Amended in Senate May 28, 2013

Amended in Senate May 13, 2013

Amended in Senate April 25, 2013

Amended in Senate April 9, 2013

Senate BillNo. 218


Introduced by Senator Yee

February 11, 2013


An act to amend Sections 4935, 4955, 4955.1, 4955.2, 4956, 4960.2, 4961, 4965, 4966, 4967, and 4969 of, to add Section 4964.5 to, and to add Article 3 (commencing with Section 4950) to Chapter 12 of Division 2 of, the Business and Professions Code, relating to healing arts.

LEGISLATIVE COUNSEL’S DIGEST

SB 218, as amended, Yee. Healing arts.

Existing law, the Acupuncture Licensure Act, establishes the Acupuncture Board and makes it responsible for enforcing and administering the act, including licensing persons who meet specified licensure requirements. Under the act, licensees are titled “acupuncturists,” and are authorized to perform designated activities pursuant to their license. The unlawful practice of acupuncture, as specified, is a crime.

This bill would, commencing May 1, 2014, require the board to issue a certificate to practice as a traditional Chinese medicine traumatologist to an applicant who meets certain education, training, and clinical experience requirements and pays abegin insert reasonableend insert feebegin delete of an unspecified amountend deletebegin insert, as determined by the boardend insert. This bill would require the board to establish the California Traditional Chinese Medicine Traumatology Committee to provide advice and carry out specified duties, including investigation and evaluation of whether an applicant meets those education, training, and clinical experience requirements.

The bill would set forth procedures for the renewal of an unexpired or expired certificate to perform traditional Chinese medicine traumatology and wouldbegin delete establish fees in unspecified amountsend deletebegin insert require the board to establish reasonable feesend insert in that regard.

This bill would make it an unfair business practice to use the title of “certified traditional Chinese medicine traumatologist” without meeting these certification requirements and would authorize the board to suspend or revoke a certificate for unprofessional conduct, certain fraudulent acts, or specified crimes committed by the certificate holder. The bill would also make it a crime to use the title of “certified traditional Chinese medicine traumatologist” without meeting these certification requirements and to fraudulently buy or sell a certificate for traditional Chinese medicine traumatology, thereby imposing a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

P2    1

SECTION 1.  

Section 4935 of the Business and Professions
2Code
is amended to read:

3

4935.  

(a) (1) It is a misdemeanor, punishable by a fine of not
4less than one hundred dollars ($100) and not more than two
5thousand five hundred dollars ($2,500), or by imprisonment in a
6county jail not exceeding one year, or by both that fine and
7imprisonment, for any person who does not hold a current and
8valid license to practice acupuncture under this chapter, to hold
9himself or herself out as practicing or engaging in the practice of
10acupuncture, or to hold himself or herself out as a certified
11traditional Chinese medicine traumatologist or use the title of
12“certified traditional Chinese medicine traumatologist” without
13meeting the requirements of this chapter.

P3    1(2) It is a misdemeanor, punishable by a fine of not less than
2one hundred dollars ($100) and not more than two thousand five
3hundred dollars ($2,500), or by imprisonment in a county jail not
4exceeding one year, or by both that fine and imprisonment, for
5any person to fraudulently buy, sell, or obtain a license to practice
6acupuncture or a certificate for traditional Chinese medicine
7traumatology, or to violate the provisions of this chapter.

8(b) Notwithstanding any other provision of law, any person,
9other than a physician and surgeon, a dentist, or a podiatrist, who
10is not licensed under this article but is licensed under Division 2
11(commencing with Section 500), who practices acupuncture
12involving the application of a needle to the human body, performs
13any acupuncture technique or method involving the application of
14a needle to the human body, or directs, manages, or supervises
15another person in performing acupuncture involving the application
16of a needle to the human body is guilty of a misdemeanor.

17(c) A person holds himself or herself out as engaging in the
18practice of acupuncture by the use of any title or description of
19services incorporating the words “acupuncture,” “acupuncturist,”
20“certified acupuncturist,” “licensed acupuncturist,” “Asian
21medicine,” “oriental medicine,” “traditional Chinese medicine,”
22or any combination of those words, phrases, or abbreviations of
23those words or phrases, by representing that he or she is trained,
24experienced, or an expert in the field of acupuncture, Asian
25medicine, or Chinese medicine, or by representing that he or she
26is trained, experienced, or an expert in the field of traditional
27Chinese medicine traumatology.

