Section § 3640

Explanation

Naturopathic doctors in California can perform and order various physical and lab exams to help diagnose patients, like blood tests or X-rays. While they can order imaging studies such as ultrasounds, they must have a qualified health professional handle the study and interpret the results. They can prescribe natural and nonprescription remedies, conduct some types of physical therapies, and provide health education. These doctors can also remove small foreign objects from the skin and take care of minor cuts, but they can't perform stitches. They can administer treatments using multiple methods, including oral and intravenous routes, following certain guidelines. They must still meet any required licensing for lab tests.

(a)CA Business & Professions Code § 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)CA Business & Professions Code § 3640(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)CA Business & Professions Code § 3640(c) A naturopathic doctor may dispense, administer, order, prescribe, and furnish or perform the following:
(1)CA Business & Professions Code § 3640(c)(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)CA Business & Professions Code § 3640(c)(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)CA Business & Professions Code § 3640(c)(3) Devices, including, but not limited to, therapeutic devices, barrier contraception, and durable medical equipment.
(4)CA Business & Professions Code § 3640(c)(4) Health education and health counseling.
(5)CA Business & Professions Code § 3640(c)(5) Repair and care incidental to superficial lacerations and abrasions, except suturing.
(6)CA Business & Professions Code § 3640(c)(6) Removal of foreign bodies located in the superficial tissues.
(d)CA Business & Professions Code § 3640(d) A naturopathic doctor may utilize routes of administration that include oral, nasal, auricular, ocular, rectal, vaginal, transdermal, intradermal, subcutaneous, intravenous, and intramuscular.
(e)CA Business & Professions Code § 3640(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)CA Business & Professions Code § 3640(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).

Section § 3640.1

Explanation

This law allows a naturopathic doctor to supervise a licensed vocational nurse, but the doctor cannot ask the nurse to do anything that the doctor themselves is not legally allowed to do.

(a)CA Business & Professions Code § 3640.1(a) A naturopathic doctor may provide supervision and direction to a licensed vocational nurse in accordance with Sections 2859 and 2859.1.
(b)CA Business & Professions Code § 3640.1(b) A naturopathic doctor shall not direct a licensed vocational nurse under their employment to take any action outside the scope of practice of the naturopathic doctor.

Section § 3640.2

Explanation

This law allows naturopathic assistants to perform certain tasks under the supervision of a licensed naturopathic doctor. They may administer certain types of injections and skin tests, draw blood, and provide other technical support services like administering medications in various ways, collecting samples, and assisting patients. The law requires that these tasks be performed with proper authorizations and that the assistants have appropriate training. Additionally, the law outlines a process for establishing standards for these services, involving input from various medical boards and associations.

