BILL ANALYSIS                                                                                                                                                                                                    



          SENATE COMMITTEE ON
          BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
                              Senator Jerry Hill, Chair
                                2015 - 2016  Regular 

          Bill No:            AB 2190         Hearing Date:    June 27,  
          2016
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          |Author:   |Salas                                                 |
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          |Version:  |June 22, 2016                                         |
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          |Urgency:  |No                     |Fiscal:    |Yes              |
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          |Consultant|Bill Gage                                             |
          |:         |                                                      |
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                   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  







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             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  








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             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:








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          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  








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             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  








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             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.


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