TITLE 16†††††††††††† OCCUPATIONAL AND PROFESSIONAL LICENSING

CHAPTER 2††††††† ACUPUNCTURE AND ORIENTAL MEDICINE PRACTITIONERS

PART 18†††††††††††††† EDUCATIONAL COURSES FOR EXPANDED PRACTICE CERTIFICATION

 

16.2.18.1†††††††††††††† ISSUING AGENCY:New Mexico Board of Acupuncture and Oriental Medicine.

[16.2.18.1 NMAC - Rp, 16.2.18.1 NMAC, 06-16-2015]

 

16.2.18.2†††††††††††††† SCOPE:All doctors of oriental medicine who are certified for expanded practice or who are applicants for certification for expanded practice, as well as all educational courses and applicants for approval of educational courses.

[16.2.18.2 NMAC - Rp, 16.2.18.2 NMAC, 06-16-2015]

 

16.2.18.3†††††††††††††† STATUTORY AUTHORITY:This part is promulgated pursuant to the Acupuncture and Oriental Medicine Practice Act, Section 61-14A-8.1.

[16.2.18.3 NMAC - Rp, 16.2.18.3 NMAC, 06-16-2015]

 

16.2.18.4†††††††††††††† DURATION:Permanent.

[16.2.18.4 NMAC - Rp, 16.2.18.4 NMAC, 06-16-2015]

 

16.2.18.5†††††††††††††† EFFECTIVE DATE:June 16, 2015, unless a later date is cited at the end of a section.

[16.2.18.5 NMAC - Rp, 16.2.18.5 NMAC, 06-16-2015]

 

16.2.18.6†††††††††††††† OBJECTIVE: Part 18 lists the prerequisites, educational course approval requirements, class hours, curriculum knowledge and skills for certification in each of the four (4) following expanded practice categories: basic injection therapy, injection therapy, intravenous therapy and bioidentical hormone therapy.

[16.2.18.6 NMAC - Rp, 16.2.18.6 NMAC, 06-16-2015]

 

16.2.18.7†††††††††††††† DEFINITIONS: Refer to definitions in 16.2.1.7 NMAC.

[16.2.18.7 NMAC - N, 06-16-2015]

 

16.2.18.8†††††††††††††† GENERAL REQUIREMENTS FOR EDUCATIONAL COURSE APPROVAL:The board shall approve an educational course for a specific category of expanded practice upon completion of the following general requirements and the specific requirements listed for the specific category of expanded practice educational course approval.All courses shall adhere to ICE credentialing standards.All references to application in this section refer to the educational course application.

††††††††††††††† A.††††††††††† The educational course shall provide at least the minimum number of hours of education in the areas listed for the specific category of educational course hours.One (1) hour of education shall be equal to that defined by the accreditation commission for acupuncture and oriental medicine (ACAOM).The education shall be in addition to the education required to meet the minimum educational program requirements for licensure as a doctor of oriental medicine.

††††††††††††††† B.††††††††††† The educational course application shall include a description of the education being provided as required by the educational course general curriculum defined in 16.2.18.11 NMAC and the educational course curriculum defined for the specific category of expanded practice for which the educational course is applying for approval.

††††††††††††††† C.††††††††††† The educational course application shall include the curriculum vitae for all teachers, and proposed substitute teachers all classes shall be taught by qualified teachers approved by the board, provided the following conditions are met:

††††††††††††††††††††††††††††††† (1)†††††††††† the education in the pharmacology of the authorized substances shall be taught by a licensed pharmacist, Pharm D or a Ph.D. in pharmacology; and

††††††††††††††††††††††††††††††† (2)†††††††††† the education in the clinical therapeutic use of the authorized substances shall be taught by a licensed health care practitioner with appropriate training and a minimum of five (5) years experience using the authorized substances.

††††††††††††††† D.††††††††††† The educational course application shall include documentation that all required clinical practice hours shall have a teacher to student ratio of at least one (1) teacher to no more than eight (8) students.

††††††††††††††† E.††††††††††† The educational course application shall include examples of the test questions that students enrolled in the course are required to successfully pass in order to ensure competence in all required areas.Testing methodology shall be approved by the board and testing shall be administered, subject to approval by a credentialed PhD psychometrician, as described in the ICE credentialing standards and as approved by the board.The educational course shall send all student test scores and evaluation scores directly to the board.

††††††††††††††† F.††††††††††† The educational course application shall include an example of the certificate that shall be given for successful completion of the educational course.

††††††††††††††† G.††††††††††† Each educational course shall be completed within two (2) years of commencement of that course.

††††††††††††††† H.††††††††††† A student who is allergic or hypersensitive to an authorized substance may be excused from participating in clinical practice when such an authorized substance is being used.

††††††††††††††† I.†††††††††††† A board member or an agent of the board has the authority to observe, audit and evaluate educational courses at any time after an application has been filed.A course audit or evaluation may result in denial, suspension or revocation of the courseís approval by the board in accordance with law.

††††††††††††††† J.†††††††††††† The educational course provider shall specify whether the organization offering the educational course is a sole proprietorship, partnership, LLC, corporation or non-profit corporation and shall provide proof of such legal business status.

††††††††††††††† K.††††††††††† An educational course shall submit a new application on the form approved by the board, pay the appropriate fee defined in 16.2.10 NMAC and comply with all other new application requirements if any of the following changes:

††††††††††††††††††††††††††††††† (1)†††††††††† ownership;

††††††††††††††††††††††††††††††† (2)†††††††††† faculty; and

††††††††††††††††††††††††††††††† (3)†††††††††† curriculum.

††††††††††††††† L.††††††††††† An educational course shall inform the board in writing, provided that the educational course certifies that all factors defined in Subsection J of 16.2.18.8 NMAC remain unchanged, if any of the following changes:

††††††††††††††††††††††††††††††† (1)†††††††††† name;

††††††††††††††††††††††††††††††† (2)†††††††††† address; and

††††††††††††††††††††††††††††††† (3)†††††††††† phone number.

