Regulation of Traditional Chinese Medicine Practitioners and Acupuncturists

Transcription

1 STAFF REPORT ACTION REQUIRED Regulation of Traditional Chinese Medicine Practitioners and Acupuncturists Date: June 10, 2011 To: From: Wards: Reference Number: Licensing and Standards Committee Executive Director, Municipal Licensing and Standards All P:\2011\Cluster B\MLS\Ls11014 SUMMARY This report is a response to a request from the Licensing and Standards Committee to consider the issue of illegal businesses operating under the guise of being Traditional Chinese Medicine (TCM) and Acupuncture clinics and to recommend any action that the City may take to mitigate such illegal activity. The options considered included full business licensing, the establishment of a registry, and more focused enforcement. Two major considerations for staff in arriving at its recommendations were the fact that the provincial government is in the final stages of implementing the College of Traditional Chinese Medicine Practitioners and Acupuncturists, the regulatory body for these professions throughout the province, and that there is no significant evidence pointing to a substantial problem with illegal businesses operating as Traditional Chinese Medicine and Acupuncture clinics. Thus, Municipal Licensing and Standards will undertake a more focused enforcement strategy to ensure that businesses putting themselves out to be Traditional Chinese Medicine and Acupuncture clinics are not operating as an unlicensed concern (e.g., holistic centre or body rub parlour) or that they are not operating in any other way that contravenes the City's by-laws. Additionally, to avoid any ambiguity, staff further recommend that the Toronto Municipal Code licensing provisions pertaining to the regulation of traditional medicine be repealed. The City Solicitor was consulted in the preparation of this report and concurs with the recommendations therein. TCM practitioners and acupuncturists were also consulted, as was the Transitional Council of the College of Traditional Chine Medicine Practitioners and Acupuncturists and the Regulatory Programs Unit of the Ministry of Health and Long Term Care. Staff report for action on TCM Practitioners and Acupuncturists 1

2 RECOMMENDATIONS The Executive Director, Municipal Licensing and Standards Division, recommends that City Council: 1. Repeal provisions of Toronto Municipal Code Chapter 545 pertaining to the regulation of traditional medicine. Public notice has been given in a manner prescribed in the Toronto Municipal Code Chapter 162, Notice, Public. Implementation Points Since the requirement for licensing has not been in effect since 2005, the recommended changes will not require any changes to systems or work procedures. Financial Impact There is no financial impact as a result of the recommendations of this report. The Deputy City Manager and Chief Financial Officer has reviewed this report and agrees with the financial impact information. DECISION HISTORY The Licensing and Standards Committee, at its May 3, 2011 meeting, requested the Executive Director, Municipal licensing and Standards to bring forward to the June 29, 2011 meeting of the Committee a report that considers the issue of illegal businesses operating under the guise of being Traditional Chinese Medicine and Acupuncture clinics and practitioners and what action, if any, the City may take to mitigate such illegal activity. ISSUE BACKGROUND In 2004, City Council approved the regulation of Traditional Chinese Medicine establishments and practitioners (including acupuncturists). The intent of the regulatory regime was to establish business operating standards, safeguard public health and safety concerns, and ensure that establishments were not operating as body rub parlours. However, there were considerable concerns expressed by members of the Traditional Chinese medicine community with respect to municipal regulation. Of primary concern was the fact that Traditional Chinese Medicine practitioners had been working for many years with provincial authorities to establish a provincial regulatory regime to their profession and that as this objective came closer to being achieved a municipal regulatory regime might somehow thwart legislated self-regulation. Many practitioners also felt that the municipality's operating standards infringed on professional standards did and that the City did not have the required level of expertise to adequately filter qualified practitioners. Staff report for action on TCM Practitioners and Acupuncturists 2

