BILL ANALYSIS �
SB 1488
Page 1
Date of Hearing: July 3, 2012
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Mary Hayashi, Chair
SB 1488 (Yee) - As Amended: June 19, 2012
SENATE VOTE : 22-9
SUBJECT : Healing arts: California traditional Chinese Medicine
traumatologist certification.
SUMMARY : Establishes the California Traditional Chinese
Medicine Traumatology Council (Council) to administer a
"California certified traditional Chinese Medicine traumalogist"
certificate program, until January 1, 2017. Specifically,
this bill :
1)Establishes the Council to administer a California certified
traditional Chinese Medicine (TCM) traumatologist certificate
program, until January 1, 2017.
2)Requires the Council to be a 501(c)(3) non-profit organization
comprised of the following five members:
a) Three representatives from the clinical settings of
traumatology, who shall be selected by professional
societies, associations, or other entities, whose
memberships are comprise solely of practitioners of
California TCM traumatology and are eligible, as defined;
b) One representative from the Medical Board of California
(MBC); and,
c) One representative from the California Medical
Association (CMA).
3)Requires the Council to issue a two-year California TCM
traumatology certificate to applicants who satisfy the
following requirements:
a) Are at least 18 years old;
b) Provides satisfactory evidence of one of the following:
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i) Satisfactory completion of an educational and
clinical training program approved by the Council
requiring a minimum of 880 hours of instruction in
California TCM traumatology; or,
ii) In the case of an applicant who has completed
education and training outside the United States (U.S.)
and Canada, documented education, training, and at least
eight years of clinical experience in TCM traumatology
that meets standards established by the Council.
c) Is not subject to denial as a result of a crime,
disciplinary action, or misrepresentation; and,
d) Passes a written examination developed and administered
by the Council, as specified; and,
e) Submits an application fee that covers the Council's
cost to process the application and cannot exceed $200.
4)Requires the Council to investigate all of the documentation
provided by an applicant and verify its authenticity to
evaluate whether an applicant meets the certification
standards;
5)Requires the Council to develop, and report to the
Legislature, by January 1, 2015, on all of the following:
a) The standards for evaluating the education, training,
and clinical experience of an applicant who has completed
education and training outside of the U.S. and Canada;
b) The written examination;
c) A continuing education (CE) program for California
certified TCM traumatologists.
6)Allows a certificate holder to renew his or her certificate
within six months after expiration if the certificate holder
pays the necessary fees. Establishes the following
certificate fee schedule:
a) The renewal fee shall be $100;
b) The delinquency fee shall be $25;
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c) The duplicate or replacement engraved wall certificate
shall be $15; and,
d) The duplicate or replacement engraved renewal
receipt/pocket certificate shall be $10.
7)Requires that money received under this bill shall be used by
the Council to pay for associated administrative costs.
8)Provides that it is an unfair business practice for any person
to hold himself or herself out as a "California certified TCM
traumatologist" or use that title unless he or she is
certified by the Council.
9)Prohibits a California certified TCM traumatologist from
practicing:
a) Medicine as defined; and,
b) Within the scope of activities regulated by the Board of
Chiropractic Examiners (BCE).
10)Authorizes the Council to deny, suspend, or revoke a
certificate for any of the following reasons:
a) Unprofessional conduct, as specified;
b) Procuring a certificate by fraud, misrepresentation, or
mistake;
c) Violating a provision of this bill or a Council bylaw;
d) Conviction or misdemeanor relating to the certificate
holder's qualifications or duties;
e) Impersonating or acting as a proxy for an applicant;
f) Impersonating a California certified TCM traumatologist
or permitting an uncertified person to use a certificate;
g) Committing any fraudulent, dishonest, or corrupt act in
the course of duties; or,
h) Committing a sexually related crime.
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11)Subjects Council meeting to the rules of the Bagley-Keene
Open Meeting Act.
12)Creates the following definitions:
a) "California certified TCM traumatologist" to mean a
person who has been certified by the Council to perform
California TCM traumatology;
b) "Council" to mean the California Traditional Chinese
Medicine Traumatology Council; and,
c) "California traditional Chinese Medicine traumatology"
to include a range of treatments to address both acute and
chronic musculoskeletal conditions through stimulation of
acupressure points. Techniques include, but are not
limited to, brushing, kneading, rolling, pressing, rubbing,
pushing, holding, and lifting the areas between each of the
joints to open the body's defensive chi and stimulate the
energy movement in both meridians, but do not include
manipulation techniques to realign the musculoskeletal and
ligamentous relationship, also known as bone setting.
