Bill Text: IA SSB3139 | 2013-2014 | 85th General Assembly | Introduced

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Bill Title: A study bill for an act relating to the licensure of naturopathic physicians.

Spectrum: Unknown

Status: (N/A - Dead) 0000-00-00 - In State Government [SSB3139 Detail]

Download: Iowa-2013-SSB3139-Introduced.html

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Senate Study Bill 3139 - Introduced
SENATE FILE _____
BY (PROPOSED COMMITTEE ON
STATE GOVERNMENT BILL BY
CHAIRPERSON DANIELSON)
A BILL FOR
An Act relating to the licensure of naturopathic physicians.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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Section 1. Section 147.1, subsections 3 and 6, Code 2014,
are amended to read as follows:
3. “Licensed” or “certified” , when applied to a physician
and surgeon, podiatric physician, osteopathic physician
and surgeon, naturopathic physician, physician assistant,
psychologist, chiropractor, nurse, dentist, dental hygienist,
dental assistant, optometrist, speech pathologist, audiologist,
pharmacist, physical therapist, physical therapist assistant,
occupational therapist, occupational therapy assistant,
orthotist, prosthetist, pedorthist, respiratory care
practitioner, practitioner of cosmetology arts and sciences,
practitioner of barbering, funeral director, dietitian, marital
and family therapist, mental health counselor, social worker,
massage therapist, athletic trainer, acupuncturist, nursing
home administrator, hearing aid dispenser, or sign language
interpreter or transliterator means a person licensed under
this subtitle .
6. “Profession” means medicine and surgery, podiatry,
osteopathic medicine and surgery, naturopathic medicine,
practice as a physician assistant, psychology, chiropractic,
nursing, dentistry, dental hygiene, dental assisting,
optometry, speech pathology, audiology, pharmacy, physical
therapy, physical therapist assisting, occupational therapy,
occupational therapy assisting, respiratory care, cosmetology
arts and sciences, barbering, mortuary science, marital
and family therapy, mental health counseling, social work,
dietetics, massage therapy, athletic training, acupuncture,
nursing home administration, hearing aid dispensing, sign
language interpreting or transliterating, orthotics,
prosthetics, or pedorthics.
Sec. 2. Section 147.2, subsection 1, Code 2014, is amended
to read as follows:
1. A person shall not engage in the practice of medicine
and surgery, naturopathic medicine, podiatry, osteopathic
medicine and surgery, psychology, chiropractic, physical
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therapy, physical therapist assisting, nursing, dentistry,
dental hygiene, dental assisting, optometry, speech pathology,
audiology, occupational therapy, occupational therapy
assisting, orthotics, prosthetics, pedorthics, respiratory
care, pharmacy, cosmetology arts and sciences, barbering,
social work, dietetics, marital and family therapy or mental
health counseling, massage therapy, mortuary science, athletic
training, acupuncture, nursing home administration, hearing aid
dispensing, or sign language interpreting or transliterating,
or shall not practice as a physician assistant, unless the
person has obtained a license for that purpose from the board
for the profession.
Sec. 3. Section 147.13, subsection 1, Code 2014, is amended
to read as follows:
1. For medicine and surgery, osteopathic medicine and
surgery, and acupuncture, and naturopathic medicine, the board
of medicine.
Sec. 4. Section 147.74, Code 2014, is amended by adding the
following new subsection:
NEW SUBSECTION . 23A. A naturopathic physician licensed
under chapter 148G may use the words “naturopathic physician”,
“naturopathic doctor”, “doctor of naturopathy”, “naturopathic
medical doctor”, “doctor of naturopathic medicine”,
“naturopath” or the initials “N.D.” or “N.M.D.” after the
person’s name.
Sec. 5. Section 147.107, Code 2014, is amended by adding the
following new subsection:
NEW SUBSECTION . 8A. A licensed naturopathic physician
may prescribe all substances and devices consistent with the
level of training of the naturopathic physician unless added
to the exclusionary naturopathic formulary by the naturopathic
advisory council.
Sec. 6. Section 148E.3, subsection 1, Code 2014, is amended
to read as follows:
1. A person otherwise licensed to practice medicine and
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surgery, osteopathic medicine and surgery, naturopathic
medicine, chiropractic, podiatry, or dentistry who is
exclusively engaged in the practice of the person’s profession.
Sec. 7. NEW SECTION . 148G.1 Definitions.