3 As a result, in July of 2005 City Council decided to discontinue the licensing of Traditional Chinese Medicine in anticipation of provincial regulation. The Traditional Chinese Medicine Act received Royal Assent in December 2006, and with it the Traditional Chinese Medicine community took a momentous step forward towards establishing a provincially recognised regulatory regime. As of today, most of the operational provisions of the Act remain unproclaimed and the Province is still working to fully implement that regime. In the meantime, there have been allegations that some operators have continued, under the guise of being Traditional Chinese Medicine establishments, to operate as unlicensed body rub parlours. There has been some considerable concern among members of the Traditional Chinese Medicine community that this trend has worsened over the last few years as tougher restrictions imposed through the licensing regime on holistic centres have driven a significant number of illegal operators to masquerade as Traditional Chinese Medicine establishments and circumvent regulation. The result, they argue, is not only harmful to legitimate Traditional Chinese Medicine professionals, but can also be a nuisance to consumers looking for legitimate practitioners, and can attract unwanted elements to neighbourhoods and communities. As a result, these concerns were brought before the Licensing and Standards Committee, which in turn requested this report. COMMENTS It is difficult to establish the extent of the problem of illegal operators masquerading as Traditional Chinese Medicine practitioners or as Acupuncturists because the City does not regulate the latter types of businesses. However, between January 1, 2006 and April 13, 2011, the City issued 325 Notices of Violation to holistic owners or practitioners and laid 814 charges. Over the same period, the City issued 115 Notices of Violation to body rub parlour owners or attendants and laid 551 charges. Staff believe that from the perspective of illegal operators there likely is not an important difference in preference with respect to the type of business they use as a front. As long as the physical layout of the purported business lends itself well to the requirements of their true operation, these operators will likely choose the business that affords them the greater inconspicuousness. In this sense, Traditional Chinese Medicine clinics may not differ significantly from those of holistic centres. Since Traditional Chinese Medicine practitioners and Acupuncturists are not currently regulated, using these business types as fronts may present a considerable opportunity for them. Although conceptually this is possible, and although this is in fact what some members of the Traditional Chinese Medicine community have claimed, the City has no empirical evidence to support that this is in fact happening. Staff held two industry-wide consultations on April 26 and on May 25. At the first of these two meetings staff presented the issue that had been brought forward by members of the Traditional Chinese Medicine community and were then asked to comment. There were generally two opinions on the matter. There were those whose position reflected Staff report for action on TCM Practitioners and Acupuncturists 3

4 the position taken by the majority of practitioners in 2004 and were very much against municipal regulation, and there were those who supported the City establishing some type of regulatory regime. Based on the ensuing discussions, staff obtained general agreement from the stakeholders to develop some options and to present these at a subsequent meeting. At the second industry consultation staff presented three basic options to stakeholders and asked for their feedback. Each option is detailed in the following section of this report. Some consultation participants indicated that illegal activity in the industry was on the rise. These same participants indicated that they could provide the City with documented examples for follow-up. Two days before the submission of this report, a number of documented allegations were received by Municipal Licensing and Standards. These have been submitted to Licensing Enforcement for follow-up and appropriate action. Any Licensing or related matters will be dealt with by the City. Criminal matters will be deferred to the Police. Staff also met with the Transitional Council of the College of Traditional Chinese Medicine on May 20 to discuss the status of the provincially established regulatory regime. At this meeting the Transitional Council provided an overview and time line for the implementation of the College. The Transitional Council indicated that they may be in a position to start to offer jurisprudence and safety programs to help practitioners prepare for registration by the end of The Transitional Council also indicated that the College is to be fully established and regulating registered members by April 1, The Transitional Council also expressed some concern over the potential overlap and confusion that a municipal regulatory system might create. It specifically pointed to how the public could be misled by a municipal system that, while providing for a licence or registry to operate a business, does not have the jurisdiction to regulate the profession itself. The Transitional Council also expressed some apprehension with respect to the allegations of any significant illicit activity within the Traditional Chinese Medicine and Acupuncture community. On June 9, staff from ML&S and the City manager's office also met with staff from the Regulatory Programs Unit of the Ministry of Health and Long-Term Care. The Ministry echoed the concerns of the Transitional Council. It reiterated the fact that there is legislation in place, that the regulations pertaining to the process of establishing the College are in effect and that the operational regulations were submitted to the Province in February for review and approval. The Ministry expressed its commitment to have everyone registered by the spring of Based on the consultations with the TCM community, staff identified three major options for dealing with the issues brought forward respecting illegal operators. Each of these is discussed in turn. Staff report for action on TCM Practitioners and Acupuncturists 4

