BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                   SB 628|
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                                 THIRD READING


          Bill No:  SB 628
          Author:   Yee (D)
          Amended:  5/31/11
          Vote:     21

           
           SENATE BUS., PROF. & ECON. DEVEL. COMMITTEE  :  5-2, 5/2/11
          AYES:  Price, Corbett, Correa, Negrete McLeod, Vargas
          NOES:  Emmerson, Walters
          NO VOTE RECORDED:  Hernandez, Wyland

           SENATE APPROPRIATIONS COMMITTEE  :  6-3, 5/23/11
          AYES:  Kehoe, Alquist, Lieu, Pavley, Price, Steinberg
          NOES:  Walters, Emmerson, Runner


           SUBJECT  :    Acupuncture:  traditional Chinese Medicine 
          traumatologist

           SOURCE  :     Author


           DIGEST  :    This bill requires, commencing May 1, 2012, the 
          California Acupuncture Board (Board) to issue a certificate 
          to practice as a traditional Chinese Medicine 
          traumatologist to an applicant who meets certain training 
          and clinical experience requirements.  Requires the Board 
          establish the Traumatology Committee, as specified, to 
          advise the Board about the certification and renewal 
          processes for traditional Chinese Medicine traumatologist.

           ANALYSIS  :    

                                                           CONTINUED





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           Existing law  :

          1. Establishes the California Acupuncture Board (Board) 
             within the 
             Department of Consumer Affairs (DCA), which licenses and 
             regulates the acupuncture profession pursuant to the 
             Acupuncture Licensure Act. 

          2. Defines an acupuncturist as an individual who has been 
             licensed to practice acupuncture pursuant to the 
             Acupuncture Licensure Act.  Defines acupuncture as the 
             stimulation of a certain point  or 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 electroacupuncture, 
             cupping, and moxibustion. 

          3. States that the Board shall issue a license to practice 
             acupuncture to any person who applies and meets 
             specified requirements:

          This bill: 

          1. Requires the Board, on or before March 1, 2012, to 
             establish a Traumatology Committee (Committee) within 
             the Board to consist of six members composed of two 
             representatives each from the clinical settings of 
             traumatology, and the California Orthopaedic 
             Association, and one representative each from the 
             Medical Board of California, and the California Medical 
             Association.

          2. Requires the Committee meet and confer to determine 
             certification standards, including the level of 
             experience and training needed for an individual to 
             qualify for traditional Chinese Medicine traumatology 
             certification.  Requires the Committee to advise the 
             Board in developing the application form for the 
             certification.  

          3. Requires the Board, commencing May 1, 2012 until 
             December 15, 2012, to issue a certificate for Chinese 







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             Medicine traumatology to any person who makes an 
             application and meets all of the following requirements, 
             as determined by the Committee:

             A.    Is at least 18 years of age.

             B.    Furnishes satisfactory evidence of training and 
                clinical experience that meets the standards 
                established by the Committee and confirmed by the 
                Board.

             C.    Is not subject to denial, as specified. 

          4. Requires the Committee evaluate whether an applicant 
             meets the certification standards, including the level 
             of experience and training to sufficiently qualify for 
             the traumatology certification.

          5. Requires an applicant for traumatology certification, 
             commencing January 1, 2012, to apply for a certificate 
             for traumatology until December 15, 2012.  Prohibits the 
             Board, on and after December 15, 2012, from issuing an 
             initial certificate to any applicant.  Specifies that on 
             and after December 15, 2012, the Board may issue only a 
             renewal of a certificate.  State that an individual who 
             is not qualified to receive a certificate or who fails 
             to apply for certification by December 15, 2012, shall 
             not hold himself/herself out as a certified 
             traumatologist.

          6. Requires certified traditional Chinese Medicine 
             traumatologist, when engaging in manipulation techniques 
             to realign the musculoskeletal and ligamentous 
             relationship, be supervised by a physician and surgeon 
             who has completed an orthopaedic residency program.  The 
             extent of the relationship between a traditional Chinese 
             Medicine traumatologist and orthopedic surgeon regarding 
             those manipulation techniques shall be determined by the 
             Committee after the qualifications necessary for 
             certification are defined by the Committee and adopted 
             by the Board.

