Bill Text: MI SB0683 | 2017-2018 | 99th Legislature | Engrossed
Bill Title: Health occupations; acupuncturists; licensure of acupuncturist; provide for. Amends secs. 16215, 16322, 16501, 16511, 16521, 16525 & 16529 of 1978 PA 368 (MCL 333.16215 et seq.) & adds secs. 16513, 16515 & 16517.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Engrossed - Dead) 2018-12-05 - Referred To Second Reading [SB0683 Detail]
Download: Michigan-2017-SB0683-Engrossed.html
SB-0683, As Passed Senate, June 12, 2018
SUBSTITUTE FOR
SENATE BILL NO. 683
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 16215, 16322, 16501, 16511, 16521, 16525,
and 16529 (MCL 333.16215, 333.16322, 333.16501, 333.16511,
333.16521, 333.16525, and 333.16529), section 16215 as amended by
2005 PA 211, sections 16322, 16501, 16525, and 16529 as added by
2006 PA 30, section 16511 as amended by 2006 PA 397, and section
16521 as amended by 2010 PA 79, and by adding sections 16513,
16515, and 16517.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
1 Sec. 16215. (1) Subject to subsections (2) to (6), a
2 licensee who holds a license other than a health profession
3 subfield license may delegate to a licensed or unlicensed
4 individual who is otherwise qualified by education, training, or
1 experience the performance of selected acts, tasks, or functions
2 where the acts, tasks, or functions fall within the scope of
3 practice of the licensee's profession and will be performed under
4 the licensee's supervision. A licensee shall not delegate an act,
5 task, or function under this section if the act, task, or
6 function, under standards of acceptable and prevailing practice,
7 requires the level of education, skill, and judgment required of
8 the licensee under this article.
9 (2) Subject to subsection (1) and except as otherwise
10 provided in this subsection and subsections (3) and (4), a
11 licensee who is an allopathic physician or osteopathic physician
12 and surgeon shall delegate an act, task, or function that
13 involves the performance of a procedure that requires the use of
14 surgical instrumentation only to an individual who is licensed
15 under this article. A licensee who is an allopathic physician or
16 osteopathic physician and surgeon may delegate an act, task, or
17 function described in this subsection to an individual who is not
18 licensed under this article if the unlicensed individual is 1 or
19 more of the following and if the procedure is directly supervised
20 by a licensed allopathic physician or osteopathic physician and
21 surgeon who is physically present during the performance of the
22 procedure:
23 (a) A student enrolled in a school of medicine or
24 osteopathic medicine approved by the Michigan board of medicine
25 or the Michigan board of osteopathic medicine and surgery.
26 (b) A student enrolled in a physician's assistant training
27 program approved by the joint physician's assistant task force
1 created under part 170.
2 (3) Subject to subsection (1), a licensee who is an
3 allopathic physician or osteopathic physician and surgeon may
4 delegate an act, task, or function described in subsection (2) to
5 an individual who is not licensed under this article and who is 1
6 of the following:
7 (a) Performing Until
12 months after the effective date of
8 the rules promulgated under section 16525, performing
9 acupuncture.
10 (b) Surgically removing only bone, skin, blood vessels,
11 cartilage, dura mater, ligaments, tendons, pericardial tissue, or
12 heart valves only from a deceased individual for transplantation,
13 implantation, infusion, injection, or other medical or scientific
14 purpose.
15 (4) Subject to subsection (1), a licensee who is an
16 allopathic physician or osteopathic physician and surgeon may
17 delegate an act, task, or function described in subsection (2) to
18 an individual who is not licensed under this article if the
19 procedure is directly supervised by a licensed allopathic
20 physician or osteopathic physician and surgeon who is physically
21 present during the performance of the procedure, the delegation
22 of such procedure is not prohibited or otherwise restricted by
23 the board or that health facility or agency, and the delegation
24 of that act, task, or function is specifically authorized by that
25 health facility or agency to be delegated and performed by either
26 of the following unlicensed individuals:
27 (a) A surgical technologist who meets the qualifications
1 established by the health facility or agency with which he or she
2 is employed or under contract. with.
3 (b) A surgical first assistant who meets the qualifications
4 established by the health facility or agency with which he or she
5 is employed or under contract. with.
