BILL ANALYSIS
AB 1113
Page 1
Date of Hearing: April 26, 2005
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Gloria Negrete McLeod, Chair
AB 1113 (Yee) - As Amended: April 14, 2005
SUBJECT : Acupuncturists: diagnosis.
SUMMARY : Provides that an individual who holds an
acupuncturist's license may diagnose within the scope of his or
her practice.
EXISTING LAW establishes the California Acupuncture Board
(Board) that licenses and regulates acupuncturists. The scope
of practice of a licensed acupuncturist includes the practice of
acupuncture, as defined, and the performance or prescription of
the use of oriental massage, acupressure, breathing techniques,
exercise, heat, cold, magnets, nutrition, diet, herbs, plant,
animal, and mineral products, and dietary supplements to
promote, maintain, and restore health. The definition of
"acupuncture" is 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.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author, it is time to
clearly and formally codify that diagnosis is an aspect of an
acupuncturist's scope of practice. The author argues that this
clarification is necessary because acupuncturists are oftentimes
the first (if not the only) health care provider that a patient
sees and notes that the ability of an acupuncturist to diagnose
has been recognized by a series of legal opinions dating back to
1982.
Background . California first regulated acupuncture in 1972 when
an unlicensed practitioner was permitted to practice acupuncture
under the supervision of a licensed physician at a medical
school for the purpose of research. In 1975, the Legislature
AB 1113
Page 2
provided for the certification of acupuncturists by the Board of
Medical Examiner's (predecessor to the Medical Board of
California), but stipulated that an acupuncturist could not see
a patient without a referral from a licensed physician, dentist,
podiatrist, or chiropractor. In 1980, the Acupuncture Licensure
Act (Act) permitted acupuncturists to see patients without a
prior diagnosis and referral from a licensed physician, dentist,
podiatrist, or chiropractor. Intent language in the Act also
stated that acupuncturists be subject to regulation and control
as "primary health care" practitioners.
Little Hoover Commission (LHC) report . In September of 2004,
LHC released its report entitled "Regulation of Acupuncture: A
Complementary Therapy Framework" (Report). The Report discusses
the confusion resulting from the lack of express authority in
existing statute for acupuncturists to diagnose. LHC concludes
in the Report that acupuncturists ought to be authorized to
diagnose within their scope of practice; however, LHC also
concludes that the Legislature cannot satisfactorily resolve
this issue without also clearly defining "traditional Oriental
medicine" and clarifying the role of acupuncturists in the
health care system (i.e., whether in regard to acupuncturists a
"primary health care practitioner" means someone who manages a
patient's overall health care or, more simply, someone who may
see a patient without the need for referral or prior diagnosis).
Opposition . The California Medical Association (CMA) asserts
that the diagnosis of a medical condition requires a complex
analysis of symptoms and biological systems and is an activity
that has traditionally been reserved to physicians and surgeons
who have the highly specialized training necessary to perform
this complex task. CMA argues that, while acupuncturists have
training in acupuncture and in general principles of Western
medical science, they do not have the extensive undergraduate,
graduate, or clinical training necessary to engage in the
sophisticated medical analysis that is fundamental to medical
diagnosis. CMA requests amendments which delete the term
"diagnosis" and, instead, add the clarifying language "provide a
therapeutic assessment."
The California Chiropractic Association expresses concern that
allowing acupuncturists to diagnose for the purpose of providing
acupuncture treatment grants acupuncturists authority that is
not consistent with the training received by acupuncturists.
AB 1113
Page 3
Related legislation . AB 1114 (Yee), 2005-06 session, increases
continuing education requirements of acupuncturists from 30 to
50 hours and requires 5 of these hours to be dedicated to public
health and safety issues. AB 1114 is also set for hearing on
April 26, 2005 in the Assembly Business and Professions
Committee.
AB 1115 (Yee), 2005-06 session, provides that an "acupuncture
assistant" is someone who does not hold an acupuncture license
and who performs basic administrative, clerical, and supportive
services under the supervision of a licensed acupuncturist. AB
1115 is also set for hearing on April 26, 2005 in the Assembly
Business and Professions Committee.
AB 1116 (Yee), 2005-06 session, requires an individual seeking a
license to practice acupuncture to complete a postgraduate
residency program, in addition to existing requirements. AB
1116 is also set for hearing on April 26, 2005 in the Assembly
Business and Professions Committee.
AB 1117 (Yee), 2005-06 session, changes the terms "oriental
medicine" and "oriental massage" in existing statute to "Asian
medicine" and "Asian massage." AB 1117 is also set for hearing
on April 26, 2005 in the Assembly Business and Professions
Committee.
REGISTERED SUPPORT / OPPOSITION :
Support
Association of Korean Oriental Medicine & Acupuncture of
California
California Acupuncture Medical Association
California Alliance of Acupuncture Medicine
Council of Acupuncture and Oriental Medicine Associations
South Baylo University
United California Practitioners of Chinese Medicine
170 students of South Baylo University
3 individuals
Opposition
California Chiropractors Association
California Medical Association
AB 1113
Page 4
Analysis Prepared by : Pablo Garza / B. & P. / (916) 319-3301