The Acupuncture Society of Virginia (ASVA) is the professional membership organization of licensed acupuncturists (L.Ac.s) in Virginia. ASVA is dedicated to promoting the practice of acupuncture and Oriental medicine (AOM) within the Commonwealth.
Our mission is to uphold high professional ethics and standards by monitoring and supporting legislation regarding professional standards and public safety and to educate the general public regarding the nature and scope of acupuncture and Oriental medicine. To accomplish this mission, we support clinical research verifying the effectiveness of acupuncture and Oriental medicine. We also cooperate with national professional organizations and provide continuing education programs for licensed acupuncturists.
The following statement represents the position and public comment on the pending periodic review of the Regulations Governing the Practice of Licensed Acupuncturists. In the formulation of these comments, ASVA strived to address regulations that could meet the objectives prescribed by the Governor’s regulatory reform initiative, while continuing to account for regulations that provide for the protection of the public’s health, safety, and welfare.
18VAC85-110-50. Educational requirements: graduates of approved institutions or programs in the United States.
ASVA supports the existing regulations concerning educational requirements. However, it is necessary to update these requirements as the ACAOM program requirements have increased beyond the requirements currently contained within the regulations for individuals receiving acupuncture and Oriental medicine education after July 1, 1999. The current ACAOM requirements consist of a minimum of 1905 hours of entry-level acupuncture education to include at least 1,155 didactic hours and 660 clinical hours (http://www.nccaom.org/~nccaom/wp-content/uploads/pdf/ACAOM%20Grad%20Hour%20Requirements.pdf). Updated requirements could be added to the regulations following section C.
18VAC85-110-60. Requirements of foreign graduates of nonaccredited educational programs in acupuncture and Oriental medicine.
ASVA feels that section A of this regulation contains unnecessary and redundant language. Because ACAOM only accredits schools within the United States (http://www.acaom.org/about/) and there are no other board-approved accrediting agencies, the language “or Canada that is not accredited by ACAOM or any other board-approved accrediting agency” should be stricken. This provides an opportunity to make the regulation more concise and less confusing to potential graduates of foreign programs.
18VAC85-110-80. Examination requirements for licensure.
ASVA recommends that requirement 2, “Passing the Practical Examination of Point Location Skills (PEPLS) test,” be eliminated from the regulations. Point location examination is now part of the NCCAOM acupuncture examination. Therefore, the inclusion of this requirement within the regulations is redundant and unnecessary.
18VAC85-110-90. Test of spoken English requirements.
The test of spoken English requirements is an important factor in patient care and communications. However, after a review of other health professions regulated by the Board of Medicine, ASVA would like to note that no other profession has a similar section of regulations. This section of regulations should be reviewed for how it ensures the safety of patients in cases where an individual is referred to a licensed acupuncturist who does not speak the patient’s language.
18VAC85-110-100. General requirements.
ASVA feels that the entire regulatory requirement contained in 18VAC85-110-100 should be repealed. The requirement for written documentation of or written recommendation to receive a diagnostic evaluation by physician is an unnecessary regulatory burden on licensed acupuncturists and their businesses, and is not necessary for the protection of public health, safety, or welfare.
Virginia residents often concurrently seek care with a licensed acupuncturist in addition to a licensed doctor of medicine and / or other healthcare professionals. A patient receiving a form that notes that the state requires them to be notified of a recommendation to receive diagnostic examination by another health professional undermines the professional credibility of licensed acupuncturists, who are well aware of the limitations of the acupuncture and Oriental medicine scope of practice and their responsibility to refer patients, as necessary, to other providers. Most Insurance companies in Virginia do not currently cover acupuncture and acupuncture will not be included as an essential health benefit in Virginia. Acupuncture is an out of pocket expense for most individuals. Therefore, this regulation should be repealed to be consistent with consumer behavior, insurance coverage, and the requirements of surrounding states.
Surrounding states do not have any similar requirements for a referral or examination. States that previously have had this requirement have repealed it. The following surrounding states currently do not have this requirement: District of Columbia, Maryland, West Virginia, North Carolina, South Carolina, and Florida.
Individuals residing in localities near Virginia borders, especially those in northern Virginia, may be getting acupuncture in other states or jurisdictions (i.e. Maryland, District of Columbia) where they work. This requirement would therefore not apply to those individuals and is therefore not being applied equally to all Virginians. There have been no reported incidents of the lack of a medical examination requirement causing harm or endangering the health, safety, or welfare of these individuals.
18VAC85-110-110. Limitation of titles.
This section of regulation should be reviewed for possible amendments that would provide further clarity on the use of titles. In Virginia, the title “Lic.Ac.” is no longer commonly used by licensed acupuncturists; and most, if not all licensed acupuncturists use the title “L.Ac.” ASVA feels that the title “Lic.Ac.” can be stricken from the regulation without burden on the profession.
Additionally, ASVA is concerned that the way this regulation is currently written would allow a licensed acupuncturist to use the title of “Dr.” as there are other states (Florida, New Mexico, Rhode Island) that attribute the professional designation of doctor or physician to licensed acupuncturists, even though the acupuncturist has not obtained a clinical doctorate degree. ASVA proposes the addition of clarifying language so that the regulation would read, “and shall not use the terms "physician" or "doctor" in his name or practice unless he holds a clinical doctorate or PhD and simultaneously uses a clarifying title, initials, abbreviation or designation.”
18VAC85-110-130. Maintenance of patient records.
ASVA notes that this regulation is not contained within the regulations governing any other health profession regulated by the Board of Medicine and therefore should be repealed.
18VAC85-110-145. Registration for voluntary practice by out-of-state licensees.
ASVA recommends the subdivision of this section and the addition of an exemption to this process for organizations such as Acupuncturists Without Borders that may provide services to the public voluntarily during a state of emergency as declared by the Governor, to assist in alleviating symptoms of trauma caused by damage, loss, hardship, or suffering caused thereby. The exemption would require that any participating acupuncturist be licensed in their state of residence and comply with all applicable Virginia laws, including the Virginia acupuncture scope of practice.