Title 16, Article 3. Acupuncture Tutorials
This article shall be cited and referred to as the "Acupuncture Tutorial Regulations."
As used in these regulations:
- (a) "Acupuncture tutorial" means an acupuncture tutorial program which is approved by the board pursuant to Sections 4939 and 4940 of the code which when successfully completed meets the requirements of Section 4938 of the code for licensure as an acupuncturist.
- (b) "Supervising acupuncturist" or "supervisor" means a licensed acupuncturist who is approved by the board to provide an acupuncture tutorial to a trainee who is registered with the board pursuant to Section 4940 of the code and these regulations. Pursuant to Section 4940 no physician, podiatrist or dentist may be a supervising acupuncturist unless he or she is a licensed acupuncturist.
- (c) "Trainee" means a person who is registered with the board in order to participate in an acupuncture tutorial under a supervising acupuncturist.
No person shall practice acupuncture in tutorial without the prior approval of the board.
No acupuncturist shall supervise any person in an acupuncture tutorial without the prior approval of the board.
- (a) Applications for approval as an acupuncture trainee shall be filed on a form provided by the board at its Sacramento office and accompanied by the application fee required in Section 1399.461.
- (b) Applications for approval to supervise an acupuncture trainee shall be filed on a form provided by the board at its Sacramento office and accompanied by any necessary documents, including the training agreement, and the application fee required in Section 1399.461.
- (c) Any prior training and experience already obtained within ten (10) years of the date of the application by the trainee, which meets the standards of the board may be considered when developing a training plan between a supervisor and trainee, and specifically the required hours of theoretical and clinical training may be reduced on account of such prior training and experience. Evidence of such prior training and experience should be submitted to the board for its review with the applications for registration of the supervising acupuncturist and trainee.
- (a) An acupuncture tutorial shall provide a trainee with a structured learning experience in all the basic skills and knowledge necessary for the independent practice of acupuncture.
- (b) An acupuncture tutorial which is in the nature of on-the-job training may be a full time or part time employment relationship, however, the training plan and proposed supervision shall be contained in a written agreement between the supervisor and trainee. There shall be no tuition fees charged to the trainee by the supervising acupuncturist.
- (c) An acupuncture tutorial shall provide formal clinical training with supplemental theoretical and didactic instruction. The theoretical and didactic training required in subsections (e)(8) through (e)(20) shall be obtained in an approved acupuncture school or another postsecondary educational institution which is accredited or approved under Article 7 (commencing with section 94900) of Chapter 7 Part 59 of the Education Code or is accredited by a regional accrediting agency authorized by the U.S. Department of Education.
- (d) The clinical training shall consist of a minimum of 2250 hours in the following areas:
- (1) Practice observation
- (2) History and physical examination
- (3) Therapeutic treatment planning
- (4) Preparation of the patient
- (5) Sterilization, use and maintenance of equipment
- (6) Moxibustion
- (7) Electroacupuncture (AC and DC voltages)
- (8) Body and auricular acupuncture
- (9) Treatment of emergencies, including cardiopulmonary resuscitation
- (10) Pre- and post-treatment instructions to the patient
- (11) Contraindications and precautions
- (e) The theoretical and didactic training shall consist of a minimum of 1548 hours (approximately 100 semester units) in the following areas: Minimum Class Hours
- (1) Traditional Oriental Medicine - a survey of the theory and practice of traditional diagnostic and therapeutic procedures.
- (2) Acupuncture anatomy and physiology - fundamentals of acupuncture, including the meridian system, special and extra loci, and auriculotherapy.
- (3) Acupuncture techniques - instruction in the use of needling techniques, moxibustion, electroacupuncture, including contraindications and complications. Tutorial trainees shall either (1) successfully complete, at a board approved acupuncture school, a course which requires a student to pass an examination in clean needle technique that uses as its primary reference the most current edition of the "Clean Needle Technique Manual", published by the National Acupuncture Foundation, or (2) successfully complete a Clean Needle Technique course administered by the Council of Colleges of Acupuncture and Oriental Medicine.
- (4) Acupressure.
- (5) Breathing techniques - introductory course in Qi Gong.
- (6) Traditional Oriental exercise - introductory course in Tai Chi Chuan. 660
- (7) Traditional Oriental herbology including botany. 300
- (8) Practice management - instruction in the legal and ethical aspects of maintaining a professional practice, including record keeping, professional liability, patient accounts, and referral procedures.