[16.2.18.8 NMAC - Rp, 16.2.18.7 NMAC, 06-16-2015]

 

16.2.18.9†††††††††††††† EDUCATIONAL COURSE APPROVAL BOARD REQUIREMENTS:

††††††††††††††† A.††††††††††† The board shall have final authority for approval of all educational courses including classes and teachers.

††††††††††††††† B.††††††††††† The board shall notify the applicant in writing by mail postmarked no more than seventy five (75) days after the receipt of the initial application as to whether the application is complete or if not complete, what documentation is needed to complete the application.

††††††††††††††† C.††††††††††† If the requested information is not received at the board office within seventy five (75) days after notification the board shall notify the applicant in writing by mail that the application has expired.

††††††††††††††† D.††††††††††† Teaching must commence for an approved course within six (6) months of approval.

††††††††††††††† E.††††††††††† In the interim between regular board meetings the expanded practice Rx committee or an authorized representative of the board shall issue an interim temporary educational course approval to a qualified applicant who has filed, with the board, a complete application and complied with all requirements for educational course approval.The interim temporary educational course approval shall automatically expire on the date of the next regular board meeting and final educational course approval shall only be granted by the board.If the application is denied, the notice of denial shall state the reason the application was denied.

††††††††††††††† F.††††††††††† If the application is expired or is denied, the applicant will have to reapply as a new applicant.

[16.2.18.9 NMAC - Rp, 16.2.18.8 NMAC, 06-16-2015]

 

16.2.18.10†††††††††††† EDUCATIONAL COURSE PREREQUISITES:

††††††††††††††† A.††††††††††† An applicant for an educational course in expanded practice leading to certification must be a NM licensed doctor of oriental medicine in good standing.

††††††††††††††† B.††††††††††† The basic injection course is a prerequisite to injection therapy certification and intravenous therapy certification.

††††††††††††††† C.††††††††††† Prior to enrolling in any expanded practice educational course, the applicant shall submit proof of completion of at least three (3) college or university credit hours (30-45) contact hours in a course in pharmacology from an accredited institution. A board approved on-line course is acceptable or the applicant may sit for a pharmacology final exam at an accredited institution to satisfy this requirement.

††††††††††††††† D.††††††††††† If applying for basic injection therapy, injection therapy or intravenous therapy, the applicant shall submit proof of completion of a four (4) hour American heart association approved CPR or basic life support (BLS) course; a current card that shall remain current until the next July 31 annual renewal cycle will serve as proof.

[16.2.18.10 NMAC - Rp, 16.2.18.9 NMAC, 06-16-2015]

 

16.2.18.11†††††††††††† EDUCATIONAL COURSE GENERAL CURRICULUM: Each educational course shall provide the doctor of oriental medicine, who successfully completes the course, with the following entry level general knowledge and skills, as well as the specific knowledge and skills, at the current professional standard of care within the context of an integrative healthcare system, defined for each specific category of expanded practice education.

††††††††††††††† A.††††††††††† Expanded practice and prescriptive authority and oriental medicine: knowledge of how the principles of the developmental system of oriental medicine such as yin, yang, qi and xue apply to the expanded practice certifications.

††††††††††††††† B.††††††††††† Biomedical knowledge: anatomy, physiology, pathology, endocrinology, biochemistry, pharmacology and diagnostic options sufficient to provide a foundation required for the specific category of expanded practice.

††††††††††††††† C.††††††††††† Pharmacology knowledge:

††††††††††††††††††††††††††††††† (1)†††††††††† of the biochemistry, pharmacology, clinical application, safety and handling, side effects, interactions, contraindications, safeguards and emergency procedures for all authorized substances in the formulary defined for the relevant specific category of expanded practice;

††††††††††††††††††††††††††††††† (2)†††††††††† of how to make a differential diagnosis relative to the prescription or administration of authorized substances in the formulary defined for the relevant specific category of expanded practice;

††††††††††††††††††††††††††††††† (3)†††††††††† of the potency and appropriate dosage of single and combined authorized substances in the formulary defined for the relevant specific category of expanded practice;

††††††††††††††††††††††††††††††† (4)†††††††††† and skill in utilizing appropriate clinic based aseptic technique; and

††††††††††††††††††††††††††††††† (5)†††††††††† of the compounding requirements of the USP797 with regard to the authorized substances in the formulary defined for the relevant specific category of expanded practice.

††††††††††††††† D.††††††††††† Referral:

††††††††††††††††††††††††††††††† (1)†††††††††† knowledge and understanding of the limits of their training, and skill and when it is appropriate to refer; and

††††††††††††††††††††††††††††††† (2)†††††††††† knowledge of the options available regarding referral including an understanding of the potential benefit or contraindications of all categories of expanded practice.

††††††††††††††† E.††††††††††† Emergency care (previous CPR/BLS certification):

††††††††††††††††††††††††††††††† (1)†††††††††† knowledge of how to recognize a medical emergency situation arising in the clinic and what emergency outcomes may arise relative to performing the authorized diagnostic and therapeutic procedures and the prescription or administration of the specifically authorized substances, what procedures and substances are best for managing each emergency situation and whom to contact for emergency support and care;

††††††††††††††††††††††††††††††† (2)†††††††††† skill in providing first aid and basic life support until the medical emergency team arrives;

††††††††††††††††††††††††††††††† (3)†††††††††† appropriate initial screening for potential allergic or adverse reactions;

††††††††††††††††††††††††††††††† (4)†††††††††† skill in identifying and responding to adverse or allergic reactions or mild to severe; vasovagal reactions with knowledge of appropriate support measures depending on the type of reaction:

††††††††††††††††††††††††††††††††††††††††††††††† (a)†††††††††† patient reassurance;

††††††††††††††††††††††††††††††††††††††††††††††† (b)†††††††††† patient positioning;

††††††††††††††††††††††††††††††††††††††††††††††† (c)†††††††††† oral OTC diphenhydramine (benadryl) if appropriate;

††††††††††††††††††††††††††††††††††††††††††††††† (d)†††††††††† inhaled oxygen;

††††††††††††††††††††††††††††††††††††††††††††††† (e)†††††††††† inhaled OTC epinephrine (primatine mist) or IM injected epinephrine if appropriate; and

††††††††††††††††††††††††††††††††††††††††††††††† (f)††††††††††† emergency ambulance transport;

††††††††††††††††††††††††††††††† (5)†††††††††† the immediate and longer term indications of inadvertent pneumothorax and the appropriate procedure for patient care and guidance in such situations.

