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THE SENATE |
S.B. NO. |
845 |
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THIRTY-SECOND LEGISLATURE, 2023 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to acupuncture.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
Accordingly, the purpose of this Act is to make comprehensive updates to chapter 436E, Hawaii Revised Statutes, regarding acupuncture practitioners to reflect modernized scopes of practice and licensing requirements.
SECTION 2. Chapter 436E, Hawaii Revised Statutes, is amended by adding three new sections to be appropriately designated and to read as follows:
"§436E-A Requirements for initial licensure. (a) To qualify for licensure after
July 1, 2025, an applicant shall submit evidence satisfactory to the board that
the applicant meets the following educational and examination requirements:
(1) An individual applying for initial
licensure shall have successfully completed an acupuncture medicine program
from an accredited acupuncture medicine institution; provided that those
applicants who graduated with an earned master's degree may apply to the board
for the "L.Ac." license designation, and those applicants who
graduated with an earned doctorate degree may apply to the board for the
"D.Ac." license designation; and
(2) All applicants for initial licensure
shall pass examinations and be certified by the National Certification
Commission for Acupuncture and Oriental Medicine, or its successor entity.
(b) Applicants who have earned a bachelor's,
master's, or doctoral degree from a foreign university or college shall
demonstrate curricula and standards equivalent to or higher than accredited
acupuncture medicine institutions in the United States, which have been
recognized and approved by the board.
The board may contract with a third-party agency to determine
equivalency, at cost to the applicant.
§436E-B Legacy exemptions. Any current acupuncture licensees in the State as of July 1, 2025, shall
be designated legacy status by the board for their current license designation,
allowing for the practice of acupuncture medicine. If a license that was issued before July 1,
2025, lapses and is not restored within two years of its expiration date, the
licensee shall be subject to the licensure requirements pursuant to section
436E-A.
§436E-C Reciprocity. (a) The board may issue a license
by reciprocity if the applicant:
(1) Files an application and pays fees
as prescribed by the board;
(2) Holds a current, unencumbered,
active license pursuant to the laws of any state or territory of the United
States with qualifications for licensure that are equal to or exceed those of the
State, as specified in section 436E-A; and
(3) Holds a current certification with
the National Certification Commission for Acupuncture and Oriental Medicine, or
its successor entity.
(b) For applicants who graduated before September
1, 2000, the board may issue a license by reciprocity if the applicant:
(1) Files an application and pays fees
as prescribed by the board;
(2) Holds a current, unencumbered,
active license from any state or territory of the United States; and
(3) Holds a current certification with the National Certification Commission for Acupuncture and Oriental Medicine, or its successor entity."
SECTION 3. Section 436E-1, Hawaii Revised Statutes, is amended to read as follows:
"[[]§436E-1[]]
Declaration of necessity for regulation and control. The legislature hereby finds and declares
that acupuncture medicine is an evidence-based medicine rooted in
traditional and modern modalities and that the practice of acupuncture [is
a theory and method for] medicine includes examination, evaluation,
diagnosis, and treatment of [illness and disability and for
strengthening and invigorating the body and as such affects] the patient,
therefore requiring regulation and control as an essential service for public
health, safety, and welfare[, and therefore there is a necessity that
individuals practicing acupuncture be subject to regulation and control]."
SECTION 4. Section 436E-2, Hawaii Revised Statutes, is amended as follows:
1. By adding eight new definitions to be appropriately inserted and to read:
""Accredited
acupuncture medicine institution" means a school or college accredited or
recognized as a candidate for accreditation by an acupuncture medicine
accrediting body recognized by the United States Department of Education.
"Acupuncture"
means the integrative examination, evaluation, diagnosis, prevention, and
treatment of a physical, mental, or emotional disease in the patient by
stimulating tissue by puncturing with a needle approved by the United States
Food and Drug Administration to various depths or utilizing other means to
achieve a response.
"Acupuncture
medicine" means the evidence-based medicine rooted in traditional theories
and practices, integrated with modern biomedical theories and practices.
"Acupuncture
medicine doctor" means an acupuncture practitioner engaged in the practice
of advanced acupuncture medicine.
"Licensed
acupuncturist" or "L.Ac." means an acupuncture practitioner who
has complied with all educational and professional examination requirements as
determined by the board and whose license remains in good standing with the
board, utilizing the license designation "L.Ac.".
"Licensed doctor of acupuncture" or "D.Ac." means an acupuncture medicine doctor who has complied with all educational and professional examination requirements as determined by the board and whose license remains in good standing with the board, utilizing the license designation "D.Ac.".
"Practice
of acupuncture medicine" means the practice of acupuncture with adjunctive
therapies, including but not limited to manual, mechanical, electrical, light,
sound, electromagnetic, thermal therapy, herbal and nutraceutical medicines,
lifestyle and nutritional counseling, movement, and other traditional and modern
techniques as further determined by rule.
