Print Friendly SENATE BILL NO. 1300 – Naturopaths, licensure
SENATE BILL NO. 1300
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S1300.......................................by COMMERCE AND HUMAN RESOURCES
NATUROPATHS - Adds to existing law to provide licensure and regulation of
naturopathic medicine; to provide definitions; to require a license; to
define the scope of practice; to specify prohibitions; to specify
exemptions; to provide for the creation, powers and duties of the Board of
Naturopathic Medical Examiners; to provide for the establishment of the
Naturopathic Formulary Council; to specify fees; to provide qualifications
for licensure; to provide a restricted license for current practitioners of
naturopathic medicine; to provide licensure standards for out-of-state
applicants; to provide for investigation, hearings and subpoena powers; to
provide disciplinary actions; to provide for denial and revocation
procedure; and to provide enforcement penalties.
02/11 Senate intro - 1st rdg - to printing
02/12 Rpt prt - to Health/Wel
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-seventh Legislature Second Regular Session - 2004
IN THE SENATE
SENATE BILL NO. 1300
BY COMMERCE AND HUMAN RESOURCES COMMITTEE
1 AN ACT
2 RELATING TO NATUROPATHIC MEDICINE; AMENDING TITLE 54, IDAHO CODE, BY THE ADDI-
3 TION OF A NEW CHAPTER 51, TITLE 54, IDAHO CODE, TO PROVIDE A STATEMENT OF
4 LEGISLATIVE PURPOSE, TO PROVIDE DEFINITIONS, TO REQUIRE A LICENSE, TO
5 DEFINE SCOPE OF PRACTICE, TO SPECIFY PROHIBITIONS, TO SPECIFY EXEMPTIONS,
6 TO PROVIDE CREATION OF THE BOARD OF NATUROPATHIC MEDICAL EXAMINERS, TO
7 SPECIFY POWERS AND DUTIES OF THE BOARD, TO PROVIDE ESTABLISHMENT OF THE
8 NATUROPATHIC FORMULARY COUNCIL, TO SPECIFY FEES, TO PROVIDE QUALIFICATIONS
9 FOR LICENSURE, TO PROVIDE A RESTRICTED LICENSE FOR CURRENT PRACTITIONERS
10 OF NATUROPATHIC MEDICINE, TO PROVIDE LICENSURE STANDARDS FOR OUT-OF-STATE
11 APPLICANTS, TO PROVIDE FOR INVESTIGATION, HEARINGS AND SUBPOENA POWERS, TO
12 PROVIDE DISCIPLINARY ACTION, TO PROVIDE FOR DENIAL OR REVOCATION PROCE-
13 DURE, TO PROVIDE ENFORCEMENT PENALTIES AND TO PROVIDE SEVERABILITY.
14 Be It Enacted by the Legislature of the State of Idaho:
15 SECTION 1. That Title 54, Idaho Code, be, and the same is hereby amended
16 by the addition thereto of a NEW CHAPTER, to be known and designated as Chap-
17 ter 51, Title 54, Idaho Code, and to read as follows:
18 CHAPTER 51
19 NATUROPATHIC PHYSICIANS LICENSING ACT
20 54-5101. LEGISLATIVE PURPOSE. To protect the public health, safety and
21 welfare and provide for state administrative supervision, licensure, regula-
22 tion and disciplinary procedures, every person providing naturopathic medical
23 services who meets and maintains the standards of practice and code of ethics
24 as adopted by the board shall be licensed, unless otherwise exempted herein.
25 54-5102. DEFINITIONS. As used in this chapter, the following terms have
26 the meanings as stated:
27 (1) "Approved naturopathic medical program" means:
28 (a) A course of study from a college or university granting the degree of
29 doctor of naturopathy or doctor of naturopathic medicine accredited by an
30 accrediting agency recognized by the state or federal government; or
31 (b) A college or university granting the degree of doctor of naturopathy,
32 or doctor of naturopathic medicine that has the status of candidate for
33 accreditation with the accrediting agency; or
34 (c) A postgraduate degree granting college or university of the healing
35 arts approved by the examining board and state or federal accrediting
36 agency. Such college or university shall require a minimum of sixty (60)
37 semester units for admission and a minimum of four thousand (4,000) hours
38 in basic and clinical sciences, naturopathic philosophy, naturopathic
39 modalities, and naturopathic medicine, of which not less than two thou-
40 sand (2,000) hours shall be academic instruction and not less than two
41 thousand (2,000) hours shall be school or college approved supervised
1 clinical training. The college or university shall provide adequate
2 instruction to maintain naturopathic medicine as a separate and distinct
3 healing art.
