Naturopathic doctors: scope of practice.
SB 1333
California Bills
20250SB__133399INT INTRODUCED 2026-02-20 2025 SB INT Introduced by Senator Jones LEAD_AUTHOR SENATE Jones
An act to amend Sections 3640, 3640.5, and of, and to repeal
Section 3640.7 of, the Business and Professions Code, and to amend
Section of the Health and Safety Code, relating to healing arts. healing arts Naturopathic doctors: scope of practice. Existing law, the Naturopathic Doctors Act, provides for the licensure and regulation of naturopathic doctors by the California Board of Naturopathic Medicine. Existing law repeals the act on January 1, 2027. This bill would extend operation of the act until an unspecified date. Existing law defines naturopathic medicine and authorizes a naturopathic doctor to perform specific health care functions.
Existing law authorizes a naturopathic doctor to dispense, administer, order, prescribe, and furnish or perform, among other things, repair and care incidental to superficial lacerations and abrasions, except suturing, and the removal of foreign bodies located in the superficial tissues.
This bill would, instead, authorize a naturopathic doctor to dispense, administer, order, prescribe, and furnish or perform minor office procedures, defined, in part, to mean care and operative procedures relative to lacerations, skin lesions, and abrasions, the incision and drainage of abscesses, and the trephination of subungual hematomas, among other specified procedures. Existing law authorizes a naturopathic doctor to furnish or order drugs, including
Schedule III to
Schedule V, inclusive, controlled substances, under specified circumstances, including, among others, that the drugs are furnished or ordered under the supervision of a physician and surgeon and in accordance with standardized procedures or protocols developed by the naturopathic doctor and their supervising physician and surgeon and that the board has certified that the naturopathic doctor has completed coursework in pharmacology, as specified. Existing law authorizes a naturopathic doctor to independently prescribe and administer other specified drugs.
This bill would revise and recast the above-described authorizations to instead authorize a naturopathic doctor to furnish, order, or prescribe drugs, including, among others,
Schedule II to
Schedule V, inclusive, controlled substances, and would remove the supervision and standardized procedure requirements. The bill would make conforming changes. MAJORITY NO YES NO NO NO NO NO NO NO NO The people of the State of California do enact as follows:
SECTION 1.
Section 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 board, 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 (21 U.S.C.
Sec. 301 et seq.) 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)<xhtml:span class="EnSpace"/>Repair and care incidental to superficial lacerations and abrasions, except suturing.</xhtml:p><xhtml:p>(6)<xhtml:span class="EnSpace"/>Removal of foreign bodies located in the superficial tissues.</xhtml:p>"?>
(5) Minor office procedures. For purposes of this paragraph, “minor office procedure” means any of the following: (
A) Care and operative procedures relative to lacerations, skin lesions, and abrasions. (
B) The incision and drainage of abscesses. (
C) The trephination of subungual hematomas. (
D) The removal of foreign bodies. (
E) The topical and parenteral use of local anesthetic solutions, their adjuncts, and diluents. (
F) Obtaining samples of superficial human tissue by means of biopsy, consistent with the practice of naturopathic medicine. (
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 board 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.
Section 3640.5 of the Business and Professions Code is amended to read: <caml:Num>3640.5.</caml:Num><caml:LawSectionVersion id="id_3B65FD11-187A-4AB0-8A2B-12BFA26818EE"><caml:Content><xhtml:p>Nothing in this
chapter or any other law shall be construed to prohibit a naturopathic doctor from furnishing or ordering drugs when all of the following apply:</xhtml:p><xhtml:p>(a)<xhtml:span class="EnSpace"/>The drugs are furnished or ordered by a naturopathic doctor in accordance with standardized procedures or protocols developed by the naturopathic doctor and their supervising physician and surgeon.</xhtml:p><xhtml:p>(b)<xhtml:span class="EnSpace"/>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 their designee.</xhtml:p><xhtml:p>(c)<xhtml:span class="EnSpace"/>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 standardized procedure.</xhtml:p><xhtml:p>(d)<xhtml:span class="EnSpace"/>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:</xhtml:p><xhtml:p>(1)<xhtml:span class="EnSpace"/>Collaboration on the development of the standardized procedure.</xhtml:p><xhtml:p>(2)<xhtml:span class="EnSpace"/>Approval of the standardized procedure.</xhtml:p><xhtml:p>(3)<xhtml:span class="EnSpace"/>Availability by telephonic contact at the time of patient examination by the naturopathic doctor.</xhtml:p><xhtml:p>(e)<xhtml:span class="EnSpace"/>For purposes of this section, a physician and surgeon shall not supervise more than four naturopathic doctors at one time.</xhtml:p> <xhtml:p>(f)<xhtml:span class="EnSpace"/>Drugs furnished or ordered by a </xhtml:p></caml:Content></caml:LawSectionVersion></caml:LawSection>"?> 3640.5. (
a) A naturopathic doctor may furnish, order, or prescribe drugs, including, but not limited to, any of the following, provided they comply with the requirements of subdivision (b):
(1) Legend drugs, including
Schedule II to
Schedule V, inclusive, controlled substances under the California Uniform Controlled Substances Act (Division 10 (commencing with
Section 11000) of the Health and Safety Code).
