SB 796: Uniform Standards: Naturopathic Doctors Act: Respiratory Care Practice Act.
- Session Year: 2017-2018
- House: Senate
- Latest Version Date: 2017-10-08
(1)The Department of Consumer Affairs is comprised of healing arts boards that are responsible for the licensure and regulation of healing arts licensees. Under existing law, the Substance Abuse Coordination Committee is created within the department and the committee is required to formulate uniform and specific standards in specified areas that each healing arts board is required to use in dealing with substance-abusing licensees. Existing law, by January 1, 2010, requires the committee to formulate uniform and specific standards in specified areas, including standards governing all aspects of required testing, that each healing arts board is required to use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program.
This bill, by January 1, 2019, would require the committee to review the existing criteria for those standards governing all aspects of required testing to determine whether the existing criteria should be updated to reflect recent developments in testing research and technology.
(2)Existing law, the Naturopathic Doctors Act, establishes the Naturopathic Medicine Committee within the Osteopathic Medical Board of California for the licensure and regulation of naturopathic doctors. Existing law requires the committee to consist of 9 members appointed by the Governor, including 2 public members. Existing law requires a public member to be a citizen of the state for at least 5 years preceding his or her appointment.
This bill would instead require 7 professional members to be appointed by the Governor, one public member to be appointed by the Senate Committee on Rules, and one public member to be appointed by the Speaker of the Assembly. The bill would instead require a public member to be a resident of the state for at least 5 years preceding his or her appointment.
Existing law repeals the act on January 1, 2018. Existing law also specifies that the committee is subject to review by the appropriate policy committees of the Legislature on January 1, 2018.
This bill would instead repeal the act and subject the committee to legislative review on January 1, 2022.
Existing law requires an applicant for a license as a naturopathic doctor to file a written application with the committee, as specified. Existing law requires the committee to establish the amount of the fee assessed to conduct activities of the committee, including the amount of fees for applicant licensure, licensure renewal, late renewal, and childbirth certification. Existing law requires the committee to require the satisfactory completion of 60 hours of approved continuing education biennially, as specified, for licensure renewal.
This bill would remove the requirement that an application be written. The bill would specify the amount or maximum amount for each of the fees. The bill would require a licensee to retain certificates of continuing education course completion for 6 years. The bill would authorize the committee to audit licensees continuing education records to ensure that continuing education requirements are met. The bill would specify that furnishing false or misleading information to the committee regarding continuing education constitutes unprofessional conduct.
Existing law requires the committee to approve a specified naturopathic medical education program. Existing law requires boards within the Department of Consumer Affairs to adopt rules and regulations to provide for methods of evaluating education, training, and experience obtained in the armed services, if applicable to the requirements of the business, occupation, or profession regulated, and to specify how this education, training, and experience may be used to meet the licensure requirements for the particular business, occupation, or profession regulated. Existing law also requires these boards to consult with the Department of Veterans Affairs and the Military Department before adopting these rules and regulations.
This bill would require that the naturopathic medical program, pursuant to those provisions, evaluate an applicants education, training, and experience obtained in the armed services, and provide course credit where applicable.
Existing law requires the satisfactory completion of specified hours of approved continuing education biennially in order to renew a license. Existing law requires the continuing education to meet certain requirements and to be provided by an approved continuing education provider.
This bill would additionally require the course content to pertain to the practice of naturopathic, osteopathic, or allopathic medicine. The bill would require continuing education providers to comply with certain conflict-of-interest requirements. The bill would also require these providers to submit a related annual declaration to the committee. The bill would require the committee to maintain a list of these providers meeting those requirements on its Internet Web site.
Existing law does not prevent or restrict the practice, services, or activities of a person who makes recommendations regarding or is engaged in the sale of, among other things, food or vitamins.
This bill would authorize an unlicensed person to represent that he or she practices naturopathy if certain requirements related to restrictions on services provided and specified disclosures and acknowledgments are met.
