H.B. NO.



H.D. 1
















SECTION 1. The legislature finds that naturopathic physicians provide skilled and quality care to patients throughout the State. Naturopathic physicians also work to promote integrated health care, such as the use and application of hormone therapy. Although naturopathic physicians in Hawaii have limited prescriptive authority, they are unable to prescribe controlled substances. For instance, testosterone is an example of a controlled substance that is consistent with the practice of naturopathic medicine but is omitted from the drug formulary from which naturopathic physicians may prescribe in Hawaii.

The legislature further finds that naturopathic physicians are known for their expertise in bio-identical hormone replacement therapy, including the use of estrogens, progesterone, and testosterone. The legislature also finds that licensed naturopathic physicians in Hawaii should have prescriptive authority for testosterone, as it is a controlled substance that is consistent with the practice of naturopathic medicine. The legislature notes that the prescription of certain other controlled substances, such as narcotic drugs, are not considered consistent with naturopathic practice and should not be included in the naturopathic formulary. The legislature also notes that controlled substances have been included in the prescriptive authority for naturopathic physicians in other states, such as Arizona, California, Oregon, and Washington.

The purpose of this Act is to authorize a naturopathic physician to prescribe testosterone consistent with naturopathic medical practice.

SECTION 2. Chapter 455, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"455-   Testosterone; authorization. Subject to any requirements imposed by the department of public safety and the federal Drug Enforcement Administration, a naturopathic physician may register with the department of public safety pursuant to section 329-33 and may obtain a current federal Drug Enforcement Administration registration to prescribe and administer testosterone."

SECTION 3. Section 329-1, Hawaii Revised Statutes, is amended by amending the definition of "practitioner" to read as follows:

""Practitioner" means:

(1) A physician, dentist, veterinarian, scientific investigator, or other person licensed and registered under section 329-32 to distribute, dispense, or conduct research with respect to a controlled substance in the course of professional practice or research in this State;

(2) An advanced practice registered nurse with prescriptive authority licensed and registered under section 329-32 to prescribe and administer controlled substances in the course of professional practice in this State; [and]

(3) A pharmacy, hospital, or other institution licensed, registered, or otherwise permitted to distribute, dispense, conduct research with respect to or to administer a controlled substance in the course of professional practice or research in this State[.]; and

(4) A naturopathic physician licensed pursuant to chapter 455 who is licensed and registered to prescribe and administer testosterone in the course of professional practice in this State."

SECTION 4. Chapter 455-1, Hawaii Revised Statutes, is amended as follows:

1. By adding a new definition to be appropriately inserted and to read:

""Testosterone" means the schedule III drug identified in section 329-18(g)(24)."

2. By amending the definition of "naturopathic formulary" to read:

""Naturopathic formulary" means vitamins, minerals, dietary supplements, botanical medicines, homeopathic medicines, hormones, and those legend drugs and testosterone consistent with naturopathic medical practice[.]; provided that the naturopathic formulary shall not include any narcotic drugs, as defined in section 329-1."

SECTION 5. Section 455-11, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) In addition to any other actions authorized by law, the board shall have the power to deny, revoke, suspend, or refuse to renew any license to practice naturopathic medicine applied for or issued by the board in accordance with this chapter, and to fine or otherwise discipline a licensee for any cause authorized by law, including but not limited to the following:

(1) Failing to meet or maintain the conditions and requirements necessary to qualify for the issuance of a license;

(2) Procuring, or aiding or abetting in procuring, a criminal abortion;

(3) Employing any person to solicit patients;

(4) Obtaining a fee on the assurance that a manifestly incurable disease can be permanently cured;

(5) Betraying a patient's confidence;

(6) Making any untruthful and improbable statement in advertising one's naturopathic practice or business;

(7) False, fraudulent, or deceptive advertising;

(8) Being habituated to the excessive use of drugs or alcohol; or being addicted to, dependent on, or an habitual user of a narcotic, barbiturate, amphetamine, hallucinogen, or other drug having similar effects;

(9) Practicing naturopathic medicine while the ability to practice is impaired by alcohol, drug, physical disability, or mental instability;

(10) Procuring a license through fraud, misrepresentation, or deceit or knowingly permitting an unlicensed person to perform activities requiring a license;

(11) Professional misconduct or gross carelessness or manifest incapacity in the practice of naturopathic medicine;

(12) Conduct or practice contrary to recognized standard of ethics of the naturopathic profession;

(13) Using medical service or treatment [which] that is inappropriate or unnecessary;

(14) Submitting to or filing with the board any notice, statement, or other document required under this chapter [which] that is false or untrue or contains any material misstatement of fact, including any false certification of compliance with the continuing education requirement specified under section 455-8;

(15) Failure to report to the board any disciplinary action taken against the licensee in another jurisdiction within thirty days after the disciplinary action becomes final;

(16) Using the title "physician" without clearly identifying oneself as being a naturopathic physician;

(17) Prescribing, administering, and dispensing naturopathic formulary that are not included in the formulary established by the board under section 455-6; [and]

(18) Violation of chapter 329, the uniform controlled substances act, or any rule adopted thereunder, except as provided in section 329-122; and

[(18)] (19) Violation of any provision of this chapter or rules adopted under this chapter."

SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 7. This Act shall take effect on July 1, 3000.


Report Title:

Naturopathic Physicians; Testosterone; Naturopathic Formulary



Authorizes a naturopathic physician to prescribe testosterone consistent with naturopathic medical practice. Clarifies that narcotic drugs shall not be included within the naturopathic formulary. Authorizes the Board of Naturopathic Medicine to discipline a naturopathic physician for violation of the Uniform Controlled Substances Act. (HB1949 HD1)




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