On behalf of the Illinois Acupuncture Federation (“IAF”), an alliance consisting of the Asian-American Acupuncture Association, the Illinois State Acupuncture Association, the Korean American Acupuncture Association, the Chicago-Korean American Acupuncture Association and the Pacific College of Oriental Medicine, we have completed another successful legislative session – one resulting in the goal of independent practice being passed!

I. Independent Practice

Our priority this legislative session was the successful conclusion of our 2-year effort aimed at gaining acupuncturists the most valuable of statutory blessings – independent practice.

We began this process during the fall of 2002 and early spring of 2003, developing draft language, reviewing the statutes of the other 50 states, having conversations with experts in the field and pulling together a strategy for beginning to get movement on this issue. As you know, the Illinois State Medical Society (“ISMS”) had long opposed efforts for independent practice by us and other professional occupations. Physical therapists, for example, have attempted to gain independent practice for decades without success. Our effort sought to provide acupuncturists with independent practice, while still finding a collaborative effort between doctors, chiropractors and acupuncturists that is beneficial to all three parties.

In the spring of 2003, we introduced two shell bills amending the Acupuncture Practice Act and began moving them through the legislative process. At the same time, we finalized strong draft language and supportive documentation for our initiative and began working with the chiropractors to secure their sign-off. We worked hard to avoid opposition by the chiropractors, and the chiropractors never formally opposed our bill. Dr. Jon Sunderlage, D.C., L. Ac., deserves our appreciation for his work and support on behalf of our initiative.

Following our conversations with the chiropractors, we began working directly with ISMS. Following our initial efforts, we arranged a meeting with their chief lobbyist, IAF Director Dean Mouscher, ISAA President Claudette Baker, Steve Morrill and Evan Williams. The meeting was productive with ISMS showing some receptiveness to our thoughts and agreeing to begin moving the proposal through their committee and review process. During the remaining six weeks of the 2003 spring legislative session, we periodically checked in with ISMS and with our supportive legislators to keep the negotiation process moving and to create a groundswell of support for work over the summer. In support of this effort, Dean Mouscher and Claudette Baker traveled to Springfield in mid-May for face-to-face meetings with our bill sponsors and other legislative friends and allies. We also spent long hours developing a detailed packet of information and soliciting supportive letters from MDs and patients. We worked hard to find ISMS member doctors, national acupuncture experts and knowledgeable patients who could thoughtfully articulate our position.

On October 1st we presented our case to the Illinois State Medical Society to change the Illinois Acupuncture Practice Act to modify the physician referral requirement. The presentation was made before the ISMS’s Council on Education and Workforce Development. Attending the meeting were David Edelberg, M.D. (who also appeared before ISMS on behalf of our initial licensure effort in 1996), David Knudtson, M.D., ISAA President Claudette Baker, IAF Executive Director Dean Mouscher, as well as Steve Morrill and Evan Williams.

For the modification of the physician referral requirement, our main point was that it is undesirable for patients and physicians both, and that modifying it would not compromise patient safety in any way. It is unfair and unreasonable to ask physicians to refer to a therapy in which they have received no training. Every referral they make exposes them to some degree of liability, all the more so if it is to a practice about which they know little or nothing. Modifying or eliminating the physician referral requirement is the overwhelming national trend. In the past 12 years, 18 states have either eliminated the physician referral requirement or passed laws with no such requirement. If patient safety were a problem, the trend would be the opposite. The trend also indicates that physicians in these states are recognizing that the physician referral requirement is undesirable from their point of view. We presented a number of letters from Illinois M.D.s supporting our position.

We were also seeking as an add-on to the independent practice language, more clear language in the Acupuncture Practice Act regarding herbs. On that front, our argument was again that history demonstrates that the use of Chinese herbs is remarkably safe, particularly when prescribed by qualified practitioners. We discussed how much better and safer it would be to regulate the use of herbs by including it in our scope of practice than to leave it unregulated. Again we presented letters from several Illinois M.D.s in support of our position.

We left the meeting feeling good about our efforts, but also making plans to take our case directly to the legislature in the case the ISMS response was negative. Following the meeting, we continued to carefully cultivate our legislative and political relationships in order to achieve our goal.

Just prior to the scheduled Board of Directors meeting in late October of last year, we learned that the Council on Education and Workforce Development had “punted.” They did not pass along a specific recommendation for change, but did ask that the full ISMS Board of Directors review our request.

In late October, the full ISMS Board of Directors met and discussed our initiative. That group recommended that the full ISMS House of Delegates consider our request, only without the specific language on herbs. The ISMS House of Delegates is the legislative and policy-setting body of ISMS. You may recall that the House of Delegates considered our initial licensure effort in 1996.

Following that meeting, we began to prepare ourselves for the House of Delegates meeting in two ways. First, we worked with you, the acupuncture community, to catalog your physician contacts and also identified all of your local elected state representatives and senators. While you worked the grass roots with your local physicians and state officials, we continued working with folks in Springfield and with ISMS personnel.

In early April, our contacts at ISMS presented us with a draft copy of the proposed ISMS House of Delegates resolution. It was ideal! The resolution was practically word-for-word from our draft legislative language, with supporting information coming directly from our fact sheets.

For the remainder of April, we continued working with you to find ISMS members and sent a letter from over a dozen ISMS physicians to each of the ISMS delegations urging their support of the acupuncture resolution.

At their meeting, the ISMS House of Delegates approved the resolution! The next day we were with many of you at the Pacific College and were proud to share the news with you in person. At that time, we asked you to step up your efforts at contacting legislators and asking for their support of the acupuncture bill. You did, and your efforts were extremely helpful.

