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SPONSOR: |
Begaye |
DATE TYPED: |
|
HB |
679/aHBIC/aHTRC |
||
SHORT TITLE: |
Auricular Detoxification Specialists |
SB |
|
||||
|
ANALYST: |
Geisler |
|||||
REVENUE
Estimated Revenue |
Subsequent Years Impact |
Recurring or
Non-Rec |
Fund Affected |
|
FY03 |
FY04 |
|
|
|
|
$2.0 |
$2.0 |
Recurring |
OSF |
|
|
|
|
|
(Parenthesis ( ) Indicate Revenue Decreases)
Relates to:
HB 265, Recognition of Doctors of Oriental Medicine
Regulation
and Licensing Department (RLD)
Department
of Health (DOH)
Synopsis
of HTRC Amendment
The House Taxation and Revenue Committee Amendment to HB 679 reduced
the reporting requirements for certified auricular detoxification specialists
and auricular detoxification specialist supervisors by striking Subsection K of
the bill which allows the board the option of requiring the certified
auricular detoxification specialist and the supervisor of the auricular detoxification
specialist to collect and present data to the board.
Synopsis
of HBIC Amendments
The House Business and Industry Committee amendments to HB 679
strengthen board oversight of auricular detoxification specialist
certification, practice, and supervision in addition to streamlining supervision and reporting
requirements. Major changes included:
·
Clarification that the certified auricular detoxification
specialist must complete a board approved training program that will included
examinations on clean needle technique, jurisprudence, and other skills
required by the board.
·
The certified auricular detoxification specialist shall
utilize board approved treatment devices.
·
The certified auricular detoxification specialist shall
only practice in a board approved program that demonstrates experience in
disease prevention, harm reduction or the treatment or prevention of
alcoholism, substance abuse or chemical dependency.
·
The certified auricular detoxification specialist shall
practice under the supervision of a licensed doctor of oriental medicine
registered with the board as an auricular detoxification specialist
supervisor.
·
Removal of the requirement that the auricular
detoxification specialist supervisor shall be accessible for consultation directly
or by phone every time treatment is performed.
·
Removal of the requirement that the auricular
detoxification specialist supervisor shall evaluate a certified auricular
detoxification specialist’s patients and review treatment plans. (A treatment plan, if necessary, is the
responsibility of the program providing the treatment-- not a supervisor
overseeing the correct application of a method or technique used as part of the
treatment. Note: supervision requirements shall be provided by
rule of the board.
·
Removes the requirement that auricular detoxification
specialist supervisor prepare and submit to the board a tabulation and analysis
of treatment outcomes as part of annual registration renewal.
Synopsis of Original
Bill
House Bill 679 proposes to establish a new section of the Acupuncture
and Oriental Medicine Practice Act allowing for the licensure of specialists
trained in auricular detoxification techniques for the treatment of alcoholism,
substance abuse or chemical dependency. Specifically, HB 679 would establish
the requirements and procedures for the certification of auricular detoxification
specialists, the supervision of specialists, training program approval, and the
provision of fees.
Significant
Issues
Substance abuse and the limited availability of drug and alcohol
treatment in
The National Acupuncture Detoxification Association (NADA) protocol has
recently received federal approval for use in assisting with drug treatment for
individuals with chemical dependence.
RLD reports the enactment of HB 679
will generate approximately $2.0 in revenues based on 20 applicants. There may be minor costs associated with
application packets, rule hearings, rule drafting and rule filing. The DOH states the
proposed fee ceilings might allow interested providers to receive the training
and become certified at a reasonable cost.
However, publicly-funded treatment agencies may not be able to absorb
the necessary costs associated with this beneficial alternative treatment
technique.
ADMINISTRATIVE IMPLICATIONS
The
enactment of House Bill 679 will result in minor paperwork for the RLD’s Board
of Acupuncture and Oriental Medicine staff.
