Prepared by Lindsay Meade, DOM and Steven Malins, DOM, with help from the NMSAAM board of directors

 

Introduction

As many of you may know, there have been some difficulties over time with national organizations in the acupuncture and Oriental medicine profession. The Council of State Associations (CSA) is a group that was formed out of the American Association for Acupuncture and Oriental Medicine (AAAOM). It began as an informal group, and has become increasingly more formal as the years have gone on.

The purpose of this summary is not to point fingers at any individual or any group of people. This is merely a recap of the CSA national meeting that was held in Baltimore, Maryland on March 20-21, 2014.

Currently the CSA maintains its own bylaws, officers, and a record of formal membership. The “members” of the CSA are state organizations like NMSAAM. They must have as members individual professionals in the acupuncture and Oriental medicine field, and they must be regional associations, preferably statewide. The division to states is because many of the most pressing legal issues facing our profession occur on a state level (e.g. scope of practice issues and other licensing issues).

NMSAAM is a member of the CSA, and has been since the CSA started tracking formal membership. Members representing NMSAAM have gone to at least the past 3 CSA meetings, for the past 3 years.

Lindsay Meade and Steve Malins, the president and vice president of NMSAAM, attended the most recent in-person meeting of the CSA in Baltimore, MD. They went as observers and representatives of NMSAAM and of our profession in the state of New Mexico. They wanted to understand the history of the AAAOM and the reasons the CSA had sought to distance themselves from the AAAOM. They also wanted to know what the CSA had as a vision for the future. There were a lot of questions to be asked: Did the CSA believe that the AAAOM could and should be saved, or were they going to attempt to form yet another national organization? If they did intend to create a new national organization, how did they intend to stand apart from those which already exist?

CSA Representation

There were representatives of 19 organizations present, including one organization from each of 18 states and one from the District of Columbia (DC). In addition, representatives from three states were present by phone for at least part of the meeting. Though some of them only made it for one day and all three felt they could have participated further if they had been there in person, all of them provided valuable insight and commentary to the meeting.

The organization members present at the meeting represent 4196 professional members and 1736 student members. By contrast, the AAAOM is estimated to have about 300 professional members.

Thursday, March 20th 9am to 12pm

The meeting began Thursday, March 20 at 9am. There were general introductions of the chair of the CSA and then introductions of the state associations. Next there was a review of the CSA history and their formation within and relationship with the AAAOM. It was presented by the CSA that they had tried to have a good relationship with the AAAOM and it had not been well received. Because of the mishandling by the AAAOM leadership, the CSA decided to reach out to the state organizations directly and try to understand what representatives of each state want from a national organization.

With that in mind, the discussion of the morning focused on the bylaws of the CSA, transparency of this association, how the CSA could help state associations, what the CSA mission statement would look like, and how they could promote the profession nationally.

Lunch and American Acupuncture Council Presentation

Lunch was provided by the American Acupuncture Council (AAC) and included a presentation by Marilyn Allen. AAC is committed to furthering the practice of acupuncture and Oriental medicine nationally. The regularly fund research that helps prove the safety and effectiveness of our medicine. This helps them offer low rates on their insurance products, but it also helps professionals of all expertise levels talk to patients and other providers in a evidence-based manner. AAC wishes to further this goal and has a few projects in the works, for which they will be asking the profession for submissions. NMSAAM will forward all information on these efforts as they become available.

Thursday, March 20th 2pm to 6pm

Later Thursday afternoon we were introduced to Jeff Glassie, a lawyer who facilitated the rest of the meeting. He is an expert in nonprofit management and governance and would be advising the CSA during all discussions on organizational options. States discussed how the CSA would be arranged as an entity, what groups could join, origin of the board of directors, and other issues that tied into the setup of the CSA going forward.

Key issues regarding an ideal vision for a national association included:

  1. How would the organization be structured

    1. A senate model was suggested, where each state/organization would get a vote on organizational leadership

    2. The main model discussed was one that was similar to the CSA, that a national organization would have as members organizations that have as their members individual professionals.

  2. Given that, the following questions were discussed for the rest of the afternoon

    1. What organizations would be allowed to join

    2. Balance of power between organizations with many members and those with few

B.1. Would those with many members get more of a vote in organizational decisions?