EXISTING LAW :
1) Establishes the Acupuncture Board (Board) within the
Department of Consumer Affairs (DCA), which licenses and
regulates the acupuncture profession pursuant to the
Acupuncture Licensure Act (Act).
2) Defines an acupuncturist as an individual who has been
licensed to practice acupuncture pursuant to the 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 a licensed acupuncturist is authorized to do the
following:
a) To engage in the practice of acupuncture;
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b) To perform or prescribe the use of Asian massage,
acupressure, breathing techniques, exercise, heat, cold,
magnets, nutrition, diet, herbs, plant, animal, mineral
products, and dietary supplements to promote, maintain, and
restore health. Nothing 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.
4) States that the Board shall issue a license to practice
acupuncture to any person who applies and meets the following
requirements:
a) Is at least 18 years of age;
b) Furnishes satisfactory evidence of completion of one of
the following: an education and training program, as
specified; satisfactory completion of a tutorial program in
the practice of acupuncture which is approved by the Board;
or, in the case of an applicant who has completed education
and training outside the U.S. and Canada, documented
education training and clinical experience, as specified;
c) Passage of a written examination administered by the
Board, as specified; and,
d) Completion of a clinical internship training program
approved by the Board.
FISCAL EFFECT : Unknown. This bill has been keyed non-fiscal
by the Legislative Counsel.
COMMENTS :
Purpose of this bill . According to the author's office,
"Current law does not provide for the oversight of
traumatologists in California. SB 1488 is a titling act that
will provide the public with a level of protection through the
establishment of a non-profit council that will determine the
standards of training and experience necessary for a person to
be certified as a California certified TCM Traumatologist.
"The creation of this certification program will provide a
pathway for skilled TCM traumatologists to receive recognition
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as one of the participants in the health care of the public.
TCM traumatology, like acupuncture, takes a holistic approach to
the body with a complete theoretical system that has provided
cures to people for centuries. A group of such practitioners
exist in the State of California and have been providing care to
the public for more than 50 years to date. The intent of this
bill is to allow some oversight of this practice to ensure
public safety and to give people confidence and assurances that
for those traumatologists who are certified, they have met
certain standards and requirements to call themselves a
'California certified TCM traumatologist.'"
Background . This is the second time that the author is hearing
a bill in this committee and session related to traumatology.
This bill differs from its previous version, SB 628 (Yee) of
2009 because it removes licensure of a traumatologist from under
the Board and instead creates a certification program
administered by the Council, defines the scope of TCM
traumatology, removes the orthopedic association from the
Council membership, expressly prohibits the practice of
chiropractic by traumatologists and bone setting. Proponents of
this bill contend that there are individuals who already hold
themselves out as traumatologists, and use the term
"traumatology" in their business name, and that this bill would
regulate and provide oversight for a group of practicing
traumatologists that are unregulated.
Traumatology is one of the modalities that constitute TCM. The
term "traumatology" is also defined as the study of wounds and
injuries caused by accidents or violence to a person, and the
surgical therapy and repair of the damage. It is often
considered a subset of surgery and in countries with the
specialty of traumatology surgery it is most often a
sub-specialty to orthopedic surgery.
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.
The practice of traumatology, as practiced in other countries,
incorporates components found within different healing arts
professions licensed under DCA - acupuncture, orthopedics, and
massage therapy.
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Generally, the Business and Professions Code (BPC) specifies
education, experience, and examination requirements for
licensure for professional occupations within DCA. This bill,
as amended on June 19, 2012, requires applicants to complete
education, training, and examination requirements developed by
the Council, with a minimum of 880 hours of instruction in
California TCM traumatology. This bill also requires the
Council to develop standards for issuing a certificate to
applicants who have completed education and training related to
traumatology outside of the U.S. and Canada. This bill requires
the Council to investigate and verify the authenticity of
documentation provided by applicants to determine whether
applicants qualify for certification. This bill also requires
the Council to develop and report to the Legislature by January
1, 2015, on the standards for the approval of educational and
training programs, the written examination, and the CE program
for California certified TCM traumatologists.
The provisions relating to educational requirements for TCM
certification is one of the primary reasons TCM colleges are
opposing this measure; they contend that practicing
traumatologists in China are medical doctors specializing in
traumatology who can substantiate education requirements and are
eligible for an acupuncturist licensure if the applicant can
provide proof of education and training completed outside the
U.S. and Canada that meet specified standards (BPC Section
4938). The TCM schools state that this bill would provide a
structure for individuals who do not have the documentation to
apply for an acupuncture license to receive certification as a
TCM traumatologist with less education requirements.