- (9) Ethics relating to the practice of acupuncture. 30
- (10) Clinical medicine - a survey of the clinical practice of medicine, osteopathy, dentistry, psychology, nursing, chiropractic, podiatry, and homeopathy to familiarize practitioners with the practices of other health care practitioners.
- (11) History of medicine - a survey of medical history, including transcultural healing practices.
- (12) Medical terminology - fundamentals of English language medical terminology.
- (13) General sciences - a survey of or courses in general biology, chemistry, and physics.
- (14) Anatomy - a survey of microscopic and gross anatomy and neuroanatomy.
- (15) General Psychology - including counseling skills.
- (16) Physiology - a survey of basic physiology, including neurophysiology, endocrinology, and neurochemistry.
- (17) Pathology - a survey of the nature of disease and illness, including microbiology, immunology, psychopathology, and epidemiology.
- (18) Clinical sciences - a review of internal medicine, pharmacology, neurology, surgery, obstetrics/gynecology, urology, radiology, nutrition, vitamins, and public health.
- (19) Western pharmacology. 558
- (20) A minimum of eight (8) hours in a certified course offering first-aid and adult/child cardiopulmonary resuscitation (CPR). Such course shall be taken from the American Red Cross, American Heart Association or other organization with an equivalent course work approved by the board.
- (f) The course work specified in this section shall extend over a minimum period of four (4) academic years, eight (8) semesters, twelve (12) quarters, nine (9) trimesters, or thirty-six (36) months. No more than 1500 hours of clinical training and/or theoretical and didactic training is to be completed per twelve (12) month period.
- (g) The acupuncture services provided by the trainee shall be done so in a manner which does not endanger the health and welfare of patients receiving such services.
No trainee shall render acupuncture services to any patient unless the patient has been informed that such services will be rendered by that trainee. The patient on each occasion of treatment shall be informed of the procedure to be performed by the trainee under the supervision of the supervising acupuncturist and have consented in writing prior to performance to permit such rendering of the acupuncture procedure by the trainee. The foregoing requirements shall also be applied to those instances wherein the trainee is to assist the supervisor in the rendering of acupuncture services.
- (h) The acupuncture tutorial training program shall be set forth in a written agreement signed by the supervisor and trainee which sets forth, but is not limited to, the training plan, length of training time, the method for providing the theoretical and didactic training and guidelines for supervision of the acupuncture services rendered by the trainee. A copy of such written agreement shall be submitted with the application for approval.
- (i) As a condition of approval, or continued approval, all tutorial programs are subject to an on-site visit by representatives of the board to review and evaluate the status of the program. It will be the responsibility of the trainee and supervisor to reimburse the board for direct costs incurred in conducting such review and evaluation.
- (j) Acupuncture trainees shall have met the following prerequisites prior to the approval of the tutorial program:
- (1) Be at least 18 years of age.
- (2) Successful completion of an approved high school course of study or have passed a standard equivalency test.
- (k) An acupuncture tutorial shall be made available regardless of sex, race, religion, creed, color or physical handicap.
- (l) The requirements of this section shall not apply to persons who commenced a tutorial and registered with the board as provided in Section 1399.424 prior to January 1, 1999. Such persons shall meet the curriculum and clinical training requirements in effect at the time that their application for a tutorial program was approved by the board.
Each supervising acupuncturist shall have the following duties and responsibilities:
- (a) A supervisor shall at all times be responsible for and provide supervision of the work performed by the trainee as required in these regulations.
- (b) The supervisor shall only assign those patient treatments which can be safely and effectively performed by the trainee and which are consistent with the level of training received by the trainee. The supervisor shall provide continuous direction and immediate supervision of the trainee when patient services are provided. The supervisor shall be in the same facility as and in proximity to the location where the trainee is rendering services and shall be readily available at all times to provide advice, instruction and assistance to the trainee.
- (c) The supervisor shall insure that patient informed consent is obtained when necessary.
- (d) The supervisor shall insure that the objectives of the training plan submitted are provided and met by the trainee, and that the required theoretical training is obtained in accordance with subsection (c) of Section 1399.425.
- (e) The supervisor shall insure that the trainee complies with the standards of practice in Article 5 of the Acupuncture Regulations.
