Office of the Revisor of Statutes
Minnesota Session Laws - 1995, Regular Session
Key: (1) language to be deleted (2) new language
CHAPTER 177-H.F.No. 446
An act relating to occupations and professions;
establishing licensure for acupuncture practitioners
by the board of medical practice; appropriating money;
providing penalties; proposing coding for new law as
Minnesota Statutes, chapter 147B.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. [PURPOSE.]
Acupuncture practice is recognized as a clearly defined
system of health care with its own specialized body of
knowledge. The knowledge and skills of the acupuncture
practitioner directly affect the quality and safety of treatment
received by the practitioner's client. It is therefore in the
public interest to ensure that acupuncture practitioners meet
the generally accepted standards of competence in the
profession. The purpose of Minnesota Statutes, chapter 147B, is
to limit the practice of acupuncture to persons who meet those
standards of competence.
Sec. 2. [147B.01] [DEFINITIONS.]
Subdivision 1. [APPLICABILITY.] The definitions in this
section apply to this chapter.
Subd. 2. [ACUPRESSURE.] "Acupressure" means the
application of pressure to acupuncture points.
Subd. 3. [ACUPUNCTURE PRACTICE.] "Acupuncture practice"
means a comprehensive system of health care using Oriental
medical theory and its unique methods of diagnosis and
treatment. Its treatment techniques include the insertion of
acupuncture needles through the skin and the use of other
biophysical methods of acupuncture point stimulation, including
the use of heat, Oriental massage techniques, electrical
stimulation, herbal supplemental therapies, dietary guidelines,
breathing techniques, and exercise based on Oriental medical
principles.
Subd. 4. [ACUPUNCTURE NEEDLE.] "Acupuncture needle" means
a needle designed exclusively for acupuncture purposes. It has
a solid core, with a tapered point, and is 0.12 mm to 0.45 mm in
thickness. It is constructed of stainless steel, gold, silver,
or other board-approved materials as long as the materials can
be sterilized according to recommendations of the National
Centers for Disease Control and Prevention.
Subd. 5. [ACUPUNCTURE POINTS.] "Acupuncture points" means
specific anatomically described locations as defined by the
recognized acupuncture reference texts. These texts are listed
in the study guide to the examination for the NCCA certification
exam.
Subd. 6. [ACUPUNCTURE PRACTITIONER.] "Acupuncture
practitioner" means a person licensed to practice acupuncture
under this chapter.
Subd. 7. [BOARD.] "Board" means the board of medical
practice or its designee.
Subd. 8. [BLOOD BORNE DISEASE.] "Blood borne disease"
means a disease that is spread through exposure to blood,
inoculation or injection of blood, or exposure to
blood-contaminated body fluids or tissues. Blood borne disease
includes infection caused by such agents as human
immunodeficiency virus (HIV) and hepatitis B virus (HBV).
Subd. 9. [BREATHING TECHNIQUES.] "Breathing techniques"
means Oriental breathing exercises taught to a patient as part
of a treatment plan.
Subd. 10. [CUPPING.] "Cupping" means a therapy in which a
jar-shaped instrument is attached to the skin and negative
pressure is created by using suction.
Subd. 11. [DERMAL FRICTION.] "Dermal friction" means
rubbing on the surface of the skin, using topical ointments with
a smooth-surfaced instrument without a cutting edge that can be
sterilized or, if disposable, a one-time only use product.
Subd. 12. [DIPLOMATE IN ACUPUNCTURE.] "Diplomate in
acupuncture" means a person who is certified by the NCCA as
having met the standards of competence established by the NCCA,
who subscribes to the NCCA code of ethics, and who has a current
and active NCCA certificate. Current and active NCCA
certification indicates successful completion of continued
professional development and previous satisfaction of NCCA
requirements.
Subd. 13. [ELECTRICAL STIMULATION.] "Electrical
stimulation" means a method of stimulating acupuncture points by
an electrical current of .001 to 100 milliamps, or other current
as approved by the board. Electrical stimulation may be used by
attachment of a device to an acupuncture needle or may be used
transcutaneously without penetrating the skin.
Subd. 14. [HERBAL THERAPIES.] "Herbal therapies" are the
use of herbs and patent herbal remedies as supplements as part
of the treatment plan of the patient.
Subd. 15. [INFECTION CONTROL.] "Infection control" means
programs, procedures, and methods to reduce the transmission of
agents of infection for the purpose of preventing or decreasing
the incidence of infectious diseases.
