1-1 By: Luna, Moncrief S.B. No. 257
1-2 (In the Senate - Filed January 21, 1997; January 27, 1997,
1-3 read first time and referred to Committee on Health and Human
1-4 Services; April 28, 1997, reported adversely, with favorable
1-5 Committee Substitute by the following vote: Yeas 8, Nays 1;
1-6 April 28, 1997, sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 257 By: Nelson
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the regulation of the practice of naturopathic
1-11 medicine; providing penalties.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. PURPOSE. The legislature finds that a
1-14 significant number of the citizens of this state are turning to
1-15 naturopathic physicians for their health care needs and declares
1-16 that naturopathic medicine is a distinct health care profession
1-17 that affects the public health, safety, and welfare and provides
1-18 the public with freedom of choice in health care. The purpose of
1-19 this Act is to provide standards for the licensing and regulation
1-20 of naturopathic medicine to protect the public health, safety, and
1-21 welfare and to provide a means of identifying qualified
1-22 naturopathic physicians.
1-23 SECTION 2. DEFINITIONS. In this Act:
1-24 (1) "Advisory committee" means the Naturopathic
1-25 Physicians Advisory Committee.
1-26 (2) "Approved naturopathic college" means a college
1-27 granting the degree of doctor of naturopathy, doctor of
1-28 naturopathic health care, or doctor of naturopathic medicine that:
1-29 (A) is accredited by an agency recognized by the
1-30 federal government or approved by the board;
1-31 (B) has candidate-for-accreditation status with
1-32 the accrediting agency; or
1-33 (C) has been approved by the advisory committee
1-34 after the college was investigated and found to meet education
1-35 standards equivalent to those established by the accrediting
1-36 agency.
1-37 (3) "Board" means the Texas Board of Health.
1-38 (4) "Department" means the Texas Department of Health.
1-39 (5) "Diagnose" means to examine in any manner another
1-40 person, parts of a person's body, or substances, fluids, or
1-41 materials excreted, taken, or removed from a person's body or
1-42 produced by a person's body to determine the source, kind, or
1-43 extent of a disease or other physical condition.
1-44 (6) "Minor office procedure" means the use of
1-45 operative, electrical, or other methods for the repair and care
1-46 incidental to superficial lacerations and abrasions, the removal of
1-47 foreign bodies located in superficial tissues, and the use of
1-48 antiseptics and local anesthetics in connection with these methods.
1-49 The term includes the use of local anesthesia applied topically or
1-50 by injection, whether natural or prescription, in superficial
1-51 tissues associated with the performance of minor office procedures.
1-52 The term does not include general or spinal anesthesia, major
1-53 surgery, surgery of the body cavities, or specialized surgeries,
1-54 including plastic surgery or surgery involving the eyes, tendons,
1-55 ligaments, or major blood vessels.
1-56 (7) "Natural antibiotics" means antimicrobial,
1-57 antifungal, and antiprotozoal agents that are naturally occurring
1-58 substances or manufactured substances that are substantially
1-59 identical to the naturally occurring substances.
1-60 (8) "Natural medicines" means food, food extracts,
1-61 dietary supplements as defined by the Federal Food, Drug, and
1-62 Cosmetic Act (21 U.S.C. Section 301 et seq.), homeopathic remedies,
1-63 plant substances that are not designated as prescription drugs or
1-64 controlled substances, over-the-counter medications, prescriptions
2-1 that are consistent with the competent practice of naturopathy, and
2-2 substances prepared according to the official Homoeopathic
2-3 Pharmacopoeia of the United States.
2-4 (9) "Naturopathic medicine" means a system of primary
2-5 health care practiced by naturopathic physicians for the
2-6 prevention, evaluation, and care of human health conditions that
2-7 uses education, natural substances, and remedies to support and
2-8 stimulate the individual's intrinsic self-healing processes.
2-9 (10) "Naturopathic childbirth" means uncomplicated
2-10 natural childbirth assisted by a naturopathic physician. The term
2-11 includes the use of natural substances, ophthalmic antibiotics,
2-12 emergency childbirth medicines, and simple, uncomplicated
2-13 episiotomies but does not include the use of forceps delivery,
2-14 general or spinal anesthesia, cesarean section, or induced
2-15 abortion.
