By:  Luna, Moncrief                                    S.B. No. 257

                                A BILL TO BE ENTITLED

                                       AN ACT

 1-1     relating to the regulation of the practice of naturopathic

 1-2     medicine; providing penalties.

 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-4           SECTION 1.  PURPOSE.  The legislature finds that a

 1-5     significant number of the citizens of this state are turning to

 1-6     naturopathic physicians for their health care needs and declares

 1-7     that naturopathic medicine is a distinct health care profession

 1-8     that affects the public health, safety, and welfare and provides

 1-9     the public with freedom of choice in health care.  The purpose of

1-10     this Act is to provide standards for the licensing and regulation

1-11     of naturopathic medicine to protect the public health, safety, and

1-12     welfare and to provide a means of identifying qualified

1-13     naturopathic physicians.

1-14           SECTION 2.  DEFINITIONS.  In this Act:

1-15                 (1)  "Advisory committee" means the Naturopathic

1-16     Physicians Advisory Committee.

1-17                 (2)  "Approved naturopathic college"  means a college

1-18     granting the degree of doctor of naturopathy, doctor of

1-19     naturopathic health care, or doctor of naturopathic medicine that:

1-20                       (A)  is accredited by an agency recognized by the

1-21     federal government or approved by the board;

1-22                       (B)  has candidate-for-accreditation status with

1-23     the accrediting agency; or

 2-1                       (C)  has been approved by the advisory committee

 2-2     after the college was investigated and found to meet education

 2-3     standards equivalent to those established by the accrediting

 2-4     agency.

 2-5                 (3)  "Board" means the Texas Board of Health.

 2-6                 (4)  "Department" means the Texas Department of Health.

 2-7                 (5)  "Diagnose" means to examine in any manner another

 2-8     person, parts of a person's body, or substances, fluids, or

 2-9     materials excreted, taken, or removed from a person's body or

2-10     produced by a person's body to determine the source, kind, or

2-11     extent of a disease or other physical condition.

2-12                 (6)  "Minor office procedure" means the use of

2-13     operative, electrical, or other methods for the repair and care

2-14     incidental to superficial lacerations and abrasions, the removal of

2-15     foreign bodies located in superficial tissues, and the use of

2-16     antiseptics and local anesthetics in connection with these methods.

2-17     The term includes the use of local anesthesia applied topically or

2-18     by injection, whether natural or prescription, in superficial

2-19     tissues associated with the performance of minor office procedures.

2-20     The term does not include general or spinal anesthesia, major

2-21     surgery, surgery of the body cavities, or specialized surgeries,

2-22     including plastic surgery or surgery involving the eyes, tendons,

2-23     ligaments, or major blood vessels.

2-24                 (7)  "Natural antibiotics" means antimicrobial,

2-25     antifungal, and antiprotozoal agents that are naturally occurring

 3-1     substances or manufactured substances that are substantially

 3-2     identical to the naturally occurring substances.

 3-3                 (8)  "Natural medicines" means food, food extracts,

 3-4     dietary supplements as defined by the Federal Food, Drug, and

 3-5     Cosmetic Act (21 U.S.C. Section 301 et seq.), homeopathic remedies,

 3-6     plant substances that are not designated as prescription drugs or

 3-7     controlled substances, over-the-counter medications, prescriptions

 3-8     that are consistent with the competent practice of naturopathy, and

 3-9     substances prepared according to the official Homoeopathic

3-10     Pharmacopoeia of the United States.

3-11                 (9)  "Naturopathic medicine" means a system of primary

3-12     health care practiced by naturopathic physicians for the

3-13     prevention, evaluation, and care of human health conditions that

3-14     uses education, natural substances, and remedies to support and

3-15     stimulate the individual's intrinsic self-healing processes.

3-16                 (10)  "Naturopathic childbirth" means uncomplicated

3-17     natural childbirth assisted by a naturopathic physician.  The term

3-18     includes the use of natural substances, ophthalmic antibiotics,

3-19     emergency childbirth medicines, and simple, uncomplicated

3-20     episiotomies but does not include the use of forceps delivery,

3-21     general or spinal anesthesia, cesarean section, or induced

3-22     abortion.

