Bill Text: NJ S2735 | 2024-2025 | Regular Session | Introduced


Bill Title: "Naturopathic Doctors Licensing Act."

Spectrum: Bipartisan Bill

Status: (Introduced) 2024-02-15 - Introduced in the Senate, Referred to Senate Commerce Committee [S2735 Detail]

Download: New_Jersey-2024-S2735-Introduced.html

SENATE, No. 2735

STATE OF NEW JERSEY

221st LEGISLATURE

 

INTRODUCED FEBRUARY 15, 2024

 


 

Sponsored by:

Senator  MICHAEL L. TESTA, JR.

District 1 (Atlantic, Cape May and Cumberland)

Senator  JOSEPH A. LAGANA

District 38 (Bergen)

 

 

 

 

SYNOPSIS

     Naturopathic Doctors Licensing Act."

 

CURRENT VERSION OF TEXT

     As introduced.

  


An Act concerning the licensure of naturopathic doctors, supplementing Title 45 of the Revised Statutes, and amending various parts of the statutory law.

 

     Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

     1.    (New section)  P.L.    , c.    (C.        ) (pending before the Legislature as this bill) shall be known and may be cited as the "Naturopathic Doctors Licensing Act."

 

     2.    (New section)  As used in P.L.    , c.    (C.        ) (pending before the Legislature as this bill):

     "Board" means the State Board of Naturopathic Examiners established pursuant to section 3 of P.L.    , c.    (C.        ) (pending before the Legislature as this bill).

     "Committee" means the Naturopathic Childbirth Attendance Advisory Committee.

     "Device" means an appliance, apparatus, or instrument administered or dispensed to a patient by a naturopathic doctor.

     "Director" means the Director of the Division of Consumer Affairs in the Department of Law and Public Safety.

     "Dispense" means the delivery by a naturopathic doctor of a natural substance, drug, or device to a patient and only for a condition being diagnosed or treated by that doctor, except for free samples packaged for individual use by licensed manufacturers or repackagers, and includes the prescribing, administering, packaging, labeling, and security necessary to prepare and safeguard the natural substance, drug, or device for delivery to the treating doctor's own patient. 

     "Natural substance" means a homeopathic, botanical, or nutritional supplement that does not require a prescription by State or federal law before it is dispensed, but is prescribed to treat a medical condition diagnosed by a naturopathic doctor.

     "Naturopathic doctor" means any person licensed as a naturopathic doctor pursuant to the provisions of P.L.    , c.    (C.        ) (pending before the Legislature as this bill).

     "Naturopathic medicine" means a distinct and comprehensive system of primary health practiced by a naturopathic doctor for the diagnosis, treatment, and prevention of human health conditions, injuries, and disease.

 

     3.    (New section)  a.  There is created within the Division of Consumer Affairs in the Department of Law and Public Safety the State Board of Naturopathic Examiners.  The board shall consist of nine members who are residents of the State, six of whom shall be, except for the members first appointed, naturopathic doctors licensed pursuant to the provisions of P.L.    , c.    (C.        ) (pending before the Legislature as this bill) and shall have been actively engaged in the practice of naturopathic medicine for at least five years immediately preceding their appointment, two of whom shall be public members and one of whom shall be a State executive department member appointed pursuant to the provisions of P.L.1972, c.60 (C.45:1-2.1 et seq.).  Of the members first appointed, the individuals shall have a degree in naturopathic medicine from a program accredited by the Association of Accredited Naturopathic Medical Colleges, be licensed or otherwise credentialed in naturopathic medicine in another jurisdiction, and have practiced naturopathic medicine for at least five years.

     b.    The Governor shall appoint each member, other than the State executive department member, with the advice and consent of the Senate. The Governor shall appoint each member, other than the State executive department member, for a term of three years, except that of the naturopathic doctors first appointed, two shall serve for terms of three years, two shall serve for terms of two years and two shall serve for a term of one year. Each member shall hold office until a successor has been qualified. Any vacancy in the membership of the board shall be filled for the unexpired term only in the manner provided for the original appointment. No member of the board, other than the State executive department member, shall serve more than two successive terms in addition to any unexpired term to which the member has been appointed.

     c.     Members of the board shall be compensated and reimbursed for expenses and provided with office and meeting facilities pursuant to section 2 of P.L.1977, c.285 (C.45:1-2.5).

