BILL ANALYSIS �
SB 1246
Page 1
SENATE THIRD READING
SB 1246 (Lieu)
As Amended August 19, 2014
Majority vote
SENATE VOTE :33-0
BUSINESS & PROFESSIONS 11-0 APPROPRIATIONS 17-0
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|Ayes:|Bonilla, Jones, |Ayes:|Gatto, Bigelow, |
| |Bocanegra, Campos, | |Bocanegra, Bradford, Ian |
| |Dickinson, Eggman, | |Calderon, Campos, |
| |Gordon, Hagman, | |Donnelly, Eggman, Gomez, |
| |Maienschein, Skinner, | |Holden, Jones, Linder, |
| |Wilk | |Pan, Quirk, |
| | | |Ridley-Thomas, Wagner, |
| | | |Weber |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Extends the sunset date of the California Acupuncture
Board (CAB) to January 1, 2017, revises acupuncture program
approval requirements, and extends the sunset date of CAB's
authority to appoint an executive officer (EO) to January 1,
2016. Specifically, this bill :
1)Extends the sunset date for the CAB and its duties until
January 1, 2017, except that the CAB's authority to appoint an
EO is extended to 2016.
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:
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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),
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.
Specifies that if an applicant began his or her educational
and training program at a school or college that submitted an
eligibility report to, or attained candidacy status from, the
ACAOM, but the commission subsequently denied the school or
college candidacy status or accreditation, respectively, the
CAB may review and evaluate the program curriculum to
determine whether to waive the requirements, as specified,
with respect to that applicant.
5)Requires the CAB to establish standards for the approval of
educational training and clinical experience received outside
of the United States and Canada beginning on January 1, 2017.
6)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.
7)Repeals the $3,000 application fee for the approval of a
school or college on January 1, 2017.
8)Makes other technical and clarifying changes.
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FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)Ongoing costs of about $3.3 million per year to support the
California Acupuncture Board's licensing activities, supported
by licensing fees (all costs/revenues are Acupuncture Fund).
2)Minor reduction in costs and revenues after January 1, 2017,
due to the elimination of the Board's authority to approve
educational programs.
3)Staff costs to promulgate regulations, potentially in the
range of $100,000, to address internationally trained
applicants.
4)By changing the process for accrediting schools by the Board,
it is possible that an increased number of individuals would
meet the state's licensing requirement to have graduated from
an accredited school. This could increase the number of
applicants for licensure. This could result in a potential
increase in licensing costs in the range of $100,000 or more
due to increased applications (Acupuncture Fund), and a
commensurate one-time revenue spike due to increased fee
revenues from exam fees as well as higher revenues ongoing.
COMMENTS :
1)Purpose of this bill. This bill extends the sunset date of
the CAB until January 1, 2017, and extends its authority to
appoint an EO until January 1, 2016, 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
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
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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 BPED and BPCP
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 Department of Consumer Affairs, 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
for licensure. Currently, there are over 16,000 acupuncture
licensees in California.
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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 by two years, until
January 1, 2017, and extends its authority to appoint an EO
for one-year until January 1, 2016, 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
ACAOM is a private, not-for-profit organization whose
primary purposes are to establish comprehensive educational
and institutional requirements for acupuncture and Oriental
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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 five 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
process to include ACAOM and CAB approval for schools and
training programs beginning in January 2017. In order for
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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. This
bill extends the sunset date of CAB's authority to appoint
an EO until January 1, 2016.
Analysis Prepared by : Elissa Silva / B., P. & C.P. / (916)
319-3301
FN: 0004986