"Practice of advanced acupuncture medicine" means the practice of acupuncture medicine as further determined by rule."
2. By amending the definition of "acupuncture practitioner" to read:
""Acupuncture
practitioner" means a person engaged in the practice of acupuncture[.]
medicine."
3. By repealing the definition of "practice of acupuncture".
[""Practice
of acupuncture" means stimulation of a certain acupuncture point or points
on the human body for the purpose of controlling and regulating the flow and
balance of energy in the body. The
practice includes the techniques of piercing the skin by inserting needles and
point stimulation by the use of acupressure, electrical, mechanical, thermal,
or traditional therapeutic means."]
SECTION 5. Section 436E-3, Hawaii Revised Statutes, is amended to read as follows:
"§436E-3
License or permit required.
Except as otherwise provided by law, no person shall engage in the
practice of acupuncture medicine or practice of advanced acupuncture
medicine or use the title "acupuncturist" in [this] the
State, either gratuitously or for pay, [or shall offer to so
practice, or shall announce themselves either publicly or privately as prepared
or qualified to so practice any method of acupuncture] without having [a
valid unrevoked license or] an acupuncture medicine intern permit [from
the State; provided that the requirement for a permit shall not be enforced
until the board has initially adopted rules] pursuant to section 436E‑3.6[.]
or an L.Ac or D.Ac designation from the board."
SECTION 6. Section 436E-3.5, Hawaii Revised Statutes, is amended to read as follows:
"§436E-3.5 Physicians and osteopaths not exempt. Persons licensed under chapter 453 who desire to engage in the practice of acupuncture medicine shall be subject to licensing under this chapter."
SECTION 7. Section 436E-3.6, Hawaii Revised Statutes, is amended to read as follows:
"[[]§436E-3.6[]] Acupuncture
medicine intern permit required.
[(a) Except as otherwise
provided by law, no] No person shall engage in the practice [as
an] of acupuncture medicine as an intern in this State,
either gratuitously or for pay, [without having first obtained a permit from
the board. This permit shall entitle the
applicant to engage in the practice of acupuncture for a period of four years
under the immediate supervision of a licensed acupuncturist duly licensed under
this chapter.
(b) An acupuncture intern permit may be reissued
once, for a period not to exceed one year, upon written request to the board
and payment of the required fee.
(c) The board shall adopt rules pursuant to
chapter 91 defining the functions of an acupuncture intern, establishing the
requirements to be met by an applicant for an acupuncture intern permit, and
specifying the procedures for the immediate supervision of the acupuncture
intern by a licensed acupuncturist.] unless the person:
(1) Is actively enrolled in a program
with an accredited acupuncture medicine institution;
(2) Has obtained a permit from the
board, which shall be valid for four years and may be renewed once for a period
not to exceed one year; and
(3) Is practicing under the immediate supervision of an acupuncture practitioner or acupuncture medicine doctor who is licensed in the State and contracted or employed through an accredited acupuncture medicine institution."
SECTION 8. Section 436E-6, Hawaii Revised Statutes, is amended to read as follows:
"§436E-6 Board of acupuncture. (a) There shall be a board of acupuncture, the members of which shall be appointed by the governor.
The
board shall consist of five persons, two of whom shall be private citizens and
three shall [acupuncturists licensed in accordance with this chapter.] licensed
acupuncturists or licensed doctors of acupuncture.
(b) [Commencing July 1, 1992, and thereafter,
each] Each person appointed to the board shall have a four-year term
and shall serve not more than two consecutive terms. [Members appointed to the board prior to
July 1, 1992, shall be permitted to continue to serve on the board until such
time when a maximum of eight consecutive years from the date of initial
appointment has been attained.]"
SECTION 9. Section 436E-9, Hawaii Revised Statutes, is amended to read as follows:
"[[]§436E-9[]] Biennial renewal[.]; continuing education. (a)
Every person holding a license under this chapter shall register with
the board and pay a biennial fee on or before June 30 of each odd-numbered
year. Failure to pay the biennial fee
shall constitute a forfeiture of the license as of the date of expiration. Any license so forfeited may be restored
within [one year] two years after the expiration upon filing of
an application and payment of a restoration fee.
(b) Beginning with the renewal for the licensing
biennium commencing July 1, 2025, and every biennial renewal thereafter, all
licensees shall be in compliance with continuing education requirements, as
approved by the board, by obtaining at least thirty credit hours, which shall
include at least two credit hours of ethics and at least two credit hours of
safety. The board shall adopt rules
relating to the requirements and standards that continuing education programs
shall meet to obtain recognition and approval from the board.
(c) To determine compliance with the continuing
education requirement under subsection (b), the board may conduct a random
audit of licensees. A licensee selected
for audit shall be notified by the board.
