Acupuncture Regulations (Title 16, California Code of Regulations)

with amendments through July 1996

Issued by the Acupuncture Committee
1424 Howe Avenue, Suite 37
Sacramento, CA 95825-3233
Tel: (916) 263-2680
Fax: (916) 263-2654


CHAPTER 13.7. ACUPUNCTURE COMMITTEE

1. General Provisions
2. Applications Generally
3. Acupuncture Tutorials
3.5 Acupuncture Training Programs
4. Examinations and Demonstrations of Competency
5. Standards of Practice
6. Miscellaneous Provisions
7. Acupuncture Corporations
8. Continuing Education


Article 1. General Provisions
Section Topic
1399.400 Citation
1399.403 Definitions
1399.405 Delegation of Functions
1399.406 Filing of Addresses
Article 2. Applications Generally
Section Topic
1399.410 Verification
1399.411 Certification of Documentation
1399.412 Translation Required
1399.413 Application Deadline
1399.414 Denial of Applications
1399.415 Documentation of Training
1399.416 Equivalent Training and Clinical Experience Qualifying for Certification
1399.417 Abandonment of Applications
1399.418 Failure to Appear for Examination-- Withdrawal of Application
1399.419 Review & Processing of Exam Applications
Article 3. Acupuncture Tutorials
Section Topic
1399.420 Citation and Reference
1399.421 Definitions
1399.422 Prior Approval to Practice as an Acupuncture Trainee
1399.423 Prior Approval to Supervise an Acupuncture Trainee
1399.424 Filing of Applications; Credit for Prior Training
1399.425 Requirements for Approval of an Acupuncture Tutorial
1399.426 Supervising Acupuncturist's Responsibilities
1399.427 Trainee's Responsibilities
1399.428 Termination or Modification of Tutorial
1399.429 Application for Examination
1399.430 Denial. Suspension or Revocation of Registration as a Supervisor
1399.431 Denial, Suspension or Revocation of Registration as a Trainee
1399.432 Proceedings
Article 3.5 Acupuncture Training Programs
Section Topic
1399.436 Criteria for Approval of Acupuncture Training Programs
1399.437 Documentation Required for Approval
1399.438 Suspension or Revocation of Approval
1399.439 School Monitoring; Records; Reporting
Article 4. Examinations & Demonstrations of Competency
Section Topic
1399.440 Location
1399.441 Languages
1399.443 Examination Content
1399.444 Lapsed Licenses; Examination
1399.445 Examination Appeals
Article 5. Standards of Practice
Section Topic
1399.450 Condition of Office
1399.451 Treatment Procedures
1399.452 Treatments Outside the Office
1399.453 Record Keeping
1399.454 Prior Diagnosis or Referral Required
1399.455 Advertising
1399.456 Use of Title 'Doctor"
Article 6. Miscellaneous Provisions
Section Topic
1399.460 Fees
1399.461 Acupuncture Tutorials
1399.462 Continuing Education Fee
1399.463 Authority to Issue Citations and Fines
1399.464 Exceptions
1399.465 Citation; Assessment of Fine
1399.466 Compliance with Orders of Abatement
1399.467 Citations for Unlicensed Practice
1399.468 Contest of Citations
Article 7. Acupuncture Corporations
Section Topic
1399.470 Citation and Authority
1399.475 Requirements for Acupuncture Corporations
1399.476 Namestyle
1399.477 Shares: Ownership and Transfer
1399.478 Trusts
1399.479 Corporate Activities
Article 8. Continuing Education
Section Topic
1399.480 Definitions
1399.481 Criteria for Provider Approval
1399.482 Approved Providers
1399.483 Approval of Continuing Education Courses
1399.484 Application for Course Approval
1399.485 Instructors
1399.486 Advertisements
1399.487 Denial, Withdrawal and Appeal of Approval
1399.488 Processing Times for Provider and Course Request Applications
1399.489 Audit and Sanctions for Noncompliance
1399.489.1 Inactive License
1399.489.2 Continuing Education: Courses in Practice Management and Medical Ethics

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Article 1. General Provisions

1399.400. Citation.

This chapter may be cited and referred to as the "Acupuncture Regulations."

1399.403. Definitions.

For the purpose of the regulations contained in this chapter, the terms
(a) "Board" shall mean the Medical Board of California.
(b) 'Committee' shall mean the Acupuncture Committee.
(c) 'Code' shall mean the Business and Professions Code.

1399.405. Delegation of Functions.

Except for those powers reserved exclusively to the 'agency itself" under the Administrative Procedure Act Section 11500, et seq. of the Government Code, the committee delegates and confers upon rhe executive officer of the committee. or in his or her absence, the executive director of the board, ail functions necessary to the dispatch of business of the committee in connection with investigative and administrative proceedings under the jurisdiction of the committee.

1399.406. Filing of Addresses.

Each person holding a license, registration, approval or any other authority issued under this chapter shall file his or her proper and current mailing address with the committee, and shall notify the committee, in writing, within thirty (30) days of any and all changes of mailing address, giving both the old and new address.