28(d) Subdivision (a) shall not prohibit a person from
29administering acupuncture treatment as part of his or her
30educational training if he or she:

31(1) Is engaged in a course or tutorial program in acupuncture,
32as provided in this chapter; or

33(2) Is a graduate of a school of acupuncture approved by the
34board and participating in a postgraduate review course that does
35not exceed one year in duration at a school approved by the board.

36

SEC. 2.  

Article 3 (commencing with Section 4950) is added
37to Chapter 12 of Division 2 of the Business and Professions Code,
38to read:

 

P4    1Article 3.  California Traditional Chinese Medicine
2Traumatologist
3

 

4

4950.  

As used in this article:

5(a) “California certified traditional Chinese medicine
6traumatologist” means a person who has been certified by the
7California Traditional Chinese Medicine Traumatology Committee
8to perform traditional Chinese medicine traumatology.

9(b) “Committee” means, notwithstanding Section 4925, the
10California Traditional Chinese Medicine Traumatology Committee.

11(c) “Traditional Chinese medicine traumatology” includes a
12range of treatments to address both acute and chronic
13musculoskeletal conditions through stimulation of acupressure
14points. Techniques include, but are not limited to, brushing,
15kneading, rolling, pressing, rubbing, pushing, holding, and lifting
16the areas between each of the joints to open the body’s defensive
17chi and stimulate the energy movement in the meridians.

18

4950.1.  

(a) (1) On or before March 1, 2014, the board shall
19establish the California Traditional Chinese Medicine
20Traumatology Committee within the board. The committee shall
21consist of the following five members appointed by the board:

22(A) One representative from the California Medical Association.

23(B) One representative from the California Orthopaedic
24Association.

25(C) One representative from the Medical Board of California.

26(D) Two representatives from a traditional Chinese medicine
27traumatology clinical setting. These representatives shall be
28selected by professional societies, associations, or other entities,
29whose memberships are comprised solely of practitioners of
30traditional Chinese medicine traumatology. To qualify as a
31professional society or association, an entity shall have a dues
32paying membership in the state of at least 30 individuals for the
33last three years and shall have bylaws that require its members to
34comply with a code of ethics.

35(2) Members of the committee shall serve for a term of four
36years.

37(b) The board, in implementing this article, shall give specific
38consideration to the recommendations of the committee.

39(c) (1) Pursuant to Section 4950.2, the committee shall meet
40and confer to determine an applicant’s qualifications, as prescribed
P5    1in Section 4950.2, including the level of experience and training
2needed to qualify for California traditional Chinese medicine
3traumatology certification.

4(2) The committee shall advise the board on any other issues
5pursuant to this article.

6

4950.2.  

(a) The committee shall investigate all of the
7documentation provided by the applicant and verify its authenticity
8to evaluate whether an applicant meets the certification standards,
9including the level of education, experience, and training to
10sufficiently qualify for the traumatology certification, and shall
11report its findings and determination to the board.

12(b) Commencing May 1, 2014, the board shall issue a certificate
13for certified traditional Chinese medicine traumatology to any
14person who makes an application to the board and meets all of the
15following requirements:

16(1) Is at least 18 years of age.

17(2) Is not subject to denial pursuant to Division 1.5 (commencing
18with Section 475).

19(3) Furnishes satisfactory evidence of education, training, and
20clinical experience that meets one of the following standards:

21(A) Passed an examination and received a certificatebegin insert from an
22institution of higher educationend insert
in traditional Chinese medicine
23traumatology for completing a curriculum in the subject. The
24curriculum for all applicants shall provide for adequate instruction
25in each of the following subjects:

26(i) Human anatomy and physiology.

27(ii) Pathology.

28(iii) Western diagnosis on traumatological injury.

29(iv) Clinical management and medical ethics.

30(v) Basic theory of traditional Chinese medicine.

31(vi) Comparison of traditional Chinese medicine and western
32medicine.

33(vii) Meridian and acupoints.

