Bill S.1091

SENATE DOCKET, NO. 688 FILED ON: 1/17/2013

SENATE . . . . . . . . . . . . . . No. 1091

By Mr. Pacheco, a petition (accompanied by bill, Senate, No. 1091) of Marc R. Pacheco, Stanley C. Rosenberg, John V. Fernandes, James B. Eldridge and other members of the General Court for legislation to establish a board of registration in naturopathy. Public Health.

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 1158 OF 2011-2012.]

The Commonwealth of Massachusetts

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In the Year Two Thousand Thirteen

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An Act establishing a board of registration in naturopathy.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Chapter 13 of the General Laws is hereby amended by adding the following section:

Section 101. (a) There shall be within the division of professional licensure a board of registration in naturopathy which shall consist of the chairman of the board of registration in medicine or his designee, the commissioner of public health or his designee and 7 persons to be appointed by the governor, 5 of whom shall be naturopathic doctors who have attended and graduated from an approved naturopathic college that is accredited, or is a candidate for accreditation, by the Council of Naturopathic Medical Educators or its successor, who have at least 5 years of experience in the practice of naturopathic health care and who shall be licensed under section 239 or 241 of chapter 112; 1 of whom shall be a physician licensed to practice medicine under section 2 of chapter 112 with experience working with naturopathic doctors and 1 of whom shall be a clinical pharmacologist. The appointed members shall serve for terms of 3 years. Upon the expiration of a term of office, a member shall continue to serve until a successor has been appointed and qualified. No member shall serve for more than 2 consecutive terms, but a person who is chosen to fill a vacancy in an unexpired term of a prior board member may serve for 2 consecutive terms in addition to the remainder of that unexpired term. A member may be removed by the governor for neglect of duty, misconduct or malfeasance or misfeasance in the office after a written notice of the charges against him and sufficient opportunity to be heard thereon.

(b) The board shall annually elect from its membership a chair and a secretary who shall serve until their successors have been elected and qualified. The board shall meet at least 4 times annually and may hold additional meetings at the call of the chair or upon the request of 4 members. A quorum for the conduct of official business shall be a majority of those appointed. Board members shall serve without compensation, but shall be reimbursed for actual and reasonable expenses incurred in the performance of their duties. The members shall be public employees for the purposes of chapter 258 for all acts or omissions within the scope of their duties as board members.

SECTION 2. Chapter 112 of the General Laws is hereby amended by adding the following 10 sections:

Section 236. For the purposes of this section and sections 237 to 245, inclusive, the following terms shall have the following meanings unless the context clearly requires otherwise:

“Approved naturopathic medical college”, 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 has achieved candidacy status for accreditation by the Council on Naturopathic Medical Education (CNME) or 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

“Board”, the board of registration in naturopathy established in section 101 of chapter 13.

“Homeopathic preparations”, medicines prepared according to the Homeopathic Pharmacopoeia of the United States.

“Naturopathic doctor”, a person who is licensed by the board to practice naturopathic health care pursuant to this chapter.

“Naturopathic health care”, a system of health care practices for the prevention, diagnosis, evaluation and treatment of illnesses, injuries and conditions of the human body through the use of education, nutrition, natural medicines and therapies and other modalities which are designed to support, stimulate or supplement the human body’s own natural self-healing processes.

“Naturopathic manipulative therapy”, the manually-administered mechanical treatment of body structures or tissues in accordance with naturopathic principles for the purpose of restoring the normal physiological function of the human body.

“Naturopathic physical medicine”, the therapeutic use of the physical agents of air, water, heat, cold, sound, light and electromagnetic non-ionizing radiation and the physical modalities of electrotherapy, diathermy, ultraviolet light, ultrasound, hydrotherapy, naturopathic manipulative therapy and therapeutic exercise.

“Person”, an individual; provided, however, that “person” shall not include a partnership, corporation, association or business organization of any kind.

