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

1-24                       (C)  has been approved by the advisory committee

 2-1     after the college was investigated and found to meet education

 2-2     standards equivalent to those established by the accrediting

 2-3     agency.

 2-4                 (3)  "Board" means the Texas Board of Health.

 2-5                 (4)  "Department" means the Texas Department of Health.

 2-6                 (5)  "Diagnose" means to examine in any manner another

 2-7     person, parts of a person's body, or substances, fluids, or

 2-8     materials excreted, taken, or removed from a person's body or

 2-9     produced by a person's body to determine the source, kind, or

2-10     extent of a disease or other physical condition.

2-11                 (6)  "Minor office procedure" means the use of

2-12     operative, electrical, or other methods for the repair and care

2-13     incidental to superficial lacerations and abrasions, the removal of

2-14     foreign bodies located in superficial tissues, and the use of

2-15     antiseptics and local anesthetics in connection with these methods.

2-16     The term includes the use of local anesthesia applied topically or

2-17     by injection, whether natural or prescription, in superficial

2-18     tissues associated with the performance of minor office procedures.

2-19     The term does not include general or spinal anesthesia, major

2-20     surgery, surgery of the body cavities, or specialized surgeries,

2-21     including plastic surgery or surgery involving the eyes, tendons,

2-22     ligaments, or major blood vessels.

2-23                 (7)  "Natural antibiotics" means antimicrobial,

2-24     antifungal, and antiprotozoal agents that are naturally occurring

2-25     substances or manufactured substances that are substantially

2-26     identical to the naturally occurring substances.

2-27                 (8)  "Natural medicines" means food, food extracts,

 3-1     dietary supplements as defined by the Federal Food, Drug, and

 3-2     Cosmetic Act (21 U.S.C. Section 301 et seq.), homeopathic remedies,

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

 3-4     controlled substances, over-the-counter medications, prescriptions

 3-5     that are consistent with the competent practice of naturopathy, and

 3-6     substances prepared according to the official Homoeopathic

 3-7     Pharmacopoeia of the United States.

 3-8                 (9)  "Naturopathic medicine" means a system of primary

 3-9     health care practiced by naturopathic physicians for the

3-10     prevention, evaluation, and care of human health conditions that

3-11     uses education, natural substances, and remedies to support and

3-12     stimulate the individual's intrinsic self-healing processes.

3-13                 (10)  "Naturopathic childbirth" means uncomplicated

3-14     natural childbirth assisted by a naturopathic physician.  The term

3-15     includes the use of natural substances, ophthalmic antibiotics,

3-16     emergency childbirth medicines, and simple, uncomplicated

3-17     episiotomies but does not include the use of forceps delivery,

3-18     general or spinal anesthesia, cesarean section, or induced

3-19     abortion.

3-20                 (11)  "Naturopathic mobilization therapy" means

3-21     manually administering mechanical treatment of body structures or

3-22     tissues for the purpose of restoring normal physiological function

3-23     of the body by normalizing and balancing the musculoskeletal system

3-24     of the body, but the term does not include osseous manipulation.

3-25                 (12)  "Naturopathic physician" means a person who holds

3-26     the person out to the public as licensed to practice naturopathic

3-27     medicine or who practices naturopathic medicine under this Act.

 4-1                 (13)  "Naturopathic physical medicine" means the use of

 4-2     the physical agents of air, water, heat, cold, sound, light, and

 4-3     electromagnetic nonionizing radiation and the physical modalities

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

 4-5     ultrasound, hydrotherapy, naturopathic mobilization therapy, and

 4-6     exercise.  The term does not include the practice of physical

 4-7     therapy, acupuncture, or chiropractic.

 4-8                 (14)  "Practice of naturopathy" means a system of

 4-9     primary health care for the prevention, diagnosis, and care of

4-10     human conditions, injuries, and diseases that uses education,

4-11     natural substances, and natural therapies to support and stimulate

4-12     the patient's intrinsic self-healing processes.

4-13                 (15)  "Topical preparations" means topical analgesics,

4-14     anesthetics, antiseptics, scabicides, antifungals, and

4-15     antibacterials.