2-16 (11) "Naturopathic mobilization therapy" means
2-17 manually administering mechanical treatment of body structures or
2-18 tissues for the purpose of restoring normal physiological function
2-19 of the body by normalizing and balancing the musculoskeletal system
2-20 of the body, but the term does not include osseous manipulation.
2-21 (12) "Naturopathic physician" means a person who holds
2-22 the person out to the public as licensed to practice naturopathic
2-23 medicine or who practices naturopathic medicine under this Act.
2-24 (13) "Naturopathic physical medicine" means the use of
2-25 the physical agents of air, water, heat, cold, sound, light, and
2-26 electromagnetic nonionizing radiation and the physical modalities
2-27 of electrotherapy, biofeedback, diathermy, ultraviolet light,
2-28 ultrasound, hydrotherapy, naturopathic mobilization therapy, and
2-29 exercise. The term does not include the practice of physical
2-30 therapy, acupuncture, or chiropractic.
2-31 (14) "Practice of naturopathy" means a system of
2-32 primary health care for the prevention, diagnosis, and care of
2-33 human conditions, injuries, and diseases that uses education,
2-34 natural substances, and natural therapies to support and stimulate
2-35 the patient's intrinsic self-healing processes.
2-36 (15) "Topical preparations" means topical analgesics,
2-37 anesthetics, antiseptics, scabicides, antifungals, and
2-38 antibacterials.
2-39 SECTION 3. AUTHORIZED ACTIVITIES. (a) A person licensed as
2-40 a naturopathic physician under this Act may use for preventive and
2-41 therapeutic purposes the following preparations and therapies:
2-42 (1) natural medicines;
2-43 (2) minor office procedures;
2-44 (3) natural antibiotics;
2-45 (4) naturopathic medicine;
2-46 (5) naturopathic childbirth;
2-47 (6) naturopathic mobilization therapy;
2-48 (7) topical preparations; and
2-49 (8) naturopathic physical medicine.
2-50 (b) A person licensed as a naturopathic physician under this
2-51 Act may use for evaluation purposes:
2-52 (1) physical and orificial examinations;
2-53 (2) X-rays;
2-54 (3) electrocardiograms;
2-55 (4) therapeutic ultrasound;
2-56 (5) phlebotomy;
2-57 (6) clinical laboratory tests and examinations;
2-58 (7) physiological function tests; and
2-59 (8) the noninvasive diagnostic procedures commonly
2-60 used in general practice.
2-61 SECTION 4. POWERS AND DUTIES OF BOARD AND DEPARTMENT.
2-62 (a) The board, with the advice of the advisory committee, shall
2-63 adopt rules consistent with this Act.
2-64 (b) The department shall administer this Act, investigate
2-65 violations of this Act, prepare and administer examinations, and
2-66 perform other duties authorized by this Act.
2-67 (c) The board may adopt rules authorizing the use by
2-68 naturopathic physicians of other evaluative procedures and other
2-69 natural substances, treatments, procedures, and therapies if the
3-1 substances, treatments, procedures, and therapies are taught in
3-2 approved courses of study or used by practitioners licensed by
3-3 other entities of the state and are consistent with this Act.
3-4 (d) Chapter 2001, Government Code, applies to this Act.
3-5 SECTION 5. EXCEPTIONS. This Act does not:
3-6 (1) prevent any other professional who is licensed,
3-7 certified, or registered under the laws of this state from
3-8 providing services consistent with the professional's scope of
3-9 practice;
3-10 (2) apply to a student of naturopathy who is currently
3-11 enrolled in an approved naturopathic course of study and who
3-12 gratuitously evaluates and treats human conditions under the direct
3-13 supervision of a naturopathic physician regulated under the laws of
3-14 this state if the student's activities are within the scope of
3-15 practice of the supervising naturopathic physician and are limited
3-16 to activity consistent with the scope of practice authorized by
3-17 this Act;
3-18 (3) prohibit or restrict a person engaged in the sale
3-19 of vitamins, health foods, dietary supplements, herbs, or other
3-20 products of nature the sale of which is not otherwise prohibited
3-21 under state or federal law;
3-22 (4) prohibit a person from providing nutritional
3-23 advice, giving advice concerning proper nutrition, or giving
3-24 information as to the use and role of food and food ingredients,
3-25 including dietary supplements, except that providing nutritional
3-26 advice under this subdivision does not include the authority to
3-27 practice medicine or surgery, to undertake the prevention,
3-28 treatment, or cure of a disease, pain, injury, deformity, or
3-29 physical or mental condition, or to state that a product might cure
3-30 a disease, pain, injury, deformity, or other condition; or
3-31 (5) apply to a naturopathic physician licensed in
3-32 another state, a territory of the United States, or the District of
3-33 Columbia, if the state, territory, or the District of Columbia
3-34 requires credentials equivalent to those of this Act, when the
3-35 physician is incidentally called into this state for consultation
3-36 with a naturopathic physician licensed in this state.