††††††††††††††† F.††††††††††† Record keeping, storage and dispensing of dangerous drugs and controlled substances and knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† the proper storage requirements in the clinic for the drugs, dangerous drugs and controlled substances in the specifically authorized formulary;

††††††††††††††††††††††††††††††† (2)†††††††††† how to keep accurate records of all authorized drugs, dangerous drugs and controlled substances obtained, stored, compounded, administered or dispensed; and

††††††††††††††††††††††††††††††† (3)†††††††††† skill in handling and using appropriate clean or aseptic technique for all drugs, dangerous drugs and controlled substances in the specifically authorized formulary.

††††††††††††††† G.††††††††††† Pharmaceutical law knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† the appropriate areas of New Mexico pharmaceutical law;

††††††††††††††††††††††††††††††† (2)†††††††††† USP-797 that relates to compounding of the authorized substances in the formulary defined for the relevant specific category of expanded practice; and

††††††††††††††† ††††††††††††††† (3)†††††††††† drugs, dangerous drugs, and controlled substances and what dangerous drugs or controlled substances are or are not authorized under the provisions of the specific category or categories of expanded practice for which he is certified.

††††††††††††††† H.††††††††††† Scope of practice knowledge:

††††††††††††††††††††††††††††††† (1)†††††††††† of the areas of the New Mexico Acupuncture and Oriental Medicine Practice Act and rules that are appropriate to the scope of practice of a doctor or oriental medicine certified for the specific category of expanded practice;

††††††††††††††††††††††††††††††† (2)†††††††††† understanding of what diagnostic or therapeutic procedures are authorized by the specific category of expanded practice; and

††††††††††††††††††††††††††††††† (3)†††††††††† understanding what substances in a specific formulary are authorized for use by doctors of oriental medicine certified for the specific category of expanded practice.

[16.2.18.11 NMAC - Rp, 16.2.18.10 NMAC, 06-16-2015]

 

16.2.18.12†††††††††††† BASIC INJECTION THERAPY EDUCATIONAL COURSE APPROVAL: The board shall approve a basic injection therapy educational course after the educational course provider submits to the board:

††††††††††††††† A.††††††††††† the completed application form provided by the board;

††††††††††††††† B.††††††††††† the payment of the application fee for expanded practice educational course approval specified in 16.2.10 NMAC;

††††††††††††††† C.††††††††††† documentation of having complied with all educational course approval general requirements defined in 16.2.18.8 NMAC;

††††††††††††††† D.††††††††††† documentation demonstrating that it will provide the educational course general curriculum defined in 16.2.18.11 NMAC;

††††††††††††††† E.††††††††††† documentation demonstrating that it will provide the basic injection therapy educational course hours defined in 16.2.18.13 NMAC; and

††††††††††††††† F.††††††††††† documentation demonstrating that it will provide the basic injection therapy educational course curriculum defined in 16.2.18.14 NMAC; and

††††††††††††††† G.††††††††††† documentation demonstrating that proposed test instruments have been reviewed and approved by a credentialed PhD psychometrician, as described in the ICE credentialing standards. A passing grade of seventy (70) percentis required for certification to demonstrate learned knowledge.

[16.2.18.12 NMAC - Rp, 16.2.18.11 NMAC, 06-16-2015]

 

16.2.18.13†††††††††††† BASIC INJECTION THERAPY EDUCATIONAL COURSE HOURS: The education offered shall consist of a minimum total of fifty eight (58) contact hours with at least the minimum number of hours of education in the areas listed below:

††††††††††††††† A.††††††††††† eight (8) hours in pharmacology and biomedical differential diagnosis relative to the prescription, administration, compounding and dispensing of the authorized substances in the basic injection therapy formulary including homeopathic medicines;

††††††††††††††† B.††††††††††† two (2) hours in the drawing and compounding of the authorized substances intended for injection in compliance with USP 797, utilizing approved aseptic technique and proper record keeping and, storage of substances; at least half of the required hours shall be clinical practice;

††††††††††††††† C.††††††††††† fourteen (14) hours in orthopedic and neurological evaluation; at least half of these required hours shall be clinical practice;

††††††††††††††† D.††††††††††† two (2) hours in the theory and practice of vapocoolant spray and stretch techniques using the authorized vapocoolants; at least half of these required hours shall be clinical practice;

††††††††††††††† E.††††††††††† twenty eight (28) hours in the theory and practice of injection therapy including: eleven (11) hours of trigger point therapy and injection of acupuncture points; eleven (11) hours of basic mesotherapy; six (6) hours of basic neural therapy, and therapeutic injections (vitamins), using the authorized substances in the basic injection therapy formulary; at least half of these required hours shall be clinical practice;

††††††††††††††† F.††††††††††† one (1) hour in pharmaceutical law as provided by the New Mexico board of pharmacy;

††††††††††††††† G.††††††††††† one (1) in oriental medicine scope of practice relative to the authorized substances and techniques; and

††††††††††††††† H.††††††††††† a minimum of two (2) hours in the use of inhaled oxygen O2 and IM epinephrine for emergency use.

