BILL ANALYSIS
AB 1116
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Date of Hearing: April 26, 2005
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Gloria Negrete McLeod, Chair
AB 1116 (Yee) - As Introduced: February 22, 2005
SUBJECT : Acupuncture.
SUMMARY : Requires an individual seeking a license to practice
acupuncture to complete a postgraduate residency program, in
addition to existing requirements. Specifically, this bill :
1)Requires an individual seeking a license to practice
acupuncture, in addition to existing requirements, to complete
a postgraduate residency program approved by the California
Acupuncture Board (Board). Also requires that the individual
seeking the license shall be supervised by a licensed
acupuncturist during the postgraduate residency program.
2)Provides that the Board shall determine, and set forth in
regulation, the minimum number of hours necessary to meet the
postgraduate residency requirement.
3)Provides that an individual practicing acupuncture without a
license shall not be guilty of the unlicensed practice of
acupuncture if he or she is enrolled in a postgraduate
residency program approved by the Board.
EXISTING LAW establishes the Board which licenses and regulates
acupuncturists and makes the unlicensed practice of acupuncture
unlawful, except under specified conditions. An individual
seeking a license to practice acupuncture must meet the
following requirements: (1) be at least 18 years of age; (2)
have completed an educational and training program that includes
a minimum of 3,000 hours of study and is approved by the Board;
(3) have passed an examination administered by the Board; (4)
have not committed a crime or an act of dishonesty, fraud, or
deceit; and, (5) have completed a clinical internship program in
this state that is approved by the Board and that does not take
longer than 9 months to complete. An individual with 800 or
more hours of documented clinical training is exempted from the
clinical internship program requirement denoted in (5).
FISCAL EFFECT : Unknown
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COMMENTS :
Purpose of this bill . According to the author, there has been a
void in the assessment of an applicant's physical skill in
needling techniques since the practical component of the
examination for acupuncture licensure was discontinued in 1999.
The author notes that the Little Hoover Commission (LHC)
discusses this issue in its September 2004 report on the
regulation of acupuncture and that acupuncturists themselves
have indicated in surveys that they lack confidence in their
physical abilities as they enter the profession. The author
argues that hands-on training under the supervision of a
licensee is an important way to protect patients as well as to
increase the skill and confidence of a practitioner.
Background . When the state first began certifying
acupuncturists in 1976, new practitioners who did not have 2 to
5 years of experience were required to have 1,350 hours of
training. In 1980, the Acupuncture Licensure Act (Act)
permitted acupuncturists to see patients without a prior
diagnosis and referral from a licensed physician, dentist,
podiatrist, or chiropractor. Then, in 1985, the California
Board of Acupuncture increased from 1,350 to 2,348 the number of
hours of training required for a licensed acupuncturist. More
recently, the Board formed a Competencies and Outcomes Task
Force that recommended an increase to 3,000 hours of training
for acupuncture licensure. In 2002, AB 1943 (Chu), Chapter 781,
Statutes of 2002, was enacted and increased the number of hours
of training required of acupuncture licensees to 3,000 hours.
This change came into effect on January 1, 2005.
LHC report . The September 2004 LHC report points out that the
current California acupuncture licensure exam does not include a
component requiring applicants to demonstrate needling
practices. LHC finds that "it is essential for licensees to
master the fine dexterity required in needling," but notes that,
unfortunately, it has been difficult to reach agreement on how
best to test for practical skills. As an alternative, LHC
recommends that the Board develop a strategy for implementing a
hands-on, clinical internship that is similar to those in other
health professions and that will prove the practical skills of
an applicant for licensure.
Sunset review and the California Acupuncture Board . This year
the Joint Committee on Boards, Commissions, and Consumer
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Protection (JCBCCP) adopted the recommendation to "sunset" the
Board. This recommendation also was supported by the Department
of Consumer Affairs (DCA), and the implementing provisions are
contained in SB 233 (Figueroa), which is currently set to be
heard in the Senate Business and Professions Committee on April
26, 2006. One of the principal reasons for the recommendation
to sunset the Board is that "the Board seeks to erect
significant barriers to new acupuncturists becoming licensed."
This bill grants broad authority to the Board to determine the
nature and extent of the postgraduate residency requirements of
this bill. Such broad authority could result in substantial
requirements for new acupuncturists desiring to enter the field,
including the potential to create barriers to entering the
practice. This broad authority runs counter the recommendations
of JCBCCP and DCA. One way to mitigate granting the Board
excessive authority would be to require all Board determinations
and regulations pertaining to the postgraduate residency program
to be approved by DCA.
Opposition . The American College of Traditional Chinese
Medicine (ACTCM) and Pacific College of Oriental Medicine (PCOM)
argue that this bill will have a devastating effect on their
students and colleges because it will prevent new graduates from
entering the field in a timely manner. ACTCM and PCOM points
out that the LHC report recommends an internship in a hospital
or other clinical setting, not in the office of a private
practitioner. ACTCM and PCOM note that there are few, if any,
hospitals, clinics, or private practitioners that could meet the
requirements in this bill at the present time and that this
could be a substantial financial burden on students with loans
because an internship that occurs outside of an accredited
academic program would not permit a recent graduate to defer his
or her loans.
Acupuncture and Integrated Medicine Specialists (AIMS) argues
that the concept of a post-graduate residency requirement for
acupuncture licensure is an idea before its time, primarily
because there is clearly a lack of infrastructure to support
this requirement at this time. AIMS predicts that this lack of
infrastructure would create a substantial backlog of students
waiting to move through the residency program before sitting for
the licensure exam; this situation would delay a graduate's
entry into the field and create an undue burden.
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Related legislation . AB 1113 (Yee), 2005-06 session, provides
that an individual who holds an acupuncturist's license may
diagnose within the scope of his or her practice. AB 1113 is
also set for hearing on April 26, 2005 in the Assembly Business
and Professions Committee.
AB 1114 (Yee), 2005-06 session, increases continuing education
requirements of acupuncturists from 30 to 50 hours and requires
5 of these hours to be dedicated to public health and safety
issues. AB 1114 is also set for hearing on April 26, 2005 in
the Assembly Business and Professions Committee.
AB 1115 (Yee), 2005-06 session, provides that an "acupuncture
assistant" is someone who does not hold an acupuncture license
and who performs basic administrative, clerical, and supportive
services under the supervision of a licensed acupuncturist. AB
1115 is also set for hearing on April 26, 2005 in the Assembly
Business and Professions Committee.
AB 1117 (Yee), 2005-06 session, changes the terms "oriental
medicine" and "oriental massage" in existing statute to "Asian
medicine" and "Asian massage." AB 1117 is also set for hearing
on April 26, 2005 in the Assembly Business and Professions
Committee.
REGISTERED SUPPORT / OPPOSITION :
Support
Association of Korean Oriental Medicine & Acupuncture of
California
California Acupuncture Medical Association
California Alliance of Acupuncture Medicine
Council of Acupuncture and Oriental Medicine Associations
South Baylo University
United California Practitioners of Chinese Medicine
170 students of South Baylo University
3 individuals
Opposition
Acupuncture and Integrated Medicine Specialists
American College of Traditional Chinese Medicine
Pacific College of Oriental Medicine
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Analysis Prepared by : Pablo Garza / B. & P. / (916) 319-3301