Chapter 360-6 ACUPUNCTURE

Each applicant for licensure as an acupuncturist must meet the requirements listed below.

(a)

An affidavit that the applicant is a United States citizen, a legal permanent resident of the United States, or that he/she is a qualified alien or non-immigrant under the Federal Immigration and Nationality Act. If the applicant is not a U.S. citizen, he/she must submit documentation that will determine his/her qualified alien status. The Board participates in the DHS-USCIS SAVE (Systematic Alien Verification for Entitlements or "SAVE") program for the purpose of verifying citizenship and immigration status information of non-citizens. If the applicant is a qualified alien or non-immigrant under the Federal Immigration and Nationality Act, he/she must provide the alien number issued by the Department of Homeland Security or other federal immigration agency.

(b)	Must be at least 21 years of age and of good moral character;

(c)	Submit a completed application required by the Board. Said application shall not be considered completed until all fees have been paid and all required documents have been eceived by the Board;

(d)

Must submit three (3) acceptable references: one reference from a licensed United States physician either MD or DO in the jurisdiction where the applicant is practicing and who is familiar with the applicant's practice and two references from practicing acupuncturists familiar with the applicant's practice.

(e)

Have successfully completed a degree in acupuncture or a formal course of study and training in acupuncture. The applicant shall submit documentation satisfactory to the board to show that such education or course of study and training was:

1.	Completed at a school that is accredited by the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) or other accrediting entity approved by the board; or

2.	Completed by means of a program of acupuncture study and training that is substantially equivalent to the acupuncture education offered by an accredited school of acupuncture approved by the board.

(f)	Have passed an acupuncture examination offered by an organization accredited by the National Organization of Competency Assurance and approved by the board;

(g)	Submit proof of certification in acupuncture by the National Certification Commission for Acupuncture and Oriental Medicine;

(h)	Completed successfully a clean needle technique course approved by the Board; and

(i)

Submitted proof of having professional liability insurance of at least $100,000/$300,000.

1.	If the licensee changes liability carriers, is canceled by a liability carrier, or cancels liability coverage, the licensee must notify the Board within thirty (30) days of the date of change or cancellation.

2.

Failure to maintain liability coverage, pursuant to the Act, may result in suspension of the license for acupuncture.

(i)	An applicant must submit all documentation required for the application process within twelve months from the date the Board receives the application.

(2)	Every person who holds a license issued by the Board shall inform the Board of any change of address and any other change of information, including but not limited to professional liability coverage, for licensure by this Rule or the Act.

(3)	The titles "Licensed Acupuncturist" and "Acupuncturist" shall only be used by persons licensed to practice acupuncture pursuant to the Act and these Rules.

Rule 360-6-.04 Display of Name Tag and License for Acupuncture

A person licensed as an acupuncturist providing services in this state in a hospital, practice setting, nursing home, assisted living community or personal care home shall communicate the acupuncturist's specific licensure to all current and prospective patients and shall wear a clearly legible identification tag during all patient encounters with the licensee's name and the word "Acupuncturist."

(2)	In all advertising that names a person in relation to his or her healthcare practice, a person licensed to practice as an acupuncturist in Georgia shall identify themselves as an acupuncturist.

(3)

Every person who is licensed to practice acupuncture pursuant to the Act and these Rules and who is actively practicing acupuncture or the active practice of auricular (ear) detoxification therapy as an auricular (ear) detoxification technician shall display the license issued by the Board in a public and appropriate manner.

(4)	Any license or document evidencing licensure issued by the Board is the property of the Board and shall be surrendered on demand.

Rule 360-6-.05 Supervised Practice of Acupuncture

Any person licensed to practice acupuncture under the Act ("practitioner") who has less than one (1) year of postgraduate clinical experience may not practice on his or her own unless and until such person has completed one (1) year of active clinical practice under the supervision of a duly licensed acupuncturist. The supervising acupuncturist ("supervisor") shall be currently licensed in Georgia and shall have four (4) years of active licensed clinical experience as an acupuncturist in Georgia or a combination of four (4) years experience in other states or countries as long as the other states or countries substantially equal or exceed Georgia's standards for licensure of acupuncturists.