          7. Requires an applicant for certification as a 
             traumatologist to pay an application fee of $200 when 







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             submitting his or her application to the Board.

          8. Requires that the certificate must be renewed every five 
             years, and that an expired certificate may be renewed at 
             any time within the three years after its expiration. 

          9. Specifies fees for the following: annual renewal ($100), 
             delinquency ($25), duplicate or replacement wall 
             certificates ($15), and duplicate or replacement renewal 
             receipt ($10).

          10.States that moneys received pursuant to certification 
             shall be deposited in the Acupuncture Fund.

          11.Provides that it is an unfair business practice for any 
             person to hold himself or herself out as a certified 
             traditional Chinese Medicine traumatologist or use the 
             title "certified traditional Chinese Medicine 
             traumatologist" without meeting the requirements of this 
             bill. 

          12.Applies existing law provisions that currently relates 
             to licensed acupuncturists to certified traditional 
             Chinese Medicine.

          13.Provides that a person who holds a certificate to 
             practice traditional Chinese Medicine traumatology is 
             subject to existing disciplinary provisions contained in 
             the Acupuncture Licensure Act.

          14.Applies relevant provisions of the Acupuncture Licensure 
             Act to certified traditional Chinese Medicine   Makes 
             other technical, clarifying and conforming changes.

           Background
           
          According to the National Institutes of Health's (NIH) 
          National Center for Complementary and Alternative Medicine 
          (Center)," traditional Chinese Medicine (TCM) originated in 
          ancient China and has evolved over thousands of years.  TCM 
          practitioners use herbs, and other methods to treat a wide 
          range of conditions.  In the United States, TCM is 
          considered part of complementary and alternative medicine.  
          Herbal remedies and acupuncture are the treatments most 







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          commonly used by TCM practitioners.  Other TCM practices 
          include cupping, mind-body therapy and dietary therapy.  
          Although TCM is used by the American public, scientific 
          evidence of its effectiveness is, for the most part, 
          limited.  Acupuncture has the largest body of evidence and 
          is considered safe if practiced correctly."  In 1996, the 
          United States Food and Drug Administration approved 
          acupuncture needles for use by licensed practitioners.  The 
          FDA requirements stipulate that the needles must be 
          sterile, nontoxic, and labeled for single use by qualified 
          practitioners only.  In the past two decades, acupuncture's 
          popularity has grown in the United States.  According to 
          the 2002 National Health Interview Survey, the largest and 
          most comprehensive survey of complementary and alternative 
          medicine, an estimated 8.2 million adults have used 
          acupuncture. 

          According to the Board, there are currently 10,271 licensed 
          acupuncturists and 19 approved acupuncture schools in 
          California.  The Acupuncture Licensure Act defines 
          acupuncture as the stimulation of a certain point or 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 electroacupuncture, 
          cupping, and moxibustion.  The Act provides that an 
          acupuncturist's license authorizes the holder to engage in 
          the practice of acupuncture and 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 
          Act further provides an applicant for acupuncture licensure 
          to furnish evidence of completion of an educational and 
          training program approved by the Board or a tutorial 
          program in the practice of acupuncture that is approved by 
          the Board.  Students entering programs on or after January 
          1, 2005 are required to fulfill a minimum of 3,000 hours of 
          study pertaining to the practice of acupuncture.  
          Additionally, an applicant must pass a written examination 
          administered by the Board, and complete a clinical 
          internship training program, as specified.








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           Comments  

          According to the author's office, this bill provides a way 
          for traumatologists to become certified.  Traumatology is 
          one of the modalities that constitute TCM.  Before China 
          systemized their health care system, individuals acquired 
          their mastery of traumatology through a master-apprentice 
          relationship.  These practitioners learned from a master 
          through hands-on training.  Although highly skilled, it is 
          extremely difficult for these practitioners to obtain proof 
          of their training to qualify for the existing requirements 
          for licensure.

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

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

           Major Provisions                2011-12     2012-13    
           2013-14   Fund  

          Certification process
          -administration               Up to $120     Minor, 
          absorbable          Special*
                              costs ongoing

          -fee revenue             ($20)          ($10)          
          ($10)               Special*

          *Acupuncture Fund

          JJA:do  5/31/11   Senate Floor Analyses 

                       SUPPORT/OPPOSITION:  NONE RECEIVED

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