4-16           SECTION 3.  AUTHORIZED ACTIVITIES.  (a)  A person licensed as

4-17     a naturopathic physician under this Act may use for preventive and

4-18     therapeutic purposes the following preparations and therapies:

4-19                 (1)  natural medicines;

4-20                 (2)  minor office procedures;

4-21                 (3)  natural antibiotics;

4-22                 (4)  naturopathic medicine;

4-23                 (5)  naturopathic childbirth;

4-24                 (6)  naturopathic mobilization therapy;

4-25                 (7)  topical preparations; and

4-26                 (8)  naturopathic physical medicine.

4-27           (b)  A person licensed as a naturopathic physician under this

 5-1     Act may use for evaluation purposes:

 5-2                 (1)  physical and orificial examinations;

 5-3                 (2)  X-rays;

 5-4                 (3)  electrocardiograms;

 5-5                 (4)  therapeutic ultrasound;

 5-6                 (5)  phlebotomy;

 5-7                 (6)  clinical laboratory tests and examinations;

 5-8                 (7)  physiological function tests; and

 5-9                 (8)  the noninvasive diagnostic procedures commonly

5-10     used in general practice.

5-11           SECTION 4.  POWERS AND DUTIES OF BOARD AND DEPARTMENT.

5-12     (a)  The board, with the advice of the advisory committee, shall

5-13     adopt rules consistent with this Act.

5-14           (b)  The department shall administer this Act, investigate

5-15     violations of this Act, prepare and administer examinations, and

5-16     perform other duties authorized by this Act.

5-17           (c)  The board may adopt rules authorizing the use by

5-18     naturopathic physicians of other evaluative procedures and other

5-19     natural substances, treatments, procedures, and therapies if the

5-20     substances, treatments, procedures, and therapies are taught in

5-21     approved courses of study or used by practitioners licensed by

5-22     other entities of the state and are consistent with this Act.

5-23           (d)  Chapter 2001, Government Code, applies to this Act.

5-24           SECTION 5.  EXCEPTIONS.  This Act does not:

5-25                 (1)  prevent any other professional who is licensed,

5-26     certified, or registered under the laws of this state from

5-27     providing services consistent with the professional's scope of

 6-1     practice;

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

 6-3     enrolled in an approved naturopathic course of study and who

 6-4     gratuitously evaluates and treats human conditions under the direct

 6-5     supervision of a naturopathic physician regulated under the laws of

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

 6-7     practice of the supervising naturopathic physician and are limited

 6-8     to activity consistent with the scope of practice authorized by

 6-9     this Act;

6-10                 (3)  prohibit or restrict a person engaged in the sale

6-11     of vitamins, health foods, dietary supplements, herbs, or other

6-12     products of nature the sale of which is not otherwise prohibited

6-13     under state or federal law;

6-14                 (4)  prohibit a person from providing nutritional

6-15     advice, giving advice concerning proper nutrition, or giving

6-16     information as to the use and role of food and food ingredients,

6-17     including dietary supplements, except that providing nutritional

6-18     advice under this subdivision does not include the authority to

6-19     practice medicine or surgery, to undertake the treatment or cure of

6-20     a disease, pain, injury, deformity, or physical or mental

6-21     condition, or to state that a product might cure a disease, pain,

6-22     injury, deformity, or other condition; or

6-23                 (5)  apply to a naturopathic physician licensed in

6-24     another state, a territory of the United States, or the District of

6-25     Columbia, if the state, territory, or the District of Columbia

6-26     requires credentials equivalent to those of this Act, when the

6-27     physician is incidentally called into this state for consultation

 7-1     with a naturopathic physician licensed in this state.

 7-2           SECTION 6.  PROHIBITED ACTS.  A naturopathic physician may

 7-3     not:

 7-4                 (1)  prescribe, dispense, or administer any legend

 7-5     drugs or controlled substances except those preparations authorized

 7-6     by this Act or board rule;

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

 7-8     except those procedures authorized by this Act or board rule;

 7-9                 (3)  practice emergency care except as a samaritan

7-10     rendering gratuitous services in the case of emergency and except

7-11     for the care of minor injuries; or

7-12                 (4)  claim to practice allopathic medicine or surgery,

7-13     osteopathy, dentistry, podiatry, optometry, chiropractic, physical

7-14     therapy, acupuncture, or any other system or method of treatment

7-15     not authorized by this Act or board rule.