The supervision of postgraduate clinical practice of an acupuncture practitioner shall comply with the following provisions and guidelines.

(a)

Definitions:

1.	"Practitioner" is the person who is being supervised and monitored by the supervisor while performing acupuncture during postgraduate clinical practice.

2.	"Supervisor" is the acupuncturist who meets the qualifications of this rule and the applicable statute who is responsible for the supervision of the practitioner during supervised postgraduate clinical practice.

3.

"Supervised postgraduate clinical practice" is the practice of acupuncture performed by a practitioner under the direct supervision of an approved acupuncturist in facilities approved by the Georgia Composite Medical Board ("Board"), in consultation with the Acupuncture Advisory Committee ("Advisory Committee"), pursuant to the provisions of O.C.G.A. § 43-34-64(c) and this rule.

Supervisor: A supervisor shall be approved to supervise a practitioner by the Board, in consultation with the Advisory Committee. The supervisor must be licensed in Georgia as an acupuncturist and actively practicing in this state. The supervisor shall have no less than four (4) years of active licensed clinical experience as an acupuncturist. The four (4) years of active licensed clinical experience may be four (4) combined years of active licensed practice in Georgia or in other states or countries as long the standards for licensure of acupuncturists in said states or countries are substantially equivalent to or exceed the standards of licensure in Georgia.

(c)

Supervision: The supervisor and practitioner who are engaged in supervised post clinical practice shall adhere to the following guidelines:

1.

Plan of supervision:

(i)	The supervisor shall submit a letter of intent and a written outlined plan of supervision to the Board, which shall be reviewed and approved by the Board, in consultation with the Advisory Committee, before supervised practice is begun.

(ii)	The supervisor must be present on site and available at all times while the practitioner is seeing and treating patients. The practitioner shall practice in the same office with the supervisor.

(iii)

A supervisor may not enter into a plan of supervision with more than two practitioners at a time.

2.

Monitoring: The supervisor shall monitor no less than one (1) supervised patient treatment performed by the practitioner no less than every other week or bi-weekly. Monitoring shall include case review, supervision of safety procedures, clean needle technique, and assessment of professionalism of the practitioner.

3.

Records:

(i)

Patient treatment records: The supervisor shall keep written records of the supervised patient treatments by the practitioner and shall submit a summary of the patient treatment records along with quarterly reports to the Board for its review, in consultation with the Advisory Committee. The records shall include any information relevant to patient treatment that is included in the monitoring by the supervisor of the practitioner.

(ii)

Practice records:

I.

For supervisory purposes, practice is defined as performing a minimum of 500 acupuncture treatments on at least 100 different patients during a one (1) year or twelve (12) months supervised clinical period. Substance abuse or detoxification treatments are not acupuncture treatments for the purposes of supervised postgraduate clinical acupuncture practice.

II.

Full and complete records with all relevant and supportive documentation are to be kept at the site of treatment at all times and made available to the Board for review and inspection. Records shall include, but not be limited to, appointment schedules, patient records, treatment records, receipts, and data pertaining to invoice and payment for acupuncture treatment.

4.

Reports:

(i)

Quarterly reports: Quarterly reports shall be submitted to the Board by the supervisor and shall include the performance, progress and understanding of basic skills of the practitioner. The report shall also include the number of patients that the practitioner has seen per month and the number of acupuncture treatments provided by the practitioner. Quarterly reports shall be filed with the Board and are due three, six, nine, and twelve months after provisional licensure issue date.

(ii)

Final supervisory report: At the end of the probationary period, a final review from the supervisor shall be submitted about the practitioner's progress with a recommendation to the Board regarding fitness of the practitioner to practice acupuncture as a solo practitioner. The report shall be reviewed by the Advisory Committee and a recommendation made by the Advisory Committee concerning Board action.

(d)	Provisions regarding supervised practice may also be used as guidelines for restrictions placed upon the practice of acupuncture by persons licensed by the Board as authorized by statute.

(e)	Failure to adhere to guidelines regarding supervised postgraduate clinical practice may result in sanctions, restrictions, or disciplinary actions upon licensees by the Board.

