BILL ANALYSIS �
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|Hearing Date:April 23, 2012 |Bill No:SB |
| |1239 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Curren D. Price, Jr., Chair
Bill No: SB 1239Author:Price
As Amended:April 16, 2012 Fiscal:Yes
SUBJECT: Acupuncture.
SUMMARY: Extends to January 1, 2015 (two years only), the provisions
establishing the Acupuncture Board and extends the term of the
executive officer to January 1, 2015. Makes clarifying change to the
Board's authority to promulgate regulations regarding standards for
the approval of schools, training and educational programs; makes
other technical changes.
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. (Business and Profession Code (BPC) � 4925)
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. (BPC �
4927)
3)Provides that protection of the public shall be the highest priority
for the Board in exercising its licensing, regulatory, and
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disciplinary functions, and whenever the protection of the public is
inconsistent with other interests sought to be promoted, the
protection of the public shall be paramount. (BPC � 4928.1)
4)States that a licensed acupuncturist is authorized to do the
following: (BPC � 4937)
a) To engage in the practice of acupuncture.
b) 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. Nothing in
this section prohibits any person who does not possess an
acupuncturist's license or another license as a healing arts
practitioner from performing, or prescribing the use of any of
these modalities, as specified.
5)States that the Board shall issue a license to practice acupuncture
to any person who applies and meets the following requirements:
(BPC � 4938)
a) Is at least 18 years of age.
b) Furnishes satisfactory evidence of completion of one of the
following: 1) an education and training program, as specified; 2)
satisfactory completion of a tutorial program in the practice of
an acupuncturist which is approved by the Board; or 3) In the
case of an applicant who has completed education and training
outside the United States and Canada, documented education
training and clinical experience, as specified.
c) Passage of a written examination administered by the Board, as
specified.
d) Completion of a clinical internship training program approved
by the Board.
This bill:
1)Extends until January 1, 2015, the provisions establishing the Board.
2)Extends until January 1, 2015, the term of the executive officer of
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the Board.
3)Makes clarifying change to the Board's authority to promulgate
regulations regarding standards for the approval of schools,
training and educational programs.
4)Makes other technical changes.
FISCAL EFFECT: Unknown. This bill has been keyed "fiscal" by
Legislative Counsel.
COMMENTS:
1.Purpose. This bill is Sponsored by the Author . According to the
Author, in 2012, this Committee conducted oversight hearings to
review 7 regulatory boards within the DCA: the Acupuncture Board,
the Board of Podiatric Medicine, the Physician Assistant Committee,
the Board of Pharmacy, the Court Reporters Board, the Board of
Behavioral Sciences and the Board of Psychology. The Committee
began its review of these licensing agencies in March and conducted
two days of hearings. This bill, and the accompanying sunset bills,
is intended to implement legislative changes as recommended in the
Committee's Background Issue Papers for the agencies reviewed by the
Committee this year.
This bill is one of four "sunset bills" authored by the Chair of this
Committee. According to the Author, this bill is necessary to
extend the sunset date of the Board in order to continue the
regulation of acupuncturists in California. The continued
regulation will help to ensure that the Board's mission of
protecting the public is in place for an additional two years.
2.Background. The Board regulates the practice of acupuncture and
Asian medicine in the State of California. The Board establishes
and maintains entry standards of qualification, primarily through
its authority to license. The primary responsibility of the Board
is to protect California consumers from incompetent, and/or
fraudulent practice through the enforcement of the Acupuncture
Licensure Act and the Board's regulations. The Board 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
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exam, issuing and renewing licenses, overseeing the investigation
of complaints against licensees or allegations of unlicensed
activity, overseeing the continuing education program, and
monitoring probationer acupuncturists.
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, including pain control, for the treatment
of certain diseases or dysfunctions of the body and includes the
techniques of electroacupuncture, cupping and moxibustion. An
acupuncturist is also allowed 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. However, unlike the practice of acupuncture itself, these
treatments and modalities are not restricted just to the
acupuncture profession.
There are approximately 10,000 active licensees in California. The
Board has an annual operating budget of approximately $1.5 million.
The Board is a special fund agency, and its funding comes from the
licensing of acupuncturists and biennial renewal fees of
acupuncturists, as well as acupuncture schools and continuing
education (CE) providers. Currently, the license and renewal fee
for acupuncturists is $325. The Board also receives revenue
through its cite and fine program. The average revenue from fines
over the past three fiscal years (2008/09 through 2010/11) is
$87,000.
