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AzSOMA FAQ Guide to the Herbal Sunrise Proposal

On August 30th of this year, AZSOMA submitted a Sunrise Proposal to increase the scope of practice of Licensed Acupuncturists in the State of Arizona. To accomplish this expansion of scope, and yet still allow L.Ac.s to choose whether they want to prescribe herbs or not, we have taken a great deal of time to propose the creation of a certificate that any L.Ac. who can demonstrate competent and safe practice of herbal medicine will be able to obtain. We have proposed four pathways through which an L.Ac. can obtain this certificate to prescribe herbs.

To allay confusion and concern, we have created the following FAQ (Question and Answer). Please rest assured that in moving forward on the sunrise proposal, AZSOMA wants to hear your feedback as we work to protect your rights as a practitioner, to advance public safety, and to ensure that as a profession and the experts in this medicine, we stand for the highest standards.

What is a Sunrise Proposal?

Professions change and evolve over time and often changes in the law must occur to reflect this “expansion” of the practice of a profession. “Sunrise” is the name of the process used to make these legal changes.  It protects both the profession and the consumer through an open process in which issues are discussed, stakeholders are consulted, and proposals are changed based on meaningful feedback, before even being considered to become part of law.

How was the proposal created?

This proposal was drafted by two professional lobbyists who are experienced in anticipating the right political climate necessary to get laws passed with the greatest efficiency.  There is appropriate, legal terminology that is necessary to get a proposed change even considered.  Under the present circumstances, there seems to be little opposition from other professions. This is an expensive, time-consuming effort.  Our association is fortunate to have the services of professional lobbyists who are working for the benefit of our profession.

Why are there so many versions?

The process of legislation is ongoing. Proposals and bills may go through many drafts before they are voted on by our
legislators. We want to ensure we are responding to the professional community and that we evolve this proposal to meet your needs.

Why should we change the scope of practice?

Right now, there are no laws that say that acupuncturists can legally prescribe herbal substances and formulas to their patients. If we expand our scope of practice, we ensure that the profession, and the practices of the profession, are protected and overseen by a regulatory body with expertise in the area. We also help to ensure public safety by setting a standard that we all agree is required to practice this medicine.

Why are we doing this now?

Through polling conducted in the spring and sent to all Licensed Acupuncturists, we heard that 70% of the respondents desire to have herbal medicine in the scope in some form. Additionally, while the educational standards of our profession have grown, more practitioners and other health professions are also getting exposed to herbal medicine and are increasingly using it in their treatment of patients. Many of these other health professions already have herbs in their scope. In a consumer complaint against an acupuncturist, those other health professions could file charges against that acupuncturist unless herbal medicine was also in our scope.

Why don’t we wait?

As a profession, we are at a time when we can demonstrate high standards. We also have a responsibility to our patients to demonstrate both our concern for public safety and our willingness to stand for excellence.  It is also time for us to take ownership of the medicine in which we are the experts.

What changes in the law should we seek?

We are seeking to expand the scope of practice and allow practitioners, who can demonstrate their qualifications and ability to safely prescribe natural, botanical, and Asian herbal substances and formulas. If we make the statement that education and experience is necessary to safely prescribe herbs to our patients we must specifically state in the law what are the standards and experience that would ensure this safe practice.  This makes it easier for consumers and patients to have confidence that qualified professionals are providing them their care.

How will this affect me?

If you do not wish to prescribe herbs you will not be affected. As it reads right now, if you prescribe an herbal substance or herbal formula for treatment of conditions for which you have made a differential diagnosis (like Liver Qi Stagnation), this law will pertain to you.

Are you forcing everyone to go back to school or have to take an exam to get the herbal certificate?

No, licensed practitioners that wish to prescribe herbal substances can demonstrate competency in herbal medicine through several pathways designed to capture all qualified practitioners while maintaining a high standard and assurance of public safety.  Only one of these pathways specifically requires a minimum education.  Other pathways include any one of the following: NCCAOM or equivalent; oral or written challenge exam, completion of a minimum of 450 hours, OR  completion of below 450 hours if licensed before 2004 OR showing a history of prescribing or recommending herbs.(Please go to the Guide to Pathways of Certification for details).

Are CEU providers being limited to large organizations or schools in the new OM bill?

AzSOMA has no role in selecting CEU providers. Anyone can provide CEUS so long as they are approved by the Board of Acupuncture Examiners: This includes online courses like the ones offered by Blue Poppy Press or TCM Zone, as well as ACOM-approved courses and programs or NCCAOM approved courses or the equivalent.

I don’t use herbs in my practice; will I have to get herbal medicine training?

No. Herbal medicine training will not be a condition of being a licensed acupuncturist. Only licensed acupuncturists choosing to pursue the advanced practice certificate will need to demonstrate competency.

Can I be grandfathered in?

In the current political environment and wanting to ensure public safety and high standards, the legislature no longer accepts “grandfathering.” Because of this we have included multiple pathways to allow qualified practitioners the opportunity to obtain the certificate.

How will I qualify for the certificate to prescribe herbs in my clinic?

You will be qualified under the law to prescribe herbs in your office if you meet the requirements of any one of the following examples:

If you find yourself in compliance with any one of the above areas, you will be qualified to obtain the certificate that indicates your qualifications to legally prescribe natural, botanical, and Asian herbal substances and formulas.

Will this affect my insurance?

Yes. Because herbal prescription authority will now be within your scope your malpractice insurance would cover herbal medicine. Also, if and when insurance reimburses for herbs and supplements, you may be reimbursed along with other providers who also prescribe herbs and supplements.

How can I get involved?

This is an evolving process that is just starting. We have many months ahead of us to talk about and refine the proposal. So please get involved and tell us if we can improve upon the proposal AZSOMA will be hosting Town Hall meetings in Tucson, Phoenix, and Flagstaff to discuss the proposal, get your feedback, and talk about concerns you may have.  We will also discuss how you can get involved in this, and our other hot issue, Physical Therapists practicing acupuncture illegally. Encourage your colleagues to get involved and most importantly, join AZSOMA! Thank you!