By Van de Putte H.B. No. 752
76R4153 GJH-F
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of the practice of naturopathic
1-3 medicine; providing penalties.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. The Naturopathic Physicians Act is adopted to
1-6 read as follows:
1-7 ARTICLE 1. GENERAL PROVISIONS
1-8 Sec. 1.01. SHORT TITLE. This Act may be cited as the
1-9 Naturopathic Physicians Act.
1-10 Sec. 1.02. PURPOSE. The legislature finds that a
1-11 significant number of the citizens of this state are turning to
1-12 naturopathic physicians for their health care needs and declares
1-13 that naturopathic medicine is a distinct health care profession
1-14 that affects the public health, safety, and welfare and provides
1-15 the public with freedom of choice in health care. The purpose of
1-16 this Act is to provide standards for the licensing and regulation
1-17 of naturopathic medicine to protect the public health, safety, and
1-18 welfare and to provide a means of identifying qualified
1-19 naturopathic physicians.
1-20 Sec. 1.03. DEFINITIONS. In this Act:
1-21 (1) "Approved naturopathic college" means a college
1-22 or program granting the degree of doctor of naturopathy or doctor
1-23 of naturopathic medicine that:
1-24 (A) is accredited by an agency recognized by the
2-1 federal government or approved by the board;
2-2 (B) has candidate for accreditation status with
2-3 the accrediting agency; or
2-4 (C) has been approved by the board after the
2-5 college or program was investigated and found to meet education
2-6 standards equivalent to those established by the accrediting
2-7 agency.
2-8 (2) "Board" means the Naturopathic Physicians Board.
2-9 (3) "Commissioner" means the commissioner of public
2-10 health.
2-11 (4) "Department" means the Texas Department of Health.
2-12 (5) "Diagnose" means to examine in any manner another
2-13 person, parts of a person's body, or substances, fluids, or
2-14 materials excreted, taken, or removed from a person's body or
2-15 produced by a person's body to determine the source, kind, or
2-16 extent of a disease or other physical condition.
2-17 (6) "Minor office procedure" means the use of
2-18 operative, electrical, or other methods for the repair of, and care
2-19 incidental to, superficial lacerations and abrasions, the removal
2-20 of foreign bodies located in superficial tissues, and the use of
2-21 antiseptics and local anesthetics in connection with these methods.
2-22 The term includes the use of local anesthesia applied topically or
2-23 by injection, whether natural or prescription, in superficial
2-24 tissues associated with the performance of minor office procedures.
2-25 The term does not include general or spinal anesthesia, major
2-26 surgery, surgery of the body cavities, or specialized surgeries,
2-27 including plastic surgery or surgery involving the eyes, tendons,
3-1 ligaments, or major blood vessels.
3-2 (7) "Natural antibiotics" means antimicrobial,
3-3 antifungal, and antiprotozoal agents that are naturally occurring
3-4 substances or manufactured substances that are substantially
3-5 identical to the naturally occurring substances.
3-6 (8) "Natural medicines" means:
3-7 (A) food, food extracts, and dietary supplements
3-8 as defined by the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
3-9 Section 301 et seq.), as amended;
3-10 (B) homeopathic remedies;
3-11 (C) plant substances that are not designated as
3-12 prescription drugs or controlled substances;
3-13 (D) over-the-counter medications;
3-14 (E) prescriptions that are consistent with the
3-15 competent practice of naturopathy; and
3-16 (F) substances prepared according to the
3-17 Homeopathic Pharmacopeia of the United States.
3-18 (9) "Naturopathic medicine" or "naturopathy" means a
3-19 system of primary health care for the prevention, diagnosis, and
3-20 care of human health conditions, injuries, and diseases that uses
3-21 education and natural substances and remedies to support and
3-22 stimulate the individual's intrinsic self-healing processes.
3-23 (10) "Naturopathic childbirth" means uncomplicated
3-24 natural childbirth assisted by a naturopathic physician. The term
3-25 includes the use of natural substances, ophthalmic antibiotics,
3-26 emergency childbirth medicines, and simple uncomplicated
3-27 episiotomies, but does not include the use of forceps delivery,
4-1 general or spinal anesthesia, caesarean section, or induced
4-2 abortion.
4-3 (11) "Naturopathic mobilization therapy" means
4-4 manually administering mechanical treatment of body structures or
4-5 tissues to restore the normal physiological function of the body by
4-6 normalizing and balancing the musculoskeletal system of the body.
4-7 The term does not include osseous manipulation.
4-8 (12) "Naturopathic physician" means a person who holds
4-9 the person out to the public as licensed to practice naturopathic
4-10 medicine or who practices naturopathic medicine under this Act.
4-11 (13) "Naturopathic physical medicine" means the use of
4-12 the physical agents of air, water, heat, cold, sound, light, and
4-13 electromagnetic nonionizing radiation and the physical modalities
4-14 of electrotherapy, biofeedback, diathermy, ultraviolet light,
4-15 ultrasound, hydrotherapy, naturopathic mobilization therapy, and
4-16 exercise. The term does not include the practice of physical
4-17 therapy, acupuncture, or chiropractic.
4-18 (14) "Topical preparations" means topical analgesics,
4-19 anesthetics, antiseptics, scabicides, antifungals, and
4-20 antibacterials.
4-21 Sec. 1.04. APPLICATION OF SUNSET ACT. The Naturopathic
4-22 Physicians Board is subject to Chapter 325, Government Code (Texas
4-23 Sunset Act). Unless continued in existence as provided by that
4-24 chapter, the board is abolished and this Act expires September 1,
4-25 2011.