Subd. 16. [NCCA.] "NCCA" means the National Commission for
the Certification of Acupuncturists, a not-for-profit
corporation organized under section 501(c)(4) of the Internal
Revenue Code.
Subd. 17. [NEEDLE SICKNESS.] "Needle sickness" is a
temporary state of nausea and dizziness that is a potential side
effect to needle insertion and from which full recovery occurs
when the needles are removed.
Subd. 18. [ORIENTAL MEDICINE.] "Oriental medicine" means a
system of healing arts that perceives the circulation and
balance of energy in the body as being fundamental to the
well-being of the individual. It implements the theory through
specialized methods of analyzing the energy status of the body
and treating the body with acupuncture and other related
modalities for the purpose of strengthening the body, improving
energy balance, maintaining or restoring health, improving
physiological function, and reducing pain.
Sec. 3. [147B.02] [LICENSURE.]
Subdivision 1. [LICENSURE REQUIRED.] Except as provided
under subdivision 4, it is unlawful for any person to engage in
the practice of acupuncture without a valid license after June
30, 1997. Each licensed acupuncture practitioner shall
conspicuously display the license in the place of practice.
Subd. 2. [DESIGNATION.] A person licensed under this
chapter shall use the title of licensed acupuncturist or L.Ac.
following the person's name in all forms of advertising,
professional literature, and billings. A person may not, in the
conduct of an occupation or profession pertaining to the
practice of acupuncture or in connection with the person's name,
use the words or letters licensed acupuncturist, Minnesota
licensed acupuncturist, or any other words, letters,
abbreviations, or insignia indicating or implying that a person
is an acupuncturist without a license issued under this
section. A student attending an acupuncture training program
must be identified as a student acupuncturist.
Subd. 3. [PENALTY.] A person who violates this section is
guilty of a misdemeanor and subject to discipline under section
147.091.
Subd. 4. [EXCEPTIONS.] (a) The following persons may
practice acupuncture within the scope of their practice without
an acupuncture license:
(1) a physician licensed under this chapter;
(2) an osteopath licensed under this chapter;
(3) a chiropractor licensed under chapter 148;
(4) a person who is studying in a formal course of study or
tutorial intern program approved by the acupuncture advisory
council established in section 147B.05 so long as the person's
acupuncture practice is supervised by a licensed acupuncturist;
(5) a visiting acupuncturist practicing acupuncture within
an instructional setting for the sole purpose of teaching at a
school registered with the Minnesota higher education
coordinating board, who may practice without a license for a
period of one year, with two one-year extensions permitted; and
(6) a visiting acupuncturist who is in the state for the
sole purpose of providing a tutorial or workshop not to exceed
30 days in one calendar year.
(b) This chapter does not prohibit a person who does not
have an acupuncturist license from practicing specific
noninvasive techniques, such as acupressure, that are within the
scope of practice as set forth in section 147B.06, subdivision 4.
Subd. 5. [LICENSURE BY EQUIVALENCY DURING TRANSITIONAL
PERIOD.] (a) From July 1, 1995, to June 30, 1997, a person may
qualify for licensure if the person has engaged in acupuncture
practice for at least three years in the period from July 1,
1991, to June 30, 1995, with at least 500 patient visits in each
of the three years with at least 100 different patients.
Acupuncture practice must be the primary means of treatment, not
an adjunctive therapy. The person must also provide
documentation of successful completion of a clean needle
technique course approved by the acupuncture advisory board and
provide documentation of practice through at least four of the
following methods:
(1) original notarized letters from employers specifying
the dates and hours worked, nature of the practice, and number
of visits;
(2) notarized affidavits from a minimum of 20 patients with
current phone numbers and addresses for each, specifying the
time period of treatment and the nature of the treatment;
(3) notarized affidavits from at least two other health
care professionals, state or local acupuncture or Oriental
medicine associations, schools or colleges, with testimony based
on personal knowledge regarding the dates, volume, scope, and
type of practice;
(4) notarized affidavits from at least two other members
within the community with testimony based on personal knowledge
regarding the dates, volume, scope, and type of practice; and
(5) notarized copies of patient records. The person must
also meet any other requirements established by the board.
(b) All documentation submitted in a foreign language must
be accompanied by an accurate translation in English. Each
translated document must bear the affidavit of the translator
certifying that the translator is competent in both the language
of the document and in the English language and that the
translation is true and a complete translation of the foreign
language original and must be sworn before a notary public.
Translation of any document relative to a person's application
is at the expense of the applicant.
