Guidelines on Certification and Accreditation of Acupuncturists

Legal basis, policy intent, and purpose

The declared policy is that the State shall improve the quality and delivery of health care services to the Filipino people by developing traditional and alternative health care and integrating it into the national health care delivery system under Article 3.
The guidelines prescribe procedures and guidelines for implementing the PITAHC IRR on national certification and accreditation under Article 2.
The guidelines establish rules that also serve accreditation of acupuncture programs, training centers and clinics to pursue continuous service improvement and strengthen accountability of stakeholders in traditional and alternative health care practices under Article 2.
The guidelines apply to accreditation of training programs, training centers, and clinics, and to national certification of acupuncturists under Article 4.

Coverage and key definitions used

The guidelines cover: (1) accreditation of training programs, (2) acupuncture training centers, (3) accreditation of acupuncture clinics, and (4) national certification of acupuncturists under Article 4.
Republic Act 8423 is defined as the law creating PITAHC to accelerate development of traditional and alternative health care and as the Traditional and Alternative Medical Act (TAMA) of 1997 under Rule I, Article 5(a).
Traditional and Alternative Health Care means the total knowledge, skills, and practices other than those embodied in biomedicine used in prevention, diagnosis, and elimination of physical or mental disorders under Article 5(b).
Biomedicine means the discipline of medical care advocating therapy with remedies producing effect differing from those of the diseases treated (also called allopathy, western medicine, regular medicine, conventional medicine, mainstream medicine, orthodox medicine, or cosmopolitan medicine) under Article 5(c).
Acupuncture is defined as a comprehensive system of healthcare using traditional Chinese medical theory and diagnosis/treatment methods for promotion, maintenance, restoration of health, and prevention of disease, including needle insertion and other biophysical methods such as heat, oriental massage, electric stimulation, herbal supplemental therapies, dietary guidelines, breathing techniques, exercise, cupping, dermal friction, and acupressure under Article 5(g).
National Certification is defined as the process of issuing certificates requiring education and testing to assure practitioner and trainer competency, administered by PITAHC and other PITAHC-accredited institutions under Article 5(h).
National Accreditation is defined as the process of issuing certificates to training programs, centers and clinics under Article 5(i).
The guidelines define Acupuncture Training Center, Community Based Health Programs (CBHP), Community Based Acupuncture Training Center, Acupuncture Clinic, Community Based Acupuncture Clinic, Portfolio Assessment, Assessment, Training Program, and other terms under Rule I, Article 5.
The guidelines impose a delimitation for competence standards: for the non-medical acupuncturist, biomedicine diagnosis, correlating laboratory findings, prescribing drugs, analyzing acupuncture-related laboratory tests, performing new/advanced methods (e.g., laser, intracutaneous needling, cosmetic), and conducting clinical/experimental acupuncture-related research are not included under Article 5(j) (non-medical).
The guidelines impose a delimitation for competence standards: for the medical acupuncturist, performing new/advanced methods (e.g., laser, intracutaneous needling, cosmetic) and conducting clinical/experimental acupuncture-related research are not included under Article 5(j) (medical).
The guidelines define Code of Ethics as the standards acupuncturists agree to follow as acceptable ethical/professional behavior under Article 5(k).

Accreditation of training programs and centers

All training centers offering courses for acupuncture must register their course modules based on PITAHC Competency Standard to ensure program quality under Rule II, Article 6.
Program accreditation applies to mandatory compliance with minimum standards for all traditional and alternative health care courses, including programs/courses offered by public and private training institutions under Article 6.
Applications for accreditation of acupuncture programs must be filed at PITAHC, where the programs are evaluated and the National Certification Assessment is conducted under Article 7.
PITAHC must monitor continuous compliance by training centers with minimum requirements established by the PITAHC standard under Article 8.
Training centers seeking accreditation must submit the listed requirements to PITAHC under Article 9.
A training center accreditation certificate is issued only to applicants/institutions that submit required documents and comply with the requirements listed under Article 10.
Upon receipt of the applicant’s notice, a duly authorized PITAHC quality assessment team must conduct inspection to determine compliance with facilities and operation requirements under Article 11.
If minimum requirements are satisfactorily complied with, PITAHC issues a Certificate of Accreditation with a PITAHC dry seal under Article 12.
Accreditation is subject to cancellation upon grounds stated in Article 13 and to one-year validity rules under Article 14.

