BILL ANALYSIS
S.B. 476
By: G. Luna (Romo)
May 17, 1995
Committee Report (Substituted)
BACKGROUND
Naturopathic medicine is becoming more widely used as the public
becomes more health conscious. Naturopathic physicians treat
disease and illness using therapies from the fields of clinical
nutrition, herbal medicine, homeopathy, physical medicine, exercise
therapy, counseling, natural childbirth, and hydrotherapy.
Naturopathic physicians also perform physical examinations,
laboratory testing, gynecological exams, nutritional and dietary
assessments, metabolic analysis, allergy testing, and X-ray
examinations, combining and tailoring these treatments to the needs
of the individual. However, naturopathic physicians are not
regulated and licensed by the Texas Department of Health.
PURPOSE
As proposed, S.B. 476 sets forth regulations and licensing
requirements for the practice of naturopathic medicine and provides
penalties.
RULEMAKING AUTHORITY
It is the committee's opinion that this bill grants additional
rulemaking authority to the Texas Board of Health in SECTIONS 4, 8,
9, 11, 14, 15, 20, 21 and 22.
SECTION BY SECTION ANALYSIS
SECTION 1. PURPOSE. Sets forth the purpose of this Act.
SECTION 2. DEFINITIONS. Defines "approved naturopathic medical
college," "board," "department," "homeopathic preparations," "minor
surgery," "natural antibiotics," "naturopathic medicine,"
"naturopathic obstetrics," "naturopathic physician," "naturopathic
physical medicine," and "topical medicines."
SECTION 3. AUTHORIZED ACTIVITIES. (a) Authorizes a person licensed
as a naturopathic physician to use certain medicines and therapies
for preventive and therapeutic purposes.
(b) Authorizes a person licensed as a naturopathic physician
to use certain procedures for diagnostic purposes.
SECTION 4. BOARD POWERS AND DUTIES. Allows the board to adopt
rules authorizing the use of other diagnostic procedures, natural
medicines and therapies by naturopathic physicians if the
procedures, medicines, and therapies are taught in approved
naturopathic medical colleges and are consistent with this Act.
SECTION 5. EXCEPTIONS. Provides that this Act does not apply to
certain licensed, registered, or certified professionals; certain
students of naturopathic medicine; or any naturopathic physician
licensed in another state.
SECTION 6. PROHIBITED ACTS. Prohibits a naturopathic physician
from prescribing, dispensing, or administering any unauthorized
legend drugs or controlled substances; performing any unauthorized
surgical procedures; practicing emergency medicine, with an
exception; or claiming to practice any unauthorized system or
method of treatment.
SECTION 7. DUTIES AND RESPONSIBILITIES. States that a naturopathic
physician has the same authority and responsibility as any other
licensed physician regarding certain regulations and record
keeping, except that the authority is limited to activity
consistent with the scope of practice authorized by this Act.
SECTION 8. LICENSE QUALIFICATIONS. (a) Provides that a person who
graduates from an approved naturopathic medical college, has passed
a certain examination, and is of good moral character is qualified
to be licensed as a naturopathic physician.
(b) Provides that a person is qualified to be licensed as a
naturopathic physician without examination under certain
circumstances.
(c) Sets forth circumstances under which a person is qualified
to be licensed under this Act without examination.
(d) Authorizes a person licensed under Subsection (c) to
practice naturopathic medicine only within a scope of practice
that reflects the limits of the person's training experience.
Authorizes the board to adopt rules providing for limitations
on the practice of a person under this subsection and
prescribing methods by which a person licensed under
Subsection (c) is identified as a person whose practice is
limited.
SECTION 9. EXAMINATION. (a) Authorizes a person to sit for the
examination prescribed or endorsed by the board and be eligible for
licensure on the passage of the examination if the person submits
proof of certain information before December 1, 1995.
(b) Authorizes the board to prescribe a nationally developed
standard examination as part of the examination prescribed or
endorsed by the board. Requires the board to determine, by
rule, the passing criteria for the examination. Authorizes
the board to adopt other rules necessary to the administration
of the examination.
(c) Requires the board to set fees for the examination and
reexaminations that cover the cost of the examination and its
administration.
SECTION 10. LICENSE FEES. Authorizes licenses to be issued or
renewed on payment of the initial licensing fee and biennial
renewal fees in an amount between $100 and $500 that is determined
by the board.
SECTION 11. LICENSE RENEWAL (a) Requires a license to practice
naturopathic medicine to be renewed biennially.
(b) Requires each naturopathic physician to submit to the
Texas Department of Health (department) evidence of completion
of the required hours of approved continuing education
programs.
(c) Requires the board to adopt rules as to what constitutes
an approved continuing education program and the manner in
which attendance at the programs is monitored and submitted to
the department.
(d) Authorizes the board to adopt rules necessary to the
administration of license renewals.
SECTION 12. CONTINUING EDUCATION. (a) Provides that the total
number of required continuing education is at least 30 approved
hours annually. Sets forth required hours of continuing education
for a naturopathic physician in obstetrics or natural childbirth.