34(viii) Basic traditional Chinese medicine diagnosis.

35(ix) Basic theory of traditional Chinese medicine traumatology.

36(x) Traditional Chinese medicine diagnosis on traumatology.

37(xi) Hands on Skills of Traditional Chinese Medicine
38Traumatology I.

39(xii) Hands on Skills of Traditional Chinese Medicine
40Traumatology II.

P6    1(xiii) Chinese herbs and formulas for traumatology.

2(xiv) Traditional Chinese medicine traumatology case study.

3(xv) One thousand hours in a clinical internship on traditional
4Chinese medicine traumatology.

5(B) In the case of an applicant who completed an apprenticeship
6as a traditional Chinese medicine traumatologist for 10 years prior
7 to January 1, 2014, furnishes satisfactory evidence of completing
8education, training, and at least 10 years clinical experience in
9traditional Chinese medicine traumatology.

10(C) In the case of an applicant who has completed education
11and training outside of the United States or Canada, furnishes
12satisfactory evidence of completing education, training, and at
13least 10 years clinical experience in traditional Chinese medicine
14traumatology.

15

4950.3.  

(a) begin insert(1)end insertbegin insertend insert An applicant for traditional Chinese medicine
16traumatology certification shall file an application for that
17certificate with the board.

begin delete

18(b)

end delete

19begin insert(2)end insert When submitting his or her application to the board, the
20applicant shall pay an application fee in a reasonable amount
21determined by the board,begin delete not to exceed ____ dollars ($____), for
22the regulatory cost to the board of processing the applicationend delete

23begin insert established in accordance with subdivision (d)end insert.

begin delete

24(c)

end delete

25begin insert(b)end insertbegin insert(1)end insertbegin insertend insert A certified traditional Chinese medicine traumatologist
26shall renew his or her certificate every five years.

begin delete

27(d)

end delete

28begin insert(2)end insert An expired certificate may be renewed at any time within
29three years after its expiration. The holder of the certificate shall
30pay all accrued and unpaid renewal fees, plus a delinquency fee,
31begin delete according to the following:end delete

begin delete

32(1) An annual renewal fee of ____ dollars ($____).

33(2) A delinquency fee of ____ dollars ($____).

34(3) A fee for a duplicate or replacement engraved wall certificate
35of ____ dollars ($____).

end delete

36begin delete(4)end deletebegin deleteend deletebegin deleteA fee for a duplicate or replacement renewal receipt or
37pocket certificate of ____ dollarsend delete
begin delete ($____).end delete begin insert established in
38accordance with to subdivision (d).end insert

begin insert

P7    1(c) (1) The committee shall issue a duplicate or replacement
2engraved wall certificate or a duplicate or replacement renewal
3receipt or pocket certificate, upon request.

end insert
begin insert

4(2) The board shall charge a reasonable fee, established in
5accordance with subdivision (d), to process a request for the
6reissuance of a certificate under this subdivision.

end insert
begin insert

7(d) The board shall adopt a schedule of fees, pursuant to this
8section, in amounts that are sufficient to recover all reasonable
9costs incurred by the board, including any startup costs, under
10this article.

end insert

11(e) Moneys received under this section shall be deposited in the
12Acupuncture Fund for the purposes of carrying out this article.

13

4950.4.  

It is an unfair business practice for any person to hold
14himself or herself out as a certified traditional Chinese medicine
15traumatologist or to use the title of “certified traditional Chinese
16medicine traumatologist” without meeting the requirements of this
17article.

18

4950.5.  

(a) A California certified traditional Chinese medicine
19traumatologist shall not practice medicine, as provided in Section
202052.

21(b) A California certified traditional Chinese medicine
22traumatologist shall not practice within the scope of activities
23regulated by the State Board of Chiropractic Examiners.

24

SEC. 3.  

Section 4955 of the Business and Professions Code is
25amended to read:

26

4955.  

The board may deny, suspend, or revoke, or impose
27probationary conditions upon, the license of any acupuncturist or
28the certificate of any traditional Chinese medicine traumatologist
29if he or she is guilty of unprofessional conduct. As used in this
30section, “licensee” includes a certified traditional Chinese medicine
31traumatologist.