5 Establish a licensing regime Under the authority of the City of Toronto Act, the City may license virtually any business subject to some specific statutory exceptions. As such, the City may licence Traditional Chinese Medicine practitioners and Acupuncturists that provide services to the public in Toronto, provided that there is evidence of a proper municipal purpose to support their regulation. The authority existed under the former Municipal Act, when the City decided to license Traditional Chinese Medicine practitioners and Acupuncturists in The licensing provisions respecting Traditional Chinese Medicine practitioners and Acupuncturists were never repealed by City Council. Instead, City Council resolved to suspend the by-law. The provisions continue to exist as Article XXXVIII of Toronto Municipal Code Chapter 545, Licensing (see Appendix A). Thus, to establish a licensing regime, City Council would simply have to end the Council-invoked suspension of the by-law. The current by-law provisions, however, reflect licensing requirements that predate the amendments made as a result of the holistic by-law review in This is significant because those amendments made the process to acquire a licence more rigorous. Specifically, they require that licensees be a member of an approved Professional Holistic Association (PHA). Although staff would recommend that such a system be applied to Traditional Chinese Medicine practitioners and Acupuncturists were they to be licensed, staff also recognise that the implementation of such a system would require considerable consultation with the industry. It is also important to note that ML&S staff will be reviewing the existing PHA system, as the number of holistic centres, practitioners and subsequent charges against illegal operators have been growing over the past few years. This review has already begun and is expected to be completed by early fall of Therefore if licensing were to be implemented, staff would additionally recommend that any recommendations from the holistic practitioner licensing regime review be adapted and applied to the traditional medicine licensing regime. Given the new requirements that would have to be met, practitioners would have to be given reasonable time to come into compliance with the requirements. Staff do not anticipate that the regime could be fully implemented much before the second quarter of Licensees would be expected to pay licensing fees comparable to those currently paid by holistic centre owners and practitioners. In 2011, these fees are $ for new applications and $ for renewals thereof for owners, and $ for new applications and $ for renewals thereof for practitioners. Once licensed, ML&S would conduct inspections of the business premises on both a proactive and complaint basis. Officers would ensure that all centres and practitioners are compliant with by-law provisions. Clinic owners and practitioners without a licence Staff report for action on TCM Practitioners and Acupuncturists 5

6 would be charged accordingly. Individuals who are convicted would be subject to the City's business licensing thresholds and could have their licence suspended or revoked before a hearing of the Toronto Licensing Tribunal. Upon full implementation of the College of Traditional Chinese Medicine Practitioners and Acupuncturists, staff would recommend to City Council that it formally repeal the licensing provisions of the by-law. Establish an owner and practitioner registry Under the same authority to license businesses, the City of Toronto may also establish a registry system. A registry system differs from a licensing regime in that registrants are generally only required to provide their contact information and keep it updated for purposes of identification. Registration usually entails a nominal fee or no fee at all. Staff estimate that the cost-recovery fee for issuing a registration would be under $25. The eligibility requirements for registration could be made to mirror those of holistic licensing to ensure that there is a check-and-balance in terms of who can register. Unlike the licensing regime, clinic owners and practitioners would not have to meet any specific operating standards. Enforcement staff could enter the premises, however, to determine whether the business and the practitioners have registered with the City. Clinic owners and practitioners who fail to register could be charged. Clinic owners and practitioners found to be providing other holistic services or body rubs could be charged under Chapter 545, Licensing for doing so without a licence. Once there has been full implementation of the College of Traditional Chinese Medicine Practitioners and Acupuncturists, staff would make recommendations to City Council to repeal the requirement for registration. Refocus enforcement efforts Since City Council decided to discontinue the licensing of Traditional Chinese Medicine practitioners and Acupuncturists, there has been no enforcement on establishments operating as such. From general experience, staff know that when enforcement relaxes significantly or ceases altogether non-compliance increases. It is therefore possible that the absence of inspections and enforcement might have created a situation where TCM becomes an attractive cover for illegal elements looking to operate as a body rub parlour. Although they may put themselves out as Traditional Chinese Medicine practitioners or Acupuncturists, staff have heard from some members of the TCM community that most of the illegal operators are performing body rubs (a municipal licensing matter dealt with by ML&S) or offering sexual services (a potentially criminal matter dealt with by the Police). If this is in fact the case, enforcement may check some of this activity. There is no reason to prevent ML&S enforcement staff from attending business premises where there are reasonable grounds for believing that an unlicensed business (otherwise required to be licensed) is operating. Those that are in fact operating in contravention of City regulations can be charged accordingly. Where there is suspected illegal activity, Staff report for action on TCM Practitioners and Acupuncturists 6

