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SB-1446 Naturopathic doctors.(2011-2012)



Current Version: 09/14/12 - Chaptered        


SB1446:v92#DOCUMENT

Senate Bill No. 1446
CHAPTER 333

An act to amend Sections 3640 and 3640.7 of, and to add Section 3640.8 to, the Business and Professions Code, relating to healing arts.

[ Approved by Governor  September 14, 2012. Filed with Secretary of State  September 14, 2012. ]

LEGISLATIVE COUNSEL'S DIGEST


SB 1446, Negrete McLeod. Naturopathic doctors.
Existing law, the Naturopathic Doctors Act, provides for the licensure and regulation of naturopathic doctors by the Naturopathic Medicine Committee in the Osteopathic Medical Board of California. Existing law authorizes a naturopathic doctor to perform various tasks, including dispensing, administering, ordering, and prescribing nutraceuticals, vitamins, amino acids, and minerals, among other substances. Existing law authorizes a naturopathic doctor to furnish or order drugs when, among other requirements, the drugs are ordered or furnished under physician supervision. Existing law authorizes a naturopathic doctor to independently prescribe epinephrine and natural and synthetic hormones, as specified.
This bill would also authorize a naturopathic doctor to furnish nutraceuticals, vitamins, amino acids, and minerals, among other substances, as specified, and to independently prescribe and administer epinephrine and natural and synthetic hormones. The bill would further authorize a naturopathic doctor to independently prescribe and administer nutraceuticals, vitamins, amino acids, and minerals, among other substances that may be administered by intramuscular, intravenous, or other specified routes only when such substances are chemically identical to those for sale without a prescription. The bill would require a naturopathic doctor, in order to qualify for intravenous therapy administration, to demonstrate that he or she has complied with specified requirements, including the successful completion of specified coursework by a provider approved by the committee.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 3640 of the Business and Professions Code is amended to read:

3640.
 (a) A naturopathic doctor may order and perform physical and laboratory examinations for diagnostic purposes, including, but not limited to, phlebotomy, clinical laboratory tests, speculum examinations, orificial examinations, and physiological function tests.
(b) A naturopathic doctor may order diagnostic imaging studies, including X-ray, ultrasound, mammogram, bone densitometry, and others, consistent with naturopathic training as determined by the committee, but shall refer the studies to an appropriately licensed health care professional to conduct the study and interpret the results.
(c) A naturopathic doctor may dispense, administer, order, prescribe, and furnish or perform the following:
(1) Food, extracts of food, nutraceuticals, vitamins, amino acids, minerals, enzymes, botanicals and their extracts, botanical medicines, homeopathic medicines, all dietary supplements and nonprescription drugs as defined by the federal Food, Drug, and Cosmetic Act, consistent with the routes of administration identified in subdivision (d).
(2) Hot or cold hydrotherapy; naturopathic physical medicine inclusive of the manual use of massage, stretching, resistance, or joint play examination but exclusive of small amplitude movement at or beyond the end range of normal joint motion; electromagnetic energy; colon hydrotherapy; and therapeutic exercise.
(3) Devices, including, but not limited to, therapeutic devices, barrier contraception, and durable medical equipment.
(4) Health education and health counseling.
(5) Repair and care incidental to superficial lacerations and abrasions, except suturing.
(6) Removal of foreign bodies located in the superficial tissues.
(d) A naturopathic doctor may utilize routes of administration that include oral, nasal, auricular, ocular, rectal, vaginal, transdermal, intradermal, subcutaneous, intravenous, and intramuscular.
(e) The committee may establish regulations regarding ocular or intravenous routes of administration that are consistent with the education and training of a naturopathic doctor.
(f) Nothing in this section shall exempt a naturopathic doctor from meeting applicable licensure requirements for the performance of clinical laboratory tests, including the requirements imposed under Chapter 3 (commencing with Section 1200).

SEC. 2.

 Section 3640.7 of the Business and Professions Code is amended to read:

3640.7.
 Notwithstanding the requirements of Section 3640.5 or any other provision of this chapter, a naturopathic doctor may independently prescribe and administer the following:
(a) Epinephrine to treat anaphylaxis.
(b) Natural and synthetic hormones.
(c) Vitamins, minerals, amino acids, glutathione, botanicals and their extracts, homeopathic medicines, electrolytes, sugars, and diluents that may be administered utilizing routes of administration, pursuant to subdivision (d) of Section 3640, only when such substances are chemically identical to those for sale without a prescription.

SEC. 3.

 Section 3640.8 is added to the Business and Professions Code, to read:

3640.8.
 (a) To qualify to administer intravenous (IV) therapy in his or her practice pursuant to Section 3640.7, a naturopathic doctor shall demonstrate that he or she has complied with both of the following requirements:
(1) Has a current naturopathic doctor’s license in this state.
(2) Has completed a qualifying course on IV therapy from a course provider approved by the committee.
(b) The qualifying course shall consist of a minimum of 25 classroom hours on IV administration through injection of applicable naturopathic formulary substances, of which at least 14 classroom hours shall be identified as practicum. At a minimum, the qualifying course shall have covered all of the following topics:
(1) Evaluation of laboratory results, including, but not limited to, the fluid status, cardiovascular status, and kidney function of the patient.
(2) The use of IV fluids, including, but not limited to, osmolarity calculations, diluents, and admixtures pertinent to IV therapeutics.
(3) Sterile techniques and admixing.
(4) Vein and site selection, site preparation, and insertion techniques.
(5) Complications with therapies, nutrient and drug interactions, errors and adverse reactions, reporting errors to appropriate agencies, error prevention, and followup with patient complications.
(6) Emergency protocols, management, and referral.
(7) Pharmacology, indications, preparation, and IV administration of vitamins, minerals, amino acids, glutathione, botanicals and their extracts, homeopathic medicines, electrolytes, sugars, and diluents.
(8) Practicum, including, but not limited to, the following:
(A) Observation of at least 10 IV setups, including administration and management.
(B) Successful completion of at least 10 IV setups, including administration and management.
(9) Successful completion of an examination with 70 percent or greater correct answers to a minimum of 50 questions, where 10 percent or more of the questions have direct content to the California formulary.
(c) For the purposes of the qualifying course required by this section, one classroom hour is defined as 50 minutes out of each 60-minute segment and may include time devoted to examinations. No credit shall be granted for distance education, including, but not limited to, correspondence courses, Internet courses, or video or remote television offerings.
(d) Pursuant to subdivision (e) of Section 3640, the committee may establish regulations regarding IV administration that are consistent with the education and training of a naturopathic doctor.