BILL ANALYSIS �
SB 1246
Page 1
Date of Hearing: June 24, 2014
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Susan A. Bonilla, Chair
SB 1246 (Lieu) - As Amended: June 15, 2014
SENATE VOTE : 33-0
SUBJECT : Acupuncture.
SUMMARY : Extends the sunset date of the California Acupuncture
Board (CAB) to January 1, 2017, revises acupuncture program
approval requirements, and specifies that any executive officer
(EO) appointed on or after January 1, 2015 shall not have served
as an executive officer for the CAB prior to January 1, 2015.
Specifically, this bill :
1)Extends the sunset date for the CAB and its duties until
January 1, 2017.
2)Defines an "approved educational and training program" to mean
a program approved by the CAB under current standards, until
January 1, 2017.
3)Removes "tutorial programs" from those entities for which CAB
is required to establish standards for approval until January
1, 2017.
4)Defines an "approved educational and training program" after
January 1, 2017 to mean a school or college offering education
and training in the practice of an acupuncturist that meets
the following requirements:
a) Offers a CAB-approved curriculum that includes at least
3,000 hours, of which at least 2,050 hours are didactic and
laboratory training and at least 950 hours are supervised
clinical instruction;
b) Requires the CAB, within 30 days after receiving
curriculum to review the curriculum to determine whether
the curriculum satisfies the requirements established by
CAB, and notify the school or college, the Accreditation
Commission for Acupuncture and Oriental Medicine (ACAOM),
and the Bureau of Private Postsecondary Education (BPPE),
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of the CAB's approval.
c) Has received full institutional approval, as specified,
in the field of traditional Asian medicine or in the case
of institutions located outside of California, approval by
the appropriate governmental educational authority using
standards equivalent to California's; and,
d) Is accredited or has been granted candidacy status by
ACAOM.
5)Specifies that any EO of the CAB appointed on or after January
1, 2015, cannot have served as the CAB's EO at any time prior
to January 1, 2015.
6)Extends the CAB's authority to appoint an (EO) until January
1, 2017.
7)Specifies that an individual who graduates in the first or
second graduating class of a school or college that has been
granted candidacy status by ACAOM is deemed to have completed
an approved educational and training program.
8)Requires the CAB to establish standards for the acceptance of
educational training and clinical experience received outside
of the United States and Canada beginning on January 1, 2017.
9)Repeals the CAB's authority to investigate and evaluate each
school or college applying for approval or continued approval
and CAB's authority to recover the associated costs on January
1, 2017.
10)Repeals the $3,000 application fee for the approval of a
school or college on January 1, 2017.
11)Makes other technical and clarifying changes.
EXISTING LAW:
1)Establishes the CAB to regulate of the practice of acupuncture
within the Department of Consumer Affairs (DCA). (Business and
Professions Code (BPC) Section 4928 et seq.)
2)Defines "acupuncturist" to mean an individual to whom a
license has been issued to practice acupuncture which is in
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effect and is not suspended or revoked. (BPC 4927(c))
3)Defines "acupuncture" to mean "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
electro-acupuncture, cupping and moxibustion." (BPC 4927(d))
4)Establishes the CAB until January 1, 2015 and renders the CAB
subject to review by the appropriate policy committees of the
Legislature. (BPC 4928)
5)Permits the CAB, with the approval of the Director of the DCA,
to employ personnel and appoint an EO until January 1, 2015.
(BPC 4934)
6)Grants the CAB authority to establish standards for the
approval of schools and colleges offering education and
training in the practice of acupuncture, including standards
for the faculty in those schools and colleges and tutorial
programs. (BPC 4939 et seq.)
7)Allows the CAB to charge a fee for the inspection or
re-inspection of a school or college of acupuncture for
purposes of approval and permits the CAB to recover the direct
costs incurred by the CAB in conducting the inspection and
evaluation of the school or college. (BPC 4973)
FISCAL EFFECT : Unknown
COMMENTS :
1)Purpose of this bill . This bill extends the sunset date of
the CAB and its authority to appoint an EO until January 1,
2017 and makes other changes related to accreditation
requirements and the leadership of the CAB in order to address
issues identified during the CAB's 2014 sunset review. This
bill is author sponsored.
2)Author's statement . According to the author, "[This bill]
extends until January 1, 2017, the provisions establishing the
[CAB], directs the board to hire a new [EO] as of January 1,
2015 who has not served as an [EO] before and requires all
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acupuncture schools to be accredited by the [ACAOM]. Unless
legislation is carried this year to extend the sunset dates
for the [CAB], it will be repealed on January 1, 2015."