In January 2005, the Board promulgated regulations that included
traumatology as a subject matter for didactic instruction that
could be counted towards licensure requirements (Board
Regulation, Title 16, Article 3.5, Section 1399.434). The
curriculum in acupuncture and Oriental medicine principles,
theories and treatment consists of at least 1,255 hours of
didactic instruction in specified areas, including traumatology.
Some TCM schools will offer a one-year certification program
that specializes in traumatology for acupuncturists.
There are approximately 60 accredited TCM educational institutes
nationwide, and 20 of them are located in California.
Currently, there are no national standards for traumatologists.
Acupuncture is legalized in 50 states of the U.S. Currently,
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traumatology courses are offered in accredited schools for
acupuncture, as a portion of the study. Currently, there is no
traumatology school in California. The author's office also
notes that for at least the previous ten years, traumatologists
have had regular, annual, and special workshops and seminars in
the Bay Area and abroad, including China and Hong Kong.
While the Board is overseen by the DCA, this bill establishes a
non-profit Council to certify TCM traumatologists that is not
overseen by the DCA or any other state agency or entity.
Last year, the author's office estimated that approximately
70-100 individuals would be eligible for certification as a TCM
traumatologist. This bill caps the certification fee at $200,
and initial certification of traumatologists under this bill
results in estimates of up to $20,000 in revenue to the Council.
On the other hand, there are approximately 12,000 licensed
acupuncturists in this state and the initial license fee is
$325. The certification of traumatologists may have the
unintentional consequence of redirecting individuals who would
have applied for an acupuncture license to instead obtain a
California certified TCM Traumalogist certificate, due to lower
fees and eligibility requirements.
This bill requires the Council to determine California TCM
traumatology certification standards, including experience and
training requirements. The committee membership is comprised of
three representatives from the clinical settings of
traumatology, one representative from the MBC, one
representative from the CMA. The Acupuncture Board, which
licenses practitioners of eastern medicine, and has promulgated
regulations relating to traumatology, is not represented on the
Council.
This bill allows for the Council to develop and report to the
Legislature, by January 1, 2015, or two years later on the
standards for the approval of educational and training programs,
the written examination, and the CE program for California
certified TCM traumatologists. While the provisions of this
bill would take effect on January 1, 2013, the standards could
technically be developed two years after a certificate may be
issued, or half-way through the term of the pilot program, which
sunsets on January 1, 2017.
Support . According to the American Traditional Chinese Medical
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Traumatology Association, "This bill would provide a pathway for
a skilled traumatologist, trained in this aspect of TCM, to
achieve California certification. This certification process,
within SB 1488, would thereby provide Californians with basic
health and safety assurances.
"SB 1488 would safeguard would safeguard the public by:
1) Requiring government oversight through the creation of a
non-profit Council consisting of �five] members: one
representative each from the MBC and the CMA and three
representatives from the clinical settings of practicing
traumatology to assist in assuring the highest standard and
peer review oversight;
2) Regulating the use of the title 'traumatologist' so that
those using the term would have to satisfy the standards
and level of experience set forth by the newly created
Council, allowing the public to distinguish between those
that are certified and qualified from those that are not;
and,
3) Requiring, for the first time in law, that a
traumatologist shall not practice medicine or chiropractic
manipulations."
Opposition . According to the BCE, "The BCE has public safety
concerns related to the proposed scope of traumatology and
questions whether the proposed training and certification
standards would assure public protection? Only after competent
training and adequate education, supported by standardized
education and nationally recognized testing, can the BCE support
the introduction of any new health care entity which would
potentially need to make an urgent and accurate diagnosis and
referral of patients who may need urgent or even emergency
medical care?"
According to the Southern California University of Health
Sciences and several TCM colleges, "''TCM Traumatology is part
of TCM. Traumatologists use TCM theories, diagnosis,
tui-na/massage skills and herbs in their practice. Therefore,
the regulation of this discipline should not be separated from
the current acupuncture license system which is overseen by the
Board? The proposed 880 hour education requirement for the TCM
traumatology �certificate] is clearly below the current higher
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standards of the existing Acupuncture and Oriental Medicine
requirements (minimum 3,000 hours). Inadequate controls are
provided for in this bill relative to ensuring the legitimacy of
foreign training? The most recent version of this bill would
require, but not until January 1, 2015, the Council to submit a
plan for the educational, training, and examination standards
for TCM traumatology certification. This is not too little, but
too late to protect the public for two years until standards and
tests are formulated."