(3)Existing law, the Respiratory Care Practice Act, establishes the Respiratory Care Board of California for the licensure and regulation of respiratory care practitioners. Existing law specifies that the board is subject to review by the appropriate policy committees of the Legislature upon repeal of the provision establishing the board. Existing law also authorizes the board to employ an executive officer. Existing law repeals these provisions on January 1, 2018.
This bill would instead repeal those provisions on January 1, 2022.
Existing law establishes the Respiratory Care Fund in the State Treasury to carry out the purposes of the act, and requires all collections from persons licensed or seeking to be licensed under the Respiratory Care Practice Act to be paid into the fund, as specified.
This bill would make the availability of the moneys in the fund contingent upon appropriation by the Legislature.
(1)The Department of Consumer Affairs is comprised of healing arts boards that are responsible for the licensure and regulation of healing arts licensees. Under existing law, the Substance Abuse Coordination Committee is created within the department and the committee is required to formulate uniform and specific standards in specified areas that each healing arts board is required to use in dealing with substance-abusing licensees. Existing law, by January 1, 2010, requires the committee to formulate uniform and specific standards in specified areas, including standards governing all aspects of required testing, that each healing arts board is required to use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program.
This bill, by January 1, 2019, would require the committee to review the existing criteria for those standards governing all aspects of required testing to determine whether the existing criteria should be updated to reflect recent developments in testing research and technology.
(2)Existing law, the Naturopathic Doctors Act, establishes the Naturopathic Medicine Committee within the Osteopathic Medical Board of California for the licensure and regulation of naturopathic doctors. Existing law requires the committee to consist of 9 members appointed by the Governor, including 2 public members. Existing law requires a public member to be a citizen of the state for at least 5 years preceding his or her appointment.
This bill would instead require 7 professional members to be appointed by the Governor, one public member to be appointed by the Senate Committee on Rules, and one public member to be appointed by the Speaker of the Assembly. The bill would instead require a public member to be a resident of the state for at least 5 years preceding his or her appointment.
Existing law repeals the act on January 1, 2018. Existing law also specifies that the committee is subject to review by the appropriate policy committees of the Legislature on January 1, 2018.
This bill would instead repeal the act and subject the committee to legislative review on January 1, 2022.
Existing law requires an applicant for a license as a naturopathic doctor to file a written application with the committee, as specified. Existing law requires the committee to establish the amount of the fee assessed to conduct activities of the committee, including the amount of fees for applicant licensure, licensure renewal, late renewal, and childbirth certification. Existing law requires the committee to require the satisfactory completion of 60 hours of approved continuing education biennially, as specified, for licensure renewal.
This bill would remove the requirement that an application be written. The bill would specify the amount or maximum amount for each of the fees. The bill would require a licensee to retain certificates of continuing education course completion for 6 years. The bill would authorize the committee to audit licensees continuing education records to ensure that continuing education requirements are met. The bill would specify that furnishing false or misleading information to the committee regarding continuing education constitutes unprofessional conduct.
Existing law requires the committee to approve a specified naturopathic medical education program. Existing law requires boards within the Department of Consumer Affairs to adopt rules and regulations to provide for methods of evaluating education, training, and experience obtained in the armed services, if applicable to the requirements of the business, occupation, or profession regulated, and to specify how this education, training, and experience may be used to meet the licensure requirements for the particular business, occupation, or profession regulated. Existing law also requires these boards to consult with the Department of Veterans Affairs and the Military Department before adopting these rules and regulations.
This bill would require that the naturopathic medical program, pursuant to those provisions, evaluate an applicants education, training, and experience obtained in the armed services, and provide course credit where applicable.
Existing law requires the satisfactory completion of specified hours of approved continuing education biennially in order to renew a license. Existing law requires the continuing education to meet certain requirements and to be provided by an approved continuing education provider.