3)Oversight Hearings and Sunset Review of Licensing Boards of
DCA . In March and April of 2014, the Assembly Business,
Professions and Consumer Protection (BPCP) Committee and the
Senate Business, Professions and Economic Development (BPED)
Committee conducted a joint oversight hearing to review nine
regulatory entities, including the CAB. The Committees began
their review of these entities in March and conducted three
days of public hearings. This bill, like other sunset bills,
is intended to implement the legislative changes recommended
in the background reports authored by the Senate BPED and
Assembly BPCP Committees.
The sunset review process itself provides a formal opportunity
and mechanism for the DCA, the Legislature, the boards and
bureaus, and interested parties and stakeholders to discuss
the performance of the boards, bureaus, and committees, and
make recommendations for improvements. This is performed on a
standard four-year cycle as envisioned by SB 2036
(McCorquodale) (Chapter 908, Statutes of 1994). The major
provisions of this bill are based on specific issues raised
and addressed in the reports released by the BPED committee.
4)California Acupuncture Board . In 1976, California became the
eighth state to license acupuncturists. Acupuncturists are
allowed to engage in the practice of acupuncture,
electroacupuncture, perform or prescribe the use of oriental
massage, acupressure, moxibustion, cupping, breathing
techniques, exercise, heat, cold, magnets, nutrition, diet,
herbs, plant, animal, and mineral products, and dietary
supplements to promote, maintain, and restore health as
specified.
In order to be licensed as an acupuncturist in California, an
applicant must be at least 18 years of age and complete either
an educational and training program that includes 3,000 hours
of study in the practice of acupuncture, or a supervised
tutorial program which is approved by the CAB. An applicant
must also pass a California-specific written examination that
tests an applicant's knowledge in the practice of acupuncture.
The CAB does not currently grant reciprocity to those
individuals who have taken and passed the national examination
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for licensure. Currently, there are over 16,000 acupuncture
licensees in California.
The 2014 BPED background paper for the CAB identified multiple
issues relating to the administration and oversight of the
CAB, and its ability to properly regulate and license
acupuncturists. These issues include a lack of communication
to its licensees through CAB's Web site and listserve,
application backlogs, failure to query a National Practitioner
Databank to check the history of licensees, failure to
complete an audit of a national licensing examination, and
concerns with the CAB's school approval process.
This bill extends the sunset of the CAB and its authority to
appoint an EO for two-years until January 1, 2017, specifies
that any EO appointed on or after January 1, 2015 may have not
served as the EO prior to January 1, 2015, and revises the
current approval process for schools. The CAB was last
reviewed in 2012.
a) Accreditation . The Senate BPED Committee's background
paper expressed concerns about CAB's school approval
process. Currently, the CAB establishes standards for the
approval of schools and colleges offering education and
training, including setting standards for faculty and
tutorial programs. The approval process requires the CAB
to review a school's application, its governance,
curriculum, catalogs, and admission policy, among other
items. The CAB also conducts onsite visits.
According to the CAB, the time required to process and review
a new school application can take anywhere from six to 12
months. In addition, those institutions "approved" by CAB
must also receive approval from the BPPE. There are
currently 38 schools approved by CAB, including 16 located
outside of California. Only those students who attend
CAB-approved schools are eligible to sit for the licensing
examination. Graduates from non-approved schools are not
eligible and must either enter an approved program or
request special approval from the CAB.
The ACAOM is a national accrediting body, approved by the
United States Department of Education (USDE), which
accredits acupuncture schools both in California and
nationwide. According to the organization's Web site, the
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ACAOM is a private, not-for-profit organization whose
primary purposes are to establish comprehensive educational
and institutional requirements for acupuncture and Oriental
medicine programs, and to accredit programs and
institutions that meet these requirements. While all 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 a condition of being eligible to take the
licensing exam.
Because of ACAOM's nationwide ubiquity, many California
schools choose to receive ACAOM's accreditation in addition
to the approval of CAB. Currently only 5 of 22 schools
approved by the CAB in California do not have ACAOM
accreditation as well. All other schools in California
have dual approval/accreditation.
According to the Senate BPED background paper CAB's
administration of its own school-approval process creates a
problem for students who are educated in ACAOM-accredited
schools that are not approved by CAB. For those students
educated outside of California at an educational
institution that has not been approved by CAB, if they wish
to gain licensure in California, they must complete a
CAB-approved training program or receive special approval
from the CAB to have their education counted. According to
the Senate BPED background paper, the CAB has been slow to
approve applications for schools located outside of
California due to budget constraints and staff vacancies,
although the CAB has recently begun conducting ongoing site
reviews of the schools seeking CAB approval.