Rule 360-6-.06 License Requirements for Auricular Detoxification Technician

Each applicant for a license to perform auricular (ear) detoxification therapy as an auricular (ear) detoxification technician must meet the requirements listed below. If an applicant does not meet all requirements for licensure stated in this Rule, the Board may, in its discretion, grant a license to an applicant upon the recommendation of the Advisory Committee.

(a)	Be at least 21 years of age and of good moral character;

(b)	Submit a completed application as required by the Board;

(c)	Submit an application fee as required by the Board;

(d)	Have successfully completed a nationally recognized training program in auricular (ear) detoxification therapy for the treatment of chemical dependence as approved by the Board; and

(e)	Have successfully completed a nationally recognized clean needle technique course approved by the Board.

(f)	Submit verification of applicant's coverage by employer's professional liability insurance.

(g)	An applicant must satisfactorily complete all requirements for licensure within one year from the date the Board receives the application.

The practice of auricular (ear) detoxification therapy may take place only in a city, county, state, federal or private chemical dependency program approved by the Board and under the direct supervision of a licensed acupuncturist or a person licensed to practice acupuncture by the Board who is also authorized to practice medicine in the State of Georgia.

(3)	The title "Auricular Detoxification Technician (ADT)" may only be used by persons licensed pursuant to the Act and these rules who practice auricular (ear) detoxification therapy. Licensure as an ADT does not by itself entitle a person to use the title "Acupuncturist" or "Licensed Acupuncturist."

(4)	Every person who holds a license issued by the Board shall inform the Board of any change of address or any other change of information, including but not limited to a change of employment, required for licensure pursuant to the Act and these Rules.

(5)

A license for an Auricular Detoxification Technician (ADT) is limited to and only valid for the employer designated at time of licensure. The ADT licensee shall be covered by the professional liability insurance of the licensee's employer.

(a)	If an ADT licensee changes employers, the licensee must file a "Request To Change Employers" form with the Board and must receive permission from the Board to change employers.

(b)	If an ADT licensee terminates employment with the designated employer, the ADT license becomes automatically inactive until such time a new application is made.

(6)	Every person who holds a license issued by the Board as an Auricular Detoxification Technician must wear an identification badge stating their name and title at all times while rendering therapy.

Rule 360-6-.07 Display of License for Auricular Detoxification Technician

(1)	Every person who is licensed to practice auricular (ear) detoxification therapy pursuant to the Act and these Rules and who is actively practicing auricular (ear) detoxification therapy shall display the license issued by the Board in a public and appropriate manner.

(2)	Any license or document evidencing licensure issued by the Board is the property of the Board and shall be surrendered on demand.

Rule 360-6-.08 Unlicensed Practice of Acupuncture and Auricular Detoxification Therapy Prohibited. Exemptions

No person shall:

(a)	Practice acupuncture or auricular detoxification therapy in Georgia without a license; or

(b)	Represent himself or herself to be an Acupuncturist or Auricular Detoxification Technician if he or she is not licensed under the Act.

The following persons are exempt from licensure by the Board to practice acupuncture or auricular detoxification therapy in Georgia:

(a)	Students who practice acupuncture as an integral part of a program of study and who are enrolled in a Board-approved acupuncture education program under the direct clinical supervision of a licensed acupuncturist with at least five years of clinical experience; or

Persons who are licensed or certified to perform acupuncture in any other jurisdiction where such persons are doing so in the course of regular instruction in a Board-approved educational program of acupuncture or in an educational seminar of a Board-approved professional organization of acupuncture; provided that in the latter case, the practice is supervised directly by a person licensed to practice acupuncture pursuant to the Act or an acupuncturist who is licensed to practice medicine under Georgia law.

Rule 360-6-.09 Physicians

Licensed physicians desiring to practice acupuncture in Georgia shall successfully complete a Board-approved 300 hour course and notify the Board in writing of their intent to practice acupuncture no less than thirty (30) days prior to incorporating such therapies into their medical practice. Physicians authorized by the Board to perform acupuncture are entitled to the same rights and privileges as those licensed to practice acupuncture and auricular detoxification therapy.