4-26 Sec. 1.05. APPLICATION OF ACT. This Act does not apply to:
4-27 (1) a person licensed in this state in any health care
5-1 profession while the person is practicing within the scope of the
5-2 license;
5-3 (2) a student of naturopathy who is currently enrolled
5-4 in an approved naturopathic course of study and who, without
5-5 compensation, evaluates and treats human conditions under the
5-6 direct supervision of a naturopathic physician regulated under the
5-7 laws of this state if the student's activities are within the scope
5-8 of practice of the supervising naturopathic physician and are
5-9 limited to activity within the scope of practice authorized by this
5-10 Act;
5-11 (3) a person engaged in the sale of vitamins, health
5-12 foods, dietary supplements, herbs, or other products of nature the
5-13 sale of which is not otherwise prohibited under state or federal
5-14 law;
5-15 (4) a person providing nutritional advice, giving
5-16 advice concerning proper nutrition, or giving information as to the
5-17 use and role of food and food ingredients, including dietary
5-18 supplements, except that providing nutritional advice under this
5-19 subdivision does not include the authority to practice medicine or
5-20 surgery, to undertake the treatment or cure of a disease, pain,
5-21 injury, deformity, or physical or mental condition, or to state
5-22 that a product might cure a disease, pain, injury, deformity, or
5-23 other condition; or
5-24 (5) a naturopathic physician licensed in another
5-25 state, a territory of the United States, or the District of
5-26 Columbia, if the state, territory, or the District of Columbia
5-27 requires credentials equivalent to those of this Act, during a
6-1 period when the physician is incidentally called into this state
6-2 for consultation with a naturopathic physician licensed in this
6-3 state.
6-4 ARTICLE 2. NATUROPATHIC PHYSICIANS BOARD
6-5 Sec. 2.01. BOARD; MEMBERSHIP. (a) The Naturopathic
6-6 Physicians Board consists of nine members appointed by the governor
6-7 with the advice and consent of the senate as follows:
6-8 (1) two physicians licensed in this state;
6-9 (2) one chiropractor licensed in this state;
6-10 (3) three naturopathic physicians licensed under this
6-11 Act; and
6-12 (4) three representatives of the general public.
6-13 (b) Appointments to the board shall be made without regard
6-14 to the race, color, disability, sex, religion, age, or national
6-15 origin of the appointees.
6-16 Sec. 2.02. MEMBERSHIP ELIGIBILITY. A person may not be a
6-17 public member of the board if the person or the person's spouse:
6-18 (1) is registered, certified, or licensed by a
6-19 regulatory agency in the field of naturopathy;
6-20 (2) is employed by or participates in the management
6-21 of a business entity or other organization regulated by or
6-22 receiving money from the department;
6-23 (3) owns or controls, directly or indirectly, more
6-24 than a 10 percent interest in a business entity or other
6-25 organization regulated by or receiving money from the department;
6-26 or
6-27 (4) uses or receives a substantial amount of tangible
7-1 goods, services, or money from the department, other than
7-2 compensation or reimbursement authorized by law for board
7-3 membership, attendance, or expenses.
7-4 Sec. 2.03. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a) In
7-5 this section, "Texas trade association" means a cooperative and
7-6 voluntarily joined association of business or professional
7-7 competitors in this state designed to assist its members and its
7-8 industry or profession in dealing with mutual business or
7-9 professional problems and in promoting their common interest.
7-10 (b) A person may not be a member of the board and may not be
7-11 a department employee employed in a "bona fide executive,
7-12 administrative, or professional capacity," as that phrase is used
7-13 for purposes of establishing an exemption to the overtime
7-14 provisions of the federal Fair Labor Standards Act of 1938 (29
7-15 U.S.C. Section 201 et seq.), as amended, if:
7-16 (1) the person is an officer, employee, or paid
7-17 consultant of a Texas trade association in the field of
7-18 naturopathic medicine; or
7-19 (2) the person's spouse is an officer, manager, or
7-20 paid consultant of a Texas trade association in the field of
7-21 naturopathic medicine.
7-22 (c) A person may not be a member of the board or act as the
7-23 general counsel to the board or the department if the person is
7-24 required to register as a lobbyist under Chapter 305, Government
7-25 Code, because of the person's activities for compensation on behalf
7-26 of a profession related to the operation of the department.
7-27 Sec. 2.04. TERMS; VACANCY. (a) Members of the board serve
8-1 staggered six-year terms, with the terms of three members expiring
8-2 February 1 of each odd-numbered year.
8-3 (b) If a vacancy occurs during a member's term, the governor
8-4 shall appoint a replacement to fill the unexpired term.
8-5 (c) A board member may not serve more than two consecutive
8-6 full terms.
8-7 Sec. 2.05. GROUNDS FOR REMOVAL. (a) It is a ground for
8-8 removal from the board that a member:
8-9 (1) does not have at the time of appointment the
8-10 qualifications required by Section 2.01 of this Act;
8-11 (2) does not maintain during service on the board the
8-12 qualifications required by Section 2.01 of this Act;
8-13 (3) is ineligible for membership under Section 2.02 or
8-14 2.03 of this Act;
8-15 (4) cannot, because of illness or disability,
8-16 discharge the member's duties for a substantial part of the
8-17 member's term; or
8-18 (5) is absent from more than half of the regularly
8-19 scheduled board meetings that the member is eligible to attend
8-20 during a calendar year without an excuse approved by a majority
8-21 vote of the board.
8-22 (b) The validity of an action of the board is not affected
8-23 by the fact that it is taken when a ground for removal of a board
8-24 member exists.
8-25 (c) If the commissioner has knowledge that a potential
8-26 ground for removal exists, the commissioner shall notify the
8-27 presiding officer of the board of the potential ground. The
9-1 presiding officer shall then notify the governor that a potential
9-2 ground for removal exists. If the potential ground for removal
9-3 involves the presiding officer, the commissioner shall notify the
9-4 next highest ranking officer of the board, who shall then notify
9-5 the governor and the attorney general that a potential ground for
9-6 removal exists.