The Senate BPED background paper noted that this issue has
been a concern raised during past sunset reviews of the
CAB. During the 2012 sunset review process, the Senate
BPED Committee then recommended that "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
[USDE]."
This bill addresses the accreditation issue raised by the
Senate BPED Committee by revising the current accreditation
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process to include ACAOM and CAB approval for schools and
training programs beginning in January 2017. In order for
a school or training program to be approved, it would need
CAB approval of its curriculum and ACAOM accreditation.
This bill provides a two-year implementation delay in order
to provide schools, CAB and ACAOM time to review standards
and implement the joint process. This bill does not alter
the current BPPE approval process, so schools seeking to
provide education in the practice of acupuncture would need
approval of their curriculum standards from CAB, and
receive accreditation from ACAOM and approval from BPPE.
b) Continued regulation by the CAB . Although the report
noted several areas where the CAB has failed to address
important administrative issues, the Senate BPED background
paper determined that it is necessary to extend the sunset
of the CAB in order to maintain an appropriate regulatory
authority for licensees and maintain consumer protection.
While the sunset review process typically results in a four
year extension for satisfactorily performing entities, this
bill only grants the CAB a two-year sunset extension. The
CAB will be required to address the Assembly BPCP and
Senate BPED Committees on its progress in addressing all
the issues identified in the report in 2017. CAB has
received two-year extensions in four of its last five
sunset reviews.
c) Personnel . Currently, the CAB is authorized to employ
personnel, including the authority to appoint an EO. As
with the other provisions relating to Acupuncture, the
CAB's authority to appoint an EO has been extended by
two-years until January 1, 2017. However, this bill
specifically states that the EO appointed on or after
January 1, 2015, cannot have served as the EO of the CAB
any time prior to January 1, 2015.
5)Arguments in support . The California State Oriental Medicine
Association writes in support, "CSOMA strongly supports a
requirement that applicants for licensure under the CAB
graduate from a program that has achieved candidacy or
accreditation by an accrediting agency recognized by the
[USDE] as an authority for the quality of education and
training in acupuncture and Oriental medicine.
Accreditation-in conjunction with the CAB's continued
authority to create, modify, review, and approve
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California-specific curricula requirements-will create a
robust regulatory framework for the education of licensed
acupuncturist."
6)Arguments in opposition . The National Guild of Acupuncture
and Oriental Medicine, writes in opposition, "[this] bill
removes the authority of the [CAB] to approve schools. This
creates several problems including the elimination of
curriculum standards that are written in the regulations.
These standards are the highest in the nation."
7)Comments for the Committee . The sunset review process
provides the Legislature with the opportunity to address
serious concerns raised about boards, bureaus, commissions and
other entities which are charged with the protection of
consumers and licensee oversight. While many issues can be
addressed through the sunset review process and its subsequent
legislation, there are often issues that remain unresolved and
which need additional time to find resolution.
While this bill addresses a number of important issues that were
raised during the sunset hearing, the issue of the California
Licensure Examination (CALE), its perceived shortcomings, and
whether or not it should be phased out in favor of the
national exam is notably absent from this bill. This
Committee may wish to discuss what further work remains to be
done in conjunction with the Senate BPED committee, the
Administration, and other relevant stakeholders to finally
resolve the licensure examination troubles that have plagued
the CAB for the past nine years.
Finally, while the authority for many of the boards to appoint
EOs and employ personnel is provided in statute, this bill
specifies that the EO appointed on or after January 1, 2015,
may not have served prior to January 1, 2015. The Committee
may wish to inquire of the author as to what necessitates the
change in personnel required by this bill.
8)Related legislation . SB 1242 (Lieu) of 2014 amends the
Automotive Repair Act and updates the sunset provisions for
the Bureau of Automotive Repair. This bill is pending in the
Assembly Business, Professions and Consumer Protection
Committee.
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SB 1243 (Lieu) of 2014 extends until January 1, 2017 the
provisions establishing the Veterinary Medical Board and the
term of the executive officer, and extends the Certified
Common Interest Development Manager program and the Tax
Preparer program to January 1, 2019. This bill is pending in
the Assembly Business, Professions and Consumer Protection
Committee.
SB 1244 (Lieu) of 2014 extends until January 1, 2019 the term
of the Structural Pest Control Board, which provides for the
licensing and regulation of individuals and business involved
in the structural pest control industry in California. The
bill also extends the term of the board's executive officer
and subjects the board to review by the appropriate policy
committees of the Legislature. This bill is pending in the
Assembly Appropriations Committee.