7 the Traditional Chinese Medicine community can play an active role by referring complaints to ML&S or the Police (depending on the nature of the issue) for follow-up. From a logistical perspective, this is the simplest approach. No by-law amendments would be required and no new programs would have to be created. There would not be a significant impact arising from the redeployment of resources to ensure that the appropriate level of enforcement required were available. In particularly difficult cases, requiring a multijurisdictional approach, staff could refer matters to the Toronto Multi-jurisdictional Enforcement Team. This team consists of ML&S, Toronto Fire, Toronto Building, Toronto Public Health, Transportation Services, Parks, Forestry and Recreation, and Toronto Water. It also interacts with other agencies such as the Toronto Police Service and the Alcohol Gaming Commission of Ontario. If approved by City Council, the public could also bring matters forward to the proposed Problem Property Sub Committee; a sub-committee of Licensing and Standards intended to use a cooperative, multi-pronged, community approach to identify and refer to Municipal Licensing and Standards matters related to particular neighbourhoods. This enforcement approach could continue unabated even after the College of Traditional Chinese Medicine Practitioners and Acupuncturists is fully established. Where there are reasonable grounds to believe that owners of operators are carrying on illegal activities within the jurisdiction of the City, such as providing services, other than Traditional Chinese Medicine and Acupuncture, that require a licence, ML&S could lay charges and take any other enforcement action deemed appropriate. Recommended approach Given the inevitable regulation by the College and the limited evidence indicating that a substantial problem exists (and thus that there is a valid municipal purpose for licensing), staff are of the opinion that it is neither practical nor efficient to implement a full licensing regime for Traditional Chinese Medicine practitioners or Acupuncturists. In any case, the implementation of licensing could not be fully achieved until the second quarter of As such, it may only be in place six to twelve months before Council would be asked to consider its repeal. In addition, a short-lived municipal licensing regime could create considerable confusion with the public. A registry, as provided for in this report, is much more easily and quickly implemented. It would provide enforcement staff with the information necessary to identify illegal operators masquerading as Traditional Chinese Medicine practitioners or Acupuncturists. It would also not involve other regulatory matters, which in any case are highly objectionable to many practitioners. As with licensing, the problem with a registry is that there is no evidence to warrant its implementation (and hence, again, there is no valid municipal purpose) and that, especially since the College will also be requiring "registration", it could result in even more confusion for the public. Additionally, without any other regulatory purpose, a registry as proposed could be viewed as an attempt to get around the illegal search and seizure requirements of the Charter of Rights. Staff report for action on TCM Practitioners and Acupuncturists 7

8 A focused enforcement strategy is key to the effectiveness of any regulatory regime. Enforcement on Traditional Chinese Medicine practitioners and Acupuncturists has not been conducted on establishments since the by-law was suspended. ML&S can still, however, respond to complaints and conduct inspections where it has reasonable grounds to believe that its by-laws may be in contravention. ML&S encourages the TCM community to report suspected violations. Licensing matters can be dealt with by the City and criminal matters can be handled by the Police. For this reason staff believe that a more focused enforcement approach, in conjunction with a revamped holistics by-law and, in the not-too-distant future, a regulatory partner in the form of the College, will be a more effective and efficient approach to mitigating any illegal activity of individuals masquerading as TCM practitioners or acupuncturists. Finally, staff recommend that the existing licensing provisions in Chapter 545 relating to traditional medicine be repealed. Their presence in the By-law often gives the impression that the City continues to license traditional medicine. This is evidenced by the inquiries sometimes received by Municipal Licensing and Standards respecting the licensing standards for Traditional Chinese Medicine practitioners and/or Acupuncturists. CONTACT Rudi Czekalla Manager, Policy and Planning Services Municipal Licensing and Standards Telephone: (416) Fax: (416) rczekal@toronto.ca SIGNATURE Jim Hart Executive Director Municipal Licensing and Standards ATTACHMENTS Appendix A: Article XXXVIII of Toronto Municipal Code Chapter 545, Licensing Staff report for action on TCM Practitioners and Acupuncturists 8

