BILL ANALYSIS Ó
SB 1488
Page 1
Date of Hearing: June 19, 2012
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Mary Hayashi, Chair
SB 1488 (Yee) - As Amended: June 12, 2012
SENATE VOTE : 22-9
SUBJECT : Healing arts: California traditional Chinese Medicine
traumatologist certification.
SUMMARY : Establishes the California Traditional Chinese
Medicine Traumatology Council (Council) to administer a
"California certified traditional Chinese Medicine traumalogist"
certificate program, until January 1, 2017. Specifically,
this bill :
1)Establishes the Council to administer a California certified
traditional Chinese Medicine (TCM) traumatologist certificate
program, until January 1, 2017.
2)Requires the Council to be a 501(c)(3) non-profit organization
comprised of the following five members:
a) Three representatives from the clinical settings of
traumatology, who shall be selected by professional
societies, associations, or other entities, whose
memberships are comprise solely of practitioners of
California TCM traumatology and are eligible, as defined;
b) One representative from the Medical Board of California
(MBC); and,
c) One representative from the California Medical
Association (CMA).
3)Requires the Council to meet to determine California TCM
traumatology certification standards, including experience and
training, and the certification application.
4)Requires the Council to issue a two-year California TCM
traumatology certificate to applicants who satisfy the
following requirements:
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a) Are at least 18 years old;
b) Provides satisfactory evidence that meet training and
clinical experience requirements;
c) Is not subject to denial as a result of a crime,
disciplinary action, or misrepresentation; and,
d) Submits an application fee that covers the Council's
cost to process the application and cannot exceed $200.
5)Allows a certificate holder to renew his or her certificate
within six months after expiration if the certificate holder
pays the necessary fees. Establishes the following
certificate fee schedule:
a) The renewal fee shall be $100;
b) The delinquency fee shall be $25;
c) The duplicate or replacement engraved wall certificate
shall be $15; and,
d) The duplicate or replacement engraved renewal
receipt/pocket certificate shall be $10.
6)Requires that money received under this bill shall be used by
the Council to pay for associated administration costs.
7)Provides that it is an unfair business practice for any person
to hold himself or herself out as a "California certified TCM
traumatologist" or use that title unless he or she is
certified by the Council.
8)Prohibits a California certified TCM traumatologist from
practicing:
a) Medicine as defined; and,
b) Within the scope of activities regulated by the Board of
Chiropractic Examiners (BCE).
9)Authorizes the Council to deny, suspend, or revoke a
certificate for any of the following reasons:
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a) Unprofessional conduct, as specified;
b) Procuring a certificate by fraud, misrepresentation, or
mistake;
c) Violating a provision of this bill or a Council bylaw;
d) Conviction or misdemeanor relating to the certificate
holder's qualifications or duties;
e) Impersonating or acting as a proxy for an applicant;
f) Impersonating a California certified TCM traumatologist
or permitting an uncertified person to use a certificate;
g) Committing any fraudulent, dishonest, or corrupt act in
the course of duties; or,
h) Committing a sexually related crime.
10)Subjects Council meeting to the rules of the Bagley-Keene
Open Meeting Act.
11)Creates the following definitions:
a) "California certified TCM traumatologist" to mean a
person who has been certified by the Council to perform
California TCM traumatology;
b) "Council" to mean the California Traditional Chinese
Medicine Traumatology Council; and,
c) "California traditional Chinese Medicine traumatology"
to include a range of treatments to address both acute and
chronic musculoskeletal conditions through stimulation of
acupressure points. Techniques include, but are not
limited to, brushing, kneading, rolling, pressing, rubbing,
pushing, holding, and lifting the areas between each of the
joints to open the body's defensive chi and stimulate the
energy movement in both meridians, but do not include
manipulation techniques to realign the musculoskeletal and
ligamentous relationship, also known as bone setting.
EXISTING LAW :
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1) Establishes the Acupuncture Board (Board) within the
Department of Consumer Affairs (DCA), which licenses and
regulates the acupuncture profession pursuant to the
Acupuncture Licensure Act (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;
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 acupuncture which is approved by the Board;
or, in the case of an applicant who has completed education
and training outside the United States (U.S.) and Canada,
documented education training and clinical experience, as
specified;
c) Passage of a written examination administered by the
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Board, as specified; and,
d) Completion of a clinical internship training program
approved by the Board.
FISCAL EFFECT : Unknown. This bill has been keyed non-fiscal
by the Legislative Counsel.