3-23                 (11)  "Naturopathic mobilization therapy" means

3-24     manually administering mechanical treatment of body structures or

3-25     tissues for the purpose of restoring normal physiological function

 4-1     of the body by normalizing and balancing the musculoskeletal system

 4-2     of the body, but the term does not include osseous manipulation.

 4-3                 (12)  "Naturopathic physician" means a person who holds

 4-4     the person out to the public as licensed to practice naturopathic

 4-5     medicine or who practices naturopathic medicine under this Act.

 4-6                 (13)  "Naturopathic physical medicine" means the use of

 4-7     the physical agents of air, water, heat, cold, sound, light, and

 4-8     electromagnetic nonionizing radiation and the physical modalities

 4-9     of electrotherapy, biofeedback, diathermy, ultraviolet light,

4-10     ultrasound, hydrotherapy, naturopathic mobilization therapy, and

4-11     exercise.  The term does not include the practice of physical

4-12     therapy, acupuncture, or chiropractic.

4-13                 (14)  "Practice of naturopathy" means a system of

4-14     primary health care for the prevention, diagnosis, and care of

4-15     human conditions, injuries, and diseases that uses education,

4-16     natural substances, and natural therapies to support and stimulate

4-17     the patient's intrinsic self-healing processes.

4-18                 (15)  "Topical preparations" means topical analgesics,

4-19     anesthetics, antiseptics, scabicides, antifungals, and

4-20     antibacterials.

4-21           SECTION 3.  AUTHORIZED ACTIVITIES.  (a)  A person licensed as

4-22     a naturopathic physician under this Act may use for preventive and

4-23     therapeutic purposes the following preparations and therapies:

4-24                 (1)  natural medicines;

4-25                 (2)  minor office procedures;

 5-1                 (3)  natural antibiotics;

 5-2                 (4)  naturopathic medicine;

 5-3                 (5)  naturopathic childbirth;

 5-4                 (6)  naturopathic mobilization therapy;

 5-5                 (7)  topical preparations; and

 5-6                 (8)  naturopathic physical medicine.

 5-7           (b)  A person licensed as a naturopathic physician under this

 5-8     Act may use for evaluation purposes:

 5-9                 (1)  physical and orificial examinations;

5-10                 (2)  X-rays;

5-11                 (3)  electrocardiograms;

5-12                 (4)  therapeutic ultrasound;

5-13                 (5)  phlebotomy;

5-14                 (6)  clinical laboratory tests and examinations;

5-15                 (7)  physiological function tests; and

5-16                 (8)  the noninvasive diagnostic procedures commonly

5-17     used in general practice.

5-18           SECTION 4.  POWERS AND DUTIES OF BOARD AND DEPARTMENT.

5-19     (a)  The board, with the advice of the advisory committee, shall

5-20     adopt rules consistent with this Act.

5-21           (b)  The department shall administer this Act, investigate

5-22     violations of this Act, prepare and administer examinations, and

5-23     perform other duties authorized by this Act.

5-24           (c)  The board may adopt rules authorizing the use by

5-25     naturopathic physicians of other evaluative procedures and other

 6-1     natural substances, treatments, procedures, and therapies if the

 6-2     substances, treatments, procedures, and therapies are taught in

 6-3     approved courses of study or used by practitioners licensed by

 6-4     other entities of the state and are consistent with this Act.

 6-5           (d)  Chapter 2001, Government Code, applies to this Act.

