SR53 SD2.DOC

WHEREAS, naturopathic doctors licensed in Hawaii and nationwide have been administering natural substances including vitamins, minerals, and amino acids subcutaneously, intramuscularly, and intravenously (parenterally) for over twenty years; and

WHEREAS, the Board of Naturopathic Medicine issued an opinion in 1984 that the injection of vitamins was within the scope of practice of naturopathic physicians; and

WHEREAS, licensing laws exist to ensure a minimal level of competency in the practice of naturopathic medicine; and

WHEREAS, the licensing examinations accepted by the State of Hawaii have included and covered parenteral therapeutics; and

WHEREAS, all accredited professional schools of naturopathic medicine educate, train, and qualify students to perform parenteral therapeutics including intramuscular, subcutaneous, and intravenous injection techniques and skills; and

WHEREAS, in addition to education, training, and examination, error-free and complaint-free performance demonstrates professional competency among naturopathic physicians of parenteral therapy; and

WHEREAS, for example, insurance companies issuing naturopathic malpractice insurance cover practitioners using parenteral techniques, and the largest malpractice insurance companies have not received one malpractice claim throughout the nation against a naturopathic physician for the misuse of injection methods; and

WHEREAS, in addition, there has not been one case of misuse or harm caused by parenteral therapy reported to the Hawaii Board of Naturopathic Medicine or the Hawaii Society of Naturopathic Physicians; and

WHEREAS, in 2006, the Legislature approved H.B. No. 1155 to clarify that naturopathic physicians have the authority to administer natural medicines by injection but the bill was vetoed by the Governor; and

WHEREAS, the Legislature, through Act 22, Special Session Laws of Hawaii 2009, directed the Board of Naturopathic Medicine to "establish the education and training requirements for parenteral therapy and the standards to administer parenteral therapy" for licensed naturopathic physicians; and

WHEREAS, the Legislature also directed the Board of Naturopathic Medicine to "[a]nnually establish and publish a naturopathic formulary that has been approved by the board for prescription, administration, or dispensing by naturopathic physicians" through Act 22, Special Session Laws of Hawaii 2009; and

WHEREAS, the Board of Naturopathic Medicine established a naturopathic formulary effective January 1, 2010 that specifically prohibits the prescription, administration, or dispensation of formulary items "in injectable form or by injection unless this is specifically authorized by the Board's administrative rules"; and

WHEREAS, however, the administrative rules of the Board of Naturopathic Medicine contain no provisions authorizing the prescription, administration, or dispensation of formulary items via parenteral therapy; and

WHEREAS, the absence of administrative rules allowing the administration of parenteral therapy by naturopathic physicians effectively prohibits the practice; and

WHEREAS, the intent of the Legislature in passing Act 22, Special Session Laws of Hawaii 2009, was to allow naturopathic physicians to practice parenteral therapy pursuant to rules and subject to requirements established by the Board of Naturopathy; and

WHEREAS, accordingly, Act 22 prohibits naturopathic doctors from performing parenteral therapy unless permitted to do so by administrative rules issued by the Board, and the Act's delayed effective date of January 1, 2010 was specifically intended to provide the Board adequate time to pass the requisite administrative rules; and

WHEREAS, the effective prohibition on the use of parenteral therapy by naturopathic physicians that currently exists is in contradiction to the intent of the Legislature in passing Act 22 and to the general and historical practice of naturopathic medicine in this State; now, therefore,

BE IT RESOLVED by the Senate of the Twenty-fifth Legislature of the State of Hawaii, Regular Session of 2010, that the Board of Naturopathic Medicine is urged to expeditiously adopt administrative rules in accord with Act 22, Special Session Laws of Hawaii 2009, to allow the use of parenteral therapy by naturopathic physicians that include education and training requirements; and

BE IT FURTHER RESOLVED that the Board of Naturopathic Medicine is urged to immediately adopt rules that grandfather all persons licensed under chapter 455, Hawaii Revised Statutes, prior to January 1, 2010, and allow those persons to perform intramuscular, subcutaneous, and intravenous injection and prescribe, administer, and dispense naturopathic formulary substances manufactured for injection pending passage of the administrative rules; and

BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Board of Naturopathic Medicine and the Director of Commerce and Consumer Affairs.

Report Title:

Naturopathic Medicine; Parenteral Therapy; Administrative Rules

THE SENATE	S.R. NO.	53
TWENTY-FIFTH LEGISLATURE, 2010		S.D. 2
STATE OF HAWAII