7-16           SECTION 7.  DUTIES AND RESPONSIBILITIES.  A naturopathic

7-17     physician has the same responsibility as any other licensed health

7-18     care provider regarding public health laws, reportable diseases and

7-19     conditions, communicable disease control and prevention, the

7-20     recording of vital statistics, health and physical examinations,

7-21     competency examinations, and local boards of health, except that

7-22     the authority under this section is limited to activity consistent

7-23     with the scope of practice authorized by this Act or board rule.

7-24           SECTION 8.  LICENSE QUALIFICATIONS.  (a)  A person is

7-25     qualified to be licensed as a naturopathic physician if the person:

7-26                 (1)  completes and submits to the department an

7-27     application accompanied by the appropriate fees;

 8-1                 (2)  is a graduate of an approved naturopathic college;

 8-2                 (3)  has passed an examination prescribed or endorsed

 8-3     by the advisory committee covering the appropriate naturopathic

 8-4     subjects; and

 8-5                 (4)  is of good moral character.

 8-6           (b)  A person is qualified to be licensed as a naturopathic

 8-7     physician without examination if:

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

 8-9     in another state, a territory of the United States, or the District

8-10     of Columbia under conditions and circumstances that the board finds

8-11     to be comparable to the requirements of this state for obtaining a

8-12     license to practice naturopathy and the state, the territory, or

8-13     the District of Columbia requires the successful completion of a

8-14     professional examination for the issuance of a license;

8-15                 (2)  the applicant has graduated from an approved

8-16     naturopathic college or, if the applicant was licensed before a

8-17     date designated by board rule, the applicant graduated from a

8-18     college approved by the advisory committee after the college was

8-19     investigated and found to meet the acceptable education standards

8-20     in existence at the time of the applicant's graduation; and

8-21                 (3)  the applicant produces evidence satisfactory to

8-22     the advisory committee that the applicant holds a valid,

8-23     unsuspended, and unrevoked license, has been actively engaged in

8-24     the practice of naturopathy for not less than one year, and is of

8-25     good moral character.

8-26           (c)  A person may sit for the examination prescribed or

8-27     endorsed by the advisory committee under Subsection (a) of this

 9-1     section and be eligible for licensure as a naturopathic physician

 9-2     on the passage of the examination if, before December 1, 1997, the

 9-3     person files a license application, pays the required fees, and

 9-4     submits proof to the department that the person:

 9-5                 (1)  attended a naturopathic college and received a

 9-6     doctorate degree in naturopathy from the college before January 1,

 9-7     1997, and the college is subsequently approved by the advisory

 9-8     committee;

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

9-10     and that that practice included providing health care services

9-11     using natural medicines or therapies to patients in this state on a

9-12     regular and ongoing basis; and

9-13                 (3)  is of good moral character.

9-14           (d)  A person is qualified to be licensed under this Act

9-15     without taking the examination or meeting the requirements of

9-16     Subsections (a) and (b) of this section if the person:

9-17                 (1)  is a resident of the state;

9-18                 (2)  is 21 years of age or older;

9-19                 (3)  provides proof acceptable to the advisory

9-20     committee that the person has been actively engaged in naturopathic

9-21     health care and has held the person out to the public as a

9-22     naturopathic physician for at least three years before January 1,

9-23     1999, or has accumulated not less than 3,080 patient contact hours

9-24     before January 1, 1999;

9-25                 (4)  is not licensed as a physician or chiropractor;

9-26                 (5)  derives the majority of the person's earned income

9-27     from the practice of naturopathy; and

 10-1                (6)  applies for a license under this subsection before

 10-2    January 1, 1999.

 10-3          (e)  A person licensed under Subsection (d) of this section

 10-4    may:

 10-5                (1)  use the title "naturopathic physician" and any

 10-6    other title permitted under Subsection (a) of Section 16 of this

 10-7    Act; and

 10-8                (2)  practice naturopathy only within the scope of

 10-9    practice that reflects the limits of the person's training and

10-10    experience.

10-11          (f)  The board may adopt rules providing for limitations on

10-12    the practice of a person licensed under Subsection (d) of this

10-13    section. The board may not require a person licensed under

10-14    Subsection (d) of this section to be identified as a person whose

10-15    practice is limited.