(c) Application for licensure under this subdivision must
be submitted to the board from July 1, 1995, to June 30, 1997.
All of the required patient visits must have been completed
before application for licensure.
Subd. 6. [LICENSE BY RECIPROCITY.] The board shall issue
an acupuncture license to a person who holds a current license
or certificate as an acupuncturist from another jurisdiction if
the board determines that the standards for certification or
licensure in the other jurisdiction meet or exceed the
requirements for licensure in Minnesota and a letter is received
from that jurisdiction that the acupuncturist is in good
standing in that jurisdiction.
Subd. 7. [LICENSURE REQUIREMENTS.] (a) After June 30,
1997, an applicant for licensure must:
(1) submit a completed application for licensure on forms
provided by the board, which must include the applicant's name
and address of record, which shall be public;
(2) unless licensed under subdivision 5 or 6, submit a
notorized copy of a current NCCA certification;
(3) sign a statement that the information in the
application is true and correct to the best of the applicant's
knowledge and belief;
(4) submit with the application all fees required; and
(5) sign a waiver authorizing the board to obtain access to
the applicant's records in this state or any state in which the
applicant has engaged in the practice of acupuncture.
(b) The board may ask the applicant to provide any
additional information necessary to ensure that the applicant is
able to practice with reasonable skill and safety to the public.
(c) The board may investigate information provided by an
applicant to whether the information is accurate and complete.
The board shall notify an applicant of action taken on the
application and the reasons for denying licensure if licensure
is denied.
Subd. 8. [LICENSURE EXPIRATION.] Licenses issued under
this section expire annually.
Subd. 9. [RENEWAL] (a) To renew a license an applicant
must:
(1) annually, or as determined by the board, complete a
renewal application on a form provided by the board;
(2) submit the renewal fee;
(3) provide evidence annually of one hour of continuing
education in the subject of infection control, including blood
borne pathogen diseases;
(4) provide documentation of current and active NCCA
certification; or
(5) if licensed under subdivision 5 or 6, meet one-half the
then current NCCA professional development activity requirements.
(b) An applicant shall submit any additional information
requested by the board to clarify information presented in the
renewal application. The information must be submitted within
30 days after the board's request, or the renewal request is
nullified.
Subd. 10. [LICENSURE RENEWAL NOTICE.] At least 30 days
before the license renewal date, the board shall send out a
renewal notice to the last known address of the licensee. The
notice must include a renewal application and a notice of fees
required for renewal. If the licensee does not receive a
renewal notice, the licensee must still meet the requirements
for registration renewal under this section.
Subd. 11. [RENEWAL DEADLINE.] The renewal application and
fee must be postmarked on or before June 30 of the year of
renewal or as determined by the board.
Subd. 12. [INACTIVE STATUS.] (a) A license may be placed
in inactive status upon application to the board and upon
payment of an inactive status fee. The board may not renew or
restore a license that has lapsed and has not been renewed
within two annual license renewal cycles.
(b) An inactive license may be reactivated by the license
holder upon application to the board. A licensee whose license
is canceled for nonrenewal must obtain a new license by applying
for licensure and fulfilling all the requirements then in
existence for the initial license to practice acupuncture in the
state of Minnesota. The application must include:
(1) evidence of current and active NCCA certification;
(2) evidence of the certificate holder's payment of an
inactive status fee;
(3) an annual fee; and
(4) all back fees since previous renewal.
(c) A person licensed under subdivision 5 who has allowed
the license to reach inactive status must become NCCA certified.
Subd. 13. [TEMPORARY PERMIT.] The board may issue a
temporary permit to practice acupuncture to an applicant
eligible for licensure under this section only if the
application for licensure is complete, all applicable
requirements in this section have been met, and a nonrefundable
fee set by the board has been paid. The permit remains valid
only until the meeting of the board at which a decision is made
on the acupuncturist's application for licensure.
Sec. 4. [147B.03] [NCCA PROFESSIONAL DEVELOPMENT ACTIVITY
REQUIREMENTS.]
Subdivision 1. [NCCA REQUIREMENTS.] Unless a person is
licensed under section 147B.02, subdivision 5 or 6, each
licensee is required to meet the NCCA professional development
activity requirements to maintain NCCA certification. These
requirements may be met through a board approved continuing
education program.