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Article 2. Applications Generally

1399.410. Verification.

All statements submitted by or on behalf of an applicant shal! be made under penalty of perjury.

1399.411. Certiftcation of Documentation.

Documentation submitted by or on behalf of the applicant shall be certified by the appropriate official or govemmental seal or authority. The committee in its discretion may waive this requirement when it is determined that it cannot be obtained through the exercise of due diligence.

1399.412. Translation Required.

All documentation submitted in a language other than English shall be accompanied by a translation into English certified by a translator other than the applicant who shall attest to the accuracy of such translation under penalty of perjury.

1399.413. Application Deadline.

(a) All new applications for examination shall be submitted on a form provided by the committee, accompanied by such statements and documents as required. All applications shall be received in the committee's Sacramento office at least 120 days prior to the date of the examination for which the application is made.
(b) All applications for re-examination shall be submitted on a form provided by the committee ('Application Update for Examination/Licensure', revised 3/96), accompanied by such statements and documents as required. All applications shall be received jn the committee's office at least 30 days prior to the date of the examination for which the application is made.
(c) All transcripts and supporting documents from qualifying education institutions and rutorial supervisors shall be received in the committee's office at least 30 days prior to the date of examination for which an application was made.
(d) The committee may waive the foregoing filing dates if there are difficulties with the administration of the examination or other circumstances warrant.

1399.414. Denial of Applications.

(a) Any applicant whose application is denied, may submit within fifteen (15) calendar days from the date of rejection, a request in writing that his or her application be presented to the committee for further evaluation.
(b) As part of this evaluation procedure, the committee may, in its discretion, request that the applicant be orally interviewed with respect to his or her qualifications for licensure.
(c) If the committee determines that an applicant has met the requirements for acupuncture certification, it shall schedule the applicant for examination.
(d) Nothing in this section shall be constructed to deprive an applicant of his or her rights of appeal as afforded by other provisions of law.

1399.415. Documentation of Training.

(a) Each applicant shall have completed the minimum educational or tutorial requirements set forth in these regulations as documented by the registrar of each school from which the applicant attended or from the applicant's tutor, in the case of a tutorial program.
(b) All applicants who are graduates of an approved educational program who take the examination for licensure shall have completed the coursework and training set forth in Section 1399.436, subsection (b).
(c) All applicants applying for examination shall meet the minimum educational or tutorial requirements set forth in these regulations by the date of the examination for which the application has been made.

1399.416. Equivalent iraining and Clinical Experience Qualifying for Licensure.

In order for documented educational training and clinical experience to qualify for licensure under Section 4938, subdivision (b)(3) of the code, the applicant shall document that such education and experience meets the requirements of Section 1399.436, subsections (a), (b). (c) and (I).

1399.417. Absndonment of Applications.

An application shall be denied without prejudice when, in the discretion of the committee, an applicant does not exercise due diligence in the completion of his or her application, in furnishing additional infofmation or documents required or in the payment of any required fees.

1399.418. Failure to Appear for Examination-Withdrawal of Application.

An applicant for examination who. without a written explanation which is satisfactory to the committee. fails to appear for two examinations shall have his or her application withdrawn. Should the applicant subsequently decide to take the examination, he or she shall be required to file a new application and pay the full application fee.

1399.419. Review and Processing of Exam Applications.

(a) Within forty-five 145) days after receipt of an application for examination, the committee shall inform the applicant whether the application is complete and accepted for filing or that it is deficient and what specific information or documentation is required to complete the application.
(b) Within forty-five (45) days of receipt of a completed application, the applicant wiil be notified as to his/her eligibility for the written examination.
(c) Within thirty (30) days from the date the written examination is administered, candidates will be notified of their results. and if passed, will be scheduled for the clinical examination.
(d) Within forty-five (45) days of completion of the clinical examination, candidates will be notified of their results and offered to receive. upon payment of specified fee, a license to practice acupuncture.
(e) The minimum. median and maximum processing times for examination results from the time of receipt of a complete application until the committee makes a decision is set forth below.
Minimum - 130 days
Median - 155 days
Maximum - 180days
These processing times apply to those candidates who take and pass the first available examination and who submit a complete application by the first available application deadline.


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Article 3. Acupuncture Tutorials

1399.420. Citation and Reference

This article shall be cited and referred to as the "Acupuncture Tutorial Regulations."

1399.421. Definitions.

As used in these regulations:
(a) "Acupuncture tutorial" means an acupuncture tutorial program which is approved by the committee pursuant to Sections 4939 and 4940 of the code which when successfully completed meets the requirements of Section 4938 of the code for certification as an acupuncturist.
(b) "Supervising acupuncturist" or 'supervisor" means a certified acupuncturist who is approved by the committee to provide an acupuncture tutorial to a trainee who is registered with the committee 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 certified acupuncturist.
(c) 'Trainee' means a person who is registered with the committee in order to participate in an acupuncture tutorial under a supervising acupuncturist.

