|CCE Cited for Violations by U.S. Dept of Education
By Thomas J. Sidoti, D.C.
CCE Cited For Accreditation Violations By U.S. Department of Education
New Jersey and DECE Complaints Spur Two Year Investigation
The United States Department of Education (USDOE) has found the Council on Chiropractic Education (CCE) in violation of criteria necessary to maintain its status as a recognized accrediting agency. The violations were uncovered during a two year investigation initiated by separate complaints filed during 2003 by the Council of New Jersey Chiropractors (CNJC) and Doctors for Excellence in Chiropractic Education (DECE). In a July 5, 2005 letter, the USDOE found CCE in non-compliance of various accreditation criteria, some of which require immediate action.
The complaints centered on the circumstances and appropriateness of CCE's June 10, 2002 decision to revoke the accreditation of Life University College of Chiropractic (Life). Under the leadership of Founder and President, Sid E. Williams, D.C., Life had become the largest and most successful chiropractic institution in the world. After CCE revoked its accreditation, thousands of its chiropractic students were forced to abruptly uproot themselves and their families and finish their chiropractic education at other institutions. The resulting sudden loss of tuition revenue caused Life to teeter on the brink of insolvency, requiring that it sell some of its property, dismiss many of its faculty, and dismantle its unique championship sports programs.
Upon exhausting CCE's appeal process, Life filed a lawsuit and requested a preliminary injunction to regain its accreditation in Federal Court. The defendants named in the lawsuit included CCE and Paul D. Walker, CCE's then Executive Director. On February 10, 2003 the Court granted Life's motion for injunctive relief and ordered CCE to restore Life's accreditation.
THE FEDERAL COURT RULING
In rendering its decision ordering CCE to immediately restore Life's accreditation, and in explaining its rationale for Life's likelihood of winning its lawsuit against CCE, the Federal Court ruled in part:
.as to Plaintiff's (Life) likelihood of success, the Court finds that Plaintiff has demonstrated that it is substantially likely to succeed on the merits for the following reasons: Although decisions of accrediting agencies have historically been given deference, where, as here, accreditation decisions are made by actors with a financial interest in the outcome, little deference should be given. Here, there were admitted conflicting economic financial interests in the decisions that were made. That fact is shown by the recruitment of Life students, after the June 2002 decision, by competitors whose representatives were involved in the decisionmaking on accreditation; an attempt by a competitor whose representative was one of the decisionmakers to buy Life University after its accreditation was withdrawn, at a time when the monetary value of Life University had been reduced by the accreditation decision; the fact that persons with competing financial interests to those of Life University made the accreditation decisions on Life University; the fact that the elimination of Life University as a chiropractic college would increase the number of students and money available to those competitors; that an aggressive group of leaders of the eight liberal chiropractic schools, who had only one-third of the chiropractic students, had undertaken a series of corporate manipulations in order to reduce the representation and dominance of the eight conservative chiropractic schools (of which Life University was one), who had approximately two-thirds of all chiropractic students; that these corporate manipulations, which may very well have violated CCE's corporate charter, were calculated to give dominance to the liberal minority group over the conservative majority group; that the end result has been the disaccreditation of the largest of all the colleges of chiropractic and the turning loose of hundreds, perhaps thousands, of students to be attracted to the other schools. Actions which would violate the antitrust laws if incorporated in an accreditation procedure, per se, indicate a lack of due process.
COMPLAINT TO CCE
In a letter dated March 24, 2003, CNJC submitted a formal complaint to CCE requesting information concerning compliance with various USDOE accreditation requirements. Included in the complaint were allegations that CCE did not comply with USDOE regulations concerning separate and independent criteria for accrediting agencies and conflicts of interest of its board members involved in the Life accreditation decision. The complaint also requested a list of the names and professional qualifications of CCE's policy and decision-making bodies.
THE CCE RESPONSE
Rather than properly address the complaint, Paul D. Walker, CCE Executive Vice President, officially responded to CNJC in a rambling, evasive April 8, 2003 letter stating:
.the information presented in your correspondence is somewhat ambiguous with regard to the CCE complaint process. In brief, the information seems not open to the stated Informal Process because you have requested that your complaint be addressed through the Formal Process. However, your material does not meet the requirements of the requested process because it does not cite specific violations of any CCE Bylaws, Policies, or Standards and it does not provide a summary of the actions taken and outcomes of an effort to resolve your complaint at the informal level. .Consequently, your correspondence does not enable the action you have requested.
