TSBAE Education Committee and Board Meeting
On Friday, May 14, 2010, the TAAOM Executive Director attended the Texas State Board of Acupuncture Examiners (TSBAE) Education Committee Meeting as well as the TSBAE Board Meeting. TAAOM members Will Morris, Leslie Myers, Chris Butler, and Dee Ann Neubold were also in attendance.
Education Committee. The Education Committee met for just under an hour to discuss and act on requests to become approved providers of Continuing Acupuncture Education (CAE) and to approve specific courses that the agency staff did not feel comfortable with approving on their own. The committee business was generally uneventful, but significant discussion did take place about offering distance learning using a course that was already offered and approved for a live setting. The concern seemed to focus on the need for interaction during the distance-learning course so that there were some assurances that educational benefits would be the same as the live offering and those licensees taking the course would be actively participating. Leslie Myers was on hand to address these concerns by explaining mechanisms to ensure active learning when taking an online or other distance-learning course.
Committee members were receptive as was staff, and it appears that their concerns were adequately addressed. There was additional discussion about handling biomedicine related courses in the future, and it can be anticipated that agency staff and the Education Committee will be scrutinizing these types of courses more closely due to the recent interest in these offerings. Included in committee discussion was the need to make sure the credentials of CAE providers were appropriate for the particular offering. It was also noted that approved providers will need to be establishing a track record of offering more than one course in the approved three-year period to give the agency a comfort level with the adequacy of the course offerings and justification for approved provider status.
Board Meeting. The full Texas State Board of Acupuncture Examiners met at 10:00 a.m. on May 14, 2010, and the meeting lasted until around 3:00 p.m. Will Morris and Leslie Myers were in attendance for all but the last few agenda items. Chris Butler attended a portion of the meeting as well. The TAAOM Executive Director was present throughout the meeting and stayed for a few minutes afterwards during which time he was able to meet one-on-one with several Board members. Discussions with these TSBAE members were predominantly about the TAAOM, the TAAOM leadership and staff, and the need for legislative efforts to ensure the viability of the profession and public access to acupuncture services.
The meeting itself covered routine reports on the Chiropractic Stakeholder Workgroup by TSBAE acupuncturist member Rachelle Webb who acknowledged the value of the TAAOM Executive Director and TAAOM members being present at the meeting. Assistant General Counsel for the TMB, Suzanne Mitchell, also provided a report. Each indicated that the next step was to meet to compare qualifications and training of the two professions in regard to acupuncture, and to continue to look at ways to ensure adequate knowledge and skills while clarifying for the public the services that are actually available from the two professions. Some skepticism was expressed regarding the intent of the Chiropractic Board to legitimately address the acupuncture community’s concerns. Full participation in the stakeholder process is still anticipated.
The TMB Executive Director reported on the implementation of the peer assistance program, 5% budget cut for the agency, database updates causing enforcement report delays, and how to post agenda items for discussion. Committee minutes were also discussed as well as the agency strategic plan and related legislative appropriations requests. It was reported that due to the state budget shortfall a license fee increase is likely. A hiring freeze is already in effect with the agency down 15 employees.
Public comments were received on a range of issues. Dee Ann Neubold testified about the need for parity in CAE requirements for acupuncturist as compared to other regulated professions and credit for ethics course offerings taken by acupuncturists when presented for other professions. Lisa Lin raised the issue of the DOM degree and designation in Texas. General discussion followed.
Discussion was also held on the problems surrounding use of the doctor designation under the Healing Art Identification Act. A decision was reached to post frequently asked questions (FAQs) and answers in an effort to give more guidance to licensees. Agency staff was given two projects to work on. One project is the creation of an electronic newsletter for licensees, and the other is the drafting of FAQs on the use of the doctor designation.
Discussion was held on the licensure process for visiting acupuncturists teaching in PhD programs in Texas schools. Will Morris provided guidance to the Board on this issue.
The subject of dry needling and related proposed definition change under agency rules was discussed, and it was explained that it would be more fully addressed at the upcoming stakeholders gathering with a report back to the Board at its next meeting.
Committee action items and meeting minutes were approved, and routine administrative housekeeping matters were handled (i.e., license applications, dismissal of an investigation, approval of agreed orders). Discussion was held on the idea of eliminating some of the Board’s committees in order to avoid duplication of effort and streamline Board business. Concerns were raised about the website accurately reflecting the activities of the Board.
A significant portion of the meeting was focused on a proposal for decision in a contested disciplinary case involving the alleged misuse of the title of “Dr.” due to an administrative error on a fax transmittal sheet by a licensee’s office staff. The recommended fine of $500 as proposed by the administrative law judge was reduced by the Board to $250 and extenuating and mitigating circumstances were added in the language of the decision to better explain events and put the licensee in a better light.
Overall, the meeting was longer than typical for this Board with much of the time dedicated to the proposal for decision and various routine reports.
Acupuncture Stakeholders Meeting. At 1:30 p.m. on May 18, 2010, the TSBAE held its Acupuncture Stakeholders Meeting. Chris Butler was in attendance as an association representative. John Paul Liang and Will Morris were present as representatives of their respective schools. TAAOM Executive Director Tim Weitz was also in attendance. Lisa Lin was present on behalf of her school along with Alan M. Preston, Vice President of Academic Affairs, Research and Assessment. TAAOM member Dee Ann Neubold was also present. Representatives of the Texas Medical Association (TMA) and various agency staff members were on hand. The Texas Medical Board (TMB) Executive Director conducted the meeting.
The meeting lasted just under an hour. The primary focus was on proposed changes to Rule 183.2 (Definitions) pertaining to a possible addition of language to clarify that an acupuncture needle is a solid body dry needle. There was considerable discussion of the benefits and problems of including this language in the definition of acupuncture. While it was acknowledged that the change may be beneficial in laying the groundwork for preventing physical therapists and others from performing acupuncture under the guise of dry needling, there was concern that it was somewhat limiting if the language was not styled in terms of inclusiveness.
There was additional discussion over the current statutory definition of acupuncture as reflected in the rule. The TMB Executive Director emphasized that a statutory change would be needed to address the longstanding concerns about the non-incisive insertion of needles terminology currently in the practice act definition of acupuncture. It was further noted that the acupuncture community and acupuncture associations would need to be unified in bringing a proposed statutory change to the legislature. Ultimately, the stakeholders group reached a consensus on language for the rule that made the language defining acupuncture to be inclusive of the use of a solid body needle, but not limited solely to use of such a needle. Timelines for passage of the rule were explained including the need for TSBAE approval at its November meeting. Consequently, publication and formal comments on the rule would not be likely until November and thereafter. Due to state budget concerns, the TSBAE, like other state agencies, cancelled one meeting this year leaving only the November meeting on the calendar for the rest of 2010. An additional stakeholders meeting is still anticipated for later this summer.
The rest of the stakeholders meeting focused on a change to Rule 183.20 (Continuing Acupuncture Education), and specifically on a requirement that approved providers give at least one CAE course in each year of approved status. In addition, the subject of biomedicine was proposed to be added as one of the categories for CAE hours in keeping with Education Committee and full Board considerations of this topic. These changes appeared to be without controversy.
The meeting also included discussion of adding agenda items to future stakeholder meeting agendas such as problems and potential solutions surrounding the use of the doctor designation. When a date for the next stakeholders meeting is determined, notices will be sent out and the agenda will be posted on the agency website.
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