10-16          SECTION 9.  EXAMINATION.  (a)  The advisory committee may

10-17    prescribe a nationally developed standard examination as part or

10-18    all of the examination prescribed or endorsed under Subsection (a)

10-19    of Section 8 of this Act.  The board by rule shall determine the

10-20    passing criteria for the examination.  The board may adopt other

10-21    rules necessary to the administration of the examination.

10-22          (b)  The board shall set the fees for the examination,

10-23    reexamination of the entire examination, and reexamination of

10-24    separate components of the examination in amounts necessary to

10-25    cover the actual cost of the examination and the expenses of

10-26    administration.

10-27          SECTION 10.  LICENSE FEES.  The board by rule shall adopt an

 11-1    initial licensing fee and annual renewal fees.  Fees adopted under

 11-2    this section shall be in amounts necessary to cover the costs of

 11-3    administering this Act.

 11-4          SECTION 11.  LICENSE RENEWAL.  (a)  A license to practice as

 11-5    a naturopathic physician must be renewed annually.

 11-6          (b)  To renew a license, each naturopathic physician must

 11-7    submit to the department evidence of successful completion of the

 11-8    required hours of continuing education from programs approved by

 11-9    the board.

11-10          (c)  The board shall adopt rules as to what constitutes an

11-11    approved program of continuing education and the manner in which

11-12    attendance at all approved courses, clinics, forums, lectures,

11-13    programs, or seminars is monitored, recorded, and submitted to the

11-14    department.

11-15          (d)  The board may adopt other rules necessary to the

11-16    administration of license renewals.

11-17          SECTION 12.  CONTINUING EDUCATION.  (a)  The total number of

11-18    required continuing education hours for all naturopathic physicians

11-19    is not less than 15 approved hours annually.  The number and type

11-20    of required continuing education hours for a naturopathic physician

11-21    certified in naturopathic childbirth is not less than 15 approved

11-22    specialty hours in obstetrics or natural childbirth and not less

11-23    than 20 approved hours biennially for a total of not less than 35

11-24    approved hours biennially.

11-25          (b)  A person who seeks to renew a license that expired

11-26    within the preceding year must comply with the continuing education

11-27    requirements for the regular renewal of the license.  A person

 12-1    seeking to renew a license that has been expired for more than one

 12-2    year must present evidence of completion of not less than one-half

 12-3    of the required hours of approved continuing education requirements

 12-4    during the year preceding the date of the application for renewal.

 12-5          SECTION 13.  INACTIVE STATUS; RETIRED STATUS.  (a)  A license

 12-6    holder seeking to place the person's license on inactive status

 12-7    must notify the department at the time of renewal and pay a fee for

 12-8    inactive status.

 12-9          (b)  To activate a license on inactive status, the license

12-10    holder must pay the regular renewal fee and present evidence of

12-11    having completed not less than one-half of the required hours of

12-12    approved continuing education requirements during the year

12-13    preceding the date of the application for activation.

12-14          (c)  A license holder seeking to place a license on retired

12-15    status must notify the department at the time of renewal.  A

12-16    license on retired status may not be reactivated.

12-17          (d)  A license holder who holds a license that is on inactive

12-18    or retired status may not practice naturopathic medicine.

12-19          SECTION 14.  SPECIALTY PRACTICE.  (a)  A naturopathic

12-20    physician may not practice naturopathic childbirth without

12-21    obtaining a certificate of specialty practice in naturopathic

12-22    childbirth.  The board shall adopt rules to certify naturopathic

12-23    physicians for specialty practice.

12-24          (b)  To be certified in naturopathic childbirth, a

12-25    naturopathic physician must:

12-26                (1)  pass a specialty examination in obstetrics or

12-27    natural childbirth approved by the advisory committee; and

 13-1                (2)  comply with the requirements adopted by the board

 13-2    for issuance of the specialty certification that are equivalent to

 13-3    the minimum requirements, including any examination requirements,

 13-4    to obtain a license to practice midwifery in this state.

 13-5          (c)  The advisory committee may prescribe a national

 13-6    standardized examination in obstetrics or natural childbirth as

 13-7    constituting the specialty examination.

 13-8          SECTION 15.  USE OF X-RAY.  A naturopathic physician licensed

 13-9    under this Act may use an X-ray in the course of the person's

13-10    practice only if the person is certified by the board as qualified

13-11    to perform X-ray procedures.  The board shall adopt rules for the

13-12    issuance of a certification under this section that are equivalent

13-13    to the requirements for other health professionals to engage in the

13-14    use of X-rays.