6 (5) A board may promulgate rules to further prohibit or
7 otherwise restrict delegation of specific acts, tasks, or
8 functions to a licensed or unlicensed individual if the board
9 determines that the delegation constitutes or may constitute a
10 danger to the health, safety, or welfare of the patient or
11 public.
12 (6) To promote safe and competent practice, a board may
13 promulgate rules to specify conditions under which, and
14 categories and types of licensed and unlicensed individuals for
15 whom, closer supervision may be required for acts, tasks, and
16 functions delegated under this section.
17 (7) An individual who performs acts, tasks, or functions
18 delegated pursuant to this section does not violate the part that
19 regulates the scope of practice of that health profession.
20 (8) The amendatory act that added this subsection does not
21 require new or additional third party reimbursement or mandated
22 worker's compensation benefits for services rendered by an
23 individual authorized to perform those services under subsection
24 (4).
25 Sec. 16322. Fees for a person registered or seeking
26 registration as an acupuncturist an individual who is licensed or
27 seeking licensure to engage in the practice of acupuncture under
1 part 165 are as follows:
|
2 |
(a) Application processing fee................. $ 75.00 |
|
3 |
(b) |
|
4 |
(c) Limited license, per year.................. $ 200.00 |
|
5 |
(d) Temporary license fee...................... $ 200.00 |
6 Sec. 16501. (1) As used in this part:
7 (a) "Acupressure" means a form of manual therapy in which
8 physical pressure is applied to various points on the body.
9 (b) (a) "Acupuncture"
means the insertion and manipulation
10 of needles through the surface of the human body. at
specific
11 locations on the human body for the prevention or correction of
12 disease, injury, pain, or other condition.Acupuncture includes,
13 but is not limited to, laser acupuncture, electroacupuncture,
14 pricking therapy, dry needling, and intramuscular stimulation.
15 (c) (b) "Acupuncturist"
means an individual who practices
16 acupuncture and is registered,
or otherwise authorized, licensed
17 under this part to engage in the practice of acupuncture.
18 (d) "Cupping" means the placement of a specially designed
19 cup on the body to create suction.
20 (e) "Dermal friction" means the use of repeated, closely
21 timed, unidirectional press-stroking with a smooth-edged
22 instrument over a lubricated area of the body.
23 (f) "Dietary counseling" means the process of advising a
24 patient about healthy food choices and healthy eating habits in
25 accordance with East Asian medical theory.
26 (g) "Dry needling" means a rehabilitative procedure using
1 filiform needles to penetrate the skin or underlying tissues by
2 targeting only myofascial trigger points and muscular and
3 connective tissues to affect change in body structures and
4 functions for the evaluation and management of
5 neuromusculoskeletal pain and movement impairment. Dry needling
6 does not include the stimulation of auricular points or other
7 acupuncture points.
8 (h) "East Asian medicine techniques" includes, but is not
9 limited to, acupuncture, manual therapy, moxibustion, heat
10 therapy, dietary counseling, therapeutic exercise, acupressure,
11 cupping, dermal friction, homeopathy, lifestyle coaching, and
12 treatment with herbal medicines.
13 (i) "Heat therapy" means the use of heat in therapy, such as
14 for pain relief and health.
15 (j) "Herbal medicine" means the internal and external use of
16 a plant or a plant extract, a mineral, or an animal product, that
17 is not a prescription drug as that term is defined in section
18 17708.
19 (k) "Homeopathy" means the use of a highly diluted natural
20 remedy from the plant, mineral, and animal domain.
21 (l) "Lifestyle coaching" means the process of advising a
22 patient about healthy lifestyle choices and habits in accordance
23 with East Asian medical theory.
24 (m) "Manual therapy" means the application of an accurately
25 determined and specifically directed manual force to the body,
26 excluding a high-velocity, low-amplitude thrust to the spine.
27 (n) "Moxibustion" means burning the dried plant Artemisia
1 vulgaris on or very near the surface of the skin as a form of
2 therapy.
3 (o) "Practice of acupuncture", subject to subsection (2),
4 means the use of traditional and contemporary east Asian medical
5 theory to assess and diagnose a patient, to develop a plan to
6 treat the patient, and to treat the patient through East Asian
7 medicine techniques.
8 (p) "Practice of chiropractic" means that term as defined in
9 section 16401.
10 (q) "Practice of massage therapy" means that term as defined
11 in section 17951.
12 (r) "Practice of medicine" means that term as defined in
13 section 17001.
