

Chiropractic-Anchorage-AK-Infographic-Theraputic-Exercises

What Are the Benefits of Therapeutic Exercises?

Improved Range of Motion: Helps patients regain flexibility and joint mobility
Pain Reduction: Eases chronic or acute musculoskeletal pain by strengthening weak areas
Rehabilitation Support: Speeds recovery from injury or postural dysfunction
Injury Prevention: Reinforces spinal alignment and neuromuscular coordination
Patient Empowerment: Encourages self-management through active participation in care
Enhanced Outcomes: Improves the long-term effectiveness of chiropractic treatment

Who Should Supervise These Activities?

Therapeutic exercises should be prescribed and supervised by a licensed Doctor of Chiropractic. However, under appropriate delegation laws (such as those proposed in HB1106), trained and certified Chiropractic Assistants (CCAs) may safely administer these exercises under direct supervision. This delegation allows for better clinical efficiency while maintaining high standards of patient care and accountability.

A Comparative Effectiveness Clinical Trial JAMA

Join the Movement for Chiropractic Advancement

We invite you to explore, share, and utilize the comprehensive materials provided to support chiropractic advancement in Pennsylvania. Your involvement is crucial in driving positive change and ensuring that chiropractic care remains accessible and effective for all. Together, we can make a significant impact. YOUR PCA is working for you in Harrisburg and on Capitol Hill!

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Addressing Workforce Challenges & Expanding Employment Opportunities

Pennsylvania’s chiropractic community is facing a critical workforce challenge, but there is a clear path forward.

Grow Healthcare Jobs:
Support High-Quality Care:
Stay Competitive:
The Certified Chiropractic Assistant (CCA) Bill establishes a clearly defined career pathway for those interested in chiropractic care.

Maintaining High Standards of Safety & Professionalism

CCA Bill introduces a uniform, statewide certification process; chiropractic assistants are trained to meet nationally recognized standards
Federation of Chiropractic Licensing Boards (FCLB),
Pennsylvania will adopt the gold standard in chiropractic assistant education and oversight.

Certification will be administered by the National Board of Chiropractic Examiners (NBCE)

Rigorous evaluations will include the following core areas:

Foundational Knowledge (30%)
Patient Safety & Clinical Procedures (40%)
Documentation & Compliance (15%)
Ethics & Professional Boundaries (15%)

Modernizing the Delivery of Care with HB1106

House Bill 1106 offers a smart, immediate step forward. The bill would restore chiropractors’ ability to delegate therapeutic exercises to certified assistants, which would:

Reduce provider burnout by easing workload pressure.
Create new job pathways for entry-level professionals.
Bring Pennsylvania in line with best practices adopted by other states.

Confronting the Workforce Crisis in Chiropractic Care

Mounting Financial Pressures on Practices

Chiropractic providers are navigating an increasingly unsustainable financial environment.

- Insurance reimbursements continue to decline while patient copays are rising.
- These trends are making it harder for practices to stay open and for patients to access consistent, preventive care, despite chiropractic being a proven, non-opioid alternative for musculoskeletal pain.

An Access Crisis on the Horizon

If left unaddressed, this workforce shortage will leave thousands of Pennsylvanians without meaningful access to conservative, whole-person care. Chiropractic isn’t just about back pain; it’s a comprehensive health approach focusing on long-term outcomes without medication. In the midst of a national opioid crisis, we can’t afford to let this resource disappear.

A Shrinking Workforce with Rising Demand

Pennsylvania is experiencing a severe and accelerating chiropractic workforce shortage. Projections show the state could lose over 100 chiropractors each year over the next decade, while new practitioner entry is falling far short of what’s needed to replace them. This growing shortfall directly threatens access to care across the Commonwealth.

Retirement Looms while Recruitment Lags

With many chiropractors nearing retirement, Pennsylvania faces a shrinking pipeline of replacements.

The lack of structured support, incentives, and career pathways is causing younger practitioners to leave the profession—or the state—altogether, especially in rural and underserved communities.

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