32Unprofessional conduct shall include, but not be limited to, the
33following:

34(a) Using or possessing any controlled substance as defined in
35Division 10 (commencing with Section 11000) of the Health and
36Safety Code, or dangerous drug or alcoholic beverage to an extent
37or in a manner dangerous to himself or herself, or to any other
38person, or to the public, and to an extent that the use impairs his
39or her ability to engage in the practice of acupuncture or
40traumatology with safety to the public.

P8    1(b) Conviction of a crime substantially related to the
2qualifications, functions, or duties of an acupuncturist or certified
3traditional Chinese medicine traumatologist, the record of
4conviction being conclusive evidence thereof.

5(c) False or misleading advertising.

6(d) Aiding or abetting in, or violating or conspiring in, directly
7or indirectly, the violation of the terms of this chapter or any
8regulation adopted by the board pursuant to this chapter.

9(e) Except for good cause, the knowing failure to protect patients
10by failing to follow infection control guidelines of the board,
11thereby risking transmission of bloodborne infectious diseases
12from licensee to patient, from patient to patient, and from patient
13to licensee. In administering this subdivision, the board shall
14consider referencing the standards, regulations, and guidelines of
15the State Department of Public Health developed pursuant to
16Section 1250.11 of the Health and Safety Code and the standards,
17regulations, and guidelines pursuant to the California Occupational
18Safety and Health Act of 1973 (Part 1 (commencing with Section
196300) of Division 5 of the Labor Code) for preventing the
20transmission of HIV, hepatitis B, and other bloodborne pathogens
21in health care settings. As necessary, the board shall consult with
22the Medical Board of California, the California Board of Podiatric
23Medicine, the Dental Board of California, the Board of Registered
24Nursing, and the Board of Vocational Nursing and Psychiatric
25Technicians of the State of California, to encourage appropriate
26consistency in the implementation of this subdivision.

27The board shall seek to ensure that licensees are informed of the
28responsibility of licensees and others to follow infection control
29guidelines, and of the most recent scientifically recognized
30safeguards for minimizing the risk of transmission of bloodborne
31infectious diseases.

32(f) The use of threats or harassment against any patient or
33licensee for providing evidence in a disciplinary action, other legal
34action, or in an investigation contemplating a disciplinary action
35or other legal action.

36(g) Discharging an employee primarily for attempting to comply
37with the terms of this chapter.

38(h) Disciplinary action taken by any public agency for any act
39substantially related to the qualifications, functions, or duties of
P9    1an acupuncturist, certified traditional Chinese medicine
2traumatologist, or any professional health care licensee.

3(i) Any action or conduct that would have warranted the denial
4of the acupuncture license or the traumatology certificate.

5(j) The violation of any law or local ordinance on a licensee’s
6business premises by a licensee’s employee or a person who is
7working under the licensee’s professional license or business
8permit, that is substantially related to the qualifications, functions,
9or duties of the licensee. These violations shall subject the licensee
10who employed the individuals, or under whose acupuncturist
11license or traumatology certificate the employee is working, to
12disciplinary action.

13(k) The abandonment of a patient by the licensee without written
14notice to the patient that treatment is to be discontinued and before
15the patient has had a reasonable opportunity to secure the services
16of another practitioner.

17(l) The failure to notify the board of the use of any false,
18assumed, or fictitious name other than the name under which he
19or she is licensed as an individual to practice acupuncture or as an
20individual certified in traditional Chinese medicine traumatology.

21

SEC. 4.  

Section 4955.1 of the Business and Professions Code
22 is amended to read:

23

4955.1.  

The board may deny, suspend, revoke, or impose
24probationary conditions upon the license of any acupuncturist or
25certificate of any certified traditional Chinese medicine
26traumatologist if he or she is guilty of committing a fraudulent act,
27including, but not limited to, the following:

28(a) Securing a license by fraud or deceit.

29(b) Committing a fraudulent or dishonest act as an acupuncturist
30or certified traditional Chinese medicine traumatologist.

31(c) Committing any act involving dishonesty or corruption with
32 respect to the qualifications, functions, or duties of an acupuncturist
33or certified traditional Chinese medicine traumatologist.