14 (s) "Practice of osteopathic medicine and surgery" means
15 that term as defined in section 17501.
16 (t) "Practice of physical therapy" means that term as
17 defined in section 17801.
18 (u) "Registered acupuncturist" means an individual who is
19 registered or otherwise authorized under this part before the
20 effective date of the amendatory act that added section 16513.
21 (v) "Systematic acupuncture education" means a course of
22 education that covers the foundation of acupuncture science and
23 theory, channel and point location, needling techniques,
24 approaches to diagnosis and therapy, and patient management.
25 (w) "Therapeutic exercise" means a range of physical
26 activities that help restore and build physical strength,
27 endurance, flexibility, balance, and stability.
1 (2) For purposes of this part, practice of acupuncture does
2 not include the practice of medicine, the practice of osteopathic
3 medicine and surgery, the practice of physical therapy, the
4 practice of occupational therapy, the practice of podiatric
5 medicine and surgery, the practice of nursing, the practice of
6 dentistry, the practice of massage therapy, or the practice of
7 chiropractic.
8
(3) (2) In addition to the definitions in this part, article
9 1 contains general definitions and principles of construction
10 applicable to all articles in the code and part 161 contains
11 definitions applicable to this part.
12 Sec. 16511. (1) Except as otherwise provided under
13 subsection (2), after in
this part, beginning on the effective
14
date of rules are promulgated
under section 16145, 16525,
an
15 individual shall not use the words, titles, or letters
16 "acupuncturist", "certified acupuncturist", or "registered
17 acupuncturist", "licensed acupuncturist", "L.Ac.", or a
18 combination thereof, with or without qualifying words or phrases,
19 similar word or initial that indicates that the individual is an
20
acupuncturist, unless he or she is registered
authorized under
21 this part to use the terms and in a way prescribed in this part.
22 (2) Neither of the following is subject to the provisions of
23 this part:
24 (a) A physician who is licensed under part 170 or 175.
25 (b) An individual who is certified by the national
26 acupuncture detoxification association.
27 Sec. 16513. (1) Beginning on the effective date of rules
1 promulgated under section 16525, an individual shall not engage
2 in the practice of acupuncture unless he or she is licensed under
3 this part or is otherwise authorized under this article. For a
4 period not to exceed 12 months from the effective date of the
5 rules promulgated under section 16525, a registered acupuncturist
6 may, without a license under this part, continue to use the
7 titles "acupuncturist", "registered acupuncturist", or "certified
8 acupuncturist" and engage in the practice of acupuncture.
9 (2) In addition to the exemptions from licensure under
10 section 16171, this part does not apply to any of the following:
11 (a) Except as otherwise provided in subdivision (e), an
12 individual licensed, registered, or otherwise authorized under
13 any other part or act who is performing activities that are
14 considered to be within the practice of acupuncture if those
15 activities are within the individual's scope of practice and if
16 the individual does not use the words, titles, or letters
17 protected under section 16511.
18 (b) A physician who is licensed under part 170 or part 175
19 if the physician has completed a total of not less than 300 hours
20 of systematic acupuncture education that include not less than
21 100 hours of live lectures, demonstrations, and supervised
22 clinical training specific to acupuncture.
23 (c) An individual who meets all of the following
24 requirements:
25 (i) He or she meets the requirements for a certificate of
26 training as an acupuncture detoxification specialist issued by
27 the National Acupuncture Detoxification Association or an
1 organization that the board determines is a successor
2 organization.
3 (ii) He or she only uses the auricular protocol for substance
4 use disorder prevention and treatment developed by the National
5 Acupuncture Detoxification Association or an organization that
6 the board determines is a successor organization.
7 (iii) He or she is under the supervision of an acupuncturist
8 or a physician licensed under part 170 or part 175 when using the
9 protocol described in subparagraph (ii).
10 (iv) He or she does not use the words, titles, or letters
11 protected under section 16511.
12 (d) An individual performing acupressure, cupping, dermal
13 friction, dietary counseling, heat therapy, herbal medicine,
14 homeopathy, lifestyle coaching, manual therapy, or therapeutic
15 exercise, while engaged in the practice of a profession with
16 established standards and ethics and as long as those services
17 are not designated as or implied to be the practice of
18 acupuncture and the individual does not use the titles, words, or
19 letters protected under section 16511.