COMMENTS :
Purpose of this bill . According to the author's office,
"Current law does not provide for the oversight of
traumatologists in California. SB 1488 is a titling act that
will provide the public with a level of protection through the
establishment of a non-profit council that will determine the
standards of training and experience necessary for a person to
be certified as a California certified TCM Traumatologist.
"The creation of this certification program will provide a
pathway for skilled TCM traumatologists to receive recognition
as one of the participants in the health care of the public.
TCM traumatology, like acupuncture, takes a holistic approach to
the body with a complete theoretical system that has provided
cures 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 some oversight of this practice to ensure
public safety and to give people confidence and assurances that
for those traumatologists who are certified, they have met
certain standards and requirements to call themselves a
'California certified TCM traumatologist.'"
Background . This is the second time that the author is hearing
a bill in this committee and session related to traumatology.
This bill differs from its previous version, SB 628 (Yee) of
2009 because it removes licensure of a traumatologist from under
the Board and instead creates a certification program
administered by the Council, defines the scope of TCM
traumatology, removes the orthopedic association from the
Council membership, expressly prohibits the practice of
chiropractic by traumatologists and bone setting. Proponents of
this bill contend that there are individuals who already hold
themselves out as traumatologists, and use the term
"traumatology" in their business name, and that this bill would
regulate and provide oversight for a group of practicing
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traumatologists that are unregulated.
Traumatology is one of the modalities that constitute TCM. The
term "traumatology" is also defined as the study of wounds and
injuries caused by accidents or violence to a person, and the
surgical therapy and repair of the damage, and is considered as
a branch of medicine. It is often considered a subset of
surgery and in countries with the specialty of traumatology
surgery it is most often a sub-specialty to orthopedic surgery.
Before China systemized their health care system, individuals
acquired their mastery of traumatology through a
master-apprentice relationship. These practitioners learned
from a master through hands-on training. Although highly
skilled, it is extremely difficult for these practitioners to
obtain proof of their training to qualify for the existing
requirement for licensure as an acupuncturist."
The practice of traumatology, as practiced in other countries,
incorporates components found within different healing arts
professions licensed under DCA - acupuncture, orthopedics, and
massage therapy.
Generally, the Business and Professions Code (BPC) specifies
education, experience, and examination requirements for
licensure for professional occupations within DCA. While the
author's office has amended this bill since it was last heard in
this committee to address training and experience requirements,
bill is silent on educational experience and examination
requirements for certification as a traumatologist.
The absence of any educational requirements for TCM
certification is one of the primary reasons TCM colleges are
opposing this measure; they contend that practicing
traumatologists in China are medical doctors specializing in
traumatology who can substantiate education requirements and are
eligible for an acupuncturist licensure if the applicant can
provide proof of education and training completed outside the
U.S. and Canada that meet specified standards (BPC Section
4938). The TCM schools state that this bill would provide a
structure for individuals who do not have the documentation to
apply for an acupuncture license to receive certification as a
TCM traumatologist without any education or examination
requirements.
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In January 2005, the Board promulgated regulations that included
traumatology as a subject matter for didactic instruction that
could be counted towards licensure requirements (Board
Regulation, Title 16, Article 3.5, Section 1399.434). The
curriculum in acupuncture and Oriental medicine principles,
theories and treatment consists of at least 1,255 hours of
didactic instruction in specified areas, including traumatology.
Some TCM schools will offer a one-year certification program
that specializes in traumatology for acupuncturists.
There are approximately 60 accredited TCM educational institutes
nationwide, and 20 of them are located in California.
Currently, there are no national standards for traumatologists.
Acupuncture is legalized in 50 states of the U.S. Currently,
traumatology courses are offered in accredited schools for
acupuncture, as a portion of the study. Currently, there is no
traumatology school in California at this time. 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.
While the Board is overseen by the DCA, this bill establishes a
non-profit Council to certify TCM traumatologists that is not
overseen by the DCA or any other state agency or entity.
Last year, the author's office estimated that approximately
70-100 individuals would be eligible for certification as a TCM
traumatologist. This bill caps the certification fee at $200,
and initial certification of traumatologists under this bill
results in estimates of up to $20,000 in revenue to the Council.
On the other hand, there are approximately 12,000 licensed
acupuncturists in this state and the initial license fee is
$325. The certification of traumatologists may have the
unintentional consequence of redirecting individuals who would
have applied for an acupuncture license to instead obtain a
California certified TCM Traumalogist certificate, due to lower
fees and eligibility requirements.