4 (2) "Board" means the board of naturopathic medical examiners created
5 pursuant to section 54-5107, Idaho Code.
6 (3) "Minor office procedures" means the methods for the repair and care
7 incidental to superficial lacerations and abrasions, superficial lesions lim-
8 ited to warts and epitheliomas and the removal of foreign bodies located in
9 the superficial tissues.
10 (4) "Naturopathic formulary" means the list of natural medicines, nonpre-
11 scription and prescription, which naturopathic physicians use in the practice
12 of their profession, as determined by the formulary council and reviewed by
13 the board.
14 (5) "Naturopathic formulary council" means that council comprised of mem-
15 bers appointed pursuant to this chapter to determine and authorize the formu-
16 lary list.
17 (6) "Naturopathic medicine" means a distinct and comprehensive system of
18 primary health care practiced by naturopathic physicians for the prevention,
19 diagnosis and treatment of human health conditions, injuries and diseases,
20 that uses education, natural medicines and therapies to promote and restore
21 health by support and stimulation of the individual's self-healing processes.
22 (7) "Naturopathic physician" and all titles defined in section
23 54-5103(2), Idaho Code, means a person authorized and licensed to practice
24 naturopathic medicine under this chapter.
25 (8) "Naturopathy" means a philosophy of healing that employs natural
26 modalities that may be utilized by naturopathic physicians and other persons
27 not licensed pursuant to this chapter.
28 54-5103. LICENSE REQUIRED. (1) No person shall hold himself out to others
29 as a naturopathic physician without first applying for and receiving a license
30 to engage in that practice.
31 (2) A person holds himself or herself out to others as a naturopathic
32 physician when the person adopts or uses any or all of the following designa-
33 tions: "naturopathic physician," "naturopathic doctor," "physician of
34 naturopathic medicine," "physician of natural medicine," "doctor of naturopa-
35 thy," or its abbreviation, "N.D.," "doctor of naturopathic medicine," or its
36 abbreviation, "N.M.D.," which shall be restricted to persons graduated from an
37 accredited school granting the "doctor of naturopathic medicine" degree, and
38 licensed under this chapter. The terms "naturopath" and "naturopathy" are in
39 the public domain.
40 (3) The titles and terms in subsection (2) of this section identify
41 naturopathic physicians and are restricted to describing and identifying
42 licensed practitioners.
43 54-5104. SCOPE OF PRACTICE. (1) Diagnostic procedures. A naturopathic
44 physician may use physical and laboratory examinations consistent with
45 naturopathic education and training for diagnostic purposes including
46 phlebotomy, clinical laboratory tests, speculum examinations and physiological
47 function tests. A naturopathic physician may order and perform diagnostic and
48 imaging tests consistent with naturopathic education and training. All imaging
49 and diagnostic tests not consistent with naturopathic education and training,
50 must be referred for performance and interpretation by an appropriately
51 licensed health care professional.
52 (2) Natural medicines. Naturopathic physicians are authorized to dis-
53 pense, administer and prescribe:
1 (a) Nonprescription substances, including: food, extracts of foods,
2 nutraceuticals, vitamins, minerals, amino acids, enzymes, botanicals and
3 their extracts, and homeopathic medicines prepared according to the Homeo-
4 pathic Pharmacopoeia of the United States, and all dietary supplements and
5 nonprescription drugs as defined by the federal food, drug, and cosmetic
7 (b) Prescription substances determined by the formulary council.