Section 237. (a) The practice of naturopathic health care shall include, but not be limited to:

(1) the prevention and treatment of human illness, injury or disease through education, dietary or nutritional advice and the promotion of healthy ways of living;

(2) the use of physical examinations and the ordering of clinical, laboratory and radiological diagnostic procedures from licensed clinics or laboratories for the purpose of diagnosing and evaluating injuries, illnesses and conditions in the human body;

(3)dispensing, administering, ordering and prescribing to prevent or treat illnesses, injuries and conditions of the human body: natural medicines of mineral, animal or botanical origin, including food products or extracts, vitamins, minerals, enzymes, digestive aids; natural hormones; plant substances; homeopathic preparations; natural antibiotics, topical medicines and nonprescription drugs; therapeutic devices and barrier contraceptives; and

(4) the use of manual mechanical manipulation of body structures or tissues, in accordance with naturopathic principles; the use of naturopathic physical medicine for the purpose of maintaining or restoring normal physiological functioning of the human body.

(b) The practice of naturopathic health care shall not include:

(1) performing surgery or abortions or the administration of therapeutic ionizing radiation, radioactive substances or general or spinal anesthesia;

(2) prescribing , dispensing or administering a drug classified as a controlled substance under chapter 94C;

(3) the practice of acupuncture and Traditional Chinese Medicine; or

(4) the practice of emergency medicine, except as a person rendering gratuitous services in an emergency or for the care of minor injuries.

(1) a person who is licensed, certified or registered to practice a profession or occupation under any other law from engaging in activities which are within the lawful scope of practice for the profession or occupation for which he is licensed;

(2) the practice of naturopathic health care by a person employed by the government of the United States if that person engages in such practice in the performance of his duties as such an employee;

(3) the practice of naturopathic health care by students enrolled in an approved naturopathic medical college; provided, however, that the performance of all such services shall be pursuant to a course of instruction or assignments from and under the supervision of an instructor who is licensed as a naturopathic doctor pursuant to this chapter or a licensed professional in the field in which he or she is providing instruction;

(4) Any person from treating himself or a member of his immediate family based on religious or health beliefs;

(5) Any person who sells vitamins and herbs from providing information about his products; or

(6) a person or practitioner who is not licensed as a naturopathic doctor pursuant to this chapter from recommending ayurvedic medicine, herbal remedies, nutritional advice, homeopathy or any other therapy that is within the scope of practice of naturopathic health care; provided, however, that such person or practitioner shall not represent himself or hold himself out to the public as practicing naturopathic health care in the commonwealth or otherwise use any name, title or other designation which indicates or implies that he is licensed to practice naturopathic health care.

(d) Licensed naturopathic doctors shall have the same authority and responsibilities as licensed physicians regarding public health laws, reportable diseases and conditions, communicable disease control and prevention, recording of vital statistics, health and physical examinations and local boards of health, except that the authority of licensed naturopathic doctors regarding such matters shall be limited to the scope of practice authorized by this chapter.

Section 238 (a) The board shall have the following powers and duties:

(1) to adopt rules and regulation governing the licensing of naturopathic doctors and the practice of naturopathic health care to promote the public health, welfare and safety of the citizens of the commonwealth including, but not limited to:

(i) regulations governing the activities of naturopathic medical assistants;

(ii) requirements for specialty practice by licensed naturopathic doctors; and

(iii) continuing education requirements for the renewal of licenses including, but

not limited to, the number of hours required, the subjects required and board approval of

continuing education programs or lectures;

(2) to receive, review and approve or disapprove applications for licensing and to issue licenses;

(3) to establish administrative procedures for processing applications and renewals;

(4) to establish a code of ethics for naturopathic doctors;

(5) to establish and maintain records of its actions and proceedings in accordance with the public records laws;

(6) to perform such other functions and duties as may be necessary to carry out the provisions of this chapter.

(b) The board shall have the right to investigate all complaints relating to the proper practice of naturopathy, including any violations of this chapter or any rule or regulation of the board. Such complaints may be brought by any person or the board.