1399.422. Prior Approval to Practice as an Acupuncture Trainee.

No person shall practice acupuncture in tutorial without the prior approval of the committee.

1399.423. Prior Approval to Supervise an Acupuncture Trainee.

No acupuncturist shall supervise any person in an acupuncture tutorial without the prior approval of the committee.

1399.424. Filing of Applications: Credit for Prior Training.

(a) Applications for approval as an acupuncture trainee shall be filed on a form provided by the committee 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 committee 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 by the trainee outside California or in California. which meets the standards of the committee 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 committee for its review with the app!ications for registration of the supervising acupuncturist and trainee.

1399.425. Requirements for Approval of an Acupuncture Tutorial.

(a) An acupuncture tutorial should provide a trainee with a structured learning experience in all the basic skills and knowledge necessary for the independent practice of acupuncture and should prepare the trainee for the committee's examination for acupuncture certification.
(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.
(c) An acupuncture tutorial shall provide formal clinical training with supplemental theoretical and didactic instruction. That training required in subsection (e) (5) through (e) (11) shall be obtained in an approved acupuncture school or another postsecondary educational institution which is accredited or approved under Section 94310.1 or 94310.2 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:

(e) The theoretical and didactic training shall consist of a minimum of 600 hours (approximately 40 semester units) in the following areas:

(f) The trainee shall be at least 18 years of age.
(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 infoimed 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) Acupuncture trainees shall have successfully completed an approved high school course of study or have passed a standard equivalency test.
(j) An acupuncture tutorial shall be made available regardless of sex, race, religion, creed, color or physical handicap.

1399.426. Supervising Acupuncturist's Responsibilities.

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. 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 committee a progress report on a form provided by the committee 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.

1399.427. Trainee's Responsibilities.

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 division. 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 othennrise 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 committee any delay. interruption or termination of the acupuncture tutorial not reported by the supervisor.

1399.428. Termination or Modification of Tutorial.

(a) The committee shall be notified in writing within ten (10) 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 canceled. If the supervisor or trainee subsequently participate in an acupuncture tutorial, a new application for registration shall be filed with the committee 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 committee. There shall be no charge for filing such a report.

1399.429. Application for Examination.

At the completion of the tutorial the trainee may file an application for examination. 1399.430. Denial. Suspension or Revocation of Registration as a Supenrisor. The committee 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 Certification 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.

1399.431. Denial, Suspension or Revocation of Registration as a Trainee.

The committee 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 Certification 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 identih/ 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 committee or whose registration as a supervisor has been disciplined under Section 1399.430.

1399.432. Proceedings.

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 Procedures Act (Section 11500 et seq. of the Government Code).


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Article 3.5. Acupuncture Training Programs

1399.436. Criteria for Approval of Acupuncture Training Programs.

In order to be approved by the committee, an acupuncture training program shall meet the following criteria:
(a) The curriculum shall include adequate theoretical training in the following:

Subject Minimum Class Hours
(1) General biology
(2) Chemistry--including organic and biochemistry.
(3) General physics--including a general survey of biophysics.
(4) General psychology-including counseling skills.
(5) Anatomy--a survey of microscopic, gross anatomy and neuroanatomy.
(6) Physiology--a survey of basic physiology, including neurophysiology, endocrinology, and neurochemistry.
(7) Pathology--a survey of the nature of disease and illness, including microbiology. immunologyl psychopathology, and epidemiology.
(8) Nutrition and vitamins. 400
(9) History of medicine--a survey of medical history, including transcultural healing practices.
(10) Medical terminology-fundamentals of English language medical terminology. 30
(11) Clinical sciences-a review of internal medicine. pharmacology, neuroiogy. surgery. obstetrics/gynecology, urology, radiology, nutrition and pub!ic health.
(12) 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. !13) Western pharmacology.
(14) Approved course in cardiopulmonary resuscitation (CPR). 128
(15) Traditional Oriental medicine-a survey of the theory and practice of traditional diagnostic and therapeutic procedures. (16) Acupuncture anatomy and physiology--fundamentals of acupuncture. inciuding the meridian system, special and extra loci, and auriculotherapy.
(17) Acupuncture techniques--instruction in the use of needling techniques. moxibustion, and electroacupuncture, including precautions (e.g., sterilization of needles), contraindication and complications.
(18) Acupressure
(19) Breathing techniques--introductory course in Chi Kung.
(20) Traditional Oriental exercise--introductory course in Tai Chi Chuan. 660
(21) Traditional Oriental herbology including botany--a portion of the hours shall be given in a clinical setting. 300
(22) Practice management--instruction in the legal and ethical aspects of maintaining a professional practice, including record keeping, professional liability, patient accounts. and referral procedures.
(23) Ethics relating to the practice of acupuncture. 30

(b) The curriculum shall include adequate clinical instruction, 75% of which shall be in a clinic which is owned and operated by the training program, which includes direct patient contact where appropriate in the following:

Subject Minimum Hours
(1) Practice Observation--supervised observation of the clinical practice of acupuncture with case presentations and discussions.
(2) Diagnosis and evaluation--the application of Eastern and Western diagnostic procedures in evaluating patients.
(3) Supervised practice--the clinical treatment of a patient with acupuncture. 800

During the initial 235 hours of diagnosis. evaluation and clinical practice the supervisor shall be physically present at all times during the diagnosis and treatment of the patient. Thereafter, for a second period of 235 hours the supervisor shall be physically present at the needling of the patient. The supervisor shall othennrise be in close proximity to the location at which the patient is being treated during the clinical instruction. The student shall also consult with the supervisor before and after each treatment.
(c) The total number of hours of all theoretical training shall consist of a minimum of 1,548 hours and the total number of hours of clinical instruction shall consist of a minimum of 800 hours. and the course work shall extend over a minimum period of four (4) academic years, eight (8) semesters, twelve (121 quarters, nine (9) trimesters, or thiny-six (36) months.
(d) Candidates for admission shall have successfully completed an approved high school course of study or have passed a standard equivalency test.
(e) The training program shall be located in a state university or college, an institution approved by the Council on Private Postsecondary and Vocational Education (CPPVE) under Section 94310 of the Education Code, or in the case of training programs located outside California, in an institution which is approved by the appropriate governmental accrediting authority or an accrediting agency recognized by the U.S. Department of Education.
(f) The training program shall deveiop an evaluation mechanism to determine the effectiveness of its theoretical and clinical program.
(g) Coursework shall carry academic credit.
(h) The director of the clinical portion of the training program shall be a licensed acupuncturist or other licensed practitioner authorized to practice acupuncture.
(i) All instructors shall be competent to teach their designated courses by virtue of their education, training and experience.
(j) Each approved program shall receive accreditation or approval under Section 94310 of the Education Code. or the approval of the program by the committee shall automatically lapse.
(k) Each training program shall develop a mechanism to evaluate and award transfer credit to students for prior coursework and experience which is equivalent to that coursework and clinical instruction required in subsections (b) and (d). The training program's policies and procedures for evaluating and awarding transfer credit shall be set forth in writing and submitted to the committee. Such policies and procedures shall include all of the following:

1399.437. Documentation Required for Approval.

Educational institutions or programs seeking approval of an acupuncture training program shall provide the committee with such documents and other evidence as may be necessary for the committee to determine the actual nature and extent of the training offered, including but not limited to. catalogues, course description. curricula plans, and study bulletins.

1399.438. Suspension or Revocation of Approval.

The committee may deny, place on probation. suspend or revoke the approval granted to any acupuncture training program for any failure to comply with the regulations in this article, the Acupuncture Regulations or the Acupuncture Certification Act.

1399.439. School Monitoring: Records: Reporting.

(a) Every approved acupuncture school shall be required to submit to the committee within sixty (60) days after the close of the school's fiscal year a current course catalog with a letter outlining the following: 1) any courses added/deleted or significantly changed from the previous year's curriculum; 2) any changes in faculty. administration. or governing body; 3) any major changes in the school facility; and 4) a statement regarding the school's financial condition, which enables the committee to evaluate whether the school has sufficient resources to ensure the capability of the program for enrolled students.
(b) If determined necessary an on-site visit by representatives of the committee will be made to the school to review and evaluate the status of the school. The school will be required to reimburse the committee for direct costs incurred in conducting such review and evaluation.
(c) All student records shall be maintained at least in English.
(d) Each approved acupuncture school shall report to the committee within 30 days any substantial changes to the facility and/or clinic(s), and curriculum required in this section.


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Article 4. Examinations and Demonstrations of Competency

1399.440. Location.

Examinations shall be administered at times and locations to be determined by the committee. If the same examination is administered in more than one location, it shall be administered concurrently in each location.

1399.441. Languages.

Examinations shall be administered in English. Chinese, and Korean. An applicant shall notify the committee of the desired language where provided for in the Application for Examination/Licensure. Translations and translators, when necessary for other languages. shall be provided in any language for which a translation is formally requested as provided above by a minimum of five percent (5) of the total number of approved applications. Otherwise, such applicants shall take the examination in one of the languages listed above.

1399.443. Examination Content.

(a) The examination shall consist of both a written examination and an oral and practical examination.
(b) The examination shall test the applicant's knowledge and competency in the practice of oriental medicine through acupuncture.
(c) In order to pass an examination an applicant shall be required to obtain a passing score as determined by a criterion-referenced method of establishing the passing point on each part of the examination.
(d) In order for an applicant to sit for the clinical examination, he or she shall first pass the written portion of the examination.

1399.444. Lapsed Licenses; Examination

Any acupuncturist whose license has been expired for more than three years and who is applying for a new license under Section 4967 of the code shall be required to take and pass the clinical examination before a new license may be issued.