13-15          SECTION 16.  USE OF TITLES; PENALTY; INJUNCTION.  (a)  A

13-16    naturopathic physician may use the title "naturopathic physician"

13-17    and the recognized abbreviation for the professional degree of

13-18    "N.D."  A naturopathic physician has the exclusive right to use the

13-19    terms "naturopathic physician," "doctor of naturopathic medicine,"

13-20    "doctor of naturopathy," "naturopathy," and "N.D."

13-21          (b)  A person commits an offense if the person holds the

13-22    person out as a naturopathic physician, suggests that the person

13-23    practices naturopathic medicine, or uses the terms and abbreviation

13-24    described by Subsection (a) of this section without holding a

13-25    license or while the person is on retired or inactive status under

13-26    this Act.

13-27          (c)  An offense under Subsection (b) of this section is a

 14-1    felony of the third degree.

 14-2          (d)  A person who violates this section may be enjoined by

 14-3    the district court on petition by the board.

 14-4          SECTION 17.  COMPLAINT PROCEDURE IN GENERAL.  (a)  The

 14-5    department shall keep an information file about each complaint

 14-6    filed with the department.  The department's information file shall

 14-7    be kept current and contain a record for each complaint of:

 14-8                (1)  all persons contacted in relation to the

 14-9    complaint;

14-10                (2)  a summary of findings made at each step of the

14-11    complaint process;

14-12                (3)  an explanation of the legal basis and reason for a

14-13    complaint that is dismissed; and

14-14                (4)  other relevant information.

14-15          (b)  If a written complaint is filed with the department that

14-16    the department has authority to resolve, the department, at least

14-17    as frequently as quarterly and until final disposition of the

14-18    complaint, shall notify the parties to the complaint of the status

14-19    of the complaint unless the notice would jeopardize an undercover

14-20    investigation.

14-21          (c)  The board by rule shall adopt a form to standardize

14-22    information concerning complaints made to the department.  The

14-23    board by rule shall prescribe information to be provided to a

14-24    person when the person files a complaint with the department.

14-25          (d)  The department shall provide reasonable assistance to a

14-26    person who wishes to file a complaint with the department.

14-27          SECTION 18.  COMPLAINT INVESTIGATION AND DISPOSITION.

 15-1    (a)  The board shall adopt rules concerning the investigation of a

 15-2    complaint filed with the department.  The rules adopted under this

 15-3    subsection shall:

 15-4                (1)  distinguish between categories of complaints;

 15-5                (2)  ensure that complaints are not dismissed without

 15-6    appropriate consideration;

 15-7                (3)  require that the advisory committee be advised of

 15-8    a complaint that is dismissed and that a letter be sent to the

 15-9    person who filed the complaint explaining the action taken on the

15-10    dismissed complaint;

15-11                (4)  ensure that the person who filed the complaint has

15-12    an opportunity to explain the allegations made in the complaint;

15-13    and

15-14                (5)  prescribe guidelines concerning the categories of

15-15    complaints that require the use of a private investigator and the

15-16    procedures for the advisory committee to obtain the services of a

15-17    private investigator.

15-18          (b)  The department shall dispose of all complaints in a

15-19    timely manner.

15-20          SECTION 19.  DISCIPLINE OF LICENSE HOLDER.  (a)  A license to

15-21    practice naturopathy may be denied or, after notice and hearing,

15-22    suspended, probated, or revoked if the applicant for a license or

15-23    the holder of a license:

15-24                (1)  uses drugs or intoxicating liquors to an extent

15-25    that affects the person's professional competence;

15-26                (2)  obtains or attempts to obtain a license by fraud

15-27    or deception;

 16-1                (3)  is adjudged mentally incompetent by a court of

 16-2    competent jurisdiction;

 16-3                (4)  practices naturopathy in a manner detrimental to

 16-4    the public health and welfare;

 16-5                (5)  violates this Act or a rule adopted under this

 16-6    Act;

 16-7                (6)  is convicted of a felony or a crime involving

 16-8    moral turpitude; or

 16-9                (7)  holds the person out as a physician or surgeon or

16-10    any combination or derivative of those terms unless the person is

16-11    also licensed under the Medical Practice Act (Article 4495b,

16-12    Vernon's Texas Civil Statutes) as a physician or surgeon.

