BILL ANALYSIS Ó
SB 628
Page 1
Date of Hearing: July 5, 2011
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Mary Hayashi, Chair
SB 628 (Yee) - As Amended: June 29, 2011
SENATE VOTE : 25-12
SUBJECT : Acupuncture: regulation.
SUMMARY : Creates a Traumatology Committee (Committee) within
the Acupuncture Board (Board) and authorizes the Committee to
determine certification standards for, and certify traumalogists
from March 1, 2012 to December 1, 2012. Specifically, this
bill :
1)Requires the Board to establish a Committee within the Board
by March 1, 2012, which shall be comprised of the following
six members:
a) Two representatives from the clinical settings of
traumatology;
b) Two representatives from California Orthopaedic
Association (COA);
c) One representative from the Medical Board of California
(MBC); and,
d) One representative from the California Medical
Association (CMA).
2)Requires the Committee to:
a) Meet and confer to determine traditional Chinese
Medicine (TCM) traumatology certification standards,
including the level of experience and training needed for
individual qualification;
b) Advise the Board in developing the application for
certification; and,
c) Evaluate whether traumatology applicants qualify for
certification based on experience and training.
SB 628
Page 2
3)Requires the Board, from May 1, 2012 to December 15, 2012, to
issue a certificate for traumatology to any person who applies
and meets all of the following requirements:
a) Is at least 18 years of age;
b) Furnishes satisfactory evidence of training and clinical
experience which meets the standards established by the
Committee and confirmed by the Board; and,
c) Is not subject to denial, as specified.
4)Requires an applicant for traumatology certification to apply
from January 1, 2012 to December 15, 2012. Specifies that on
and after December 15, 2012, the Board cannot issue an initial
certificate and may only issue a certificate renewal.
Prohibits an individual unqualified to receive a certificate
or who fails to apply for certification by December 15, 2012,
from holding himself or herself out as a certified
traumatologist.
5)Requires an applicant for certification as a traumatologist to
pay an initial application fee of $200 when submitting his or
her application to the Board.
6) Requires that the certificate must be renewed every five
years, and that an expired certificate may be renewed at any
time within the three years after its expiration.
7)Specifies fees for the following traumatology certificates:
initial ($200), renewal ($75), delinquency ($25), duplicate or
replacement wall certificates ($15), and duplicate or
replacement renewal receipt ($10).
8)Specifies that all fees for traumatologist certificates shall
be deposited into the Acupuncture Fund.
9)Requires a certified TCM traumatologist, when engaging in
manipulation techniques to realign the musculoskeletal and
ligamentous relationship, to be supervised by a physican and
surgeon who has completed an orthopaedic residency program.
Requires the extent of the relationship between a TCM
traumatologist and orthopedic surgeon regarding manuipulation
techniques to be determined by the Committee after the
SB 628
Page 3
certification standards are defined by the Committee and
adopted by the Board.
10)Provides that it is an unfair business practice for any
person to hold himself or herself out as a certified
traumatologist or use the title "certified traumatologist"
without meeting the requirements of this bill.
11)Applies existing law provisions that currently relates to
licensed acupuncturists to certified traumatologists.
12)Provides that a person who holds a certificate to practice
traumatology is subject to existing disciplinary provisions
contained in the Act.
13)Applies relevant provisions of the Act to certified
traumatologists. Makes other technical, clarifying and
conforming changes.
14)Notwithstanding any other provision of law, authorizes a
licensed acupuncturist to use the title Doctor of Acupuncture
only if he or she has received a Doctorate of Acupuncture and
Oriental Medicine Degree, a Doctorate of Acupuncture Degree,
or a Doctorate of Oriental Medicine.
EXISTING LAW :
1) Establishes the Board within the Department of Consumer
Affairs (DCA), which licenses and regulates the acupuncture
profession pursuant to the Act.
2) Defines an acupuncturist as an individual who has been
licensed to practice acupuncture pursuant to the Act.
Defines acupuncture as the stimulation of a certain point or
points on or near the surface of the body by the insertion of
needles to prevent or modify the perception of pain or to
normalize physiological functions, including pain control,
for the treatment of certain diseases or dysfunctions of the
body and includes the techniques of electroacupuncture,
cupping, and moxibustion.