    1. How would these groups/members provide for concrete day-to-day leadership of the organization?

      1. The primary, but not only, model was that the organizational members would elect a board of directors who would handle day-to-day business of the the organization as a whole.

  1. Other concerns to a national organization were discussed

    1. Staffing needs

    2. Conflicts of interest of leadership

    3. Inclusion of advisory members/representatives from other organizations like NCCAOM, CCAOM, ACAOM, others

Friday March 21 9am to 12pm

The discussion from the previous afternoon continued. The states and the CSA decided on several points, all of which were called for a formal vote. Each point listed was voted unanimously by the members present.

  1. As part of our ideal structure, a flat fee per approved participating member, with an additional capitated fee based on membership numbers of that particular member organization.

  2. Naming CCAOM, NCCAOM, ACAOM as allied members (non-voting, advisory).

  3. A Vendor member category, non-voting, no seat in meetings, benefits to be determined.

  4. A nominating committee made up of representatives from the council receives and makes nominations and vets board candidates and makes recommendations to the council to present for voting.

  5. Current members of the CSA would remain members of the future organization, and the qualifications for membership would remain unchanged from the CSA charter dated 6/9/2013. New groups applying for membership to the council would go through a vetting process to be determined. Voting rules would remain status quo to current CSA charter bylaws and requires a supermajority vote, with a removal process.

The CSA agenda called for two separate discussions: 1. An ideal professional association and 2. Practical ways we could get as close to this as possible.

Due to time constraints and the complex nature of each of those discussions, they were somewhat merged. The above points constitute a unanimous vote of those representatives present on an ideal professional association. They implicitly include using the current CSA structure as a base. This represents the CSA’s feeling that major legal issues are state wide in the current legal climate. It also echoes the fact that current CSA organizations represent the largest number of individual professionals nationwide.

Friday Afternoon (12pm – 6pm with lunch served in session)

After lunch we were given a presentation about Meridians, a new proposed research journal. Jen Stone from Indiana is the lead editor of Meridians. She formerly worked with AAAOM on their research journal The American Acupuncturist. A research journal presents peer-reviewed original research, and holds the research to strict standards. Jen Stone has a background in research reviewing in other subjects and a long history working on such projects with the AAAOM. She has decided not to continue working with the AAAOM due to conflicts over funding; instead she is looking to run an independent journal.

Meridians will be almost completely funded by advertisers, and a small portion by subscriber fees. Jen sought the support of state organizations for her journal, offering reduced-cost or no-cost subscriptions for professional and student members of endorsing organizations. No formal action was taken, as the CSA does not have individual professional members1. It was agreed that organizations would review the proposal from Meridians but that their specific organizations would need to decide (i.e. the representatives present could not speak for their organizations as a whole).

Statement Regarding AAAOM

Discussions from the morning and Thursday afternoon continued. Given the previous and existing issues the CSA had with the AAAOM, the focus of the discussion was what would be non-negotiable details for working with the AAAOM. Highlighted in the discussion was the fact that the CSA has tried to work with the AAAOM in the past, but has not received the results it desired. These efforts included third-party mediators, most notably at the CSA/AAAOM meeting in Chicago during 2012.

After much discussion, refining, and clarification, the following statement was unanimously voted on by the representatives present.

Having shared the CSA’s vision for an ideal federation style professional association, we have carefully considered the complexities inherent in proceeding with this vision given the current situation. We would consider proceeding with this vision within the current structure of the AAAOM if there is a commitment within ten days that the current board resigns and is appointed with CSA designated individuals, or we will plan to proceed with our vision outside of the AAAOM structure.

Statement to be Presented at AOML Meeting

The preceding statement was expressly intended to be presented at the Acupuncture and Oriental Medicine Leadership Meeting. This meeting is put on by the Council of Colleges of Acupuncture and Oriental Medicine (CCAOM). The purpose is to provide leadership to the profession nationally through consensus-building by leaders in the profession. The CSA was asked to send two officers (chair and vice-chair) by CCAOM. The CSA has been invited to the AOML for the past several years.