16-13          (b)  If a license suspension is probated, the department may

16-14    require the license holder:

16-15                (1)  to report regularly to the department on matters

16-16    that are the basis of the probation;

16-17                (2)  to limit practice to the areas prescribed by the

16-18    department; or

16-19                (3)  to continue the person's professional education

16-20    until the license holder attains a degree of skill satisfactory to

16-21    the department in those areas that are the basis of the probation.

16-22          (c)  A person whose application for a license is denied or

16-23    whose license is suspended or revoked is entitled to a hearing

16-24    before the department if the person submits a written request to

16-25    the department.  Hearings are governed by the board rules for a

16-26    contested hearing and by Chapter 2001, Government Code.

16-27          SECTION 20.  NATUROPATHIC PHYSICIANS ADVISORY COMMITTEE.  (a)

 17-1    The Naturopathic Physicians Advisory Committee is created as an

 17-2    advisory committee to the board.  The board shall appoint nine

 17-3    members who must have the following qualifications:

 17-4                (1)  three must be representatives of the general

 17-5    public;

 17-6                (2)  two must be physicians licensed in this state;

 17-7                (3)  one must be a chiropractor licensed in this state;

 17-8    and

 17-9                (4)  three must be naturopathic physicians licensed

17-10    under this Act.

17-11          (b)  Members are appointed for staggered terms of six years,

17-12    with three members' terms expiring January 1 of each even-numbered

17-13    year.  If a vacancy occurs on the advisory committee, the board

17-14    shall appoint a person having the appropriate qualifications to

17-15    serve the unexpired part of the term.

17-16          (c)  The advisory committee may adopt rules for the conduct

17-17    of its activities and shall elect a presiding officer from among

17-18    its members.  The advisory committee shall meet at least once each

17-19    calendar year and shall meet at other times at the call of the

17-20    presiding officer as necessary to transact its business.

17-21          (d)  The members of the advisory committee may not receive

17-22    compensation, but a member is entitled to receive the per diem and

17-23    travel allowance authorized by the General Appropriations Act for

17-24    state employees.

17-25          (e)  The advisory committee shall recommend for the

17-26    consideration of the board rules to implement standards adopted

17-27    under this Act and perform other duties assigned by the board.

 18-1          (f)  The advisory committee shall recommend for the approval

 18-2    of the department examinations required by this Act.

 18-3          (g)  A naturopathic physician member of the advisory

 18-4    committee may be licensed as a member of another health profession

 18-5    regulated or licensed by the state.

 18-6          SECTION 21.  CONFORMING AMENDMENT.  Subsection (b), Section

 18-7    3.06, Medical Practice Act (Article 4495b, Vernon's Texas Civil

 18-8    Statutes), is amended to read as follows:

 18-9          (b)  This Act does not apply to:

18-10                (1)  dentists, duly qualified and registered under the

18-11    laws of this state who confine their practice strictly to

18-12    dentistry;

18-13                (2)  duly licensed optometrists who confine their

18-14    practice strictly to optometry as defined by law;

18-15                (3)  duly licensed chiropractors who confine their

18-16    practice strictly to chiropractic as defined by law;

18-17                (4)  registered or professional nurses and licensed

18-18    vocational nurses registered or licensed under the laws of this

18-19    state who confine their practice strictly within the provisions of

18-20    such applicable licensing Acts and the laws of this state;

18-21                (5)  duly licensed podiatrists who confine their

18-22    practice strictly to podiatry as defined by law;

18-23                (6)  duly licensed or certified psychologists who

18-24    confine their activities or practice strictly to psychology as

18-25    defined by law;

18-26                (7)  duly licensed physical therapists who confine

18-27    their activities or practice strictly to physical therapy and who

 19-1    are not in violation of any law relating to physical therapy

 19-2    practice;

 19-3                (8)  commissioned or contract surgeons of the uniformed

 19-4    services of the United States or in the Public Health Service in

 19-5    the performance of their duties and not engaged in private

 19-6    practice;

 19-7                (9)  any person furnishing medical assistance in case

 19-8    of an emergency or disaster situation if no charge is made for the

 19-9    medical assistance;