3) States that a licensed acupuncturist is authorized to do the
following:
a) To engage in the practice of acupuncture;
SB 628
Page 4
b) To perform or prescribe the use of Asian massage,
acupressure, breathing techniques, exercise, heat, cold,
magnets, nutrition, diet, herbs, plant, animal, mineral
products, and dietary supplements to promote, maintain, and
restore health. Nothing prohibits any person who does not
possess an acupuncturist's license or another license as a
healing arts practitioner from performing, or prescribing
the use of any of these modalities, as specified.
4) States that the Board shall issue a license to practice
acupuncture to any person who applies and meets the following
requirements:
a) Is at least 18 years of age;
b) Furnishes satisfactory evidence of completion of one of
the following: an education and training program, as
specified; satisfactory completion of a tutorial program in
the practice of an acupuncturist which is approved by the
Board; or, in the case of an applicant who has completed
education and training outside the United States and
Canada, documented education training and clinical
experience, as specified;
c) Passage of a written examination administered by the
Board, as specified; and,
d) Completion of a clinical internship training program
approved by the Board.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author's office, "SB 628
will provide a pathway for a skilled TCM traumatologist to
achieve certification. TCM traumatology, like acupuncture,
takes a holistic approach to the body with a complete
theoretical system that has provided cure to people for
centuries. A group of such practitioners exist in the State of
California and have been providing care to the public for more
than 50 years to date. The intent of this bill is to allow
government oversight of this practice to ensure public safety.
This bill will regulate the use of the title "traumatologist."
SB 628
Page 5
In order to advertise oneself as a traumatologist, the
individual must satisfy the standards and level of experience
set forth by the Committee. This will allow the public to
distinguish between those that are qualified from the ones that
are not."
Background . The Committee composition, traumatology
certification standards, and scope of practice issues are
summarized below.
Scope of Practice into Acupuncture . As this bill is currently
drafted, by incorporating traumatologists into the existing Act
instead of establishing a separate Traumatology Act, suggests
that traumatologists eligible for a certificate can practice
acupuncture and hold themselves out as acupuncturists.
Further, prior versions of this bill suggested renaming the
Board to the TCM Board.
Committee Membership . The six committee members who would
determine traumatology certification standards, including the
level of experience and training needed for individual
qualification are: two representatives from the clinical
settings of traumatology; two representatives from COA; one
representative from MBC; and, one representative from CMA. It
is unclear how the Board would set up the Committee and select
the traumatologists, whose scope of practice is undefined, to
determine the certification standards for traumatology. This
bill does not provide for the two boards that primarily license
practitioners of eastern medicine, the ÝAcupuncture] Board and
the Board of Chiropractic Examiners, with Committee
representation to develop certification standards to prevent any
scope of practice conflicts. However, the MBC, which has no
jurisdiction over acupuncturists or chiropractors, would sit on
this Committee.
Undetermined Scope of Practice for Traumatology . This bill does
not define the scope of practice of traumatology, or what a
traumalogist is. Yet, this bill would require that two
traumatologists, whose scope of practice are undefined, to be
included as a member in a Committee that determines the
standards of certification for a traumatologist.
Traumatology Certification . Under this bill, the Board is
responsible for issuing a certificate to traumatologists,
SB 628
Page 6
although the Board does not determine certification standards.
This may confuse consumers, and lead them to believe that
certificated traumatologists can practice acupuncture.
This bill requires that applicants for certification as a
traumatologist apply before the Committee is established and
before the certification standards are determined. Therefore,
it may be premature for applicants to apply before the standards
are even set. It would be unclear how the Board could even
produce the application form without any guidelines. This bill
only allows the Board seven and a half months to certify
traumatologists. After that, no new traumatologists would be
certified, and only existing certified traumatologists would be
eligible to renew their certification. Eventually, the
traumatology will be phased out through retirement of existing
traumatologists, unless another statute is enacted.
Generally, the Business and Professions Code specifies
education, experience, and examination requirements for
licensure for professional occupations within DCA. This bill is
silent on the number of hours of training or years of experience
required for certification as a traumatologist. By allowing the
Committee to determine certification standards instead of
placing them in statute first, an unintended consequence would
potentially be the certification of traumatologists with minimal
qualifications and experience.
Fees . An acupuncturist currently pays $325 for both initial
licensure and renewal. On the other hand, a traumatologist
would only pay $200 for the initial licensure and $75 for
renewal. The author's office estimates that 70-100 individuals
would be eligible for certification as a traumalogist under this
bill. It is unclear how why the fees for the two professions
should differ if the license, certification, and regulation
would be conducted by the same Board. The ambiguity of this
bill's language suggests that certified traumatologists will be
able to practice acupuncture, yet pay significantly less for
fees to practice.