This bill would additionally require the course content to pertain to the practice of naturopathic, osteopathic, or allopathic medicine. The bill would require continuing education providers to comply with certain conflict-of-interest requirements. The bill would also require these providers to submit a related annual declaration to the committee. The bill would require the committee to maintain a list of these providers meeting those requirements on its Internet Web site.
Existing law does not prevent or restrict the practice, services, or activities of a person who makes recommendations regarding or is engaged in the sale of, among other things, food or vitamins.
This bill would authorize an unlicensed person to represent that he or she practices naturopathy if certain requirements related to restrictions on services provided and specified disclosures and acknowledgments are met.
(3)Existing law, the Respiratory Care Practice Act, establishes the Respiratory Care Board of California for the licensure and regulation of respiratory care practitioners. Existing law specifies that the board is subject to review by the appropriate policy committees of the Legislature upon repeal of the provision establishing the board. Existing law also authorizes the board to employ an executive officer. Existing law repeals these provisions on January 1, 2018.
This bill would instead repeal those provisions on January 1, 2022.
Existing law establishes the Respiratory Care Fund in the State Treasury to carry out the purposes of the act, and requires all collections from persons licensed or seeking to be licensed under the Respiratory Care Practice Act to be paid into the fund, as specified.
This bill would make the availability of the moneys in the fund contingent upon appropriation by the Legislature.
(1)The Department of Consumer Affairs is comprised of healing arts boards that are responsible for the licensure and regulation of healing arts licensees. Under existing law, the Substance Abuse Coordination Committee is created within the department and the committee is required to formulate uniform and specific standards in specified areas that each healing arts board is required to use in dealing with substance-abusing licensees. Existing law, by January 1, 2010, requires the committee to formulate uniform and specific standards in specified areas, including standards governing all aspects of required testing, that each healing arts board is required to use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program.
This bill, by January 1, 2019, would require the committee to review the existing criteria for those standards governing all aspects of required testing to determine whether the existing criteria should be updated to reflect recent developments in testing research and technology.
(2)Existing law, the Naturopathic Doctors Act, establishes the Naturopathic Medicine Committee within the Osteopathic Medical Board of California for the licensure and regulation of naturopathic doctors. Existing law requires the committee to consist of 9 members appointed by the Governor, including 2 public members. Existing law requires a public member to be a citizen of the state for at least 5 years preceding his or her appointment.
This bill would instead require 7 professional members to be appointed by the Governor, one public member to be appointed by the Senate Committee on Rules, and one public member to be appointed by the Speaker of the Assembly. The bill would instead require a public member to be a resident of the state for at least 5 years preceding his or her appointment.
Existing law repeals the act on January 1, 2018. Existing law also specifies that the committee is subject to review by the appropriate policy committees of the Legislature on January 1, 2018.
This bill would instead repeal the act and subject the committee to legislative review on January 1, 2022.
Existing law requires an applicant for a license as a naturopathic doctor to file a written application with the committee, as specified. Existing law requires the committee to establish the amount of the fee assessed to conduct activities of the committee, including the amount of fees for applicant licensure, licensure renewal, late renewal, and childbirth certification. Existing law requires the committee to require the satisfactory completion of 60 hours of approved continuing education biennially, as specified, for licensure renewal.
This bill would remove the requirement that an application be written. The bill would specify the amount or maximum amount for each of the fees. The bill would require a licensee to retain certificates of continuing education course completion for 6 years. The bill would authorize the committee to audit licensees continuing education records to ensure that continuing education requirements are met. The bill would specify that furnishing false or misleading information to the committee regarding continuing education constitutes unprofessional conduct.
Existing law requires the committee to approve a specified naturopathic medical education program. Existing law requires boards within the Department of Consumer Affairs to adopt rules and regulations to provide for methods of evaluating education, training, and experience obtained in the armed services, if applicable to the requirements of the business, occupation, or profession regulated, and to specify how this education, training, and experience may be used to meet the licensure requirements for the particular business, occupation, or profession regulated. Existing law also requires these boards to consult with the Department of Veterans Affairs and the Military Department before adopting these rules and regulations.