Rule 360-6-.10 Composition and Responsibilities of the Acupuncture Advisory Committee

The intention and policy of the Board is to reflect the cultural diversity of the citizens of Georgia in the composition of the Acupuncture Advisory Committee ("Advisory Committee"). The Advisory Committee shall be comprised as follows:

(a)

At least four (4) appointees, including one (1) individual who may be a lay person or a licensed acupuncturist, three (3) individuals who are licensed acupuncturists and representative of the acupuncture profession and other such individuals as the Board, in its discretion, may determine.

1.	At time of appointment by the Board, such individuals shall be licensed to practice acupuncture;

2.	All appointees to the Advisory Committee shall have on file with the Executive Director of the Board, or his/her designee, a resume and three (3) letters of recommendation, (one of which may be from a physician familiar with the appointee's practice of acupuncture);

3.

In order to preserve continuity on the Advisory Committee, two (2) appointees shall serve a two year term and two (2) appointees shall serve a one year term which will be considered a partial term. At the time of appointment, each appointee will be notified in writing by the Executive Director of the Board as to the beginning and ending dates of their respective appointment terms. Each may reapply to the full Board to serve an additional term, but may not serve more than two consecutive terms;

4.

In the event an Advisory Committee member is replaced during a term, the replacement member will serve the remaining time of that term as a partial term. An Advisory Committee member who serves a partial term will, after the completion of the partial term, be eligible to serve two consecutive two-year terms;

5.	Appointees shall serve without compensation from the State of Georgia for their time and expenses;

One (1) individual who is a licensed physician and who practices or teaches acupuncture who:

1.	Shall serve a two year term and may be reappointed for an additional two year term by a majority vote of the Board, but may not serve more than two consecutive terms; and

2.	Shall serve without compensation for time and expenses from the State of Georgia; and

The Advisory Committee shall advise the Board on matters pertaining to the appointment of the Advisory Committee members and on all matters within the purview of the Act. The Board, in consultation with the Advisory Committee, shall:

(a)	Determine the qualifications and fitness of applicants for licensure and renewal of licensure;

(b)	Adopt and revise rules consistent with the laws of the State of Georgia that are necessary to conduct its duties and administer the Act; and

(c)	Examine, approve, issue, deny, revoke, suspend and renew the license of applicants and licensees and conduct hearings in connection with all duties to be performed pursuant to the Act.

(3)

Advisory Committee members, who are not members of the Board, must be available to meet on an as needed basis and may not miss more than three (3) consecutive meetings of the Advisory Committee, or four (4) meetings in a calendar year, without an excused absence from either the Executive Director of the Board or the Board President.

(a)	The Advisory Committee may recommend to the Board the removal of a member for violation of the attendance rule. Such a recommendation shall be by majority vote of the Advisory Committee.

(b)	Upon receipt of a recommendation for removal, the Board may remove a member of the Advisory Committee by a majority vote.

(4)

Advisory Committee vacancies may be filled by the Board upon recommendation from the Advisory Committee by advertising on the Board's web page or by any other appropriate means. All applicants must meet any deadline set by the Board and shall have on file with the Executive Director of the Board, or with his/her designee, a resume and three (3) letters of recommendation (one of which may be from a physician familiar with the applicant's practice of acupuncture).

Rule 360-6-.11 License Renewal

(1)	All licenses issued pursuant to the Act shall be renewed on a biennial basis. The license will expire on the last day of the month in which the applicant's birthday falls.

(2)	Failure to renew a license by the expiration date shall result in a penalty for late renewal as required by the Board.

(3)	Licenses not renewed within three (3) months of expiration shall be administratively revoked for failure to renew and shall be posted to the public and posted on the Board's website.

(4)

Notwithstanding the provisions of paragraph (3) of this Rule, any service member as defined in O.C.G.A. § 15-12-1 whose license expired while serving on active duty outside the state shall be permitted to practice in accordance with the expired license and shall not be charged with a violation relating to such practice on an expired license for a period of six (6) months from the date of his or her discharge from active duty or reassignment to a location within the state. Such service member shall be entitled to renew such expired license without penalty within six (6) months after the date of his or her discharge from active duty or reassignment to a location within this state. The service member must present to the Board a copy of the official military orders or written verification signed by the service member's commanding officer to waive any charges.