In concluding his letter, Walker advised the CNJC to address its issues to the office of the proper governmental entity.
COMPLAINTS TO USDOE
Lacking other recourse, CNJC heeded Walker's advice and submitted its complaint directly to the USDOE on April 30, 2003. Included in its complaint was the original letter to CCE and Walker's letter in response. On November 20, 2003, DECE filed an additional complaint against CCE also alleging various USDOE violations.
THE USDOE FINDINGS
After lengthy investigation, and correspondence with CCE, the USDOE has now concluded its review of the two complaints. In a July 5, 2005 letter, the USDOE informed CCE of the following:
1. With respect to the allegation that CCE did not comply with specific USDOE criteria concerning conflicts of interest of CCE board members, the USDOE found as follows:
The agency is not in compliance with this criterion. CCE apparently has never directly responded to the allegation of conflicts of interest by its members, commissioners, and evaluation team members despite having received a letter of complaint from CNJC on March 24, 2003. Although the agency identifies policies designed to prevent conflicts of interest, it has apparently not investigated this allegation to determine if violations of its policies took place. In the absence of such an investigation, Department staff must conclude that either CCE does not have clear and effective controls against conflict of interest or has failed to implement such controls where appropriate.
With regard to the DECE allegation, staff is concerned that continuing discrepancies between CCE internal policy documents may compromise the agency's ability to effectively carry out its accreditation activities.
The CCE needs to review its internal policy documents for discrepancies and take corrective action to correct all discrepancies. The agency also needs to investigate the allegation of conflicts of interest by its members, commissioners, and evaluation team members in its review of LUCC (Life).
2. With respect to the allegation that CCE did not comply with criteria requiring disclosure of the names and professional qualifications of CCE's decision-making bodies, and in specifically addressing Walker's response to the CNJC refusing to address their complaints, the USDOE found as follows:
The agency is not in compliance with this criterion. CCE did not fully provide, as requested in a letter dated April 8, 2003, a list of the names, academic and professional qualifications, and employment and organizational affiliations of its policy and decision-making bodies and its administrative staff. In addition, pursuant to this same letter, CCE did not review itself in a timely and fair manner, and apply unbiased judgment to, a complaint against itself. There are no provisions within 602.23(c)(3) that would exempt an agency from responding either to a complaint that lacks particular formatting or that fails to cite specific violations of agency bylaws, policies or standards.
The agency needs to revise its complaint policy and procedures to ensure that they cannot be used to impede but rather support a thorough and balanced review of the agency itself as well as its accredited institutions.
3. With respect to the allegation that CCE did not comply with specific USDOE mandated separate and independent criteria for accrediting agencies, the USDOE found as follows:
The agency is not in compliance with this criterion. This criterion applies exclusively to the mechanism by which members of an accrediting agency's decision making body are elected or selected. In the case of CCE, members of the Commission on Accreditation are elected by the CCE Board of Directors. Since members of the Board of Directors may not also serve as officers or board members of affiliated trade associations such as FCLB, there is no possibility that the FCLB president or board can elect members of the Commission on Accreditation in violation of this criterion. However, the same restriction does not apply to the Association of Chiropractic Colleges, whose officers apparently may serve on the Board of Directors, and therefore be in a position to elect members of the Commission on Accreditation.
The CCE needs to revise its policies pertaining to the election of its commissioners such that the CCE Board of Directors cannot serve as officers or board members of any related, associated, or affiliated trade association or membership organization to include the Association of Chiropractic Colleges.
4. The USDOE concluded its letter to CCE by stating:
For those findings for which your agency has been found to be in noncompliance with the Criteria, we request that you take immediate steps to correct the violations identified. Please forward to us by October 17, 2005 your plan of corrective action to include timelines for completion of such actions. A follow-on report of your agency's corrective actions will be requested.
The fact that the CCE has been found in violation of so many major accrediting criteria has been characterized as a major embarrassment and "another black eye" for the entire chiropractic profession. The findings of the USDOE, many of which mirror those of the federal court, appears to support the prevalent perception that CCE's decision to revoke Life's accreditation was based on political objectives and had little to do with the quality of its chiropractic program. Indeed, both the USDOE and the Federal Court's findings either fault the CCE for apparent financial conflicts of interest, or cite failures to implement controls to prevent conflicts of interest. The Federal Court even speculated that CCE may have violated anti-trust laws.