3-37 SECTION 6. PROHIBITED ACTS. A naturopathic physician may
3-38 not:
3-39 (1) prescribe, dispense, or administer any legend
3-40 drugs or controlled substances except those preparations authorized
3-41 by this Act or board rule;
3-42 (2) perform surgical procedures or X-ray procedures
3-43 except those procedures authorized by this Act or board rule;
3-44 (3) practice emergency care except as a samaritan
3-45 rendering gratuitous services in the case of emergency and except
3-46 for the care of minor injuries; or
3-47 (4) claim to practice allopathic medicine or surgery,
3-48 osteopathy, dentistry, podiatry, optometry, chiropractic, physical
3-49 therapy, acupuncture, or any other system or method of treatment
3-50 not authorized by this Act or board rule.
3-51 SECTION 7. DUTIES AND RESPONSIBILITIES. A naturopathic
3-52 physician has the same responsibility as any other licensed health
3-53 care provider regarding public health laws, reportable diseases and
3-54 conditions, communicable disease control and prevention, the
3-55 recording of vital statistics, health and physical examinations,
3-56 competency examinations, and local boards of health, except that
3-57 the authority under this section is limited to activity consistent
3-58 with the scope of practice authorized by this Act or board rule.
3-59 SECTION 8. LICENSE QUALIFICATIONS. (a) A person is
3-60 qualified to be licensed as a naturopathic physician if the person:
3-61 (1) completes and submits to the department an
3-62 application accompanied by the appropriate fees;
3-63 (2) is a graduate of an approved naturopathic college;
3-64 (3) has passed an examination prescribed or endorsed
3-65 by the advisory committee covering the appropriate naturopathic
3-66 subjects; and
3-67 (4) is of good moral character.
3-68 (b) A person is qualified to be licensed as a naturopathic
3-69 physician without examination if:
4-1 (1) the applicant is licensed to practice naturopathy
4-2 in another state, a territory of the United States, or the District
4-3 of Columbia under conditions and circumstances that the board finds
4-4 to be comparable to the requirements of this state for obtaining a
4-5 license to practice naturopathy and the state, the territory, or
4-6 the District of Columbia requires the successful completion of a
4-7 professional examination for the issuance of a license;
4-8 (2) the applicant has graduated from an approved
4-9 naturopathic college or, if the applicant was licensed before a
4-10 date designated by board rule, the applicant graduated from a
4-11 college approved by the advisory committee after the college was
4-12 investigated and found to meet the acceptable education standards
4-13 in existence at the time of the applicant's graduation; and
4-14 (3) the applicant produces evidence satisfactory to
4-15 the advisory committee that the applicant holds a valid,
4-16 unsuspended, and unrevoked license, has been actively engaged in
4-17 the practice of naturopathy for not less than one year, and is of
4-18 good moral character.
4-19 (c) A person may sit for the examination prescribed or
4-20 endorsed by the advisory committee under Subsection (a) of this
4-21 section and be eligible for licensure as a naturopathic physician
4-22 on the passage of the examination if, before December 1, 1997, the
4-23 person files a license application, pays the required fees, and
4-24 submits proof to the department that the person:
4-25 (1) attended a naturopathic college and received a
4-26 doctorate degree in naturopathy from the college before January 1,
4-27 1997, and the college is subsequently approved by the advisory
4-28 committee;
4-29 (2) was in practice in this state before May 1, 1997,
4-30 and that that practice included providing health care services
4-31 using natural medicines or therapies to patients in this state on a
4-32 regular and ongoing basis; and
4-33 (3) is of good moral character.