Within sixty days of notification, the licensee shall provide the board
documentation to verify compliance with the continuing education requirements.
(d) Licensees shall hold a current and valid cardiopulmonary resuscitation certification."
SECTION 10. Section 436E-10, Hawaii Revised Statutes, is amended to read as follows:
"§436E-10
Revocation or suspension of licenses[.]; penalties.
(a) In addition to any
other actions authorized by law, any license to engage in the practice of
acupuncture medicine or practice of advanced acupuncture medicine under
this chapter may be revoked or suspended by the board [of acupuncture] at
any time in a proceeding before the board for any cause authorized by law,
including but not limited to the following:
(1) Obtaining a fee on the assurance that a manifestly incurable ailment can be permanently cured;
(2) The use of false, fraudulent, or deceptive advertising and making untruthful and improbable statements;
(3) [Habitually using] Using
any [habit-forming] intoxicant or controlled substance[, such
as opium or any of its derivatives, morphine, heroin, or cocaine;] that
impairs or compromises a licensee's duties, as determined by rule;
(4) Procuring a license through fraud, misrepresentation, or deceit;
(5) Professional misconduct [or],
gross [carelessness] negligence, ethics violations, or manifest
incapacity [in the practice of acupuncture;], as determined by rule;
or
(6) Violating any rules adopted under this chapter.
(b) Any person who practices, treats, or instructs in any phase of acupuncture medicine, or uses any word or title to induce the belief that the person is engaged in the practice of any type of acupuncture medicine, without a license or permit issued by the board, shall be guilty of a misdemeanor and subject to a fine of not less than $1,000 for each day of violation. The board may also seek all legal and equitable remedies available to it for the enforcement of the provisions of this chapter, including injunctive relief."
SECTION 11. Section 436E-5, Hawaii Revised Statutes, is repealed.
["§436E-5
Qualifications for examination. (a) No
person shall be licensed to practice acupuncture unless the person has passed
an examination and has been found to have the necessary qualifications as
prescribed in the rules adopted by the board pursuant to chapter 91.
(b) Prior to September 1, 2000, and except as provided
in subsection (c), before any applicant shall be eligible for the examination,
the applicant shall furnish satisfactory proof to the board that the applicant
has received a total of not less than one thousand five hundred hours of
education and training consisting of:
(1) A formal program in the science of
acupuncture (traditional oriental medicine) at an institute or school approved
by the board that:
(A) Shall be for a period of not less
than two academic years (not less than six hundred hours); and
(B) Shall result in the award of a
certificate or diploma; and
(2) One clinical year in a clinical
internship program (not less than twelve months and not less than nine hundred
hours) supervised by a licensed acupuncturist; provided that the nine hundred
hours of the clinical internship program may be obtained from the institute or
school awarding the certificate or diploma or may be obtained under the
supervision of a licensed acupuncturist not affiliated with an institute or
school.
(c) Students who started training prior to
December 31, 1984, in a school approved by the board prior to December 31,
1984, and who complete their training by December 31, 1989, and who file an
application with the board before September 1, 2000 shall:
(1) Not lose their rights of continued
education, and earned or accumulated credits; and
(2) For the purposes of this chapter,
meet requirements for examination and licensure as provided in chapter 436D and
rules adopted by the board as they existed on December 31, 1984; provided that
the school has not altered its program so as to lower the standards for
completion of the program. These
students may qualify for examination if they submit evidence of having
completed:
(A) At least eighteen months (not less
than five hundred seventy-six hours) of academic training; and
(B) At least six months (not less than
four hundred eighty hours) of clinical training in the practice of acupuncture
on human subjects under the supervision of a licensed acupuncturist.
(d) Notwithstanding subsections (b) and (c),
effective September 1, 2000, before any applicant shall be eligible to take the
licensing examination, the applicant shall furnish satisfactory proof to the
board that the applicant has completed a formal acupuncture program and has
received a total of at least two thousand, one hundred seventy-five hours of
academic and clinical training consisting of an academic program of at least
one thousand, five hundred fifteen hours in the science of acupuncture
(traditional oriental medicine) and a clinical training program of at least six
hundred sixty hours under the supervision of a licensed acupuncturist, which
shall result in the award of a certificate or diploma. For applicants who graduated from an
institute, school, or college located in the United States or any territory
under the jurisdiction of the United States, the institute, school, or college
shall be accredited or recognized as a candidate for accreditation by any
acupuncture or oriental medicine accrediting body recognized by the United
States Department of Education. For
applicants who graduated from a foreign institute, school, or college with a
formal program in the science of acupuncture, the applicant, at the applicant's
own expense, shall have the applicant's transcripts and curriculum evaluated by
a board approved and designated
professional evaluator who shall make a determination whether the transcripts
and curriculum are at least equivalent to that of the United States accredited
acupuncture program, and that the foreign institute is licensed, approved, or
accredited by the appropriate governmental authority or an agency recognized by
a governmental authority in the respective foreign jurisdiction and whose
curriculum is approved by the board."]
