BILL NUMBER: SB 1446	ENROLLED
	BILL TEXT

	PASSED THE SENATE  AUGUST 29, 2012
	PASSED THE ASSEMBLY  AUGUST 27, 2012
	AMENDED IN ASSEMBLY  AUGUST 22, 2012
	AMENDED IN ASSEMBLY  JUNE 28, 2012
	AMENDED IN ASSEMBLY  JUNE 12, 2012
	AMENDED IN SENATE  MAY 14, 2012
	AMENDED IN SENATE  APRIL 9, 2012

INTRODUCED BY   Senator Negrete McLeod

                        FEBRUARY 24, 2012

   An act to amend Sections 3640 and 3640.7 of, and to add Section
3640.8 to, the Business and Professions Code, relating to healing
arts.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 1446, Negrete McLeod. Naturopathic doctors.
   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 various
tasks, including dispensing, administering, ordering, and prescribing
nutraceuticals, vitamins, amino acids, and minerals, among other
substances. Existing law authorizes a naturopathic doctor to furnish
or order drugs when, among other requirements, the drugs are ordered
or furnished under physician supervision. Existing law authorizes a
naturopathic doctor to independently prescribe epinephrine and
natural and synthetic hormones, as specified.
   This bill would also authorize a naturopathic doctor to furnish
nutraceuticals, vitamins, amino acids, and minerals, among other
substances, as specified, and to independently prescribe and
administer epinephrine and natural and synthetic hormones. The bill
would further authorize a naturopathic doctor to independently
prescribe and administer nutraceuticals, vitamins, amino acids, and
minerals, among other substances that may be administered by
intramuscular, intravenous, or other specified routes only when such
substances are chemically identical to those for sale without a
prescription. The bill would require a naturopathic doctor, in order
to qualify for intravenous therapy administration, to demonstrate
that he or she has complied with specified requirements, including
the successful completion of specified coursework by a provider
approved by the committee.


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 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.
   (c) A naturopathic doctor may dispense, administer, order,
prescribe, and 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.
   (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 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).
  SEC. 2.  Section 3640.7 of the Business and Professions Code is
amended to read:
   3640.7.  Notwithstanding the requirements of Section 3640.5 or any
other provision of this chapter, a naturopathic doctor may
independently prescribe and administer the following:
   (a) Epinephrine to treat anaphylaxis.
   (b) Natural and synthetic hormones.
   (c) Vitamins, minerals, amino acids, glutathione, botanicals and
their extracts, homeopathic medicines, electrolytes, sugars, and
diluents that may be administered utilizing routes of administration,
pursuant to subdivision (d) of Section 3640, only when such
substances are chemically identical to those for sale without a
prescription.
  SEC. 3.  Section 3640.8 is added to the Business and Professions
Code, to read:
   3640.8.  (a) To qualify to administer intravenous (IV) therapy in
his or her practice pursuant to Section 3640.7, a naturopathic doctor
shall demonstrate that he or she has complied with both of the
following requirements:
   (1) Has a current naturopathic doctor's license in this state.
   (2) Has completed a qualifying course on IV therapy from a course
provider approved by the committee.
   (b) The qualifying course shall consist of a minimum of 25
classroom hours on IV administration through injection of applicable
naturopathic formulary substances, of which at least 14 classroom
hours shall be identified as practicum. At a minimum, the qualifying
course shall have covered all of the following topics:
   (1) Evaluation of laboratory results, including, but not limited
to, the fluid status, cardiovascular status, and kidney function of
the patient.
   (2) The use of IV fluids, including, but not limited to,
osmolarity calculations, diluents, and admixtures pertinent to IV
therapeutics.
   (3) Sterile techniques and admixing.
   (4) Vein and site selection, site preparation, and insertion
techniques.
   (5) Complications with therapies, nutrient and drug interactions,
errors and adverse reactions, reporting errors to appropriate
agencies, error prevention, and followup with patient complications.
   (6) Emergency protocols, management, and referral.
   (7) Pharmacology, indications, preparation, and IV administration
of vitamins, minerals, amino acids, glutathione, botanicals and their
extracts, homeopathic medicines, electrolytes, sugars, and diluents.

   (8) Practicum, including, but not limited to, the following:
   (A) Observation of at least 10 IV setups, including administration
and management.
   (B) Successful completion of at least 10 IV setups, including
administration and management.
   (9) Successful completion of an examination with 70 percent or
greater correct answers to a minimum of 50 questions, where 10
percent or more of the questions have direct content to the
California formulary.
   (c) For the purposes of the qualifying course required by this
section, one classroom hour is defined as 50 minutes out of each
60-minute segment and may include time devoted to examinations. No
credit shall be granted for distance education, including, but not
limited to, correspondence courses, Internet courses, or video or
remote television offerings.
   (d) Pursuant to subdivision (e) of Section 3640, the committee may
establish regulations regarding IV administration that are
consistent with the education and training of a naturopathic doctor.