Notwithstanding any other provision of law, a naturopathic assistant may do all of the following:
(a)CA Business & Professions Code § 3640.2(a) Administer medication only by intradermal, subcutaneous, or intramuscular injections and perform skin tests and additional technical support services upon the specific authorization and supervision of a licensed naturopathic doctor. A naturopathic assistant may also perform all these tasks and services in a clinic licensed pursuant to subdivision (a) of Section 1204 of the Health and Safety Code upon the specific authorization of a naturopathic doctor.
(b)CA Business & Professions Code § 3640.2(b) Perform venipuncture or skin puncture for the purposes of withdrawing blood upon specific authorization and under the supervision of a licensed naturopathic doctor if prior thereto the naturopathic assistant has met the educational and training requirements for medical assistants as established in Section 2070. A copy of any related certificates shall be retained as a record by each employer of the assistant.
(c)CA Business & Professions Code § 3640.2(c) Perform the following naturopathic technical support services:
(1)CA Business & Professions Code § 3640.2(c)(1) Administer medications orally, sublingually, topically, vaginally, or rectally, or by providing a single dose to a patient for immediate self-administration. Administer medication by inhalation if the medications are patient-specific and have been or will be repetitively administered to the patient. In every instance, prior to administration of medication by the naturopathic assistant, the naturopathic doctor shall verify the correct medication and dosage.
(2)CA Business & Professions Code § 3640.2(c)(2) Apply and remove bandages.
(3)CA Business & Professions Code § 3640.2(c)(3) Collect by noninvasive techniques and preserve specimens for testing, including urine, sputum, semen, and stool.
(4)CA Business & Professions Code § 3640.2(c)(4) Assist patients to and from a patient examination room or examination table.
(5)CA Business & Professions Code § 3640.2(c)(5) As authorized by the naturopathic doctor, provide patient information and instructions.
(6)CA Business & Professions Code § 3640.2(c)(6) Collect and record patient data, including height, weight, temperature, pulse, respiration rate, and blood pressure, and basic information about the presenting and previous conditions.
(7)CA Business & Professions Code § 3640.2(c)(7) Perform simple laboratory and screening tests customarily performed in a medical office.
(d)CA Business & Professions Code § 3640.2(d) Perform additional naturopathic technical support services under the regulations and standards established by the board. The board, before the adoption of any regulations, shall request recommendations regarding these standards from appropriate public agencies, including, but not limited to, the Osteopathic Medical Board of California, the Medical Board of California, the Board of Registered Nursing, the Board of Vocational Nursing and Psychiatric Technicians of the State of California, the Laboratory Field Services division of the State Department of Public Health, and the Physical Therapy Board of California. The California Board of Naturopathic Medicine shall also request recommendations regarding these standards from associations of medical assistants, physicians, and others, as appropriate, including, but not limited to, the Osteopathic Physicians and Surgeons of California, the California Medical Association, the California Society of Medical Assistants, and the California Medical Assistants’ Association. Nothing in this subdivision shall be construed to supersede or modify that portion of the Administrative Procedure Act that relates to the procedure for the adoption of regulations set forth in Article 5 (commencing with Section 11346) of Chapter 3.5 of Part 1 of Division 3 of Title 2 of the Government Code.

Section § 3640.3

Explanation

This law section makes it clear that naturopathic assistants in California are not allowed to get licensed, administer local anesthetics, or perform tasks like diagnostics or treatment beyond their scope. They can’t do clinical lab tests unless specifically authorized by other laws. Furthermore, naturopathic assistants are not allowed to work in inpatient care within general acute care hospitals.

(a)CA Business & Professions Code § 3640.3(a) Nothing in this chapter shall be construed as authorizing the licensure of naturopathic assistants. Nothing in this chapter shall be construed as authorizing the administration of local anesthetic agents by a naturopathic assistant. Nothing in this chapter shall be construed as authorizing the California Board of Naturopathic Medicine to adopt any regulations that violate the prohibitions on diagnosis or treatment in Section 2052.
(b)CA Business & Professions Code § 3640.3(b) Nothing in this chapter shall be construed as authorizing a naturopathic assistant to perform any clinical laboratory test or examination for which they are not authorized under Chapter 3 (commencing with Section 1200).
(c)CA Business & Professions Code § 3640.3(c) Notwithstanding any other law, a naturopathic assistant may not be employed for inpatient care in a licensed general acute care hospital, as defined in subdivision (a) of Section 1250 of the Health and Safety Code.

Section § 3640.5

Explanation

This law allows naturopathic doctors in California to provide or prescribe drugs if certain conditions are followed. First, they must work under standardized procedures or protocols created with their supervising physician. These procedures must outline who can prescribe, what drugs can be prescribed, and under what circumstances, including the level of supervision required. The supervising physician doesn't need to be physically present but must approve the procedures and be available by phone. Naturopathic doctors can prescribe certain controlled substances, but there are extra rules for Schedule III drugs. Additionally, naturopathic doctors must have completed training in pharmacology. Their prescribing authority is treated the same as if it were done by their supervising physician.

