BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 218|
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THIRD READING
Bill No: SB 218
Author: Yee (D)
Amended: 5/28/13
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEV. COMM. : 4-2, 4/22/13 (FAIL)
AYES: Price, Block, Hill, Yee
NOES: Emmerson, Corbett
NO VOTE RECORDED: Galgiani, Hernandez, Padilla, Wyland
SENATE BUSINESS, PROF. & ECON. DEV. COMM. : 6-1, 4/29/13
AYES: Price, Block, Galgiani, Hernandez, Hill, Yee
NOES: Corbett
NO VOTE RECORDED: Emmerson, Padilla, Wyland
SENATE APPROPRIATIONS COMMITTEE : 4-2, 5/23/13
AYES: De León, Hill, Lara, Steinberg
NOES: Walters, Gaines
NO VOTE RECORDED: Padilla
SUBJECT : Healing arts
SOURCE : American Traditional Chinese Medical Traumatology
Association
DIGEST : This bill establishes the California Traditional
Chinese Medicine Traumatology Committee under the California
Acupuncture Board (Board) and requires the Board to issue a
certificate to practice as a Traditional Chinese Medicine
Traumatologist to applicants who meet certain education,
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training and clinical experience requirements and pay fees, as
specified.
ANALYSIS :
Existing law:
1. Defines "acupuncturist" as an individual who has been
licensed to practice acupuncture pursuant to the Acupuncture
Licensure Act; and "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.
2. States that a licensed acupuncturist is authorized to engage
in the practice of acupuncture, and 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. Specifies that nothing in
Business and Professions Code Section 4937 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.
3. Provides for certification of massage practitioners and
massage therapists, as defined, by a Massage Therapy
Organization (MTO) and specifies that the MTO is a nonprofit
organization meeting specified requirements, and imposes
certain duties on the MTO.
4. Requires the MTO to issue either a "massage practitioner"
certificate or a "massage therapist" certificate to an
applicant, who submits a written application and provides
satisfactory evidence that he/she meets all of the specified
education, experience or examination requirements, or has a
current valid license from a local jurisdiction and meets
other education and/or experience requirements.
5. Provides for various grounds for discipline against a
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certificate holder or for denial of a certificate to an
applicant, including unprofessional conduct; procurement of
certificate by fraud; misrepresentation or mistake;
conviction of a felony or misdemeanor substantially related
to their qualifications, functions or duties, or committing
any fraudulent, dishonest, or corrupt act that is
substantially related; and committing any act punishable as a
sexually related crime.
6. Provides that it is an unfair business practice for any
person to state or advertise or put out any sign or card or
other device, or to represent to the public through any print
or electronic media, that he/she is certified, registered, or
licensed by a governmental agency as a massage therapist or
practitioner.
7. Provides that it is an unfair business practice for any
person to use the title of "certified massage therapist" or
certified massage practitioner" or any other term, such as
"licensed," "registered," or "CMT," that implies or suggest
that the person is certified as a massage therapist or
practitioner without meeting the requirements, as specified.
8. Makes the unlawful practice of medicine a public offense
with both misdemeanor or felony penalty provisions which
would apply.
This bill:
1. Defines "Traditional Chinese Medicine Traumatology (TCMT)"
and "Certified Traditional Chinese Medicine Traumatologist
(CTCMT)."
2. Makes it a misdemeanor, for any individual who does not hold
a valid certificate, to hold oneself out as or to
fraudulently buy, sell, or obtain a certificate as a
"Certified Traditional Chinese Medicine Traumatologist."
3. Establishes the TCMT Committee within the Board.
4. Specifies the composition, membership, and term of the TCMT
Committee.
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5. Requires an applicant to furnish satisfactory evidence of
education, training and clinical experience that meets one of
the following standards:
A. Passed an examination and received a certificate from
an institution of higher education in TCMT for completing
a curriculum in the subject. The curriculum for all
applicants shall provide for adequate instruction in each
of the following subjects: (1) human anatomy and
physiology, (2) pathology, (3) Western diagnosis on
traumatological injury, (4) clinical management and
medical ethics, (5) basic theory of traditional Chinese
medicine, (6) comparison of traditional Chinese medicine
and western medicine, (7) meridian and acu-points, (8)
basic traditional Chinese medicine diagnosis, (9) basic
theory of TCMT, (10) traditional Chinese medicine
diagnosis on traumatology, (11) Hands on Skills of TCMT I,
(12) Hands on Skills of TCMT II, (13) Chinese herbs and
formulas for traumatology, (14) TCMT case study, and (15)
completes 1,000 hours in a clinical internship on TCMT.