 

     4.    (New section)  The board shall:

     a.     establish criteria and standards for licensure;

     b.    review the qualification of applicants for licensure;

     c.     adopt a code of ethics;

     d.    ensure proper conduct and standards of practice;

     e.     issue and renew licenses pursuant to P.L.    , c.    (C.        ) (pending before the Legislature as this bill);

     f.     adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) as it may deem necessary to perform its duties under, and to enforce the provisions of, P.L.    , c.    (C.        ) (pending before the Legislature as this bill);

     g.    establish standards for continuing education;

     h.    suspend, revoke, or decline to renew licenses of naturopathic doctors pursuant to the provisions of P.L.1978, c.73 (C.45:1-14 et seq.);

     i.     maintain a record of every naturopathic doctor licensed in this State, and the date and number of a license, and publish a list of the names and addresses of all licensees annually; and

     j.     establish fees for applications for licensure, examinations, initial licensure, renewals, late renewals, temporary licenses, provisional licenses, and for duplication of lost licenses, pursuant to section 2 of P.L.1974, c.46 (C.45:1-3.2).

 

     5.    (New section) a. No person shall practice or offer to practice naturopathic medicine unless the person possesses a valid license to practice naturopathic medicine in accordance with the provisions of P.L.    , c.    (C.        ) (pending before the Legislature as this bill).

     b.    No person shall use the titles or designations "doctor of naturopathic medicine," "doctor of naturopathy," or "naturopathic physician," "naturopathic doctor," "licensed naturopath," "naturopath," nor the abbreviations "N.M.D." or "N.D." or any other title or designation which indicates or implies that the person is a naturopathic doctor unless that person possesses a valid license to practice naturopathic medicine in accordance with the provisions of P.L.    , c.    (C.        ) (pending before the Legislature as this bill).

 

     6.    (New section)  The provisions of P.L.    , c.    (C.        ) (pending before the Legislature as this bill) shall not apply to:

     a.     the practices of other persons and health care providers licensed by appropriate agencies of the State of New Jersey, provided that their duties are consistent with the accepted standards of the person's profession and the persons do not present themselves as a licensed naturopathic doctor which otherwise would require licensure by the board;

     b.    a person employed by the federal government in the practice of naturopathic medicine while the person is engaged in the performance of duties prescribed by laws and regulations of the United States;

     c.     a person who makes recommendations regarding, or is engaged in, the sale of food, extracts of food, nutraceuticals, vitamins, amino acids, minerals, enzymes, botanicals and their extracts, botanical medicines, homeopathic medicines, dietary supplements, and nonprescription drugs or other products of nature, the sale of which is not otherwise prohibited under State or federal law;

     d.    a person who is licensed in another state or possession of the United States or the District of Columbia to practice naturopathic medicine if the person is incidentally called into this State for consultation with a licensed naturopathic doctor; or

     e.     a student enrolled in an approved naturopathic medical program whose services are performed in accordance with a course of instruction under the supervision of a naturopathic doctor.

     7.    (New section)  a.  The board shall approve a naturopathic medical education program accredited by the Council on Naturopathic Medical Education or an equivalent federally recognized accrediting body for the naturopathic medical profession that has the following minimum requirements:

     (1)   admission requirements that include a minimum of three-quarters of the credits required for a bachelor's degree from a regionally accredited college or university or the equivalency, as determined by the board; and

     (2)   program requirements for its degree or diploma of a minimum of 4,100 total hours in basic and clinical sciences, naturopathic philosophy, naturopathic modalities, and naturopathic medicine, with not less than 2,500 of those hours consisting of academic instruction, and not less than 1,200 of those hours consisting of supervised clinical training approved by the naturopathic medical school.

     b.    To be approved by the board, a naturopathic medical education program in the United States shall offer graduate-level full-time studies and training leading to the degree of Doctor of Naturopathy or Doctor of Naturopathic Medicine.  The program shall be offered at an institution, or part of an institution, of higher education that is either accredited or is a candidate for accreditation by a regional institutional accrediting agency recognized by the United States Secretary of Education and the Council on Naturopathic Medical Education, or an equivalently federally recognized accrediting body for naturopathic doctor education.

     c.     To qualify as an approved naturopathic medical school, a naturopathic medical education program located in the United States or Canada shall offer a full-time, doctoral-level, naturopathic medical education program with its graduates being eligible to apply to the board for licensure and to the North American Board of Naturopathic Examiners that administers the naturopathic licensing examination.