4-34 (d) A person is qualified to be licensed under this Act
4-35 without taking the examination or meeting the requirements of
4-36 Subsections (a) and (b) of this section if the person:
4-37 (1) is a resident of the state;
4-38 (2) is 21 years of age or older;
4-39 (3) provides proof acceptable to the advisory
4-40 committee that the person has been actively engaged in naturopathic
4-41 health care and has held the person out to the public as a
4-42 naturopathic physician for at least three years before January 1,
4-43 1999, or has accumulated not less than 3,080 patient contact hours
4-44 before January 1, 1999;
4-45 (4) is not licensed as a physician or chiropractor;
4-46 (5) derives the majority of the person's earned income
4-47 from the practice of naturopathy; and
4-48 (6) applies for a license under this subsection before
4-49 January 1, 1999.
4-50 (e) A person licensed under Subsection (d) of this section
4-51 may:
4-52 (1) use the title "naturopathic physician" and any
4-53 other title permitted under Subsection (a) of Section 16 of this
4-54 Act; and
4-55 (2) practice naturopathy only within the scope of
4-56 practice that reflects the limits of the person's training and
4-57 experience.
4-58 (f) The board may adopt rules providing for limitations on
4-59 the practice of a person licensed under Subsection (d) of this
4-60 section. The board may not require a person licensed under
4-61 Subsection (d) of this section to be identified as a person whose
4-62 practice is limited.
4-63 SECTION 9. EXAMINATION. (a) The advisory committee may
4-64 prescribe a nationally developed standard examination as part or
4-65 all of the examination prescribed or endorsed under Subsection (a)
4-66 of Section 8 of this Act. The board by rule shall determine the
4-67 passing criteria for the examination. The board may adopt other
4-68 rules necessary to the administration of the examination.
4-69 (b) The board shall set the fees for the examination,
5-1 reexamination of the entire examination, and reexamination of
5-2 separate components of the examination in amounts necessary to
5-3 cover the actual cost of the examination and the expenses of
5-4 administration.
5-5 SECTION 10. LICENSE FEES. The board by rule shall adopt an
5-6 initial licensing fee and annual renewal fees. Fees adopted under
5-7 this section shall be in amounts necessary to cover the costs of
5-8 administering this Act.
5-9 SECTION 11. LICENSE RENEWAL. (a) A license to practice as
5-10 a naturopathic physician must be renewed annually.
5-11 (b) To renew a license, each naturopathic physician must
5-12 submit to the department evidence of successful completion of the
5-13 required hours of continuing education from programs approved by
5-14 the board.
5-15 (c) The board shall adopt rules as to what constitutes an
5-16 approved program of continuing education and the manner in which
5-17 attendance at all approved courses, clinics, forums, lectures,
5-18 programs, or seminars is monitored, recorded, and submitted to the
5-19 department.
5-20 (d) The board may adopt other rules necessary to the
5-21 administration of license renewals.
5-22 SECTION 12. CONTINUING EDUCATION. (a) The total number of
5-23 required continuing education hours for all naturopathic physicians
5-24 is not less than 15 approved hours annually. The number and type
5-25 of required continuing education hours for a naturopathic physician
5-26 certified in naturopathic childbirth is not less than 15 approved
5-27 specialty hours in obstetrics or natural childbirth and not less
5-28 than 20 approved hours biennially for a total of not less than 35
5-29 approved hours biennially.
5-30 (b) A person who seeks to renew a license that expired
5-31 within the preceding year must comply with the continuing education
5-32 requirements for the regular renewal of the license. A person
5-33 seeking to renew a license that has been expired for more than one
5-34 year must present evidence of completion of not less than one-half
5-35 of the required hours of approved continuing education requirements
5-36 during the year preceding the date of the application for renewal.
5-37 SECTION 13. INACTIVE STATUS; RETIRED STATUS. (a) A license
5-38 holder seeking to place the person's license on inactive status
5-39 must notify the department at the time of renewal and pay a fee for
5-40 inactive status.
5-41 (b) To activate a license on inactive status, the license
5-42 holder must pay the regular renewal fee and present evidence of
5-43 having completed not less than one-half of the required hours of
5-44 approved continuing education requirements during the year
5-45 preceding the date of the application for activation.
5-46 (c) A license holder seeking to place a license on retired
5-47 status must notify the department at the time of renewal. A
5-48 license on retired status may not be reactivated.
