In 1980, Florida legislators created the Acupuncture practice scope as seen in F.S. 457. Beginning with 457.101 ‘Legislative Intent’, they set out to protect the health, welfare and safety of all Floridians and clearly noted that ‘Acupuncture’ was a healing art and that this statute was to also enable freedom of access to all Floridians ‘who sought this care’.
In addition, the legal definition of Acupuncture, F.S. 457.102(1), establishes that this healing art is a form of primary healthcare……
457.102 Definitions.--As used in this chapter:
(1) "Acupuncture" means a form of primary health care, based on
traditional Chinese medical concepts and modern oriental medical techniques,
that employs acupuncture diagnosis and treatment, as well as adjunctive
therapies and diagnostic techniques, for the promotion, maintenance, and
restoration of health and the prevention of disease. Acupuncture shall include,
but not be limited to, the insertion of acupuncture needles and the application
of moxibustion to specific areas of the human body and the use of
electroacupuncture, Qi Gong, oriental massage, herbal therapy, dietary
guidelines, and other adjunctive therapies, as defined by board rule.
Bear in mind that the majority of this definition was in fact set down in 1980 with some clarification during recent years.
Also attached please find the Florida Administrative Code provision to further define Licensed Acupuncturists (Acupuncture Physicians). More specifically these code provisions establish the basis for the significant healthcare didactic and clinical training required of all Florida Licensed Acupuncturists:
64B1-4.001(2) Program Requirements.
64B1-4.001(5) Safe & beneficial use of western laboratory and image test findings.
64B1-4.0015 Supervised Clinical Experience utilizing findings of laboratory & image findings.
64B1-4.010 Traditional Chinese Medical Concepts, Modern Oriental Medical Techniques.
64B1-4.011 Diagnostic Techniques.
64B1-4.012 Acupoint hypodermic needle injection therapy.
64B1-7.0015 Continuing Education Requirements in HIV/AIDS, Medical Errors, Laboratory & Imaging, Law & Rules plus additional requirements.
64B1-8.005 Infection Control Training
64B1-10.002 Medical Records
There exist two administrative case law rulings by Florida Administrative Law Judge E.J. Davis, which we have provided for your review to further obtain other underlying important perspectives regarding Florida Licensed Acupuncturists as ‘primary care providers’. A copy of Department of Administrative Hearing Case #00-4737 and Case #01-0025 are attached.
While Florida is only one state in the United States of America, it has clearly defined the physician role of its Licensed Acupuncturists within the healthcare system through state statutory, regulatory and case law. Similar law and public policy exists in California, New Mexico, and Arkansas. This professional recognition is significant in that these states which regulate about 80% of all the best-trained Licensed Acupuncturists within the United States.
If additional information would be required or you would like for either of us to attend future hearings or other meetings pertaining to these matters, we would welcome the opportunity for further involvement.
Thank you for the opportunity to provide this information to assist the committee in it’s information gathering and decision making process.
The 2002 Florida Statutes
Title XXXII
Regulation Of Professions And Occupations
CHAPTER 457 ACUPUNCTURE
457.101 Legislative intent.--The Legislature finds that the interests of the
public health require the regulation of the practice of acupuncture in this
state for the purpose of protecting the health, safety, and welfare of our
citizens while making this healing art available to those who seek it.
History.--ss. 1, 2, ch. 80-375; ss. 2, 3, ch. 81-318; ss. 1, 13, 14, ch.
86-265; s. 57, ch. 91-137; s. 4, ch. 91-156; s. 4, ch. 91-429. Note.--Former s.
468.321.
457.102 Definitions.--As used in this chapter:
(1) "Acupuncture" means a form of primary health care, based on
traditional Chinese medical concepts and modern oriental medical techniques,
that employs acupuncture diagnosis and treatment, as well as adjunctive
therapies and diagnostic techniques, for the promotion, maintenance, and
restoration of health and the prevention of disease. Acupuncture shall include,
but not be limited to, the insertion of acupuncture needles and the application
of moxibustion to specific areas of the human body and the use of
electroacupuncture, Qi Gong, oriental massage, herbal therapy, dietary
guidelines, and other adjunctive therapies, as defined by board rule.
(2) "Acupuncturist" means any person licensed as provided in this chapter to practice acupuncture as a primary health care provider.
(3) "Board" means the Board of Acupuncture.
(4) "License" means the document of authorization issued by the department for a person to engage in the practice of acupuncture.
(5) "Department" means the Department of Health.
(6) "Oriental medicine" means the use of acupuncture, electroacupuncture, Qi Gong, oriental massage, herbal therapy, dietary guidelines, and other adjunctive therapies.
(7) "Prescriptive rights" means the prescription,
administration, and use of needles and devices, restricted devices, and
prescription devices that are used in the practice of acupuncture and oriental
medicine.
History.--ss. 1, 2, ch. 80-375; ss. 2, 3, ch. 81-318; s. 38, ch. 83-329; ss. 2,
13, 14, ch. 86-265; s. 57, ch. 91-137; s. 4, ch. 91-156; s. 4, ch. 91-429; s.