 6-6           SECTION 5.  EXCEPTIONS.  This Act does not:

 6-7                 (1)  prevent any other professional who is licensed,

 6-8     certified, or registered under the laws of this state from

 6-9     providing services consistent with the professional's scope of

6-10     practice;

6-11                 (2)  apply to a student of naturopathy who is currently

6-12     enrolled in an approved naturopathic course of study and who

6-13     gratuitously evaluates and treats human conditions under the direct

6-14     supervision of a naturopathic physician regulated under the laws of

6-15     this state if the student's activities are within the scope of

6-16     practice of the supervising naturopathic physician and are limited

6-17     to activity consistent with the scope of practice authorized by

6-18     this Act;

6-19                 (3)  prohibit or restrict a person engaged in the sale

6-20     of vitamins, health foods, dietary supplements, herbs, or other

6-21     products of nature the sale of which is not otherwise prohibited

6-22     under state or federal law;

6-23                 (4)  prohibit a person from providing nutritional

6-24     advice, giving advice concerning proper nutrition, or giving

6-25     information as to the use and role of food and food ingredients,

 7-1     including dietary supplements, except that providing nutritional

 7-2     advice under this subdivision does not include the authority to

 7-3     practice medicine or surgery, to undertake the treatment or cure of

 7-4     a disease, pain, injury, deformity, or physical or mental

 7-5     condition, or to state that a product might cure a disease, pain,

 7-6     injury, deformity, or other condition; or

 7-7                 (5)  apply to a naturopathic physician licensed in

 7-8     another state, a territory of the United States, or the District of

 7-9     Columbia, if the state, territory, or the District of Columbia

7-10     requires credentials equivalent to those of this Act, when the

7-11     physician is incidentally called into this state for consultation

7-12     with a naturopathic physician licensed in this state.

7-13           SECTION 6.  PROHIBITED ACTS.  A naturopathic physician may

7-14     not:

7-15                 (1)  prescribe, dispense, or administer any legend

7-16     drugs or controlled substances except those preparations authorized

7-17     by this Act or board rule;

7-18                 (2)  perform surgical procedures or X-ray procedures

7-19     except those procedures authorized by this Act or board rule;

7-20                 (3)  practice emergency care except as a samaritan

7-21     rendering gratuitous services in the case of emergency and except

7-22     for the care of minor injuries; or

7-23                 (4)  claim to practice allopathic medicine or surgery,

7-24     osteopathy, dentistry, podiatry, optometry, chiropractic, physical

7-25     therapy, acupuncture, or any other system or method of treatment

 8-1     not authorized by this Act or board rule.

 8-2           SECTION 7.  DUTIES AND RESPONSIBILITIES.  A naturopathic

 8-3     physician has the same responsibility as any other licensed health

 8-4     care provider regarding public health laws, reportable diseases and

 8-5     conditions, communicable disease control and prevention, the

 8-6     recording of vital statistics, health and physical examinations,

 8-7     competency examinations, and local boards of health, except that

 8-8     the authority under this section is limited to activity consistent

 8-9     with the scope of practice authorized by this Act or board rule.

8-10           SECTION 8.  LICENSE QUALIFICATIONS.  (a)  A person is

8-11     qualified to be licensed as a naturopathic physician if the person:

8-12                 (1)  completes and submits to the department an

8-13     application accompanied by the appropriate fees;

8-14                 (2)  is a graduate of an approved naturopathic college;

8-15                 (3)  has passed an examination prescribed or endorsed

8-16     by the advisory committee covering the appropriate naturopathic

8-17     subjects; and

8-18                 (4)  is of good moral character.

8-19           (b)  A person is qualified to be licensed as a naturopathic

8-20     physician without examination if:

8-21                 (1)  the applicant is licensed to practice naturopathy

8-22     in another state, a territory of the United States, or the District

8-23     of Columbia under conditions and circumstances that the board finds

8-24     to be comparable to the requirements of this state for obtaining a

8-25     license to practice naturopathy and the state, the territory, or

 9-1     the District of Columbia requires the successful completion of a

 9-2     professional examination for the issuance of a license;

 9-3                 (2)  the applicant has graduated from an approved

 9-4     naturopathic college or, if the applicant was licensed before a

 9-5     date designated by board rule, the applicant graduated from a

 9-6     college approved by the advisory committee after the college was

 9-7     investigated and found to meet the acceptable education standards

 9-8     in existence at the time of the applicant's graduation; and

 9-9                 (3)  the applicant produces evidence satisfactory to

9-10     the advisory committee that the applicant holds a valid,

9-11     unsuspended, and unrevoked license, has been actively engaged in

9-12     the practice of naturopathy for not less than one year, and is of

9-13     good moral character.