(c) The board shall be under the supervision of the division of professional licensure and it shall have the powers and duties provided in sections 61 to 65E , inclusive . For the purposes of this section and sections 61 to 65E, inclusive, conduct which places into question the holder's competence to practice naturopathy shall include, but not be limited to:

(1) the commission of fraud or misrepresentation in obtaining a license;

(2) criminal conduct which the board determines to be of such a nature as to render the person unfit to practice naturopathy, as evidenced by criminal proceedings resulting in a conviction, a guilty plea, a plea of nolo contendere or an admission of sufficient facts;

(3) violation of a rule or regulation of the board;

(4) failure to cooperate with the board or its agents in the conduct of an inspection or investigation;

(5) failure to fulfill any continuing education requirements set out by the board;

(6) aiding or abetting an unlicensed person to practice naturopathy; or

(7) negligence in the course of professional practice.

(d) The board may issue an order to a licensee directing him to cease and desist from unethical or unprofessional conduct if the board finds, after notice and the opportunity for a hearing, that the licensee has engaged in such conduct.

(e) Nothing in this section shall limit the board's authority to impose, by agreement, sanctions that are considered reasonable and appropriate by the board. Any person aggrieved by any disciplinary action taken by the board pursuant to this section or for violation of any other law or rule or regulations may, pursuant to section 64, file a petition for judicial review.

Section 239. (a) An application for original licensure as a naturopathic doctor shall be made on forms approved by the board. Such application shall be sworn and shall be accompanied by payment of the fee prescribed by the secretary of administration pursuant to section 3B of chapter 7. The board shall issue a license as a naturopathic doctor to an applicant upon receipt of satisfactory proof that the applicant:

(1) is at least 18 years old and of good moral character; and

(2) possesses a baccalaureate degree from an accredited educational institution or its equivalent, as determined by the board;

(3) has graduated from and holds a doctor of naturopathic medicine or doctor of naturopathy degree from:

(a) an approved naturopathic medical college as defined in section 236; or

(b) a degree granting college or university that, prior to the existence of the CNME, offered a full-time structured curriculum in basic sciences and supervised patient care comprising a doctoral naturopathic medical education; such course, as a prerequisite to graduation there from, having been not less than 132 weeks in duration and which required completion within a period of not less than 35 months; such college of naturopathic medicine shall have been reputable and in good standing in the judgment of the Board; and if still in existence has current programmatic accreditation by the CNME or federally recognized equivalent accrediting agency; or

(c) a diploma granting, degree-equivalent college or university, that if in Canada and prior to accreditation by the CNME, had provincial approval for participation in government funded student aid programs, and that offered a full-time structured curriculum in basic sciences and supervised patient care comprising a doctoral naturopathic medical education; such course, as a prerequisite to graduation there from, having been not less than 132 weeks in duration and shall require completion within a period of not less than 35 months; such college of liberal arts and naturopathic medicine having been reputable and in good standing in the judgment of the Board; and if still in existence has current programmatic accreditation by the CNME or federally recognized equivalent accrediting agency. Additionally, this college or university currently has provincial approval for participation in government funded student aid programs; or:

(d) a diploma granting, degree-equivalent college or university in Canada that offers graduate-level full-time didactic and supervised clinical training and shall be 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. Additionally, this college or university has provincial approval for participation in government funded student aid programs.

(4) (a) successfully 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 that represents federal standards of education and training; or

(b) if graduating from an institution outlined in Section 239, (b), 3, b, c, or d, has successfully passed a state or provincial (Canadian) competency-based licensing examination that was substantially similar to the licensing examination outlined in Section 239 (4) (a).

(5) has not had a license to practice naturopathic medicine or other health care license registration or certificate refused, revoked or suspended by 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 by that jurisdiction.

Section 240. The board, in consultation with the division of professional licensure, shall determine the renewal cycle and renewal period for naturopathic licenses. A naturopathic doctor licensed under this chapter shall apply to the board for renewal of his license on or before the expiration date, as determined by the board, unless earlier revoked, suspended or canceled as a result of a disciplinary proceeding instituted pursuant to section 243. As a condition for renewal under this section, the board may require a naturopathic doctor to furnish the board with satisfactory proof that he has successfully completed the required number of hours of continuing education for naturopathic doctors in courses or programs approved by the board has complied with such other requirements or equivalent requirements as approved by the board. Upon satisfactory compliance with the licensing requirements for naturopathic doctors and successful completion of the continuing education requirements, the board shall issue a renewal license. The board may provide for the late renewal of a license that has lapsed and may require payment of a late fee.