9-7 Sec. 2.06. OFFICERS. (a) The governor shall designate
9-8 biennially a board member as the presiding officer of the board to
9-9 serve in that capacity at the will of the governor.
9-10 (b) The board shall elect biennially from among its members
9-11 an assistant presiding officer and secretary-treasurer.
9-12 Sec. 2.07. COMPENSATION; REIMBURSEMENT. (a) A board member
9-13 may not receive compensation for service on the board.
9-14 (b) A board member is entitled to:
9-15 (1) the per diem set by the General Appropriations Act
9-16 for each day that the member performs duties as a board member; and
9-17 (2) reimbursement for expenses as provided by the
9-18 General Appropriations Act.
9-19 Sec. 2.08. MEETINGS. (a) The board shall meet at least
9-20 twice during each year.
9-21 (b) The board may meet at other times at the call of the
9-22 presiding officer or as provided by board rule.
9-23 Sec. 2.09. TRAINING REQUIREMENTS. (a) A person who is
9-24 appointed to and qualifies for office as a board member may not
9-25 vote, deliberate, or be counted as a member in attendance at a
9-26 meeting of the board until the person completes a training program
9-27 that complies with this section.
10-1 (b) The training program must provide the person with
10-2 information regarding:
10-3 (1) the legislation that created the department and
10-4 the board;
10-5 (2) the programs operated by the board;
10-6 (3) the role and functions of the board;
10-7 (4) the rules of the board, with an emphasis on the
10-8 rules that relate to disciplinary and investigatory authority;
10-9 (5) the current budget for the board;
10-10 (6) the results of the most recent formal audit of the
10-11 board;
10-12 (7) the requirements of:
10-13 (A) the open meetings law, Chapter 551,
10-14 Government Code;
10-15 (B) the public information law, Chapter 552,
10-16 Government Code;
10-17 (C) the administrative procedure law, Chapter
10-18 2001, Government Code; and
10-19 (D) other laws relating to public officials,
10-20 including conflict of interest laws; and
10-21 (8) any applicable ethics policies adopted by the
10-22 board or the Texas Ethics Commission.
10-23 (c) A person appointed to the board is entitled to
10-24 reimbursement, as provided by the General Appropriations Act, for
10-25 travel expenses incurred in attending the training program
10-26 regardless of whether the attendance at the program occurs before
10-27 or after the person qualifies for office.
11-1 ARTICLE 3. BOARD POWERS AND DUTIES
11-2 Sec. 3.01. GENERAL RULEMAKING AUTHORITY. The board shall
11-3 adopt rules consistent with this Act as necessary for the
11-4 performance of its duties under this Act.
11-5 Sec. 3.02. RULES REGARDING BOARD PROCEDURES. The board may
11-6 adopt rules establishing the board's procedures.
11-7 Sec. 3.03. FEES. The board by rule shall set fees in
11-8 amounts reasonable and necessary to cover the costs of
11-9 administering this Act.
11-10 Sec. 3.04. POWERS AND DUTIES REGARDING EXAMINATION. (a) The
11-11 board shall:
11-12 (1) approve examinations required by this Act;
11-13 (2) determine the times and places for licensing
11-14 examinations;
11-15 (3) offer examinations at least semiannually; and
11-16 (4) give reasonable public notice of the examinations
11-17 in the manner provided by board rules.
11-18 (b) The board may prescribe a nationally developed standard
11-19 examination as part or all of the examination prescribed or
11-20 endorsed under Article 6 of this Act.
11-21 (c) The board by rule shall determine the passing criteria
11-22 for the examination.
11-23 (d) The board may adopt other rules necessary to the
11-24 administration of the examination.
11-25 Sec. 3.05. POWERS AND DUTIES REGARDING CONTINUING EDUCATION.
11-26 The board shall adopt rules as to what constitutes an approved
11-27 program of continuing education and the manner in which attendance
12-1 at all approved courses, clinics, forums, lectures, programs, or
12-2 seminars is monitored, recorded, and submitted to the department.
12-3 Sec. 3.06. RULES RESTRICTING COMPETITIVE BIDDING OR
12-4 ADVERTISING. (a) The board may not adopt rules restricting
12-5 advertising or competitive bidding by a license holder except to
12-6 prohibit false, misleading, or deceptive practices by the person.
12-7 (b) In its rules to prohibit false, misleading, or deceptive
12-8 practices, the board may not include a rule that:
12-9 (1) restricts the use of any medium for advertising;
12-10 (2) restricts the use of a license holder's personal
12-11 appearance or voice in an advertisement;
12-12 (3) relates to the size or duration of an
12-13 advertisement by the license holder; or
12-14 (4) restricts the license holder's advertisement under
12-15 a trade name.
12-16 Sec. 3.07. ANNUAL REPORT. Not later than February 1 of each
12-17 year, the board shall file with the governor and the presiding
12-18 officer of each house of the legislature a written report that:
12-19 (1) describes the activities of the board; and
12-20 (2) contains a detailed accounting of all funds
12-21 received and disbursed by the board during the preceding year.
12-22 ARTICLE 4. POWERS AND DUTIES OF DEPARTMENT
12-23 Sec. 4.01. GENERAL DUTIES OF DEPARTMENT. The department
12-24 shall:
12-25 (1) administer this Act;
12-26 (2) prepare and administer examinations; and
12-27 (3) investigate a person who may be engaging in a
13-1 practice that violates this Act.
13-2 ARTICLE 5. PUBLIC INTEREST INFORMATION AND COMPLAINT
13-3 PROCEDURES
13-4 Sec. 5.01. PUBLIC INTEREST INFORMATION. (a) The board
13-5 shall prepare information of public interest describing the
13-6 functions of the board and the procedures by which complaints are
13-7 filed with and resolved by the board.
13-8 (b) The board shall make the information available to the
13-9 public and to appropriate state agencies.