Subd. 2. [BOARD APPROVAL.] The board shall approve a
continuing education program if the program meets the following
requirements:
(1) it directly relates to the practice of acupuncture;
(2) each member of the faculty shows expertise in the
subject matter by holding a degree or certificate from an
educational institution, has verifiable experience in
traditional Oriental medicine, or has special training in the
subject area;
(3) the program lasts at least one contact hour;
(4) there are specific written objectives describing the
goals of the program for the participants; and
(5) the program sponsor maintains attendance records for
four years.
Subd. 3. [CONTINUING EDUCATION TOPICS.] (a) Continuing
education program topics may include, but are not limited to,
Oriental medical theory and techniques including Oriental
massage; Oriental nutrition; Oriental herbology and diet
therapy; Oriental exercise; western sciences such as anatomy,
physiology, biochemistry, microbiology, psychology, nutrition,
history of medicine; and medical terminology or coding.
(b) Practice management courses are excluded under this
section.
Subd. 4. [VERIFICATION.] The board shall periodically
select a random sample of acupuncturists and require the
acupuncturist to show evidence of having completed the NCCA
professional development activities requirements. Either the
acupuncturist, the state, or the national organization that
maintains continuing education records may provide the board
documentation of the continuing education program.
Sec. 5. [147B.04] [BOARD ACTION ON APPLICATIONS.]
Subdivision 1. [VERIFICATION OF APPLICATION
INFORMATION.] The board or acupuncture advisory council
established under section 147B.05, with the approval of the
board, may verify information provided by an application for
licensure under section 147B.02 to determine if the information
is accurate and complete.
Subd. 2. [NOTIFICATION OF BOARD ACTION.] Within 120 days
of receipt of the application, the board shall notify each
applicant in writing of the action taken on the application.
Subd. 3. [REQUEST FOR HEARING BY APPLICANT DENIED.] An
applicant denied licensure must be notified of the
determination, and the grounds for it, and may request a hearing
on the determination by filing a written statement of issues
with the board within 20 days after receipt of the notice from
the board. After the hearing, the board shall notify the
applicant in writing of its decision.
Sec. 6. [147B.05] [ACUPUNCTURE ADVISORY COUNCIL.]
Subdivision 1. [CREATION.] The advisory council to the
board of medical practice for acupuncture consists of seven
members appointed by the board to three-year terms. Four
members must be licensed acupuncture practitioners, one member
must be a licensed physician or osteopath who also practices
acupuncture, one member must be a licensed chiropractor who is
NCCA certified, and one member must be a member of the public
who has received acupuncture treatment as a primary therapy from
a NCCA certified acupuncturist.
Subd. 2. [ADMINISTRATION; COMPENSATION; REMOVAL;
QUORUM.] The advisory council is governed by section 15.059,
except that the council does not expire until June 30, 1999.
Subd. 3. [DUTIES.] The advisory council shall:
(1) advise the board on issuance, denial, renewal,
suspension, revocation, conditioning, or restricting of licenses
to practice acupuncture;
(2) advise the board on issues related to receiving,
investigating, conducting hearings, and imposing disciplinary
action in relation to complaints against acupuncture
practitioners;
(3) maintain a register of acupuncture practitioners
licensed under section 147B.02;
(4) maintain a record of all advisory council actions;
(5) prescribe registration application forms, license
forms, protocol forms, and other necessary forms;
(6) review the patient visit records submitted by
applicants during the transition period;
(7) advise the board regarding standards for
acupuncturists;
(8) distribute information regarding acupuncture practice
standards;
(9) review complaints;
(10) advise the board regarding continuing education
programs;
(11) review the investigation of reports of complaints and
recommend to the board whether disciplinary action should be
taken; and
(12) perform other duties authorized by advisory councils
under chapter 214, as directed by the board.
Sec. 7. [147B.06] [PROFESSIONAL CONDUCT.]
Subdivision 1. [PRACTICE STANDARDS.] (a) Before treatment
of a patient, an acupuncture practitioner shall ask whether the
patient has been examined by a licensed physician or other
professional, as defined by section 145.61, subdivision 2, with
regard to the patient's illness or injury, and shall review the
diagnosis as reported.
(b) The practitioner shall obtain informed consent from the
patient, after advising the patient of the following information
which must be supplied to the patient in writing before or at
the time of the initial visit:
(1) the practitioner's qualifications including:
(i) education;
(ii) license information; and
(iii) outline of the scope of practice of acupuncturists in
Minnesota; and
(2) side effects which may include the following:
(i) some pain in the treatment area;
(ii) minor bruising;
(iii) infection;
(iv) needle sickness; or
(v) broken needles.