101, ch. 94-218; s. 6, ch. 97-264; s. 1, ch. 98-418; s. 90, ch. 99-397; s. 62,
ch. 2000-318.
Note.--Former s. 468.322.
64B1-4.001 Acupuncture Program Requirements.
In order to be certified to take the licensure examination, the applicant must
establish that he/she has met the following minimal requirements. For persons
who enrolled on or after July 1, 1997, the applicant must complete the program
in which they have enrolled.
(1) For students enrolled in a program prior to August 1, 1997, applicants
under this section must have completed at least 900 hours of supervised
instruction in traditional oriental acupuncture and at least 600 hours of
supervised clinical experience. All applicants under this provision must have
started classes no later than February 1, 1998.
(2) For applicants who enroll on or after August 1, 1997, applicants must have
completed a program that meets the following minimum requirements:
(a) 330 hours of supervised instruction in Biomedical Clinical Science, to
include 90 hours of pathology, 120 hours of anatomy and physiology and 120
hours of western biomedical and diagnostic terminology;
(b) 1,155 hours of supervised instruction in Traditional Oriental Acupuncture
Diagnosis and Treatment, to include 705 hours in Oriental Medical Theory,
Diagnosis and Treatment Techniques in Acupuncture and Related Studies, and 450
hours in Herbal Studies;
(c) 30 hours of supervised instruction in Introduction to Adjunctive Therapies
and 200 hours of supervised instruction in Electives in Adjunctive Therapies;
(d) 660 hours of supervised clinical experience as defined in Rule 64B1-4.0015,
F.A.C.;
(e) 15 hours of supervised instruction in Universal Precautions and 3 hours of
HIV/AIDS that complies with the requirements of Section 456.033, F.S.;
(f) 20 hours of supervised instruction in Florida Statutes & Rules,
including Chapters 456 and 457, F.S., and this rule chapter.
(3) Applicants who apply for licensure on or after August 1, 2001 must have
completed a core curriculum comparable to that of the Accreditation Commission
for Acupuncture and Oriental Medicine (ACAOM) master’s level program in
oriental medicine with a minimum of 2700 hours of supervised instruction:
(a) 15 hours of supervised instruction in universal precautions and 3 hours of
HIV/AIDS that complies with the requirements of Section 456.033, F.S.; and
(b) 20 hours of supervised instruction in Florida Statutes and Rules, including
Chapters 456 and 457, F.S., and this rule chapter.
(4) Applicants who apply for licensure on or after October 1, 2003 must have
graduated from an ACAOM candidate or accredited 4-year master’s level
program or foreign equivalent in oriental medicine with a minimum of 2700 hours
of supervised instruction:
(a) 15 hours of supervised instruction in universal precautions and 3 hours of
HIV/AIDS that complies with the requirements of Section 456.033, F.S.; and
(b) 20 hours of supervised instruction in Florida Statutes and Rules, including
Chapters 456 and 457, F.S., and this rule chapter.
(5) For applicants who enroll on or after July 31, 2001, applicants must have
completed an eight hour program that incorporates the safe and beneficial use
of laboratory test and imaging findings in the practice of acupuncture and
oriental medicine.
Specific Authority 456.033, 457.102, 457.104 457.105 FS. Law Implemented
456.033, 457.102, 457.105 FS. History–New 8-30-84, Formerly 21AA-4.01,
Amended 7-20-88, 4-30-89, 9-19-89, 3-18-92, Formerly 21AA-4.001, 61F1-4.001,
Amended 3-24-96, Formerly 59M-4.001, Amended 12-31-97, 11-1-99, 6-21-00,
4-3-01.
64B1-4.0015 Supervised Clinical Experience Defined.
For the purposes of Rule 64B1-4.001, F.A.C., the Board defines “supervised
clinical experience” as follows:
(6) For applicants who enroll on or after July 31, 2001, during supervised
clinical experience, the student must observe and use the findings of
laboratory test and imaging findings in the course of patient treatment.
Specific Authority 457.104, 457.105 FS. Law Implemented 457.105 FS.
History–New 11-21-95, Amended 2-19-96, Formerly 59M-4.0015 Amended
8-3-00,2-26-01.
64B1-4.010 Traditional Chinese Medical Concepts, Modern Oriental
Medical Techniques.
Traditional Chinese medical concepts and modern oriental medical techniques
shall include acupuncture diagnosis and treatment to prevent or correct malady,
illness, injury, pain, addictions, other conditions, disorders, and dysfunction
of the human body; to harmonize the flow of Qi or vital force; to balance the
energy and functions of a patient; and to promote, maintain, and restore
health; for pain management and palliative care; for acupuncture anesthesia;
and to prevent disease by the use or administration of: stimulation to
acupuncture points, ah-shi points, auricular points, channels, collaterals,
meridians, and microsystems which shall include the use of: akabane; allergy
elimination techniques; breathing; cold; color; correspondence; cupping;
dietary guidelines; electricity; electroacupuncture; electrodermal screening
(EDS); exercise; eight principles; five element; four levels; hara; heat;
herbal therapy consisting of plant, animal, and/or mineral substances; infrared
and other forms of light; inquiring of history; jing-luo; listening;
moxibustion; needles; NAET; observation; oriental massage - manual and
mechanical methods; palpation; physiognomy; point micro-bleeding therapy;
pulses; qi; xue and jin-ye; ryodoraku; san-jiao; six stages; smelling; tongue;
tai qi; qi gong; wulun-baguo; yin-yang; zang-fu; Ayurvedic, Chinese, Japanese,
Korean, Manchurian, Mongolian, Tibetan, Uighurian, Vietnamese, and other east
Asian acupuncture and oriental medical concepts and treatment techniques;
French acupuncture; German acupuncture including electroacupuncture and
diagnosis; and, the use of laboratory test and imaging findings.