5-49 (d) A license holder who holds a license that is on inactive
5-50 or retired status may not practice naturopathic medicine.
5-51 SECTION 14. SPECIALTY PRACTICE. (a) A naturopathic
5-52 physician may not practice naturopathic childbirth without
5-53 obtaining a certificate of specialty practice in naturopathic
5-54 childbirth. The board shall adopt rules to certify naturopathic
5-55 physicians for specialty practice.
5-56 (b) To be certified in naturopathic childbirth, a
5-57 naturopathic physician must:
5-58 (1) pass a specialty examination in obstetrics or
5-59 natural childbirth approved by the advisory committee; and
5-60 (2) comply with the requirements adopted by the board
5-61 for issuance of the specialty certification that are equivalent to
5-62 the minimum requirements, including any examination requirements,
5-63 to obtain a license to practice midwifery in this state.
5-64 (c) The advisory committee may prescribe a national
5-65 standardized examination in obstetrics or natural childbirth as
5-66 constituting the specialty examination.
5-67 SECTION 15. USE OF X-RAY. A naturopathic physician licensed
5-68 under this Act may use an X-ray in the course of the person's
5-69 practice only if the person is certified by the board as qualified
6-1 to perform X-ray procedures. The board shall adopt rules for the
6-2 issuance of a certification under this section that are equivalent
6-3 to the requirements for other health professionals to engage in the
6-4 use of X-rays.
6-5 SECTION 16. USE OF TITLES; PENALTY; INJUNCTION. (a) A
6-6 naturopathic physician may use the title "naturopathic physician"
6-7 and the recognized abbreviation for the professional degree of
6-8 "N.D." A naturopathic physician has the exclusive right to use the
6-9 terms "naturopathic physician," "doctor of naturopathic medicine,"
6-10 "doctor of naturopathy," "naturopathy," and "N.D."
6-11 (b) A person commits an offense if the person holds the
6-12 person out as a naturopathic physician, suggests that the person
6-13 practices naturopathic medicine, or uses the terms and abbreviation
6-14 described by Subsection (a) of this section without holding a
6-15 license or while the person is on retired or inactive status under
6-16 this Act.
6-17 (c) An offense under Subsection (b) of this section is a
6-18 felony of the third degree.
6-19 (d) A person who violates this section may be enjoined by
6-20 the district court on petition by the board.
6-21 SECTION 17. COMPLAINT PROCEDURE IN GENERAL. (a) The
6-22 department shall keep an information file about each complaint
6-23 filed with the department. The department's information file shall
6-24 be kept current and contain a record for each complaint of:
6-25 (1) all persons contacted in relation to the
6-26 complaint;
6-27 (2) a summary of findings made at each step of the
6-28 complaint process;
6-29 (3) an explanation of the legal basis and reason for a
6-30 complaint that is dismissed; and
6-31 (4) other relevant information.
6-32 (b) If a written complaint is filed with the department that
6-33 the department has authority to resolve, the department, at least
6-34 as frequently as quarterly and until final disposition of the
6-35 complaint, shall notify the parties to the complaint of the status
6-36 of the complaint unless the notice would jeopardize an undercover
6-37 investigation.
6-38 (c) The board by rule shall adopt a form to standardize
6-39 information concerning complaints made to the department. The
6-40 board by rule shall prescribe information to be provided to a
6-41 person when the person files a complaint with the department.
6-42 (d) The department shall provide reasonable assistance to a
6-43 person who wishes to file a complaint with the department.
6-44 SECTION 18. COMPLAINT INVESTIGATION AND DISPOSITION.
6-45 (a) The board shall adopt rules concerning the investigation of a
6-46 complaint filed with the department. The rules adopted under this
6-47 subsection shall:
6-48 (1) distinguish between categories of complaints;
6-49 (2) ensure that complaints are not dismissed without
6-50 appropriate consideration;
6-51 (3) require that the advisory committee be advised of
6-52 a complaint that is dismissed and that a letter be sent to the
6-53 person who filed the complaint explaining the action taken on the
6-54 dismissed complaint;
6-55 (4) ensure that the person who filed the complaint has
6-56 an opportunity to explain the allegations made in the complaint;
6-57 and
6-58 (5) prescribe guidelines concerning the categories of
6-59 complaints that require the use of a private investigator and the
6-60 procedures for the advisory committee to obtain the services of a
6-61 private investigator.