It is the policy of CCAOM that the public record of the meeting is a press release that is agreed to by all participating organizations. This is to encourage honest and meaningful discussion without fear that individual remarks will be taken as position statements from the leaders involved. This policy has existed since the beginning of the AOML meetings. The 2014 press release was forwarded to Acupuncture Today in April2.

National Organization Presentations

We moved on with a presentation by the National Guild of Acupuncture and Oriental Medicine (NGAOM). Jeannette Hoyt gave us some good information about the NGAOM but was met with some hostility and disrespect. The CSA groups apparently had previous dealings with the NGAOM and its local chapters, and it did not seem that the relationship was good.

Next the NCCAOM did a presentation, explaining their role as a national organization. Unlike the AAAOM or NMSAAM, NCCAOM is a credentialing agency. Its role is to provide a national standard of credentialing for the profession3. Discussions were had as to what role the CSA would want NCCAOM to play in an ideal national professional association. NCCAOM cannot directly contribute money from its funds, due to legal issues. However, the possibility exists to form a separate leadership within NCCAOM to assist a national professional association. Notably, former NMSAAM president Eric Raymond Buckley presented the model used by physical therapists. It is somewhat different, as they have an association whose members are the state licensing boards, a model that was attempted with acupuncture and Oriental medicine but did not succeed at that time.

A major issue with NCCAOM support was brought forward by the California representative, Bill Mosca. California is currently considering adopting the NCCAOM exam as part of the state license requirements. Debate is intense, and Bill’s organization (California State Oriental Medical Association or CSOMA) wishes to be impartial to NCCAOM. Bill stated it would look bad for his organization as an impartial voice if its participation in the CSA was colored by even the appearance of financial support of the CSA (or another new national organization) by NCCAOM. Ultimately no formal decision was reached, mainly due to details not being concrete at this time.

Committee Formation

The meeting concluded on Friday, March 21 with the formation of several committees. Each was assigned a chair. The chair of each committee was tasked with finding volunteers for their committee. The committees formed were as follows.

  1. Governance Committee

    1. Will develop the bylaws for the new federation.

  2. Public Education Committee

    1. This committee is tasked with developing outreach strategies and messaging the general public.

    2. They are also going to create and coordinate outreach strategies and messaging within the organization and also among other members and organizations within the professional AOM community.

  3. State-Level Governance Committee

    1. Support each state in effectively advocating for itself with its own state’s regulatory/legislative boards.

    2. Foster leadership development for state organization boards, especially in the area of affecting state-level legislative efforts.

  4. Unregulated States

    1. Provide support for unregulated states that have expressed an interest in achieving licensure or other regulation.

    2. Coordinate the sharing of resources and expertise in this domain to foster progress.

  5. Allied Health Committee

    1. Identify and propose baseline standards for professional training of non-graduates of ACAOM schools (including MDs, DOs, DCs, and others).

    2. Consider other standards for baseline competency in techniques such as dry needling.

  6. Futures Committee

    1. Create the strategic plan for the organization, including identifying the priority deliverables, financial strategies, and a multi-year implementation plan for the additional objectives in the organization’s mission statement.

Funding the CSA Meeting for March 2014

State organizations were asked to contribute funding for this meeting. NMSAAM believes that the meeting was necessary given the current national state of the profession and that the meeting was useful to the profession as a whole. However, the NMSAAM board decided not to contribute financially to this meeting for the following reasons:

  1. The CSA does not have its own bank account. This made the accounting of funds for NMSAAM as a nonprofit unclear.

  2. The final costs, in the form of a line-item budget, were not provided until a decision was almost too late.

  3. It was unclear until after the meeting what would happen to funds in excess of the actual costs.

NMSAAM remains committed to using its membership funds as effectively as possible nationally.

Please note: The CSA did not receive the commitment asked for in its statement at the AOML and has been 
working hard in the direction agreed upon at the March meeting.  NMSAAM will update you as things progress.

1The members of the CSA are organizations like NMSAAM

2NMSAAM has provided a verbatim copy here http://goo.gl/5MdED0

3While a professional association has individual members, NCCAOM only has diplomates that have met its minimum credentialing standard.