[16.2.18.13 NMAC - Rp, 16.2.18.12 NMAC, 06-16-2015]

 

16.2.18.14†††††††††††† BASIC INJECTION THERAPY EDUCATIONAL COURSE CURRICULUM: The basic injection therapy educational course curriculum shall provide the doctor of oriental medicine, who successfully completes the course, with the educational course general curriculum knowledge and skills defined in16.2.18.11 NMAC and the following specific skills and knowledge of:

††††††††††††††† A.††††††††††† orthopedic and neurological physical exam and differential diagnosis:

††††††††††††††††††††††††††††††† (1)†††††††††† anatomy regions to be examined and treated;

††††††††††††††††††††††††††††††† (2)†††††††††† the most common orthopedic pain differential diagnoses for these areas as well as other medical differential diagnoses that should be ruled out;

††††††††††††††††††††††††††††††† (3)†††††††††† skill in interpreting physical exam signs in context as evidence for or against the differential diagnoses;

††††††††††††††††††††††††††††††† (4)†††††††††† the most important treatment options for these differential diagnoses including but not limited to injection therapy, spray and stretch therapy, exercise, physical medicine, manipulation, manual medicine, acupuncture, moxibustion, medical therapy with herbal medicine, supplements, homeopathic medicines and diet therapy;

††††††††††††††††††††††††††††††† (5)†††††††††† which basic imaging methods, if any, are useful in the examination of the above differential diagnoses; and

††††††††††††††††††††††††††††††† (6)†††††††††† and skill in selecting and performing the most appropriate basic orthopedic and neurologic physical examination methods including but not limited to the most basic forms of reflex testing, motor power testing, sensory exam, common orthopedic provocations, ligament stretch testing, accurate palpation and marking of anatomic landmarks, ligament and tendon compression testing and myofascial trigger point compression;

††††††††††††††† B.††††††††††† general injection therapy knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† the needles, syringes and other equipment used to perform the various types of injection therapy;

††††††††††††††††††††††††††††††† (2)†††††††††† appropriate aseptic techniques and clean needle procedures and techniques, and necessity of compliance with USP 797;

††††††††††††††††††††††††††††††† (3)†††††††††† the various solutions used in the various styles of injection therapy and skill in properly drawing and compounding into syringes the authorized substances intended for injection, using approved aseptic technique; in compliance with USP 797;

††††††††††††††††††††††††††††††† (4)†††††††††† how to generate and carry out a comprehensive treatment plan that addresses the causative factors leading to pain and dysfunction from the perspective of the understanding of each style of injection therapy, offers post treatment palliation and provides post therapy recommendations to support rehabilitation and prevent recurrence;

††††††††††††††††††††††††††††††† (5)†††††††††† how to explain to the patient the purpose of the therapy, the expected outcome and possible complications of the therapy that could occur;

††††††††††††††††††††††††††††††† (6)†††††††††† understanding that injection therapy techniques authorized for the basic injection therapy certification are limited to intradermal, subcutaneous and intramuscular, injections; and

††††††††††††††††††††††††††††††† (7)†††††††††† the anatomical locations that are relatively safe for injection therapy, as well as those locations that should be avoided for injection therapy;

††††††††††††††† C.††††††††††† acupuncture point injection therapy knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† how acupuncture point injections can complement traditional acupuncture;

††††††††††††††††††††††††††††††† (2)†††††††††† the conditions that can be treated with acupuncture point injections; and

††††††††††††††††††††††††††††††† (3)†††††††††† skill in injecting acupuncture points;

††††††††††††††† D.††††††††††† trigger point therapy knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† what a trigger point is, what the causative factors leading to trigger points are, what the most common perpetuating factors are and how to recognize and identify the most common pain referral patterns in the head, back, hip and extremities;

††††††††††††††††††††††††††††††† (2)†††††††††† how to locate and palpate trigger points; and

††††††††††††††††††††††††††††††† (3)†††††††††† skill in locating, injecting and spraying and stretching the most commonly treated trigger points and muscles;

††††††††††††††† E.††††††††††† neural therapy knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† the relationship between interference fields, the autonomic nervous system, pain and disease;

††††††††††††††††††††††††††††††† (2)†††††††††† skill in identifying common interference fields in the body; and

††††††††††††††††††††††††††††††† (3)†††††††††† skill in injecting common neural therapy injection sites such as peripheral nerves, scars, tonsils, intercutaneous and subcutaneous sites;

††††††††††††††† F.††††††††††† mesotherapy knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† the mechanism of action of mesotherapy injections for pain and sports medicine and cosmetic treatment; and

††††††††††††††††††††††††††††††† (2)†††††††††† skill in injecting using mesotherapy methodology;

††††††††††††††† G.††††††††††† therapeutic injections knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† how to evaluate the patient and determine a treatment plan with appropriate dosage, using appropriate authorized substances; and

††††††††††††††††††††††††††††††† (2)†††††††††† skill in performing therapeutic injections at appropriate anatomical locations and depths.

[16.2.18.14 NMAC - Rp, 16.2.18.13 NMAC, 06-16-2015]

 

16.2.18.15†††††††††††† INJECTION THERAPY EDUCATIONAL COURSE APPROVAL:The board shall approve an injection therapy educational program requirements:

††††††††††††††† A.††††††††††† the completed application form provided by the board;

††††††††††††††† B.††††††††††† payment of the application fee for expanded practice educational course approval specified in 16.2.10 NMAC;

††††††††††††††† C.††††††††††† documentation that it will comply with all educational course approval general requirements defined in 16.2.18.8 NMAC;

††††††††††††††† D.††††††††††† documentation demonstrating that it will provide the educational course general curriculum defined in 16.2.18.11 NMAC;

††††††††††††††† E.††††††††††† documentation demonstrating that it will provide the injection therapy educational course hours defined in 16.2.18.17 NMAC;

††††††††††††††† F.††††††††††† documentation demonstrating that it will provide the injection therapy educational course curriculum defined in 16.2.18.18 NMAC; and

††††††††††††††† G.††††††††††† documentation demonstrating that proposed test instruments have been reviewed and approved by a credentialed PhD psychometrician as described in the ICE credentialing standards.A passing grade of seventy (70) percent is required for certification to demonstrate learned knowledge.

