BILL ANALYSIS


                                                         S.B. 476
                                                         By: Luna
                                        Health and Human Services
                                                          4-27-95
                                       Committee Report (Amended)
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 sciences of clinical
nutrition, herbal medicine, homeopathy, physical medicine, exercise
therapy, counseling, acupuncture, 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; provides
penalties.

RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is granted
to the Texas Board of Health in SECTIONS 4, 8(d), 9(b), 11(c) and
(d), and 14(a) of this bill.

SECTION BY SECTION ANALYSIS

SECTION 1. PURPOSE.  Sets forth the purpose of this Act.

SECTION 2. DEFINITIONS.  Defines "acupuncture," "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.  Authorizes the board to adopt
rules authorizing the use 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.  Provides 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 or acupuncture
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.
     
     (d) Requires a naturopathic physician to complete an approved
     program in acupuncture and pass an approved specialty
     examination in acupuncture.  Authorizes the board to prescribe
     a national standardized examination in acupuncture as
     constituting the specialty examination to be certified in
     acupuncture.
SECTION 15.    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) Authorizes a person who violates this section to be
     enjoined by the district court on petition by the board.
SECTION 16.    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 17.    CONFORMING AMENDMENT.  Amends Section 3.06(b),
Article 4495b, V.T.C.S. (Medical Practice Act), to include licensed
athletic trainers who confine their activities strictly to athletic
training and naturopathic physicians who confine their practice
strictly to naturopathic medicine in the list of persons to whom
this act does not apply.

SECTION 18.    CONFORMING AMENDMENT.  Amends Section 6.06, Article
4495b, V.T.C.S., as follows:

     Sec. 6.06.  New title:  LICENSE REQUIRED; EXCEPTION. 
     Authorizes a person licensed to practice naturopathic medicine
     to engage in the practice of acupuncture without a license
     under this subchapter.
SECTION 19.    CONFORMING AMENDMENT.  Amends Section 3(a), Article
4512g, V.T.C.S. (Licensed Professional Counselor Act), to include
the activities of licensed naturopathic physicians in the list of
actions to which this Act does not apply.

SECTION 20.    Effective date: September 1, 1995.

SECTION 21.    Emergency clause.