BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                            



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          |SENATE RULES COMMITTEE            |                       SB 1246|
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                                 UNFINISHED BUSINESS


          Bill No:  SB 1246
          Author:   Lieu (D), et al.
          Amended:  8/22/14
          Vote:     21

           
           SENATE BUSINESS, PROF. & ECONOMIC DEVELOP. COMM  :  9-0, 4/28/14
          AYES:  Lieu, Wyland, Berryhill, Block, Corbett, Galgiani,  
            Hernandez, Hill, Padilla

           SENATE APPROPRIATIONS COMMITTEE  :  7-0, 5/23/14
          AYES:  De León, Walters, Gaines, Hill, Lara, Padilla, Steinberg

           SENATE FLOOR  :  33-0, 5/29/14
          AYES:  Anderson, Beall, Block, Cannella, Corbett, Correa, De  
            León, DeSaulnier, Evans, Fuller, Gaines, Hancock, Hernandez,  
            Hill, Hueso, Huff, Jackson, Knight, Lara, Leno, Lieu, Liu,  
            Monning, Morrell, Padilla, Pavley, Roth, Steinberg, Torres,  
            Vidak, Walters, Wolk, Wyland
          NO VOTE RECORDED:  Berryhill, Calderon, Galgiani, Mitchell,  
            Nielsen, Wright, Yee

           ASSEMBLY FLOOR  :  75-0, 8/27/14 - See last page for vote


           SUBJECT  :    California Acupuncture Board

           SOURCE  :     Author


           DIGEST  :    This bill extends the sunset date of the California  
          Acupuncture Board (CAB) to January 1, 2017, revises acupuncture  
          program approval requirements; and extends the sunset date of  
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          CAB's authority to appoint an executive officer (EO) to January  
          1, 2017.

           Assembly Amendments  delete the provision prohibiting the  
          appointed EO from having served as the EO prior to January 1,  
          2015; delete requirements that schools and colleges offering  
          acupuncturist education and training obtain specified approvals  
          within three years of CAB approval; further defines "approved  
          educational and training program;" and make other technical and  
          conforming changes.  

           ANALYSIS  :    

          Existing law:

          1.Provides for the licensure and regulation of the practice of  
            acupuncture by the CAB within the Department of Consumer  
            Affairs (DCA).

          2.Establishes the CAB until January 1, 2015, and renders the CAB  
            subject to review by the appropriate policy committees of the  
            Legislature. 

          3.Permits the CAB, with the approval of the Director of DCA, to  
            employ personnel and appoint an executive officer until  
            January 1, 2015. 

          4.Authorizes the CAB to establish standards for the approval of  
            schools and colleges offering education and training in the  
            practice of acupuncture, including standards for the faculty  
            in those schools and colleges and tutorial programs.

          5.Allows the CAB to charge a fee for the inspection or  
            re-inspection of a school or college of acupuncture for  
            purposes of approval and permits the CAB to recover the direct  
            costs incurred by the CAB in conducting the inspection and  
            evaluation of the school or college. 

          6.Requires a school or college approved by the CAB, within three  
            years of CAB approval, to receive full institutional approval  
            to operate from the Bureau for Private Postsecondary Education  
            (BPPE) or comparable approval by a governmental authority  
            outside of the state, as applicable.


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          This bill:

          1.Extends the sunset date for the CAB and its duties until  
            January 1, 2017, and the CAB's authority to appoint an EO is  
            extended to 2017. 

          2.Defines an "approved educational and training program" to mean  
            a program approved by the CAB under current standards, until  
            January 1, 2017. 

          3.Removes "tutorial programs" from those entities for which CAB  
            is required to establish standards for approval until January  
            1, 2017. 

          4.Defines an "approved educational and training program" after  
            January 1, 2017, to mean a school or college offering  
            education and training in the practice of an acupuncturist  
            that meets the following requirements: 

             A.   Offers a CAB-approved curriculum that includes at least  
               3,000 hours, of which at least 2,050 hours are didactic and  
               laboratory training and at least 950 hours are supervised  
               clinical instruction.

             B.   Requires the CAB, within 30 days after receiving  
               curriculum to review the curriculum to determine whether  
               the curriculum satisfies the requirements established by  
               CAB, and notify the school or college, the Accreditation  
               Commission for Acupuncture and Oriental Medicine (ACAOM),  
               and BPPE, of the CAB's approval.

             C.   Meets either of the following requirements: 

               (1)    Has been granted candidacy status by ACAOM; or

               (2)    Has submitted a letter of intent to pursue  
                 accreditation to the ACAOM within 30 days of receiving  
                 full institutional approval, as specified, and is granted  
                 candidacy within three years of the date the letter was  
                 submitted. 

             A.   Has received full institutional approval, as specified,  
               in the field of traditional Asian medicine or in the case  
               of institutions located outside of California, approval by  

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               the appropriate governmental educational authority using  
               standards equivalent to California's. 

          1.Specifies that if an applicant began his/her educational and  
            training program at a school or college that submitted a  
            letter of intent to pursue accreditation, or attained  
            candidacy status from, the ACAOM, but the ACAOM subsequently  
            denied the school or college candidacy status or  
            accreditation, respectively, the CAB may review and evaluate  
            the educational training and clinical experience to determine  
            whether to waive the requirements, as specified, with respect  
            to that applicant. 

          2.Requires the CAB to establish standards for the approval of  
            educational training and clinical experience received outside  
            of the United States and Canada beginning on January 1, 2017. 

          3.Repeals the CAB's authority to investigate and evaluate each  
            school or college applying for approval or continued approval  
            and CAB's authority to recover the associated costs on January  
            1, 2017. 