1399.445. Reconsideration of Practical Examination

(a) An applicant who has received a failing score on the practical examination may petition the committee for reconsideration of his/her examination results. A petition for reconsideration shall be limited to situations where an applicant has alleged that he or she was significantly disadvantaged due to significant procedural error in. or adverse environmental conditions during. the test administration.
(b) The petition for reconsideration shall be filed with the committee within fifteen (15) days after the date on the Notification of Failure of the exam. The petition shall be made in writing. and it shall state the reason for reconsideration.
(c) The review of the petition shall be conducted by one or more committee members, or the committee's designee, to determine if there is clear and convincing evidence to sustain the applicant's petition. Such findings shall be subject to the approval of the committee.
(d) Within thirty days after the committee has approved the determination after reconsideration, the applicant will be notified in writing of the results of his or her petition. In acting on petitions for reconsideration, the commirtee may take such action as it deems appropriate. The committee shall not issue a license unless it has determined that the applicant has demonstrated the required competence.
(e) All examination materials shall be retained by the committee at its office in-Sacramento for a period of at least two years after the date of the examination.


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Article 5. Standards af Practice

1399.450. Condition of Office.

(a) Every acupuncture office shall be maintained in a clean and sanitary condition at all times, and shall have a readily accessible bathroom facility in accordance with Title 24, Part 2, Building Standards Code Section 705(g).
(b) In all offices where non-disposable needles are used, there shall be functioning sterilization equipment.

1399.451. Treatment Procedures.

In treating a patient, an acupuncturist shall adhere to the following procedures:
(a) The acupuncturist's hands shall be brush-scrubbed with soap and warm water immediately before examining patients or handling acupuncture needles and other instruments, and between patients.
(b) All acupuncture needles and other instruments shall be sterilized before and between uses in a manner which will destroy all microorganisms. All needle trays which contain sterile needles shall also be sterile. Each time needles or other instruments are sterilized, the acupuncturist shall use a tape or strip indicator which shows that sterilization is complete.
(c) Acupuncture points, where needles are to be inserted, shall be cleaned with an appropriate antiseptic before insertion of the needle.
(d) In the event an acupuncture needle inserted in a patient breaks subcutaneously, the treating acupuncturist shall immediately consult a physician. An acupuncturist shall not sever or penetrate the tissues in order to excise such a needle.
(e) Any complications, including but not limited to, hematoma, peritonitis or pneumothorax arising out of acupuncture treatment shall be referred immediately to a physician or dentist or podiatrist, if appropriate, if immediate medical treatment is required.
(f) Acupuncture shall not be performed using hypodermic needles.
(g) All acupuncture needles and instNments to be discarded shall be safely disposed of. Needles shall be discarded in one of the two following ways.

1399.452. Treatments Outside the Office.

(a) Any acupuncturist who provides acupuncture treatment outside the office shall carry the required sterile needles and other instruments in a sterile airtight container.
(b) All standards of practice applicable to treatment outside the office shall be adhered to by the acupuncturist providing such treatment.

1399.453. Recordkeeping.

An acupuncturist shall keep complete and accurate records on each patient who is given acupuncture treatment, including but not limited to, treatments given and progress made as a result of the acupuncture treatments.

1399.455. Advertising.

(a) A certified acupuncturist may advertise the provision of any acupuncture services authorized to be provided by such certification in a manner authorized by Section 651 of the code so long as such advertising does not promote the excessive or unnecessary use of such services.
(b) It is improper advertising as provided in Section 4955 of the code to disseminate any advertising which represents in any manner that the acupuncturist can cure any type of disease, condition or symptom.
(c) It is improper adveRising as provided in Section 4955 of the code to disseminate any advertising of a practice. technique or procedure which is not within the scope of the practice of acupuncture as defined in Section 4927 and 4937 of the code and which is the unlawful practice of medicine.

1399.456. Use of the Title "Doctor".

It is unprofessional conduct for an acupuncturist to use the title "Doctor" or the abbreviation "Dr." in connection with the practice of acupuncture unless he or she possesses a license or ceRificate which authorizes such use or possesses an earned doctorate degree from an accredited, approved or authorized educational institution as set forth in Section 94310 of the California Education Code which is in acupuncture, Oriental medicine, a biological science, or is otherwise related to the authorized practice of an acupuncturist as set forth in Section 4927 and 4937 of the Code. The use of the title "Doctor" or the abbreviation 'Dr.' by an acupuncturist as authorized above without further indicating the type of license, certificate or degree which authorizes such use, constitutes unprofessional conduct.