[16.2.18.15 NMAC - Rp, 16.2.18.14 NMAC, 06-16-2015]

 

16.2.18.16†††††††††††† Injection Therapy Course Prerequisites: only a New Mexico licensed DOM, in good standing, and board certified in basic injection therapy, may apply for an injection therapy educational course.

[16.2.18.16 NMAC - Rp, 16.2.18.15 NMAC, 06-16-2015]

 

16.2.18.17†††††††††††† INJECTION THERAPY EDUCATIONAL COURSE HOURS: The education shall be completed within two (2) years of commencement of the course as specified in Subsection G of 16.2.18.7 NMAC and consists of a minimum total of one hundred fifteen (115) hours and with at least the minimum number of hours of education in the areas listed below:

††††††††††††††† A.††††††††††† eight (8) hours in pharmacology and relevant pharmaceutical law, including compliance with USP seven hundred ninety seven (797) differential diagnosis relative to the selection, prescription, compounding and administration, of the authorized substances in the injection therapy formulary listed in Paragraph (2) of Subsection F of 16.2.20.8 NMAC, and the use of some of these substances as pain medicine: upon completion and certification in injection therapy some of these substances can be used with previously learned basic injection techniques including trigger point, mesotherapy, and neural therapy techniques;

††††††††††††††† B.††††††††††† four (4) hours in the art and practice of phlebotomy in order to safely perform injection of ozone or platelet rich plasma when considered as appropriate therapeutic intervention and at least half of the required hours shall be in clinical practice; a certificate of completion of a board approved course in phlebotomy is acceptable;

††††††††††††††† C.††††††††††† fifteen (15) hours in a board approved course in oxidative medicine;

††††††††††††††† D.††††††††††† fifty two (52) hours to include:

††††††††††††††††††††††††††††††† (1)†††††††††† the scientific principles of prolotherapy;

††††††††††††††††††††††††††††††† (2)†††††††††† aseptic technique as it relates to injecting a joint;

††††††††††††††††††††††††††††††† (3)†††††††††† detailed anatomy of joints, supporting soft tissue structures, and specific injection sites;

††††††††††††††††††††††††††††††† (4)†††††††††† orthopedic and neurological functional evaluation;

††††††††††††††††††††††††††††††† (5)†††††††††† the use of platelet rich plasma and prolozone;

††††††††††††††††††††††††††††††† (6)†††††††††† theory and practice of advanced neural therapy techniques;

††††††††††††††††††††††††††††††† (7)†††††††††† differentiation and selection of authorized substances in the injection therapy formulary as defined in Paragraph (2) of Subsection F of 16.2.20.8 NMAC; and

††††††††††††††††††††††††††††††† (8)†††††††††† at least half of these required hours shall be clinical practice;

††††††††††††††† E.††††††††††† thirty (30) hours of diagnostic musculoskeletal ultrasound and ultrasound guided musculoskeletal procedures from a board approved course; and

††††††††††††††† F.††††††††††† six (6) hours in the theory and practice of advanced injection therapy techniques including: mesotherapy for cellulite reduction, refer to Subsection F of 16.2.18.14 NMAC and apitherapy: at least half of these hours shall be in clinical practice; a certificate of completion from a board approved course in advanced mesotherapy or apitherapy will be considered to meet these hours.

[16.2.18.17 NMAC - Rp, 16.2.18.16 NMAC, 06-16-2015]

 

16.2.18.18†††††††††††† INJECTION THERAPY EDUCATIONAL COURSE CURRICULUM:The injection therapy educational course curriculum shall provide the doctor of oriental medicine, who successfully completes the course, with the educational course general curriculum knowledge and skills defined in 16.2.18.11 and 16.2.18.14 NMAC and the following specific knowledge and skills in:

††††††††††††††† A.††††††††††† regenerative injection therapy (RIT or prolotherapy):

††††††††††††††††††††††††††††††† (1)†††††††††† understanding of the scientific principles of prolotherapy, its application, alternatives, risks and consequences;

††††††††††††††††††††††††††††††† (2)†††††††††† recognizing the most common pain patterns generated from injured and lax ligaments of the joints of the extremities, lumbar and sacral regions;

††††††††††††††††††††††††††††††† (3)†††††††††† the concept of tissue regeneration and proliferation and how it can be promoted in the body;

††††††††††††††††††††††††††††††† (4)†††††††††† injecting some of the most commonly treated ligamentous, tendonous, and cartilaginous and intra-articular structures of the joints of the extremities, lumbar and sacral regions;

††††††††††††††††††††††††††††††† (5)†††††††††† how to perform regional anesthesia or a nerve block for pain relief; and

††††††††††††††††††††††††††††††† (6)†††††††††† the use of diagnostic musculoskeletal ultrasound and ultrasound guided procedures;

††††††††††††††† B.††††††††††† orthopedic and neurological physical exam and differential diagnosis:

††††††††††††††††††††††††††††††† (1)†††††††††† anatomy of the regions to be examined and treated;

††††††††††††††††††††††††††††††† (2)†††††††††† selecting and performing orthopedic and neurologic physical examination methods including but not limited to reflex testing, motor power testing, sensory exam, common orthopedic provocations, ligament stretch testing, accurate palpation and marking of anatomic landmarks, ligament and tendon compression testing;

††††††††††††††††††††††††††††††† (3)†††††††††† interpreting physical exam signs in context as evidence for or against the differential diagnoses;

††††††††††††††††††††††††††††††† (4)†††††††††† most common orthopedic pain differential diagnoses for these areas as well as other medical differential diagnoses that should be ruled out; and