 

     8.    (New section)  Each person desiring to obtain a license to practice naturopathic medicine shall apply to the board upon the form and in the manner the board prescribes and shall furnish satisfactory evidence to the board that the applicant:

     a.     is at least 21 years of age;

     b.    is of good moral character;

     c.     has received a degree in naturopathic medicine from an approved naturopathic medical school where the degree substantially meets the educational requirements specified in section 7 of P.L.    , c.    (C.        ) (pending before the Legislature as this bill); and

     d.    has passed the Naturopathic Physicians Licensing Examination (NPLEX) or an equivalent approved by the North American Board of Naturopathic Examiners.

     9.    (New section)  a.  A naturopathic doctor may order and perform physical and laboratory examinations for diagnostic purposes, including, but not limited to, phlebotomy, clinical laboratory tests, speculum examinations, orificial examinations, and physiological function tests.

     b.    A naturopathic doctor may order diagnostic imaging studies, including X-ray, ultrasound, mammogram, bone densitometry, and others, consistent with naturopathic training, as determined by the board, but shall refer the studies to an appropriately licensed health care professional to conduct the study and interpret the results.

     c.     A naturopathic doctor may dispense, administer, order and prescribe, or perform the following:

     (1)   food, extracts of food, nutraceuticals, vitamins, amino acids, minerals, enzymes, botanicals and their extracts, botanical medicines, homeopathic medicines, all dietary supplements, and nonprescription drugs;

     (2)   hot or cold hydrotherapy, naturopathic physical medicine inclusive of the manual use of massage, stretching, resistance, or joint play examination including high-velocity low-amplitude movement at or beyond the end range of normal joint motion, electromagnetic energy, colon hydrotherapy, and therapeutic exercise;

     (3)   devices, including but not limited to, therapeutic devices, barrier contraception, and durable medical equipment;

     (4)   health education and health counseling;

     (5)   repair and care incidental to superficial lacerations and abrasions, except for suturing;

     (6)   removal of foreign bodies located in the superficial tissues; and

     (7)   prescription drugs that are consistent with the education and training of a naturopathic doctor.

     d.    A naturopathic doctor may utilize routes of administration that include oral, nasal, auricular, ocular, rectal, vaginal, transdermal, intradermal, subcutaneous, intraarticular, intravenous, and intramuscular.

     e.     The board may establish regulations regarding ocular or intravenous routes of administration that are consistent with the education and training of a naturopathic doctor.

    

     10.  (New section)  A naturopathic doctor may dispense a natural substance, drug, or device to a patient for a condition being diagnosed or treated by the doctor if:

     a.     the natural substance, drug, or device is dispensed and properly labeled with the following dispenser information:

     (1)   the dispensing doctor's name, address, and telephone number and a prescription number or other method of identifying the prescription;

     (2)   the date the natural substance, drug, or device is dispensed;

     (3)   the patient's name; and

     (4)   the name and strength of the natural substance, drug, or device, directions for proper and appropriate use and any cautionary statements for the natural substance, drug, or device, and if a generic drug is dispensed, the manufacturer's name; or

     b.    the dispensing doctor enters into the patient's medical record the name and strength of the natural substance, drug, or device dispensed, the date the natural substance, drug, or device is dispensed and the therapeutic reason for which it is dispensed.

 

     11.  (New section)  a.  A license as a naturopathic doctor shall be issued for a period of two years, and may be renewed for additional two-year periods upon submission by the holder of a renewal application on a form prescribed by the board, completion by the holder of any requirements for renewal established by the board, and payment of the renewal fee prescribed by the board.

     b.    If a renewal fee is not paid by the expiration date, the license shall automatically expire, but may be renewed within two years of its expiration date on payment to the board of a sum determined by the board for each year or part thereof during which the license was expired and an additional restoration fee.

 

     12.  (New section)  Upon receipt of a fee and a written application on forms provided, the board shall issue a license without examination to a naturopathic doctor who holds a valid license issued by another state or possession of the United States or the District of Columbia that has education and experience requirements substantially equivalent to the requirements of P.L.    , c.    (C.        ) (pending before the Legislature as this bill).

