BILL ANALYSIS Ó
AB 808
Page 1
Date of Hearing: April 16, 2013
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Richard S. Gordon, Chair
AB 808 (Fong) - As Amended: April 9, 2013
SUBJECT : Acupuncture: license requirements.
SUMMARY : Requires applicants for an acupuncture license to
pass a practical examination in addition to the existing written
examination, beginning January 1, 2016. Specifically, this
bill :
1)Requires an applicant for an acupuncture license to pass a
practical examination administered by the Acupuncture Board
(Board) that tests an applicant's ability, competency, and
knowledge in the practice of an acupuncturist on and after
January 1, 2016.
2)Requires the new practical examination to be developed by the
Office of Professional Examination Services (OPES) of the
Department of Consumer Affairs (DCA).
EXISTING LAW
1)Regulates and licenses the practice of acupuncture by the
Board. (Business and Professions Code (BPC) Section 4928)
2)Requires the Board to issue a license to practice acupuncture
to any person who makes an application, pays specified fees,
and meets the following requirements:
a) Is at least 18 years of age;
b) Furnishes satisfactory evidence of completion of one of
the following:
i) An educational and training program approved by the
Board, as specified;
ii) Satisfactory completion of a tutorial program in the
practice of an acupuncturist which is approved by the
Board; and,
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iii) In the case of an applicant who has completed
education and training outside the United States and
Canada, documented educational training and clinical
experience which meets specified standards;
c) Passes a written examination developed by OPES and
administered by the Board that tests the applicant's
ability, competency, and knowledge in the practice of an
acupuncturist;
d) Is not subject to denial, as specified; and,
e) Completes a clinical internship training program
approved by the Board, as specified. (BPC 4938)
3)Requires the Board to establish standards for the approval of
schools and colleges offering education and training in the
practice of an acupuncturist, as specified, and requires
training programs to include 3000 hours of study in curricula
pertaining to the practice of acupuncture. (BPC 4939)
4)Requires each acupuncturist to complete 50 hours of continuing
education (CE) every two years as a condition of renewal of
his or her license. (BPC 4945)
FISCAL EFFECT : Unknown
COMMENTS :
1)Purpose of this bill . This bill requires applicants for
licensure as an acupuncturist to take a newly created
practical examination in addition to the current written
examination. The practical examination would be intended to
provide applicants with an additional testing method to
demonstrate their proficiency of the practice of acupuncture.
This bill is sponsored by the Council of Acupuncture and
Oriental Medicine Associations.
2)Author's statement . According to the author's office, "[This
bill] will [assure] consumers or patients that [an]
acupuncturist [professional] has [met] the essential
educational and clinical standards to practice acupuncture.
The practical examination will determine if the
acupuncturist's competence to diagnose and treat patients is
effective. This will help [assure] that licensed
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acupuncturists have both the ability and quality to practice
in California."
3)Acupuncture Licensure Requirements . In order to be licensed
as an acupuncturist in California, an applicant must be at
least 18 years of age and complete either 1) an educational
and training program that includes 3000 hours of study in the
practice of acupuncture, or 2) a supervised tutorial program
which is approved by the Board. An applicant must also pass a
California-specific written examination that tests an
applicant's knowledge in the practice of acupuncture. The
Board does not currently grant reciprocity to those
individuals who have taken and passed the national examination
for licensure.
An acupuncturist's license must be renewed every two years, and
a licensee is required to complete 50 hours of board-approved
CE. If a licensee is renewing an initial license, they are
required to obtain between 35-45 hours of CE, depending on the
issuance and renewal dates. There are currently over 13,000
licensees regulated by the Board.
4)California's written examination . The Board administers one
examination, the California Acupuncture Licensing Examination
(CALE), which must be taken by all qualified applicants for
licensure. The CALE is a written exam consisting of 200
multiple choice questions. The Board currently administers
the CALE in English, Chinese and Korean. The exam is
administered twice a year, in February and August and the exam
fees are $75 for initial application, $550 for the
examination, and $550 for a re-examination. The Board
estimates that between 480 and 700 individuals take the exam
each time. Passage rates from each exam vary as the passing
score is specific to each examination, although the February
2013 test had a passage rate of 71%.
According to the Board, the CALE is developed by OPES according
to the Standards for Educational and Psychological Testing
published by the American Educational Research Association,
the American Psychological Association, and the National
Council on Measurement in Education. OPES supports DCA and
its regulatory entities by providing professional examination
services. OPES provides all aspects of the examination
validation process including occupational analyses,
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examination development, test score statistical analysis and
audits. They develop performance, oral, and practical
examinations and prepare the formats for computer based
testing.