††††††††††††††††††††††††††††††† (5)†††††††††† the most important treatment options for these differential diagnoses;

††††††††††††††† C.††††††††††† how to generate and carry out a comprehensive treatment plan that addresses the causative factors leading to pain and dysfunction from the perspective of the understanding of each style of injection therapy, offers post treatment palliation and provides post therapy recommendations to support rehabilitation and prevent recurrence:

††††††††††††††† ††††††††††††††† (1)†††††††††† how to explain to the patient the purpose of the therapy, the expected outcome and possible complications of the therapy that could occur; and

††††††††††††††††††††††††††††††† (2)†††††††††† anatomical locations that are relatively safe for injection therapy, as well as those locations that should be avoided for injection therapy;

††††††††††††††† D.††††††††††† perform phlebotomy and collect and centrifuge blood to be used for platelet rich plasma injection; knowledge of diagnostic and physical exam findings which indicate the need for platelet rich plasma as a treatment modality;

††††††††††††††† E.††††††††††† advanced neural therapy techniques; knowledge and skills as described in 16.2.18.14 NMAC of basic injection;

††††††††††††††† F.††††††††††† advanced mesotherapy;

††††††††††††††††††††††††††††††† (1)†††††††††† how to evaluate and treat the patient with cellulite including determination of a treatment plan, utilizing appropriate substance(s) and dosing to accomplish treatment goals;

††††††††††††††††††††††††††††††† (2)†††††††††† how to evaluate and treat fat;

††††††††††††††††††††††††††††††† (3)†††††††††† technique of injections to reduce fat or cellulite; and

††††††††††††††††††††††††††††††† (4)†††††††††† mechanisms of action of substances used for cellulite and fat reduction;

††††††††††††††† G.††††††††††† apitherapy;

††††††††††††††††††††††††††††††† (1)†††††††††† knowledge of and skill in performing apitherapy; and

††††††††††††††††††††††††††††††† (2)†††††††††† understanding theory and application of apitherapy, expected outcomes, benefits and potential risks and complications.

[16.2.18.18 NMAC - Rp, 16.2.18.17 NMAC, 06-16-2015]

 

16.2.18.19†††††††††††† INTRAVENOUS THERAPY EDUCATIONAL COURSE APPROVAL REQUIREMENTS FOR CERTIFICATION: The board will approve an intravenous therapy educational course for certification after the educational course provider submits to the board:

††††††††††††††† A.††††††††††† the completed application form provided by the board;

††††††††††††††† B.††††††††††† the payment of the application fee for expanded practice educational course approval specified in 16.2.10 NMAC;

††††††††††††††† C.††††††††††† documentation of having complied with all educational course approval general requirements defined in 16.2.18.8 NMAC;

††††††††††††††† D.††††††††††† documentation demonstrating that it will provide the educational course general curriculum defined in 16.2.18.10 NMAC;

††††††††††††††† E.††††††††††† documentation demonstrating that it will provide the intravenous therapy educational course hours defined in 16.2.18.20 NMAC;

††††††††††††††† F.††††††††††† documentation demonstrating that it will provide the intravenous therapy educational course curriculum defined in 16.2.18.21 NMAC; and

††††††††††††††† G.††††††††††† documentation that proposed test instruments have been reviewed and approved by a credentialed PhD psychometrician, as described in the ICE credentialing standards.

[16.2.18.19 NMAC - N, 06-16-2015]

 

16.2.18.20†††††††††††† INTRAVENOUS THERAPY COURSE PREREQUISITES:Only a New Mexico licensed DOM, in good standing, and board certified in basic injection therapy, may apply for an intravenous therapy educational course in expanded practice.

††††††††††††††† A.††††††††††† Proof of current BLS/CPR certification that will be current for two (2) years from an American heart association provider.

††††††††††††††† B.††††††††††† Proof of completion of at least three (3) semester hours of college level biochemistry from an accredited institution that provides evaluation of competencies by examination. A board approved college level on line course is acceptable.

[16.2.18.20 NMAC - N, 06-16-2015]

 

16.2.18.21†††††††††††† INTRAVENOUS THERAPY EDUCATIONAL COURSE HOURS:The intravenous therapy educational coursework shall be completed within two (2) years of commencement of the course, Subsection G of 16.2.18.8 NMAC, and shall consist of a minimum of one hundred thirty seven (137) total hours and with the minimum number of hours of education in the areas listed below:

††††††††††††††† A.††††††††††† eight (8) hours in the pharmacology, biochemistry, relevant pharmaceutical law, including 16.19.36 NMAC, differential diagnosis and clinical application relative to the selection, prescription, compounding and administration of the authorized substances in the intravenous therapy formulary;

††††††††††††††† B.††††††††††† ten (10) hours in the studying, drawing and sterile compounding, (in compliance with USP-797) of the authorized substances intended for infusion and injection utilizing approved aseptic technique and proper record keeping, and storage of substances. At least half of these required hours shall be clinical practice;

††††††††††††††† C.††††††††††† twenty-four (24) hours in all aspects of safely performing phlebotomy, intravenous infusions and intravenous pushes including calculation of osmolarity. At least half of these required hours shall be clinical practice with documented evidence of having prepared and started at least 10 IVís. Proof of completion of a board approved phlebotomy course may be applied toward a portion of these hours;

††††††††††††††† D.††††††††††† twenty-four (24) hours in oxidative medicine as defined in Paragraph (39) of Subsection B of 16.2.1.7 NMAC, including; ozone therapy, ultraviolet blood irradiation (photoluminescence), hyperbaric oxygen therapy and the use of oxygen therapeutically. At least half of these required hours shall be in clinical practice;

††††††††††††††† E.††††††††††† twenty-four (24) hours in nutritional IVís; vitamin C, meyers cocktails, vitamins, minerals, and amino acids;

††††††††††††††† F.††††††††††† twenty four (24) hours in detoxification, utilizing glutathione, phosphatidylcholine and calcium EDTA including practice standards that meet the requirement guidelines from the College of Physician and Surgeons of Alberta, on file in the board office;

††††††††††††††† G.††††††††††† sixteen (16) hours in blood chemistry analysis: including instruction of normal value ranges, critical values, clinical implications of abnormal values, and whether these values warrant reconsideration of proceeding with any intravenous therapy;

††††††††††††††† H.††††††††††† five (5) hours in urine analysis: including evaluation of unprovoked and provoked nutrient and toxic element testing;

††††††††††††††† I.†††††††††††† one (1) hour in pharmaceutical law as provided by the New Mexico board of pharmacy; and

††††††††††††††† J.†††††††††††† one (1) hour in oriental medicine scope of practice relative to the authorized substances and techniques.