9 APPENDIX A Toronto Municipal Code Chapter 545, Licensing ARTICLE XXXVIII Traditional Medicine Establishments and Practitioners Owners and practitioners to be licensed. A. No traditional medicine establishment may open for business or operate or be operated unless its owner is licensed as such under this chapter. For the purposes of this article, the term owner shall be as generally defined in and shall be taken to refer to the owner of a traditional medicine establishment. B. No owner shall permit any traditional medicine service to be provided or offered upon or at a traditional medicine establishment by any person other than a licensed traditional medicine practitioner. C. No traditional medicine practitioner shall provide or offer traditional medicine services in any traditional medicine establishment unless the owner of the establishment is duly licensed as an owner under this chapter. D. No owner may provide traditional medicine services in the traditional medicine establishment of which he or she is the owner unless he or she is also licensed as a traditional medicine practitioner under this chapter Application to be filed in person. A. On every application for an owner s or a traditional medicine practitioner s licence or for the renewal thereof, the applicant shall attend in person and not by an agent at the offices of the Municipal Licensing and Standards Division and shall complete the required forms and shall furnish to the Municipal Licensing and Standards Division such information as the Municipal Licensing and Standards Division may direct. B. In the case of a traditional medicine establishment owned by a partnership, the attendance required under Subsection A of this section shall be by one of the partners, and in the case of a traditional Chinese medicine establishment owned by a corporation, such attendance shall be by an officer of the corporation. C. On every application for an owner s licence by an individual, partnership or corporation, the applicant shall provide: (1) In the case of an individual, his or her date of birth; (2) In the case of a partnership, the date of birth of each partner in the partnership; and (3) In the case of a corporation, including a corporation which is a partner in an applicant partnership or which has an interest in an applicant corporation, the date of birth of every shareholder or other person having a beneficial interest in the corporation. Staff report for action on TCM Practitioners and Acupuncturists 9

10 Practitioner application requirements. Every applicant for a traditional medicine practitioner s licence shall: A. Be prepared to be photographed for the purposes of the licence by the Municipal Licensing and Standards Division, and upon application for renewal of any licence, the applicant shall pose for a new photograph if required to do so by the Municipal Licensing and Standards Division. B.Subject to C of this article, every applicant for a traditional medicine practitioner s licence shall submit with the application a certificate, diploma or other documentation satisfactory to the Municipal Licensing and Standards Division, certifying that the applicant has, in respect of the traditional medicine services intended to be offered or provided by the applicant, successfully completed a course of training at an educational institution in Canada that is, within the meaning of section of the Income Tax Act, R.S.C. 1985, c.1 (5th Supp.), as amended: (1) A university, college or other educational institution providing courses at a postsecondary school level; or (2) An institution certified by the Minister of Human Resources and Development to be an educational institution providing courses, other than courses designed for university credit, that furnish a person with skill for, or improve a person s skills in, an occupation. C. Where an applicant does not have the documentation required under Subsection B, the applicant shall submit with the application evidence satisfactory to the Municipal Licensing and Standards Division that the applicant: (1) Has demonstrated himself or herself to be a member in good standing of an acupuncture and/or traditional medicine organization; and (2) Has demonstrated acceptance and practice of the procedures, practices and ethics of the acupuncture and/or traditional Chinese medicine organization of which the applicant is a member. D. Be prepared, if required by the Municipal Licensing and Standards Division, to be examined with respect to his or her knowledge, and satisfactorily pass such examination. E. Applicants shall demonstrate the nature and purpose of an acupuncture and/or traditional Chinese medicine organization by filing with the Municipal Licensing and Standards Division particulars in writing providing details of: (1) The documents or instruments evidencing the creation of the organization; (2) The names of the organization s principals and officers, members and employees; (3) A short history summarizing the organization s activities and achievements to date; (4) An outline of the procedures and practices pursued by the organization and its members; (5) A copy of the organization s code of ethics applicable to its members; (6) The nature of the services promoted and provided by the organization and its members, and of the qualifications required to provide every such service; (7) A list of criteria for membership in the organization, and a list of its members; (8) A list of courses and qualifications recognized or provided by the organization; and Staff report for action on TCM Practitioners and Acupuncturists 10