 

     13.  (New section)  a.  The State Board of Naturopathic Medicine shall establish a Naturopathic Childbirth Attendance Advisory Committee to issue recommendations concerning medical education and training for the specialty practice of naturopathic childbirth attendance.  The advisory committee shall be composed of one licensed medical doctor with a clinical specialty or board certification in obstetrics, one certified nurse midwife or certified midwife, and two licensed naturopathic doctors with clinical experience in naturopathic childbirth attendance.

     b.    A naturopathic doctor may not practice naturopathic childbirth attendance without first obtaining a certificate of special competency in naturopathic childbirth attendance in accordance with the provisions of this section.

     c.     Upon payment of the required fee, the State Board of Naturopathic Medicine shall issue a certificate of special competency in naturopathic childbirth attendance to a licensed naturopathic doctor who meets the requirements prescribed by the board to practice naturopathic childbirth attendance.

     d.    The board, after consultation with the advisory committee may adopt rules applicable to special competency certification which:

     (1)   establish medical education, training, and qualifications necessary for certification;

     (2)   limit or restrict the specialty practice;

     (3)   define the scope of the specialty practice; and

     (4)   establish procedures for maintaining certification;

 

     14.  Section 1 of P.L.1971, c.60 (C.45:1-2.1) is amended to read as follows:

     1.    The provisions of this act shall apply to the following boards and commissions:  the New Jersey State Board of Accountancy, the New Jersey State Board of Architects, the New Jersey State Board of Cosmetology and Hairstyling, the Board of Examiners of Electrical Contractors, the New Jersey State Board of Dentistry, the State Board of Mortuary Science of New Jersey, the State Board of Professional Engineers and Land Surveyors, the State Board of Marriage and Family Therapy Examiners, the State Board of Medical Examiners, the New Jersey Board of Nursing, the New Jersey State Board of Optometrists, the State Board of Examiners of Ophthalmic Dispensers and Ophthalmic Technicians, the Board of Pharmacy, the State Board of Professional Planners, the State Board of Psychological Examiners, the State Board of Examiners of Master Plumbers, the New Jersey Real Estate Commission, the State Board of Court Reporting, the State Board of Veterinary Medical Examiners, the Radiologic Technology Board of Examiners, the Acupuncture Examining Board, the State Board of Chiropractic Examiners, the State Board of Respiratory Care, the State Real Estate Appraiser Board, the State Board of Social Work Examiners, the State Board of Examiners of Heating, Ventilating, Air Conditioning and Refrigeration Contractors, the Elevator, Escalator, and Moving Walkway Mechanics Licensing Board, the State Board of Physical Therapy Examiners, the Orthotics and Prosthetics Board of Examiners, the New Jersey Cemetery Board, the State Board of Polysomnography, the New Jersey Board of Massage and Bodywork Therapy, the Genetic Counseling Advisory Committee, the State Board of Dietetics and Nutrition, the State Board of Naturopathic Medicine, and any other entity hereafter created under Title 45 to license or otherwise regulate a profession or occupation.

(cf:  P.L.2019, c.331, s.16)

 

     15.  Section 2 of P.L.1971, c.60 (C.45:1-2.2) is amended to read as follows:

     2.    a.  All members of the several professional boards and commissions shall be appointed by the Governor in the manner prescribed by law; except in appointing members other than those appointed pursuant to subsection b. or subsection c., the Governor shall give due consideration to, but shall not be bound by, recommendations submitted by the appropriate professional organizations of this State.

     b.    In addition to the membership otherwise prescribed by law, the Governor shall appoint in the same manner as presently prescribed by law for the appointment of members, two additional members to represent the interests of the public, to be known as public members, to each of the following boards and commissions: the New Jersey State Board of Accountancy, the New Jersey State Board of Architects, the New Jersey State Board of Cosmetology and Hairstyling, the New Jersey State Board of Dentistry, the State Board of Mortuary Science of New Jersey, the State Board of Professional Engineers and Land Surveyors, the State Board of Medical Examiners, the New Jersey Board of Nursing, the New Jersey State Board of Optometrists, the State Board of Examiners of Ophthalmic Dispensers and Ophthalmic Technicians, the Board of Pharmacy, the State Board of Professional Planners, the State Board of Psychological Examiners, the New Jersey Real Estate Commission, the State Board of Court Reporting, the State Board of Social Work Examiners, the Elevator, Escalator, and Moving Walkway Mechanics Licensing Board, the State Board of Naturopathic Medicine, and the State Board of Veterinary Medical Examiners, and one additional public member to each of the following boards: the Board of Examiners of Electrical Contractors, the State Board of Marriage and Family Therapy Examiners, the State Board of Examiners of Master Plumbers, and the State Real Estate Appraiser Board.  Each public member shall be appointed for the term prescribed for the other members of the board or commission and until the appointment of a  successor.  Vacancies shall be filled for the unexpired term only. The Governor may remove any such public member after hearing, for misconduct, incompetency, neglect of duty or for any other sufficient cause.

