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, 6/16/2015]
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, 6/16/2015]
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, 6/16/2015]
16.2.18.4 DURATION: Permanent.
[16.2.18.4 NMAC - Rp, 16.2.18.4 NMAC, 6/16/2015]
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, 6/16/2015]
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 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, 6/16/2015]
16.2.18.7 DEFINITIONS: Refer to definitions in Section 7 of 16.2.1 NMAC.
[16.2.18.7 NMAC - N, 6/16/2015]
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 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 Section 11 of 16.2.18 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 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 teacher to no more than eight 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 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 course’s 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, 6/16/2015]
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 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 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 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, 6/16/2015]
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 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 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, 6/16/2015]
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 USP 797 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, 6/16/2015]
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 Section 8
of 16.2.18 NMAC;
D. documentation demonstrating that it
will provide the educational course general curriculum defined in Section 11 of
16.2.18 NMAC;
E. documentation demonstrating that it
will provide the basic injection therapy educational course hours defined in Section
13 of 16.2.18 NMAC; and
F. documentation demonstrating that it will
provide the basic injection therapy educational course curriculum defined in Section
14 of 16.2.18 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 70 percent is required for certification to demonstrate learned
knowledge.
[16.2.18.12 NMAC - Rp, 16.2.18.11 NMAC, 6/16/2015]
16.2.18.13 BASIC INJECTION THERAPY
EDUCATIONAL COURSE HOURS: The education offered shall consist of a minimum
total of 58 contact hours with at least the minimum number of hours of
education in the areas listed below:
A. eight 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 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
for storage and dispensing of substances; at least half of the required hours
shall be clinical practice;
C. 14 hours in orthopedic and
neurological evaluation; at least half of these required hours shall be
clinical practice;
D. two 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. 28 hours in the theory and practice
of injection therapy including: 11 hours of trigger point therapy and injection
of acupuncture points; 11 hours of basic mesotherapy;
six 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 hour in pharmaceutical law as
provided by the New Mexico board of pharmacy;
G. one in
oriental medicine scope of practice relative to the authorized substances and
techniques; and
H. a minimum of two 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, 6/16/2015; A, 1/4/2020]
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 in Section 11 of 16.2.18 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, 6/16/2015]
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, 6/16/2015]
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, 6/16/2015]
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 115 hours and with at least the minimum number of hours of education
in the areas listed below:
A. eight hours in pharmacology and
relevant pharmaceutical law, including compliance with USP 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 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. 15 hours in a board approved course
in oxidative medicine;
D. 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. 30 hours of diagnostic musculoskeletal
ultrasound and ultrasound guided musculoskeletal procedures from a board
approved course; and
F. six 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, 6/16/2015]
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 Sections 11 and 14 of 16.2.18 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 Section 14 of 16.2.18 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, 6/16/2015]
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 Section 8
of 16.2.18 NMAC;
D. documentation demonstrating that it
will provide the educational course general curriculum defined in Section 10 of
16.2.18 NMAC;
E. documentation demonstrating that it
will provide the intravenous therapy educational course hours defined in Section
20 of 16.2.18 NMAC;
F. documentation demonstrating that it will
provide the intravenous therapy educational course curriculum defined in
Section 21 of 16.2.18 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, 6/16/2015]
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 years from an American heart
association provider.
B. Proof of completion
of at least three 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, 6/16/2015]
16.2.18.21 INTRAVENOUS THERAPY EDUCATIONAL
COURSE HOURS: The intravenous therapy educational coursework shall
be completed within two years of commencement of the course, Subsection G of 16.2.18.8
NMAC, and shall consist of a minimum of 137 total hours and with the minimum
number of hours of education in the areas listed below:
A. eight 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 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. 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 IV’s. Proof of completion of a board approved
phlebotomy course may be applied toward a portion of these hours;
D. 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. 24 hours in nutritional IV’s;
vitamin C, meyers cocktails,
vitamins, minerals, and amino acids;
F. 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. 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 hours in urine analysis: including
evaluation of unprovoked and provoked nutrient and toxic element testing;
I. one hour in pharmaceutical law as
provided by the New Mexico board of pharmacy; and
J. one hour in oriental medicine scope
of practice relative to the authorized substances and techniques.
[16.2.18.21 NMAC - N, 6/16/2015]
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 solution’s 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, 6/16/2015]
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 150 hours under the supervision of a board approved physician and three
hundred (300) individual patients to be completed within two years of
completion of the coursework.
[16.2.18.23 NMAC - N, 6/16/2015]
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 Section 8
of 16.2.18 NMAC;
D. documentation demonstrating that it
will provide the educational course general curriculum defined in Section 11 of
16.2.18 NMAC;
E. documentation demonstrating that it
will provide the bioidentical hormone therapy educational course hours defined
in Section 25 of 16.2.18 NMAC;
F. documentation demonstrating that it
will provide the bioidentical hormone therapy educational course curriculum
defined in Section 26 of 16.2.18 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 70 percent is required for certification to demonstrate learned
knowledge.
[16.2.18.24 NMAC - Rp, 16.2.18.19 NMAC, 6/16/2015]
16.2.18.25 BIOIDENTICAL HORMONE THERAPY
EDUCATIONAL COURSE HOURS: The
bioidentical hormone educational course shall consist of a minimum total of 80
hours of education, with at least 27 hours of practical experience defined in
Subsections B, C, D, E, and F below:
A. eight hours in the pharmacology of
bioidentical hormones;
B. 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. 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, men’s hormone
imbalances and women’s 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. 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 hours in urine analysis;
F. 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 hour in pharmaceutical law as
provided by the New Mexico board of pharmacy; and
H. one 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, 6/16/2015; A, 1/4/2020]
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 Section 11 of 16.2.18
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, 6/16/2015]
HISTORY OF 16.2.18 NMAC:
History of Repealed Material:
16.2.18 NMAC, Expanded
Practice Educational Courses, filed 1/9/2013, repealed, 6/16/2015.