The Board's anticipated expenditures for FY 2010/2011 are $1.9
million. The Board is scheduled to loan the General Fund $5
million in Fiscal Year 2011/12. That loan is scheduled to be
repaid with interest in FY 2013/14. However, the reserve funds
will be reduced to 2.1 months before the loan is scheduled for
repayment. The Board spends approximately 40% of its budget on its
enforcement program, with the major portion of these expenditures
going to OE&E.
The Board is authorized 9 staff positions, three of which were vacant
when the Board submitted its sunset review report in November 1,
2011. Due to the hiring freeze at that time, the Board had not
filled these positions. The Board stated that "the vacancies have
had a negative impact on the Board's ability to handle our
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workload;" however, there was no evidence provided by the Board to
support this statement.
3.Prior Review of the Board. The Board was last reviewed by the
former Joint Committee on Boards, Commissions and Consumer
Protection (JCBCCP, formerly the JLSRC) in 2005. At that time, the
JCBCCP identified 10 issues for discussion. On November 1, 2011,
the Board submitted its required Sunset Report to this Committee.
In this report the Board described actions it has taken since its
last sunset review. Below are the Board's responses to the issues
raised during the last sunset review.
The Board was fully reconstituted effective January 1, 2006.
SB 248 (Chapter 659, Statutes of 2005) repealed the nine-member
Board on January 1, 2006, creating a new Board of seven members
with a revised membership.
Scope of practice has continued to be an issue for the Board.
The Board formed a "Blue Ribbon Panel" in November 2010 to look
into primary care definition, scope of practice and related
educational requirements. According to the Board's Sunset
Report, the panel was unable to hold its first meeting in
November 2011, due to staffing limitations. That meeting has
not been held.
In 2005, the Board enacted emergency regulations requiring
acupuncturists to use needles labeled for single use only and
made it unprofessional conduct for an acupuncturist to use a
needle more than once. This regulation benefits consumers by
helping to protect them from life-threatening conditions such as
HIV, hepatitis, and antibiotic resistant bacteria.
In 2005, legislation was introduced to define the term
"acupuncture assistant," which was administrative in nature and
prohibited the assistants from performing acupuncture. This
bill was vetoed by the Governor stating the bill was
unnecessary. The Board has found over the last three years that
the use of unlicensed acupuncture assistants is not a current
issue. They report that they had only one enforcement issue
involving an unlicensed acupuncture assistant in the last three
years. The majority of unlicensed cases involve individuals
whose licenses are delinquent.
Physicians and surgeons, podiatrists and dentists are
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specifically exempt from the licensure requirements of an
acupuncturist as long as they are licensed. The Board is not
aware of any complaints against these professions for practicing
acupuncture. However, any complaints regarding their practice
would have been directed to the appropriate regulatory body.
SB 248 changed the quorum requirement from a majority of the
members to five members. This did affect the ability of the
Board to conduct business. Subsequently SB 821 (Chapter 307,
Statutes of 2009) changed the quorum requirement to four members
of the Board which shall include at least one acupuncturist.
The Board has been randomly auditing 10 licensees a month.
The results have shown that 93% of licensees are in compliance
with the continuing education requirements. The Board states
that it wishes to increase those audits. Unfortunately, with
furloughs and vacancies the Board has not been able to deal with
that additional workload.
In 2009, the Board sponsored legislation to require
acupuncture training programs be located in a school which has
been approved by an accrediting agency of acupuncture and Asian
medicine program that is recognized by the U.S. Department of
Education. This legislation was opposed by one of the
acupuncture associations. Subsequently, the bill was amended
deleting everything to do with the Acupuncture Board.
The Board is still of the belief that the California
Acupuncture Licensing Examination (CALE) should remain the
state's licensing examination. The CALE is developed by the
Department of Consumer Affairs Office of Professional
Examination Services according to the Standards for Educational
and Psychological Testing (Standards) published by the American
Educational Research Association, the American Psychological
Association, and the National Council on Measurement in
Education. The Standards are the criteria used by the
psychometric and legal professions to judge whether an
examination is legally defensible and psychometrically sound.
The Office of Professional Examination Services has proven to be
a very reliable and professional partner in the development of
the licensing examination. Consistent with the Board's policy
to ensure a psychometrically sound and valid licensing
examination, the Board indicated that it has and will continue
to review and evaluate testing alternatives.
