Title of Regulation: 18VAC85-110. Regulations Governing the Practice of Licensed Acupuncturists (amending 18VAC85-110-50, 18VAC85-110-60; repealing 18VAC85-110-130).

Statutory Authority: §§ 54.1 2400 and 54.1-2956.9 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: September 11, 2013.

Effective Date: September 26, 2013.

Agency Contact: William L. Harp, M.D., Executive Director, Board of Medicine, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4558, FAX (804) 527-4429, or email william.harp@dhp.virginia.gov.

Basis: Section 54.1-2400 of the Code of Virginia provides the Board of Medicine the authority to promulgate regulations to administer the regulatory system, and § 54.1-2956.9 of the Code of Virginia provides the board specific authority for regulation of licensed acupuncturists.

Purpose: The purpose of the amended regulation is to update educational standards for consistency with the accrediting body for acupuncture education and eliminate a redundant requirement for maintenance of patient records. Existing regulations are essential for the protection of the public's health and safety in receiving acupuncture services.

Rationale for Using Fast-Track Process: The regulatory amendments provide less restrictive regulations, which have been approved by the Advisory Board on Acupuncture and have the unanimous approval of the Board of Medicine, and will not be controversial.

Substance: There are no substantive changes to existing regulations. Amendments to 18VAC85-110 (i) update and clarify regulations for acupuncture education and maintenance of records consistent with current requirements and policies of the board; (ii) repeal redundant, unnecessary requirements for maintenance of patient records; (iii) add educational standards that have been in effect for accredited institutions or programs since 2011; and (iv) allow applicants from foreign countries to use a translating service for their documents rather than having to go through their embassies.

Issues: There are no advantages or disadvantages to the public, which will continue to be protected by the same criteria for minimal competency for initial licensure. There are no advantages or disadvantages to the agency or the Commonwealth.

Small Business Impact Report of Findings: This regulatory action serves as the report of findings of the regulatory review pursuant to § 2.2-4007.1 of the Code of Virginia.

The Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Medicine (the Board) proposes to allow acupuncturist applicants to use a translating service for their documents in a foreign language rather than having to go through the embassy of the issuing government.

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact. The proposed regulations will allow applicants to use a translating service for their documents in a foreign language rather than having to go through the embassy of the issuing government. Currently, regulations require that documents which are not in English be translated and certified by the embassy of the issuing government. According to the Department of Health Professions (DHP), embassies often do not fulfill that service, so documents are generally translated by a translating service. The regulations are amended to allow for that option.

According to DHP, approximately one half of the 450 licensed acupuncturists in Virginia are from foreign countries. This proposed change will make it easier for them to have their documents translated and submitted to the Board.

The remaining changes are not expected to have any significant economic impact as they merely update and clarify regulations for acupuncture education and maintenance of records consistent with current requirements and policies of the Board.

Businesses and Entities Affected. The proposed regulations apply to 450 licensed acupuncturists in Virginia. One half of the licensed acupuncturists are estimated to be foreign and likely to benefit from being able to use a translating service for their foreign documents.

Localities Particularly Affected. The proposed regulations apply throughout the Commonwealth.

Projected Impact on Employment. Although the proposed changes have the potential to reduce demand for translating services from embassies and to increase demand from private entities offering translation services, the magnitude of the impact on employment is expected to be very small.

Effects on the Use and Value of Private Property. Although the proposed changes have the potential to increase demand from private entities offering translation services and have a positive impact on their asset values, the magnitude of the impact is not expected to be significant.

Small Businesses: Costs and Other Effects. Almost all of the licensed acupuncturists are thought to practice as small businesses. The proposed changes do not introduce any costs on them, but rather provide some benefit as discussed above.

Small Businesses: Alternative Method that Minimizes Adverse Impact. No adverse impact on small businesses is expected.

Real Estate Development Costs. No real estate development costs are expected from the proposed changes.

Legal Mandate. The Department of Planning and Budget (DPB) has analyzed the economic impact of this proposed regulation in accordance with § 2.2-4007.04 of the Administrative Process Act and Executive Order Number 14 (10). Section 2.2-4007.04 requires that such economic impact analyses include, but need not be limited to, a determination of the public benefit, the projected number of businesses or other entities to whom the regulation would apply, the identity of any localities and types of businesses or other entities particularly affected, the projected number of persons and employment positions to be affected, the projected costs to affected businesses or entities to implement or comply with the regulation, and the impact on the use and value of private property. Further, if the proposed regulation has an adverse effect on small businesses, § 2.2-4007.04 requires that such economic impact analyses include (i) an identification and estimate of the number of small businesses subject to the regulation; (ii) the projected reporting, recordkeeping, and other administrative costs required for small businesses to comply with the regulation, including the type of professional skills necessary for preparing required reports and other documents; (iii) a statement of the probable effect of the regulation on affected small businesses; and (iv) a description of any less intrusive or less costly alternative methods of achieving the purpose of the regulation. The analysis presented above represents DPB's best estimate of these economic impacts.