Section 241. Each licensed naturopathic doctor shall advise the board, in writing, of the address of his principal place of business and all other addresses at which he is currently engaged in practice. The naturopathic doctor shall immediately provide written notice to the board of any change in the address of any place of business at which he practices. He shall also advise the board, in writing, of his current residential address and of any change thereof.

Section 242. (a) No person shall represent himself or hold himself out to the public as a licensed naturopathic doctor in the commonwealth unless he is licensed pursuant to this chapter. A person who is not licensed pursuant to this act shall not use any of the following titles: naturopathic physician, naturopathic practitioner, natural doctor , naturopathic doctor, doctor of naturopathy, doctor of natural medicine, doctor of naturopathic medicine, NMD, N.D, naturopath or any other term that indicates or implies that the person is licensed to practice any form of naturopathic health care in the commonwealth. The board of registration in naturopathy may modify the list of titles.

(b) Nothing in this section shall prevent a person who is licensed under this statute from disclosing that he is a member of the American Association of Naturopathic Physicians.

(c) A person acting or purporting to act as a naturopathic doctor without first obtaining a license under this chapter shall be punished by a fine of not more than $5,000 or by imprisonment for not more than 1 year, or both. Upon conviction of a second or subsequent offense, such person shall be punished by a fine of not more than $10,000 or by imprisonment for not more than 2 years, or both(d) (d) A person who receives money or an equivalent thing of value as a fee, commission, compensation or profit by or as the consequence of a violation of sections 237 to 243, inclusive, shall, in addition to any other penalty, be liable for a fine of not less than the sum of the money so received and not more than 3 times the sum so received, as determined by the board.

(e) No action shall be commenced and no recovery shall be had by any person for compensation for any act performed or service rendered by him as a licensed naturopathic practitioner unless such person held a current valid license under this chapter at the time of performance of such act or service.

Section 243. All licensing and application fees and civil administrative penalties collected pursuant to sections 236 to 244, inclusive, shall be deposited into the trust fund established in section 35V of chapter 10.

Section 244. Nothing in sections 236 to 244 of this chapter shall be construed as requiring reimbursement by insurance policies purchased under chapter 32A, an insurer licensed or otherwise authorized to transact accident and health insurance under chapter 175; a nonprofit hospital service corporation organized under chapter 176A; a non-profit medical service corporation organized under chapter 176B; or a health maintenance organization organized under chapter 176G.

SECTION 3. A license to practice as a naturopathic doctor may be issued without examination to an applicant who meets the requirements of subsections (1 ,2,3 and 5), of section 239 of chapter 112 of the General Laws if he submits satisfactory proof to the board that he is or has been actively engaged in the practice of naturopathic health care for compensation in the Commonwealth for at least 5 of the last 10 years immediately preceding the effective date of this act. Applications for licensure under this section shall be filed with the board not later than 18 months after the effective date of this act.

SECTION 4. The terms of the initial appointed members of the board of registration in naturopathy pursuant to section 101 of chapter 13 of the General Laws shall be as follows: 2 shall serve for a term of 1 year; 2 shall serve for terms of 2 years and the remaining 3 shall serve for terms of 3 years. The 5 members required to be naturopathic doctors shall be persons with 5 years of experience in the practice of naturopathic health care who would be eligible for licensure in the commonwealth if said section 101 of said chapter 13 were in effect prior to the effective date of this act and must have attended and graduated from an approved naturopathic college that is accredited, or is a candidate for accreditation, by the Council of Naturopathic Medical Educators or its successor.

SECTION 5. The punishment provisions of section 243 of chapter 112 of the General Laws shall take effect not later than 6 months after the board of registration in naturopathy first issues licenses pursuant to said chapter 112. 0.

SECTION 6. This act shall take effect in 180 days.

Name:	District/Address:
Marc R. Pacheco	First Plymouth and Bristol
Stanley C. Rosenberg	Hampshire, Franklin and Worcester
John V. Fernandes	10th Worcester
James B. Eldridge	Middlesex and Worcester
Daniel B. Winslow	9th Norfolk