BILL ANALYSIS Ó SENATE COMMITTEE ON BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT Senator Jerry Hill, Chair 2015 - 2016 Regular Bill No: AB 2190 Hearing Date: June 27, 2016 ----------------------------------------------------------------- |Author: |Salas | |----------+------------------------------------------------------| |Version: |June 22, 2016 | ----------------------------------------------------------------- ---------------------------------------------------------------- |Urgency: |No |Fiscal: |Yes | ---------------------------------------------------------------- ----------------------------------------------------------------- |Consultant|Bill Gage | |: | | ----------------------------------------------------------------- Subject: Acupuncture Board: executive officer SUMMARY: Extends the operation of the California Acupuncture Board (CAB) and the CAB's authority to appoint an executive officer until January 1, 2019, and authorizes the CAB to require an applicant who completed education outside of the United States to submit documentation of his or her education to a credential service approved by the CAB to assess the educational equivalency of the applicant, and requires the CAB to establish by regulation an application process, criteria and procedures for the approval of a credential evaluation services. Existing law: 1)Provides under the Acupuncture Licensure Act (Act) for the licensure and regulation of the practice of acupuncture by the CAB within the Department of Consumer Affairs (DCA). (Business and Professions Code (BPC) § 4925 et seq.) 2)Defines "acupuncture" as the stimulation of certain 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 electro-acupuncture, cupping and moxibustion. (BPC § 4927) 3)Establishes the CAB until January 1, 2017, and renders the CAB subject to review by the appropriate policy committees of the AB 2190 (Salas) Page 2 of ? Legislature. (BPC § 4928) 4)Permits the CAB, with the approval of the director of the DCA, to employ personnel and appoint an executive officer until January 1, 2017. (BPC § 4934) 5)Provides that "approved educational and training program, means a program approved by the CAB pursuant to standards adopted by the CAB. This authority is repealed as of January 1, 2017. (BPC § 4927.5 and § 4939) 6)Operative January 1, 2017, provides that an "approved educational and training program" means a school or college offering education and training in the practice of an acupuncturist that meets requirements, as specified, including that it has received approval of its curriculum by the CAB, full institutional approval by the Bureau for Private Postsecondary Education, a governmental educational authority, or has been accredited by the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), granted candidacy by ACAOM, or submitted a letter of intent to become accredited by ACAOM. (BPC § 4927.5) 7)Operative January 1, 2017, provides that that CAB shall establish standards for the approval of educational training and clinical experience received outside the United States. (BPC § 4939) 8) Provides that the CAB shall establish standards for the approval of tutorial programs for education and training in the practice of acupuncture that satisfies requirements, as specified. (BPC § 4940) 9) Provides that the CAB in reviewing applications for licensure based upon the completion of a tutorial program in acupuncture, that the CAB may provide that credit is granted for relevant prior training and experience when that training or experience otherwise meets the standards set by the CAB. (BPC § 4941) 10)Provides that the CAB shall have the authority to investigate and evaluate each and every applicant applying for a license to practice acupuncture and to make the final determination AB 2190 (Salas) Page 3 of ? of the admission of the applicant to the examination, or for the issuance of a license, in conformance with the Act. (BPC § 4944) 11)Provides for a guest acupuncturist from another state or country to engage in the practice of acupuncture in conjunction with lectures, clinics, or demonstrations for a maximum of six months, as specified. (BPC § 4949) This bill: 1) Provides that when education is completed outside the United States, the CAB may require an applicant to submit documentation of his or her education to a credential service approved by the CAB for evaluation and to cause the results of this evaluation to be reported to the CAB in order to assess educational equivalency. 2) Requires the CAB to establish by regulation an application process, criteria and procedures for approval of credential evaluation services accepted by the CAB and that these regulations shall require the credential evaluation service to provide information, furnish evaluations, be reevaluated, perform evaluations, and perform other functions and tasks, as specified. 3) Extends the sunset date of the CAB and the CAB's authority to appoint an executive officer from January 1, 2017 to January 1, 2019. FISCAL EFFECT: This bill is keyed "fiscal" by Legislative Counsel. According to the Assembly Appropriations analysis dated April 20, 2016, there would be costs of approximately $3.5 million per year, for calendar years 2017 and 2018, to continue the operation of the CAB beyond the current January 1, 2017 sunset date. COMMENTS: AB 2190 (Salas) Page 4 of ? 