By: Luna S.B. No. 1432
73R8986 JMM-F
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of the practice of naturopathic
1-3 medicine; providing penalties.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. PURPOSE. The legislature finds that a
1-6 significant number of the citizens of this state are turning to
1-7 naturopathic medicine for their health care needs and declares that
1-8 naturopathic medicine is a distinct health care profession that
1-9 affects the public health, safety, and welfare and provides the
1-10 public with freedom of choice in health care. The purpose of this
1-11 Act is to provide standards for the licensing and regulation of
1-12 naturopathic physicians to protect the public health, safety, and
1-13 welfare and to provide a means of identifying qualified
1-14 naturopathic physicians.
1-15 SECTION 2. DEFINITIONS. In this Act:
1-16 (1) "Acupuncture" means the insertion of acupuncture
1-17 needles into specific points on the skin to treat human disease and
1-18 impairment and to relieve pain.
1-19 (2) "Approved naturopathic medical college" means a
1-20 college or program granting the degree of doctor of naturopathic
1-21 medicine or doctor of naturopathy that:
1-22 (A) is accredited by the Council on Naturopathic
1-23 Medical Education or other accrediting agency if recognized by the
1-24 federal government;
2-1 (B) has candidate for accreditation status with
2-2 the accrediting agency; or
2-3 (C) has been approved by the board after the
2-4 college or program was investigated and found to meet education
2-5 standards equivalent to those established by the accrediting
2-6 agency.
2-7 (3) "Board" means the Texas Board of Health.
2-8 (4) "Department" means the Texas Department of Health.
2-9 (5) "Homeopathic preparations" means medicines
2-10 prepared according to the Homeopathic Pharmacopeia of the United
2-11 States.
2-12 (6) "Minor surgery" means the use of operative,
2-13 electrical, or other methods for the surgical repair and care
2-14 incidental to superficial lacerations and abrasions, superficial
2-15 lesions, and the removal of foreign bodies located in superficial
2-16 tissues and the use of antiseptics and local anesthetics in
2-17 connection with these methods. The term does not include general
2-18 or spinal anesthetics, major surgery, surgery of the body cavities,
2-19 or specialized surgeries including plastic surgery or surgery
2-20 involving the eyes, tendons, ligaments, or major blood vessels.
2-21 (7) "Natural antibiotics" means antimicrobial,
2-22 antifungal, and antiprotozoal agents that are naturally occurring
2-23 substances or manufactured substances that are substantially
2-24 identical to the naturally occurring substances.
2-25 (8) "Naturopathic medicine" means a system of primary
2-26 health care practiced by naturopathic physicians for the
2-27 prevention, diagnosis, and treatment of human health conditions,
3-1 injuries, and diseases that uses education, natural medicines, and
3-2 therapies to support and stimulate the individual's intrinsic
3-3 self-healing processes.
3-4 (9) "Naturopathic obstetrics" means obstetrics and
3-5 natural childbirth. The term includes the use of natural
3-6 obstetrical medicines, ophthalmic antibiotics, obstetrical
3-7 emergency medicines, and minor surgery including episiotomies, but
3-8 does not include the use of forceps delivery, general or spinal
3-9 anesthesia, cesarean section, or induced abortion.
3-10 (10) "Naturopathic physician" means a person
3-11 authorized and licensed to practice naturopathic medicine under
3-12 this Act.
3-13 (11) "Naturopathic physical medicine" means the
3-14 therapeutic use of the physical agents of air, water, heat, cold,
3-15 sound, light, and electromagnetic nonionizing radiation and the
3-16 physical modalities of electrotherapy, diathermy, ultraviolet
3-17 light, ultrasound, hydrotherapy, naturopathic manipulative therapy,
3-18 and therapeutic exercise.
3-19 (12) "Topical medicines" means topical analgesics,
3-20 anesthetics, antiseptics, scabicides, antifungals, and
3-21 antibacterials.