34(d) Altering or modifying the medical record of any person,
35with fraudulent intent, or creating any false medical record.

36(e) Failing to maintain adequate and accurate records relating
37to the provision of services to his or her patients.

38

SEC. 5.  

Section 4955.2 of the Business and Professions Code
39 is amended to read:

P10   1

4955.2.  

The board may deny, suspend, revoke, or impose
2probationary conditions upon the license of any acupuncturist or
3certified traditional Chinese medicine traumatologist if he or she
4is guilty of committing any one of the following:

5(a) Gross negligence.

6(b) Repeated negligent acts.

7(c) Incompetence.

8

SEC. 6.  

Section 4956 of the Business and Professions Code is
9amended to read:

10

4956.  

A plea or verdict of guilty or a conviction following a
11plea of nolo contendere made to a charge that is substantially
12related to the qualifications, functions, or duties of an acupuncturist
13or certified traditional Chinese medicine traumatologist is deemed
14to be a conviction within the meaning of this chapter.

15The board may order a license or certificate suspended or
16revoked, or may deny a license or certificate, or may impose
17probationary conditions upon a license or certificate, when the
18time for appeal has elapsed, or the judgment of conviction has
19been affirmed on appeal, or when an order granting probation is
20made suspending the imposition of sentence irrespective of a
21subsequent order under Section 1203.4 of the Penal Code allowing
22the person to withdraw his or her pleas of guilty and to enter a plea
23of not guilty, or setting aside the verdict of guilty, or dismissing
24the accusation, complaint, information, or indictment.

25

SEC. 7.  

Section 4960.2 of the Business and Professions Code
26 is amended to read:

27

4960.2.  

The board in all cases of revocation shall certify the
28fact of the revocation, under the seal of the board, to the business
29licensing entity of the cities or counties in which the license of the
30acupuncturist or the certificate of the traditional Chinese medicine
31traumatologist has been revoked. The record of the revocation
32made by the county or city clerk shall be sufficient evidence of
33the revocation, and of the regularity of all proceedings of the board
34in the matter of the revocation.

35

SEC. 8.  

Section 4961 of the Business and Professions Code is
36amended to read:

37

4961.  

(a) Every person who is now or hereafter licensed to
38practice acupuncture or certified to practice traditional Chinese
39medicine traumatology in this state shall register, on forms
40prescribed by the board, his or her place of practice, or, if he or
P11   1she has more than one place of practice, all of the places of practice.
2If the licensee or certificate holder has no place of practice, he or
3she shall notify the board of that fact. A person licensed or certified
4by the board shall register within 30 days after the date of his or
5her licensure or certification.

6(b) A licensee or certificate holder shall post his or her license
7or certificate in a conspicuous location in his or her place of
8practice at all times. If an acupuncturist or certified traditional
9Chinese medicine traumatologist has more than one place of
10practice, he or she shall obtain from the board a duplicate license
11or certificate for each additional location and post the duplicate
12license or certificate at each location.

13(c) Any licensee or certificate holder that changes the location
14of his or her place of practice shall register each change within 30
15days of making that change. If a licensee or certificate holder fails
16to notify the board of any change in the address of a place of
17practice within the time prescribed by this section, the board may
18deny renewal of licensure or certification. An applicant for renewal
19of licensure or certification shall specify in his or her application
20whether or not there has been a change in the location of his or
21her place of practice and, if so, the date of that change. The board
22may accept that statement as evidence of the change of address.

23

SEC. 9.  

Section 4964.5 is added to the Business and Professions
24Code
, immediately following Section 4964, to read:

25

4964.5.  

The provisions of this article apply to both licensed
26acupuncturists and certified traditional Chinese medicine
27traumatologists.

28

SEC. 10.  

Section 4965 of the Business and Professions Code
29 is amended to read:

30

4965.  

(a) (1) A license to practice acupuncture issued pursuant
31to this chapter shall expire on the last day of the birth month of
32the licensee during the second year of a two-year term, if not
33renewed.

34(2) The board shall establish and administer a birth date renewal
35program for purposes of this subdivision.

36(3) To renew an unexpired license, the holder shall apply for
37renewal on a form provided by the board and pay the renewal fee
38fixed by the board.