SB 1245 (Lieu) of 2014 extends until January 1, 2019 the term
of the Dental Hygiene Committee of California, which provides
for the licensing and regulation of dental hygienists. The
bill also extends the term of the committee's executive
officer and subjects the committee to be reviewed by the
appropriate policy committees of the Legislature. This bill
is pending in the Assembly Business, Professions and Consumer
Protection Committee.
SB 1247 (Lieu) of 2014 extends until January 1, 2019 the term
of the California Private Postsecondary Education Act of 2009,
which provides for the regulation of private postsecondary
educational institutions by the BPPE within the Department of
Consumer Affairs. The bill also extends the term of the
Student Tuition Recovery Fund under the administration of the
bureau, and subjects the bureau to review by the appropriate
policy committees of the Legislature. This bill is pending in
the Assembly Business, Professions and Consumer Protection
Committee.
AB 1147 (Bonilla, Gomez & Holden) of 2013 revises and recasts
the massage therapy act and extends the operation of the
California Massage Therapy Council until December 1, 2017.
This bill is pending in the Senate Business, Professions and
Economic Development Committee.
AB 2741 (Bonilla) of 2014 extends the sunset date on the
Professional Fiduciaries Bureau (PFB) from January 1, 2015 to
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January 1, 2019. This bill is pending in the Senate Business,
Professions and Economic Development Committee.
AB 2740 (Bonilla) of 2014 requires the Bureau of Electronic
and Appliance Repair, Home Furnishings and Thermal Insulation
(BEARHFTI) to be subject to review by the Legislature before
January 1, 2019, and requests that BEARHFTI report on
specified concerns to the Legislature by March 1, 2015. This
bill is pending in the Senate Business, Professions and
Economic Development Committee.
9)Previous legislation . SB 1236 (Price) Chapter 332, Statutes
of 2012, extends the sunset dates of numerous boards,
committees and programs under the Department of Consumer
Affairs (DCA) and makes related conforming and technical
changes.
AB 1391 (Eng) of 2010, would have extended the sunset date of
the CAB and its authority to appoint an EO from January 1,
2011 to January 1, 2017. This bill was held in the Senate
Business, Professions and Economic Development Committee.
SB 963 (Ridley-Thomas), Chapter 385, Statutes of 2008,
extended the sunset date on seven boards and their respective
EOs until January 1, 2011.
SB 233 (Figueroa) of 2005 provides for the sunset of the Board
and modifies the definition of acupuncture. This bill was
held in the Senate Appropriations Committee.
REGISTERED SUPPORT / OPPOSITION :
Support
American College of Traditional Chinese Medicine
AOMA Graduate School of Integrative Medicine
Atlantic Institute of Oriental Medicine
California State Oriental Medical Association
Council of Colleges of Acupuncture and Oriental Medicine
Japanese Acupuncture Association of California
Oregon College of Oriental Medicine
Pacific College of Oriental Medicine
Southwest Acupuncture College
Multiple individuals
Association of Korean Asian Medicine and Acupuncture of
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California (04/23/14 version)
Council of Colleges of Acupuncture and Oriental Medicine
(04/23/14 version)
Southern California University of Health Sciences (04/23/14
version)
Opposition
American Traditional Chinese Medicine Traumatology Association
American Association of Acupuncture & Traditional Chinese
Medicine
Council of Acupuncture and Oriental Medicine Associations
National Guild of Acupuncture and Oriental Medicine
California Acupuncture Medical Association (04/23/14 version)
California Acupuncture Medicine Association (04/23/14 version)
California Acupuncture Oriental Medicine Association (04/23/14
version)
California Certified Acupuncturists Association (04/23/14
version)
Chiu's Acupuncture Clinic (04/23/14 version)
CNA Medical Group, Inc. (04/23/14 version)
Korean Acupuncture & Asian Medicine Association in the U.S.A.
(04/23/14 version)
Li Sage Acupuncture Clinic (04/23/14 version)
North American Oriental & Western Medicine Academy (04/23/14
version)
Pine Springs Acupuncture Clinic (04/23/14 version)
Sacramento Chinese Culture Foundation (04/23/14 version)
United Acupuncture Association (04/23/14 version)
United California Practitioners of Chinese Medicine (04/23/14
version)
Multiple individuals
Analysis Prepared by : Elissa Silva / B.,P. & C.P. / (916)
319-3301