Bill Text: CA SB538 | 2015-2016 | Regular Session | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Naturopathic doctors.
Spectrum: Slight Partisan Bill (Democrat 3-1)
Status: (Failed) 2016-09-01 - From Assembly without further action. [SB538 Detail]
Download: California-2015-SB538-Introduced.html
Bill Title: Naturopathic doctors.
Spectrum: Slight Partisan Bill (Democrat 3-1)
Status: (Failed) 2016-09-01 - From Assembly without further action. [SB538 Detail]
Download: California-2015-SB538-Introduced.html
BILL NUMBER: SB 538 INTRODUCED
BILL TEXT
INTRODUCED BY Senator Block
FEBRUARY 26, 2015
An act to amend Sections 3640 and 3640.5 of the Business and
Professions Code, relating to naturopathic doctors.
LEGISLATIVE COUNSEL'S DIGEST
SB 538, as introduced, Block. Naturopathic doctors.
(1) Existing law, the Naturopathic Doctors Act, provides for the
licensure and regulation of naturopathic doctors by the Naturopathic
Medicine Committee in the Osteopathic Medical Board of California.
Existing law authorizes a naturopathic doctor to perform certain
tasks, including physical and laboratory examinations for diagnostic
purposes, and to order diagnostic imaging studies, as specified.
This bill would revise and recast those provisions and would
expressly authorize a naturopathic doctor to order, perform, review,
and interpret the results of diagnostic procedures commonly used by
physicians and surgeons in general practice and to dispense,
administer, order, prescribe, provide, furnish, or perform parenteral
therapy and minor procedures, among other duties. The bill would
include cervical routes of administration among the authorized routes
of administration. The bill would define terms for those purposes.
(2) Existing law, the California Uniform Controlled Substances
Act, classifies controlled substances into 5 designated schedules,
with the most restrictive limitations generally placed on controlled
substances classified in Schedule I, and the least restrictive
limitation generally placed on controlled substances classified in
Schedule V.
Existing law states that nothing in the Naturopathic Doctors Act
or any other law shall be construed to prohibit a naturopathic doctor
from furnishing or ordering drugs when, among other requirements,
the naturopathic doctor is functioning pursuant to standardized
procedure, as defined, or protocol developed and approved, as
specified, and the Naturopathic Medicine Committee has certified that
the naturopathic doctor has satisfactorily completed adequate
coursework in pharmacology covering the drugs to be furnished or
ordered. Existing law requires that the furnishing or ordering of
drugs by a naturopathic doctor occur under the supervision of a
physician and surgeon. Existing law also authorizes a naturopathic
doctor to furnish or order controlled substances classified in
Schedule III, IV, or V of the California Uniform Controlled
Substances Act, but limits this authorization to those drugs agreed
upon by the naturopathic doctor and physician and surgeon as
specified in the standardized procedure. Existing law further
requires that drugs classified in Schedule III be furnished or
ordered in accordance with a patient-specific protocol approved by
the treating or supervising physician.
This bill would instead provide that nothing in the provisions
governing naturopathic doctors or any other law shall be construed to
prohibit a naturopathic doctor from furnishing, prescribing,
administering, or ordering drugs and would make a conforming change
to the scope of the certification duties of the Naturopathic Medicine
Committee. The bill would delete the other provisions described
above restricting the authority of naturopathic doctors to furnish or
order drugs, including the requirements that the naturopathic doctor
function pursuant to a standardized procedure, or furnish or order
drugs under the supervision of a physician and surgeon.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 3640 of the Business and Professions Code is
amended to read:
3640. (a) A naturopathic doctor may order and perform physical
and laboratory examinations for diagnostic purposes, including, but
not limited to, phlebotomy, clinical laboratory tests, speculum
examinations, orificial examinations, and physiological function
tests.
(b)
3640. (a) A naturopathic doctor
may order , perform, review, and interpret the results of
diagnostic imaging studies, including X-ray, ultrasound,
mammogram, bone densitometry, and others, consistent with
naturopathic training as determined by the committee, but shall refer
the studies to an appropriately licensed health care professional to
conduct the study and interpret the results.
procedures commonly used by physicians and surgeons in general
practice, including:
(1) Venipuncture.
(2) Physical and orificial examinations.
(3) Electrocardiograms.
(4) Diagnostic imaging technique consistent with the practice of
naturopathic medicine.
(5) Phlebotomy.
(6) Clinical laboratory test and examinations, as described in
subdivision (e).
(7) Obtaining samples of human tissue, consistent with the
practice of naturopathic medicine.
(c)
(b) A naturopathic doctor may dispense, administer,
order, prescribe, and furnish provide,
furnish, or perform the following:
(1) Food, extracts of food, nutraceuticals, vitamins, amino acids,
minerals, enzymes, botanicals and their extracts, botanical
medicines, homeopathic medicines, all dietary supplements and
nonprescription drugs as defined by the federal Food, Drug, and
Cosmetic Act, consistent with the routes of administration identified
in subdivision (d).
(2) Hot or cold hydrotherapy; naturopathic physical medicine
inclusive of the manual use of massage, stretching, resistance, or
joint play examination but exclusive of small amplitude movement at
or beyond the end range of normal joint motion; electromagnetic
energy; colon hydrotherapy; and therapeutic exercise.
(3) Devices, including, but not limited to, therapeutic devices,
barrier contraception, and durable medical equipment consistent
with naturopathic train ing as determined by the committee
.