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:
(a)CA Business & Professions Code § 3640.5(a) 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.
(b)CA Business & Professions Code § 3640.5(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 their designee.
(c)CA Business & Professions Code § 3640.5(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 standardized procedure.
(d)CA Business & Professions Code § 3640.5(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)CA Business & Professions Code § 3640.5(d)(1) Collaboration on the development of the standardized procedure.
(2)CA Business & Professions Code § 3640.5(d)(2) Approval of the standardized procedure.
(3)CA Business & Professions Code § 3640.5(d)(3) Availability by telephonic contact at the time of patient examination by the naturopathic doctor.
(e)CA Business & Professions Code § 3640.5(e) For purposes of this section, a physician and surgeon shall not supervise more than four naturopathic doctors at one time.
(f)CA Business & Professions Code § 3640.5(f) 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.
(g)CA Business & Professions Code § 3640.5(g) 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)CA Business & Professions Code § 3640.5(h) 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)CA Business & Professions Code § 3640.5(h)(1) Ordering a drug in accordance with the standardized procedure.
(2)CA Business & Professions Code § 3640.5(h)(2) Transmitting an order of a supervising physician and surgeon.
(i)CA Business & Professions Code § 3640.5(i) 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)CA Business & Professions Code § 3640.5(j) Notwithstanding any other law, the following apply:
(1)CA Business & Professions Code § 3640.5(j)(1) A drug order issued pursuant to this section shall be treated in the same manner as a prescription of the supervising physician.
(2)CA Business & Professions Code § 3640.5(j)(2) All references to prescription in this code and the Health and Safety Code shall include drug orders issued by naturopathic doctors.
(3)CA Business & Professions Code § 3640.5(j)(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.

Section § 3640.7

Explanation

This law allows naturopathic doctors in California to prescribe and give certain treatments without needing another doctor's supervision. They can administer epinephrine for severe allergic reactions, use natural and synthetic hormones, and provide various nutritional substances like vitamins and amino acids. These treatments must be the same as those available over-the-counter.

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)CA Business & Professions Code § 3640.7(a) Epinephrine to treat anaphylaxis.
(b)CA Business & Professions Code § 3640.7(b) Natural and synthetic hormones.
(c)CA Business & Professions Code § 3640.7(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.

Section § 3640.8

Explanation

This law section outlines the qualifications that a naturopathic doctor in California must meet to administer intravenous (IV) therapy. They need to have a valid naturopathic license and complete a specific IV therapy course approved by the board. This course must include at least 25 hours of instruction, covering key topics like evaluating lab results, IV fluid use, sterile techniques, vein selection, managing complications, emergency protocols, and pharmacology. The course must include practical experience and an exam with a passing score of at least 70%. Distance learning methods cannot be used to fulfill these requirements.

(a)CA Business & Professions Code § 3640.8(a) To qualify to administer intravenous (IV) therapy in their practice pursuant to Section 3640.7, a naturopathic doctor shall demonstrate that they have complied with both of the following requirements:
(1)CA Business & Professions Code § 3640.8(a)(1) Have a current naturopathic doctor’s license in this state.
(2)CA Business & Professions Code § 3640.8(a)(2) Have completed a qualifying course on IV therapy from a course provider approved by the board.
(b)CA Business & Professions Code § 3640.8(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)CA Business & Professions Code § 3640.8(b)(1) Evaluation of laboratory results, including, but not limited to, the fluid status, cardiovascular status, and kidney function of the patient.
(2)CA Business & Professions Code § 3640.8(b)(2) The use of IV fluids, including, but not limited to, osmolarity calculations, diluents, and admixtures pertinent to IV therapeutics.
(3)CA Business & Professions Code § 3640.8(b)(3) Sterile techniques and admixing.
(4)CA Business & Professions Code § 3640.8(b)(4) Vein and site selection, site preparation, and insertion techniques.
(5)CA Business & Professions Code § 3640.8(b)(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)CA Business & Professions Code § 3640.8(b)(6) Emergency protocols, management, and referral.
(7)CA Business & Professions Code § 3640.8(b)(7) Pharmacology, indications, preparation, and IV administration of vitamins, minerals, amino acids, glutathione, botanicals and their extracts, homeopathic medicines, electrolytes, sugars, and diluents.
(8)CA Business & Professions Code § 3640.8(b)(8) Practicum, including, but not limited to, the following:
(A)CA Business & Professions Code § 3640.8(b)(8)(A) Observation of at least 10 IV setups, including administration and management.
(B)CA Business & Professions Code § 3640.8(b)(8)(B) Successful completion of at least 10 IV setups, including administration and management.
(9)CA Business & Professions Code § 3640.8(b)(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)CA Business & Professions Code § 3640.8(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)CA Business & Professions Code § 3640.8(d) Pursuant to subdivision (e) of Section 3640, the board may establish regulations regarding IV administration that are consistent with the education and training of a naturopathic doctor.