[16.2.18.21 NMAC - N, 06-16-2015]

 

16.2.18.22†††††††††††† INTRAVENOUS THERAPY EDUCATIONAL COURSE CURRICULUM:The intravenous therapy educational course curriculum shall provide the doctor of oriental medicine, who successfully completes the course, with the knowledge and skills defined in Section 10 of 16.2.18 NMAC and the following specific knowledge and skills.

††††††††††††††† A.††††††††††† Pharmaceutical law: knowledge of compatibility and sterile compounding procedures of authorized substances in the intravenous therapy formulary in compliance with the compounding requirements of the USP-797.

††††††††††††††† B.††††††††††† Diagnostic phlebotomy knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† and skill in drawing blood for diagnostic purposes using appropriate aseptic procedure;

††††††††††††††††††††††††††††††† (2)†††††††††† needles, lancets, winged sets, syringes, vacutainer tubes, and other equipment used to draw blood for diagnostic purposes; and

††††††††††††††††††††††††††††††† (3)†††††††††† the various blood tests most relevant to the protocols being taught.

††††††††††††††† C.††††††††††† Intravenous therapy knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† and skill in the use of the equipment used for intravenous infusions;

††††††††††††††††††††††††††††††† (2)†††††††††† equipment used for an intravenous push;

††††††††††††††††††††††††††††††† (3)†††††††††† equipment used for injecting a bolus into an infusion;

††††††††††††††††††††††††††††††† (4)†††††††††† local anatomy of common infusion sites and skill in selecting an appropriate infusion site;

††††††††††††††††††††††††††††††† (5)†††††††††† authorized substances that are appropriate or not appropriate for intravenous infusion or injection from the intravenous therapy formulary;

††††††††††††††††††††††††††††††† (6)†††††††††† concept and importance of osmolarity, pH and skill in determining pH and calculating a given solutionís osmolarity using an osmolarity chart †††††††††††† simple algebraic equation or computer software;

††††††††††††††††††††††††††††††† (7)†††††††††† prerequisite lab tests that should be evaluated prior to initiating intravenous therapy of any kind;

††††††††††††††††††††††††††††††† (8)†††††††††† and skill in preparing and administering an intravenous push, intravenous infusion and injecting a bolus into an IV infusion; and

††††††††††††††††††††††††††††††† (9)†††††††††† possible complications that could occur during an intravenous infusion or push and how to identify, treat and manage these complications.

††††††††††††††† D.††††††††††† Oxidative medicine, photo-oxidation and the use of oxygen therapeutically knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† biochemistry of oxidative medicine including the biological electron transfer sequence (BETS) oxidation and reduction (redox) reactions;

††††††††††††††††††††††††††††††† (2)†††††††††† and skill in the relevant clinical application and use of the authorized substances in the intravenous therapy formulary;

††††††††††††††††††††††††††††††† (3)†††††††††† history, physics, equipment and therapeutic use of ultraviolet blood irradiation (photoluminescence);

††††††††††††††††††††††††††††††† (4)†††††††††† history, physics, physiology and therapeutic use, contraindications and safety considerations of hyperbaric oxygen chamber therapy; and

††††††††††††††††††††††††††††††† (5)†††††††††† blood borne pathogen training.

††††††††††††††† E.††††††††††† Detoxification and chelation therapy knowledge of:

††††††††††††††††††††††††††††††† (1)†††††††††† diagnostic tools available for determining and tracking the therapeutic elimination of body burden of toxic elements including hair analysis, blood analysis and urinalysis with provocation agents;

††††††††††††††††††††††††††††††† (2)†††††††††† how to determine that the kidneys, colon and liver are functioning appropriately prior to commencement of detoxification or chelation diagnostic and therapeutic procedures;

††††††††††††††††††††††††††††††† (3)†††††††††† critical importance of, and methods for, optimizing kidney and bowel function, and phase 1/phase 2 liver detox pathways, prior to and during detoxification or chelation therapy, how to recognize when these systems are overburdened and what to do if they are overburdened;

††††††††††††††††††††††††††††††† (4)†††††††††† biochemistry, clinical use, and safety concerns relevant to all modes of administration of the authorized substances used in detoxification or chelation therapy; and

††††††††††††††††††††††††††††††† (5)†††††††††† how to explain to the patient the purpose of the therapy, the expected outcome, alternatives and possible complications of the therapy that could occur.

[16.2.18.22 NMAC- N, 06-16-2015]

 

16.2.18.23†††††††††††† INTRAVENOUS THERAPY EXPANDED PRACTICE CERTIFICATION: The board shall only issue certification to applicants after successful completion of the Intravenous Therapy Expanded Practice Course, and successful completion and documentation of a practicum to include one hundred fifty (150) hours under the supervision of a board approved physician and three hundred (300) individual patients to be completed within two (2) years of completion of the coursework.