SECTION 12. Section 436E-12, Hawaii Revised Statutes, is repealed.
["[§436E-12] Penalty. (a)
Any person except a person licensed under this chapter who practices,
treats, or instructs in any phase of acupuncture without a license or permit
issued by the board, or uses any word or title to induce the belief that they
are engaged in the practice of any type of acupuncture, shall be guilty of a
misdemeanor and subject to a fine of not less than $50 nor more than $1,000 for
each violation.
(b) Any person, except a licensed acupuncturist,
who:
(1) Practices or attempts to practice
acupuncture;
(2) Buys, sells, or fraudulently obtains
any diploma or license to practice acupuncture whether recorded or not;
(3) Uses the title
"acupuncturist", "D.Ac." or "D.O.M." or any word
or title to induce the belief that the person is engaged in the practice of
acupuncture without complying with this chapter; or
(4) Violates this chapter;
shall be
penalized as provided in subsection (a).
The department may also seek all legal and equitable remedies available
to it for the enforcement of the provisions of this chapter, including seeking
injunctive relief."]
SECTION 13. Section 436E-13, Hawaii Revised Statutes, is repealed.
["§436E-13
Use of titles.
(a) A licensee who has been
awarded a license to practice acupuncture by the board in this State may use
the title of "Licensed Acupuncturist" or designation
"L.Ac." with the licensee's name in an advertisement for acupuncture
or announce or append the designation to the licensee's name.
(b) A licensee who has been awarded an earned
doctoral degree may use the designation "Ph.D." in an advertisement
for acupuncture or announce or append the designation to the licensee's name if
the degree was granted from a university or college recognized by a regional or
national accrediting body recognized by the United States Department of
Education. A Ph.D. recognized by the
board under this subsection shall designate a nonpractitioner as opposed to a
practitioner or "doctor" of acupuncture as provided in subsection
(c).
(c) A licensee who has been
approved by the board to use the doctor of acupuncture title, may use the title
"Doctor of Acupuncture" or designation of "D.Ac.", after the licensee's
name, or the term "Doctor" or prefix "Dr." provided that the word "Acupuncturist" immediately follows the licensee's name if the term "Doctor", or the prefix "Dr." is used alone.
(d) Before any licensee shall be eligible to use
the doctor of acupuncture title, the licensee shall furnish satisfactory proof
to the board that the licensee has been awarded an earned doctoral degree in
acupuncture (traditional oriental medicine).
For licensees who graduated from an institute, school, or college located
in the United States or any territory under the jurisdiction of the United
States, the institute, school, or college shall be accredited or recognized as
a candidate for accreditation by a regional or national accrediting body that
is recognized by the United States Department of Education for the
accreditation or pre‑accreditation ("candidacy") of professional post-graduate doctoral programs in
acupuncture and oriental medicine. For
licensees who graduated from a foreign institute, school, or college, the
licensee, at the licensee's own expense, shall have the licensee's transcripts and curriculum evaluated by a board approved
and designated professional evaluator who shall make a determination on whether
the transcripts and curriculum are at least equivalent to the United States
recognized doctoral program of study in acupuncture and oriental medicine, and
that the foreign institute is licensed, approved, or accredited by the
appropriate governmental authority or an agency recognized by a governmental
authority in the respective foreign jurisdiction and whose curriculum is
approved by the board.
(e) Except as provided in this section, use of
other titles, prefixes, or designations shall not be permitted."]
SECTION 14. Section 436E-14, Hawaii Revised Statutes, is repealed.
["[§436E-14] Foreign school curricula and standards. The board of acupuncture shall not recognize
and approve an earned doctoral degree from a foreign university or college
whose curricula and standards are not equivalent to or higher than institutions
in the United States which have been recognized and approved by the board in
the study or practice of acupuncture."]
SECTION 15. In codifying the new sections added by section 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.
SECTION 16. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 17. This Act shall take effect on July 1, 2023.
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INTRODUCED BY: |
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Report Title:
Acupuncture; Acupuncture Practitioners; Acupuncture Medicine Doctors; Licensure; Continuing Education
Description:
Makes
comprehensive updates to chapter 436E, Hawaii Revised Statutes, regarding
acupuncture practitioners to reflect modernized scopes of practice, titles, and
licensing and renewal requirements.
Beginning with the renewal for the licensing biennium commencing
7/1/2025, requires licensees to obtain thirty hours of continuing education per
licensing biennium. Allows the Board of Acupuncture
to issue licenses by reciprocity.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.