11 (9) Any other information which may be required in order to confirm that the organization meets the requirements of the definition of an acupuncture and/or traditional Chinese medicine organization as contained in this chapter. F. The filing of any record or document with the Municipal Licensing and Standards Division referred to in Subsection E of this section may be done by the acupuncture and/or traditional medicine organization in respect of its members Applicant for owner s licence to submit list of traditional medicine practitioners. Every applicant for an owner s licence shall, at the time of making the application, file with the Municipal Licensing and Standards Division a list showing the names of all traditional medicine practitioners employed by, or performing traditional medicine services in, the traditional medicine establishment and all such persons intended or expected to be employed or to perform traditional medicine services in the traditional medicine establishment Minimum age of practitioner. Every applicant for a traditional medicine practitioner s licence shall file with or produce to the Municipal Licensing and Standards Division proof of his or her age, if required to do so by the Municipal Licensing and Standards Division, and no such licence shall be issued unless the Municipal Licensing and Standards Division is satisfied that every such person is of the full age of 18 years Application for owner s licence by partnerships and corporations; notification of changes in partnership. A. Persons associated in a partnership applying for an owner s licence shall file with their application to the Municipal Licensing and Standards Division a declaration in writing signed by all the members of the partnership, which declaration shall state: (1) The full name and birth date of every partner and the address of his or her ordinary residence; (2) The name or names under which they carry on or intend to carry on business; (3) That the persons therein named are the only members of the partnership; and (4) The mailing address for the partnership. B. If any member of a partnership applying for an owner s licence is a corporation, such corporation shall, for the purposes of this article, be deemed to be a corporation applying for an owner s licence, and if such licence is issued to the partnership, such corporation shall, for the purposes of this article, be deemed to be a corporation which holds an owner s licence. C. Every member of a partnership shall advise the Municipal Licensing and Standards Division immediately in writing of any change in the membership of the partnership and of any other change in any of the particulars relating to the partnership or its business which are required to be filed with the Municipal Licensing and Standards Division. Staff report for action on TCM Practitioners and Acupuncturists 11

12 D. Where, by reason of any change in the membership of a partnership, the Municipal Licensing and Standards Division has reasonable grounds to believe that the partnership is not entitled to the continuation of its licence in accordance with this chapter, the Toronto Licensing Tribunal may, in its discretion, determine whether the licence or licences shall be revoked or terminated and whether or not a new licence should issue to the partnership as presently constituted Filing of incorporating document and annual returns. A. Every corporation applying for an owner s licence shall file with the Municipal Licensing and Standards Division at the time of its application a copy of its letters of incorporation or other incorporating document, duly certified by the proper government official or department, together with an annual return in a form supplied by the Municipal Licensing and Standards Division, which annual return shall contain a list of all of the shareholders of the corporation. B. Where the shares in a corporation applying for an owner s licence are held in whole or in part by another corporation, the corporation so applying shall file with the Municipal Licensing and Standards Division an annual return in a form supplied by the Municipal Licensing and Standards Division, which annual return shall contain a list of all of its shareholders, and if such annual return discloses that the shares in such other corporation are in turn held in whole or in part by a third corporation, then the said applicant shall also file such an annual return in respect of such third corporation listing its shareholders, and so on until the names of all living persons are shown and identified as the shareholders of any and all corporations having an interest, direct or indirect, in the shares of the applicant corporation. C. Every owner which is a corporation shall, in every year, on or before the time at which it applies for the renewal of its licence, file with the Municipal Licensing and Standards Division an annual return on a form supplied by the Municipal Licensing and Standards Division Transfer of shares and issue of new shares in corporations holding owner s licence; termination of licence upon transfer of controlling interest. A. Where a corporation is the holder of an owner s licence or licences, the corporation shall forthwith notify the Municipal Licensing and Standards Division in writing of all transfers of existing shares and of the issue of any existing or new shares of the capital stock of the corporation, and of any such transaction involving the shares of any corporation referred to in Subsection C. B. Where, as a result of the transfer of existing shares or by the issue of new shares of a limited company, the Municipal Licensing and Standards Division has reasonable grounds to believe that the limited company may not be entitled to the continuation of its licence in accordance with this chapter, the Toronto Licensing Tribunal may determine whether the licence or licences shall be revoked or have conditions placed on it. C. Where, by a transfer of existing shares, or by an issue of new shares, the controlling interest in a corporation holding one or more owner s licences is sold, transferred or Staff report for action on TCM Practitioners and Acupuncturists 12