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1.Current Issues and Problems Identified. The following are some of
the major unresolved issues pertaining to the Board, or areas of
concern presented to the Committee for consideration, along with
background information concerning the particular issue.
Recommendations were made by Committee staff regarding the
particular issues or problem areas which needed to be addressed.
a) Issue : Board Lacking in its Overall Operation.
Background : When the Board was last reviewed in 2005, the JCBCCP
found that "while the vast majority of the Board's licensees are
competent, responsible professionals and provided a valuable and
valued service, the Board itself may not be serving the public
and those licensees well."
Because of problems also identified by the former JLSRC in a 2002
sunset review of this Board, the Little Hoover Commission (LHC)
was charged by statute (BPC � 4934.1) to assess longstanding and
contentious issues regarding the State's regulation of the
acupuncture profession including a review of the scope of
practice and educational requirements for acupuncturists, the
process for accrediting acupuncture schools and for examining
licensees. The LHC released its report in 2004, and identified
the core problem with the Board this way:
"Many of the specific issues that the Governor and the
Legislature asked the Commission to review have festered
because the Acupuncture Board has often acted as a venue for
promoting the profession rather than regulating the
profession." (Little Hoover Commission, Regulation of
Acupuncture: A Complementary Therapy Framework: September
2004, page 63 - emphasis added)
Some of these problems continue to persist with this Board
and it appears to struggle with decision making and lacks
follow through. For example:
A "Blue Ribbon Panel" was established in November of 2010
in order to look into important issues regarding a primary care
definition, scope of practice and related educational
requirements. The Panel has not met and there is a question of
the mandate given to this Panel for consideration.
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The Board approved six different regulation changes
(transfer credits for out of state students, independent study,
additional practice locations, clinical training, repeal of
non-English exam, and disciplinary guidelines). None of these
were mentioned in the Board's sunset report even though they
are supposed to be included. Additionally, it appears no
further action was taken on these regulations after the Board's
vote to move forward with the regulations.
In 2009, the Board decided to make important changes to
the law regarding school approvals but ended up deferring to a
national acupuncture association and hasn't moved forward with
dealing with problems surrounding school approvals.
Additional problems with this Board include its scheduled
meetings. The written meeting materials are, at times,
insufficient to foster meaningful discussion or decision making
by the Board members, or open discussion with the public and
participants at the meetings, and they are not always available
in a timely manner.
There is also a problem in the way in which the Board utilizes
its standing committees. It is unclear if or when these
committees meet. Additionally, it appears committee meetings
are not typically held in public, as only six have been publicly
noticed between February 2006 and February 2012. Because the
meetings are not held in public, it is unclear how the
committees conduct their business or how often they meet.
Additionally, the public is not permitted to observe or join in
the policy discussions.
Another problem regards the Board's compliance or adherence to
its Strategic Plan. The Board's Strategic Plan was adopted in
2007. It lays out its mission, vision, principles, goals and
objectives. According to the strategic plan, the mission of the
Board is to "benefit, educate, and protect the public through
regulation of licensure, development of education standards,
provision of consumer information, and enforcement of the
Acupuncture Licensure Act." The Board's seven key goals outlined
in the plan are:
i. Advance higher education standards.
ii. Review, clarify and disseminate the scope of
practice.
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iii. Promote ethical conduct of licensees and
students.
iv. Reduce or eliminate unlicensed activity.
v. Clarify the process of school approval.
vi. Re-evaluate and improve continuing education
standards.
vii. Improve communication with industry and
consumers.
It is unclear which of the goals have been met and which remain
unresolved. It is also unclear what actions have been taken in
an effort to meet the strategic goals that were adopted in 2007.
For example, how has the Board advanced higher education
standards? The objectives were to clarify issues regarding the
title of doctor and upgrade MAc level practitioner standards.
How have these objectives been accomplished?
Most of the other issues of concern raised by the Committee are
the same as those that this Committee and the former sunset
review committees have struggled with for almost 14 years.
Taken individually, these may not be particularly significant
issues, but on the whole, they appear to indicate a general lack
of accountability and follow through on the part of the Board
and whether there is a willingness on the part of the Board to
take direction and implement recommendations of the Legislature.