(5)	To be eligible for renewal, a licensee must furnish satisfactory evidence of having met 40 hours of Board approved continuing education requirements, including a minimum of one hour concerning infectious disease.

(6)	Licensees must certify on the renewal form that they have read, understand and are familiar with the Centers for Disease Control and Prevention (CDC) guidelines for preventing the transmission of the Human Immuno-deficiency virus, Ebola, Hepatitis B and C and other infectious diseases.

(7)	Licensees are subject to audit to determine compliance with the continuing education requirements as stipulated in rules promulgated by the Board.

(8)	Failure to maintain continuing education requirements is a basis for non-renewal and revocation of license issued pursuant to the Act.

(9)

All renewal applicants must provide an affidavit and a secure and verifiable document in accordance with O.C.G.A. 50-36-1(f). If the applicant has previously provided a secure and verifiable document and affidavit of United States citizenship, no additional documentation of citizenship is required for renewal. If the applicant for renewal is not a United States citizen, he/she must submit documentation that will determine his/her qualified alien status. The Board participates in the DHS-USCIS SAVE (Systematic Alien Verification for Entitlements or "SAVE") program for purpose of verifying citizenship and immigration status information of non-U.S. citizens. If the applicant for renewal is a qualified alien or non-immigrant under the Federal Immigration and Nationality Act, he/she must provide the alien number issued by the Department of Homeland Security or other federal agency.

Rule 360-6-.12 Disposal of Biohazard Material and Clean Needle Inventory Records and Used Needle Inventory Records

(1)	The practice of acupuncture and auricular (ear) detoxification is found to affect the public health, safety and welfare and is a proper subject of regulation.

As acupuncture and auricular (ear) detoxification are prolonged invasive procedures of the human skin utilizing sharp instruments, all necessary precautions should be taken for the prevention of the transmission of the Human Immuno-deficiency Virus, (the virus known to cause Acquired Immune Deficiency Syndrome), Hepatitis B and C and other infectious diseases. Persons licensed under this Act and those exempt individuals practicing acupuncture should take all measures to conform to the most current recommendations of the Centers for Disease Control and Prevention (CDC) for preventing transmission of Human Immuno-deficiency Virus, Hepatitis B and C and other infectious diseases to patients during prolonged invasive procedures that are contained in the Morbidity and Mortality Weekly Report 1991; 40 (No. RR-8) pages 1-9. It is the responsibility of all persons currently licensed by the Board to maintain familiarity with these recommendations, which are considered by the Board to be the minimum standards of acceptable and prevailing medical practice. Failing to meet these minimum standards will be considered by the Board to be unprofessional conduct and subject to review and disciplinary action by the Board.

(3)

Disposable acupuncture needles are considered a biohazard waste material and must be disposed of in accordance with all applicable federal and state laws, rules and regulations. To further ensure the public health and safety of the citizens of Georgia, persons licensed under this Act and exempt individuals practicing acupuncture must keep accurate medical and office records that reflect the following detailed information:

(a)	Invoices for the purchase of disposable needles; and

(b)	Documentive disposal of all needles and method of disposal.

(4)

Records pertaining to needle purchase and needle disposal must be kept for a period of no less than five (5) years and are to be surrendered to the Board, when requested in writing by an authorized representative of the Board or requested by an agent of the Board, in reference to a complaint, allegation and/or investigation of the Board.

(5)

All licensees licensed pursuant to this Act must file a notarized document, devised and approved by the Board, acknowledging that they have read, understand and are familiar with the Centers for Disease Control and Prevention (CDC) guidelines for preventing the transmission of the Human Immuno-deficiency virus, Hepatitis B and C and other infectious diseases. This document must be filed with the Board at the time of application and at each renewal cycle.

Rule 360-6-.13 Temporary Permits

Temporary permits for the license of acupuncturists and auricular (ear) detoxification technicians may be issued by the Board.