13 acquired, such licence or licences shall be terminated forthwith, and the Municipal Licensing and Standards Division may issue a new licence or new licences upon payment of the prescribed fee. The Toronto Licensing Tribunal may refuse to issue a new licence or licences if it determines that it is in the public interest so to do. D. For the purpose of this section, shareholder and any words referring to the holding of shares includes all persons having a beneficial interest of any kind in the shares of the corporation Name or designation of business. A. Every person applying for an owner s or practitioner s licence who carries on or intends to carry on the business in or relating to a traditional medicine establishment under any name or designation other than his or her own name shall, at the time of the making of the application, file with the Municipal Licensing and Standards Division a declaration, which declaration shall state: (1) His or her full name, date of birth and address of ordinary residence; and (2) Any name or designation under which he or she carries on or intends to carry on business, and the date when the name or designation was first used by him or her. B. A person to whom this section relates shall notify the Municipal Licensing and Standards Division immediately of any change in any of the particulars required to be filed with the Municipal Licensing and Standards Division under Subsection A of this section Review of application for owner s licence by Medical Officer of Health, Chief of Police and other officials. An application for an owner s licence may be submitted by the Municipal Licensing and Standards Division for a report to the Medical Officer of Health and to the Chief of Police and may also be referred to any other government official or functionary for a report as the suitability of the applicant and the proposed premises or procedures; and where any such report is negative or unfavourable to the applicant, the applicant shall be furnished with a copy of such report and shall have the right to appear before the Toronto Licensing Tribunal for a hearing to determine whether or not the application should be granted, notwithstanding such report Notification of change of address. Every owner or traditional medicine practitioner who changes his or her address shall, within two days after such change, attend at the offices of the Municipal Licensing and Standards Division and notify the Municipal Licensing and Standards Division of such change of address Bookkeeping requirements; access to records. A. Every owner shall keep proper records and books of account of all business transacted in, by, or in respect of his or her traditional medicine establishment, which Staff report for action on TCM Practitioners and Acupuncturists 13

14 books shall give the amount of gross receipts for all services performed or provided in the said traditional medicine establishment, the name and licence number of every traditional medicine practitioner or other person performing services in the said traditional medicine establishment, including the date of commencement and the date of termination of such services, the amount of salary or commission paid to each traditional medicine practitioner, in respect of such traditional medicine establishment or traditional medicine establishment business. B. Every owner shall keep all books and records as are required by Subsection A for at least one year after the information required by that subsection is entered therein, and the Municipal Licensing and Standards Division and any person designated by the Commissioner shall at all times have access to such records Bill and receipt to be provided; copies to be retained. A. Immediately before any traditional medicine services are provided in a traditional medicine establishment, the traditional medicine practitioner shall give to the customer an itemized bill for such services, listing the traditional medicine services to be provided and the price to be paid for each. B. Upon payment of the bill referred to in Subsection A, the customer shall be given a written receipt for the full amount paid. C. Every owner shall ensure that the bill and receipt required by Subsections A and B contain the name and Toronto licence number of the traditional medicine practitioner who provided the traditional medicine services and the name, address and Toronto licence number of such owner. D. Every owner shall ensure that the bill and receipt required by this section are provided to every customer of the traditional medicine establishment and shall retain and keep a copy of each such bill and receipt for at least one year after the services referred to therein are performed, and the Municipal Licensing and Standards Division shall at all times have access to such copies Advertisements to include licence number. Every owner shall ensure that all advertisements used in respect of such owner s traditional medicine establishment clearly state the number of the licence issued to such owner under this chapter Insurance requirements. Every owner shall, in respect of each traditional medicine establishment for which he or she holds a licence, procure a policy of insurance endorsed to the effect that the Municipal Licensing and Standards Division will be given at least 10 days notice in writing of any cancellation, expiration or variation in the amount of the policy, and insuring, in at least the amount of $1,000,000 (exclusive of interest and costs) comprehensive against loss or damage resulting from bodily injury to or the death of one or more persons, or from loss or damage to property resulting from any one accident. A Staff report for action on TCM Practitioners and Acupuncturists 14

