Senate Joint Resolution (SJR) 493 of the 1999 Session of the General Assembly directed the Joint Commission on Health Care to examine direct access to acupuncture services. This resolution is shown in Appendix A. Specifically, SJR 493 directs the Joint Commission on Health Care to examine: (i) the availability of and direct access to acupuncturists by the citizens of the Commonwealth, (ii) certification or licensure of doctors of oriental medicine who have graduated from accredited or certified schools, and (iii) other issues which may affect accessibility.

Based on our research and analysis during this review, we concluded the following:

• the practice of acupuncture by physician acupuncturists and licensed acupuncturists is regulated by the Virginia Board of Medicine;

• there are less than 300 acupuncturists who are regulated by the Board of Medicine, but it appears that there may be some unlicensed practice of acupuncture within Virginia;

• physician acupuncturists are licensed physicians who have 200 hours of training in acupuncture;

• licensed acupuncturists are non-physicians who generally have completed 2,000 hours of study, passed two national examinations, and (if applicable) passed an English proficiency examination;

• the Board of Medicine previously proposed eliminating physician acupuncturists as a separately-regulated category within the medical profession, but enacting legislation was never introduced;

• the Code of Virginia requires an individual to be examined by a physician, but not necessarily receive a referral, prior to receiving treatment from a licensed acupuncturist; and

• the English proficiency requirement for licensure was cited as a potential barrier to access to licensed acupuncturists, particularly on the part of Asian-Americans.

A number of policy options were offered for consideration by the Joint Commission on Health Care regarding the issues discussed in this report. These policy options are listed on page 13.

Our review process on this topic included an initial staff briefing, which comprises the body of this report. This was followed by a public comment period during which time interested parties forwarded written comments to us regarding the report. The public comments provide additional insight into the various issues covered in this report.