39(b) A certificate for traditional Chinese medicine traumatology
40 issued pursuant to this chapter shall expire five years after the date
P12   1of issuance, if not renewed. To renew an unexpired certificate, the
2holder shall apply for renewal on a form provided by the board
3and pay the renewal fee set forth in Section 4950.3.

4

SEC. 11.  

Section 4966 of the Business and Professions Code
5 is amended to read:

6

4966.  

(a) Except as provided in Section 4969, a license to
7practice acupuncture that has expired may be renewed at any time
8within three years after its expiration by filing an application for
9renewal on a form provided by the board, paying all accrued and
10unpaid renewal fees, and providing proof of completing continuing
11education requirements. If the license is not renewed prior to its
12expiration, the acupuncturist, as a condition precedent to renewal,
13shall also pay the prescribed delinquency fee.

14(b) Except as provided in Section 4969, a certificate for
15traditional Chinese medicine traumatology that has expired may
16be renewed at any time within three years after its expiration by
17filing an application for renewal on a form provided by the board,
18and paying all accrued and unpaid renewal fees. If the certificate
19is not renewed prior to its expiration, the traditional Chinese
20medicine traumatologist, as a condition precedent to renewal, shall
21also pay a delinquency fee, set in accordance with Section 163.5.

22(c) Renewal under this section shall be effective on the date on
23which the application is filed, on the date on which the renewal
24fee is paid, or on the date the delinquency fee is paid, whichever
25occurs last. If so renewed, the license or certificate shall continue
26in effect through the expiration date provided in Section 4965,
27after the effective date of the renewal, when it shall expire and
28become invalid if it is not again renewed.

29

SEC. 12.  

Section 4967 of the Business and Professions Code
30 is amended to read:

31

4967.  

A person who fails to renew his or her license or
32certificate within three years after its expiration may not renew it,
33and it may not be restored, reissued, or reinstated thereafter, but
34that person may apply for and obtain a new license or certificate
35if he or she meets all of the following requirements:

36(a) Has not committed any acts or crimes constituting grounds
37for denial of licensure or certification under Division 1.5
38(commencing with Section 475).

39(b) If an acupuncturist takes and passes the examination, if any,
40which would be required of him or her if an initial application for
P13   1licensure was being made, or, if an acupuncturist or certified
2traditional Chinese medicine traumatologist otherwise establishes
3to the satisfaction of the board that, with due regard for the public
4interest, he or she is qualified to practice as an acupuncturist or
5certified traditional Chinese medicine traumatologist.

6(c) Pays all of the fees that would be required if an initial
7application for licensure or certification was being made.

8(d) The board may provide for the waiver or refund of all or
9any part of an examination fee in those cases in which a license
10to practice acupuncture is issued without an examination pursuant
11to this section.

12

SEC. 13.  

Section 4969 of the Business and Professions Code
13 is amended to read:

14

4969.  

(a) A suspended license or certificate is subject to
15expiration and shall be renewed as provided in this article, but the
16renewal does not entitle the acupuncturist or certified traditional
17Chinese medicine traumatologist, while the license or certificate
18remains suspended, and until it is reinstated, to engage in the
19practice of acupuncture or traditional Chinese medicine
20traumatology, or in any other activity or conduct in violation of
21the order or judgment by which the license or certificate was
22suspended.

23(b) A revoked license or certificate is subject to expiration as
24provided in this article, but it may not be renewed. If it is reinstated
25after its expiration, the former licensee or certificate holder, as a
26condition to reinstatement, shall pay a reinstatement fee in an
27amount equal to the renewal fee in effect on the last regular renewal
28date before the date on which the license or certificate was
29reinstated, plus the delinquency fee, if any, accrued at the time of
30its expiration.

31

SEC. 14.  

No reimbursement is required by this act pursuant to
32Section 6 of Article XIII B of the California Constitution because
33the only costs that may be incurred by a local agency or school
34district will be incurred because this act creates a new crime or
35infraction, eliminates a crime or infraction, or changes the penalty
36for a crime or infraction, within the meaning of Section 17556 of
37the Government Code, or changes the definition of a crime within
P14   1the meaning of Section 6 of Article XIII B of the California
2Constitution.



O

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