This bill would require that the naturopathic medical program, pursuant to those provisions, evaluate an applicants education, training, and experience obtained in the armed services, and provide course credit where applicable.
Existing law requires the satisfactory completion of specified hours of approved continuing education biennially in order to renew a license. Existing law requires the continuing education to meet certain requirements and to be provided by an approved continuing education provider.
This bill would additionally require the course content to pertain to the practice of naturopathic, osteopathic, or allopathic medicine. The bill would require continuing education providers to comply with certain conflict-of-interest requirements. The bill would also require these providers to submit a related annual declaration to the committee. The bill would require the committee to maintain a list of these providers meeting those requirements on its Internet Web site.
Existing law does not prevent or restrict the practice, services, or activities of a person who makes recommendations regarding or is engaged in the sale of, among other things, food or vitamins.
This bill would authorize an unlicensed person to represent that he or she practices naturopathy if certain requirements related to restrictions on services provided and specified disclosures and acknowledgments are met.
Existing law requires that a person be licensed to use the professional abbreviation N.D. or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor, except as specified. Existing law makes a violation of this provision a crime. Existing law also specifies that the Naturopathic Doctors Act permits, and does not restrict the use of, the titles naturopath, naturopathic practitioner, and traditional naturopathic practitioner by persons who are educated and trained for those positions.This bill instead would specify that the Naturopathic Doctors Act permits, and does not restrict, the use of those titles by persons who are educated and trained for those positions and who comply with requirements related to restrictions on services provided and specified disclosures and acknowledgments.(3)Existing law, the Respiratory Care Practice Act, establishes the Respiratory Care Board of California for the licensure and regulation of respiratory care practitioners. Existing law specifies that the board is subject to review by the appropriate policy committees of the Legislature upon repeal of the provision establishing the board. Existing law also authorizes the board to employ an executive officer. Existing law repeals these provisions on January 1, 2018.
This bill would instead repeal those provisions on January 1, 2022.
Existing law establishes the Respiratory Care Fund in the State Treasury to carry out the purposes of the act, and requires all collections from persons licensed or seeking to be licensed under the Respiratory Care Practice Act to be paid into the fund, as specified.
This bill would make the availability of the moneys in the fund contingent upon appropriation by the Legislature.
(4)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.This bill would provide that no reimbursement is required by this act for a specified reason.(1)The Department of Consumer Affairs is comprised of healing arts boards that are responsible for the licensure and regulation of healing arts licensees. Under existing law, the Substance Abuse Coordination Committee is created within the department and the committee is required to formulate uniform and specific standards in specified areas that each healing arts board is required to use in dealing with substance-abusing licensees. Existing law, by January 1, 2010, requires the committee to formulate uniform and specific standards in specified areas, including standards governing all aspects of required testing, that each healing arts board is required to use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program.
This bill, by January 1, 2019, would require the committee to review the existing criteria for those standards governing all aspects of required testing to determine whether the existing criteria should be updated to reflect recent developments in testing research and technology.
(2)Existing law, the Naturopathic Doctors Act, establishes the Naturopathic Medicine Committee within the Osteopathic Medical Board of California for the licensure and regulation of naturopathic doctors. Existing law requires the committee to consist of 9 members appointed by the Governor, including 2 public members. Existing law requires a public member to be a citizen of the state for at least 5 years preceding his or her appointment.
This bill would instead require 7 professional members to be appointed by the Governor, one public member to be appointed by the Senate Committee on Rules, and one public member to be appointed by the Speaker of the Assembly. The bill would instead require a public member to be a resident of the state for at least 5 years preceding his or her appointment.