     No public member appointed pursuant to this section shall have any association or relationship with the profession or a member thereof regulated by the board of which the person is a member, where such association or relationship would prevent such public member from representing the interest of the public. Such a relationship includes a relationship with members of one's immediate family; and such association includes membership in the profession regulated by the board. To receive services rendered in a customary client relationship will not preclude a prospective public member from appointment.  This paragraph shall not apply to individuals who are public members of boards on the effective date of this act.

     It shall be the responsibility of the Attorney General to insure that no person with the aforementioned association or relationship or any other questionable or potential conflict of interest shall be appointed to serve as a public member of any board regulated by this section.

     Where a board is required to examine the academic and professional credentials of an applicant for licensure or to test such applicant orally, no public member appointed pursuant to this section shall participate in such examination process; provided, however, that public members shall be given notice of and may be present at all such examination processes and deliberations concerning the results thereof, and, provided further, that public members may participate in the development and establishment of the procedures and criteria for such examination processes.

     c.     The Governor shall designate a department in the Executive Branch of the State Government which is closely related to the profession or occupation regulated by each of the boards or commissions designated in section 1 of P.L.1971, c.60 (C.45:1-2.1) and shall appoint the head of such department, or the holder of a designated office or position in such department, to serve without compensation at the pleasure of the Governor as a member of such board or commission.

     d.    A majority of the voting members of such boards or commissions shall constitute a quorum thereof and no action of any such board or commission shall be taken except upon the affirmative vote of a majority of the members of the entire board or commission.

(cf:  P.L.2012, c.71, s.14)

    

     16.  Section 1 of P.L.1974, c.46 (C.45:1-3.1) is amended to read as follows:

     1.    The provisions of this act shall apply to the following boards and commissions:  the New Jersey State Board of Accountancy, the New Jersey State Board of Architects, the New Jersey State Board of Cosmetology and Hairstyling, the Board of Examiners of Electrical Contractors, the New Jersey State Board of Dentistry, the State Board of Mortuary Science of New Jersey, the State Board of Professional Engineers and Land Surveyors, the State Board of Marriage and Family Therapy Examiners, the State Board of Medical Examiners, the New Jersey Board of Nursing, the New Jersey State Board of Optometrists, the State Board of Examiners of Ophthalmic Dispensers and Ophthalmic Technicians, the Board of Pharmacy, the State Board of Professional Planners, the State Board of Psychological Examiners, the State Board of Examiners of Master Plumbers, the State Board of Court Reporting, the State Board of Veterinary Medical Examiners, the Radiologic Technology Board of Examiners, the Acupuncture Examining Board, the State Board of Chiropractic Examiners, the State Board of Respiratory Care, the State Real Estate Appraiser Board, the New Jersey Cemetery Board, the State Board of Social Work Examiners, the State Board of Examiners of Heating, Ventilating, Air Conditioning and Refrigeration Contractors, the Elevator, Escalator, and Moving Walkway Mechanics Licensing Board, the State Board of Physical Therapy Examiners, the State Board of Polysomnography, the Orthotics and Prosthetics Board of Examiners, the New Jersey Board of Massage and Bodywork Therapy, the Genetic Counseling Advisory Committee, the State Board of Dietetics and Nutrition, the State Board of Naturopathic Medicine, and any other entity hereafter created under Title 45 to license or otherwise regulate a profession or occupation.