This bill requires the Council to determine California TCM
traumatology certification standards, including experience and
training requirements. The committee membership is comprised of
three representatives from the clinical settings of
traumatology, one representative from the MBC, one
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representative from the CMA. The Acupuncture Board, which
licenses practitioners of eastern medicine, and has promulgated
regulations relating to traumatology, is not represented on the
Council.
Support . According to the American Traditional Chinese Medical
Traumatology Association, "This bill would provide a pathway for
a skilled traumatologist, trained in this aspect of TCM, to
achieve California certification. This certification process,
within SB 1488, would thereby provide Californians with basic
health and safety assurances. .
"SB 1488 would safeguard would safeguard the public by:
1) Requiring government oversight through the creation of a
non-profit Council consisting of Ýfive] members: one
representative each from the MBC and the CMA and three
representatives from the clinical settings of practicing
traumatology to assist in assuring the highest standard and
peer review oversight;
2) Regulating the use of the title 'traumatologist' so that
those using the term would have to satisfy the standards
and level of experience set forth by the newly created
Council, allowing the public to distinguish between those
that are certified and qualified from those that are not;
and,
3) Requiring, for the first time in law, that a
traumatologist shall not practice medicine or chiropractic
manipulations."
Opposition . According to the BCE, "The BCE has public safety
concerns related to the proposed scope of traumatology and
questions whether the proposed training and certification
standards would assure public protection? Only after competent
training and adequate education, supported by standardized
education and nationally recognized testing, can the BCE support
the introduction of any new health care entity which would
potentially need to make an urgent and accurate diagnosis and
referral of patients who may need urgent or even emergency
medical care?"
According to the Southern California University of Health
Sciences and several TCM colleges, "''TCM Traumatology is part
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of TCM. Traumatologists use TCM theories, diagnosis,
tui-na/massage skills and herbs in their practice. Therefore,
the regulation of this discipline should not be separated from
the current acupuncture license system which is overseen by the
Board. "
According to the National Federation of TCM Organizations,
"Since the legalization of acupuncture in California 37 years
ago, the profession has grown. Today, acupuncture is legalized
in 50 states across the nation. This growth and recognition is
based on the standards that were set by the profession through
its national professional certification and accredited bodies
that are accredited by related federal agencies and accepted by
state governments.
This bill strives to bypass these standards to offer a
Ýcertificate] to a certain group of people, without concern of
their educational background. Without any examinations to prove
their knowledge and experience, it is a blatant inconsideration
of the safety of the consumers and the quality of the
profession. We consider it a self-serving means to satisfy the
individuals who refuse to abide by the standards of the
Ýacupuncture] profession and get their license through the
standard process as all other practitioners have been doing."
Christy Vitiello, a licensed acupuncturist, writes, "SB 1488
contains no Ýeducational] standards and requires no written or
practical examination. Instead, it allows an independent
non-profit - without the controls, resources, and protection of
the DCA - to establish any standards that it wishes."
Related Legislation . SB 628 (Yee) of 2011, would have created a
Traumatology Committee (Committee) within the Board and would
have authorized the Committee to determine certification
standards for, and certify traumalogists from March 1, 2012 to
December 1, 2012. This bill was amended to delete all
provisions relating to traumatology, and to instead codify
regulations promulgated by the related to an acupuncturist's
permitted use of the title "Doctor." This bill is pending in
the Assembly Appropriations Committee.
REGISTERED SUPPORT / OPPOSITION :
Support
American Association of Acupuncture and Traditional Chinese
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Medicine
American Chinese Cultural Exchange & Trading Association
American Traditional Chinese Medical Traumatology Association
California Acupuncture Medical Association
California Acupuncture Oriental Medicine Association
Cathay Post No. 384
Chi Wan Mok Traditional Chinese Medical Center
Chinese Consolidated Benevolent Association
Chinese Culture & Health Center
Ching's Chinese Medical & Therapy Center
David Lu Traditional Chinese Medical Center
Deng Shao Ji Chinese Medical Center
Dian Gui Liu Chinese Herbal Medical Center
Gee Association
GL Health & Herbs Service Center
Hai Feng Chinese Herbal Center
Hai Feng Traditional Chinese Medical Center
Ho Ying Heng
Hoy-Sun Ning Yung Benevolent Association in America
Huang's Traditional Chinese Medical Center
Hung Yue Louie Chinese Medical Acupuncture Center
Jian Zheng's Chinese Medical Center
Jiang Die Liang Chinese Medical Center
Jiang's Wellness Center
Johnson Herb Services
Kang Hua Chinese Herbal Center
Kwong Tim Leung Traditional Chinese Medical Center
Las Tunas Acupuncture & Herbs Pain Relief Center
Liang's Traditional Chinese Medical Center
Nathan Lee Traditional Chinese Medical Center
National Guild of Acupuncture and Oriental Medicine
Peng Tsing Tong Chinese Medical Center
RiYing Gong Traditional Chinese Medical Center
S.H. Body Therapy
Shu Lin Han Traditional Chinese Medical Center
Sidra Yoy Wu Chinese Medical Center
Simon Tang Chinese Medical Center
Soo Yuen Benevolent Association
Tim Lee Traditional Chinese Medical Center
Tony's Pain Medical Center
Toy's American Traditional Chinese Medical Center
Traditional Chinese Medical Center
Vietnamese Acupuncture and Oriental Medicine Association
Institute
Wang Guo Zhu Traditional Chinese Medical Center
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William Wu Traditional Chinese Medical Center
Wong Family Benevolent Association, Inc.