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Article 6. Miscellaneous Provisions

1399.460. Fees.

(a) The application fee shall be seventy-five dollars ($75).
(b) The examination and reexamination fee shall be two hundred dollars ($200), plus the applicable fingerprint processing fee in effect at the time the application is submitted.
(c) In order to establish and administer a birthdate renewal program, the initial license fee for an acupuncture license will be based on the date the license is issued and the birthmonth of the applicant. No license will be issued for less than twelve (12) months. The fee for an initial license shall be in accordance witht he following schedule:

(Table deleted from world wide web document for the sake of brevety)

(d) Effective January 1, 1996. the biennial renewal fee for a licensed acupuncturist shall be three hunared twenty-five dollars ($325.)
(e) An expired license may be renewed at any time within three years after its expiration. The licensee will be required to pay ali accrued and unpaid renewal fees, plus any delinquency fee.
(f) The delinquency fea is twenty-five dollars ($25).
(g) The application fee for the approval of a school or college shall be one thousand and five hundred dollars ($1,500).
(h) The fee for a duplicate or replacement engraved wall license shall be fifteen dollars ($15).
(i) The fee for a duplicate or replacement renewal receipt/pocket license shall be ten dollars ($l0).
(j) The fee for a letter of endorsement shall be ten dollars ($l0).

1399.461. Acupuncture Tutorials.

The annual renewal fees shall be due within 30 days of completion of one (1) year of an approved acupuncture tutorial.

1399.462. Continuing Education Fee.

The approval fee for each provider of continuing education shall be $150.

1399.463. Authority to Issue Citations and Fines.

(a) The executive officer of the committee is authorized to issue a citation which may contain an order of abatement and/or an administrative fine for violations by an acupuncturist of the statutes contained in the Acupuncture Licensing Act (commencing with Business and Professions Code Section 4925 et seq.) or the regulations adopted by the committee.
(b) Each citation shall be in writing and shall describe with particularity the nature and facts of the violation, including a reference to the statvte or regulation alleged to have been violated. The citation shall be served upon the individual personally or by certified mail.

1399.464. Exceptions.

A citation shall not be issued in any of the following circumstances:
(a) The violatipn is of such a nature and/or severity that revocation of the license or restrictions on the license are necessary in order to ensure consumer protection.
(b) The licensee's conduct displayed a disregard for the patient and/or patient's rights. This includes, but is not limited to, physical abuse, neglect; abandonment; fiduciary abuse (as defined in Welfare and Institution Code Section 15610).
(c) The licensee failed to comply with any requirement of any previous citation, including any order of abatement or fine.
(d) The violation involves unprofessional conduct related to controlled substances or dangerous drugs.
(e) The violation involves unprofessional conduct related to sexual abuse. misconduct or relations with a patient.
(f) The licensee was convicted of an offense substantially related to the qualifications, functions and duties of an acupuncturist and there is insufficient evidence of rehabilitation.

1399.465. Citation: Assessment of Fine.

The amount of any administrative fine to be levied by the executive officer shall be no less than $100 nor more than $2500. In assessing the amount of the fine, the executive officer will consider the following factors in determining the amount of the fine:
(a) Gravity of the violation.
(b) History of previous violations of the same or similar nature.
(c) The good or bad faith exhibited by the cited person.
(d) Evidence that the violation was willful.
(e) The extent to which the cited person cooperated with the committee's investigation.
(f) The extent to which the cired person has mitigated or attempted to mitigate any damage caused by his or her violation.
(g) Such other factors as justice may require.

1399.466. Compliance with Orders of Abatement.

(a) If a cited person who has been issued an order of abatement is unable to complete the abatement within the time set forth in the citation because of conditions beyond his or her control after the exercise of reasonable diligence, the person cited may request an extension of time from the executive officer in which to complete the correction. Such a request shall be in writing and shall be made within the time set forth for abatement.
(b) When an order of abatement is not contested or if the order is appealed and the person cited does not prevail, failure to abate the violation charged in the citation within the time allowed shall constitute a violation and failure to comply with the order of abatement. Such failure may result in disciplinary action being taken by the committee or other appropriate judicial relief being taken against the person cited.

1399.467 Citations for Unlicensed Practice.

The executive officer of the committee is authorized to determine when and against whom a citation will be issued and to issue citations containing orders of abatement and fines against persons who are performing or who have performed services for which license as an acupuncturist is required under the Acupuncture Licensure Act. Each citation issued for unlicensed activity shall contain either an order of abatement. or, where appropriate, the executive officer shall levy a fine for such unlicensed activity in accordance with section 1399.465 of these regulations. The provisions of sections 1399.463. 1399.465. 1399.466, and 1399.468 apply to the issuance of citations for unlicensed activity under this section. The citation issued under this section shall be separate from and in addition to any other civil or criminal remedies.

1399.468. Contest of Citations.

(a) In addition to requesting a hearing provided for in subdivision (b)(4) of section 125.9 of the code, the person cited may, within ten (10) days after service or receipt of the citation, notify the executive officer in writing of his or her request for an informal conference with the executive officer regarding the acts charged in the citation.
(b) The executive officer shall hold, within 60 days from the receipt of the request, an informal conference with the person cited. At the conclusion of the informal conference, the executive officer may affirm. modify or dismiss the citation, including any fine levied or order of abatement issued. The executive officer shall state in writing the reasons for his or her action and serve or mail, as provided in subsection (b) of section 1399.463, a copy of his or her findings and decision to the person cited within ten days from the date of the informal conference. This decision shall be deemed to be a final order with regard to the citation issued, including the fine levied and the order of abatement.
(c) The person cited does not waive his or her request for a hearing to contest a citation by requesting an informal conference after which the citation is affirmed by the executive officer. If the citation is dismissed after the informal conference. the request for a hearing on the matter of the citation shall be deemed to be withdrawn. If the citation, including any fine levied or order of abatement. is modified, the citation originally issued shall be considered withdrawn and new citation issued. If a hearing is requested for the subsequent citation, it shall be requested within 30 days in accordance with subdivision (b)(4) of section 125.9.