Training center facilities, personnel, curriculum

An Acupuncture Training Center must provide a well-ventilated and lighted classroom with audio/visual equipment and teaching materials accommodating at least 20 persons at any given time under Article 9.1.1.1.
An Acupuncture Training Center must provide a prototype assessment/examination room with chairs and tables and specified instruments (including stethoscope, sphygmomanometer, thermometer, acupuncture needles, moxa, cups, sterilization equipment, etc.) under Article 9.1.1.2.
An Acupuncture Training Center must provide at least one well-ventilated and lighted acupuncture clinic treatment room prototype accommodating at least 10 students at any given time under Article 9.1.1.3.
An Acupuncture Training Center must have auxiliary rooms including a comfort room, dressing room, waiting room, and administrative office under Article 9.1.1.4.
An Acupuncture Training Center must maintain a library with books and AV tapes/cassettes/CDs relevant to offered courses and must refer to PITAHC Competency Standard on Acupuncture under Article 9.1.1.5.
An Acupuncture Training Center must have training materials, equipment, and accessories based on training standards and course offering under Article 9.1.1.6.
An Acupuncture Training Center must submit an original copy of the PITAHC Competency Standards of Acupuncture and PITAHC Code of Ethics and Standards of Practice under Article 9.1.1.7.
An Acupuncture Training Center must have regular staff including a full-time Training officer who must at least be a college graduate under Article 9.1.2.1.
Academic and skills trainers must have passed the PITAHC Training of Trainers Competency Assessment under Article 9.1.2.2.
A Community Based Acupuncture Training Center must provide a well-ventilated and well-lighted room/area for a classroom with audio/visual equipment accommodating at least 5 persons at any time under Article 9.2.1.1(a).
A Community Based Acupuncture Training Center must provide an assessment/examination room with chairs and tables equipped with specified instruments (including stethoscope, sphygmomanometer, thermometer, acupuncture needles, moxa, cups, sterilization equipment, etc.) under Article 9.2.1.1(b).
A Community Based Acupuncture Training Center must provide a clinic treatment room accommodating at least 5 students at any given time under Article 9.2.1.1(c).
A Community Based Acupuncture Training Center must provide auxiliary rooms including comfort room/dressing room and waiting room/administrative office under Article 9.2.1.2.
Community Based Acupuncture Training Center training officers/trainers must have passed the PITAHC Training of Trainers Competency Assessment under Article 9.2.2.
Training centers’ curricula must be based on the PITAHC Competency Standard for Acupuncture under Article 9 (Training Curriculum).

Training center accreditation validity, fees, penalties

Training center accreditation is issued only after compliance with requirements under Article 10, including documents such as: registration evidence (SEC or DTI), updated personnel list, municipal/city permits, proof of premises ownership or lease/rental agreement, list of training equipment, fire safety inspection certificates, list of training programs offered, valid health certificates of employees, a duly accomplished application form, application fees, and other committee-required documents under Article 10.
For an Acupuncture Training Center, the application fee is PHP 1,000.00 and it may be collected based on national accounting rules and regulations under Article 10.10 and 10.10.1.
For a Community Based Acupuncture Training Center, the application fee is PHP 300.00 under Article 10.10.2.
An Acupuncture Training Center accreditation certificate is valid for 1 year from date of issue for a newly accredited training center under Article 14.
Renewal of training center accreditation is for 3 years thereafter, subject to suspension or cancellation for cause determined by PITAHC under Article 14.
A training center certificate of accreditation is non-transferable under Article 15.
Accreditation fees may be changed upon review of the PITAHC committee under Article 16.
For new Acupuncture Training Centers, the accreditation fee is PHP 10,000.00 for one year, plus an additional PHP 300.00 accreditation certificate fee under Article 16.1.1.
For renewal Acupuncture Training Centers, the renewal accreditation fee is PHP 3,000 under Article 16.1.2.
For new Community-Based Acupuncture Training Centers, the accreditation fee is PHP 1,000.00 plus an additional PHP 300.00 accreditation certificate fee under Article 16.2.1.
For renewing Community-Based Acupuncture Training Centers, the accreditation fee is PHP 1,500.00 plus an additional PHP 100.00 accreditation certificate fee under Article 16.2.2.
Training center renewal must be done on or before its date of expiration under Article 17.
If the Acupuncture Training Center fails to renew, it must pay a penalty of PHP 500.00 per year under Article 17.1.
If the Community Based Acupuncture Training Center fails to renew, it must pay a penalty of PHP 150.00 per year under Article 17.2.