(c) The practitioner shall obtain acknowledgment by the
patient in writing that the patient has been advised to consult
with the patient's primary care physician about the acupuncture
treatment if the patient circumstances warrant or the patient
chooses to do so.
(d) The practitioner shall inquire whether the patient has
a pacemaker or bleeding disorder.
Subd. 2. [STERILIZED EQUIPMENT.] An acupuncture
practitioner shall use sterilized equipment that has been
sterilized under standards of the National Centers for Disease
Control and Prevention.
Subd. 3. [STATE AND MUNICIPAL PUBLIC HEALTH
REGULATIONS.] An acupuncture practitioner shall comply with all
applicable state and municipal requirements regarding public
health.
Subd. 4. [SCOPE OF PRACTICE.] The scope of practice of
acupuncture includes, but is not limited to, the following:
(1) using Oriental medical theory to assess and diagnose a
patient;
(2) using Oriental medical theory to develop a plan to
treat a patient. The treatment techniques that may be chosen
include:
(i) insertion of sterile acupuncture needles through the
skin;
(ii) acupuncture stimulation including, but not limited to,
electrical stimulation or the application of heat;
(iii) cupping;
(iv) dermal friction;
(v) acupressure;
(vi) herbal therapies;
(vii) dietary counseling based on traditional Chinese
medical principles;
(viii) breathing techniques; or
(ix) exercise according to Oriental medical principles.
Subd. 5. [PATIENT RECORDS.] An acupuncturist shall
maintain a patient record for each patient treated, including:
(1) a copy of the informed consent;
(2) evidence of a patient interview concerning the
patient's medical history and current physical condition;
(3) evidence of a traditional acupuncture examination and
diagnosis;
(4) record of the treatment including points treated; and
(5) evidence of evaluation and instructions given to the
patient.
Subd. 6. [REFERRAL TO OTHER HEALTH CARE PRACTITIONERS.]
Referral to other health care practitioners is required when an
acupuncturist practitioner sees patients with potentially
serious disorders including, but not limited to:
(1) cardiac conditions including uncontrolled hypertension;
(2) acute, severe abdominal pain;
(3) acute, undiagnosed neurological changes;
(4) unexplained weight loss or gain in excess of 15 percent
of the body weight in less than a three-month period;
(5) suspected fracture or dislocation;
(6) suspected systemic infections;
(7) any serious undiagnosed hemorrhagic disorder; and
(8) acute respiratory distress without previous history.
The acupuncturist shall request a consultation or written
diagnosis from a licensed physician for patients with
potentially serious disorders.
Subd. 7. [DATA PRACTICES.] Data maintained on an
acupuncture patient by an acupuncture practitioner is subject to
section 144.336.
Sec. 8. [147B.07] [DISCIPLINE; REPORTING.]
For purposes of this chapter, acupuncturist licensees and
applicants are subject to the provisions of sections 147.091 to
147.162.
Sec. 9. [147B.08] [FEES.]
Subdivision 1. [ANNUAL REGISTRATION FEE.] The board shall
establish the fee of $150 for initial licensure and $150 annual
licensure renewal. The board may prorate the initial licensure
fee.
Subd. 2. [PENALTY FEE FOR LATE RENEWALS.] The penalty fee
for late submission for renewal application is $50.
Subd. 3. [DEPOSIT.] Fees collected by the board under this
section must be deposited in the state government special
revenue fund.
Sec. 10. [INITIAL ADVISORY COUNCIL.]
(a) Notwithstanding Minnesota Statutes, section 147B.05,
the four members of the advisory council required by that
section to be acupuncture practitioners, who are appointed to
the initial advisory committee, need not be licensed under
Minnesota Statutes, section 147B.02, but must satisfy the
qualifications for licensure provided in section 147B.02,
subdivision 7, and must have been engaged in acupuncture
practice a minimum of three years.
(b) Two members of the initial advisory committee appointed
must have an initial term of one year, two members an initial
term of two years, and three members an initial term of three
years.
Sec. 11. [APPROPRIATION.]
$10,000 in fiscal year 1996 and $10,000 in fiscal year 1997
are appropriated from the state government special revenue fund
to the state board of medical practice to license acupuncture
practitioners under this act.
Sec. 12. [EFFECTIVE DATE.]
This act is effective July 1, 1995.
Presented to the governor May 15, 1995
Signed by the governor May 17, 1995, 2:00 p.m.
Official Publication of the State of Minnesota
Revisor of Statutes