Now that we had official agreement with the ISMS, we moved forward with isolating bills to place our language on. We agreed on final language with the ISMS – with short notice before the deadline for passing bills out of committee. We also worked with the Department of Professional Regulation to be sure they had no last minute objections.

We were now seeking bills for our language. Representative Saviano, who was instrumental in this process from the beginning, allowed us to use a vehicle bill he had been holding for another issue. That bill – SB 2254 – was amended in the House Registration and Regulation Committee on May 6 and passed unanimously out of that committee.

On the Senate side, Senator John Cullerton, a Rules Committee member, worked with us to free HB 2981 – our bill from last spring – from the Rules Committee and sent the bill to the Licensed Activities Committee. HB 2981 was amended with our independent practice language and passed out of that committee on a unanimous roll call.

We continued to work each member of the committee and talk to key legislators and staffs on both sides of the aisle.

We also worked with you and your legislative contacts to build a groundswell of grass-roots support for our effort. Along with our efforts, Claudette Baker, Dr Jon Sunderlage and Dr. Louis DiStasio, D.C.,. L. Ac., (from Springfield) appeared with us before both committees to provide expert testimony and spent valuable time away from their practices talking face-to-face with many members of the legislature. Their efforts were invaluable, as were Dean Mouscher’s in Chicago.

In mid-May, we secured passage of each of our bills from their initial chamber. Both bills, SB 2254 and HB 2981, now needed to go back to the Senate and House respectively for “concurrence” votes as the bills had been amended from the form they were in when they originally passed the chamber of introduction. Bills must pass both houses in exactly the same form to be sent to the Governor.

On May 26, the Senate passed SB 2254 to the Governor’s desk on a unanimous roll call. The next day, HB 2981 passed the House without a negative vote. We succeeded in passing two identical bills granting independent practice to the acupuncture community to the Governor’s desk.

We are proud to report that on August 23, Governor Blagojevich signed our bill into law.

We all worked hard and our legislation enjoyed broad support throughout the General Assembly, passing committees in the House and Senate and the full Senate unanimously. Ever since our initial licensure effort was successful, we have sought to be able to practice independent of a physician’s referral. That dream is now a reality.

II. Merger of DPR

Early in the spring legislative session, the Governor called us to a meeting to announce his plans to merge the Department of Professional Regulation with the Department of Financial Institutions, Department of Insurance, Comprehensive Health Insurance Plan and Office of Banks and Real Estate. The new agency will be the Department of Financial and Professional Regulation and will be headed by the current Director of the Department of Professional Regulation, Fernando Grillo. We have been assured that while support staff will be cut for administrative consolidation and budget savings, our level of services will not be cut. We also do not believe the consolidation of the agency will have any effect on the Board of Acupuncture. The Governor’s Executive Order creating the new agency took effect on July 1 and the merger is already taking place. The Senate has considered a resolution, SR 488, which would disapprove the Governor’s Executive Order creating the new agency; however, the Senate is not expected to pass that resolution. The legislature did pass legislation (HB 966) to require Senate confirmation of the various department heads of the new agency.

III. Legislative Monitoring and Defense

While our main legislative priority this year was to work towards our successful passage of our proactive initiative described above, we also needed to play “defense,” or guard against any adverse action regarding our licensure law, the Illinois Acupuncture Practice Act, or other statutory items of interest to IAF. In this vein, we remained vigilant to ensure that nothing passed the General Assembly that would jeopardize the gains won by the acupuncture profession in Illinois. In this effort, we carefully tracked every piece of legislation that amended any professional licensure act, even those that have no relationship to health care or acupuncture, because these bills could possibly be amended in the process to affect the profession of acupuncture. Among the issues before the General Assembly this year were:

Acupuncture Practice Act. No legislation was specifically introduced to amend the Act other than our own proactive bills. Insurance Mandates. Numerous insurance mandates were introduced this session; however, following the precedent set in previous years, very few were passed into law. The business and insurance communities remain steadfastly opposed to expanding the statutory mandates on practices and procedures that must be covered under health insurance plans.

Naprapaths. Two bills amending the Naprapathic Practice Act were filed this year. One was a shell bill and never advanced (shell bills are bills that amend a particular act, but have no substantive language in them, and which are considered placeholder bills for later amendment). The second was also a shell bill and was amended with language for pharmacists. We continued to guard against any possible changes to the Act that would allow naprapaths to practice acupuncture, or become referring agents to acupuncturists – expansions of their authority that have previously been sought by that profession. We are pleased to report that neither of these bills amending the Naprapathic Practice Act, or any other licensure bill, contained any language, nor were amended to contain language, expanding the scope of naprapathic practice into acupuncture.

Nurse Legislation. Once again, this legislative session saw a tremendous amount of activity regarding licensure of registered nurses. Illinois continues to have a shortage of nurses and efforts were made to address that issue. There was also concern that nurses would seek to gain authority to practice acupuncture without a license. No such legislation passed.

Throughout the session we kept in regular contact with the IAF, providing verbal, e-mail and written updates. Special appreciation goes out to Dean Mouscher and Claudette Baker who spent countless hours these past two years developing background materials, talking to members of the acupuncture community, traveling to meetings and performing other necessary tasks. We also must thank you for your efforts in this successful initiative, not to mention people like Drs. David Edelberg, David Knudtson, Jon Sunderlage and Louis DiStasio, and the many other MDs and patients who supported our effort. Independent practice could not have been achieved without the effort of all involved.