As used in this chapter, unless the context otherwise
requires:
1. “Approved naturopathic medical program” means any of the
following:
a. A naturopathic medical education program in the
United States providing the degree of doctor of naturopathy
or doctor of naturopathic medicine. Such program shall
offer graduate-level, full-time didactic and supervised
clinical training and shall be accredited, or shall have
achieved candidacy status for accreditation by the council
on naturopathic medical education or by an equivalent
federally recognized accrediting body for naturopathic medical
programs also recognized by the board. Additionally, the
program shall be an institution, or part of an institution of
higher education that is either accredited or is a candidate
for accreditation by a regional or national institutional
accrediting agency recognized by the United States secretary
of education.
b. A diploma-granting, degree-equivalent college or
university in Canada that offers graduate-level, full-time
didactic and supervised clinical training and is accredited, or
has achieved candidacy status for accreditation by the council
on naturopathic medical education or an equivalent federally
recognized accrediting body for naturopathic medical programs
also recognized by the board; and the college or university
has provincial approval for participation in government-funded
student aid.
2. “Board” means the board of medicine established in
section 147.13.
3. “Director” means the executive director of the board of
medicine.
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4. “Exclusionary naturopathic formulary” means the
exclusionary list of medicines, nonprescription and
prescription, which naturopathic physicians may not use in the
practice of their profession, as determined by the naturopathic
advisory council.
5. “Minor office procedures” means methods for the repair
and care incidental to superficial lacerations and abrasions,
superficial lesions, and the removal of foreign bodies located
in the superficial tissues.
6. “Naturopathic advisory council” means the naturopathic
advisory council established under this chapter.
7. “Naturopathic medicine” means a system of primary health
care for the prevention, diagnosis, and treatment of human
health conditions, injury, and disease, and the promotion or
restoration of health. “Naturopathic medicine” includes the use
of physiological, psychological, or mechanical methods, and the
use of natural medicines, prescription or legend drugs, foods,
herbs, or other natural remedies.
8. “Naturopathic physician” means a practitioner of
naturopathic medicine who has been properly licensed for that
purpose by the board of medicine under this chapter, who may
diagnose, treat, and help prevent diseases using a system
of practice that is based on the natural healing capacity
of individuals, and may use physiological, psychological,
or mechanical methods, and may use natural medicines,
prescription, or legend drugs, foods, herbs, or other natural
remedies.
9. “Prescription drug” means any drug described in section
503(b) of the federal Food, Drug and Cosmetic Act, 21 U.S.C.
§353, if its label is required to bear the symbol “RX only”.
Sec. 8. NEW SECTION . 148G.2 Licensure —— naturopathic
medicine.
1. Qualifications for licensure. An applicant for a license
to practice naturopathic medicine shall be granted a license
by the board if the applicant satisfies all of the following
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requirements:
a. Submits an application for licensure designed and
approved by the naturopathic advisory council.
b. Pays an application fee established by the board.
c. Has graduated from an approved naturopathic medical
program.
d. Has passed a competency-based national naturopathic
licensing examination administered by the north American board
of naturopathic examiners or successor agency, that has been
nationally recognized to administer a naturopathic examination
representing federal standards of education and training. For
applicants who completed an approved naturopathic medical
program located in Canada, eligibility for licensure may be
granted with evidence of successful passage of a Canadian
provincial competency examination.
e. Provides evidence that the applicant is of good ethical
and professional reputation. An applicant shall not have had
a license to practice naturopathic medicine or other health
care license, registration, or certificate refused, revoked,
or suspended by this state or any other jurisdiction for
reasons that relate to the applicant’s ability to skillfully
and safely practice naturopathic medicine unless that license,
registration, or certification has been restored to good
standing.
f. Provides evidence that the applicant is physically and
mentally capable of safely practicing naturopathic medicine
with or without reasonable accommodation.
2. Term of license. A license granted pursuant to this
section shall be renewed every two years.
Sec. 9. NEW SECTION . 148G.3 Use of title —— exceptions.
1. A person shall not represent that the person is a
naturopathic physician, a doctor of naturopathic medicine, a
doctor of naturopathy, a naturopath, or as being otherwise
authorized to practice naturopathic medicine in this state, or
use the titles “N.D.” or “N.M.D.” or any other titles, words,
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letters, abbreviations, or insignia indicating or implying that
the individual is a licensed naturopathic physician unless
the individual has been licensed as a naturopathic physician
pursuant to this chapter without first obtaining from the board
a license to practice naturopathic medicine pursuant to the
provisions of this chapter.