9-14           (c)  A person may sit for the examination prescribed or

9-15     endorsed by the advisory committee under Subsection (a) of this

9-16     section and be eligible for licensure as a naturopathic physician

9-17     on the passage of the examination if, before December 1, 1997, the

9-18     person files a license application, pays the required fees, and

9-19     submits proof to the department that the person:

9-20                 (1)  attended a naturopathic college and received a

9-21     doctorate degree in naturopathy from the college before January 1,

9-22     1997, and the college is subsequently approved by the advisory

9-23     committee;

9-24                 (2)  was in practice in this state before May 1, 1997,

9-25     and that that practice included providing health care services

 10-1    using natural medicines or therapies to patients in this state on a

 10-2    regular and ongoing basis; and

 10-3                (3)  is of good moral character.

 10-4          (d)  A person is qualified to be licensed under this Act

 10-5    without taking the examination or meeting the requirements of

 10-6    Subsections (a) and (b) of this section if the person:

 10-7                (1)  is a resident of the state;

 10-8                (2)  is 21 years of age or older;

 10-9                (3)  provides proof acceptable to the advisory

10-10    committee that the person has been actively engaged in naturopathic

10-11    health care and has held the person out to the public as a

10-12    naturopathic physician for at least three years before January 1,

10-13    1999, or has accumulated not less than 3,080 patient contact hours

10-14    before January 1, 1999;

10-15                (4)  is not licensed as a physician or chiropractor;

10-16                (5)  derives the majority of the person's earned income

10-17    from the practice of naturopathy; and

10-18                (6)  applies for a license under this subsection before

10-19    January 1, 1999.

10-20          (e)  A person licensed under Subsection (d) of this section

10-21    may:

10-22                (1)  use the title "naturopathic physician" and any

10-23    other title permitted under Subsection (a) of Section 16 of this

10-24    Act; and

10-25                (2)  practice naturopathy only within the scope of

 11-1    practice that reflects the limits of the person's training and

 11-2    experience.

 11-3          (f)  The board may adopt rules providing for limitations on

 11-4    the practice of a person licensed under Subsection (d) of this

 11-5    section. The board may not require a person licensed under

 11-6    Subsection (d) of this section to be identified as a person whose

 11-7    practice is limited.

 11-8          SECTION 9.  EXAMINATION.  (a)  The advisory committee may

 11-9    prescribe a nationally developed standard examination as part or

11-10    all of the examination prescribed or endorsed under Subsection (a)

11-11    of Section 8 of this Act.  The board by rule shall determine the

11-12    passing criteria for the examination.  The board may adopt other

11-13    rules necessary to the administration of the examination.

11-14          (b)  The board shall set the fees for the examination,

11-15    reexamination of the entire examination, and reexamination of

11-16    separate components of the examination in amounts necessary to

11-17    cover the actual cost of the examination and the expenses of

11-18    administration.

11-19          SECTION 10.  LICENSE FEES.  The board by rule shall adopt an

11-20    initial licensing fee and annual renewal fees.  Fees adopted under

11-21    this section shall be in amounts necessary to cover the costs of

11-22    administering this Act.

11-23          SECTION 11.  LICENSE RENEWAL.  (a)  A license to practice as

11-24    a naturopathic physician must be renewed annually.

11-25          (b)  To renew a license, each naturopathic physician must

 12-1    submit to the department evidence of successful completion of the

 12-2    required hours of continuing education from programs approved by

 12-3    the board.

 12-4          (c)  The board shall adopt rules as to what constitutes an

 12-5    approved program of continuing education and the manner in which

 12-6    attendance at all approved courses, clinics, forums, lectures,

 12-7    programs, or seminars is monitored, recorded, and submitted to the

 12-8    department.