The USDOE finding that, "continuing discrepancies between CCE internal policy documents may compromise the agency's ability to effectively carry out its accreditation activities" is now sounding warning alarms throughout the profession. Violations of the USDOE criteria, particularly pertaining to its revocation of Life's accreditation, may now have placed CCE in serious jeopardy of losing its own status as a recognized accrediting agency. Because many state licensing boards require that candidates for licensure be graduates of CCE accredited colleges, and USDOE recognition of an accrediting agency is required for many student loans, the ramifications to the chiropractic profession of CCE possibly losing its accreditation are enormous.
LICENSING BOARDS UNDER PRESSURE
While some states never mandated that candidates for licensure be graduates of CCE approved schools, many states have statutes or regulations requiring the schools of their candidates retain CCE approval. After the Federal Court detailed the multitude of reasons it ordered CCE to restore Life's accreditation, some state licensing boards began questioning CCE's integrity and the wisdom of their mandatory CCE requirement. Nevada was the first state to have the foresight to change its licensure requirements to include specific waivers to its CCE requirement. The USDOE findings will in all likelihood put tremendous pressure on other licensing boards to follow Nevada's lead and insert waivers into their own CCE requirement language. Such waivers will be a necessary safeguard in the event the USDOE revokes CCE's accreditation.
RENEWED CALLS FOR A SECOND ACCREDITING AGENCY
After years of relative stability, CCE's failure to adhere to basic USDOE regulations has justifiably renewed calls for a second chiropractic accrediting agency. Rationale for a second accrediting agency ranges from both the necessity of the chiropractic profession to have a legitimate back-up agency in the event CCE loses its accreditation, to ensuring that future accreditation decisions are not politically motivated. The USDOE has indicated that the chiropractic profession is not constrained to a single accrediting agency, and it will entertain all applications for additional chiropractic accrediting agencies.
INDEPENDENT REVIEW OF CCE'S ACTIONS
According to the USDOE, CCE has apparently never directly responded to the allegation of conflicts of interest, as a result it has now ordered CCE "to investigate the allegation of conflicts of interest by its members, commissioners, and evaluation team members in review of LUCC (Life)." Based on its prior conduct, an open question is whether CCE is capable of objectively investigating itself. It appears that despite the 2003 Federal Court ruling, and complaints by DECE and CNJC, CCE has yet to investigate or fully acknowledge the allegations detailed in the Court ruling. As more chiropractors and chiropractic organizations learn of the USDOE violations, calls for an independent review of CCE's actions appear to be gaining momentum. Many believe that an objective review of all concerns raised by both the Court and the USDOE be performed by an objective outside agency unrelated to the chiropractic profession. Such a review may be the only way to restore credibility to the CCE and the entire chiropractic profession.
CONCLUSION - A LINE IN THE SAND
If the chiropractic profession is to be viewed as a respected and credible member of the health care community, the agencies that govern it must be beyond reproach. When a court grants an injunction based on conflicts of interest, reversing the decision of the chiropractic's sole accrediting agency, the profession's credibility suffers. When the same agency refuses to answer proper complaints from the profession it serves, credibility erodes further. When that agency is finally found in violation of its own accreditation criteria, credibility becomes non-existent.
Has the chiropractic profession matured enough to put politics aside and demand accountability when warranted? Should actions gravely detrimental to the credibility of the entire profession go unchecked, or should calls for an independent review be heeded? The profession has reached yet another crossroad, we can take the road of denial and dismiss the court ruling and USDOE violations as trivial, or we can take the road of responsibility and demand accountability. The profession must take a good hard look at itself and draw a line in the sand. We can either stand on the side of corruption and political agendas, or the side of integrity and honesty, the decision is ours.
Dr. Tom Sidoti is a 1984 graduate of Life Chiropractic College and maintains a family practice in Passaic, NJ. He currently serves on the Board of Directors of both the regional Council of NJ Chiropractors (CNJC) and statewide Association of NJ Chiropractors (ANJC). Dr. Sidoti was recently instrumental in helping develop the unique structure that allowed six disparate NJ chiropractic groups to come together and function as a single unified organization.
Dr. Sidoti is a former Vice President of the NJ State Board of Chiropractic Examiners, and served as chairman of its Rules and Regulations Committee. During his term he was selected as one of NJ's representatives to the Federation of Chiropractic Licensing Boards (FCLB), and was also selected by the National Board of Chiropractic Examiners (NBCE) to help write one of its Part III National Board Examinations. Some of Dr. Sidoti's accomplishments include Life University "Alumnus of the Year" and CNJC "Chiropractor of the Year."