According to the American College of Traditional Chinese
Medicine, "The title 'TCM Traumatologist' requires a minimum of
6,000 hours of training in China. In China, the title of
'TCM Traumatologist' is designated only to individuals who have
graduated from a TCM college or university (4,000 hours and a
minimum of two more years specializing in traumatology - for a
total of at least 6,000 hours). We do not offer this level of
training in the U.S."
According to the National Federation of TCM Organizations,
"Since the legalization of acupuncture in California 37 years
ago, the profession has grown. Today, acupuncture is legalized
in 50 states across the nation. This growth and recognition is
based on the standards that were set by the profession through
its national professional certification and accredited bodies
that are accredited by related federal agencies and accepted by
state governments. We consider it a self-serving means to
satisfy the individuals who refuse to abide by the standards of
the �acupuncture] profession and get their license through the
standard process as all other practitioners have been doing."
Related Legislation . SB 628 (Yee) of 2011, would have created a
Traumatology Committee (Committee) within the Board and would
have authorized the Committee to determine certification
standards for, and certify traumalogists from March 1, 2012 to
December 1, 2012. This bill was amended to delete all
provisions relating to traumatology, and to instead codify
regulations promulgated by the related to an acupuncturist's
permitted use of the title "Doctor." This bill is pending in
the Assembly Appropriations Committee.
REGISTERED SUPPORT / OPPOSITION :
Support
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American Association of Acupuncture and Traditional Chinese
Medicine
American Chinese Cultural Exchange & Trading Association
American Traditional Chinese Medical Traumatology Association
California Acupuncture Medical Association
California Acupuncture Oriental Medicine Association
Cathay Post No. 384
Chi Wan Mok Traditional Chinese Medical Center
Chinese Consolidated Benevolent Association
Chinese Culture & Health Center
Ching's Chinese Medical & Therapy Center
Chinlien Association
Daminh Alumni Association U.S.A.
David Lu Traditional Chinese Medical Center
Deng Shao Ji Chinese Medical Center
Dian Gui Liu Chinese Herbal Medical Center
Gee Association
GL Health & Herbs Service Center
Hai Feng Chinese Herbal Center
Hai Feng Traditional Chinese Medical Center
Hai Phong Overseas Chinese Association
Ho Ying Heng
Hoy-Sun Ning Yung Benevolent Association in America
Huang's Traditional Chinese Medical Center
Hung Yue Louie Chinese Medical Acupuncture Center
Jian Zheng's Chinese Medical Center
Jiang Die Liang Chinese Medical Center
Jiang's Wellness Center
Johnson Herb Services
Kang Hua Chinese Herbal Center
Kwong Tim Leung Traditional Chinese Medical Center
Las Tunas Acupuncture & Herbs Pain Relief Center
Liang's Traditional Chinese Medical Center
Nathan Lee Traditional Chinese Medical Center
National Guild of Acupuncture and Oriental Medicine
Peng Tsing Tong Chinese Medical Center
RiYing Gong Traditional Chinese Medical Center
S.H. Body Therapy
Shu Lin Han Traditional Chinese Medical Center
Sidra Yoy Wu Chinese Medical Center
Simon Tang Chinese Medical Center
Soo Yuen Benevolent Association
Tim Lee Traditional Chinese Medical Center
Tony's Pain Medical Center
Toy's American Traditional Chinese Medical Center
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Traditional Chinese Medical Center
United Association
U.S. Organization of Chinese Merchants from Vietnam, Cambodia
and Laos
Vietnam Chinese Mutual Aid Friendship Association of Oakland
Vietnamese Acupuncture and Oriental Medicine Association
Institute
Wang Guo Zhu Traditional Chinese Medical Center
William Wu Traditional Chinese Medical Center
Wong Family Benevolent Association, Inc.
Wong Man Keung Traditional Chinese Medical Center
Wong's Traditional Chinese Medical & Traumatology Center
Yu's Herbal Chinese Medical Center
Numerous Individuals
Opposition
1-2-3 Acupuncture Clinic
AAA Acupuncture
Academy of Chinese Medicine
AcuEnergize
Acu-Herbs Healing
Acu-Medi Health Center
AcuSpa
Acupuncture & Healing Arts Center of Visalia
Acupuncture & Herbs Clinic
Acupuncture & Herbal Care of Los Altos
Acupuncture Herb Center
Acupuncture and Natural Herbs
Acupuncture in Yan Clinic
Acupuncture for Wellness
Acupuncture RN
Acupuncture Weight Control Center
Ahola Clinic Corp.