3-22 SECTION 3. AUTHORIZED ACTIVITIES. (a) A person licensed as
3-23 a naturopathic physician under this Act may use for preventive and
3-24 therapeutic purposes the following medicines and therapies:
3-25 (1) food;
3-26 (2) food extracts;
3-27 (3) nutritional medicines;
4-1 (4) enzymes;
4-2 (5) digestive aids;
4-3 (6) whole gland thyroid;
4-4 (7) medicinal plant and animal substances;
4-5 (8) homeopathic preparations;
4-6 (9) natural antibiotics;
4-7 (10) immunizations;
4-8 (11) topical medicines;
4-9 (12) nonprescription medications;
4-10 (13) counseling and psychotherapy;
4-11 (14) hypnotherapy;
4-12 (15) biofeedback;
4-13 (16) dietary therapy;
4-14 (17) naturopathic physical medicine;
4-15 (18) acupuncture;
4-16 (19) therapeutic devices;
4-17 (20) barrier devices for contraception;
4-18 (21) naturopathic obstetrics; and
4-19 (22) minor surgery.
4-20 (b) A person licensed as a naturopathic physician under this
4-21 Act may use for diagnostic purposes:
4-22 (1) physical and orificial examinations;
4-23 (2) X-rays;
4-24 (3) electrocardiograms;
4-25 (4) ultrasound;
4-26 (5) phlebotomy;
4-27 (6) clinical laboratory tests and examinations;
5-1 (7) physiological function tests; and
5-2 (8) the noninvasive diagnostic procedures commonly
5-3 used by physicians in general practice.
5-4 SECTION 4. BOARD POWERS AND DUTIES. The board may adopt
5-5 rules authorizing the use by naturopathic physicians of other
5-6 diagnostic procedures and other natural medicines and therapies if
5-7 the procedures, medicines, and therapies are taught in approved
5-8 naturopathic medical colleges and are consistent with this Act.
5-9 SECTION 5. EXCEPTIONS. This Act does not:
5-10 (1) prevent any other professional who is licensed,
5-11 certified, or registered under the laws of this state from
5-12 providing services consistent with the professional's scope of
5-13 practice;
5-14 (2) apply to a student of naturopathic medicine who is
5-15 currently enrolled in an approved naturopathic medicine college and
5-16 who gratuitously diagnoses and treats disease under the direct
5-17 supervision of a naturopathic physician or other health care
5-18 practitioner regulated under the laws of this state if the
5-19 student's activities are within the scope of practice of the
5-20 supervising practitioner and are limited to activity consistent
5-21 with the scope of practice authorized by this Act; or
5-22 (3) apply to any naturopathic physician licensed in
5-23 another state, a territory of the United States, or the District of
5-24 Columbia, if the state, territory, or the District of Columbia
5-25 requires credentials equivalent to those of this Act, when the
5-26 physician incidentally called into this state for consultation with
5-27 a naturopathic physician.
6-1 SECTION 6. PROHIBITED ACTS. A naturopathic physician may
6-2 not:
6-3 (1) prescribe, dispense, or administer any legend
6-4 drugs or controlled substances except those medicines authorized by
6-5 this Act;
6-6 (2) perform surgical procedures except those
6-7 procedures authorized by this Act;
6-8 (3) practice emergency medicine except as a samaritan
6-9 rendering gratuitous services in the case of emergency and except
6-10 for the care of minor injuries; or
6-11 (4) claim to practice medicine and surgery,
6-12 osteopathy, dentistry, podiatry, optometry, chiropractic, physical
6-13 therapy, or any other system or method of treatment not authorized
6-14 by this Act.
6-15 SECTION 7. DUTIES AND RESPONSIBILITIES. A naturopathic
6-16 physician has the same authority and responsibility as any other
6-17 licensed physician regarding public health laws, reportable
6-18 diseases and conditions, communicable disease control and
6-19 prevention, the recording of vital statistics, health and physical
6-20 examinations, competency examinations, and local boards of health,
6-21 except that the authority under this section is limited to activity
6-22 consistent with the scope of practice authorized by this Act.
6-23 SECTION 8. LICENSE QUALIFICATIONS. (a) A person is
6-24 qualified to be licensed as a naturopathic physician if the person:
6-25 (1) is a graduate of an approved naturopathic medical
6-26 college;
6-27 (2) has passed an examination prescribed or endorsed
7-1 by the board covering the appropriate naturopathic subjects; and
7-2 (3) is of good moral character.