- (f) The supervisor shall file quarterly with the board a progress report on a form provided by the board which sets forth the schedules for theoretic and didactic training and for clinical training of the trainee.
- (g) The supervisor shall insure that when rendering services or otherwise engaging in professional activity the trainee always identifies himself or herself as an "acupuncture trainee" and wears at such times the identification badge required in Section 1399.427.
- (h) There shall be no separate billing by the trainee.
- (i) The supervisor shall comply with the provisions of the acupuncture law, the Acupuncture Regulations and applicable laws and regulations governing wages and compensation paid to employees or apprentices, maximum hours and working conditions. Any overtime worked by the trainee shall not interfere with or impair the training program and shall not be detrimental to the health and safety of the trainee or patients.
Each acupuncture trainee shall have the following duties and responsibilities:
- (a) The trainee shall not provide acupuncture services without the required supervision or autonomously, and shall not provide any services for which he or she is not trained or competent to perform.
- (b) The trainee shall satisfactorily meet the objectives of the training plan submitted to the board, including the necessary theoretical training.
- (c) The trainee shall comply with the standards of practice in Article 5 of the Acupuncture Regulations.
- (d) The trainee shall always identify himself or herself as an acupuncture trainee when rendering services or otherwise engaging in professional activity and shall wear at such times an identification badge on an outer garment and in plain view which states the trainee's name and the title "Acupuncture Trainee."
- (e) The trainee shall report to the board any delay, interruption or termination of the acupuncture tutorial not reported by the supervisor.
- (f) The trainee shall maintain a written log of the patients whom he or she has seen during the clinical training. The log shall contain the date and time of the patient visit and a description of the acupuncture services provided by the trainee to the patient. The log shall be made available to the board upon request.
- (a) The board shall be notified in writing within ten (10) calendar days of the termination of any acupuncture tutorial for any reason. At the time of such notification the registration of both the supervisor and trainee shall be cancelled. If the supervisor or trainee subsequently participate in an acupuncture tutorial, a new application for registration shall be filed with the board as set forth in Section 1399.424.
- (b) If the training plan of the acupuncture tutorial is substantially modified then a report of such modifications shall be filed with the board. There shall be no charge for filing such a report.
At the completion of the tutorial the trainee may file an application for examination.
The board may deny, issue subject to terms and conditions, suspend, revoke or place on probation a registration to supervise a trainee in an acupuncture tutorial for the following causes:
- (a) Failure to comply with the provisions of Section 4940 of the code or the Acupuncture Tutorial Regulations for approval of an acupuncture tutorial.
- (b) Violation of the Acupuncture Licensure Act or the Acupuncture Regulations.
- (c) The supervisor is the subject of a successful disciplinary action or has had charges in a disciplinary action filed against him or her.
- (d) The registration was obtained by fraud or misrepresentation or false or misleading information was presented to the division with respect to an acupuncture tutorial.
- (e) Failure of the supervisor or the trainee to comply with the regulations relating to supervision, patient care or informed consent.
- (f) The trainee has rendered acupuncture services in violation of this act within the setting of the acupuncture tutorial regardless of whether the supervising acupuncturist has knowledge of the acts performed.
The board may deny, issue, subject to terms and conditions, suspend, revoke or place on probation a registration as a trainee in an acupuncture tutorial for the following causes:
- (a) Failure to comply with the Acupuncture Tutorial Regulations for approval and registration as a trainee.
- (b) Violation of the Acupuncture Licensure Act or the Acupuncture Regulations.
- (c) The registration was obtained by fraud or misrepresentation or false or misleading information was presented to the division with respect to the acupuncture tutorial.
- (d) Failure to comply with the regulations relating to supervision, patient care or informed consent.
- (e) The rendering of acupuncture services outside the approved acupuncture tutorial.
- (f) Failure to identify oneself as an acupuncture trainee or failure to wear an appropriate identification badge when rendering acupuncture services.
- (g) Rendering acupuncture services under a supervising acupuncturist who is not approved as a supervisor by the board or whose registration as a supervisor has been disciplined under Section 1399.430.
Any proceedings to suspend or revoke the registration of a supervising acupuncturist or trainee or to deny such registration on grounds of unprofessional conduct shall be conducted pursuant to the Administrative Procedure Act (Section 11500 et seq. of the Government Code).