8 (3) Therapies. A naturopathic physician may:
9 (a) Administer, prescribe, and dispense natural medicines and devices
10 from the naturopathic formulary; and
11 (b) Perform minor office procedures pursuant to privileges granted by the
12 board of naturopathic medical examiners; and
13 (c) Perform those therapies as trained and educated, and approved by
14 board rule.
15 54-5105. PROHIBITIONS. A naturopathic physician shall not:
16 (1) Prescribe, dispense or administer any controlled substance or device
17 identified under the controlled substance act, chapter 27, title 37, Idaho
18 Code, or identified in the federal controlled substance act, 21 U.S.C. sec-
19 tions 801 through 971 (1988), as amended, except as authorized by this chap-
21 (2) Perform surgical procedures except those minor office procedures
22 authorized by this chapter;
23 (3) Practice or claim to practice as a medical doctor, osteopath, den-
24 tist, podiatrist, optometrist, psychologist, advanced practice professional
25 nurse, physician assistant, chiropractor, physical therapist, acupuncturist,
26 or any other health care professional not authorized in this chapter unless
27 licensed by the state of Idaho to do so;
28 (4) Use general or spinal anesthetics;
29 (5) Administer ionizing radioactive substances for therapeutic purposes;
30 (6) Perform surgical procedures using a laser device;
31 (7) Induce or perform an abortion;
32 (8) Perform surgical procedures involving the eye, ear, tendons, nerves,
33 veins or arteries extending beyond superficial tissue;
34 (9) Surgically remove any lesion contemplated to be suspicious of
35 malignancy or requiring surgical removal. Lesions requiring surgical removal
36 shall be referred to an appropriately licensed health care professional.
37 Nothing in this chapter shall negate previous court decisions or current Idaho
39 54-5106. EXEMPTIONS. This chapter is not intended to prohibit or
41 (1) The practice of a profession by individuals who are licensed, certi-
42 fied or registered under other laws of this state and are performing services
43 within the authorized scope of practice; or
44 (2) The practice of naturopathic medicine by an individual employed by
45 the federal government while the individual is engaged in the performance of
46 duties prescribed by the laws and regulations of the United States; or
47 (3) An individual rendering aid to a family member or in an emergency,
48 when no fee or other consideration for the service is charged, received,
49 expected or contemplated; or
50 (4) A person engaged in the sale of vitamins, health foods, dietary sup-
51 plements, herbs, or other products of nature, the sale of which is not other-
52 wise prohibited under state or federal law; or
53 (5) A person engaged in good faith for religious reasons as a matter of
1 conscience or based on a personal belief; or
2 (6) A person who administers treatment or provides advice regarding the
3 human body and its functions who:
4 (a) Does not use legend drugs or prescription drugs in such practice;
5 (b) Does not recommend the discontinuance of prescribed drugs;
6 (c) Uses natural elements such as air, heat, water and light;
7 (d) Only uses class I or II nonprescription, approved, medical devices as
8 defined in section 513 of the federal food, drug, and cosmetic act;
9 (e) Uses only vitamins, minerals, herbs, natural food products and their
10 extracts, and nutritional supplements;
11 (f) Does not perform surgery;
12 (g) Requires each person receiving services to sign a declaration of
13 informed consent which includes an overview of the health care provider's
14 education and states that the health care provider is not licensed under
15 this chapter.
16 (7) The practice by a naturopathic physician duly licensed in another
17 state, territory or the District of Columbia when that naturopathic physician
18 is incidentally called into this state for consultation with a licensed physi-
19 cian; or
20 (8) The practice of naturopathic medicine by students enrolled in an
21 approved naturopathic medical program. Services shall be performed pursuant to
22 a course of instruction or assignments from an instructor and under the super-
23 vision and observation of the instructor.
24 54-5107. BOARD OF NATUROPATHIC MEDICAL EXAMINERS. (1) There is hereby
25 established in the department of self-governing agencies, bureau of occupa-
26 tional licenses, the board of naturopathic medical examiners. Members thereof
27 shall be appointed by the governor.
28 (2) The board shall consist of five (5) members, four (4) of whom shall
29 be licensed pursuant to this chapter and one (1) of whom shall be a member of
30 the public with an interest in the rights of consumers of naturopathic physi-
31 cian services.