6-62 (b) The department shall dispose of all complaints in a
6-63 timely manner.
6-64 SECTION 19. DISCIPLINE OF LICENSE HOLDER. (a) A license to
6-65 practice naturopathy may be denied or, after notice and hearing,
6-66 suspended, probated, or revoked if the applicant for a license or
6-67 the holder of a license:
6-68 (1) uses drugs or intoxicating liquors to an extent
6-69 that affects the person's professional competence;
7-1 (2) obtains or attempts to obtain a license by fraud
7-2 or deception;
7-3 (3) is adjudged mentally incompetent by a court of
7-4 competent jurisdiction;
7-5 (4) practices naturopathy in a manner detrimental to
7-6 the public health and welfare;
7-7 (5) violates this Act or a rule adopted under this
7-8 Act;
7-9 (6) is convicted of a felony or a crime involving
7-10 moral turpitude; or
7-11 (7) holds the person out as a physician or surgeon or
7-12 any combination or derivative of those terms unless the person is
7-13 also licensed under the Medical Practice Act (Article 4495b,
7-14 Vernon's Texas Civil Statutes) as a physician or surgeon.
7-15 (b) If a license suspension is probated, the department may
7-16 require the license holder:
7-17 (1) to report regularly to the department on matters
7-18 that are the basis of the probation;
7-19 (2) to limit practice to the areas prescribed by the
7-20 department; or
7-21 (3) to continue the person's professional education
7-22 until the license holder attains a degree of skill satisfactory to
7-23 the department in those areas that are the basis of the probation.
7-24 (c) A person whose application for a license is denied or
7-25 whose license is suspended or revoked is entitled to a hearing
7-26 before the department if the person submits a written request to
7-27 the department. Hearings are governed by the board rules for a
7-28 contested hearing and by Chapter 2001, Government Code.
7-29 SECTION 20. NATUROPATHIC PHYSICIANS ADVISORY COMMITTEE. (a)
7-30 The Naturopathic Physicians Advisory Committee is created as an
7-31 advisory committee to the board. The board shall appoint nine
7-32 members who must have the following qualifications:
7-33 (1) three must be representatives of the general
7-34 public;
7-35 (2) two must be physicians licensed in this state;
7-36 (3) one must be a chiropractor licensed in this state;
7-37 and
7-38 (4) three must be naturopathic physicians licensed
7-39 under this Act.
7-40 (b) Members are appointed for staggered terms of six years,
7-41 with three members' terms expiring January 1 of each even-numbered
7-42 year. If a vacancy occurs on the advisory committee, the board
7-43 shall appoint a person having the appropriate qualifications to
7-44 serve the unexpired part of the term.
7-45 (c) The advisory committee may adopt rules for the conduct
7-46 of its activities and shall elect a presiding officer from among
7-47 its members. The advisory committee shall meet at least once each
7-48 calendar year and shall meet at other times at the call of the
7-49 presiding officer as necessary to transact its business.
7-50 (d) The members of the advisory committee may not receive
7-51 compensation, but a member is entitled to receive the per diem and
7-52 travel allowance authorized by the General Appropriations Act for
7-53 state employees.
7-54 (e) The advisory committee shall recommend for the
7-55 consideration of the board rules to implement standards adopted
7-56 under this Act and perform other duties assigned by the board.
7-57 (f) The advisory committee shall recommend for the approval
7-58 of the department examinations required by this Act.
7-59 (g) A naturopathic physician member of the advisory
7-60 committee may be licensed as a member of another health profession
7-61 regulated or licensed by the state.