7-3 (b) A person is qualified to be licensed as a naturopathic
7-4 physician without examination if:
7-5 (1) the applicant is licensed to practice naturopathic
7-6 medicine or naturopathy in another state, a territory of the United
7-7 States, or the District of Columbia under conditions and
7-8 circumstances that the board finds to be comparable to the
7-9 requirements of this state for obtaining a license to practice
7-10 naturopathic medicine and the state, the territory, or the District
7-11 of Columbia requires the successful completion of a professional
7-12 examination for the issuance of such a license;
7-13 (2) the applicant has graduated from an approved
7-14 naturopathic medical college or, if the applicant was licensed
7-15 before a date designated by board rule, the applicant graduated
7-16 from a college approved by the board after the college was
7-17 investigated and found to meet the acceptable education standards
7-18 in existence at the time of the applicant's graduation; and
7-19 (3) the applicant produces evidence satisfactory to
7-20 the board that the applicant holds a valid, unsuspended, and
7-21 unrevoked license, has been actively engaged in the practice of
7-22 naturopathic medicine or naturopathy for not less than one year,
7-23 and is of good moral character.
7-24 SECTION 9. EXAMINATION. (a) A person may sit for the
7-25 examination prescribed or endorsed by the board under Section 8(a)
7-26 of this Act and be eligible for licensure on the passage of the
7-27 examination if, not later than the 90th day after the effective
8-1 date of this Act, the person submits proof to the department that
8-2 the person:
8-3 (1) attended a naturopathic college and received a
8-4 doctorate degree in naturopathic medicine or naturopathy from the
8-5 college before May 1, 1992, and the college is subsequently
8-6 approved by the board;
8-7 (2) was in practice in this state before May 1, 1992,
8-8 that included providing health care services using natural
8-9 medicines or therapies to patients in this state on a regular and
8-10 ongoing basis; and
8-11 (3) is of good moral character.
8-12 (b) The board may prescribe a nationally developed standard
8-13 examination as part or all of the examination prescribed or
8-14 endorsed under Section 8(a) of this Act. The passing criteria for
8-15 the examination shall be determined by board rule. The board may
8-16 adopt other rules necessary to the administration of the
8-17 examination.
8-18 (c) Fees for the examination, reexamination of the entire
8-19 examination, and reexamination of separate components of the
8-20 examination shall be set by the board in amounts necessary to cover
8-21 the actual cost of the examination and the expenses of
8-22 administration.
8-23 SECTION 10. LICENSE FEES. A license to practice
8-24 naturopathic medicine issued on the basis of examination or issued
8-25 without examination based on a license granted in another state, a
8-26 territory of the United States, or the District of Columbia may be
8-27 issued and renewed on payment of the initial licensing fee and
9-1 biennial renewal fees as determined by the board. The amounts of
9-2 the fees may not be less than $100 or more than $500.
9-3 SECTION 11. LICENSE RENEWAL. (a) A license to practice
9-4 naturopathic medicine must be renewed biennially.
9-5 (b) To renew a license, each naturopathic physician must
9-6 submit to the department evidence of successful completion of the
9-7 required hours of continuing education from programs approved by
9-8 the board.
9-9 (c) The board shall adopt rules as to what constitutes an
9-10 approved program of continuing education and the manner in which
9-11 attendance at all approved courses, clinics, forums, lectures,
9-12 programs, or seminars is monitored, recorded, and submitted to the
9-13 department.
9-14 (d) The board may adopt other rules necessary to the
9-15 administration of license renewals.
9-16 SECTION 12. CONTINUING EDUCATION. (a) The total number of
9-17 required continuing education hours for all naturopathic physicians
9-18 is not less than 30 approved hours biennially. The number and type
9-19 of required continuing education hours for a naturopathic physician
9-20 certified in naturopathic obstetrics is not less than 15 approved
9-21 specialty hours in obstetrics or natural childbirth and not less
9-22 than 20 approved hours biennially for a total of not less than 35
9-23 approved hours biennially.
9-24 (b) A person who seeks to renew a license that expired
9-25 within the preceding year must comply with the continuing education
9-26 requirements for the regular renewal of the license. A person
9-27 seeking to renew a license that has been expired for more than one
10-1 year must present evidence of completion of not less than one-half
10-2 of the required hours of approved continuing education requirements
10-3 during the year preceding the date of the application for renewal.
