H-0204.5          _______________________________________________

 

                                  HOUSE BILL 1392

                  _______________________________________________

 

State of Washington              52nd Legislature             1991 Regular Session

 

By Representatives Locke, Prince, Braddock, Ballard, Wang and Brekke.

 

Read first time January 28, 1991.  Referred to Committee on Health Care.Making major changes to acupuncturist licensure.


     AN ACT Relating to acupuncture; amending RCW 18.06.010, 18.06.020, 18.06.030, 18.06.040, 18.06.080, 18.06.090, 18.06.110, 18.06.120, 18.06.130, 18.06.140, 18.06.170, and 18.06.190; adding a new section to chapter 18.06 RCW; creating a new section; and repealing RCW 18.06.910 and 18.06.911.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

 

     Sec. 1.  RCW 18.06.010 and 1985 c 326 s 1 are each amended to read as follows:

     The following terms in this chapter shall have the meanings set forth in this section unless the context clearly indicates otherwise:

     (1) "Acupuncture" means a health care service based on a traditional Oriental system of medical theory utilizing Oriental diagnosis and treatment to promote health and treat organic or functional disorders by treating specific acupuncture points or meridians.  Acupuncture includes but is not necessarily limited to the following techniques:

     (a) Use of acupuncture needles to stimulate acupuncture points and meridians;

     (b) Use of electrical, mechanical, or magnetic devices to stimulate acupuncture points and meridians;

     (c) Moxibustion;

     (d) Acupressure and therapeutic massage based on traditional Asian medical theory;

     (e) Cupping;

     (f) Dermal friction technique (((gwa hsa)));

     (g) Infra-red;

     (h) Sonopuncture;

     (i) Laserpuncture;

     (j) Dietary advice based on traditional Chinese medical theory; ((and))

     (k) Point injection therapy (aquapuncture); and

     (l) Therapeutic breathing and exercise techniques based on traditional Asian medical theory.

     (2) "Acupuncturist" means a person ((certified)) licensed under this chapter.

     (3) "Department" means the department of ((licensing)) health.

     (4) (("Director" means the director of licensing or the director's designee)) "Secretary" means the secretary of health or the secretary's designee.

 

     Sec. 2.  RCW 18.06.020 and 1985 s 326 s 2 are each amended to read as follows:

     (1) No one may hold themselves out to the public as an acupuncturist or ((certified)) licensed acupuncturist or any derivative thereof which is intended to or is likely to lead the public to believe such a person is an acupuncturist or ((certified)) licensed acupuncturist unless ((certified)) licensed as provided for in this chapter.  No one may perform acupuncture unless licensed as provided for in this chapter or exempted.

     (2) No one may use any configuration of letters after their name (including Ac.) which indicates a degree or formal training in acupuncture unless ((certified)) licensed as provided for in this chapter.

     (3) The ((director)) secretary may by rule proscribe or regulate advertising and other forms of patient solicitation which are likely to mislead or deceive the public as to whether someone is ((certified)) licensed under this chapter.

 

     Sec. 3.  RCW 18.06.030 and 1985 c 326 s 3 are each amended to read as follows:

     Any person ((certified)) licensed as provided for in this chapter may practice acupuncture irrespective of any other occupational licensing law.  This authorization also extends to:

     (1) The practice of acupuncture by a person who is a regular student in a school of acupuncture approved by the ((director)) secretary:  PROVIDED, HOWEVER, That the performance of such services be pursuant only to a regular course of instruction or assignments from his or her instructor and that such services are performed only under the direct supervision and control of a person ((certified)) licensed pursuant to this chapter or licensed under any other healing art whose scope of practice includes acupuncture; and

     (2) The practice of acupuncture by any person licensed or certified to perform acupuncture in any other jurisdiction where such person is doing so in the course of regular instruction of a school of acupuncture approved by the ((director)) secretary or in an educational seminar sponsored by a professional organization of acupuncture:  PROVIDED, That in the latter case, the practice is supervised directly by a person ((certified)) licensed pursuant to this chapter or licensed under any other healing art whose scope of practice includes acupuncture.