Agency's Response to Economic Impact Analysis: The Board of Medicine concurs with the analysis of the Department of Planning and Budget for 18VAC85-110, Regulations Governing the Practice of Licensed Acupuncturists, relating to regulatory reform changes.

Summary:

Amendments to 18VAC85-110 (i) update and clarify regulations for acupuncture education and maintenance of records consistent with current requirements and policies of the board; (ii) repeal redundant, unnecessary requirements for maintenance of patient records; (iii) add educational standards, which have been in effect for accredited institutions or programs since 2011; and (iv) allow applicants from foreign countries to use a translating service for their documents rather than having to go through their embassies.

Part II
Requirements for Licensure

18VAC85-110-50. Educational requirements: graduates of approved institutions or programs in the United States.

A. Requirements for acupuncture education obtained prior to July 1, 1990, shall be as provided in this subsection.

1. An applicant applying for licensure to practice as an acupuncturist on the basis of successful completion of education in a school or college of acupuncture accredited by the ACAOM or other accrediting agencies approved by the Board of Medicine, which confers a degree or certificate in acupuncture in the United States, shall submit evidence of successful completion of an acupuncture course of study in an accredited school or college for acupuncture, providing evidence of not less than 1,000 hours of schooling in not less than a continuous 18-month period.

2. The studies shall include not less than 700 didactic hours and not less than 250 clinical hours. Additional hours may be in either didactic or clinical hours based upon the school or college curriculum.

B. Requirements for acupuncture education obtained after July 1, 1990, shall be as provided in this subsection.

An applicant applying for licensure to practice as a licensed acupuncturist on the basis of successful completion of education in a school or college for acupuncture accredited by ACAOM or any other accrediting agency approved by the Board of Medicine, which confers a degree or certificate in acupuncture in the United States, shall submit evidence of having a minimum of three academic years in length equivalent to 90 semester credit hours or 135 quarter credit hours.

One academic year means full-time study completed in three four quarters, two semesters, or three trimesters. A full-time continuous study program shall be a concentrated educational process in acupuncture which that requires individual study with assigned materials in a classroom or clinical setting.

C. Requirements for acupuncture education obtained after July 1, 1999, shall be as provided in this subsection. An applicant applying for licensure to practice as a licensed acupuncturist on the basis of successful completion of education in a school or college for acupuncture accredited by ACAOM or any other accrediting agency approved by the Board of Medicine, which confers a degree or certificate in acupuncture in the United States, shall submit evidence of having a minimum of 1,725 hours of entry-level acupuncture education to include at least 1,000 didactic hours and 500 clinical hours. Clinical hours may include observation, as well as internship or treatment hours; the remaining 225 hours may be earned as either didactic or clinical. Correspondence programs or courses in acupuncture are excluded and do not may not be used to meet the requirements for acupuncture education.

D. Requirements for acupuncture education obtained after February 1, 2011, shall be as provided in this subsection. An applicant applying for licensure to practice as a licensed acupuncturist on the basis of successful completion of education in a school or college for acupuncture accredited by ACAOM or any other accrediting agency approved by the Board of Medicine, which confers a degree or certificate in acupuncture in the United States, shall submit evidence of having a minimum of 1,905 hours of entry-level acupuncture education to include at least 1,155 didactic hours and 660 clinical hours. Clinical hours may include observation, as well as internship or treatment hours; the remaining 90 hours may be earned as either didactic or clinical hours. Correspondence programs or courses in acupuncture are excluded and may not be used to meet the requirements for acupuncture education.

D. E. An applicant from an acupuncture program in a school or college that has achieved candidacy status for accreditation by ACAOM shall be eligible for licensure provided the program has subsequently been granted accreditation within three years of the applicant's graduation.

18VAC85-110-60. Requirements of foreign graduates of nonaccredited educational programs in acupuncture.

A. An applicant who has completed an educational course of study in a school or college outside the United States or Canada that is not accredited by ACAOM or any other board-approved accrediting agency shall:

1. Submit a transcript from his educational course of study in acupuncture to a credential evaluation service approved by the board to determine equivalency in education and training to that required in 18VAC85-110-50.

2. Meet the examination requirements as prescribed in 18VAC85-110-80 and 18VAC85-110-90.

B. All documents submitted to the board which are not in English must be translated into English and certified by the embassy of the issuing government or by a translating service.

18VAC85-110-130. Maintenance of patient records. (Repealed.)

A licensed acupuncturist shall maintain records of his diagnosis and treatment, and the patient's response to acupuncture and shall submit records to the board upon request, unless release of subject records is otherwise prohibited by law. Failure to maintain patient records of those patients treated with acupuncture or failure to respond to the board's request for patient records within 30 days shall be grounds for suspension or revocation of a license to practice acupuncture.