In comparison, 43 states currently utilize national written
testing services through the National Certification Commission
for Acupuncture and Oriental Medicine (NCCAOM). California is
the only state that administers its own independently created
examination. The national examination as administered by
NCCAOM does not offer a practical examination.
5)History of practical examination in California . In 1999, the
practical examination component of the California acupuncture
licensure exam was discontinued. AB 1105 (Jackson, Dunn,
Reyes and Solis), Chapter 67, Statutes of 1999, was a budget
trailer bill which made numerous changes in the law concerning
DCA, and included a provision which deleted the practical
examination requirement for an acupuncture license and
replaced it with the written examination mandate currently in
effect. Unfortunately, there is little historical data
available regarding the administration of the practical
examination, including the costs, testing procedures, failure
rates, the type of test administered and the number of
individuals who may have taken the examination.
This bill is a reintroduction of AB 1889 (Fong) from 2012, which
would have also reinstated a practical examination in addition
to the current written examination. That bill was held on the
Suspense File of the Assembly Appropriations Committee,
presumably due to the projected high cost of administering the
examination. The Assembly Appropriations Committee analysis
cited ongoing costs of at least $500,000 annually for the
Board to administer the practical examination, and found that
the examination fee of $550 would have to be increased by $500
or more per licensee to fund a practical exam.
6)Current examination issues . During the November 15, 2012
Board meeting, acupuncture students and industry
representatives raised concerns about the low passage rate of
the August 2012 CALE administration where only 36% of the 433
test takers passed. Because of the abnormally low passage
rate, the Board ordered the executive officer to conduct an
independent analysis of the examination.
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The Board released an "Investigative Findings Report" at its
February 19, 2013 Board meeting, which found the test to be
satisfactory. The Board is now in the process of conducting
an external audit of the exam in order to ensure the test
development and testing process is structurally sound. The
most recent exam offered on February 13, 2013 had a
significantly higher passage rate of 71%.
7)Questions regarding implementation . Implementing a practical
acupuncture exam would be a complicated endeavor with numerous
issues that would need to be addressed , including how the
practice test would be administered, how frequently it would
be offered, how it would be scored, what would be tested, etc.
This bill includes a delayed implementation date of two years so
that the Board has time to develop detailed regulations to
formulate and administer a new practical examination.
8)Arguments in support . The Council of Acupuncture and Oriental
Medicine Associations writes in support "The addition of a
practical examination that [this bill] requires will further
determine an acupuncturist's competence in safely diagnosing
and treating patients effectively and will help ensure that
licensed acupuncturists have a high medical standard of
ability and quality to practice in California."
9)Previous legislation . AB 1889 (Fong) of 2012 would have
required applicants for an acupuncture license to pass a
practical examination administered by the Board and developed
by OPES. That bill was held in Assembly Appropriations.
AB 1116 (Yee) of 2005 would have required an individual
seeking an acupuncture license to complete a postgraduate
residency program, in addition to existing requirements. That
bill was subsequently amended to address a different subject
matter.
AB 1943 (Chu), Chapter 781, Statutes of 2002, increased the
entry-level curriculum standards for acupuncturists to a
minimum of 3,000 hours of study pertaining to the practice of
acupuncture.
SB 1951 (Figueroa), Chapter 714, Statutes of 2002, extended
the sunset dates for the Board, requested the LHC to conduct a
comprehensive analyses, required the Board to conduct two
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particular studies, and made other changes to the Board, as
specified.
AB 1105 (Jackson, Dunn, Reyes and Solis), Chapter 67, Statutes
of 1999, made numerous changes in the law concerning the
responsibilities of DCA, and included a provision deleting the
practical examination requirement for an acupuncture license
and replaced it with a written examination.
REGISTERED SUPPORT / OPPOSITION :
Support
Council of Acupuncture and Oriental Medicine Associations
(sponsor)
Alhambra Medical University
American Association of Acupuncture & Traditional Chinese
Medicine
American Tradition Chinese Medical Traumatology Association
American Traditional Chinese Medicine Society
Association of Traditional Medical Doctors
California Acupuncture Oriental Medicine Association
California TCM University Alumni
CNA Medical Group, Inc.
Korean Acupuncture and Asian Medicine Association in U.S.A.
North American Oriental and Western Medicine Academy
Sacramento Acupuncture Center
Tung and Lau Acupuncture Clinic
Vietnamese Acupuncture Oriental Medicine Association
One individual
Opposition
Nine Star University of Health Services
Analysis Prepared by : Elissa Silva / B.,P. & C.P. / (916)
319-3301