Recommendation : Staff of the Committee recommended that the
Board should explain the purpose of the "Blue Ribbon Panel" and
what the Board intends to accomplish by convening the Panel. The
Board should also submit to the Committee a corrective action
plan to implement the following operational management tools:
i. The Board should establish tracking mechanism for
approved regulatory changes and other instructions given to
staff.
ii. The Board should use its committees in a more open
and productive manner. The Board should explain why it has
a history of cancelling meetings.
iii. The Board should explain to the Committee whether it
believes it is meeting the goals and objectives of its
Strategic Plan of 2007.
iv. The Board should update its strategic plan and
develop and publish a detailed action plan with specific
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action items and realistic target dates for how each of the
objectives will be met.
v. The Board should be given a written status report on
the action plan at each Board meeting.
vi. Board meetings should be webcast, when feasible.
vii. Board meeting materials should provide sufficient
information to permit Board members to make informed
decisions and the public ability to understand the issues
discussed.
Because of the deficiencies and related problems with this Board
it was recommended that this Board's sunset not be extended
beyond two years and be reviewed once again to assure that
corrective action has been taken by this Board.
a) Issue . Board Overly Involved in Scope of Practice Issues.
Background : Over the years this Board has struggled with scope of
practice issues regarding the practice of acupuncture. Because
of the constant interpretations or misinterpretations of scope of
practice by the Board, the former JLSRC requested the LHC to
examine this issue. The primary issue for the Board at that time
was whether an acupuncturist should be considered as a "primary
health care provider" and, therefore, its scope of practice
should be broadened. Both the LHC and Legislative Counsel did
not believe that the law creating the Acupuncture Act intended
for an acupuncturist to be the primary care professional
responsible for coordinating (or being the "gatekeeper") for the
ultimate care of a patient. As the LHC indicated:
"While some people may turn to acupuncturists first for
everything that ails them ? it is difficult to see how
practitioners of an alternative healing paradigm can be
responsible for coordinating care with biomedical specialists
(another potential meaning)." (Little Hoover Commission,
Regulation of Acupuncture: A Complementary Therapy Framework,
page 25)
Legislative Counsel observed that the intent language in the
Acupuncture Act could "have any number of meanings," but none is
sufficiently clear to warrant overriding or expanding the scope
of practice as it is established by the operative provisions of
the BPC � 4937. Counsel asserts that an acupuncturist is not
authorized to "engage in a broader scope of practice than is
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authorized by Section 4937 of the Business and Professions Code."
There are many definitions of "primary care provider," some of
which were delineated in the LHC report in 2004. The LHC and
prior sunset reports have thoroughly documented the discussion
and evidence about primary care providers and its legislative
history. In general, all agree that being a primary care
provider allows acupuncturists to be first point of contact for
patients. A patient does not need prior diagnosis or referral
from a licensed physician in order to seek treatment from an
acupuncturist.
However, some in the acupuncture community are still trying to
push the definition to enhance the scope of practice toward
western evidence based medicine and away from traditional Chinese
medicine (TCM). Those efforts cloud almost every aspect of the
Board's policy discussions. We note that, according to the
LHC's report, "some of those advocating for greater Western
training are seeking the title of 'doctor' and access to
insurance reimbursements making it difficult to sort out economic
aspirations from medical issues." (Little Hoover Commission,
Regulation of Acupuncture: A Complementary Therapy Framework,
page 21)
In 2005, an attempt to further define the scope of acupuncture
was introduced in Assembly Bill 1113 (Yee). This bill proposed
to authorize acupuncturists to diagnose within his or her scope
of practice. The bill was vetoed by the Governor stating the
term scope of practice is vague and leaves room for
interpretation. The veto message went on to say the Governor
would consider signing a bill that authorizes an acupuncturist to
diagnose specifically for the purpose of providing acupuncture
treatment. However, the Board uses the proposed language in
their sunset report, "An acupuncturist may diagnose within their
scope of practice and treat illnesses and injuries, in addition
to prescribing herbs and herbal formulas, perform Oriental
massage, electroacupuncture and moxibustion."
Recommendation : As stated by Committee staff, it appears after
many years of this ongoing dispute and continued efforts of the
Board to somehow resolve this issue and now with the creation of
a "Blue Ribbon Panel" to revisit this issue, it is time for the
Board to relinquish its involvement in trying to clarify scope of
practice for acupuncturists. It was recommended by Committee
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staff that any scope of practice changes should be referred to
the Legislature and certainly should not be attempted pursuant to
regulations since there appears to be no authority for the Board
to broaden scope of practice. It is only the prerogative of the
Legislature to make such changes regarding scope of practice in
statute.
b) Issue : Additional Improvements Needed to Board's Oversight of
Acupuncture Schools.
