Jurisdictions Prescribing Authority U.S. States / Province Licensing Laws? Prescribing Authority Alabama Alaska Arizona Arkansas California Colorado

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1 Jurisdictions Prescribing Authority U.S. States / Province Licensing Laws? Prescribing Authority Alabama No Alabama does not have full prescribing authority and no licensing laws for Naturopathic Physicians. We can prescribe with the request of an MD and a copy of a diploma is needed. Alaska Zero prescriptive authority for legend or scheduled substances and not even bio identical glandulars though that is being debated. Need to modernize our law but there are some legislative road blocks despite wide support for naturopathic care. Ironically we are designated primary care providers with insurance reimbursement parity with other primary providers. Arizona Arizona ND's can prescribe. To qualify for a certificate to dispense, an applicant shallhave completed before the submission date of the application, Board approved training in the safe administration of natural substances, drugs, or devices. The Board approves documentation of the following as evidence of completion of Board approved training in the safe administration of natural substances, drugs, or devices: Graduation from an approved school of naturopathic medicine; Completion of a 60 hour or more pharmacological course on natural substances, drugs, or devices that is offered, approved, or recognized. If an applicant intends to administer a natural substance or drug intravenously, the Board approved training completed by the applicant shall include administration of a natural substance or drug by intravenous means. Arkansas No No prescribing authority California The California Naturopathic Medicine Committee (NMC) has a very restrictive formulary in regards to prescribing. At this time, the Committee is trying to create an Exclusionary Formulary and we will be discussing this at our upcoming Committee Meeting. Please see the Statutes surrounding the Independent and non independent prescribing rights and vehicles of administration as outlined within CA Business & Professions Code and 3640 (e). If anything falls outside of the independent prescribing authority, then a MD/DO Supervising Agreement must be in place. (This is pretty much the same as with the Physicians Assistants). As for the certification for prescribing, any Licensee that has met the minimum 48 hours of Phamacoloty/cognosy, will recieve an Naturopathic Drug Furnishing Number (NDF), this information will be on their license showing proof that they have met the requirements. During renewals, (every 2 years), licensees must show 60 hours of CE and 20 must be Pharmacology CEUs. Colorado Connecticut Section Practice defined. (a) The practice of natureopathy means the science, art and practice of healing by natural methods as recognized by the Council of Natureopathic Medical Education and approved by the State Board of Natureopathic Examiners, with the consent of the commissioner, and shall include (1) counseling and (2) the practice of the mechanical and material sciences of healing as follows: The mechanical sciences such as mechanotherapy, articular manipulation, corrective and orthopedic gymnastics, physiotherapy, hydrotherapy, electrotherapy and phototherapy; and the material sciences such as nutrition, dietetics, phytotherapy, treatment by natural substances and external applications. (b) For purposes of subsection (a), "natural substances" are substances which are not narcotic substances as defined in subsection (30) of section 21a 240, do not require the written or oral prescription of a licensed practitioner to be dispensed and are only administered orally. Delaware No No prescribing authority Florida No No prescribing authority

2 Georgia No No prescribing authority Hawaii Naturopathic physicians are permitted to prescribe pursuant to the Board's naturopathic formulary. The naturopathic formulary only includes vitamins, minerals, dietary supplements, botanical medicines, homeopathic medicines, hormones, and legend drugs that are consistent with naturopathic medical practice. Therefore, naturopathic physicians can prescribe any and all drugs in the classifications that are listed in the naturopathic formulary; provided that naturopathic physicians cannot prescribe, administer, or dispense any of these items in the injectable form or by injection unless the naturopathic physician is specifically authorized by the board. Naturopathic physicians who possess a "parenteral therapy" special privilege issues by the Board may prescribe, administer, or dispense any of these items in the injectable form or by injection. With regard to our inquiry naturopathic physicians carrying a certificate or proof of specialized education to prescribe, there is no requirement in HRS chapter 455. However, every licensee is issued a pocket license card. A notice that is attached to the pocket license card states, "This pocket ID card identifies you to the public as being currently licensed and should be kept in your possession at all times." Idaho No No prescribing authority Illinois No No prescribing authority Indiana No No prescribing authority Iowa No No prescribing authority Kansas Kentucky No No prescribing authority Louisiana No No prescribing authority Maine A naturopathic doctor mary prescribe non prescription medication without limitation. Licensed naturopathic doctors may use, prescribe, dispense, and order certain medicines of mineral, animal, and botanical origin including the following: Nonlegend medicines derived from animal organs, tissues, and oils, minerals, and plants administered orally and topically; Non controlled legend topical ointments, creams and lotions containing antiseptics; Noncontrolled legend topical, local anesthetics applied to superficial structures for use during minor office procedures as appropriate; Noncontrolled legend vitamins, minerals, trace minerals, and whole glandulars including whole gland thyroid; Contraceptive devices except intrauterine deveices; all homeopathic preparations; Immunizing agents approved by the Bureau of Biologics, United States Food and Drug Administration and listed in the current Recommendations of the United States Public Health Services Immunizations Practices Advisory Committee or the Report of the Committee of Infectious Diseases published by the American Academy of Pediatrics; IM injections of vitamins, minerals and medications administered consistent with their scope of practice as a naturopathic doctor and training and Terms of collaborative relationship. Maryland No No prescribing authority Massachusetts No No prescribing authority Michigan No No prescribing authority