32 (3) Appointments to the board shall be made by the governor from nomina-
33 tions received from the Idaho association of naturopathic physicians, who
34 shall nominate two (2) persons qualified for each position to be filled.
35 (4) All members of the board shall be naturopathic physicians licensed
36 pursuant to this chapter, practicing within the state of Idaho for the dura-
37 tion of their appointment and shall have been practitioners within the state
38 of Idaho for a minimum of three (3) years immediately preceding appointment.
39 (5) The initial four (4) licensed naturopathic physician members of the
40 board shall be persons with at least two (2) years of experience in the prac-
41 tice of naturopathic medicine who are eligible to become licensed pursuant to
42 this chapter.
43 (6) The initial board shall be appointed for staggered terms, the longest
44 of which shall not exceed five (5) years. After the initial appointments, all
45 terms shall be five (5) years and a member may be appointed for a second term.
46 No member shall serve more than two (2) consecutive terms. In the event of
47 death, resignation or removal of any member before the expiration of the term
48 to which appointed, the vacancy shall be filled for the unexpired portion of
49 the term in the same manner as the original appointment.
50 (7) The governor may remove any member of the board for cause, prior to
51 the expiration of the member's term.
52 (8) The board, within thirty (30) days after its appointment, and at
53 least annually thereafter, shall hold a meeting and elect a chairman. The
54 board may hold additional meetings on the call of the chair or at the written
1 request of any two (2) members of the board. The board may appoint such com-
2 mittees as it considers necessary to carry out its duties. A majority of the
3 board shall constitute a quorum.
4 54-5108. POWERS AND DUTIES OF THE BOARD. The board shall have the author-
5 ity to:
6 (1) Determine the qualifications of persons applying for licensure pursu-
7 ant to this chapter and define, by rule, the appropriate scope of naturopathic
8 medicine in this state, provided however, that the scope of practice may not
9 exceed that defined in section 54-5104, Idaho Code;
10 (2) Grant approval for naturopathic childbirth attendance privileges to
11 those licensees who apply, provided that such applicant can document training
12 and experience equal to or greater than that required by the rules of the
13 Idaho board of nursing, pursuant to section 54-1404, Idaho Code, and that the
14 applicant meets the practice standards governing hospital privileges and
15 supervising physicians established by the Idaho board of nursing, and the
16 applicant holds hospital privileges or performs such procedures under the
17 supervision of an M.D. or D.O.;
18 (3) Establish special competency certification requirements for licensees
19 as deemed necessary by action of the board;
20 (4) Adopt rules that govern action limiting the scope of practice of a
22 (5) Hire and appoint employees, including an executive director, investi-
23 gators, attorneys, consultants and independent hearing examiners;
24 (6) Adopt such rules as are necessary for the administration of this
25 chapter, including standards of professional conduct;
26 (7) Conduct investigations and examinations and hold hearings;
27 (8) Collect fees and other funds as prescribed by this chapter;
28 (9) Contract, sue and be sued, and pursue other matters lawful in this
29 state relating to naturopathic medicine;
30 (10) Provide such other services and perform such other functions as are
31 necessary and desirable to fulfill its purposes;
32 (11) Establish by rule examination standards for licensure and when those
33 examinations will be provided;
34 (12) Establish a minimum amount and kind of continuing education to be
35 required annually for each naturopathic physician seeking licensure renewal;
36 (13) Limit the performance of minor office procedures to physicians who
37 have graduated from an approved naturopathic medical college or have up-to-
38 date certification of equivalent training.
39 54-5109. NATUROPATHIC FORMULARY COUNCIL ESTABLISHED. There is hereby
40 established a naturopathic formulary council, which is separate and distinct
41 from the board, to be composed of five (5) members. Two (2) members shall be
42 naturopathic physicians licensed under this chapter, appointed by the board.