Background : BPC Section 4939, subsection (a) requires the Board,
on or before January 1, 2004, to "establish standards for the
approval of schools and colleges offering education and training
the practice of an acupuncturist, including standards for the
faculty in those schools and colleges and tutorial programs."
Section 4939 subsection (b) states that the training program
shall include a minimum of 3,000 hours of study.
There are approximately 60 acupuncture schools throughout the
U.S., 36 of which are approved by the Board. Twenty of the
California-approved schools are located in California and 16 in
other states.
The Board approves the schools and their curriculum programs to
ensure they meet the standards adopted by the Board. The school
approval process requires review of the application, governance,
program curriculum, catalogs, admission policies, student and
faculty policies and procedures, and financial solvency. An
onsite visit is performed to review implementation of policies
and procedures, facilities and clinical training. According to
the Board's Sunset Report, the Board and Bureau of Private
Postsecondary Education (BPPE) "may perform a joint onsite visit,
if the education institution has applied to both entities for
approval."
However, the prior Bureau of Private Postsecondary and Vocational
Education (BPPVE) was sunsetted in 2007, and reconstituted as the
BPPE in 2010. During the time the Bureau was not in operation,
schools were permitted to operate without the oversight
previously provided by the Bureau. The reconstituted Bureau is
in the process of implementing its new oversight responsibilities
and has published plans for review and approval of schools
subject to its jurisdiction. The impact of the sunset and
reconstitution of the Bureau on oversight of acupuncture schools
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is as yet unclear.
The Accreditation Commission of Acupuncture and Oriental Medicine
(ACAOM) is the nationally recognized accrediting agency for the
field of acupuncture and oriental (Asian) medicine. While many
other states defer to ACAOM accreditation as being a sufficient
condition for applicants to take the licensing exam in their
states, California does not accept accreditation by ACAOM, nor
does it require graduation from an accredited school as condition
of being eligible to take the licensing exam. Instead, it
conducts its own school evaluation and approvals.
In 2004, the LHC conducted a comprehensive comparative analysis
of the school approval process of the ACAOM, the approval process
of the BPPVE, and the Board approval process. The LHC's report
concluded that the processes used by ACAOM appeared to be
superior to the school approval process used by the Board and
could be used by the state to ensure the quality of education for
potential licensees.
In 2009, the Board sponsored legislation (AB 1260, Huffman) that
would have required accreditation by a national accrediting
agency recognized by the United States Department of Education
(such as ACAOM) and would have eliminated the tutorial program as
an avenue to licensure. According to the Board, the bill was
opposed by one of the acupuncture associations and eventually it
was amended to remove all reference to acupuncture.
Because California performs its own school approvals, there are a
number of consequences and problems. These include:
Students who are educated in accredited schools that are
not approved by California receive only partial credit for
their training. If they wish to gain licensure in California,
they must complete a Board approved training program.
Applications for Board approval from schools located
outside of California are not being processed due to budget
constraints. The Board has not been able to process at least
one out of state school application for four years.
The Board is not conducting ongoing site reviews after a
school is approved. According to the Board, "In 2010, the
Board began scheduling and conducting annual onsite review of
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approved schools; however, because of staff vacancies and
travel restrictions, this has temporarily been postponed."
Another indication of the Board's lack of appropriate school
oversight and the possible need to utilize ACAOM for school
approvals is the following:
At the February 2009 Board meeting, the Board voted to
approve a school despite a number of findings that included
instructors did not meet minimum criteria, subject matter was
missing, the curriculum and some classes were defined as
electives which should have been mandatory, there was evidence
that students were permitted to do needling, which is not
allowed. Despite the evidence, the school was approved. Staff
was instructed to conduct an unannounced site visit within a
year. It is unclear if the site visit has occurred.
At the September 2009 Board meeting, an application for
approval from a school in Hawaii was discussed. Board staff
was unable to conduct an onsite visit, due to travel
restrictions, so the application was not approved. During the
discussion, it was revealed that another out of state school
may have been approved without benefit of an onsite visit. As
of February 2011, the Board had still not obtained approval to
conduct the onsite evaluations and the applications are still
pending.