Wong Man Keung Traditional Chinese Medical Center
Wong's Traditional Chinese Medical & Traumatology Center
Yu's Herbal Chinese Medical Center
Numerous Individuals
Opposition
1-2-3 Acupuncture Clinic
AAA Acupuncture
Academy of Chinese Medicine
AcuEnergize
Acu-Herbs Healing
Acu-Medi Health Center
Acupuncture & Herbal Care of Los Altos
Acupuncture and Natural Herbs
Acupuncture in Yan Clinic
Acupuncture RN
Acupuncture Weight Control Center
Ahola Clinic Corp.
Al Acupuncture Healing Center
All Care Acupuncture & Herbs Clinic
American College of Traditional Chinese Medicine
American Institute of Acupuncture Orthopedics & Traumatology
American Institute of Chinese Medicine, Inc.
Anna Lin Natural Healthcare
Asian Bodywork Therapy
Association of World Traditional Medicine
Aurora Acupuncture
Awareness Center
AXOS Acupuncture
Bin Zhi Acupuncture Clinic
Bliss Acupuncture Clinic
Blossom Hill Chiropractic
Board of Acupuncture
Board of Chiropractic Examiners
California Acuptuncture Center
California Acupuncture Coalition
California Certified Acupuncturists Association
California Green Cross Clinic
California Traditional Articulated Healing Center
Chen's Acupuncture and Chinese Medicine Clinic
Chinese-West Medical Center, LLC
Da Ming Acupuncture and Herb Center
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Ding Li Acupuncture Clinic
DO Oriental Medical Group
California Neurohealth
Dong Kook Health Care Center
Dr. Wang Acupuncture Clinic
Echoi Acupuncture
Emperor's College
Family Health Group
Fang's Art Studio
Five Branches University
Five Element Care
Fullness Auto Service Centre
Goodkin Acupuncture
Health Tune-up
Heaven Grace Herbal Clinic
Holistic Healing Center
Hong Yan Medical Clinic
JJ Acu & Herb Clinic
Jun Paek Acupuncture Clinic
Karen Acupuncture Clinic Inc.
Kim Neumann Acupuncture
Korean Acupuncture & Asian Medicine Association
Larchmont Traditional Medicine
Livermore Acupuncture & Herbal Clinic
Lotus East-West Medical Center
Middle Path Acupuncture Clinic
National Federation of Chinese TCM Organizations
N's Quick Printing
Oceanside Acupuncture
Oriental Cosmos Health Center
Ou's Acupuncture
Ouyang Paint Management Center
Pacific College of Oriental Medicine
Pacific Complementary Medicine Center
Peace Acupuncture Clinic
Professional Skin & Body Care Inc.
PSW Acupuncture Inc.
Qi Dragon Healing Center
Rancho Bernardo Chiropractic
Research Institute of Chinese Medicine
San Jose Functional Medicine
Sheila's Acupuncture and Herbs
Southern California University of Health Sciences
Stephen Imports, Inc.
Su Clinic
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Temescal Acupuncture Center
The American Institute of Finger Surgery
Tong Zhang Acupuncture
Traditional Healing Arts Center
Tsubakiyama Acupuncture Clinic
Underground Stream Qi Acup.
UniCare
United Acupuncture & Herbs
United California Practitioners of Chinese Medicine
University of East-West Medicine
Valley Health & Acupuncture
Wang Ping Acupuncture Clinic
World Alternative Medicine Health
WTX Medical Group
Xing Lin Acupuncture & Chinese Medicine Clinic
Yan Xiang Li's Acupuncture Clinic
Yan-Hua Total Health Care, Inc.
Yo San University
Numerous individuals
Analysis Prepared by : Joanna Gin / B.,P. & C.P. / (916)
319-3301