          4.Repeals the $3,000 application fee for the approval of a  
            school or college on January 1, 2017. 

          5.Makes other technical and clarifying changes. 

           Background
           
          This bill is one of six "sunset review bills" authored by the  
          Chair of the Senate Business, Professions and Economic  
          Development (BPED) Committee.  This bill provides for the CAB to  
          be reviewed by the appropriate policy committees of the  
          Legislature, and makes legislative changes regarding the CAB  
          recommended in the Committee's Background Paper.

          In 2014, the Senate BPED Committee and the Assembly Business,  
          Professions and Consumer Protection Committee conducted joint  
          oversight hearings to review nine regulatory entities:  Bureau  
          of Automotive Repair; Bureau of Home Furnishings and Thermal  
          Insulation; Bureau for Private Postsecondary Education;  
          California Massage Therapy Certification program; CAB;  
          California Tax Preparer program; Dental Hygiene Committee of  
          California; Professional Fiduciaries Bureau; and the Structural  

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          Pest Control Board.  

          The Committees began their review of the aforementioned  
          licensing agencies in March and conducted two days of hearings.   
          This bill, and the accompanying sunset bills, are intended to  
          implement legislative changes as recommended in the Committee's  
          Background Papers prepared for each bureau and program reviewed  
          for this year.

          Note:For a summary of the issues and recommendations of the CAB,  
               refer to the Senate BPED Committee analysis of April 28,  
               2014.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Assembly Appropriations Committee: 

           Ongoing costs of about $3.3 million per year to support the  
            CAB's licensing activities, supported by licensing fees (all  
            costs/revenues are Acupuncture Fund). 

           Minor reduction in costs and revenues after January 1, 2017,  
            due to the elimination of the CAB's authority to approve  
            educational programs. 

           Staff costs to promulgate regulations, potentially in the  
            range of $100,000, to address internationally trained  
            applicants. 

           By changing the process for accrediting schools by the CAB, it  
            is possible that an increased number of individuals would meet  
            the state's licensing requirement to have graduated from an  
            accredited school.  This could increase the number of  
            applicants for licensure.  This could result in a potential  
            increase in licensing costs in the range of $100,000 or more  
            due to increased applications (Acupuncture Fund), and a  
            commensurate one-time revenue spike due to increased fee  
            revenues from exam fees as well as higher revenues ongoing. 

           SUPPORT  :   (Verified  8/27/14)

          American College of Traditional Chinese Medicine
          Atlantic Institute of Oriental Medicine

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          California State Oriental Medical Association
          Council of Colleges of Acupuncture and Oriental Medicine
          Five Branches University
          National Certification Commission for Acupuncture and Oriental  
          Medicine
          National College of Natural Medicine
          Oregon College of Oriental Medicine
          Pacific College of Oriental Medicine
          South Baylo University
          Southern California University of Health Sciences
          Southwest Acupuncture College
          University of East-West Medicine
          Yo San University of Traditional Chinese Medicine

           ARGUMENTS IN SUPPORT  :    The Council of Colleges of Acupuncture  
          and Oriental Medicine writes, "The Council's member colleges,  
          all of which have been approved in accordance with ACAOM's  
          national accreditation standards, believe that the quality of  
          acupuncture education for students, patient safety, and consumer  
          protection are best maintained by acupuncture educational  
          institutions participating in an accreditation process with a  
          USDE [U.S. Department of Education] recognized accreditor such  
          as ACAOM.  Accreditation protects patients, students, and the  
          profession by ensuring that graduates are well qualified as  
          entry-level practitioners able to sit for licensing and  
          certification exams." 

          The National Certification Commission for Acupuncture and  
          Oriental Medicine points out that nationwide, every state with  
          an acupuncture practice act requires ACAOM accredited education-  
          the sole outlier is California.

          Five Branches University writes, "Our university [is concerned]  
          about the continuing failure of the CAB to address the useful  
          recommendations of the Senate Committee?we would like to see a  
          responsible Acupuncture Board in California that meets the same  
          rigorous requirements of other health profession Boards [which]  
          require accreditation of schools."

          The American College of Traditional Chinese Medicine writes,  
          "The purpose of this letter is to offer our continued strong  
          support for the incorporation of accreditation by an accreditor  
          recognized by the United States Department of Accreditation?We  
          support the mission of the CAB to 'protect, benefit and inform  

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          the people of California by exercising the licensing, regulatory  
          and enforcement mandates of the Acupuncture Licensure Act.'  We  
          feel that incorporation of accreditation?will strengthen the  
          ability of the CAB to meet its mission."

           ASSEMBLY FLOOR  :  75-0, 8/27/14
          AYES:  Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,  
            Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian  
            Calderon, Campos, Chau, Chávez, Chesbro, Conway, Cooley,  
            Dababneh, Dahle, Daly, Dickinson, Donnelly, Eggman, Fox,  
            Frazier, Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon,  
            Gorell, Gray, Grove, Hagman, Hall, Roger Hernández, Holden,  
            Jones, Jones-Sawyer, Levine, Linder, Logue, Lowenthal,  
            Maienschein, Mansoor, Medina, Melendez, Mullin, Muratsuchi,  
            Nazarian, Nestande, Olsen, Pan, Patterson, Perea, John A.  
            Pérez, V. Manuel Pérez, Quirk-Silva, Rendon, Ridley-Thomas,  
            Rodriguez, Salas, Skinner, Stone, Wagner, Waldron, Weber,  
            Wieckowski, Wilk, Williams, Yamada, Atkins
          NO VOTE RECORDED:  Fong, Harkey, Quirk, Ting, Vacancy

          MW:nl:k  8/27/14   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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