(2) Epinephrine to treat anaphylaxis.
(3) Natural and synthetic hormones.
(4) 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. (g)</xhtml:p>"?> (
b) The board has certified that the naturopathic doctor has satisfactorily completed adequate coursework in pharmacology covering the drugs to be furnished or ordered under this section. The board shall establish the requirements for satisfactory completion of this subdivision. (h)</xhtml:p>"?> (
c) Use of the term “furnishing” in this section, in health facilities defined in subdivisions (b), (c), (d), (e), and (
i) of
Section of the Health and Safety Code, shall include Ordering"?> ordering or furnishing a drug in accordance with the standardized procedure. (2)<xhtml:span class="EnSpace"/>Transmitting an order of a supervising physician and surgeon.</xhtml:p>"?> (i)</xhtml:p>"?> (
d) 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 of the Code of Federal Regulations. (j)</xhtml:p>"?> (
e) Notwithstanding any other law, both of the following apply: (1)<xhtml:span class="EnSpace"/>A drug order issued pursuant to this
section shall be treated in the same manner as a prescription of the supervising physician.</xhtml:p>"?> (2)</xhtml:p>"?>
(1) All references to prescription in this code and the Health and Safety Code shall include drug orders issued by naturopathic doctors. (3)</xhtml:p>"?>
(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.
SEC.
Section 3640.7 of the Business and Professions Code is repealed. <caml:Num>3640.7.</caml:Num><caml:LawSectionVersion id="id_0391CBD9-513E-40B1-8496-D6EF9E333488"><caml:Content><xhtml:p>Notwithstanding the requirements of
Section 3640.5 or any other provision of this chapter, a naturopathic doctor may independently prescribe and administer the following:</xhtml:p><xhtml:p>(a)<xhtml:span class="EnSpace"/>Epinephrine to treat anaphylaxis.</xhtml:p><xhtml:p>(b)<xhtml:span class="EnSpace"/>Natural and synthetic hormones.</xhtml:p><xhtml:p>(c)<xhtml:span class="EnSpace"/>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.</xhtml:p></caml:Content></caml:LawSectionVersion></caml:LawSection>"?>
SEC. 4.
Section of the Business and Professions Code is amended to read: 3686. This
chapter shall remain in effect only until January 1, ____, and as of that date is repealed.
SEC. 5.
Section of the Health and Safety Code is amended to read: 11150. No person other than a physician, dentist, podiatrist, or veterinarian, or naturopathic doctor acting pursuant to
Section 3640.5 of the Business and Professions Code, or pharmacist acting within the scope of a project authorized under
Article 1 (commencing with
Section 128125) of
Chapter of Part of Division or within the scope of
Section 4052.1, 4052.2, or 4052.6 of the Business and Professions Code, a registered nurse acting within the scope of a project authorized under
Article 1 (commencing with
Section 128125) of
Chapter of Part of Division 107, a certified nurse-midwife acting within the scope of
Section 2746.51 of the Business and Professions Code, a nurse practitioner acting within the scope of
Section 2836.1 of the Business and Professions Code, a physician assistant acting within the scope of a project authorized under
Article 1 (commencing with
Section 128125) of
Chapter of Part of Division or
Section 3502.1 of the Business and Professions Code, or an optometrist acting within the scope of
Section of the Business and Professions Code, or an out-of-state prescriber acting pursuant to