Accreditation of acupuncture clinics

Acupuncture clinics must submit requirements to PITAHC for accreditation under Rule IV, Article 18.
An Acupuncture Clinic must provide well-ventilated and lighted acupuncture treatment rooms with practice/medical equipment (including electro-acupuncture machine, timers, sterilizers, etc.), clinic supplies (including needles, cotton, alcohol), beds for acupuncture/acupressure/moxibustion/cupping, communications equipment, acupuncture references, acupuncture meridian charts and/or models, patient clinical records based on acupuncture competency standards, a logbook of patient visits, and administrative equipment/materials under Article 18.1.1.1.
An Acupuncture Clinic must provide a well-ventilated and lighted prototype assessment/examination room with chairs and tables equipped with instruments including stethoscope, sphygmomanometer, thermometer, weighing scale, and timers under Article 18.1.1.2.
An Acupuncture Clinic must provide auxiliary rooms including comfort room, dressing room, waiting room, and an administrative office under Article 18.1.1.3.
Acupuncturists in an Acupuncture Clinic must be either PITAHC Certified Acupuncturists (CA) or PITAHC Certified Medical Acupuncturists (CMA) under Article 18.1.2.1.
A PITAHC Certified Associate Acupuncturist (CAA) or PITAHC Certified Associate Medical Acupuncturist (CAMA) must work under the supervision of a PITAHC Certified Acupuncturist (CA) or PITAHC Certified Medical Acupuncturist (CMA) under Article 18.1.2.2.
Community-based acupuncture clinics must have treatment rooms and auxiliary rooms with facilities and supplies specified for acupuncture clinic operations, including equipment, clinical records based on standards, and a logbook of patient visits under Article 18.2.1.1.
In a Community Based Acupuncture Clinic, acupuncturists must be at least a PITAHC Certified Acupuncturist (CA), and a CAA must be under supervision of a CA under Article 18.2.2 and Article 18.1.2.3.

Clinic accreditation: validity, fees, cancellation, renewal

A clinic accreditation certificate is issued only after submission of required documents and compliance with the requirements listed under Article 19.
Clinic accreditation application documents include registration evidence (SEC or DTI where applicable), municipal or city permits, fire safety inspection certificates, a duly accomplished application form for clinic accreditation, application fees, and other committee-required documents under Article 19.
For an Acupuncture Clinic, the application fee is PHP 1,000.00 under Article 19.19.1.
For a Community Based Acupuncture Clinic, the application fee is PHP 300.00 under Article 19.19.2.
Upon receipt of an applicant’s notice, a duly authorized PITAHC quality assessment team must inspect the clinic to determine compliance with facilities and operation requirements under Article 20.
If minimum requirements are satisfactorily complied with, PITAHC issues a Certificate of Accreditation with a PITAHC dry seal under Article 21.
A clinic certificate of accreditation is subject to cancellation for falsification of documents, failure to maintain accreditation standards, or illegal and immoral activities under Article 22.
A certificate of accreditation for an Acupuncture Clinic is valid for 3 years, subject to suspension or cancellation for cause determined by PITAHC under Article 23.
Clinic accreditation certificates are non-transferable under Article 24.
Accreditation fees are collected based on national accounting rules and regulations and may be changed upon review of the PITAHC committee under Article 25.
For Acupuncture Clinics, the accreditation fee is PHP 1,500.00 plus an additional PHP 300.00 accreditation certificate fee under Article 25.1.
For Community-Based Acupuncture Clinics, the accreditation fee is PHP 500.00 plus an additional PHP 100.00 accreditation certificate fee under Article 25.2.
Renewal must be on or before expiration under Article 26.
If an Acupuncture Clinic fails to renew, it must pay a penalty of PHP 1,000.00 per year under Article 26.1.
If a Community Based Acupuncture Clinic fails to renew, it must pay a penalty of PHP 300.00 per year under Article 26.2.

