BILL ANALYSIS                                                                                                                                                                                                    �



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          Date of Hearing:   April 24, 2012

              ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER 
                                     PROTECTION
                                 Mary Hayashi, Chair
                     AB 1889 (Fong) - As Amended:  March 29, 2012
           
          SUBJECT  :   Acupuncture: license requirements.

           SUMMARY  :   Requires applicants for an acupuncture license to 
          pass a practical examination administered by the Acupuncture 
          Board (Board) and developed by the Office of Professional 
          Examination Services of the Department of Consumer Affairs 
          (DCA).

           EXISTING LAW  :

          1)Regulates and licenses the practice of acupuncture under the 
            Board. 

          2)Requires the Board to issue a license to practice acupuncture 
            to any person who makes an application, pays certain fees and 
            meets the following requirements:

             a)   Is at least 18 years of age.

             b)   Furnishes satisfactory evidence of completion of one of 
               the following:

               i)     An educational and training program approved by the 
                 Board, as specified.

               ii)    Satisfactory completion of a tutorial program in the 
                 practice of an acupuncturist which is approved by the 
                 Board.

               iii)   In the case of an applicant who has completed 
                 education and training outside the United States and 
                 Canada, documented educational training and clinical 
                 experience which meets specified standards.

             c)   Passes a written examination administered by the Board 
               that tests the applicant's ability, competency, and 
               knowledge in the practice of an acupuncturist.  The written 
               examination  shall be developed by the Office of 








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               Professional Examination Services (OPES) of DCA.

             d)   Is not subject to denial, as specified.

             e)   Completes a clinical internship training program 
               approved by the Board, as specified.

           FISCAL EFFECT  :   Unknown

           COMMENTS  :  

           Purpose of this bill  .  According to the author, "Acupuncture 
          applicants are not required to take a practical examination in 
          order to obtain a license to practice in California.  Without a 
          standard, the Board cannot ensure consumer safety and uniformity 
          within the profession. 

          "Acupuncturists play an important role in offering healthcare.  
          AB 1889 will ensure consumers or patients that the acupuncturist 
          profession has the essential educational and clinical standards 
          to practice acupuncture, because any reduction to the 
          acupuncture examinations would dilute the quality of the 
          profession.  The practical examination will determine if the 
          acupuncturist's competence to diagnose and treat patients is 
          effective.  This will help ensure that licensed acupuncturists 
          have both the ability and quality to practice in California. 

          "This bill will require the Board, within DCA, to include a 
          practical examination along with a current written examination."

           Background  .  In 1999, the practical component of the acupuncture 
          licensing exam was discontinued.  Since that time, the licensing 
          exam has been entirely a written test.

          Acupuncture, like other healing arts, is a uniquely hands-on 
          profession.  The Little Hoover Commission (LHC) addressed this 
          in its 2004 study "Regulation of Acupuncture:  A Complementary 
          Therapy Framework," which found:

          "California's regulator has had difficulties with the 
          acupuncture examination, including documented fraud and criminal 
          charges during the 1980s that spawned security improvements that 
          require continuous refinement.  In debating improvements to the 
          examination, policy-makers also have considered replacing the 
          California test with the examination offered by the National 








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          Certification Commission for Acupuncture and Oriental Medicine.  


          "Most other California health professionals are licensed based 
          on a national examination. However, the acupuncture profession 
          is still relatively new in its evolution within the United 
          States and the profession in California has evolved somewhat 
          differently than it has developed nationally.  Just as different 
          nations take different regulatory approaches to acupuncture, 
          herbs and other modalities of traditional Oriental medicine, so 
          do different states.  As the profession evolves in America, a 
          national examination may become the norm.  

          "However, at this juncture, the independent psychometric 
          analysis of the two examinations determined that while both the 
          California and national examinations are statistically sound and 
          meet all other measures of quality, the California examination 
          was somewhat more robust.  In addition, by controlling its own 
          examination, California can directly control the evolution of 
          policies and priorities.  California has been able to achieve 
          this goal even though the exam is administered by a private firm 
          under contract.  

          "The California examination does need to be refined to ensure 
          that critical knowledge is tested and passed.  Further, when the 
          practical component of the examination was canceled in 1999, 
          regulators lost the means to ensure that candidates possess the 
          physical skills necessary for safe practice.  Finally, ongoing 
          concerns regarding exam security plague all professional 
          examinations, requiring sophisticated and continuous vigilance."

           Support  .  Supporters state, "A practical examination was 
          required under California law until 1999, when it was 
          inexplicably deleted by a budget trailer bill without benefit of 
          notice or policy committee hearing.  Every other healthcare 
          professional is required to have a practical examination.  We 
          believe such a requirement helps protect consumers as well as 
          improve the acupuncture profession."

          Opposition  .  The California State Oriental Medical Association 
          asserts that the need for a clinical skills exam has not been 
          demonstrated, that clinical skills competency is best 
          demonstrated through clinical internships completed as part of 
          an accredited professional training program, and that 
          development of a meaningful, legally-defensible, valid, and 








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          reliable clinical skills exam at a reasonable cost is not 
          possible.

           Previous legislation  .  AB 1116 (Yee) of 2005, requires an 
          individual seeking a license to practice acupuncture to complete 
          a postgraduate residency program, in addition to existing 
          requirements.  This bill was subsequently amended to address a 
          different subject matter.

          AB 1943 (Chu), Chapter 781, Statutes of 2002, increases the 
          entry-level curriculum standards for acupuncturists to a minimum 
          of 3,000 hours of study pertaining to the practice of an 
          acupuncturist.

          SB 1951 (Figueroa) Chapter 714, Statutes of 2002, extends the 
          sunset dates for the Board, requests the LHC to conduct 
          specified comprehensive analyses, requires the Board to conduct 
          two specified studies, and makes other changes to the Board, as 
          specified.

          AB 1105 (Jackson, Dunn, Reyes and Solis), Chapter 67, Statutes 
          of 1999, makes numerous changes in the law concerning DCA, and 
          includes a provision deleting the practical examination 
          requirement for an acupuncture license and replacing it with a 
          written examination.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Council of Acupuncture and Oriental Medicine Associations 
          (sponsor)
          American Traditional Chinese Medicine Society
          Korean Acupuncture and Asian Medicine Association in U.S.A.

           Opposition 
           
          California State Oriental Medical Association
           
          Analysis Prepared by  :    Angela Mapp / B.,P. & C.P. / (916) 
          319-3301 












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