Honorable Calvin K.Y. Say

Speaker, House of Representatives

Twenty-Third State Legislature

Regular Session of 2005

State of Hawaii

Sir:

Your Committee on Consumer Protection & Commerce, to which was referred H.B. No. 1155 entitled:

begs leave to report as follows:

The purpose of this bill is to dispel any ambiguity in the naturopathy law as to whether naturopaths are authorized to administer natural medicines by injection, by expressly authorizing naturopaths to do so.

The Hawaii Society of Naturopathic Physicians and a number of concerned individuals supported this bill. Testimony in opposition was received from the Hawaii Medical Association. The Board of Examiners in Naturopathy commented.

Your Committee finds that Hawaii's naturopathy law does not specifically prohibit administration of natural medicines by injection. The law does authorize the use of "natural methods and modalities" of the type taught at naturopathic medical colleges. Your Committee further finds that accredited naturopathic colleges instruct students in the use of injections, and applicants for licensure as a naturopath must pass a national examination that includes procedures for intravenous, intramuscular, and subcutaneous injection and vaccinations.

Your Committee finds that in 1984, the Board of Examiners in Naturopathy (Board) issued an opinion that the injection of vitamins was within the scope of practice of naturopathic physicians. Naturopathic physicians in Hawaii, and nationwide, have been administering natural medicines by injection for over a decade. However, based on a 1994 committee report (Hse. Stand. Com. Rep. No. 712-94), questions were recently raised by the Board as to whether Hawaii's naturopathy law actually authorizes administration of natural medicines by injection.

Although your Committee recognizes the testimony that there has not been a reported case of misuse or harm caused by injection of natural medicines, your Committee still has concerns, centering around the risk of anaphylactic reactions to injections and the naturopathic physician's lack of immediate access to treatment for those reactions.

Accordingly, the bill has been amended to impose a procedure similar to that for advanced practice registered nurse prescriptive authority, by which the authority to inject may be reviewed, and guidelines established. As amended this bill:

To encourage further discussion, your Committee has also included an effective date of July 1, 2099.

As affirmed by the record of votes of the members of your Committee on Consumer Protection & Commerce that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 1155, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 1155, H.D. 1, and be placed on the calendar for Third Reading.