At the Board meeting on February 24, 2011, there was an
agenda item regarding a problem with teachouts at a school that
had gone out of business. The Board became involved in
negotiating between the new owners of the school and some of
the students. The Board's authority to perform this function
is unclear since the BPPE is generally responsible for dealing
with issues surrounding school closures.
The National Guild of Acupuncture and Oriental Medicine (NGAOM)
has argued that the low pass rates are a direct result of poor
training in Board approved schools. NGAOM has also argued that
the Board has refused to take action on low employment rates and
low salaries earned by acupuncture school graduates. This is
not, however, the responsibility of the Board. It is related
more to the student protection provisions of the BPPE, and there
may be a cause of action against the school for any
misrepresentations it makes to students or for the failures of
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the school.
Recommendations : Committee staff recommended that, for now, the
Board should continue its overall responsibility to approve
acupuncture schools and their educational programs, however, the
Board should enter into a Memorandum of Understanding (MOU) with
the BPPE to assure there is no duplication of site visits, or in
the role that each agency has in both the approval and oversight
of these schools. It should also be required that these
acupuncture schools either have currently, or obtain within a
reasonable time, accreditation from an accrediting agency
recognized by the United States Department of Education.
Especially since the accrediting process for these schools
appears to be superior to that of the Board. At some time in the
future, consideration could be given, based on the success of
accreditation of these schools, to eliminating the Board's
responsibility and need for approving acupuncture educational
programs.
1.Responses Regarding Issues Raised by the Committee. The Board
responded to the issues raised by Committee staff on April 11, 2012.
In terms of the Board lacking in its overall operation, the Board
argued that it held up on regulatory changes because of the need for
changes in legislation or that they are currently proceeding with
regulatory changes that were considered as important by this
Committee. They agree that the "Blue Ribbon Panel" has not met but
that issues have been delegated to the Education Committee of the
Board. They indicated that they do hold committee meetings in a
public setting. Also, the legislation to require accreditation of
acupuncture schools was opposed and they dropped the bill. The
Board believes that it is meeting or has attempted to meet the
majority of its goal and objective, but because of past problems
with developing an adequate Strategic Plan they are moving forward
with a 2012 Strategic Planning Session. The Board finally believes
that the information they provide for their meeting is sufficient
and in the future they will try to assure the materials are
available more than just a day before their meetings.
In terms of the Board being overly involved in scope of practice
issues, the Board agrees with the Committee staff recommendations
and that all scope of practice changes will be referred to the
Legislature. In terms of the Board's oversight of schools, the
Board is in agreement that they will work more closely with BPPE and
that legislation should be pursued to require acupuncture schools to
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obtain approval from an accrediting agency recognized by the U.S.
Department of Education.
The National Guild of Acupuncture and Oriental Medicine (NGAOM)
believes that although the Board was created with the best of
intentions, it has in its short history been unable to address the
most basic and essential issues under it purview. "This failure has
led to serious problems in education, workforce opportunities, scope
of practice concerns and licensing examination pass rates. All of
this affects the public since most licensees have not be adequately
prepared to practice within their scope or to practice within the
medical mainstream. Both outcomes are called for in statute and
under the Board Mission and Vision."
As further stated by NGAOM, the California acupuncture profession and
educational system under the Board is a study in dismal outcomes
from failed leadership and policymaking. NGAOM has documented how
the Board has failed in its regulatory role by permitting the
proliferation and continued operation of marginal schools and
ignoring legislative intent to prepare licensees to find work
opportunities in conventional medicine along with traditional solo
private practices. "We believe the �Board] is a substandard
regulatory Board within the Department of Consumer Affairs and has
been for years."
In terms of issues identified by Committee staff, NGAOM agreed with
Committee staff recommendations that the Board relinquish its
involvement in trying to alter the scope of practice for
acupuncture. NGAOM also agreed that the Board does a poor job of
reviewing and approving schools, but that they are concerned about
possibly handing off this responsibility to an accrediting agency.
They argue for the Board to be better staffed and that they begin
the process of culling the worst programs, e.g., those with pass
rates below 50%, or those who graduate a high proportion of students
who never sit for the licensing exam.
SUPPORT AND OPPOSITION:
Support: None on file as of April 18, 2012.
Opposition: None on file as of April 18, 2012.
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Consultant:Bill Gage