3 Minnesota No 147E.05 SCOPE OF PRACTICE. Subdivision 1.Practice parameters. (a) The practice of naturopathic medicine includes, but is not limited to, the following services: (1) ordering, administering, prescribing, or dispensing for preventive and therapeutic purposes: food, extracts of food, nutraceuticals, vitamins, minerals, amino acids, enzymes, botanicals and their extracts, botanical medicines, herbal remedies, homeopathic medicines, dietary supplements and nonprescription drugs as defined by the Federal Food, Drug, and Cosmetic Act, glandulars, protomorphogens, lifestyle counseling, hypnotherapy, biofeedback, dietary therapy, electrotherapy, galvanic therapy, oxygen, therapeutic devices, barrier devices for contraception, and minor office procedures, including obtaining specimens to assess and treat disease; (2) performing or ordering physical examinations and physiological function tests; (3) ordering clinical laboratory tests and performing waived tests as defined by the United States Food and Drug Administration Clinical Laboratory Improvement Amendments of 1988 (CLIA); (4) referring a patient for diagnostic imaging including x ray, CT scan, MRI, ultrasound, mammogram, and bone densitometry to an appropriately licensed health care professional to conduct the test and interpret the results; (5) prescribing nonprescription medications and therapeutic devices or ordering noninvasive diagnostic procedures commonly used by physicians in general practice; and (6) prescribing or performing naturopathic physical medicine. (b) A registered naturopathic doctor may admit patients to a hospital if the naturopathic doctor meets the hospital's governing body requirements regarding credentialing and privileging process. Subd. 2.Prohibitions on practice. (a) The practice of naturopathic medicine does not include: (1) administering therapeutic ionizing radiation or radioactive substances; (2) administering general or spinal anesthesia; (3) prescribing, dispensing, or administering legend drugs or controlled substances including chemotherapeutic substances; or (4) performing or inducing abortions. (b) A naturopathic doctor registered under this chapter shall not perform surgical procedures using a laser device or perform surgical procedures beyond superficial tissue. (c) A naturopathic doctor shall not practice or claim to practice as a medical doctor, surgeon, osteopath, dentist, podiatrist, optometrist, psychologist, advanced practice professional nurse, physician assistant, chiropractor, physical therapist, acupuncturist, dietician, nutritionist, or any other health care professional, unless the naturopathic physician also holds the appropriate license or registration for the health care practice profession. Mississippi No No prescribing authority Missouri No No prescribing authority Montana NATUROPATHIC PHYSICIAN NATURAL SUBSTANCE FORMULARY LIST Naturopathic physicians may prescribe and administer for preventive and therapeutic purposes the drugs listed in this natural substance formulary list as provided for in , MCA. No certificate required. Nebraska No No prescribing authority Nevada No No prescribing authority New Hampshire The Naturopathic Doctors are licensed with the state of New Hampshire. The Naturopathic Board meet quarterly to license new licensees and to renew licenses as well. They do need to send in the Transcript for the accepted schools. New Jersy No No prescribing authority