19-10                (10)  a student in training in a medical school

19-11    approved by the board while performing the duties assigned in the

19-12    course of training, providing the duties are performed under the

19-13    supervision of a licensed practitioner, except that medical

19-14    residents, interns, and fellows shall be required to register and

19-15    be subject to the other applicable provisions of this Act;

19-16                (11)  a legally qualified physician of another state

19-17    who is in this state for consultation with physicians licensed in

19-18    this state but who does not:

19-19                      (A)  have an office in this state; or

19-20                      (B)  appoint a place in this state for seeing,

19-21    examining, or treating patients; [or]

19-22                (12)  a licensed naturopathic physician who confines

19-23    the physician's practice strictly to naturopathy as defined by law;

19-24    or

19-25                (13)  any other activities that the board may designate

19-26    as exempt from the application of this Act.

19-27          SECTION 22.  CONFORMING AMENDMENT.  Subsection (a), Section

 20-1    3, Licensed Professional Counselor Act (Article 4512g, Vernon's

 20-2    Texas Civil Statutes), is amended to read as follows:

 20-3          (a)  Except as provided by Subsection (b) of this section,

 20-4    this Act does not apply to:

 20-5                (1)  the activities and services of or use of an

 20-6    official title by a person employed as a counselor by a federal,

 20-7    state, county, or municipal agency or public or private educational

 20-8    institution, if the person is performing counseling or

 20-9    counseling-related activities within the scope of his employment;

20-10                (2)  the activities and services of a student, intern,

20-11    or trainee in counseling pursuing a course of study in counseling

20-12    in a regionally accredited institution of higher education or

20-13    training institution, if these activities and services constitute a

20-14    part of the supervised course of study and the person is designated

20-15    a "counselor intern";

20-16                (3)  the activities and services of a nonresident

20-17    rendered not more than 30 days during any year, if the person is

20-18    authorized to perform the activities and services under the law of

20-19    the state or country of his residence;

20-20                (4)  the activities and services of members of other

20-21    professions licensed or certified by the state, such as physicians,

20-22    registered nurses, psychologists, licensed [certified] social

20-23    workers, licensed marriage and family therapists, licensed chemical

20-24    dependency counselors, licensed naturopathic physicians, licensed

20-25    physician assistants, licensed occupational therapists, licensed

20-26    optometrists in the evaluation and remediation of learning or

20-27    behavioral disabilities associated with or caused by a defective or

 21-1    abnormal condition of vision, Christian Science practitioners who

 21-2    are recognized by the Church of Christ Scientist as registered and

 21-3    published in the Christian Science Journal, or other recognized

 21-4    religious practitioners performing counseling consistent with the

 21-5    law of the state, their training, and any code of ethics of their

 21-6    professions, if they do not represent themselves by any title or

 21-7    description in the manner prescribed by Section 2 of this Act;

 21-8                (5)  the activities, services, titles, and descriptions

 21-9    of persons licensed to practice law;

21-10                (6)  the activities, services, titles, and descriptions

21-11    of persons employed as professionals or who are volunteers in the

21-12    practice of counseling for public and private nonprofit

21-13    organizations or charities who are accountable to the persons'

21-14    sponsoring organization and do not use the title or hold themselves

21-15    out to be licensed counselors; or

21-16                (7)  persons owning, operating, or employed by a

21-17    certified career counseling service regulated under Chapter 222,

21-18    Acts of the 70th Legislature, Regular Session, 1987 (Article

21-19    5221a-8, Vernon's Texas Civil Statutes).

21-20          SECTION 23.  INITIAL APPOINTMENTS TO ADVISORY COMMITTEE.  In

21-21    appointing the initial naturopathic physician members of the

21-22    Naturopathic Physicians Advisory Committee, the board, in lieu of

21-23    appointing members who are naturopathic physicians licensed under

21-24    this Act, shall appoint three members who are qualified and have

21-25    applied for licenses as naturopathic physicians under this Act.

21-26          SECTION 24.  EFFECTIVE DATE.  This Act takes effect September

21-27    1, 1997.

 22-1          SECTION 25.  EMERGENCY.  The importance of this legislation

 22-2    and the crowded condition of the calendars in both houses create an

 22-3    emergency and an imperative public necessity that the

 22-4    constitutional rule requiring bills to be read on three several

 22-5    days in each house be suspended, and this rule is hereby suspended.