Traumatology Education . Currently, traumatology courses are
offered in accredited schools for acupuncture, as a portion of
the study. It is unclear why these individuals are not applying
for licensure as an acupuncturist. Currently, there is no
traumatology school in California at this time. According to
the author's office, if this legislation is chaptered, the
SB 628
Page 7
traumatologists are committed to establishing one. The author's
office also notes that for at least the previous ten years,
traumatologists have had regular, annual, and special workshops
and seminars in the Bay Area and abroad, including China and
Hong Kong.
Doctor of Acupuncture . Existing regulations authorize a
licensed acupuncturist possessing an earned doctorate degree
from an accredited, approved, or authorized educational
institution related to acupuncture, Oriental medicine, or
biological science to use the title "Doctor" or the abbreviation
"Dr." The recent amendments would permit what is already
allowed under existing law, except that this bill does not
require that the educational institutions conferring the
doctorate degrees be accredited.
Support . According to the list of supporters, "Currently, in
California, practitioners of TCM are recognized as licensed
acupuncturists. Acupuncture is one of the many modalities
within TCM. This nomenclature is misleading and problematic, as
the scope of practice of a licensed acupuncturist includes other
modalities of TCM, and not just acupuncture.
"Traumatology is one of the modalities that constitute TCM. It
is a very important part of TCM science, with a complete
theoretical system. Traumatology, like orthopedics, includes a
range of treatments to address both acute and chronic
musculoskeletal conditions, as well as many non-musculoskeletal
conditions. Before China systemized their health care system,
individuals acquired their competence of traumatology through
clinical practicum and internships. Although highly skilled,
these practitioners' trainings are not yet recognized by
California. "
According to the Chinese American Association of Commerce, "TCM
traumatology, like acupuncture, takes a holistic approach to the
body with a complete theoretical system that has provided cures
to people for centuries. Traumatology includes a range of
treatments to address both acute and chronic musculoskeletal
conditions, as well as many non-musculoskeltal conditions. A
group of such practitioners exist in the State of California and
has been providing care to the public for more than 50 years to
date. The intent of this bill is to allow government oversight
of this practice to ensure public safety. This bill will
regulate the use of the title 'traumatologist.' In order to
SB 628
Page 8
advertise oneself as a traumatologist, the individual must
satisfy the standards and level of experience set forth by the
Committee. This will allow the public to distinguish between
those that are qualified from the ones that are not."
According to a representative from Suey Sing Chamber of
Commerce, "I am a patient of TCM, and am delighted with the
intent of this bill to provide traumatologists with a process to
attain certification. I have a keen interest in this, as I have
personally benefitted from traumatology treatments. I value and
appreciate the holistic approach that underlies this practice.
I believe this is a benefit to the public as it affords a less
invasive method of treatment."
Opposition . According to the California State Oriental Medical
Association (CSOMA), "Given that the brief and transient period
during which individuals may apply for certification as a TCM
traumatologist, this bill appears to be focused upon satisfying
the needsof a special interest group that is unable or unwilling
to obtain licensing or certification through existing means. SB
628 does not specify certification standards for TCM
traumatologists. However, the bill presupposes that such
standards can be appropriately established. Given the complete
absence of educational and certification standards for TCM
traumatology as a stand-alone field in the United States, CSOMA
is uncertain that a sufficiently safe and protective
certification standard can be set.
"TCM traumatologists would be certified with absolutely no
certification examination - written or practical. We are aware
of no other health care field licensed or certified by the State
of California that is exempt from an examination to objectively
measure essential knowledge, skills, and abilities required of
entry-level practitioners. The absence of a certification
examination poses a significant threat to consumer safety. No
scope of practice for TCM traumatologists is prescribed by SB
628. It is possible that the ultimate scope of these
certificate holders could be broader than those of
acupuncturists, physical therapists, or chiropractors.
"No continuing education (CE) would be required of TCM
traumatologists as part of their certification renewal process.
We are unaware of any other health care field regulated by the
State of California that is exempt from continuing education
requirements. CE is the accepted mechanism used by regulators
SB 628
Page 9
to encourage health care practitioners to expand their knowledge
base and abreast new developments in the field.
"The Committee composition is inappropriate for a licensing
board that does not regulate physicians and surgeons and does
not have any physicians or surgeons among its members. The term
"TCM traumatologist" is potentially misleading and confusing.
