Bill Text: CA SB538 | 2015-2016 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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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-Amended.html

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BILL NUMBER: SB 538	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  AUGUST 17, 2015
	AMENDED IN ASSEMBLY  JULY 7, 2015
	AMENDED IN SENATE  APRIL 16, 2015
	AMENDED IN SENATE  APRIL 6, 2015

INTRODUCED BY   Senator Block
   (Coauthor: Senator Hueso)
    (   Coauthor:   Assembly Member  
Nazarian   ) 

                        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 amended, 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, consistent with
naturopathic training as determined by the committee. Under the act,
a naturopathic doctor is authorized to dispense, administer, order,
prescribe, furnish, or perform certain things, including health
education and health counseling.
   This bill would, instead, authorize a naturopathic doctor to
perform certain tasks, consistent with the practice of naturopathic
medicine, and would additionally authorize a naturopathic doctor to
dispense, administer, order, prescribe, provide, or  furnish,
  furnish  devices and durable medical equipment
consistent with the naturopathic training as determined by the
committee.
   (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, except as specified, nothing
in the provisions governing naturopathic doctors or any other law
shall be construed to prohibit a naturopathic doctor from
administering, furnishing, ordering, or prescribing drugs and would
make a conforming change to the scope of the certification duties of
the Naturopathic Medicine Committee. The bill would delete certain
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 for Schedule V controlled substances and for
any drug approved by the federal Food and Drug Administration and
labeled "for prescription only," except chemotherapeutics, that is
not classified.
   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) A naturopathic doctor may order diagnostic imaging studies,
including X-ray, ultrasound, mammogram, bone densitometry, and
others, consistent with the practice of naturopathic medicine, but
shall refer the studies to an appropriately licensed health care
professional to conduct the study and interpret the results.
   (c) A naturopathic doctor may dispense, administer, order,
prescribe, 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
the naturopathic training 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.
   (d) A naturopathic doctor may utilize routes of administration
that include oral, nasal, auricular, ocular, rectal, vaginal,
transdermal, intradermal, subcutaneous, intravenous, and
intramuscular.
   (e) 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)  Nothing in this   This  section
shall  not  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).
  SEC. 2.  Section 3640.5 of the Business and Professions Code is
amended to read:
   3640.5.  (a) Except as set forth in this section, nothing in this
chapter or any other provision of law shall be construed to prohibit
a naturopathic doctor from administering, furnishing, ordering, or
prescribing drugs when functioning pursuant to this section.
    (b) Schedule III and Schedule IV controlled substances under the
California Uniform Controlled Substances Act (Division 10 (commencing
with Section 11000) of the Health and Safety Code) shall be
administered, furnished, ordered, and prescribed by a naturopathic
doctor in accordance with standardized procedures or protocols
developed by the naturopathic doctor and his or her supervising
physician and surgeon.
   (c) The naturopathic doctor shall function pursuant to a
standardized procedure, as defined by paragraphs (1) and (2) of
subdivision (c) of Section 2725, 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.
   (d) The standardized procedure or protocol covering the
administering, furnishing, ordering, or prescribing of Schedule III
and Schedule IV drugs shall specify which naturopathic doctors may
administer, furnish, order, or prescribe Schedule III and Schedule IV
drugs, which Schedule III through Schedule IV drugs may be
administered, furnished, ordered, or prescribed and under what
circumstances, the extent of physician and surgeon supervision, the
method of periodic review of the naturopathic doctor's competence,
including peer review, which shall be subject to the reporting
requirement in Section 805, and review of the provisions of the
standardized procedure.
   (e) The administering, furnishing, ordering, or prescribing of
Schedule III and Schedule IV drugs by a naturopathic doctor shall
occur 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.
   (f) When Schedule III controlled substances, as defined in Section
11056 of the Health and Safety Code, are administered, furnished,
ordered, or prescribed by a naturopathic doctor, the controlled
substances shall be administered, furnished, ordered, or prescribed
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 or protocol 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.
   (g) For purposes of this section, a physician and surgeon shall
not supervise more than four naturopathic doctors at one time.
    (h) Notwithstanding subdivision (c), drugs administered,
furnished, ordered, or prescribed by a naturopathic doctor without
the supervision of a physician and surgeon shall include Schedule V
controlled substances under the California Uniform Controlled
Substances Act (Division 10 (commencing with Section 11000) of the
Health and Safety Code) and any drug approved by the federal Food and
Drug Administration and labeled "for prescription only" or words of
similar import, except chemotherapeutics, that is not classified.
   (i) The committee shall certify that the naturopathic doctor has
satisfactorily completed adequate coursework in pharmacology covering
the drugs to be administered, furnished, ordered, or prescribed
under this section. The committee shall establish the requirements
for satisfactory completion of this subdivision.
   (j) 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 for Schedule III through Schedule IV controlled
substances.
   (1) Ordering a drug in accordance with the standardized procedure.

   (2) Transmitting an order of a supervising physician and surgeon.
   (k) 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.
   (l) Notwithstanding any other law, all of the following shall
apply:
   (1) A Schedule III through Schedule IV drug order issued pursuant
to this section shall be treated in the same manner as a prescription
of the supervising physician.
   (2) All references to prescription in this code and the Health and
Safety Code shall include drug orders issued by naturopathic
doctors.
   (3) 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.