Existing law repeals the act on January 1, 2018. Existing law also specifies that the committee is subject to review by the appropriate policy committees of the Legislature on January 1, 2018.
This bill would instead repeal the act and subject the committee to legislative review on January 1, 2022.
Existing law requires an applicant for a license as a naturopathic doctor to file a written application with the committee, as specified. Existing law requires the committee to establish the amount of the fee assessed to conduct activities of the committee, including the amount of fees for applicant licensure, licensure renewal, late renewal, and childbirth certification. Existing law requires the committee to require the satisfactory completion of 60 hours of approved continuing education biennially, as specified, for licensure renewal.
This bill would remove the requirement that an application be written. The bill would specify the amount or maximum amount for each of the fees. The bill would require a licensee to retain certificates of continuing education course completion for 6 years. The bill would authorize the committee to audit licensees continuing education records to ensure that continuing education requirements are met. The bill would specify that furnishing false or misleading information to the committee regarding continuing education constitutes unprofessional conduct.
Existing law requires the committee to approve a specified naturopathic medical education program. Existing law requires boards within the Department of Consumer Affairs to adopt rules and regulations to provide for methods of evaluating education, training, and experience obtained in the armed services, if applicable to the requirements of the business, occupation, or profession regulated, and to specify how this education, training, and experience may be used to meet the licensure requirements for the particular business, occupation, or profession regulated. Existing law also requires these boards to consult with the Department of Veterans Affairs and the Military Department before adopting these rules and regulations.
This bill would require that the naturopathic medical program, pursuant to those provisions, evaluate an applicants education, training, and experience obtained in the armed services, and provide course credit where applicable.
Existing law requires the satisfactory completion of specified hours of approved continuing education biennially in order to renew a license. Existing law requires the continuing education to meet certain requirements and to be provided by an approved continuing education provider.
This bill would additionally require the course content to pertain to the practice of naturopathic, osteopathic, or allopathic medicine. The bill would require continuing education providers to comply with certain conflict-of-interest requirements. The bill would also require these providers to submit a related annual declaration to the committee. The bill would require the committee to maintain a list of these providers meeting those requirements on its Internet Web site.
Existing law does not prevent or restrict the practice, services, or activities of a person who makes recommendations regarding or is engaged in the sale of, among other things, food or vitamins.
This bill would authorize an unlicensed person to represent that he or she practices naturopathy if certain requirements related to restrictions on services provided and specified disclosures and acknowledgments are met.
Existing law requires that a person be licensed to use the professional abbreviation N.D. or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor, except as specified. Existing law makes a violation of this provision a crime. Existing law also specifies that the Naturopathic Doctors Act permits, and does not restrict the use of, the titles naturopath, naturopathic practitioner, and traditional naturopathic practitioner by persons who are educated and trained for those positions. Existing law specifies that the Naturopathic Doctors Act permits, and does not restrict, the education of these persons, and does not require these persons to be licensed under the act.
This bill would repeal the provisions restricting the scope of the act, and instead would require that a person be licensed to use the title naturopath, naturopathic practitioner, or traditional naturopathic practitioner with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor, except as specified. Until January 1, 2020, the bill would authorize the use of the terms naturopath, naturopathic practitioner, and traditional naturopathic practitioner to be used in certain materials by persons who are educated and trained, but not licensed, to practice naturopathy pursuant to this act. By expanding the definition of a crime, this bill would impose a state-mandated local program. instead would specify that the Naturopathic Doctors Act permits, and does not restrict, the use of those titles by persons who are educated and trained for those positions and who comply with requirements related to restrictions on services provided and specified disclosures and acknowledgments.
(3)Existing law, the Respiratory Care Practice Act, establishes the Respiratory Care Board of California for the licensure and regulation of respiratory care practitioners. Existing law specifies that the board is subject to review by the appropriate policy committees of the Legislature upon repeal of the provision establishing the board. Existing law also authorizes the board to employ an executive officer. Existing law repeals these provisions on January 1, 2018.