20 (e) Dry needling by an individual licensed, registered, or
21 otherwise authorized under any other part if dry needling is
22 within the individual's scope of practice.
23 Sec. 16515. (1) Except as otherwise provided in subsection
24 (2), the department shall issue a license to an applicant who
25 meets the requirements of section 16174 and the requirements for
26 licensure established in rules promulgated under section 16525.
27 (2) On or before the expiration of 12 months after the
1 effective date of the rules promulgated under section 16525, the
2 department shall issue a license to an applicant who meets the
3 requirements of section 16174 and 1 of the following:
4 (a) He or she is a registered acupuncturist.
5 (b) He or she has the education, training, and experience
6 appropriate to the practice of acupuncture as established in
7 rules promulgated under section 16525. In determining whether an
8 applicant has met the requirements for licensure under this
9 subdivision, the department, in consultation with the board,
10 shall promulgate rules establishing criteria for considering
11 patient records, billing records, education records, training
12 records, or other evidence of the applicant's education,
13 training, and experience that is submitted to the department. An
14 applicant shall ensure that any document that is submitted to the
15 department under this subdivision ensures the confidentiality of
16 a patient's identity.
17 Sec. 16517. (1) Notwithstanding the requirements of part
18 161, the department, in consultation with the board, shall
19 promulgate rules requiring a licensee seeking renewal of a
20 license to furnish the department with satisfactory evidence that
21 during the license cycle immediately preceding the application
22 for renewal the licensee has attended continuing education
23 courses or programs approved by the board in subjects related to
24 the practice of acupuncture and designed to further educate
25 licensees. An individual is considered to have completed the
26 continuing education requirements described in this subsection if
27 the department determines that the individual has met the
1 continuing education standards of the National Certification
2 Commission for Acupuncture and Oriental Medicine or equivalent
3 standards as determined by the board.
4 (2) As required under section 16204, the department, in
5 consultation with the board, shall promulgate rules requiring
6 each applicant for license renewal to complete as part of the
7 educational courses or programs required under subsection (1) an
8 appropriate number of hours or courses in pain and symptom
9 management.
10 Sec. 16521. (1) The Michigan board of acupuncture is created
11 in the department and shall consist consists of
the following 13
12 voting members, who each
of whom must meet the requirements of
13 part 161:
14 (a) Until June 30, 2010, 4 acupuncturists. Beginning July 1,
15 2010, 7 Seven acupuncturists. The members appointed under this
16 subdivision shall must
meet the requirements of section 16135.
17 (b) Three physicians licensed under part 170 or 175, at
18 least 1 of whom has met the requirement in section 16513(2)(b).
19 (c) Until June 30, 2010, 2 public members. Beginning July 1,
20 2010, 3 Three public members.
21 (2) The terms of office of individual members of the board
22 created under this part, except those appointed to fill
23 vacancies, expire 4 years after appointment on June 30 of the
24 year in which the term expires pursuant to section 16122.
25 Sec. 16525. (1) The Within 12 months after the effective
26 date of the amendatory act that amended this section, the
27 department, in consultation with the board, shall promulgate
1 rules setting forth the minimum standards for registration as an
2 acupuncturist. The department, in consultation with the board,
3 may adopt by reference the professional standards issued by a
4 certified program that is recognized by the national commission
5 for certifying agencies or by a nationally recognized trade
6 association.that
establish the minimum standards for licensure as
7 an acupuncturist and implement the licensure program for the
8 practice of acupuncture. In promulgating rules for purposes of
9 section 16515(1), the department, in consultation with the board,
10 may adopt by reference the professional standards issued by a
11 certified program that is recognized by the National Commission
12 for Certifying Agencies. In promulgating rules for purposes of
13 section 16515(2), the department, in consultation with the board,
14 shall consider whether an applicant has completed systematic
15 acupuncture education that includes live lectures,
16 demonstrations, and supervised clinical training specific to
17 acupuncture.
18 (2) The department, in consultation with the board, shall
19 not promulgate rules under this section that diminish competition
20 or exceed the minimum level of regulation necessary to protect
21 the public.
22 Sec. 16529. This part does not require new or additional
23 third party reimbursement or mandated worker's compensation
24 benefits for services by an individual registered licensed as
an
25 acupuncturist under this part.
26 Enacting section 1. This amendatory act takes effect 90 days
27 after the date it is enacted into law.
