BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | SB 1246| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- 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 CONTINUED SB 1246 Page 2 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. CONTINUED SB 1246 Page 3 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 CONTINUED SB 1246 Page 4 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 CONTINUED SB 1246 Page 5 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 CONTINUED SB 1246 Page 6 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 CONTINUED SB 1246 Page 7 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 **** END **** CONTINUED