13-10 Sec. 5.02. COMPLAINTS. (a) The board by rule shall
13-11 establish methods by which consumers and service recipients are
13-12 notified of the name, mailing address, and telephone number of the
13-13 board for the purpose of directing complaints to the board. The
13-14 board may provide for that notice:
13-15 (1) on each registration form, application, or written
13-16 contract for services of a person regulated by the board;
13-17 (2) on a sign prominently displayed in the place of
13-18 business of each person regulated by the board; or
13-19 (3) in a bill for service provided by a person
13-20 regulated by the board.
13-21 (b) The board shall list with its regular telephone number
13-22 any toll-free telephone number established under other state law
13-23 that may be called to present a complaint about a health
13-24 professional.
13-25 Sec. 5.03. RECORDS OF COMPLAINTS. (a) The board shall
13-26 maintain a file on each written complaint filed with the board.
13-27 The file must include:
14-1 (1) the name of the person who filed the complaint;
14-2 (2) the date the complaint is received by the board;
14-3 (3) the subject matter of the complaint;
14-4 (4) the name of each person contacted in relation to
14-5 the complaint;
14-6 (5) a summary of the results of the review or
14-7 investigation of the complaint; and
14-8 (6) an explanation of the reason the file was closed,
14-9 if the agency closed the file without taking action other than to
14-10 investigate the complaint.
14-11 (b) The department shall provide to the person filing the
14-12 complaint and to each person who is a subject of the complaint a
14-13 copy of the department's policies and procedures relating to
14-14 complaint investigation and resolution.
14-15 (c) The department, at least quarterly and until final
14-16 disposition of the complaint, shall notify the person filing the
14-17 complaint and each person who is a subject of the complaint of the
14-18 status of the investigation unless the notice would jeopardize an
14-19 undercover investigation.
14-20 Sec. 5.04. GENERAL RULES REGARDING COMPLAINT INVESTIGATION
14-21 AND DISPOSITION. (a) The board shall adopt rules concerning the
14-22 investigation of a complaint filed with the board. The rules
14-23 adopted under this subsection must:
14-24 (1) distinguish between categories of complaints;
14-25 (2) ensure that complaints are not dismissed without
14-26 appropriate consideration;
14-27 (3) require that the board be advised of a complaint
15-1 that is dismissed and that a letter be sent to the person who filed
15-2 the complaint explaining the action taken on the dismissed
15-3 complaint;
15-4 (4) ensure that the person who filed the complaint has
15-5 an opportunity to explain the allegations made in the complaint;
15-6 and
15-7 (5) prescribe guidelines concerning the categories of
15-8 complaints that require the use of a private investigator and the
15-9 procedures for the board to obtain the services of a private
15-10 investigator.
15-11 (b) The board shall:
15-12 (1) dispose of all complaints in a timely manner; and
15-13 (2) establish a schedule for conducting each phase of
15-14 a complaint that is under the control of the board not later than
15-15 the 30th day after the date the board receives the complaint.
15-16 (c) The board shall keep the schedule established under
15-17 Subsection (b)(2) of this section in the information file for the
15-18 complaint. Each party shall be notified of the projected schedule
15-19 for the complaint.
15-20 (d) A change in the schedule must be noted in the complaint
15-21 information file and each party to the complaint must be notified
15-22 of the change not later than the seventh day after the date the
15-23 change is made.
15-24 (e) The commissioner shall notify the board of a complaint
15-25 that is unresolved after the time prescribed by the board for
15-26 resolving the complaint so that the board may take necessary action
15-27 on the complaint.
16-1 ARTICLE 6. LICENSE REQUIREMENTS AND EXEMPTIONS
16-2 Sec. 6.01. LICENSE REQUIRED. (a) A person may not practice
16-3 as a naturopathic physician unless the person holds a license under
16-4 this Act.
16-5 (b) A person may not use the title "naturopath,"
16-6 "naturopathic physician," "doctor of naturopathic medicine,"
16-7 "doctor of naturopathy," or "naturopathy" or the abbreviation
16-8 "N.D." unless the person is licensed under this Act.
16-9 (c) A person may not hold the person out as a naturopathic
16-10 physician or suggest that the person practices naturopathic
16-11 medicine or naturopathy unless the person is licensed under this
16-12 Act.
16-13 Sec. 6.02. LICENSE APPLICATION. An applicant for a license
16-14 must:
16-15 (1) file a written application with the board on a
16-16 form prescribed by the board; and
16-17 (2) pay the application fee set by the board.
16-18 Sec. 6.03. LICENSE ELIGIBILITY. To be eligible for a
16-19 license, a person must:
16-20 (1) hold a doctorate from an approved naturopathic
16-21 college;
16-22 (2) be of good moral character;
16-23 (3) have not been convicted of a crime involving moral
16-24 turpitude or a felony;
16-25 (4) not use drugs or alcohol to an extent that affects
16-26 the applicant's professional competency;
16-27 (5) not have had a license or certification revoked by
17-1 a licensing agency or by a certifying professional organization;
17-2 and
17-3 (6) not have engaged in fraud or deceit in applying
17-4 for a license under this Act.
17-5 Sec. 6.04. DETERMINATION WHETHER EXAMINATION REQUIRED. Each
17-6 applicant determined to be eligible for a license under this Act
17-7 must pass an examination prescribed or endorsed by the board unless
17-8 the applicant:
17-9 (1) is licensed to practice naturopathy in another
17-10 state, a territory of the United States, or the District of
17-11 Columbia under conditions and circumstances that the board finds to
17-12 be comparable to the requirements of this state for obtaining a
17-13 license to practice naturopathy and the state, the territory, or
17-14 the District of Columbia requires the successful completion of a
17-15 professional examination for the issuance of a license;
17-16 (2) has graduated from an approved naturopathic
17-17 college or, if the applicant was licensed before a date designated
17-18 by board rule, from a college approved by the board after the
17-19 college was investigated and found to meet the acceptable education
17-20 standards in existence at the time of the applicant's graduation;
17-21 and
17-22 (3) produces evidence satisfactory to the board that
17-23 the applicant holds a valid, unsuspended, and unrevoked license,
17-24 has been actively engaged in the practice of naturopathy for not
17-25 less than one year, and is of good moral character.