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Article 7. Acupuncture Corpotations.

1399.470. Citation and Authority.

These regulations may be cited and referred to as the "Acupuncture Corporation Regulations'.

1399.475. Requirements for Acupuncture Corporations.

An acupuncture corporation shall comply with the following provisions:
(a) The corporation is organized and exists pursuant to the general corporation law and is a professional corporation within the meaning of Part 4. Division 3, Title 1 of the Corporations Code.
(b) Each shareholder. director, and officer (except as provided in Section 13403 of the Corporations Code and Section 4977.2 of the code) holds a valid acupuncture certificate. An acupuncturist may be a shareholder in more than one acupuncture corporation.
(c) Each professional employee of the corporation who will practice acupuncture. whether or not a director, officer, or shareholder, holds a valid acupuncture certificate.

1399.476. Namestyle.

The name of the corporation and any name or names under which it may render professional services shall include words or abbreviations denoting corporate existence limited to the following: "Professional Corporation', 'Prof. Corp.', 'Corporation", "Corp.', 'Incorporated", or 'Inc.'

1399.477. Shares: Ownership and Transfer.

(a) Where there are two or more shareholders in an acupuncture corporation and one of the shareholders:

(b) A corporation and its shareholders may, but need not. agree that shares sold to it by a person who becomes a disqualified person may be resold to such person if and when he or she again becomes an eligible shareholder.
(c) The share certificates of an acupuncture corporation shall contain an appropriate legend setting forth the restrictions of subsection (a).
(d) Nothing in these regulations shall be construed to prohibit an acupuncture corporation from owning shares in a nonprofessional corporation.

1399.478. Trusts.

The restrictions on the ownership of the shares of professional corporations shall apply to both the legal and equitable title to such shares.

1399.479. Corporate Activities.

(a) An acupuncture corporation may perform any act authorized in its articles of incorporation or bylaws so long as that act is not in conflict with or prohibited by these regulations, the Acupuncture Certification Act or the regulations adopted pursuant thereto.
(b) An acupuncture corporation may enter into partnership agreements with other acupuncturists practicing individually or in a group or with other acupuncture corporations.


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Article 8. Continuing Education

1399.480. Definitions.

(a) For purposes of this article:

1399.481. Criteria for Provider Approval.

(a) In order to be an approved provider, a provider shall submit to the committee a provider application on a form provided by the committee accompanied by the fee set forth in Section 1399.462. All provider applications and documentation submitted to the Committee shall be typewritten and in English.
(b) The approval of the provider shall expire two (2) years after it is issued by the Committee and may be renewed upon the filing of the required application and fee.
(c) Acupuncture schools and colleges which ave been approved by the committee under Section 4939 of the code and Article 3.5 (commencing with Section 1399.436) who seek to be approved providers shall be required to submit an application to the Committee accompanied by the appropriate fee, but shall be deemed to have met the requirements for approval under this article.

1399.482. Approved Providers.

(a) For the purpose of this Article, the title "approved provider' can only be used when a person or organization has submitted a provider application form. remitted the appropriate fee and has been issued a provider number.
(b) A person or organization may be issued only one provider number. When two or more approved providers co-sponsor a course, the course shall be identified by only one provider number and that provider shall assume responsibility for recordkeeping, advertising. issuance of certificates and instructor(s) qualifications.
(c) An approved provider shall keep the following records for a period of four years in one identified location:

(d) Within ten (10) days of completion of an approved course, the provider shall submit to the committee the following:

(e) Approved providers shall issue, within 60 days of the conclusion of an approved course, to each participant who has completed the course a. certificate of completion which contains the following information:

(f) Approved providers shall notify the committee of any changes to the date or location of an approved course. A change to the date of an approved course shall not be prior to the date for which the course was approved. if the new date would occur less than 45 days from receipt of the course request.
(g) Any changes in the content of or instructor(s) for an approved course shall require prior approval of the committee. A request to change the content of or instructor(s) for an approved course shall be received by the committee at least ten (10) days before the course begins.
(h) Approved providers shall notify the committee within 30 days of any changes in organizational structure of a provider and/or the person(s) responsible for the provider's continuing education course, including name, address, or telephone number changes.
(i) Provider approval is non-transferable.
(j) The committee may audit during reasonable business hours records, courses, instructors and related activities of an approved provider.