Section § 3641

Explanation

Naturopathic doctors in California must keep accurate patient records, including observations, diagnosis, and treatment summaries, for at least seven years after a patient is discharged. If the patient is a minor, the records must be kept until the minor turns 19, or for seven years after discharge, whichever is later. Additionally, naturopathic doctors have the same obligations as licensed physicians regarding public health duties, such as reporting diseases, controlling communicable diseases, and recording vital statistics, all in line with their education and training.

(a)CA Business & Professions Code § 3641(a) A naturopathic doctor shall document their observations, diagnosis, and summary of treatment in the patient record. Patient records shall be maintained for a period of not less than seven years following the discharge of the patient. The records of an unemancipated minor shall be maintained until at least one year after the minor has reached 18 years of age or seven years following the discharge of the minor, whichever is longer.
(b)CA Business & Professions Code § 3641(b) A naturopathic doctor shall have the same authority and responsibility as a licensed physician and surgeon with regard to public health laws, including laws governing reportable diseases and conditions, communicable disease control and prevention, recording vital statistics, and performing health and physical examinations consistent with their education and training.

Section § 3642

Explanation

Naturopathic doctors in California have certain restrictions on what they can do. They cannot prescribe or give out controlled substances unless allowed by specific rules, use radiation or radioactive treatments, or perform treatments needing a different license. They're also not allowed to use general or spinal anesthesia, perform abortions, do surgery, or practice acupuncture or traditional Asian medicine unless they have a separate acupuncture license.

A naturopathic doctor may not perform any of the following functions:
(a)CA Business & Professions Code § 3642(a) Prescribe, dispense, or administer a controlled substance or device identified in Sections 801 to 971, inclusive, of Title 21 of the United States Code, except as authorized by this chapter.
(b)CA Business & Professions Code § 3642(b) Administer therapeutic ionizing radiation or radioactive substances.
(c)CA Business & Professions Code § 3642(c) Practice or claim to practice any other system or method of treatment beyond that authorized by this chapter, for which licensure is required, unless otherwise licensed to do so.
(d)CA Business & Professions Code § 3642(d) Administer general or spinal anesthesia.
(e)CA Business & Professions Code § 3642(e) Perform an abortion.
(f)CA Business & Professions Code § 3642(f) Perform any surgical procedure.
(g)CA Business & Professions Code § 3642(g) Perform acupuncture or traditional Chinese and Asian medicine, including Chinese herbal medicine, unless licensed as an acupuncturist as defined in subdivision (c) of Section 4927.

Section § 3643

Explanation

This law makes it clear that naturopathic doctors in California aren't allowed to practice medicine like medical doctors do, unless it's specifically allowed by this chapter.

This chapter may not be construed to authorize a naturopathic doctor to practice medicine, as defined under Chapter 5 (commencing with Section 2000), except as specifically authorized in this chapter.

Section § 3643.5

Explanation

This law clarifies that it doesn't restrict individuals who are licensed in the healing arts from practicing under their respective legal authorizations. Additionally, it ensures that activities not requiring a license, like certain naturopathic practices, are still allowed as long as they comply with specific state regulations.

(a)CA Business & Professions Code § 3643.5(a) This chapter may not be construed to limit the practice of a person licensed, certified, or registered under any other provision of law relating to the healing arts when the person is engaged in his or her authorized and licensed practice.
(b)CA Business & Professions Code § 3643.5(b) This chapter may not be construed to limit an activity that does not require licensure or is otherwise allowed by law, including the practice of naturopathy, when performed consistent with Sections 2053.5 and 2053.6.