(4) Health education and health counseling.
(5) Repair and care incidental to superficial lacerations and
abrasions, except suturing.
(6) Removal of foreign bodies located in the superficial tissues.
(5) Parenteral therapy.
(6) Minor procedures.
(d)
(c) A naturopathic doctor may utilize routes of
administration that include oral, nasal, auricular, ocular,
cervical, rectal, vaginal, transdermal, intradermal,
subcutaneous, intravenous, and intramuscular.
(e)
(d) The committee may establish regulations regarding
ocular or intravenous routes of administration that are consistent
with the education and training of a naturopathic doctor.
(f)
(e) Nothing in this section shall exempt a naturopathic
doctor from meeting applicable licensure requirements for the
performance of clinical laboratory tests, including the requirements
imposed under Chapter 3 (commencing with Section 1200).
(f) For purposes of this section:
(1) "Minor procedures" means care and operative procedures
relative to superficial laceration, lesions, and abrasions, and the
removal of foreign bodies located in superficial structures and
aspiration of joints, and the topical and parenteral use of
substances consistent with the practice of naturopathic medicine, in
accordance with rules established by the Naturopathic Medicine
Committee.
(2) "Parenteral therapy" means the administration of substances by
means other than through the gastrointestinal tract, including
intravenous, subcutaneous and intramuscular, intravenous and other
areas of the body excluding the ventral and dorsal body cavities.
SEC. 2. Section 3640.5 of the Business and Professions Code is
amended to read:
3640.5. (a) Nothing in this chapter or any
other provision of law shall be construed to
prohibit a naturopathic doctor from furnishing or
, prescribing, administering, or ordering drugs
when all of the following apply: .
(a) The drugs are furnished or ordered by a naturopathic doctor in
accordance with standardized procedures or protocols developed by
the naturopathic doctor and his or her supervising physician and
surgeon.
(b) The naturopathic doctor is functioning pursuant to
standardized procedure, as defined by subdivisions (a), (b), (d),
(e), (h), and (i) of Section 2836.1 and paragraph (1) of subdivision
(c) of Section 2836.1, or protocol. The standardized procedure or
protocol shall be developed and approved by the supervising physician
and surgeon, the naturopathic doctor, and, where applicable, the
facility administrator or his or her designee.
(c) The standardized procedure or protocol covering the furnishing
of drugs shall specify which naturopathic doctors may furnish or
order drugs, which drugs may be furnished or ordered under what
circumstances, the extent of physician and surgeon supervision, the
method of periodic review of the naturopathic doctor's competence,
including peer review, and review of the provisions of the
standardized procedure.
(d) The furnishing or ordering of drugs by a naturopathic doctor
occurs under physician and surgeon supervision. Physician and surgeon
supervision shall not be construed to require the physical presence
of the physician, but does include all of the following:
(1) Collaboration on the development of the standardized
procedure.
(2) Approval of the standardized procedure.
(3) Availability by telephonic contact at the time of patient
examination by the naturopathic doctor.
(e) For purposes of this section, a physician and surgeon shall
not supervise more than four naturopathic doctors at one time.
(f)
(b) Drugs furnished or ordered by a naturopathic doctor
may include Schedule III through Schedule V controlled substances
under the California Uniform Controlled Substances Act (
Division 10 (commencing with Section 11000) of the Health
and Safety Code) and shall be further limited to those drugs
agreed upon by the naturopathic doctor and physician and surgeon as
specified in the standardized procedure. When Schedule III controlled
substances, as defined in Section 11056 of the Health and Safety
Code, are furnished or ordered by a naturopathic doctor, the
controlled substances shall be furnished or ordered in accordance
with a patient-specific protocol approved by the treating or
supervising physician. A copy of the section of the naturopathic
doctor's standardized procedure relating to controlled substances
shall be provided upon request, to a licensed pharmacist who
dispenses drugs, when there is uncertainty about the naturopathic
doctor furnishing the order. Code.
(g)
(c) The committee has certified
shall certify that the naturopathic doctor has satisfactorily
completed adequate coursework in pharmacology covering the drugs to
be furnished , prescribed, administered, or ordered under
this section. The committee shall establish the requirements for
satisfactory completion of this subdivision.
(h)
(d) Use of the term "furnishing" in this section, in
health facilities defined in subdivisions (b), (c), (d), (e), and (i)
of Section 1250 of the Health and Safety Code, shall include
both of the following:
(1) Ordering
ordering and furnishing a drug in
accordance with the standardized procedure drug
.
(2) Transmitting an order of a supervising physician and surgeon.
(i)
(e) For purposes of this section, "drug order" or
"order" means an order for medication which is dispensed to or for an
ultimate user, issued by a naturopathic doctor as an individual
practitioner, within the meaning of Section 1306.02 of Title 21 of
the Code of Federal Regulations.
(j)
(f) Notwithstanding any other provision of law,
both of the following shall apply:
(1) A drug order issued pursuant to this section shall be treated
in the same manner as a prescription of the supervising physician.
(2)
(1) All references to prescription in this code and the
Health and Safety Code shall include drug orders issued by
naturopathic doctors.
(3)
(2) The signature of a naturopathic doctor on a drug
order issued in accordance with this section shall be deemed to be
the signature of a prescriber for purposes of this code and the
Health and Safety Code.