17-26 Sec. 6.05. SPECIAL ELIGIBILITY FOR LICENSE.
17-27 (a) Notwithstanding Section 6.03 of this Act, a person is eligible
18-1 to be licensed as a naturopathic physician under this Act and may
18-2 take the examination under Section 6.04 of this Act if, before
18-3 December 1, 1999, the person:
18-4 (1) files a license application;
18-5 (2) pays the fee set by the board; and
18-6 (3) submits proof to the department that the person:
18-7 (A) attended an approved naturopathic college
18-8 and received a doctorate in naturopathy from the college before
18-9 January 1, 1997, and the college is subsequently approved by the
18-10 board;
18-11 (B) practiced naturopathic medicine in this
18-12 state before May 1, 1997, including the provision of health care
18-13 services on a regular and ongoing basis; and
18-14 (C) is of good moral character.
18-15 (b) Notwithstanding Sections 6.03 and 6.04 of this Act, a
18-16 person may be licensed as a naturopathic physician under this Act
18-17 without meeting the requirements of Section 6.03 of this Act or
18-18 taking the examination under Section 6.04 of this Act if the
18-19 person:
18-20 (1) is a resident of this state;
18-21 (2) is at least 21 years of age;
18-22 (3) provides proof acceptable to the board that the
18-23 person has been actively engaged in naturopathic health care and
18-24 has held the person out to the public as practicing naturopathy for
18-25 at least three years before January 1, 1999, or has accumulated not
18-26 less than 3,080 patient contact hours before January 1, 1999;
18-27 (4) derives the majority of the person's income from
19-1 the practice of naturopathy; and
19-2 (5) applies for a license under this subsection before
19-3 January 1, 2001.
19-4 (c) The board by rule may provide for limitations on the
19-5 practice of a person licensed under Subsection (b) of this section.
19-6 The board may not require a person licensed under Subsection (b) of
19-7 this section to be identified as a person whose practice is
19-8 limited.
19-9 (d) A person licensed under Subsection (b) of this section
19-10 may:
19-11 (1) use the title "naturopathic physician" and any
19-12 other title allowed under Section 6.01(b) of this Act; and
19-13 (2) practice naturopathy only within the scope of
19-14 practice that reflects the limits of the person's training and
19-15 experience.
19-16 Sec. 6.06. EXAMINATION. To be eligible to take the license
19-17 examination, an applicant must:
19-18 (1) file an application on a form prescribed by the
19-19 board not later than the 90th day before the date of the
19-20 examination; and
19-21 (2) pay the examination fee set by the board in an
19-22 amount sufficient to cover the cost of administering the
19-23 examination.
19-24 Sec. 6.07. EXAMINATION RESULTS. (a) Not later than the
19-25 30th day after the date a person takes a licensing examination
19-26 under this Act, the department shall notify the person of the
19-27 results of the examination.
20-1 (b) If the examination is graded or reviewed by a testing
20-2 service:
20-3 (1) the department shall notify the person of the
20-4 results of the examination not later than the 14th day after the
20-5 date the department receives the results from the testing service;
20-6 and
20-7 (2) if notice of the examination results will be
20-8 delayed for longer than 90 days after the examination date, the
20-9 department shall notify the person of the reason for the delay
20-10 before the 90th day.
20-11 (c) The department may require a testing service to notify a
20-12 person of the results of the person's examination.
20-13 (d) If requested in writing by a person who fails a
20-14 licensing examination administered under this Act, the department
20-15 shall furnish the person with an analysis of the person's
20-16 performance on the examination.
20-17 Sec. 6.08. REEXAMINATION. (a) If an applicant fails an
20-18 examination, the applicant may retake the examination by:
20-19 (1) paying an additional examination fee set by the
20-20 board; and
20-21 (2) retaking the examination not later than the first
20-22 anniversary of the date of the unsuccessful examination.
20-23 (b) If an applicant fails the examination two or more times,
20-24 the board may require the applicant to:
20-25 (1) complete additional courses of study designated by
20-26 the board; and
20-27 (2) present satisfactory evidence of completion of the
21-1 required courses.
21-2 Sec. 6.09. ISSUANCE OF LICENSE. (a) The board shall issue
21-3 a license to an applicant who:
21-4 (1) complies with the requirements of this Act; and
21-5 (2) pays the licensing fee set by the board.
21-6 (b) The board by rule may adopt a system under which
21-7 licenses expire on various dates during the year. For the year in
21-8 which the license expiration date is changed, the department shall
21-9 prorate license fees on a monthly basis so that each license holder
21-10 pays only that portion of the license fee that is allocable to the
21-11 number of months during which the license is valid. On renewal of
21-12 the license on the new expiration date, the total license renewal
21-13 fee is payable.
21-14 Sec. 6.10. NATUROPATHIC CHILDBIRTH CERTIFICATION. (a) A
21-15 naturopathic physician may not practice naturopathic childbirth
21-16 without obtaining a certificate of specialty practice in
21-17 naturopathic childbirth. The board shall adopt rules to certify
21-18 naturopathic physicians for specialty practice.
21-19 (b) To be certified in naturopathic childbirth, a
21-20 naturopathic physician must:
21-21 (1) pass a specialty examination in obstetrics or
21-22 natural childbirth approved by the board; and
21-23 (2) comply with the requirements adopted by the board
21-24 for issuance of the specialty certification that are equivalent to
21-25 the minimum requirements, including any examination requirements,
21-26 to obtain a license to practice midwifery in this state.