Section § 3644

Explanation

This section outlines who can practice naturopathy in California without breaking the law. It allows people who are licensed or certified under other regulations to practice their profession, federal employees doing their jobs, and individuals providing care to family or during emergencies for free. It also permits those giving advice about or selling health-related products like vitamins and herbs to do so if they aren't otherwise prohibited by law. People practicing their religion without prescribing drugs can also provide health information. Those from other states consulting within California, and students working under supervision, are allowed, too. Unlicensed individuals can say they 'practice naturopathy' if they follow specific rules, but they can't call themselves 'naturopathic doctor' without an official license.

This chapter does not prevent or restrict the practice, services, or activities of any of the following:
(a)CA Business & Professions Code § 3644(a) A person licensed, certified, or otherwise recognized in this state by any other law or regulation if that person is engaged in the profession or occupation for which they are licensed, certified, or otherwise recognized.
(b)CA Business & Professions Code § 3644(b) A person employed by the federal government in the practice of naturopathic medicine while the person is engaged in the performance of duties prescribed by laws and regulations of the United States.
(c)CA Business & Professions Code § 3644(c) A person rendering aid to a family member or in an emergency, if no fee or other consideration for the service is charged, received, expected, or contemplated.
(d)Copy CA Business & Professions Code § 3644(d)
(1)Copy CA Business & Professions Code § 3644(d)(1) A person who makes recommendations regarding or is engaged in the sale of food, extracts of food, nutraceuticals, vitamins, amino acids, minerals, enzymes, botanicals and their extracts, botanical medicines, homeopathic medicines, dietary supplements, and nonprescription drugs or other products of nature, the sale of which is not otherwise prohibited under state or federal law.
(2)CA Business & Professions Code § 3644(d)(2) An unlicensed person described in this subdivision may represent that they “practice naturopathy” if they comply with Section 2053.6. However, an unlicensed person may not use the title “naturopathic doctor” unless they have been issued a license by the board.
(e)CA Business & Professions Code § 3644(e) A person engaged in good faith in the practice of the religious tenets of any church or religious belief without using prescription drugs.
(f)CA Business & Professions Code § 3644(f) A person acting in good faith for religious reasons as a matter of conscience or based on a personal belief, while obtaining or providing information regarding health care and the use of any product described in subdivision (d).
(g)CA Business & Professions Code § 3644(g) A person who provides the following recommendations regarding the human body and its function:
(1)CA Business & Professions Code § 3644(g)(1) Nonprescription products.
(2)CA Business & Professions Code § 3644(g)(2) Natural elements such as air, heat, water, and light.
(3)CA Business & Professions Code § 3644(g)(3) Class I or class II nonprescription, approved medical devices, as defined in Section 360c of Title 21 of the United States Code.
(4)CA Business & Professions Code § 3644(g)(4) Vitamins, minerals, herbs, homeopathics, natural food products and their extracts, and nutritional supplements.
(h)CA Business & Professions Code § 3644(h) A person who is licensed in another state, territory, or the District of Columbia to practice naturopathic medicine if the person is incidentally called into this state for consultation with a naturopathic doctor.
(i)CA Business & Professions Code § 3644(i) A student enrolled in an approved naturopathic medical program whose services are performed pursuant to a course of instruction under the supervision of a naturopathic doctor.

Section § 3645

Explanation

This section explains that people who are trained in naturopathy can use titles like "Naturopath," "Naturopathic practitioner," and "Traditional naturopathic practitioner." It also states that these people can receive education in these fields without needing a license under this specific chapter.

(a)CA Business & Professions Code § 3645(a) This chapter permits, and does not restrict, the use of the following titles by persons who are educated and trained as any of the following:
(1)CA Business & Professions Code § 3645(a)(1) “Naturopath.”
(2)CA Business & Professions Code § 3645(a)(2) “Naturopathic practitioner.”
(3)CA Business & Professions Code § 3645(a)(3) “Traditional naturopathic practitioner.”
(b)CA Business & Professions Code § 3645(b) This chapter permits, and does not restrict, the education of persons as described in paragraphs (1) to (3), inclusive, of subdivision (a). Those persons are not required to be licensed under this chapter.