 12-9          (d)  The board may adopt other rules necessary to the

12-10    administration of license renewals.

12-11          SECTION 12.  CONTINUING EDUCATION.  (a)  The total number of

12-12    required continuing education hours for all naturopathic physicians

12-13    is not less than 15 approved hours annually.  The number and type

12-14    of required continuing education hours for a naturopathic physician

12-15    certified in naturopathic childbirth is not less than 15 approved

12-16    specialty hours in obstetrics or natural childbirth and not less

12-17    than 20 approved hours biennially for a total of not less than 35

12-18    approved hours biennially.

12-19          (b)  A person who seeks to renew a license that expired

12-20    within the preceding year must comply with the continuing education

12-21    requirements for the regular renewal of the license.  A person

12-22    seeking to renew a license that has been expired for more than one

12-23    year must present evidence of completion of not less than one-half

12-24    of the required hours of approved continuing education requirements

12-25    during the year preceding the date of the application for renewal.

 13-1          SECTION 13.  INACTIVE STATUS; RETIRED STATUS.  (a)  A license

 13-2    holder seeking to place the person's license on inactive status

 13-3    must notify the department at the time of renewal and pay a fee for

 13-4    inactive status.

 13-5          (b)  To activate a license on inactive status, the license

 13-6    holder must pay the regular renewal fee and present evidence of

 13-7    having completed not less than one-half of the required hours of

 13-8    approved continuing education requirements during the year

 13-9    preceding the date of the application for activation.

13-10          (c)  A license holder seeking to place a license on retired

13-11    status must notify the department at the time of renewal.  A

13-12    license on retired status may not be reactivated.

13-13          (d)  A license holder who holds a license that is on inactive

13-14    or retired status may not practice naturopathic medicine.

13-15          SECTION 14.  SPECIALTY PRACTICE.  (a)  A naturopathic

13-16    physician may not practice naturopathic childbirth without

13-17    obtaining a certificate of specialty practice in naturopathic

13-18    childbirth.  The board shall adopt rules to certify naturopathic

13-19    physicians for specialty practice.

13-20          (b)  To be certified in naturopathic childbirth, a

13-21    naturopathic physician must:

13-22                (1)  pass a specialty examination in obstetrics or

13-23    natural childbirth approved by the advisory committee; and

13-24                (2)  comply with the requirements adopted by the board

13-25    for issuance of the specialty certification that are equivalent to

 14-1    the minimum requirements, including any examination requirements,

 14-2    to obtain a license to practice midwifery in this state.

 14-3          (c)  The advisory committee may prescribe a national

 14-4    standardized examination in obstetrics or natural childbirth as

 14-5    constituting the specialty examination.

 14-6          SECTION 15.  USE OF X-RAY.  A naturopathic physician licensed

 14-7    under this Act may use an X-ray in the course of the person's

 14-8    practice only if the person is certified by the board as qualified

 14-9    to perform X-ray procedures.  The board shall adopt rules for the

14-10    issuance of a certification under this section that are equivalent

14-11    to the requirements for other health professionals to engage in the

14-12    use of X-rays.

14-13          SECTION 16.  USE OF TITLES; PENALTY; INJUNCTION.  (a)  A

14-14    naturopathic physician may use the title "naturopathic physician"

14-15    and the recognized abbreviation for the professional degree of

14-16    "N.D."  A naturopathic physician has the exclusive right to use the

14-17    terms "naturopathic physician," "doctor of naturopathic medicine,"

14-18    "doctor of naturopathy," "naturopathy," and "N.D."

14-19          (b)  A person commits an offense if the person holds the

14-20    person out as a naturopathic physician, suggests that the person

14-21    practices naturopathic medicine, or uses the terms and abbreviation

14-22    described by Subsection (a) of this section without holding a

14-23    license or while the person is on retired or inactive status under

14-24    this Act.

14-25          (c)  An offense under Subsection (b) of this section is a

 15-1    felony of the third degree.