43 Three (3) members shall be pharmacists licensed under chapter 17, title 54,
44 Idaho Code, appointed by the board of naturopathic medical examiners from a
45 list of nominees provided by the Idaho state board of pharmacy. It shall be
46 the duty of the naturopathic formulary council to establish a formulary for
47 use by naturopathic physicians, and immediately upon adoption or revision of
48 the formulary, the council shall transmit the approved formulary to the board,
49 which shall adopt the formulary by temporary rule. The formulary will be
50 reviewed annually by the council, or at any time at the request of the board.
51 The formulary list may not go beyond the scope of natural medicines and
52 devices covered by approved naturopathic education and training and existing
53 naturopathic formularies, or board approved continuing education. The
1 naturopathic formulary shall not include medicines and devices that are incon-
2 sistent with the training provided by approved naturopathic medical colleges.
3 Nothing herein shall allow a naturopathic physician to dispense, administer or
4 prescribe any legend drug as defined in section 54-1705(27), Idaho Code, or
5 legend device unless such prescription drug or legend device is specifically
6 included in the naturopathic formulary.
7 54-5110. FEES. (1) All fees received under the provisions of this chapter
8 shall be paid to the department of self-governing agencies, bureau of occupa-
9 tional licenses, and deposited to the state treasury to the credit of the
10 occupational licenses fund. All costs and expenses incurred under the provi-
11 sions of this chapter shall be a charge against and paid from said fund. In no
12 case shall any salary, expense or other obligation of the board be charged
13 against the general fund.
14 (2) The board, by rule, may impose the following fees up to the amounts
15 listed below:
16 (a) License fee...................................................$500.00
17 (b) Renewal fee...................................................$500.00
18 (c) Late renewal penalty..........................................$100.00
19 (d) License by endorsement........................................$500.00
20 (e) Duplicate license.............................................$ 50.00
21 (f) Reinstatement fee.............................................$ 50.00
22 54-5111. QUALIFICATIONS FOR LICENSURE. To be eligible for a license to
23 practice naturopathic medicine in the state of Idaho, the applicant shall:
24 (1) Be a graduate of an approved naturopathic medical program in accor-
25 dance with section 54-5102(1), Idaho Code, and pass or have passed a
26 competency-based examination approved by the board covering the appropriate
27 naturopathic subjects, including basic and clinical sciences;
28 (2) Possess a good, ethical and professional reputation;
29 (3) Be physically and mentally capable of safely practicing naturopathic
30 medicine with or without reasonable accommodation;
31 (4) Have never had a license to practice naturopathic medicine refused,
32 revoked or suspended by any other state or country for reasons that relate to
33 the applicant's ability to skillfully and safely practice naturopathic medi-
34 cine unless that license has been restored to good standing by that state or
35 country; and
36 (5) File a board approved application and pay the licensing fees.
37 54-5112. LICENSURE OF CURRENT PRACTITIONERS OF NATUROPATHIC MEDICINE.
38 (1) Any practitioner who cannot prove sufficient education and training to be
39 licensed as required in section 54-5102(1)(a), (b) or (c), Idaho Code, but
40 who can:
41 (a) Provide evidence of four thousand (4,000) hours of board approved
42 basic science and clinical naturopathic education and training;
43 (b) Comply with section 54-5111(2) through (4), Idaho Code;
44 (c) Pass or have passed a competency examination approved by the board;
46 (d) Document practicing as a naturopathic physician in the state of Idaho
47 for the past five (5) years;
48 may be eligible for a restricted license granted by the board under such rules
49 as the board may adopt with a scope of practice limited to that determined by
50 the board to be justified and in accordance with such practitioners' education
51 and training. A restricted license shall exclude minor office procedures, dis-
52 pensing prescription substances contained in the naturopathic formulary, and
1 diagnostic and imaging tests. Each person receiving health care services from
2 practitioners granted a restricted license must sign a declaration of informed
3 consent, approved by the board, which states the scope of each practitioner's
5 (2) Nothing in this section is to be construed to allow any naturopathic
6 physician to increase their scope of practice without appropriate additional
7 education, training and testing approved by the board.