(cf:  P.L.2019, c.331, s.17)

    

     17.  Section 2 of P.L.1978, c.73 (C.45:1-15) is amended to read as follows:

     2.    The provisions of this act shall apply to the following boards and all professions or occupations regulated by, through or with the advice of those boards:  the New Jersey State Board of Accountancy, the New Jersey State Board of Architects, the New Jersey State Board of Cosmetology and Hairstyling, the Board of Examiners of Electrical Contractors, the New Jersey State Board of Dentistry, the State Board of Mortuary Science of New Jersey, the State Board of Professional Engineers and Land Surveyors, the State Board of Marriage and Family Therapy Examiners, the State Board of Medical Examiners, the New Jersey Board of Nursing, the New Jersey State Board of Optometrists, the State Board of Examiners of Ophthalmic Dispensers and Ophthalmic Technicians, the Board of Pharmacy, the State Board of Professional Planners, the State Board of Psychological Examiners, the State Board of Examiners of Master Plumbers, the State Board of Court Reporting, the State Board of Veterinary Medical Examiners, the State Board of Chiropractic Examiners, the State Board of Respiratory Care, the State Real Estate Appraiser Board, the State Board of Social Work Examiners, the State Board of Examiners of Heating, Ventilating, Air Conditioning and Refrigeration Contractors, the Elevator, Escalator, and Moving Walkway Mechanics Licensing Board, the State Board of Physical Therapy Examiners, the State Board of Polysomnography, the Professional Counselor Examiners Committee, the New Jersey Cemetery Board, the Orthotics and Prosthetics Board of Examiners, the Occupational Therapy Advisory Council, the Electrologists Advisory Committee, the Acupuncture Advisory Committee, the Alcohol and Drug Counselor Committee, the Athletic Training Advisory Committee, the Certified Psychoanalysts Advisory Committee, the Fire Alarm, Burglar Alarm, and Locksmith Advisory Committee, the Home Inspection Advisory Committee, the Interior Design Examination and Evaluation Committee, the Hearing Aid Dispensers Examining Committee, the Perfusionists Advisory Committee, the Physician Assistant Advisory Committee, the Audiology and Speech-Language Pathology Advisory Committee, the New Jersey Board of Massage and Bodywork Therapy, the Genetic Counseling Advisory Committee, the State Board of Dietetics and Nutrition, the State Board of Naturopathic Medicine, and any other entity hereafter created under Title 45 to license or otherwise regulate a profession or occupation.

(cf:  P.L.2019, c.331, s.18)

    

     18.  This act shall take effect immediately, except that section 5 shall take effect 360 days following the appointment and qualification of the board members, and that the director and board may take such anticipatory action as may be necessary to effectuate that provision of the act.

 

 

STATEMENT

 

     This bill provides for the licensure of naturopathic doctors and establishes the State Board of Naturopathic Examiners in the Division of Consumer Affairs in the Department of Law and Public Safety.  As defined in the bill, "naturopathic medicine" means a distinct and comprehensive system of primary health practiced by a naturopathic doctor for the diagnosis, treatment, and prevention of human health conditions, injuries, and disease.  The board would consist of nine members who are residents of the State, six of whom would be, except for the members first appointed, licensed naturopathic doctors who have been actively engaged in the practice of naturopathic medicine for at least five years immediately preceding their appointment; two of whom would be public members; and one of whom would be a State executive department member.

     Under the bill, the board is authorized to, among other items, (1) establish criteria and standards for licensure; (2) review the qualification of applicants for licensure; (3) adopt rules and regulations to enforce the provisions of the bill; and (4) establish standards for continuing education.  The bill stipulates that a person can practice or hold themselves out to the public as able to practice naturopathic medicine only if the person possesses a valid license.  The license is to be renewed every two years.

     The bill delineates the scope of services of a naturopathic doctor. This includes physical and laboratory examinations for diagnostic purposes, including, but not limited to, phlebotomy, clinical laboratory tests, speculum examinations, orificial examinations, and physiological function tests.  A naturopathic doctor may also order diagnostic imaging studies consistent with naturopathic training, as determined by the board, but is to refer the studies to an appropriately licensed health care professional to conduct the study and interpret the results. 

     Lastly, the bill establishes a naturopathic childbirth attendance advisory committee to issue recommendations concerning the medical education and training for the specialty practice of naturopathic childbirth attendance.  A naturopathic doctor may not practice naturopathic childbirth attendance without first obtaining a certificate of special competency in naturopathic childbirth attendance. 

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