 15-2          (d)  A person who violates this section may be enjoined by

 15-3    the district court on petition by the board.

 15-4          SECTION 17.  COMPLAINT PROCEDURE IN GENERAL.  (a)  The

 15-5    department shall keep an information file about each complaint

 15-6    filed with the department.  The department's information file shall

 15-7    be kept current and contain a record for each complaint of:

 15-8                (1)  all persons contacted in relation to the

 15-9    complaint;

15-10                (2)  a summary of findings made at each step of the

15-11    complaint process;

15-12                (3)  an explanation of the legal basis and reason for a

15-13    complaint that is dismissed; and

15-14                (4)  other relevant information.

15-15          (b)  If a written complaint is filed with the department that

15-16    the department has authority to resolve, the department, at least

15-17    as frequently as quarterly and until final disposition of the

15-18    complaint, shall notify the parties to the complaint of the status

15-19    of the complaint unless the notice would jeopardize an undercover

15-20    investigation.

15-21          (c)  The board by rule shall adopt a form to standardize

15-22    information concerning complaints made to the department.  The

15-23    board by rule shall prescribe information to be provided to a

15-24    person when the person files a complaint with the department.

15-25          (d)  The department shall provide reasonable assistance to a

 16-1    person who wishes to file a complaint with the department.

 16-2          SECTION 18.  COMPLAINT INVESTIGATION AND DISPOSITION.

 16-3    (a)  The board shall adopt rules concerning the investigation of a

 16-4    complaint filed with the department.  The rules adopted under this

 16-5    subsection shall:

 16-6                (1)  distinguish between categories of complaints;

 16-7                (2)  ensure that complaints are not dismissed without

 16-8    appropriate consideration;

 16-9                (3)  require that the advisory committee be advised of

16-10    a complaint that is dismissed and that a letter be sent to the

16-11    person who filed the complaint explaining the action taken on the

16-12    dismissed complaint;

16-13                (4)  ensure that the person who filed the complaint has

16-14    an opportunity to explain the allegations made in the complaint;

16-15    and

16-16                (5)  prescribe guidelines concerning the categories of

16-17    complaints that require the use of a private investigator and the

16-18    procedures for the advisory committee to obtain the services of a

16-19    private investigator.

16-20          (b)  The department shall dispose of all complaints in a

16-21    timely manner.

16-22          SECTION 19.  DISCIPLINE OF LICENSE HOLDER.  (a)  A license to

16-23    practice naturopathy may be denied or, after notice and hearing,

16-24    suspended, probated, or revoked if the applicant for a license or

16-25    the holder of a license:

 17-1                (1)  uses drugs or intoxicating liquors to an extent

 17-2    that affects the person's professional competence;

 17-3                (2)  obtains or attempts to obtain a license by fraud

 17-4    or deception;

 17-5                (3)  is adjudged mentally incompetent by a court of

 17-6    competent jurisdiction;

 17-7                (4)  practices naturopathy in a manner detrimental to

 17-8    the public health and welfare;

 17-9                (5)  violates this Act or a rule adopted under this

17-10    Act;

17-11                (6)  is convicted of a felony or a crime involving

17-12    moral turpitude; or

17-13                (7)  holds the person out as a physician or surgeon or

17-14    any combination or derivative of those terms unless the person is

17-15    also licensed under the Medical Practice Act (Article 4495b,

17-16    Vernon's Texas Civil Statutes) as a physician or surgeon.

17-17          (b)  If a license suspension is probated, the department may

17-18    require the license holder:

17-19                (1)  to report regularly to the department on matters

17-20    that are the basis of the probation;

17-21                (2)  to limit practice to the areas prescribed by the

17-22    department; or

17-23                (3)  to continue the person's professional education

17-24    until the license holder attains a degree of skill satisfactory to

17-25    the department in those areas that are the basis of the probation.