This bill would instead repeal those provisions on January 1, 2022.
Existing law establishes the Respiratory Care Fund in the State Treasury to carry out the purposes of the act, and requires all collections from persons licensed or seeking to be licensed under the Respiratory Care Act to be paid into the fund, as specified.
This bill would make the availability of the moneys in the fund contingent upon appropriation by the Legislature.
(4)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
(1)The Department of Consumer Affairs is comprised of healing arts boards that are responsible for the licensure and regulation of healing arts licensees. Under existing law, the Substance Abuse Coordination Committee is created within the department and the committee is required to formulate uniform and specific standards in specified areas that each healing arts board is required to use in dealing with substance-abusing licensees. Existing law, by January 1, 2010, requires the committee to formulate uniform and specific standards in specified areas, including standards governing all aspects of required testing, that each healing arts board is required to use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program.
This bill, by January 1, 2019, would require the committee to review the existing criteria for those standards governing all aspects of required testing to determine whether the existing criteria should be updated to reflect recent developments in testing research and technology.
Existing(2)Existing law, the Naturopathic Doctors Act, establishes the Naturopathic Medicine Committee within the Osteopathic Medical Board of California for the licensure and regulation of naturopathic doctors. Existing law requires the committee to consist of 9 members appointed by the Governor, including 2 public members. Existing law requires a public member to be a citizen of the state for at least 5 years preceding his or her appointment.
This bill would instead require 7 professional members to be appointed by the Governor, one public member to be appointed by the Senate Committee on Rules, and one public member to be appointed by the Assembly Committee on Rules. Speaker of the Assembly. The bill would instead require a public member to be a resident of the state for at least 5 years preceding his or her appointment.
Existing law repeals the act on January 1, 2018. Existing law also specifies that the committee is subject to review by the appropriate policy committees of the Legislature on January 1, 2018.
This bill would instead repeal the act and subject the committee to legislative review on January 1, 2022.
Existing law requires an applicant for a license as a naturopathic doctor to file a written application with the committee, as specified. Existing law requires the committee to establish the amount of the fee assessed to conduct activities of the committee, including the amount of fees for applicant licensure, licensure renewal, late renewal, and childbirth certification. Existing law requires the committee to require the satisfactory completion of 60 hours of approved continuing education biennially, as specified, for licensure renewal.
This bill would remove the requirement that an application be written. The bill would specify the amount or maximum amount for each of the fees. The bill would require a licensee to retain certificates of continuing education course completion for 6 years. The bill would authorize the committee to audit licensees continuing education records to ensure that continuing education requirements are met. The bill would specify that furnishing false or misleading information to the committee regarding continuing education constitutes unprofessional conduct.
Existing law requires the committee to approve a specified naturopathic medical education program. Existing law requires boards within the Department of Consumer Affairs to adopt rules and regulations to provide for methods of evaluating education, training, and experience obtained in the armed services, if applicable to the requirements of the business, occupation, or profession regulated, and to specify how this education, training, and experience may be used to meet the licensure requirements for the particular business, occupation, or profession regulated. Existing law also requires these boards to consult with the Department of Veterans Affairs and the Military Department before adopting these rules and regulations.
This bill would require that the naturopathic medical program, pursuant to those provisions, evaluate an applicants education, training, and experience obtained in the armed services, and provide course credit where applicable.
Existing law requires the satisfactory completion of specified hours of approved continuing education biennially in order to renew a license. Existing law requires the continuing education to meet certain requirements to be provided by an approved continuing education provider.
This bill would additionally require the course content to pertain to the practice of naturopathic, osteopathic, or allopathic medicine. The bill would require continuing education providers to comply with certain conflict-of-interest requirements. The bill would also require these providers to submit a related annual declaration to the committee. The bill would require the committee to maintain a list of these providers meeting those requirements on its Internet Web site.