21-27 (c) The board may prescribe a national standardized
22-1 examination in obstetrics or natural childbirth as constituting the
22-2 specialty examination.
22-3 Sec. 6.11. X-RAY CERTIFICATION. A naturopathic physician
22-4 licensed under this Act may not use an x-ray in the course of the
22-5 person's practice unless the board certifies the person to perform
22-6 x-ray procedures. The board shall adopt rules for certification
22-7 that are equivalent to the requirements for other health
22-8 professionals to engage in the use of x-rays.
22-9 Sec. 6.12. INACTIVE STATUS. (a) The board may place a
22-10 license holder's license under this Act on inactive status if the
22-11 holder:
22-12 (1) is not actively engaged in the practice of
22-13 naturopathy;
22-14 (2) submits a written request to the board before the
22-15 expiration of the holder's license; and
22-16 (3) pays the required fee set by the board.
22-17 (b) The department shall maintain a list of each license
22-18 holder whose license is on inactive status.
22-19 (c) A license holder whose license is on inactive status:
22-20 (1) is not required to pay an annual renewal fee; and
22-21 (2) may not perform an activity regulated under this
22-22 Act.
22-23 (d) The board shall remove the license holder's license from
22-24 inactive status if the person:
22-25 (1) notifies the board in writing that the person
22-26 intends to return to active practice;
22-27 (2) pays a renewal fee set by the board; and
23-1 (3) presents evidence of having completed at least
23-2 half of the required hours of continuing education during the year
23-3 preceding the date of the application for activation.
23-4 Sec. 6.13. RETIRED STATUS. (a) The board may place a
23-5 license holder's license under this Act on retired status if the
23-6 holder notifies the department at the time of renewal.
23-7 (b) A license on retired status may not be reactivated.
23-8 (c) A person may not practice naturopathic medicine if that
23-9 person's license is on retired status.
23-10 ARTICLE 7. LICENSE RENEWAL
23-11 Sec. 7.01. RENEWAL OF LICENSE. (a) A license issued under
23-12 this Act must be renewed annually.
23-13 (b) To renew a license, a license holder must submit to the
23-14 department evidence of successful completion of the required hours
23-15 of continuing education from programs approved by the board.
23-16 (c) A person who is otherwise eligible to renew a license
23-17 may renew an unexpired license by paying the renewal fee set by the
23-18 board to the department before the expiration date of the license.
23-19 A person whose license has expired may not engage in activities
23-20 that require a license until the license has been renewed.
23-21 (d) A person whose license has been expired for 90 days or
23-22 less may renew the license by paying to the department a renewal
23-23 fee that is equal to 1-1/2 times the normally required renewal fee.
23-24 (e) A person whose license has been expired for more than 90
23-25 days but less than one year may renew the license by paying to the
23-26 department a renewal fee that is equal to two times the normally
23-27 required renewal fee.
24-1 (f) A person whose license has been expired for one year or
24-2 more may not renew the license. The person may obtain a new
24-3 license by complying with the requirements and procedures,
24-4 including the examination requirements, for obtaining an original
24-5 license.
24-6 (g) A person who was licensed in this state, moved to
24-7 another state, and is currently licensed and has been in practice
24-8 in the other state for the two years preceding the date of
24-9 application may obtain a new license without reexamination. The
24-10 person must pay to the department a fee that is equal to two times
24-11 the normally required renewal fee for the license.
24-12 (h) Not later than the 30th day before the date a person's
24-13 license is scheduled to expire, the department shall send written
24-14 notice of the impending expiration to the person at the person's
24-15 last known address according to the records of the department.
24-16 Sec. 7.02. CONTINUING EDUCATION. (a) Except as provided by
24-17 Subsection (b) of this section, a naturopathic physician shall
24-18 complete at least 15 approved hours of continuing education
24-19 annually.
24-20 (b) A naturopathic physician certified in naturopathic
24-21 childbirth shall complete at least 7-1/2 approved specialty hours
24-22 in obstetrics or natural childbirth and at least 10 approved
24-23 general continuing education hours annually for a total of at least
24-24 17-1/2 approved hours annually.
24-25 (c) A person who seeks to renew a license expired for less
24-26 than one year must comply with the continuing education
24-27 requirements for the regular renewal of the license.
25-1 ARTICLE 8. PRACTICE BY LICENSE HOLDERS
25-2 Sec. 8.01. DUTIES AND RESPONSIBILITIES. A naturopathic
25-3 physician has the same responsibility as any other licensed health
25-4 care provider regarding public health laws, reportable diseases and
25-5 conditions, communicable disease control and prevention, the
25-6 recording of vital statistics, health and physical examinations,
25-7 competency examinations, and local boards of health, except that
25-8 the authority under this section is limited to activity consistent
25-9 with the scope of practice authorized by this Act or board rule.
25-10 Sec. 8.02. AUTHORIZED ACTIVITIES. (a) A person licensed as
25-11 a naturopathic physician under this Act may use for preventive and
25-12 therapeutic purposes the following preparations and therapies:
25-13 (1) natural medicine;
25-14 (2) minor office procedures;
25-15 (3) natural antibiotics;
25-16 (4) naturopathic medicine;
25-17 (5) naturopathic childbirth;
25-18 (6) naturopathic mobilization therapy;
25-19 (7) topical preparations; and
25-20 (8) naturopathic physical medicine.
25-21 (b) A person licensed as a naturopathic physician under this
25-22 Act may use for evaluation purposes:
25-23 (1) physical and orificial examinations;
25-24 (2) electrocardiograms;
25-25 (3) ultrasound;
25-26 (4) phlebotomy;
25-27 (5) clinical laboratory tests and examinations;
26-1 (6) physiological function tests; and
26-2 (7) the noninvasive diagnostic procedures commonly
26-3 used in general practice.