[16.2.18.23 NMAC - N, 06-16-2015]

 

16.2.18.24†††††††††††† BIOIDENTICAL HORMONE THERAPY EDUCATIONAL COURSE APPROVAL:The board shall have final authority for approval of a bioidentical hormone educational program upon completion of the following requirements. The educational course shall submit to the board:

††††††††††††††† A.††††††††††† the completed application form provided by the board;

††††††††††††††† B.††††††††††† payment of the application fee for expanded practice educational course approval specified in 16.2.10 NMAC;

††††††††††††††† C.††††††††††† documentation that it will comply with all educational course approval general requirements defined in 16.2.18.8 NMAC;

††††††††††††††† D.††††††††††† documentation demonstrating that it will provide the educational course general curriculum defined in 16.2.18.11 NMAC;

††††††††††††††† E.††††††††††† documentation demonstrating that it will provide the bioidentical hormone therapy educational course hours defined in 16.2.18.25 NMAC;

††††††††††††††† F.††††††††††† documentation demonstrating that it will provide the bioidentical hormone therapy educational course curriculum defined in 16.2.18.26 NMAC; and

††††††††††††††† G.††††††††††† documentation demonstrating that proposed test instruments have been reviewed and approved by a credentialed PhD psychometrician, as described in the ICE credentialing standards. A passing grade of seventy (70) percent is required for certification to demonstrate learned knowledge.

[16.2.18.24 NMAC - Rp, 16.2.18.19 NMAC, 06-16-2015]

 

16.2.18.25†††††††††††† BIOIDENTICAL HORMONE THERAPY EDUCATIONAL COURSE HOURS:The bioidentical hormone educational course shall consist of a minimum total of eighty (80) hours of education, with at least twenty four (24) hours of practical experience defined in Subsections B, E and F of 16.2.18.26 NMAC in the areas listed below:

††††††††††††††† A.††††††††††† eight (8) hours in the pharmacology of bioidentical hormones;

††††††††††††††† B.††††††††††† eighteen (18) hours in an overview of the endocrine system, including the anatomy and interactive physiology of the hypothalamic-pituitary-adrenal-thyroid (HPAT) and gonadal axis, the stress response and normal adrenal and thyroid function; also to include normal male and female sex hormone physiology; at least half of these hours shall be in practice or review of case studies;

††††††††††††††† C.††††††††††† twenty (20) hours in theory and practice of endocrinology including evaluation and treatment of the patient with hormonal dysfunction and imbalances including but not limited to; adrenal fatigue, auto-immune endocrine disorders, hypothyroid, hyperthyroid, menís hormone imbalances and womenís hormonal imbalances pre, peri and post menopause and consideration and assessment for treatment with bio-identical hormone replacement therapy, BHRT; at least half of these hours will be in practice or review of case studies;

††††††††††††††† D.††††††††††† fourteen (14) hours in blood chemistry analysis including but not limited to; CBC, CMP, LFT, lipids, ferritin, homocysteine, vitamin D, iodine, hs CRP, fibrinogen, ANA, ESR, HgBAIC, insulin antibodies;

††††††††††††††† E.††††††††††† two (2) hours in urine analysis;

††††††††††††††† F.††††††††††† sixteen (16) hours in the assessment and treatment of hormone and neurotransmitter imbalances through blood, urine and saliva hormone testing and evaluation; appropriate treatment options for the biomedical differential diagnoses including, but not limited to; adrenal fatigue, thyroid imbalances, andropause, menopausal syndrome, and other male and female hormone imbalances; at least half of these hours shall be in practice or case study review;

††††††††††††††† G.††††††††††† one (1) hour in pharmaceutical law as provided by the New Mexico board of pharmacy; and

††††††††††††††† H.††††††††††† one (1) hour in oriental medicine scope of practice relative to the prescription or administration of the authorized substances.

[16.2.18.25 NMAC - Rp, 16.2.18.20 NMAC, 06-16-2015]

 

16.2.18.26†††††††††††† BIOIDENTICAL HORMONE THERAPY EDUCATIONAL COURSE CURRICULUM:The bioidentical hormone therapy educational course curriculum shall provide the doctor of oriental medicine, who successfully completes the course, with the educational course general curriculum knowledge and skills defined in 16.2.18.11 NMAC and the following specific knowledge and skills:

††††††††††††††† A.††††††††††† bioidentical hormone therapy;

††††††††††††††††††††††††††††††† (1)†††††††††† anatomy, physiology, endocrinology, pathology, biochemistry, pharmacology, diagnostic and referral options including imaging, and clinical strategies with a focus on hormone pathways, neurotransmitter imbalances, precursors and intermediaries relevant to bioidentical hormone therapy;

††††††††††††††††††††††††††††††† (2)†††††††††† how to perform a diagnosis of the various aspects of the endocrine and neurotransmitter system using blood, urine, and saliva testing;

††††††††††††††††††††††††††††††† (3)†††††††††† the application, clinical use, dosage, dosage adjustment or discontinuation consequences and safety concerns relevant to all modes of administration of the authorized substances; and

††††††††††††††††††††††††††††††† (4)†††††††††† how to explain to the patient the purpose, expected outcome, risks and possible complications of bioidentical hormone therapy as well as the advantages of bioidentical hormone therapy, relative to non bioidentical hormone therapy;

††††††††††††††† B.††††††††††† non-hormone therapy:

††††††††††††††††††††††††††††††† (1)†††††††††† how to optimize hormone balance using authorized substances that are not hormones or are hormone precursors, and the benefits and limits of such therapy; and

††††††††††††††††††††††††††††††† (2)†††††††††† how to explain to the patient the purpose, expected outcome, risks and possible complications of non-hormone therapy as well as the advantages of non-hormone therapy relative to bioidentical hormone therapy.

[16.2.18.26 NMAC - Rp, 16.2.18.21 NMAC, 06-16-2015]

 

HISTORY OF 16.2.18 NMAC:

 

History of Repealed Material:

16.2.18 NMAC, Expanded Practice Educational Courses, filed 1-9-13, repealed, 06-16-2015.