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: Expanding access to chiropractic assistant roles will create new employment opportunities across Pennsylvania’s healthcare sector.

• Support High-Quality Care: Enabling chiropractors to delegate routine therapeutic tasks allows them to focus on high-level clinical decision-making and patient outcomes.

• Stay Competitive: Pennsylvania is currently one of the few states that prohibits delegation of therapeutic care. This puts our providers at a disadvantage compared to neighboring states with modernized laws.

The Certified Chiropractic Assistant (CCA) Bill establishes a clearly defined career pathway for those interested in chiropractic care. By implementing a statewide certification process, the bill creates a trained support workforce—empowering chiropractic practices while maintaining high standards of patient care.

To strengthen Pennsylvania’s chiropractic workforce and ensure long-term sustainability, we must modernize our approach. Supporting this legislation means creating jobs, improving care, and retaining the next generation of healthcare professionals.

Maintaining High Standards of Safety & Professionalism

The CCA Bill introduces a uniform, statewide certification process that ensures all chiropractic assistants are trained to meet nationally recognized standards for clinical safety and professionalism. By aligning with the 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) and will include rigorous evaluation in the following core areas:

• Foundational Knowledge (30%)
  Anatomy, physiology, chiropractic terminology, and common therapeutic procedures.

• Patient Safety & Clinical Procedures (40%)
  Safe use of therapeutic equipment, emergency protocols, x-ray safety, and identifying clinical contraindications.

• Documentation & Compliance (15%)
  HIPAA standards, proper billing practices, fraud prevention, and accurate clinical record-keeping.

• Ethics & Professional Boundaries (15%)
  Confidentiality, harassment prevention, professional conduct, and respectful patient interactions.

By establishing this structured, nationally aligned training and certification framework, the bill ensures that Certified Chiropractic Assistants (CCAs) will be competent, professional, and fully prepared to support chiropractic providers—while upholding the highest standards of patient care and clinical safety

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, 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.

Mounting Financial Pressures on Practices
Chiropractic providers are navigating an increasingly unsustainable financial environment.

• Insurance reimbursements continue to decline.

• Patient copays are rising, discouraging regular visits.
  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.