15 certified copy or certificate of such policy shall be deposited with the Municipal Licensing and Standards Division Regulations for operation of traditional medicine establishments. Every owner shall, in the operation of his or her traditional medicine establishment, comply with, and ensure compliance with, the following regulations: A. The premises and the fixtures and equipment therein shall be regularly washed and be kept in a sanitary condition. B. All needles, other equipment, and supplies used in the performance of traditional medicine services shall be either disposed of or sterilized after each use according to the requirements of the Ministry of Health Infection Control and Personal Services Settings Protocol, as revised or amended from time to time, and such other procedures as may be required by the Medical Officer of Health. C. Adequate toilet and washroom accommodation shall be provided and shall be equipped with: (1) An adequate supply of hot and cold water; (2) An adequate supply of liquid soap in a suitable container or dispenser; (3) Hot air dryers or individual clean towels for the use of each person using the washing facilities; and (4) A suitable receptacle for used towels and waste material Display of licences. A. Every owner shall keep his or her licence issued in respect of that traditional medicine establishment posted in a conspicuous place in the interior of the said premises at all times during the currency of the licence. B. Every traditional medicine practitioner who provides or offers traditional medicine services in a traditional medicine establishment shall keep his or her licence prominently displayed in the interior of such traditional medicine establishment at all times during the currency of the licence Advertisement of traditional medicine services by licensed owners and practitioners only. No person other than a licensed owner may use the phrase licensed, Toronto licensed, traditional medicine service, or licensed traditional medicine service or any words indicating the offering of the services or facilities of a traditional medicine establishment in pursuance of or in connection with any business, trade, or occupation carried on in a traditional medicine establishment in the City of Toronto unless the owner of the premises and every traditional medicine practitioner engaged in performing or offering traditional medicine services in, upon or at such premises has been duly licensed so to do under this chapter. Staff report for action on TCM Practitioners and Acupuncturists 15

16 List of services and fees. A. Every owner shall file with the Municipal Licensing and Standards Division a copy of a list of all services offered or provided in, upon or at his or her traditional medicine establishment, and of the respective fees charged for such services, and, if such charges be based on a computation of time, the hourly rate shall be shown on such list. B. No owner or traditional medicine practitioner shall charge, demand, or request any payment for any services offered or performed in a traditional medicine establishment except in accordance with the list filed with the Municipal Licensing and Standards Division under Subsection A. C. No owner or traditional medicine practitioner shall offer or provide any traditional medicine service in a traditional medicine establishment, or perform any services, except in accordance with the list filed under Subsection A. D. Every owner shall post a copy of the list of services and fees referred to in this section in a conspicuous place in the interior of the traditional medicine establishment plainly visible to any person upon entering the said premises Owners and practitioners to provide name, address and licence upon request. Every owner and traditional medicine practitioner shall, upon a request made by the Municipal Licensing and Standards Division or any peace officer, by-law enforcement officer, Medical Officer of Health, or public health inspector acting under the direction of the Medical Officer of Health, provide his or her name and residential address, and if licensed under this chapter, he or she shall produce his or her said licence Hours of operation. No owner shall open his or her traditional medicine establishment for business or permit the same to be or to remain open for business or permit any traditional medicine service or services of any kind to be provided or offered in the traditional medicine establishment at any time except between the hours of 8:00 a.m. and 9:00 p.m. Staff report for action on TCM Practitioners and Acupuncturists 16