National certification committee functions

Certification of acupuncturists is handled through a National Certification Committee for Acupuncturists invited by the PITAHC Director General under Article 27.
The invitation to committee members is valid only for the period indicated and may be renewed by the Director General under Article 27.
The committee is chaired ex-officio by the PITAHC Director-General under Article 27(a).
The committee includes permanent representatives: the PITAHC Advocacy and Training Division Chief and the PITAHC Standard and Accreditation Division Chief under Article 27(a).
The committee also includes representatives from sectors: one acupuncturist from the government sector, one from the private sector, one from acupuncture training centers/schools/clinics, and one from CBHP under Article 27(a).
The four (4) sector representatives are appointed by the PITAHC Director General, with two (2) having a term of two years and two (2) having a term of one year, with reappointment rules designed to comply until each attains two years under Article 27(a).
The Standard and Accreditation Division serves as the committee secretariat under Article 27(b).
The committee must develop and maintain assessments based on competency standards and code of ethics, issue training policies, accredit training programs/centers/schools/clinics, administer national certification assessments, certify practitioners, and revoke certification/accreditation under Article 28.
The committee must also reschedule or cancel assessments, accommodate candidates with disabilities, safeguard public trust through upholding the code of ethics, develop and monitor a databank, represent interests of acupuncture practitioners, and recommend commissioning research related to acupuncture services and public health impact under Article 28.

Certification levels, assessment outcomes, and process

National certification covers the knowledge and skills of each competency and also basic approaches of applied science under Article 29.
For Certified Associate Acupuncturist (CAA), required competencies include: work within a holistic or integrated framework; assess patient according to biomedicine framework (CAA); assess patient according to TCM framework (CAA); perform acupuncture-related modalities; and assist in acupuncture clinic administration under Article 29.1.
For Certified Acupuncturist (CA), required competencies include: work within a holistic or integrated framework; assess patient according to biomedicine framework (CAA); assess patient according to TCM framework (CAA); perform acupuncture-related modalities; assist in acupuncture clinic administration; assess patient according to biomedicine framework (CA); assess patient according to TCM framework (CA); determine patient’s TCM disharmony; perform acupuncture treatment; manage acupuncture clinic services; and continue professional development under Article 29.2.
For Certified Associate Medical Acupuncturist (CAMA), required competencies include: work within a holistic or integrated framework; assess patient according to biomedicine framework within TCM environment; assess patient according to TCM framework; perform acupuncture treatment; manage acupuncture clinic services; and continue professional development under Article 29.3.
For Certified Medical Acupuncturist (CMA), required competencies include: work within a holistic or integrated framework; assess patient according to biomedicine framework within TCM environment; assess patient according to TCM framework (CAMA); assess patient according to TCM framework (CMA); determine patient’s TCM disharmony; perform acupuncture treatment; perform acupuncture-related modalities; manage acupuncture clinic services; and continue professional development under Article 29.4.
Applicants for national certification must meet level-specific qualifications and submit listed requirements under Article 30.
Candidates for Certified Associate Acupuncturist must have: 240 hours Basic Health Skills Training with 600 hours OJT or equivalent; and 240 hours Basic Acupuncture Training with 500 hours supervised Clinical Practice, and within one and a half year from start of training must have properly managed no fewer than 30 different patterns of disharmony under Article 30.1.
Candidates for Certified Acupuncturist must have: certification as CAA or completion of 30.1.1 and 30.1.2; independent clinical practicum of at least 460 hours with properly managed no fewer than 30 different patterns of disharmony; and a graduate of 480 hours advanced Acupuncture Training with 960 hours OJT/internship, with properly managed no fewer than 60 different patterns of disharmony within one and a half year under Article 30.2.
Candidates for Certified Associate Medical Acupuncturist must have: a licensed physician of good moral character; and completion of not less than 200 hours limited training in acupuncture for physicians with 120 hours Basic Principles and Theories, 80 hours supervised Clinical Practice, and properly managed no fewer than 30 different patterns of disharmony within one and a half year as CAMA under Article 30.3.
Candidates for Certified Medical Acupuncturist must have: CAMA certification or completion of 30.2.1 and 30.2.2; independent clinical practicum of at least 460 hours with properly managed no fewer than 30 different patterns of disharmony; and a graduate of 1300 hours full course training in acupuncture for physicians with 380 hours Basic Principles and Theories, 500 hours Clinical Work and 420 hours supervised Clinical Practicum, with properly managed no fewer than 60 different patterns of disharmony different from those handled as CAMA within one and a half year under Article 30.4.
Applicants must present an original copy of certificate of completion of formal training from a PITAHC certified acupuncture trainer or an accredited acupuncture training center under Article 30.5.
A portfolio assessment is made for special cases of Filipino acupuncturists trained abroad under Article 30.6.
Applicants must present a valid health certificate duly issued by a government physician under Article 30.7.
Applicants must submit a duly accomplished Application Form for National Certification Examination attached with a current photograph under Article 30.8.
Applicants must pay all necessary fees under Article 30.9.
An application fee for national certification assessment is PHP 500.00, and for Community Based Health Programs it is PHP 300.00, collected from applicants who comply with requirements, and may be changed upon committee review under Article 31.
The assessment for certification is conducted at PITAHC or at other venues determined by the PITAHC committee under Article 32.
Assessment results are only “pass” or “fail”, and results must be published at the bulletin board or publication of PITAHC under Article 33.