2. The practice of naturopathic medicine by a naturopathic
physician licensed pursuant to this chapter does not constitute
the practice of medicine and surgery under chapter 148, the
practice of osteopathic medicine and surgery under chapter 148,
or the practice of nursing under chapter 152.
3. This chapter and chapter 147 do not prevent qualified
members of other professions including but not limited
to individuals licensed under chapter 148, 150, 150A, or
152 from providing services consistent with the nature of
naturopathic medicine, but these persons shall not use a title
or description denoting that they are licensed naturopathic
physicians.
Sec. 10. NEW SECTION . 148G.4 Duties of board.
The board shall adopt rules consistent with this chapter,
chapter 147, and as recommended by the naturopathic advisory
council which are necessary for the performance of the board’s
duties.
Sec. 11. NEW SECTION . 148G.5 Naturopathic advisory council.
1. A naturopathic advisory council is established,
consisting of the following members, appointed by the governor:
a. Prior to July 1, 2016, four members who are naturopathic
physicians who are residents of the state of Iowa and who are
currently licensed in good standing in another state. On
and after July 1, 2016, such members shall be naturopathic
physicians licensed under this chapter.
b. One member who is a pharmacist licensed in Iowa.
c. One member who is a medical or osteopathic physician
licensed in Iowa, who has expertise in integrative medicine.
d. One member representing the general public.
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2. Members shall not receive per diem or expense payments.
3. Members shall serve two-year terms, and shall serve until
their successors have been appointed.
4. The council shall select a chairperson from its
membership.
Sec. 12. NEW SECTION . 148G.6 Council powers and duties.
The naturopathic advisory council shall do all of the
following:
1. Advise the board regarding standards for licensed
naturopathic physicians.
2. Provide for distribution of information regarding
licensed naturopathic physician standards.
3. Advise the board on enforcement issues.
4. Review applications for licensure and license renewal
and recommend the granting or denial thereof.
5. Advise the board on issues related to receiving and
investigating complaints, conducting hearings, and imposing
disciplinary action in relation to complaints against licensed
naturopathic physicians.
6. Review naturopathic education and training for and
make specific recommendations to the board regarding the
qualifications to practice naturopathic childbirth attendance.
7. Recommend to the board any prescription drugs which
should be included on the exclusionary naturopathic formulary.
8. Advise the board regarding approval of continuing
education programs specific to naturopathic practice.
Sec. 13. NEW SECTION . 148G.7 Scope of practice.
A naturopathic physician may do any of the following:
1. Order and perform physical and laboratory examinations
consistent with naturopathic education and training for
diagnostic purposes, including but not limited to phlebotomy,
clinical laboratory tests, orificial examinations, and
physiological function tests.
2. Order diagnostic imaging studies consistent with
naturopathic training. All diagnostic tests not consistent
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with naturopathic medical education and training must be
referred for performance and interpretation to an appropriately
licensed health care professional.
3. Dispense, administer, order, and prescribe, provide, or
perform the following, as applicable:
a. Food, extracts of food, nutraceuticals, vitamins, amino
acids, minerals, enzymes, botanicals and their extracts,
botanical medicines, homeopathic medicines, and all dietary
supplements and nonprescription drugs as defined by the federal
Food, Drug, and Cosmetic Act, 21 U.S.C. §301 et seq.
b. Prescription or legend drugs and hormonal replacement.
c. Hot or cold hydrotherapy, naturopathic physical medicine,
and therapeutic exercise.
d. Devices, including but not limited to therapeutic
devices, barrier contraception, and durable medical equipment.
e. Health education and health counseling.
f. Repair and care incidental to superficial lacerations and
abrasions.
g. Removal of foreign bodies located in the superficial
tissues.
h. Musculoskeletal manipulation consistent with
naturopathic education and training.
4. Utilize routes of administration that include oral,
nasal, auricular, ocular, rectal, vaginal, transdermal,
intradermal, subcutaneous, intravenous, and intramuscular
consistent with the education and training of a naturopathic
physician.
5. Perform all therapies as trained and educated, which are
approved by the naturopathic advisory council.
Sec. 14. NEW SECTION . 148G.8 Prohibitions.
A naturopathic physician licensed under this chapter shall
not do any of the following:
1. Perform or induce abortions.
2. Perform surgical procedures except those minor office
procedures authorized by this chapter.