1. Purpose. This measure is sponsored by the Author. According to the Author, unless legislation is carried this year to extend the sunset date for the CAB, it will be repealed on January 1, 2017. The legislative changes reflected in this bill are solutions to issues raised about the CAB in the Assembly Committee on Business and Professions' staff Background Paper and during its subsequent sunset review hearing held on March 14, 2016. In addition, this bill will extend the CAB's authority to appoint an executive officer. 2. Background on CAB. The CAB regulates the practice of acupuncture and Asian medicine in California. According to the CAB's most recent sunset review report, it regulates 17,801 acupuncturists, 11,644 of which are actively practicing in the state. The practice of acupuncture involves the stimulation of certain 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. A licensed acupuncturist while engaged in the practice of acupuncture is permitted to perform or prescribe the use of Asian massage, acupressure, breathing techniques, exercise, heat, cold, magnets, nutrition, diet, herbs, plant, animal and mineral products, and dietary supplements to promote, maintain and restore health. The primary responsibility of the CAB is to protect California consumers from incompetent, and/or fraudulent practice through the enforcement of the Acupuncture Licensure Act and the CAB's regulations. The CAB implements regulatory programs and performs a variety of functions to protect consumers. These activities include setting licensure requirements for acupuncturists, developing and administering the licensure exam, issuing and renewing licenses, overseeing the investigation of complaints against licensees or allegations of unlicensed activity, overseeing the continuing education (CE) program and monitoring probationer acupuncturists. 3. Sunset Review Oversight Hearings. In March of 2016, the Senate Business and Professions Committee and the Assembly Business and Professions Committee (Committees) conducted AB 2190 (Salas) Page 5 of ? several joint oversight hearings to review 12 regulatory entities, including the CAB. This bill is intended to implement legislative changes as recommended by the Committees' staff Background Papers prepared for each entity reviewed. 4. Foreign Applicants Credential Evaluation Services. Currently, the CAB has no authority to approve schools outside the United States or provide credit for equivalency. When the provisions of SB 1246 (Lieu, Chapter 397, Statutes of 2014) take effect, the CAB will be required to establish standards for outside education approval. While the CAB will start using the ACAOM to accredit training programs when the requirement goes into effect, the ACAOM does not approve schools outside of the United States. This amendment will ensure the CAB has the specific authority to utilize educational credential evaluation services to provide a way for applicants who obtained education from outside the U.S. to obtain equivalent credits. 5. Clarifying Amendment Regarding CAB Approved Curriculum. SB 1246 requires, among other things, the CAB to start relying on ACOAM; the national accrediting agency for accrediting acupuncture schools. While all approved schools will continue to maintain the same standards, this bill will clarify that, so long as the school has not changed its curriculum or had its approval revoked, the school will not need to reapply for approval. 6. Continued Regulation of Acupuncturists by the CAB. The health, safety, and welfare of consumers is protected by a well-regulated acupuncture profession. While the CAB has had issues in the past, the current CAB is newly formed and has stated a strong commitment to protecting the public, ameliorating past deficiencies, and improving efficiency in its operations. Staff of the Committees has observed improvements in the CAB's operations since its last sunset review in 2014 and notes that the CAB has taken significant steps in improving its overall administration and performances. The CAB has responded to the request to promulgate consumer protection regulations, has improved in processing time for applications, has made strides to improve CE oversight, and has made changes to staff and management. Therefore, this bill will extend the CAB's sunset date to AB 2190 (Salas) Page 6 of ? January 1, 2019. 7. Prior Related Legislation. SB 1246 (Lieu, Chapter 397, Statues of 2014, among other things, extended the CAB and the CAB's authority to appoint an executive officer until January 1, 2017, and revises acupuncture program approval requirements. 8. Arguments in Support. The CAB is in support of this measure and indicates that they are pleased to support the Board's sunset bill and look forward to working with the Legislature as the bill advances. SUPPORT AND OPPOSITION: Support: California Acupuncture Board Opposition: None on file as of June 21, 2016. -- END --