10-4 SECTION 13. INACTIVE STATUS; RETIRED STATUS. (a) A
10-5 licensee seeking to place a license on inactive status must notify
10-6 the department at the time of renewal and pay a fee for inactive
10-7 status.
10-8 (b) The amount of the fee shall be set by the board except
10-9 the amount may not be less than $30 or more than $100.
10-10 (c) To activate a license on inactive status, the licensee
10-11 must pay the regular renewal fee and present evidence of having
10-12 completed not less than one-half of the required hours of approved
10-13 continuing education requirements during the year preceding the
10-14 date of the application for activation.
10-15 (d) A licensee seeking to place a license on retired status
10-16 must notify the department at the time of renewal. A license on
10-17 retired status may not be reactivated.
10-18 (e) A licensee who holds a license that is on inactive or
10-19 retired status may not practice naturopathic medicine.
10-20 SECTION 14. SPECIALTY PRACTICE. (a) A naturopathic
10-21 physician may not practice naturopathic obstetrics and acupuncture
10-22 without first obtaining a certificate of specialty practice. The
10-23 board shall adopt rules to certify naturopathic physicians for
10-24 specialty practice.
10-25 (b) To be certified in naturopathic obstetrics, a
10-26 naturopathic physician must:
10-27 (1) pass a specialty examination in obstetrics or
11-1 natural childbirth approved by the board;
11-2 (2) have not less than 100 hours of course work,
11-3 internship, or preceptorship in obstetrics or natural childbirth
11-4 approved by the board; and
11-5 (3) have participated in at least 40 supervised
11-6 births, including prenatal and postnatal care, under the direct
11-7 supervision of a licensed naturopathic, medical, or osteopathic
11-8 physician with specialty training in obstetrics or natural
11-9 childbirth.
11-10 (c) The board may prescribe a national standardized
11-11 examination in obstetrics or natural childbirth as constituting the
11-12 specialty examination.
11-13 (d) To be certified in acupuncture, a naturopathic physician
11-14 must complete a program in acupuncture approved by the board that
11-15 includes not less than 500 hours of training in acupuncture,
11-16 including both didactic and clinical training, and pass a specialty
11-17 examination in acupuncture approved by the board. The board may
11-18 prescribe a national standardized examination in acupuncture as
11-19 constituting the specialty examination.
11-20 SECTION 15. USE OF TITLES; PENALTY; INJUNCTION. (a) A
11-21 naturopathic physician may use the title "naturopathic physician"
11-22 and the recognized abbreviation for the professional degree of
11-23 "N.D." A naturopathic physician has the exclusive right to use the
11-24 terms "naturopathic physician," "naturopath," "doctor of
11-25 naturopathic medicine," "doctor of naturopathy," "naturopathic
11-26 medicine," "naturopathic health care," "naturopathy," and "N.D."
11-27 (b) A person commits an offense if the person holds the
12-1 person out as a naturopathic physician or naturopath, suggests that
12-2 the person practices naturopathic medicine or naturopathy, or uses
12-3 the terms and abbreviation described by Subsection (a) of this
12-4 section without being licensed or on retired or inactive status
12-5 under this Act.
12-6 (c) An offense under Subsection (b) of this section is a
12-7 Class B misdemeanor.
12-8 (d) A person in violation of this section may be enjoined by
12-9 the district court on petition by the board.
12-10 SECTION 16. DISCIPLINARY ACTIONS. A person licensed under
12-11 this Act who engages in the practice of naturopathic medicine in
12-12 violation of this Act or a rule adopted under this Act is subject
12-13 to disciplinary measures and may be subject to the person's license
12-14 being denied, refused renewal, limited, revoked, or suspended.
12-15 SECTION 17. EFFECTIVE DATE. This Act takes effect September
12-16 1, 1993.
12-17 SECTION 18. EMERGENCY. The importance of this legislation
12-18 and the crowded condition of the calendars in both houses create an
12-19 emergency and an imperative public necessity that the
12-20 constitutional rule requiring bills to be read on three several
12-21 days in each house be suspended, and this rule is hereby suspended.