 18-1          (c)  A person whose application for a license is denied or

 18-2    whose license is suspended or revoked is entitled to a hearing

 18-3    before the department if the person submits a written request to

 18-4    the department.  Hearings are governed by the board rules for a

 18-5    contested hearing and by Chapter 2001, Government Code.

 18-6          SECTION 20.  NATUROPATHIC PHYSICIANS ADVISORY COMMITTEE.  (a)

 18-7    The Naturopathic Physicians Advisory Committee is created as an

 18-8    advisory committee to the board.  The board shall appoint nine

 18-9    members who must have the following qualifications:

18-10                (1)  three must be representatives of the general

18-11    public;

18-12                (2)  two must be physicians licensed in this state;

18-13                (3)  one must be a chiropractor licensed in this state;

18-14    and

18-15                (4)  three must be naturopathic physicians licensed

18-16    under this Act.

18-17          (b)  Members are appointed for staggered terms of six years,

18-18    with three members' terms expiring January 1 of each even-numbered

18-19    year.  If a vacancy occurs on the advisory committee, the board

18-20    shall appoint a person having the appropriate qualifications to

18-21    serve the unexpired part of the term.

18-22          (c)  The advisory committee may adopt rules for the conduct

18-23    of its activities and shall elect a presiding officer from among

18-24    its members.  The advisory committee shall meet at least once each

18-25    calendar year and shall meet at other times at the call of the

 19-1    presiding officer as necessary to transact its business.

 19-2          (d)  The members of the advisory committee may not receive

 19-3    compensation, but a member is entitled to receive the per diem and

 19-4    travel allowance authorized by the General Appropriations Act for

 19-5    state employees.

 19-6          (e)  The advisory committee shall recommend for the

 19-7    consideration of the board rules to implement standards adopted

 19-8    under this Act and perform other duties assigned by the board.

 19-9          (f)  The advisory committee shall recommend for the approval

19-10    of the department examinations required by this Act.

19-11          (g)  A naturopathic physician member of the advisory

19-12    committee may be licensed as a member of another health profession

19-13    regulated or licensed by the state.

19-14          SECTION 21.  CONFORMING AMENDMENT.  Subsection (b), Section

19-15    3.06, Medical Practice Act (Article 4495b, Vernon's Texas Civil

19-16    Statutes), is amended to read as follows:

19-17          (b)  This Act does not apply to:

19-18                (1)  dentists, duly qualified and registered under the

19-19    laws of this state who confine their practice strictly to

19-20    dentistry;

19-21                (2)  duly licensed optometrists who confine their

19-22    practice strictly to optometry as defined by law;

19-23                (3)  duly licensed chiropractors who confine their

19-24    practice strictly to chiropractic as defined by law;

19-25                (4)  registered or professional nurses and licensed

 20-1    vocational nurses registered or licensed under the laws of this

 20-2    state who confine their practice strictly within the provisions of

 20-3    such applicable licensing Acts and the laws of this state;

 20-4                (5)  duly licensed podiatrists who confine their

 20-5    practice strictly to podiatry as defined by law;

 20-6                (6)  duly licensed or certified psychologists who

 20-7    confine their activities or practice strictly to psychology as

 20-8    defined by law;

 20-9                (7)  duly licensed physical therapists who confine

20-10    their activities or practice strictly to physical therapy and who

20-11    are not in violation of any law relating to physical therapy

20-12    practice;

20-13                (8)  commissioned or contract surgeons of the uniformed

20-14    services of the United States or in the Public Health Service in

20-15    the performance of their duties and not engaged in private

20-16    practice;

20-17                (9)  any person furnishing medical assistance in case

20-18    of an emergency or disaster situation if no charge is made for the

20-19    medical assistance;

20-20                (10)  a student in training in a medical school

20-21    approved by the board while performing the duties assigned in the

20-22    course of training, providing the duties are performed under the

20-23    supervision of a licensed practitioner, except that medical

20-24    residents, interns, and fellows shall be required to register and

20-25    be subject to the other applicable provisions of this Act;

 21-1                (11)  a legally qualified physician of another state

 21-2    who is in this state for consultation with physicians licensed in

 21-3    this state but who does not:

 21-4                      (A)  have an office in this state; or

 21-5                      (B)  appoint a place in this state for seeing,

 21-6    examining, or treating patients; [or]

 21-7                (12)  a licensed naturopathic physician who confines

 21-8    the physician's practice strictly to naturopathy as defined by law;

 21-9    or

21-10                (13)  any other activities that the board may designate

21-11    as exempt from the application of this Act.