The practice of TCM traumatology is part of the broader field of
acupuncture and Chinese medicine, a field already regulated by
the Board. The term "TCM" is already widely used in the field.
The use of this term in association with a stand-alone
certification will confuse consumers. Unethical or negligent
practice by TCM traumatologists may harm the reputation of
existing California Board licentiates. California licensed
acupuncturists have built a robust set of professional standards
and practices over the past four decades. Given the absence of
similar standards and practices for TCM traumatology as a
stand-alone field, CSOMA is gravely concerned about potential
harm, by perceived association, to licensed acupuncturists."
Previous Legislation . SB 577 (Burton), Chapter 820, Statutes of
2002, established that complementary and alternative health care
practitioners to practice without being in violation of the
Medical Practice Act.
REGISTERED SUPPORT / OPPOSITION :
Support
A & K Jewelry
AA Bakery
A-A Kitchen Appliance
Carrie Tours
Cathay Chinese Herbs Co.
Cathay House
Chi Wan Mok Herbalist
Chinese American Association of Commerce
Chinese Athletic Association of San Francisco
Chinese Building Worker Association
Chinese Culture Foundation of San Francisco
Chung Chon City Inc.
Coastal Pacific Distributors
Culture Lite Printing
DAAN Inc.
Daniel G. Group Company
SB 628
Page 10
Deanna Hair Design
Era Golden Gate Properties
Far East Café Inc.
Fong Kee Tofu Co. Inc.
G.T. Building Supply Inc.
Guo Zhu Wang Herbalist
Hing Fung Trucking Co.
Hip Sing Association
Hong International Travel
Hong Kong Clay Pot Restaurant
Hong Kong Trading Co.
Hop Sing Tong
Kang Hua Trading Inc.
Kang Hua Trading Inc.
Kee Cheung Co.
Dardong Company
Kin Fai Produce
LA Moon Jewelry
Law & Company
David Healing Therapy Center
Lee, Ngam Chinese Medical Orthopedics & Traumatology Therapy
Center
Longevity Ginseng
Man Sung Co.
T & S Market
Mei Wo Florist
Ming's Poultry LLC.
MP Realty
Ms. Jenny Skincare Workshop
New Sang Chong Market
New Way Beauty Salon and Hair
Orient Market
Pavillion De Paris
PC Flooring
Pearl City Seafood Restaurant
Reliable Drug Store
Rocket Ninja, Inc.
S&T Hong Kong Seafood Inc.
San Francisco Girls Volleyball Team
Shoe House
Sky Dragon Appliance, Inc.
Suey Sing Chamber of Labor & Commerce
Sun Sang Market
Tom Family Benevolent Association
Toon Kee Restaurant
SB 628
Page 11
U.S. TY Trading Co.
VIP Coffee Shop
W&N Property Investments
Wings Depot
Wings Century Trucking, Inc.
Yau Kung Moon, Kung Fu Association of U.S.A.
Yee's Restaurant
Ying On Labor & Merchant Association
Opposition
Academy of Chinese Culture and Health Sciences
Academy of Chinese Medicine
Alliance of World's Traditional Medicine
American Association of Acupuncture and Oriental Medicine
American Institute of Acupuncture Orthopedics and Traumatology
American Traditional Chinese Medical Traumatology Association
Association of Korean Asian Medicine and Acupuncture of
California
California Acupuncture Center
California Certified Acupuncturists Association
California Chiropractic Association
California State Oriental Medicine Association
Chinese Medicine Clinic and Education Center
Council of Colleges of Acupuncture and Oriental Medicine
Japanese Acupuncture Association of California
Japanese Acupuncture Kei's Clinic Inc.
Melinda Acupuncture Clinic
National Alliance of Korean Asian Medicine & Acupuncture of
U.S.A.
National Certification Commission for Acupuncture and Oriental
Medicine
National Federation of Chinese TCM Organizations
National Guild of Acupuncture & Oriental Medicine
Northern California of Korean American Association
Santa Cruz County Oriental Medical Association
Southern California University of Health Sciences
The American Institute of Finger Surgery
The Five Branches University
The Nine Star University
United California Practitioners of Chinese Medicine
Wang Ping Acupuncture Clinic
World Alternative Medicine Health Institute
Xu's Acupuncture Clinic
Numerous Individuals
SB 628
Page 12
Analysis Prepared by : Joanna Gin / B.,P. & C.P. / (916)
319-3301