(b) Requires a person who seeks to renew a license that
expired within the preceding year to comply with the
continuing education requirements for the regular renewal of
the license. Requires a person seeking to renew a license that
has been expired for more than one year to complete at least
one-half of the continuing education requirements during the
year preceding the date of the application for renewal.
SECTION 13. INACTIVE STATUS; RETIRED STATUS. (a) Requires a
license holder seeking to place the person's license on inactive
status to notify the department at the time of renewal and pay a
fee for inactive status.
(b) Requires the amount of the fee to be set between $30 and
$100.
(c) Requires the license holder to pay the regular renewal fee
and complete at least one-half of the continuing education
requirements during the year preceding the date of the
application for activation to activate a license on inactive
status.
(d) Requires a license holder seeking to place a license on
retired status to notify the department at the time of
renewal. Prohibits a license on retired status from being
reactivated.
(e) Prohibits a license holder who is on inactive or retired
status from practicing naturopathic medicine.
SECTION 14. SPECIALTY PRACTICE. (a) Prohibits a naturopathic
physician from practicing naturopathic obstetrics without first
obtaining a certificate of specialty practice. Requires the board
to adopt rules to certify naturopathic physicians for specialty
practice.
(b) Requires a naturopathic physician to meet certain
qualifications to be certified in naturopathic obstetrics.
(c) Authorizes the board to prescribe a national standardized
examination in obstetrics or natural childbirth as
constituting the specialty examination.
SECTION 15. USE OF X-RAY. States that naturopathic physicians
licensed under this Act may use an X-ray in their practice only if
they are certified by the board as qualified to perform X-ray
procedures. Requires the board to adopt rules for the issuance of
a certification under this section that are equivalent to the
requirements for other health professionals to engage in the use of
X-rays.
SECTION 16. USE OF TITLES; PENALTY; INJUNCTION. (a) Authorizes a
naturopathic physician to use the title "naturopathic physician"
and the professional degree abbreviation, "N.D." Provides that a
naturopathic physician has the exclusive right to use certain
naturopathic-related terms.
(b) Provides that a person commits an offense if the person
holds the person out as a naturopathic physician, suggests the
person practices naturopathic medicine, or uses the terms and
abbreviation described by Subsection (a) without holding a
license or while the person is on retired or inactive status.
(c) Provides that an offense is a Class B misdemeanor.
(d) States that a person who violates this section may be
enjoined by the district court on petition by the board.
SECTION 17. DISCIPLINARY ACTIONS. Subjects a licensed person
who engages in the practice of naturopathic medicine in violation
of this act or rules adopted under it to disciplinary measures and
provides that a person may be subject to other limitations.
SECTION 18. CONFORMING AMENDMENT. Amends Section 3.06(b),
Medical Practice Act (Article 4495b, V.T.C.S.), to include licensed
athletic trainers who confine their activities strictly to athletic
training and licensed naturopathic physicians who confine their
practice to naturopathic medicine among the list of persons to whom
this Act does not apply.
SECTION 19. CONFORMING AMENDMENT. Amends Section 3(a),
Licensed Professional Counselor Act (Article 4512g, V.T.C.S.) to
include the activities and services of licensed naturopathic
physicians in the list of actions to which this Act does not apply.
SECTION 20. CONFORMING AMENDMENT. Amends Section 5(39), Texas
Pharmacy Act (Article 4542a-1, V.T.C.S.) to include in the
definition of "practitioner," a naturopathic physician to the
extent permitted by rules adopted by the Texas Board of Health.
Also makes a nonsubstantial wording change.
SECTION 21. CONFORMING AMENDMENT. Amends Section 481.002(39),
Health and Safety Code, to add to the definition of "practitioner"
a naturopathic physician to the extent permitted by rules adopted
by the Texas Board of Health.
SECTION 22. CONFORMING AMENDMENT. Amends Section 483.001(12),
Health and Safety Code, to add to the definition of "practitioner,"
a person licensed by the Texas Board of Health as a naturopathic
physician to the extent permitted by board rules.
SECTION 23. Effective date: September 1, 1995.
SECTION 24. Emergency clause.
COMPARISON OF ORIGINAL TO SUBSTITUTE
The substitute for S.B. 476, as compared with the bill as
engrossed, deletes acupuncture from a licensed naturopath's scope
of practice. It also adds a provision concerning limitations on the
use of X-rays by a licensed naturopathic physician (SECTION 15).
Additional conforming amendments are included in the substitute
version of the bill, adding a naturopathic physician to the
definition for practitioner in the Texas Pharmacy Act, in Section
481.002(39) of the Health and Safety Code, and in Section
483.001(12), Health and Safety Code (SECTIONS 20, 21, and 22 of the
substitute). The substitute deletes one conforming amendment from
the engrossed version, related to acupuncture.
SUMMARY OF COMMITTEE ACTION
S.B. 476 was considered by the Public Health Committee in a formal
meeting on May 17, 1995. The committee considered a complete
substitute for the bill. The substitute was adopted without
objection. The bill was reported favorably as substituted, with the
recommendation that it do pass and be printed, by the record vote
of 5 AYES, 1 NAY, 0 PNV, and 3 ABSENT.