8 (3) Applications must be submitted to the board within one hundred eighty
9 (180) days from the date on which this chapter takes effect, and payment of
10 the licensing fees must accompany the application. Failure of persons cur-
11 rently practicing naturopathic medicine in this state to apply for licensure
12 within the one hundred eighty (180) day period, and the continuation of prac-
13 tice after that date, shall cause such persons to be subject to prosecution
14 under section 54-5117, Idaho Code.
15 54-5113. LICENSE STANDARDS FOR OTHER JURISDICTION APPLICANTS. The board
16 shall establish by rule the standards for licensure of applicants licensed in
17 another jurisdiction. However, the standards for endorsement of licensure
18 shall not be less than those required for licensure in the state of Idaho.
19 54-5114. INVESTIGATION -- HEARING -- SUBPOENA. (1) The board shall inves-
20 tigate, or cause to be investigated, all complaints made to it and all cases
21 of noncompliance with this chapter.
22 (2) The board may conduct hearings to assist with investigations, to
23 determine whether grounds exist for suspension, revocation or denial of a
24 license or to fulfill its responsibilities under this chapter as the board
25 determines necessary.
26 (3) The board may subpoena witnesses, administer oaths in any hearing or
27 disciplinary proceedings and compel, by subpoena duces tecum, the production
28 of papers and records.
29 54-5115. DISCIPLINARY ACTION. The board may suspend, revoke or refuse to
30 issue or renew a license on any of the following grounds:
31 (1) The employment of fraud or deceit in obtaining a license under this
32 chapter or in connection with services rendered as a naturopathic physician;
33 (2) A legal finding of mental incompetence;
34 (3) Aiding or abetting a person, not duly licensed under this chapter, in
35 claiming to be a naturopathic physician;
36 (4) Any negligence, incompetence or misconduct in the performance of
37 naturopathic medicine;
38 (5) Conviction of any felonious crime, which constitutes a crime of moral
40 (6) Practicing as a naturopathic physician when physical or mental abili-
41 ties are impaired by the use of controlled substances or other drugs, chemi-
42 cals or alcohol;
43 (7) Failure of the individual practitioner to maintain his or her profes-
44 sional premises in a clean and sanitary condition;
45 (8) Any person licensed in accordance with this chapter whose scope of
46 practice has been limited by the board pursuant to section 54-5104, Idaho
47 Code, and who performs any act not authorized in his or her limited scope of
48 practice, which constitutes the practice of naturopathic medicine; or
49 (9) Any other good cause, relevant to qualifications to practice
50 naturopathic medicine.
51 The board may not suspend, revoke or refuse to issue or renew a license based
52 on the findings that a licensee's practice is unconventional in the absence of
1 demonstrable harm to a patient and the patient has signed a waiver to the
2 effect that the treatment or device is considered unconventional.
3 54-5116. LICENSE DENIAL OR REVOCATION PROCEDURE. Where the board proposes
4 to refuse to issue or renew a license, or proposes to revoke or suspend a
5 license, opportunity for a hearing shall be pursuant to the provisions of
6 chapter 52, title 67, Idaho Code.
7 54-5117. ENFORCEMENT PENALTIES. (1) A person who violates any provision
8 of this chapter shall, upon conviction, be guilty of a misdemeanor.
9 (2) The board may seek an injunction against any person who practices
10 naturopathic medicine in violation of this chapter and may, in the event a
11 permanent injunction is entered against such person or plea or verdict is
12 entered in any criminal matter, impose a civil penalty in the amount of all
13 costs and fees incurred by the board in prosecuting the matter.
14 54-5118. SEVERABILITY. If any provision of this act or its application to
15 any person or circumstance is held invalid, the remainder of the act or the
16 application of the provision to other persons or circumstances is not
STATEMENT OF PURPOSE
There are a significantly growing number of residents of the State
of Idaho who choose natural health care. Naturopathic medicine is
a distinct health care profession. The purpose of this legislation
is to provide standards of practice and education, a code of ethics
for practitioners, state administrative supervision, licensure,
regulation and disciplinary procedures for every person providing
naturopathic medical services in the state.
There is no fiscal impact to the general fund.
Name: Larry Benton
Robert L. Geddes
STATEMENT OF PURPOSE/FISCAL NOTE S 1300