A tracking system must be developed and maintained. Existing staff will manage the auricular
detoxification program.
RELATIONSHIP
HB 679 is related to
HB 265, which would recognize doctors of oriental medicine.
TECHNICAL ISSUES
Per DOH, on page 3, line 9, the use of the word natural in “simple natural devices” may be misleading if acupuncture needles can be used as part of the technique
OTHER SUBSTANTIVE ISSUES
The
following is additional background provided by the DOH:
Specialists
trained in auricular detoxification techniques currently offer therapy in many
sites around the
Two
programs have recently been providing Acu-detox services by acupuncturists in
Currently,
little or no funding exists to support an acupuncturist providing such services
in the state, especially in rural areas where extensive travel would be
required to provide regular and consistent services. The licensing of specialists would make it
possible for existing programs to have their employees or volunteers trained
and certified to provide these services.
HB
679 seems overly demanding in regards to testing, on-site supervision and
record keeping. In order for the
potential of this technique to contribute widely, it needs to be as accessible,
cost-effective, and available as possible.
Several recommendations for appropriately improving
HB
679 in this regard are provided in the Amendments section. Each amendment has suggested wording changes,
followed by the rationale for the change.
The
DOH recommends the following amendments which are supported by RLD:
1.
Beginning on page 2, line 25; delete
Section B, subsection (3). Insert as subsection (3) “Complete a Board approved
training program that will include examinations on clean needle technique,
jurisprudence, and any other skills required by the Board”. (All examinations should be administered
within an approved training program to remain cost effective.)
2.
On page 3, line 9; strike the word
“natural”. Insert the words “Board Approved” between the words “simple” and
“devices”.
3.
On page 3, line 16, strike the words, “an
established program for the treatment or.”
Strike lines 17 and 18. Insert on
line 16, after the word “within”, the words “a program which demonstrates
experience in disease prevention, harm reduction, or the treatment or prevention
of alcoholism, substance abuse or chemical dependency.”
4.
On page 4, line 17; strike the words “any
time treatment is performed”. Insert on line 17 following the word “telephone”
on line 16, “to a practicing specialist.”
(Consultation should be available, but any urgent issue that may arise
while treating a patient [e.g., seizure] would be more appropriately handled by
activating EMS [calling 911] than by consulting a supervisor.)
5.
On page 4, lines 17 through 20, strike
the sentence “The supervising doctor of oriental medicine shall evaluate the
patient and review the treatment plan for a patient at a frequency defined by
rules promulgated by the board.” (A treatment plan, if necessary, is the
responsibility of the program providing the treatment or counseling service
based on the requirements of that program [e.g., drug courts], not a supervisor
overseeing the correct application of a method or technique used as part of the
treatment. It would also then be required of the supervisor to be on site to
interact with a client, which will be difficult considering the rural nature of
the state. Outreach and prevention programs often have only sporadic contact
with clients, making the evaluation of every client on an occasional visit
impossible.)
6.
On page 5, lines 17 and 18, strike the words “a tabulation
and analysis of treatment outcomes”. (Tabulation and analysis are the
responsibilities of the program providing the treatment or counseling service,
not a supervisor overseeing the correct application of a method or technique
used as part of the treatment. A certified Doctor of Oriental Medicine is not required
to present this type of data to be re-certified as an acupuncturist. It seems
unnecessary to require this of a less specific technique. There is also the Health Insurance
Portability and Accountability Act [HIPAA] issue of providing
“client-identifying” data to a board.
This needs further review before wording on client data can be
inserted.)
7.
On page 6, line 21; strike the words
”tabulation and analysis of treatment outcomes”. (Tabulation and analysis are
the responsibilities of the program providing the treatment or counseling
service, not a supervisor overseeing the correct application of a method or
technique used as part of the treatment. Outcomes data may require
sophisticated research and involve HIPAA compliance, making the act of
supervision prohibitive.)
GGG/sb:njw