Specific Authority 457.102, 457.104 FS. Law Implemented 457.102 FS.
History–New 11-6-01.
64B1-4.011 Diagnostic Techniques.
Diagnostic techniques which assist in acupuncture diagnosis, corroboration
and monitoring of an acupuncture treatment plan or in making a determination to
refer a patient to other health care providers shall include: traditional
Chinese medical concepts and modern oriental medical techniques, recommendation
of home diagnostic screening; physical examination; use of laboratory test
findings; use of imaging films, reports, or test findings; office screening of
hair, saliva and urine; muscle response testing; palpation; reflex; range of
motion; sensory testing; thermography; trigger points; vital signs; first-aid;
hygiene; and sanitation.
Specific Authority 457.102(1), 457.104 FS. Law Implemented 457.102(1) FS.
History–New 11-6-01.
64B1-4.012 Acupoint Injection Therapies.
Effective March 1, 2002, adjunctive therapies shall include acupoint
injection therapy which shall mean the injection of herbs, homeopathics, and
other nutritional supplements in the form of sterile substances into
acupuncture points by means of hypodermic needles but not intravenous therapy
to promote, maintain, and restore health; for pain management and palliative
care; for acupuncture anesthesia; and to prevent disease.
Specific Authority 457.102, 457.104 FS. Law Implemented 457.102 FS.
History–New 2-18-01.
64B1-7.0015 Continuing Education Requirement.
(1) As a condition of the biennial renewal of a license, each licensee shall
complete a minimum of 20 credit hours per biennium of continuing education that
meets the requirements of Chapter 457, Florida Statutes. Effective March 1,
2002, as a condition of the biennial renewal of a license, each licensee shall
complete a minimum of 30 credit hours per biennium of continuing education that
meets the requirements of Section 457.107, Florida Statutes. Each biennium, the
licensee shall complete a Board-approved program awarding at least 2 hours of
continuing education credit concerning HIV/AIDS, which shall comply with the
requirements of Section 456.033(2), Florida Statutes. Pursuant to Section
456.033(2), Florida Statutes, each licensee shall submit confirmation of having
completed said course when submitting fees for each biennial renewal. In lieu
of completing a course in HIV/AIDS as required above, the licensee may complete
a course in end-of-life care and palliative health care, so long as the
licensee completed an approved HIV/AIDS course in the immediately preceding
biennium. Each biennium, the licensee shall complete a program awarding at
least 5 hours of continuing education credit concerning the use of laboratory
test findings. Each biennium, the licensee shall complete a program awarding at
least 3 hours of continuing education credit concerning the use of imaging
findings. Each biennium, the licensee shall complete a program on Chapters 456
and 457, Florida Statutes, and Rule Chapter 64B1, F.A.C., consisting of at
least 2 hours of study.
Specific Authority 456.033, 457.104, 457.107, 457.108, 457.1085 FS. Law
Implemented 456.033, 457.107, 457.108, 457.109, 457.1085 FS. History–New
3-18-97, Formerly 59M-7.0015, Amended 4-25-00, 4-3-01.
64B1-8.005 Infection Control Training.
Prior to commencement of clinical training, every approved course of study
and tutorial program shall provide training in clean needle technique and
universal precautions for preventing the transmission of blood born pathogens
and other infectious diseases, including, for example, HIV/AIDS, hepatitis,
staphylococcus, and tuberculosis.
Specific Authority 457.104, 457.105, 457.1085 FS. Law Implemented 457.1085 FS.
History–New 10-25-95, Formerly 59M-8.005.
64B1-10.001 Content and Retention of Medical Records.
(1) Acupuncturists are required to maintain written medical records justifying
the course of treatment of each patient. These records must include for each
patient at least the following:
(a) Patient’s Medical History;
(b) Acupuncture Diagnostic Impressions;
(c) Points Used and/or Treatment Procedures Administered at Each Visit;
(d) Acupuncturists’ Recommendations;
(e) Patient Progress Notes;
(f) Laboratory test results when appropriate and medically necessary; and
(g) Imaging films, reports or test results when appropriate and medically
necessary.
(2) All medical records must be maintained by the acupuncturist for a period of
five (5) years from the date of the last entry to the record.
Specific Authority 457.104, 457.109(1)(m) FS. Law Implemented 457.109(1)(m) FS.
History–New 5-24-87, Amended 12-21-87, Formerly 21AA-10.001, Amended
12-26-93, Formerly 61F1-10.001, 59M-10.001, Amended 2-26-01.