B. Completed an apprenticeship in TCMT for 10 years prior
to January 1, 2014, and furnishes satisfactory evidence of
education and training, and at least 10 years clinical
experience in TCMT.
C. Applicants who completed education and training
outside of the United States or Canada must furnish
evidence of their education and at least 10 years of
clinical experience.
1. Requires an applicant for TCMT certification to file an
application with the Board and pay fees in amounts sufficient
to recover all reasonable costs incurred by the Board,
including any startup costs.
2. Authorizes the TCMT Committee to review the applicant's
qualifications for certification.
3. Requires the TCMT Committee to issue a duplicate or
replacement engraved wall certificate or a duplicate or
replacement renewal receipt or pocket certificate, upon
request.
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4. Requires the Board to charge a reasonable fee to process a
request for the reissuance of a TCMT certificate.
5. Defines unprofessional conduct and provides the Board the
ability to deny, suspend or revoke or impose probationary
conditions upon the certificate of any CTCMT if he/she is
guilty of unprofessional conduct or fraudulent act.
6. Defines fraudulent activity and provides the Board the
ability to deny, suspend or revoke or impose probationary
conditions upon the certificate of any CTCMT if he/she is
guilty of a fraudulent act.
7. Provides the Board the ability to deny, suspend or revoke or
impose probationary conditions upon the license of any CTCMT
if he/she is guilty of committing gross negligence, repeated
negligent acts, or incompetence.
8. Specifies the Board's authority regarding CTCMT's who have
been convicted of a crime.
9. Includes specifications regarding where a certificate holder
should post their license and a timeline for notifying the
Board when a certificate holder changes the location of their
practice.
10.Specifies the expiration timeframe, of five years after the
date of issuance for TCMT certificates, and renewal
requirements.
Background
Traditional Chinese Medicine (TCM) . In ancient China, TCM was
taught via family or master-apprenticeship education meaning
these practitioners learned from a master through hands-on
training. During the Tang Dynasty (618-907 A.D.), there was a
TCM school to train imperial physicians called "Taiyishu;" the
earliest medical school run and managed by the government.
After the foundation of the People's Republic of China in the
1950s, a series of policies and measures for promoting TCM
education were instituted. In 1956, China set up the first
group of TCM colleges, including Beijing College of TCM,
Shanghai College of TCM, Guangzhou College of TCM and Chengdu
College of TCM.
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To date, approximately 100,000 students have been trained in
TCM. Presently, there are 33 TCM colleges and universities in
China with approximately 30 thousand students. Among the 33
colleges and universities, 15 offer bachelor's degrees, 22 offer
masters degrees and 10 offer doctorate degrees. Three other
universities have post-doctoral programs. Over one-third of TCM
colleges and universities admit foreign students and about 2,000
foreign students have graduated to date. Generally, each
college or university of TCM has two to three affiliated
hospitals. The affiliated hospitals are the schools' clinical
training base. After completing their TCM bachelor degrees,
students may elect to spend an additional two years specializing
in a variety of tracks including acupuncture and traumatology.
Once awarded their degree, the TCM physicians, including those
who specialize in areas such as traumatology, are regarded as
highly trained medical professionals who have hospital
privileges.
TCMT . Traumatology is one of the modalities that constitute
TCM. Traumatology is defined as a range of treatments that
address both acute and chronic musculoskeletal conditions
through stimulation of 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
four meridians. Traumatologists have been unregulated in the
United States for the approximate 150 years that they have
practiced here. According to information obtained from several
long-standing professional acupuncture organizations, when the
California Acupuncture Board was instituted over 30 years ago,
many traumatologists were grandfathered as acupuncturists.
However, in California, there are still approximately 80-100
individuals practicing traumatology who chose not to be
grandfathered as acupuncturists. Although highly skilled, it is
extremely difficult for these practitioners to now obtain proof
of their training to qualify for licensure as an acupuncturist
while others do not desire to be licensed as acupuncturists.