7-62 SECTION 21. CONFORMING AMENDMENT. Subsection (b), Section
7-63 3.06, Medical Practice Act (Article 4495b, Vernon's Texas Civil
7-64 Statutes), is amended to read as follows:
7-65 (b) This Act does not apply to:
7-66 (1) dentists, duly qualified and registered under the
7-67 laws of this state who confine their practice strictly to
7-68 dentistry;
7-69 (2) duly licensed optometrists who confine their
8-1 practice strictly to optometry as defined by law;
8-2 (3) duly licensed chiropractors who confine their
8-3 practice strictly to chiropractic as defined by law;
8-4 (4) registered or professional nurses and licensed
8-5 vocational nurses registered or licensed under the laws of this
8-6 state who confine their practice strictly within the provisions of
8-7 such applicable licensing Acts and the laws of this state;
8-8 (5) duly licensed podiatrists who confine their
8-9 practice strictly to podiatry as defined by law;
8-10 (6) duly licensed or certified psychologists who
8-11 confine their activities or practice strictly to psychology as
8-12 defined by law;
8-13 (7) duly licensed physical therapists who confine
8-14 their activities or practice strictly to physical therapy and who
8-15 are not in violation of any law relating to physical therapy
8-16 practice;
8-17 (8) commissioned or contract surgeons of the uniformed
8-18 services of the United States or in the Public Health Service in
8-19 the performance of their duties and not engaged in private
8-20 practice;
8-21 (9) any person furnishing medical assistance in case
8-22 of an emergency or disaster situation if no charge is made for the
8-23 medical assistance;
8-24 (10) a student in training in a medical school
8-25 approved by the board while performing the duties assigned in the
8-26 course of training, providing the duties are performed under the
8-27 supervision of a licensed practitioner, except that medical
8-28 residents, interns, and fellows shall be required to register and
8-29 be subject to the other applicable provisions of this Act;
8-30 (11) a legally qualified physician of another state
8-31 who is in this state for consultation with physicians licensed in
8-32 this state but who does not:
8-33 (A) have an office in this state; or
8-34 (B) appoint a place in this state for seeing,
8-35 examining, or treating patients; [or]
8-36 (12) a licensed naturopathic physician who confines
8-37 the physician's practice strictly to naturopathy as defined by law;
8-38 or
8-39 (13) any other activities that the board may designate
8-40 as exempt from the application of this Act.
8-41 SECTION 22. CONFORMING AMENDMENT. Subsection (a), Section
8-42 3, Licensed Professional Counselor Act (Article 4512g, Vernon's
8-43 Texas Civil Statutes), is amended to read as follows:
8-44 (a) Except as provided by Subsection (b) of this section,
8-45 this Act does not apply to:
8-46 (1) the activities and services of or use of an
8-47 official title by a person employed as a counselor by a federal,
8-48 state, county, or municipal agency or public or private educational
8-49 institution, if the person is performing counseling or
8-50 counseling-related activities within the scope of his employment;
8-51 (2) the activities and services of a student, intern,
8-52 or trainee in counseling pursuing a course of study in counseling
8-53 in a regionally accredited institution of higher education or
8-54 training institution, if these activities and services constitute a
8-55 part of the supervised course of study and the person is designated
8-56 a "counselor intern";
8-57 (3) the activities and services of a nonresident
8-58 rendered not more than 30 days during any year, if the person is
8-59 authorized to perform the activities and services under the law of
8-60 the state or country of his residence;
8-61 (4) the activities and services of members of other
8-62 professions licensed or certified by the state, such as physicians,
8-63 registered nurses, psychologists, licensed [certified] social
8-64 workers, licensed marriage and family therapists, licensed chemical
8-65 dependency counselors, licensed naturopathic physicians, licensed
8-66 physician assistants, licensed occupational therapists, licensed
8-67 optometrists in the evaluation and remediation of learning or
8-68 behavioral disabilities associated with or caused by a defective or
8-69 abnormal condition of vision, Christian Science practitioners who
9-1 are recognized by the Church of Christ Scientist as registered and
9-2 published in the Christian Science Journal, or other recognized
9-3 religious practitioners performing counseling consistent with the
9-4 law of the state, their training, and any code of ethics of their
9-5 professions, if they do not represent themselves by any title or
9-6 description in the manner prescribed by Section 2 of this Act;
9-7 (5) the activities, services, titles, and descriptions
9-8 of persons licensed to practice law;
9-9 (6) the activities, services, titles, and descriptions
9-10 of persons employed as professionals or who are volunteers in the
9-11 practice of counseling for public and private nonprofit
9-12 organizations or charities who are accountable to the persons'
9-13 sponsoring organization and do not use the title or hold themselves
9-14 out to be licensed counselors; or
9-15 (7) persons owning, operating, or employed by a
9-16 certified career counseling service regulated under Chapter 222,
9-17 Acts of the 70th Legislature, Regular Session, 1987 (Article
9-18 5221a-8, Vernon's Texas Civil Statutes).