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3. Practice or claim to practice as a medical or osteopathic
physician, dentist, pharmacist, podiatrist, optometrist,
psychologist, advanced practice registered nurse, physician
assistant, chiropractor, physical therapist, acupuncturist, or
any other health care provider not authorized in this chapter
unless licensed by the state of Iowa as such.
4. Use general or spinal anesthetics.
5. Administer ionizing radioactive substances for
therapeutic purposes.
6. Administer or prescribe chemotherapeutic medications for
the purpose of cancer treatment.
7. Perform surgical procedures of the eye, ear, nerves,
veins, or arteries extending beyond superficial tissue.
Sec. 15. NEW SECTION . 148G.9 Exemptions.
Nothing in this chapter shall be construed to prohibit or
restrict:
1. The practice of a profession by an individual who is
licensed, certified, or registered under another law of this
state who is performing services within the individual’s
authorized scope of practice.
2. The practice of naturopathic medicine by an individual
employed by the government of the United States while the
individual is engaged in the performance of duties prescribed
by the laws and regulations of the United States.
3. The practice of naturopathic medicine by students
enrolled in an approved naturopathic medical program. The
performance of services shall be pursuant to a course of
instruction or assignments from an instructor and under the
supervision of the instructor. The instructor shall be a
naturopathic physician licensed pursuant to this chapter or a
duly licensed professional in the instructed field.
4. Persons from treating themselves and family members
based on religious or health beliefs.
5. Persons who sell vitamins and herbs from providing
information about their products.
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6. Persons or practitioners from advising in the use
of a therapy including but not limited to herbal medicine,
homeopathy, nutrition, or other nondrug or nonsurgical therapy
that is within the scope of practice of naturopathic physicians
as provided in this chapter as long as such therapy is lawful,
or, if a licensed health care provider, within the scope of
practice of the profession; and provided that such person is
not using a title protected pursuant to this chapter or holding
themselves out to be a naturopathic physician.
7. The practice of naturopathic medicine by persons who
are licensed to practice in any other state as practicing
naturopathic physicians, who enter this state to consult with
a licensed naturopathic physician in this state; provided,
however, that the consultation is to be limited to examination,
recommendation, or testimony in litigation.
Sec. 16. FUNDING. The board of medicine shall apply
to the department of administrative services to request an
allocation of moneys from the IowAccess revolving fund to fund
the estimated costs for expansion of the advanced Maryland
automatic network disk archiver (AMANDA) system to allow
licensure of naturopathic physicians in the AMANDA system.
The board shall not implement a fee increase to make this
adjustment to the AMANDA system for naturopathic physicians.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
This bill requires the licensing of naturopathic physicians
and makes the provisions of Code chapter 147, including
penalty and other regulatory provisions, applicable to other
health professions applicable to the practice of naturopathic
medicine. The bill provides that the practice of naturopathic
medicine means the provision of naturopathic services defined
as a system of primary health care for the prevention,
diagnosis, and treatment of human health conditions, injury,
and disease, and the promotion or restoration of health.
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Naturopathic medicine includes the use of physiological,
psychological, or mechanical methods, and the use of natural
medicines, prescription or legend drugs, foods, herbs, or
other natural remedies. The bill specifies qualifications
for licensure and the scope of practice for a naturopathic
physician, and details functions that a naturopathic physician
may not perform.
The practice of naturopathic medicine is regulated by the
board of medicine, with the advice of a naturopathic advisory
council. The council consists of seven members, four of
whom are naturopathic physicians, one medical or osteopathic
physician, a pharmacist, and one member representing the
general public. The council does not receive a per diem or
expenses.
The bill provides that qualified members of other
professions, including physicians and nurses, are not prevented
from providing services consistent with naturopathic medicine,
but these persons shall not use a title or description denoting
that they are naturopathic physicians. The bill sets out these
titles.
The bill provides for inclusion of licensed naturopathic
physicians in the AMANDA system. This system is a network
disk archiver system currently used by the boards of nursing,
dentistry, and medicine.
Code section 422.7(27) provides an income tax exemption for
payments received by an individual providing unskilled in-home
health-related care services to a member of the individual
caregiver’s family. This exemption is not available to health
care professionals licensed by the board of medicine. Under
the bill, naturopathic physicians are to be licensed by the
board of medicine, making them ineligible for this exemption.
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