(Note: 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 trauma
surgery it is most often a sub-specialty to orthopedic surgery.
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Traumatology may also be known as accident surgery.)
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee:
One-time costs of about $80,000 to develop program criteria,
update licensing systems, and adopt regulations. (Acupuncture
Fund).
Ongoing costs between $150,000 and $200,000 per year to
review certificate applications and provide support to the
TCMT Committee, offset by fee revenues. (Acupuncture Fund).
SUPPORT : (Verified 5/23/13) (Unable to reverify at time of
writing)
American Traditional Chinese Medical Traumatology Association
(source)
Alhambra Medical University
American Association of Acupuncture and Traditional Chinese
Medicine
American Chinese Cultural Exchange and Trading Association
American Chinese Traumatology Association
Andrew University
Association of Traditional Medical Doctors
California Acupuncture Medical Association
California Acupuncture Oriental Medicine Association
California Chiropractic Association
California Traditional Chinese Medicine University Alumni
Association
Chinese Athletic Association of San Francisco
Chinese Consolidated Benevolent Association
Chinese Medicine Society of America
Council of Acupuncture and Oriental Medicine Associations
Far East Café
Hoy Sun Wing Yung Benevolent Association in America
National Guild of Acupuncture and Oriental Medicine
North American Oriental and Western Medicine Academy
Sacramento Acupuncture Center
Tom Family Benevolent Association
Tung & Lau Acupuncture Clinic (San Francisco)
United Acupuncture Association
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Vietnamese Acupuncture and Oriental Medicine Association
Institute
Wong Family Benevolent Association Incorporated
Yau Kung Moon Kung-Fu Association of USA
OPPOSITION : (Verified 5/23/18) (Unable to reverify at time
of writing)
Academy of Chinese Medicine
Association of World Traditional Medicine
California Acupuncture Coalition
California Certified Acupuncturists Association
California State Oriental Medical Association
CFM Educational Services
Citizens for Better Community
College of Acupuncture and Oriental Medicine at Southern
California University of Health Sciences
EGA International
Pacific College of Oriental Medicine
United California Practitioners of Chinese Medicine
ARGUMENTS IN SUPPORT : According to the author's office,
existing law neither oversees nor regulates the practice of
traumatology. Currently, anyone can obtain a business license
and call themselves a traumatologist. This bill places the
profession under state oversight to ensure the proper use of the
title "Certified Traditional Chinese Medicine Traumatologist."
The bill's sponsor, the American Traditional Chinese Medical
Traumatology Association, believes that this bill provides a
pathway for skilled traumatologists to achieve California
certification and thereby provide Californians with basic health
and safety assurances when receiving services from a California
Certified Traumatologist.
The California Chapter of the National Guild of Acupuncture and
Oriental Medicine believes that this bill will provide a legal
mechanism for practitioners of traumatology to become state
certified and subject to Department of Consumer Affairs
oversight through the Acupuncture Board.
The American Chinese Cultural Exchange and Trading Association
believes that this bill will bring about a public recognition of
the profession, establish high standards and training for the
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certification process and continue to enhance the public's
access to high quality care at very affordable prices.
ARGUMENTS IN OPPOSITION : The California Acupuncture Coalition
notes, "This bill will impose significant new burdens and
regulatory complexities on a licensing board that is already
struggling?it will create consumer confusion and endanger the
reputation of existing California licensed acupuncturists. The
funds collected from licensure fees will not be sufficient to
cover the development and administration of an examination;
adequate regulatory oversight and administrative support; and
enforcement and other consumer protection mechanisms."
The California State Oriental Medical Association has concerns
that the proposed educational requirements are "substandard,"
and they point out that no continuing education would be
required.
The Academy of Chinese Medicine believes that this bill will
jeopardize public safety. They state, "Given the absence of
clear educational and certification standards for TCM
traumatology as a stand-alone medical field in California, this
bill does not define who administers the education program and
how many hours are required. In addition, there is no standard
examination given through the Acupuncture Board in this bill.
[There] is no doubt that such a bill will post a tremendous risk
for the general public."
MW:k 5/28/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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