 

     Sec. 4.  RCW 18.06.040 and 1985 c 326 s 4 are each amended to read as follows:

     The proscriptions contained in RCW 18.06.020 (1) and (2) do not extend to:

     (1) Those holding valid licenses under chapter 18.71, 18.57, 18.22, or 18.32 RCW operating within their lawful scopes of practice or valid registration authorizing the performance of acupuncture procedures pursuant to chapter 18.71A or 18.57A RCW;

     (2) Those practicing acupuncture in the state under the authority of any instrumentality of the United States; and

     (3) Those performing acupuncture procedures under RCW 18.06.030 (1) and (2).

PROVIDED, That such persons shall not hold themselves out as being ((certified)) licensed acupuncturists under this chapter.

 

     Sec. 5.  RCW 18.06.080 and 1985 c 326 s 8 are each amended to read as follows:

     (1) The ((director of licensing)) secretary of health is hereby authorized and empowered to execute the provisions of this chapter and shall offer examinations in acupuncture at least twice a year at such times and places as the ((director)) secretary may select.  The examination shall be a written examination in English and may include a practical examination.

     (2) The ((director)) secretary shall develop or approve a licensure examination in the subjects that the ((director)) secretary determines are within the scope of and commensurate with the work performed by ((certified)) licensed acupuncturists and shall include but not necessarily be limited to anatomy, physiology, ((bacteriology)) microbiology, biochemistry, pathology, hygiene, and acupuncture.  All application papers shall be deposited with the ((director)) secretary and there retained for ((a [at])) at least one year, when they may be destroyed.

     (3) If the examination is successfully passed, the ((director)) secretary shall confer on such candidate the title of ((Certified)) Licensed Acupuncturist.

 

     Sec. 6.  RCW 18.06.090 and 1985 c 326 s 9 are each amended to read as follows:

     Before ((certification)) licensure, each applicant shall demonstrate sufficient fluency in reading, speaking, and understanding the English language to enable the applicant to communicate with other health care providers and patients concerning health care problems and treatment.

 

     Sec. 7.  RCW 18.06.110 and 1987 c 150 s 9 are each amended to read as follows:

     The uniform disciplinary act, chapter 18.130 RCW, governs ((uncertified)) unlicensed practice, the issuance and denial of ((certificates)) licenses, and the disciplining of ((certificate)) license holders under this chapter.  The ((director)) secretary shall be the disciplining authority under this chapter.

 

     Sec. 8.  RCW 18.06.120 and 1985 c 326 s 12 are each amended to read as follows:

     (1) Every person ((certified)) licensed in acupuncture shall register with the ((director)) secretary annually and pay an annual renewal registration fee determined by the ((director)) secretary as provided in RCW ((43.24.086)) 43.70.250 on or before the ((certificate)) license holder's birth anniversary date.  The ((certificate)) license of the person shall be renewed for a period of one year or longer in the discretion of the ((director)) secretaryA person whose practice is exclusively out-of-state or who is on sabbatical shall be granted an inactive license status and pay a reduced registration fee.  The reduced fee shall be set by the secretary under RCW 43.70.250.

     (2) Any failure to register and pay the annual renewal registration fee shall render the ((certificate)) license invalid.  The ((certificate)) license shall be reinstated upon:  (a) Written application to the ((director)) secretary; (b) payment to the state of a penalty fee determined by the ((director)) secretary as provided in RCW ((43.24.086)) 43.70.250; and (c) payment to the state of all delinquent annual ((certificate)) license renewal fees.

     (3) Any person who fails to renew his or her ((certification)) license for a period of three years shall not be entitled to renew such ((certification)) license under this section.  Such person, in order to obtain a ((certification)) license in acupuncture in this state, shall file a new application under this chapter, along with the required fee, and shall meet examination or continuing education requirements as the ((director)) secretary, by rule, provides.