Rule 360-6-.14 Chiropractors Must Meet Acupuncturists Licensure Requirements

As stated in O.C.G.A. 43-9-16 and as amended by Section 1.1 of the Act, chiropractors who wish to practice acupuncture must meet the licensing requirements of the Act and the acupuncture rules promulgated by the Board. Chiropractor applicants must be licensed to practice as a chiropractor in the State of Georgia, have an active chiropractic license and be in good standing with the Georgia Board of Chiropractic Examiners. In compliance with the intent of the Georgia General Assembly, nothing in these rules shall be construed to prohibit a chiropractor who is licensed under Article 3 to perform acupuncture in Georgia from engaging in the practice of acupuncture. The Georgia Composite Medical Board, and no other examining board, shall have sole, exclusive and original jurisdiction over such chiropractors who have been granted a license to practice acupuncture in this State for the purpose of establishing standards for licensure of acupuncturists and for the enforcement of such standards of acupuncture through disciplinary action.

Rule 360-6-.15 Unlicensed Practice

(1)	No person licensed under this Act may hold himself or herself out as licensed to practice medicine in the State of Georgia unless he or she is licensed by the Board to practice medicine.

(2)	No person may advertise or hold himself out to the public as being a "Licensed Acupuncturist" or a licensed "Auricular Detoxification Technician" unless the person is licensed under this Act or otherwise exempt by law from licensure.

Rule 360-6-.16 Informed Consent for Treatment

Any person who undergoes acupuncture must consent in writing prior to such a procedure and shall be informed in general terms of the following:

(a)	That an acupuncturist is not licensed to practice medicine in the State of Georgia;

(b)	That an acupuncturist cannot practice medicine in the State of Georgia;

(c)	That the acupuncturist is not making a medical diagnosis of the person's disease or medical condition;

(d)	That, if the person wants to obtain a medical diagnosis, the person should see a licensed physician and seek medical advise from a licensed physician; and

(e)	The nature and purpose of the acupuncture treatment being rendered.

Any person who undergoes auricular (ear) detoxification must consent in writing prior to such a procedure and shall be informed in general terms of the following:

(a)	That an Auricular (ear) Detoxification Technician is not licensed to practice medicine in the State of Georgia;

(b)	That an Auricular (ear) Detoxification Technician cannot practice medicine in the State of Georgia;

(c)	That an Auricular (ear) Detoxification Technician is not licensed to practice acupuncture in the State of Georgia;

(d)	That an Auricular (ear) Detoxification Technician is not making a diagnosis of the person's disease or medical condition;

(e)	That, if the person wants to obtain a medical diagnosis, the person should see a licensed physician and seek medical advice from a licensed physician; and

(f)	The nature and purpose of the auricular (ear) detoxification therapy procedure being rendered.

(g)	An Auricular (ear) Detoxification Technician is strictly limited to five ear points' treatment for detoxification for substance abuse, chemical dependency, or both.

(h)	Persons licensed to practice acupuncture or auricular (ear) detoxification must use a Board approved, standardized "informed consent" form for each person treated. The form shall be signed and dated by both practitioner and patient prior to the rendering of services.

Rule 360-6-.17 Imposition of Sanctions. Use of Referral Fees Prohibited

The Board, in consultation with the Advisory Committee, may:

(1)	Impose any sanction authorized under subsection (d) of O.C.G.A. 43-1-19 upon a finding of any conduct specified in subsection (a) of O.C.G.A. 43-1-19; or

(2)	Make a finding that such conduct involved dividing or agreeing to divide a fee for acupuncture services with any person who refers a patient.

Rule 360-6-.18 Inactive Status

A person who wishes to maintain his or her Acupuncturist license, but who does not intend to practice Acupuncture, may apply to the Board for inactive status by submitting an application and the fee.

(a)	An individual with an inactive license may not practice as an Acupuncturist in this State.

In order to reinstate an Acupuncturist license, the Board must receive a completed application and reinstatement fee. The applicant must be able to demonstrate to the satisfaction of the Board that he or she has maintained current knowledge, skill and proficiency in Acupuncture and that he or she is mentally and physically able to practice with reasonable skill and safety.

A person who wishes to maintain his or her Auricular Detoxification Technician license, but who does not intend to practice auricular detoxification therapy, may apply to the Board for inactive status by submitting an application and the fee.

(a)	An individual with an inactive license may not practice as an Auricular Detoxification Technician in this State.