4 New Mexico No No prescribing authority New York No NDs are not licensed at all in New York New York State does not authorize NDs with a scope of practice nor prescribing rights. North Carolina No No prescribing authority North Dakota No Cannot prescribe legend drugs. Can prescribe prescriptive devices (e.g. orthotics), herbs, homeopathics, vitamins, minerals & other supplements, and OTC topicals (e.g. hormones). Ohio No No prescribing authority Oklahoma No No prescribing authority Pennsylvania No We are not currently licensed to practice medicine in the state of PA. We have a Bill currently in the House, but even with pasage of this bill, ND's would not have prescribing rights. Rhode Island No Naturopathic doctors are not licensed in the state of Rhode Island. As a result, we have no prescribing authority in this state. South Carolina No No prescribing authority South Dakota No No prescribing authority Tennessee No No prescribing authority Texas No No prescribing authority Utah (1) The division shall establish a naturopathic formulary advisory peer committee under Subsection (1)(f) to make recommendations to the board for the naturopathic formulary which shall: (a) consist of noncontrolled legend medications deemed appropriate for the scope of practice of naturopathic physicians; and (b) include all homeopathic remedies. (2) The committee shall consist of five members: (a) one naturopathic physician who is a member of the board; and (c) one licensed pharmacist who is also a pharmacognosist. (3) The committee members shall: (a) be appointed by the director of the division; (b) be appointed and serve in accordance with Section , except as those provisions are modified by this section; and (c) serve without compensation, travel costs, or perdiem for their services. (4) The committee and the division may seek input from other licensing boards. The formulary for ND's can be found in administrative rule: R Naturopathic Physician Formulary. (1) In accordance with Subsections (8) and (12)(a) and Section , the naturopthic physician formulary which consists of noncontrolled substance legend medications deemed appropriate for the primary health care of patients within the scope of practice of naturopathic physicians, the prescription of which is approved by the Division in collaboration with the Naturopathic Formulary Advisory Peer Committee. (3) In accordance with Subsections (8) and (12)(a) and Section , the naturopathic physician formulary includes a single controlled substance with the reference number identitied in the AHFS, published by the American Society of Health System Pharmacists, 2008 edition: 68:08 Testosterone. (4) New categories or classes of drugs will need to be approved as part of the formulary prior to prescribing/administering. (5) The licensed naturopathic physician has the responsiblity to be knowledgeable about the mediation being prescribed or administered. Vermont ND s are currently required to pass a formulary examination for prescriptive authority. There is not a special certification as it s a requirement for licensure. Virginia No At this time Virginia does not license naturopathic doctors. Thus we are seen as and function as more if a wellness counselor. Thus there is no prescribing in Virginia. If a medication is needed for a patient we refer them back to their PCP or specialist. In nearly 80% of cases our patients already are on appropriate medication. I will have to say it can be extremely discouraging when a patient is mismanaged and appropriate pharmacotherapy is not being utilized. But we hope one day Virginia will license NDs. Washington Able to prescribe all legend drugs and the 2 controlled substances codeine and testosterone products in Schedules III, IV, and V (WAC ) of the Washington State Controlled Substance Act (Chapter RCW). For legend drugs, there isn't an additional educational requirement; however, for the controlled substances, WAC requires at least 4 hours of instruction that must be part of a graduate level course from a school approved for licensure as a naturopathic physician (ND), allopathic physician (MD), osteopathic physician (DO), or registered nurse (RN). An alternative to the instruction would be if the naturopathic physician had been issued a DEA registration in another state.

5 West Virginia No No prescribing authority Wisconsin No We do not have any licensure for NDs in the state of Wisconsin. Therefore, we have no scope of practice nor formulary. NDs who are CNME graduates must be licensed by a state which licenses NDs in order to be a general member of the Wisconsin Naturopathic Physicians Association. At this point, this is the only way we can distinguish between unlicensable and licensable NDs. Wyoming No No prescribing authority District of Columbia An individual licensed to practice naturopathic medicine may: Administer or provide for preventive and therapeutic purposes natural medicines by their appropriate route of administration the following: Natural remedies; Topical medicine; Counseling; Hypnotherapy; Dietary therapy; Naturopathic physical medicine; Therapeutic devices; and Barrier devices for contraception. Order, perform, review and interpret the results of diagnostic procedures commonly used by physicians in general practice, including: Physical and orificial examinations; Electrocardiograms; Diagnostic imaging techniques; phlebotomy; Clinical laboratory test and examinations; and Physiological function tests. An individual licensed to practice naturopathic medicine under this Act shall not: Prescribe, dispense, or administer any controlled substances, except those natural medicine authorized by this Act; Perform surgical procedures, except for minor office procedures, as defined by rule; Use for therapeutic purposes, any device regulated by the United States Food and Drug Administration (FDA) that has not been approved by the FDA; Participate in naturopathic childbirth, unless the naturopathic physician Puerto Rico U.S. Virgin Islands No No prescribing authority Alberta No Alberta does not have prescriptive authority within it's scope of practice. British Columbia Licensed NSs can prescribe provided they have taken a specific prescribing authority course. When they have taken the course they require 10 hours of pharma CE every two years. There is a Standards, Limits and Conditions document which outlines the parameters of prescribing in full, but in short there is no list of what NDs can prescribe, rather there is a list of what NDs can't prescribe. Again, in very broad strokes, these are generally federally controlled substances, anti cancer drugs, some pain meds. Prescribing authority is required also for invasive therapies (e.g., chelation, prolotherapy, oxidative medicine. Manitoba We do not have any prescribing rights in Manitoba. We are seeking it when we submit our application to Manitoba Health for increased scope of practice. New Brunswick No New Brunswick is actually a province with no legislation and therefore no prescribing authority. We are 17 Naturopathic Doctors and working with the government to put in place basic title protection as a first step in the legislation process. NewFoundland/Labrador No No prescribing authority Nova Scotia No No prescribing authority Ontario Prince Edward Island No No prescribing authority Quebec No No prescribing authority Saskatchewan No prescribing authority Yukon No No prescribing authority