     (4) All fees collected under this section and RCW 18.06.060 shall be credited to the health professions account as required under RCW ((43.24.072)) 43.70.320.

 

     Sec. 9.  RCW 18.06.130 and 1985 c 326 s 13 are each amended to read as follows:

     The ((director)) secretary shall develop a form to be used by an acupuncturist to inform the patient of the acupuncturist's scope of practice and qualifications.  All ((certificate)) license holders shall bring the form to the attention of the patients in whatever manner the ((director)) secretary, by rule, provides.

 

     Sec. 10.  RCW 18.06.140 and 1985 c 326 s 14 are each amended to read as follows:

     Every ((certified)) licensed acupuncturist shall develop a written plan for consultation, emergency transfer, and referral to other health care practitioners operating within the scope of their authorized practices.  The written plan shall be submitted with the initial application for ((certification)) licensure as well as annually thereafter with the ((certificate)) license renewal fee to the department.  The department may withhold ((certification)) licensure or renewal of ((certification)) licensure if the plan fails to meet the standards contained in rules ((promulgated)) adopted by the ((director)) secretary.

     When the acupuncturist sees patients with potentially serious disorders such as cardiac conditions, acute abdominal symptoms, and such other conditions, the acupuncturist shall immediately request a consultation or recent written diagnosis from a physician licensed under chapter 18.71 or 18.57 RCW.  In the event that the patient with the disorder refuses to authorize such consultation or provide a recent diagnosis from such physician, acupuncture treatment shall not be continued.

 

     Sec. 11.  RCW 18.06.170 and 1985 c 326 s 17 are each amended to read as follows:

     (1) The acupuncture advisory committee is created.  The committee shall be composed of one physician licensed under chapter 18.71 or 18.57 RCW, three acupuncturists ((certified)) licensed under this chapter, and one public member, who does not have any financial interest in the rendering of health services.

     (2) The ((director)) secretary shall appoint members to staggered terms so as to provide continuity in membership.  Members shall serve at the pleasure of the ((director)) secretary but may not serve more than five years total.  Members of the committee shall be reimbursed for travel expenses as provided in RCW 43.03.050 and 43.03.060.

     (3) Each member of the committee shall receive fifty dollars for each day during which the member attends an official meeting of the group or performs statutorily prescribed duties approved by the ((director)) secretary.

     (4) The committee shall meet only on the request of the ((director)) secretary and consider only those matters referred to it by the ((director)) secretary.

 

     Sec. 12.  RCW 18.06.190 and 1985 c 326 s 19 are each amended to read as follows:

     The ((director)) secretary may ((certify)) license a person without examination if such person is licensed or certified as an acupuncturist in another jurisdiction if, in the ((director's)) secretary's judgment, the requirements of that jurisdiction are equivalent to or greater than those of Washington state.

 

     NEW SECTION.  Sec. 13.     The following acts or parts of acts are each repealed:

     (1) RCW 18.06.910 and 1990 c 297 s 15; and

     (2) RCW 18.06.911 and 1990 c 297 s 16.

 

     NEW SECTION.  Sec. 14.  A new section is added to chapter 18.06 RCW to read as follows:

     Irrespective of any other provisions of this chapter, a person may practice acupuncture for the treatment of alcoholism or chemical dependency or both in a facility licensed and certified by the department of social and health services for the treatment of alcoholism or chemical dependency, or statutorily exempt from such licensure and certification, provided that the person has completed a chemical dependency acupuncture assistant program approved by the department, and is supervised by an acupuncturist licensed under this chapter who has completed an approved training program in chemical dependency.  The secretary shall by rule provide for the eligibility and licensing criteria and requirements as necessary under this section.

 

     NEW SECTION.  Sec. 15.     The secretary shall adopt rules that are necessary to make the transition from certification to licensure smooth and efficient.