Accreditation fees and certificate validity (certification section)

Accreditation fees are collected from those who comply with accreditation requirements, and may be changed upon review of PITAHC committee under Article 34.
Accreditation fee for acupuncture accreditation under this section is PHP 500.00 plus an additional PHP 300.00, and for Community Based Health Programs it is PHP 300.00 plus an additional PHP 300.00, under Article 34.
A Certificate of Accreditation granted under these guidelines is valid for 3 years, subject to suspension or cancellation for cause determined by PITAHC committee under Article 35.
Renewal must be on or before expiration under Article 36.
A penalty for non-renewal by an acupuncturist is PHP 250.00 per year, and by a community based acupuncturist is PHP 75.00 per year, under Article 36.
Certificates remain subject to penalty changes upon committee review under Article 36.

Service provision, provisional certification, and non-Filipinos

National certified acupuncturists may offer services in private practice clinics and offices, salons/spas/resorts/cruise ships, health clubs and fitness centers, nursing homes and hospitals, on-site in the workplace, in clients’ homes, holistic health centers, and mobile acupuncture clinics under Article 37.
PITAHC must grant Provisional Certification to a resident Filipino applicant who has practiced acupuncture for a minimum of 3 years, is residing in the Philippines at the time of passage of the guidelines, and presents evidence satisfactory to the Accreditation Committee no later than 3 years upon effectivity of the guidelines of successful completion of a PITAHC-approved acupuncture training program under Article 38.
Certification of non-Filipino acupuncturists is available by endorsement upon application to the Accreditation Committee and payment of the appropriate application and accreditation fees under Article 39.1.
To qualify for certification by endorsement, an applicant must meet the registration requirements of foreign professionals as per Resolution No. 90-547, Series of 1998 of the Professional Regulation Commission under Article 39.1.
Certification by endorsement requires documentation of 5 years of licensed/certified acupuncture practice with a minimum of 500 acupuncture patient visits per year and at least 100 different patients, plus a letter of good standing stating years of licensure/certification, plus proof of current active certification, plus successful completion of an approved clean needle technique course under Article 39.1(a)-(d).
A non-Filipino acupuncturist issued a Certificate by Endorsement must pay US $500.00 application fee, US $300.00 annual acupuncture certification fee, and an additional US $300.00 accreditation certificate fee prior to beginning practice, and must submit a renewal form and fee 30 days before the end of the year for the next year under Article 39.1(e).
A penalty of US $100.00 per month applies for non-renewal of endorsement certification by the non-Filipino acupuncturist under Article 39.1(f).
The practice of the non-Filipino acupuncturist issued endorsement must be under supervision of a Filipino CA or CMA under Article 39.1(g).
A visiting teacher may be issued a Limited Certificate, Visiting Professor if an acupuncturist is employed in a PITAHC accredited acupuncture training center, has at least 5 years experience, and demonstrates skills/training equivalent to PITAHC competency standards under Article 39.2(a).
The Limited Certificate, Visiting Professor allows practice of acupuncture only to the extent it is incident to and necessary for the applicant’s approved duties in connection with the faculty position under Article 39.2(a).
The Limited Certificate, Visiting Professor may be granted for a total of two (2) one-year extensions upon annual review upon written request by the acupuncture training center under Article 39.2(b).
A visiting professor must pay US $200.00 application fee, US $200.00 annual acupuncture