Al Acupuncture Healing Center
All Care Acupuncture & Herbs Clinic
American College of Traditional Chinese Medicine
American Diabetes Chinese Medical Center
American Institute of Acupuncture Orthopedics & Traumatology
American Institute of Chinese Medicine, Inc.
Anna Lin Natural Healthcare
Anto Acupuncture & Chinese Medicine Clinic
Asian Bodywork Therapy
Association of Korean Asian Medicine and Acupuncture of
California
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Association of World Traditional Medicine
Asyrah's Garden
Aurora Acupuncture
Awareness Center
AXOS Acupuncture
Bina Jangda Acupuncture
Bin Zhi Acupuncture Clinic
Bliss Acupuncture Clinic
Blossom Hill Chiropractic
Board of Acupuncture
Board of Chiropractic Examiners
Buddhist Society of America
California Acupuncture Center
California Alliance of Acupuncture Medicine
California Certified Acupuncturists Association
California Green Cross Clinic
California State Oriental Medical Association
California Traditional Articulated Healing Center
Chinatrust Bank (U.S.A.)
Chen's Acupuncture and Chinese Medicine Clinic
Chinese Medicine & Acupuncture Healing Center
Chinese Medicine Clinic & Education Center
Chinese-West Medical Center, LLC
Da Ming Acupuncture and Herb Center
Ding Li Acupuncture Clinic
DO Oriental Medical Group
California Neurohealth
Dong Kook Health Care Center
Dr. Wang Acupuncture Clinic
East Traditional Medicine
Echoi Acupuncture
eCosway
Emperor's College
Family Health Group
Fang's Art Studio
Five Branches University
Five Element Care
Fullness Auto Service Centre
Good Samaritan Acupuncture
Goodkin Acupuncture
Health Tune-up
Heaven Grace Herbal Clinic
Holistic Healing Center
Holy Acupuncture
Hong Yan Medical Clinic
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Japanese Acupuncture Association of California
JJ Acu & Herb Clinic
Johnson Acupuncture Clinic
Julie Cao Acupuncture Clinic
Jun Paek Acupuncture Clinic
Karen Acupuncture Clinic Inc.
Kim Neumann Acupuncture
Korean Acupuncture & Asian Medicine Association
Larchmont Traditional Medicine
Li Ma Acupuncture
Lido Partners
Livermore Acupuncture & Herbal Clinic
Lotus East-West Medical Center
Middle Path Acupuncture Clinic
MJ Acupuncture
National Federation of Chinese TCM Organizations
N's Quick Printing
Oceanside Acupuncture
Oriental Cosmos Health Center
Ou's Acupuncture
Ouyang Paint Management Center
Pacific College of Oriental Medicine
Pan Acupuncture & Herb
Pacific Complementary Medicine Center
Peace Acupuncture Clinic
Pei YuKun Acupuncture, Acupressure and Oriental Medicine Clinic
Professional Skin & Body Care Inc.
PSW Acupuncture Inc.
Qi Dragon Healing Center
Rancho Bernardo Chiropractic
Research Institute of Chinese Medicine
San Jose Functional Medicine
Sheila's Acupuncture and Herbs
Shen's Acupuncture Clinic
Southern California University of Health Sciences
Stephen Imports, Inc.
Su Clinic
Sun Healing Center
Sunson Co. Xia's Acupuncture Clinic
Temescal Acupuncture Center
The American Institute of Finger Surgery
The Redwood Clinic
Tong Zhang Acupuncture
Total Health Care, Inc.
Traditional Healing Arts
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Traditional Healing Arts Center
Tsubakiyama Acupuncture Clinic
Underground Stream Qi Acup.
UniCare
United Acupuncture & Herbs
United California Practitioners of Chinese Medicine
University of East-West Medicine
Valley Health & Acupuncture
Wang Ping Acupuncture Clinic
Whole Health Associates
World Alternative Medicine Health
WTX Medical Group
Xing Lin Acupuncture & Chinese Medicine Clinic
Yan Xiang Li's Acupuncture Clinic
Xu's Acupuncture Clinic
Yan-Hua Total Health Care, Inc.
Yan Xiang Li's Acupuncture Clinic
Ye's Acupuncture Clinic
Yo San University
Numerous individuals
Analysis Prepared by : Joanna Gin / B.,P. & C.P. / (916)
319-3301