26-4 (c) The board by rule may authorize the use by a person
26-5 licensed as a naturopathic physician under this Act of other
26-6 evaluative procedures and other natural substances, treatments,
26-7 procedures, and therapies if the substances, treatments,
26-8 procedures, and therapies are taught in approved courses of study
26-9 or used by practitioners licensed by other entities of this state
26-10 and are consistent with this Act.
26-11 Sec. 8.03. PROHIBITED ACTS. A naturopathic physician may
26-12 not:
26-13 (1) prescribe, dispense, or administer any legend
26-14 drugs or controlled substances except those preparations authorized
26-15 by this Act or board rule;
26-16 (2) perform surgical procedures or x-ray procedures
26-17 except those procedures authorized by this Act or board rule;
26-18 (3) practice emergency care except for:
26-19 (A) gratuitous services in the case of
26-20 emergency; or
26-21 (B) the care of minor injuries; or
26-22 (4) claim to practice allopathic medicine or surgery,
26-23 osteopathy, dentistry, podiatry, optometry, chiropractic, physical
26-24 therapy, acupuncture, or any other system or method of treatment
26-25 not authorized by this Act or board rule.
26-26 ARTICLE 9. DISCIPLINARY ACTIONS AND PROCEDURES
26-27 Sec. 9.01. GROUNDS FOR DISCIPLINARY ACTIONS. The board may
27-1 take disciplinary action against a license holder if the license
27-2 holder:
27-3 (1) is convicted of a misdemeanor involving moral
27-4 turpitude or a felony;
27-5 (2) obtains or attempts to obtain a license by fraud
27-6 or deception;
27-7 (3) uses drugs or alcohol to an extent that affects
27-8 the license holder's professional competence;
27-9 (4) performs professional duties in a grossly
27-10 negligent manner;
27-11 (5) is adjudicated as mentally incompetent by a court;
27-12 (6) holds the person out as a physician and surgeon or
27-13 any combination or derivative of those terms unless the person is
27-14 also licensed under the Medical Practice Act (Article 4495b,
27-15 Vernon's Texas Civil Statutes) as a surgeon;
27-16 (7) advertises in a manner that tends to deceive or
27-17 defraud the public;
27-18 (8) has a license or certification revoked by a
27-19 licensing agency or a certifying professional organization;
27-20 (9) violates this Act or a rule or code of ethics
27-21 adopted under this Act; or
27-22 (10) commits an act for which liability exists under
27-23 Chapter 81, Civil Practice and Remedies Code.
27-24 Sec. 9.02. DISCIPLINARY ACTIONS. (a) The board may revoke,
27-25 suspend, or refuse to renew a license or may limit the scope of
27-26 practice of a license holder if the license holder engages in the
27-27 practice of naturopathy in violation of this Act or a rule of the
28-1 board.
28-2 (b) The board may place on probation a person whose license
28-3 is suspended. If a license suspension is probated, the board may
28-4 require the person:
28-5 (1) to report regularly to the department on matters
28-6 that are the basis of the probation;
28-7 (2) to limit practice to the areas prescribed by the
28-8 board; or
28-9 (3) to continue or review professional education until
28-10 the person attains a degree of skill satisfactory to the board in
28-11 those areas that are the basis of the probation.
28-12 Sec. 9.03. HEARING. A license holder is entitled to a
28-13 hearing before the State Office of Administrative Hearings before a
28-14 sanction is imposed under this Act.
28-15 Sec. 9.04. SANCTIONS. (a) The board by rule shall adopt a
28-16 broad schedule of sanctions for violations under this Act.
28-17 (b) The State Office of Administrative Hearings shall use
28-18 the schedule for a sanction imposed as the result of a hearing
28-19 conducted by that office.
28-20 ARTICLE 10. PENALTIES AND ENFORCEMENT PROVISIONS
28-21 Sec. 10.01. MONITORING OF LICENSE HOLDER. The board by rule
28-22 shall develop a system to ensure that a license holder complies
28-23 with this Act. Rules adopted under this section must include
28-24 procedures to:
28-25 (1) monitor for compliance a license holder who is
28-26 ordered by the board to perform certain acts; and
28-27 (2) identify and monitor each license holder who
29-1 represents a risk to the public.
29-2 Sec. 10.02. CIVIL PENALTY. (a) A person who violates
29-3 Section 6.01, 6.10, 6.11, or 8.03 of this Act or a rule or order
29-4 adopted by the board under this Act is liable for a civil penalty
29-5 not to exceed $1,000 a day.
29-6 (b) At the request of the board or department, the attorney
29-7 general shall bring an action to recover a civil penalty authorized
29-8 under this section.
29-9 Sec. 10.03. CRIMINAL PENALTY. (a) A person required to
29-10 hold a license under this Act commits an offense if the person
29-11 knowingly acts as a naturopathic physician without holding a
29-12 license issued under this Act.
29-13 (b) An offense under Subsection (a) of this section is a
29-14 felony of the third degree.
29-15 Sec. 10.04. INJUNCTION. The board may seek an injunction
29-16 against a violation of this Act or a board rule.