9-19 SECTION 23. CONFORMING AMENDMENT. Subdivision (39), Section
9-20 5, Texas Pharmacy Act (Article 4542a-1, Vernon's Texas Civil
9-21 Statutes), is amended to read as follows:
9-22 (39) "Practitioner" means:
9-23 (A) a physician, dentist, podiatrist, or
9-24 veterinarian, a naturopathic physician to the extent permitted by
9-25 rules adopted by the Texas Board of Health, or another [other]
9-26 person licensed or registered to prescribe, distribute, administer,
9-27 or dispense a prescription drug or device in the course of
9-28 professional practice in this state;
9-29 (B) a person licensed by another state in a
9-30 health field in which, under Texas law, licensees in this state may
9-31 legally prescribe dangerous drugs or a person practicing in another
9-32 state and licensed by another state as a physician, dentist,
9-33 veterinarian, or podiatrist, having a current Federal Drug
9-34 Enforcement Administration registration number, and who may legally
9-35 prescribe Schedule II, III, IV, or V controlled substances in such
9-36 other state; or
9-37 (C) a person licensed in the Dominion of Canada
9-38 or the United Mexican States in a health field in which, under the
9-39 laws of this state, a licensee may legally prescribe dangerous
9-40 drugs. "Practitioner" does not include a person licensed under
9-41 this Act.
9-42 SECTION 24. CONFORMING AMENDMENT. Subdivision (39), Section
9-43 481.002, Health and Safety Code, is amended to read as follows:
9-44 (39) "Practitioner" means:
9-45 (A) a physician, dentist, veterinarian,
9-46 podiatrist, or scientific investigator, a naturopathic physician to
9-47 the extent permitted by rules adopted by the Texas Board of Health,
9-48 or another [other] person licensed, registered, or otherwise
9-49 permitted to distribute, dispense, analyze, conduct research with
9-50 respect to, or administer a controlled substance in the course of
9-51 professional practice or research in this state;
9-52 (B) a pharmacy, hospital, or other institution
9-53 licensed, registered, or otherwise permitted to distribute,
9-54 dispense, conduct research with respect to, or administer a
9-55 controlled substance in the course of professional practice or
9-56 research in this state; or
9-57 (C) a person practicing in and licensed by
9-58 another state as a physician, dentist, veterinarian, or podiatrist,
9-59 having a current Federal Drug Enforcement Administration
9-60 registration number, who may legally prescribe Schedule II, III,
9-61 IV, or V controlled substances in that state.
9-62 SECTION 25. CONFORMING AMENDMENT. Subdivision (12), Section
9-63 483.001, Health and Safety Code, is amended to read as follows:
9-64 (12) "Practitioner" means a person licensed:
9-65 (A) by the Texas State Board of Medical
9-66 Examiners, State Board of Dental Examiners, Texas State Board of
9-67 Podiatric Medical Examiners, Texas Optometry Board, Texas Board of
9-68 Health as a naturopathic physician to the extent permitted by rules
9-69 adopted by the board, or State Board of Veterinary Medical
10-1 Examiners to prescribe and administer dangerous drugs;
10-2 (B) by another state in a health field in which,
10-3 under the laws of this state, a licensee may legally prescribe
10-4 dangerous drugs; or
10-5 (C) in Canada or Mexico in a health field in
10-6 which, under the laws of this state, a licensee may legally
10-7 prescribe dangerous drugs.
10-8 SECTION 26. INITIAL APPOINTMENTS TO ADVISORY COMMITTEE. In
10-9 appointing the initial naturopathic physician members of the
10-10 Naturopathic Physicians Advisory Committee, the board, in lieu of
10-11 appointing members who are naturopathic physicians licensed under
10-12 this Act, shall appoint three members who are qualified and have
10-13 applied for licenses as naturopathic physicians under this Act.
10-14 SECTION 27. EFFECTIVE DATE. This Act takes effect September
10-15 1, 1997.
10-16 SECTION 28. EMERGENCY. The importance of this legislation
10-17 and the crowded condition of the calendars in both houses create an
10-18 emergency and an imperative public necessity that the
10-19 constitutional rule requiring bills to be read on three several
10-20 days in each house be suspended, and this rule is hereby suspended.
10-21 * * * * *