1399.483. Approval Of Continuing Education Courses.

(a) Only an approved provider may obtain approval to offer continuing education courses.
(b) The content of all courses of continuing education shall be relevant to the practice of acupuncture and shall

(c) Each course shall include a method by which the course participants evaluate the following:

(d) Courses designed to be completed by an individual on an independent or home study basis shall not be acceptable.

1399.484. Application for Course Approval.

(a) In order to obtain approval for a course, an approved provider shall submit to the committee a request for course approval, in English, on a form provided by the committee. or in a similar format which contains the following information:

(b) Approved providers shall obtain committee approval for every course that is offered for continuing education credit. Where a previously approved course is to be repeated, the provider shall apply to the committee for approval of each subsequent administration of the course.
(c) All requests for course approval shall be submitted to the committee at least 45 days before the course is first offered.

1399.485. Instructors.

(a) It shall be the responsibility of each approved provider to use qualified instructors. (b) Instructors teaching approved continuing education courses shall have the following minimum qualifications:

1399.486. Advertisements.

(a) Information disseminated by approved providers publicizing continuing education shall be true and not misleading and shall include the following:

(b) A provider shall not describe a course as being committee approved until wrirten confirmation of approval by the committee has been received by the provider. Where a provider is waiting for a determination by the committee on its request for course approval. the provider may advertise that the course is "pending" approval. A provider which advertises that its course is pending approval shall assume all responsibility if a course is subsequently denied by the committee.

1399.487. Denial, Withdrawal and Appeal of Approval.

(a) The committee may withdraw its approval of a provider or deny a provider application for causes which include, but are not limited to, the following:

(b) Any material misrepresentation of fact by a provider or applicant in any information required to be submitted to the committee is grounds for withdrawal or denial of an application.
(c) The committee may withdraw its approval of a provider or a course after giving the pravider written notice setting forth its reasons for withdrawal and after giving the provider a reasonable opportunity to be heard by the committee or its designee.
(d) Should the committee deny approval of a provider or a course request, the applicant may appeal the action by filing a letter stating the reason(s) with the committee: The letter-of appeal shall be filed with the committee within ten (10) days of the mailing of the applicant's notification of the committee's denial. The appeal shall be considered by the committee or its designee. In the event that the committee or its designee considers the appeai after the date of the course for which the appeal is being made, a retroactive approval may be granted.

1399.488. Processing Times for Provider and Course Request Applications.

(a)

(b)

(c) If a provider seeking approval submits a request for a course approval along with the initial provider application, the course request wili not be considered for approval until the provider application is approved. In such cases, the committee's processing time for the course request will be in accordance with Section 1399.488(b)(1)-(3).

1399.489. Audit and Sanctions for Noncompliance.

(a) Each acupuncturist at the time of license renewal shall sign a statement under penalty of perjury that he or she has or has not complied with the continuing education requirements.
(b) The committee may audit once each year a random sample of acupuncturists who have reported compliance with the continuing education requirement. No acupuncturist shall be subject to audit more than once every two (2) years.
(c) It shall constitute unprofessional conduct for any acupuncturist to misrepresent completion of the required continuing education.
(d) Any acupuncturist selected for audit shall be required to submit documentation or records of continuing education coursework he or she has taken and completed.
(e) Each acupuncturist shall retain for a minimum of four (4) years records of all continuing education programs attended which indicate the provider's name, title of the course or program, date(s) and location of course. and number of continuing education credits awarded.
(f) Instructors of approved continuing education courses may receive a maximum of two (2) hours of continuing education credit per year. Such credit can be claimed only where the individual acts as an instructor of an approved course. In addition, one hour of CE credit shall be accrued for each classroom hour completed as an instnrctor of a committee approved CE course. Participation as a member of a panel presentation for an approved course shall not entitle the paRicipant to earn continuing education credit as an instructor.

1399.489.1. Inactive License.

(a) Any acupuncturist who is not actively engaged in the practice of acupuncture desiring an inactive license under the provisions of Article 9 (commencing with Section 700) Chapter 1 of Division 2 of the code or to restore an inactive license to active status shall submit an application to the committee on a form provided by it. (Active/lnactive License Application (Rev. 5/95). The applicant need not submit his or her certificate or a copy thereof to the committee with the application.
(b) In order to restore an inactive license to active status, the licensee shall have completed a minimum of 30 hours of approved continuing education within the last two (2) years in compliance with this anicle. In the event a license has been inactive less than two (2) years, a minimum of fifteen (15) hours of continuing education will be required.
(c) The inactive status of any licensee shall not deprive the committee of its authority to institute or continue a disciplinary proceeding against a licensee upon any ground provided by law or to enter an order suspending or revoking a license or otherwise raking disciplinary action against the licensee on any such ground.

1399.489.2. Continuing Education: Courses in Practice Management and Medical Ethics.

(a) An acupuncturist shall be allowed to use up to four (4) hours of continuing education in acupuncture practice management or medical ethics per year to meet his or her continuing education requirements.


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