21-12          SECTION 22.  CONFORMING AMENDMENT.  Subsection (a), Section

21-13    3, Licensed Professional Counselor Act (Article 4512g, Vernon's

21-14    Texas Civil Statutes), is amended to read as follows:

21-15          (a)  Except as provided by Subsection (b) of this section,

21-16    this Act does not apply to:

21-17                (1)  the activities and services of or use of an

21-18    official title by a person employed as a counselor by a federal,

21-19    state, county, or municipal agency or public or private educational

21-20    institution, if the person is performing counseling or

21-21    counseling-related activities within the scope of his employment;

21-22                (2)  the activities and services of a student, intern,

21-23    or trainee in counseling pursuing a course of study in counseling

21-24    in a regionally accredited institution of higher education or

21-25    training institution, if these activities and services constitute a

 22-1    part of the supervised course of study and the person is designated

 22-2    a "counselor intern";

 22-3                (3)  the activities and services of a nonresident

 22-4    rendered not more than 30 days during any year, if the person is

 22-5    authorized to perform the activities and services under the law of

 22-6    the state or country of his residence;

 22-7                (4)  the activities and services of members of other

 22-8    professions licensed or certified by the state, such as physicians,

 22-9    registered nurses, psychologists, licensed [certified] social

22-10    workers, licensed marriage and family therapists, licensed chemical

22-11    dependency counselors, licensed naturopathic physicians, licensed

22-12    physician assistants, licensed occupational therapists, licensed

22-13    optometrists in the evaluation and remediation of learning or

22-14    behavioral disabilities associated with or caused by a defective or

22-15    abnormal condition of vision, Christian Science practitioners who

22-16    are recognized by the Church of Christ Scientist as registered and

22-17    published in the Christian Science Journal, or other recognized

22-18    religious practitioners performing counseling consistent with the

22-19    law of the state, their training, and any code of ethics of their

22-20    professions, if they do not represent themselves by any title or

22-21    description in the manner prescribed by Section 2 of this Act;

22-22                (5)  the activities, services, titles, and descriptions

22-23    of persons licensed to practice law;

22-24                (6)  the activities, services, titles, and descriptions

22-25    of persons employed as professionals or who are volunteers in the

 23-1    practice of counseling for public and private nonprofit

 23-2    organizations or charities who are accountable to the persons'

 23-3    sponsoring organization and do not use the title or hold themselves

 23-4    out to be licensed counselors; or

 23-5                (7)  persons owning, operating, or employed by a

 23-6    certified career counseling service regulated under Chapter 222,

 23-7    Acts of the 70th Legislature, Regular Session, 1987 (Article

 23-8    5221a-8, Vernon's Texas Civil Statutes).

 23-9          SECTION 23.  INITIAL APPOINTMENTS TO ADVISORY COMMITTEE.  In

23-10    appointing the initial naturopathic physician members of the

23-11    Naturopathic Physicians Advisory Committee, the board, in lieu of

23-12    appointing members who are naturopathic physicians licensed under

23-13    this Act, shall appoint three members who are qualified and have

23-14    applied for licenses as naturopathic physicians under this Act.

23-15          SECTION 24.  EFFECTIVE DATE.  This Act takes effect September

23-16    1, 1997.

23-17          SECTION 25.  EMERGENCY.  The importance of this legislation

23-18    and the crowded condition of the calendars in both houses create an

23-19    emergency and an imperative public necessity that the

23-20    constitutional rule requiring bills to be read on three several

23-21    days in each house be suspended, and this rule is hereby suspended.