BILL ANALYSIS Ó
SB 538
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Date of Hearing: August 26, 2015
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Jimmy Gomez, Chair
SB 538
(Block) - As Amended August 17, 2015
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Urgency: No State Mandated Local Program: NoReimbursable: No
SUMMARY:
This bill provides a minor expansion of the scope of practice
for naturopathic doctors (NDs). Specifically, this bill:
SB 538
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1)Allows NDs to prescribe Schedule V drugs (those with some,
albeit low, potential for abuse) and drugs that are not
classified on the DEA schedule, without physician supervision.
2)Modifies under what circumstances an ND may order diagnostic
imaging studies and dispense, administer, order, prescribe,
provide, or furnish devices and durable medical equipment.
FISCAL EFFECT:
Minor and absorbable costs to the Osteopathic Medical Board to
oversee the new requirements (Naturopathic Doctors Fund).
COMMENTS:
1)Purpose. This bill intends to remove barriers for patients
seeking medical care from licensed NDs, by allowing them to
prescribe routine and low-risk medications, such as blood
pressure medications and antibiotics, without a written
supervision agreement.
2)Naturopathic Doctors. NDs are licensed and regulated by the
Naturopathic Medicine Committee within the Osteopathic Medical
Board. NDs must complete four years of post-graduate training
and take a national standardized licensing examination, but
they are not required to complete a residency training
program, as are medical doctors. An ND may be considered as a
primary care provider who uses herbs, supplements, vitamins,
homeopathy, nutritional counseling, some prescription
medicines, and other treatments to help the body.
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Under current law, naturopathic doctors can furnish or
prescribe Schedule III - V drugs, in accordance with
standardized procedures established by a supervising
physician. Naturopathic doctors can order diagnostic imaging
studies such as x-rays, but must refer those studies to a
properly licensed health care professional to interpret the
results.
3)Drug Schedules. Drugs are classified into five schedules
depending on the drug's medical use and potential for abuse or
dependency. Schedule I drugs are considered the most dangerous
and Schedule V are the least dangerous. Schedule V drugs
include drugs with limited quantities of narcotic and
stimulant drugs (such as cough syrups with codeine).
4)Prior Legislation. SB 1446 (McCleod), Chapter 333, Statutes of
2012) allowed NDs to independently prescribe and administer
vitamins, minerals, amino acids, and other substances.
5)Support. This bill is sponsored by the California Naturopathic
Doctors Association and supported by numerous natural and
integrative medicine groups. They support the ability of NDs
to offer more expansive primary care services.
6)Opposition. Numerous groups representing physicians, as well
as Kaiser Permanente, opposed a previous version of this bill.
The bill was substantially amended in Assembly Business and
Professions to remove many of the opposition's concerns. Some
of the groups were opposed to the expansion of NDs'
prescribing abilities, which remains in the bill. They cite
the belief NDs are inadequately prepared to prescribe drugs
without supervision.
Analysis Prepared by:Lisa Murawski / APPR. / (916)
SB 538
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319-2081