29-17 SECTION 2. Section 3.06(b), Medical Practice Act (Article
29-18 4495b, Vernon's Texas Civil Statutes), is amended to read as
29-19 follows:
29-20 (b) This Act does not apply to:
29-21 (1) dentists, duly qualified and registered under the
29-22 laws of this state who confine their practice strictly to
29-23 dentistry;
29-24 (2) duly licensed optometrists who confine their
29-25 practice strictly to optometry as defined by law;
29-26 (3) duly licensed chiropractors who confine their
29-27 practice strictly to chiropractic as defined by law;
30-1 (4) registered or professional nurses and licensed
30-2 vocational nurses registered or licensed under the laws of this
30-3 state who confine their practice strictly within the provisions of
30-4 such applicable licensing Acts and the laws of this state;
30-5 (5) duly licensed podiatrists who confine their
30-6 practice strictly to podiatry as defined by law;
30-7 (6) duly licensed or certified psychologists who
30-8 confine their activities or practice strictly to psychology as
30-9 defined by law;
30-10 (7) duly licensed physical therapists who confine
30-11 their activities or practice strictly to physical therapy and who
30-12 are not in violation of any law relating to physical therapy
30-13 practice;
30-14 (8) commissioned or contract surgeons of the uniformed
30-15 services of the United States or in the Public Health Service in
30-16 the performance of their duties and not engaged in private
30-17 practice;
30-18 (9) any person furnishing medical assistance in case
30-19 of an emergency or disaster situation if no charge is made for the
30-20 medical assistance;
30-21 (10) a student in training in a medical school
30-22 approved by the board while performing the duties assigned in the
30-23 course of training, providing the duties are performed under the
30-24 supervision of a licensed practitioner, except that medical
30-25 residents, interns, and fellows shall be required to register and
30-26 be subject to the other applicable provisions of this Act;
30-27 (11) a legally qualified physician of another state
31-1 who is in this state for consultation with physicians licensed in
31-2 this state but who does not:
31-3 (A) have an office in this state; or
31-4 (B) appoint a place in this state for seeing,
31-5 examining, or treating patients; [or]
31-6 (12) a licensed naturopathic physician who confines
31-7 the physician's practice strictly to naturopathy as defined by law;
31-8 or
31-9 (13) any other activities that the board may designate
31-10 as exempt from the application of this Act.
31-11 SECTION 3. Section 3(a), Licensed Professional Counselor Act
31-12 (Article 4512g, Vernon's Texas Civil Statutes), is amended to read
31-13 as follows:
31-14 (a) Except as provided by Subsection (b) of this section,
31-15 this Act does not apply to:
31-16 (1) the activities and services of or use of an
31-17 official title by a person employed as a counselor by a federal,
31-18 state, county, or municipal agency or public or private educational
31-19 institution, if the person is performing counseling or
31-20 counseling-related activities within the scope of the person's
31-21 [his] employment;
31-22 (2) the activities and services of a student, intern,
31-23 or trainee in counseling pursuing a course of study in counseling
31-24 in a regionally accredited institution of higher education or
31-25 training institution, if these activities and services constitute a
31-26 part of the supervised course of study and the person is designated
31-27 a "counselor intern";
32-1 (3) the activities and services of a nonresident
32-2 rendered not more than 30 days during any year, if the person is
32-3 authorized to perform the activities and services under the law of
32-4 the state or country of the person's [his] residence;
32-5 (4) the activities and services of members of other
32-6 professions licensed or certified by the state, such as physicians,
32-7 registered nurses, psychologists, licensed [certified] social
32-8 workers, licensed marriage and family therapists, licensed chemical
32-9 dependency counselors, licensed naturopathic physicians, licensed
32-10 physician assistants, licensed occupational therapists, licensed
32-11 optometrists in the evaluation and remediation of learning or
32-12 behavioral disabilities associated with or caused by a defective or
32-13 abnormal condition of vision, Christian Science practitioners who
32-14 are recognized by the Church of Christ Scientist as registered and
32-15 published in the Christian Science Journal, or other recognized
32-16 religious practitioners performing counseling consistent with the
32-17 law of the state, their training, and any code of ethics of their
32-18 professions, if they do not represent themselves by any title or
32-19 description in the manner prescribed by Section 2 of this Act;
32-20 (5) the activities, services, titles, and descriptions
32-21 of persons licensed to practice law;
32-22 (6) the activities, services, titles, and descriptions
32-23 of persons employed as professionals or who are volunteers in the
32-24 practice of counseling for public and private nonprofit
32-25 organizations or charities who are accountable to the persons'
32-26 sponsoring organization and do not use the title or hold themselves
32-27 out to be licensed counselors;
33-1 (7) the activities, services, titles, and descriptions
33-2 of persons certified by the Commission on Rehabilitation Counselor
33-3 Certification or the Commission on Certification of Work Adjustment
33-4 and Vocational Evaluation Specialists performing counseling
33-5 consistent with the law of the state, their training, and any code
33-6 of ethics of their profession and who do not use the title or hold
33-7 themselves out to be licensed counselors; or
33-8 (8) persons owning, operating, or employed by a
33-9 certified career counseling service regulated under Chapter 222,
33-10 Acts of the 70th Legislature, Regular Session, 1987 (Article
33-11 5221a-8, Vernon's Texas Civil Statutes).
33-12 SECTION 4. (a) An initial member of the Naturopathic
33-13 Physicians Board who is required to be a licensed naturopathic
33-14 physician must be licensed under the Naturopathic Physicians Act
33-15 not later than January 1, 2001.
33-16 (b) The governor shall make the initial appointments to the
33-17 board before November 1, 1999, as follows:
33-18 (1) three members for terms expiring in 2001;
33-19 (2) three members for terms expiring in 2003; and
33-20 (3) three members for terms expiring in 2005.
33-21 (c) The board shall hold its first meeting before January 1,
33-22 2000. The board shall adopt rules under this Act before July 1,
33-23 2000.
33-24 SECTION 5. (a) Except as provided by Subsection (b) of this
33-25 section, this Act takes effect September 1, 1999.
33-26 (b) Sections 6.01, 10.02, and 10.03 of the Naturopathic
33-27 Physicians Act, as adopted by this Act, take effect January 1,
34-1 2001.
34-2 SECTION 6. The importance of this legislation and the
34-3 crowded condition of the calendars in both houses create an
34-4 emergency and an imperative public necessity that the
34-5 constitutional rule requiring bills to be read on three several
34-6 days in each house be suspended, and this rule is hereby suspended.