Existing law does not prevent or restrict the practice, services, or activities of a person who makes recommendations regarding or is engaged in the sale of, among other things, food or vitamins.
This bill would authorize an unlicensed person to represent that he or she practices naturopathy if certain requirements are met.
Existing law requires that a person be licensed to use the professional abbreviation N.D. or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor, except as specified. Existing law makes a violation of this provision a crime. Existing law also specifies that the Naturopathic Doctors Act permits, and does not restrict the use of, the titles naturopath, naturopathic practitioner, and traditional naturopathic practitioner by persons who are educated and trained for those positions. Existing law specifies that the Naturopathic Doctors Act permits, and does not restrict, the education of these persons, and does not require these persons to be licensed under the act.
This bill would repeal the provisions restricting the scope of the act, and instead would require that a person be licensed to use the title naturopath, naturopathic practitioner, or traditional naturopathic practitioner with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor, except as specified. Until January 1, 2020, the bill would authorize the use of the terms naturopath, naturopathic practitioner, and traditional naturopathic practitioner to be used in certain materials by persons who are educated and trained, but not licensed, to practice naturopathy pursuant to this act. By expanding the definition of a crime, this bill would impose a state-mandated local program.
Existing(3)Existing law, the Respiratory Care Practice Act, establishes the Respiratory Care Board of California for the licensure and regulation of respiratory care practitioners. Existing law specifies that the board is subject to review by the appropriate policy committees of the Legislature upon repeal of the provision establishing the board. Existing law also authorizes the board to employ an executive officer. Existing law repeals these provisions on January 1, 2018.
This bill would instead repeal those provisions on January 1, 2022.
Existing law establishes the Respiratory Care Fund in the State Treasury to carry out the purposes of the act, and requires all collections from persons licensed or seeking to be licensed under the Respiratory Care Act to be paid into the fund, as specified.
This bill would make the availability of the moneys in the fund contingent upon appropriation by the Legislature.
The(4)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Naturopathic Doctors Act, establishes the Naturopathic Medicine Committee within the Osteopathic Medical Board of California for the licensure and regulation of naturopathic doctors. Existing law requires the committee to consist of 9 members appointed by the Governor, including 2 public members. Existing law requires a public member to be a citizen of the state for at least 5 years preceding his or her appointment.
This bill would instead require 7 professional members to be appointed by the Governor, one public member to be appointed by the Senate Committee on Rules, and one public member to be appointed by the Assembly Committee on Rules. The bill would instead require a public member to be a resident of the state for at least 5 years preceding his or her appointment.
Existing law repeals the act on January 1, 2018. Existing law also specifies that the committee is subject to review by the appropriate policy committees of the Legislature on January 1, 2018.
This bill would instead repeal the act and subject the committee to legislative review on January 1, 2022.
Existing law requires an applicant for a license as a naturopathic doctor to file a written application with the committee, as specified. Existing law requires the committee to establish the amount of the fee assessed to conduct activities of the committee, including the amount of fees for applicant licensure, licensure renewal, late renewal, and childbirth certification. Existing law requires the committee to require the satisfactory completion of 60 hours of approved continuing education biennially, as specified, for licensure renewal.
This bill would remove the requirement that an application be written. The bill would specify the amount or maximum amount for each of the fees. The bill would require a licensee to retain certificates of continuing education course completion for 6 years. The bill would authorize the committee to audit licensees continuing education records to ensure that continuing education requirements are met. The bill would specify that furnishing false or misleading information to the committee regarding continuing education constitutes unprofessional conduct.
Existing law requires the committee to approve a specified naturopathic medical education program. Existing law requires boards within the Department of Consumer Affairs to adopt rules and regulations to provide for methods of evaluating education, training, and experience obtained in the armed services, if applicable to the requirements of the business, occupation, or profession regulated, and to specify how this education, training, and experience may be used to meet the licensure requirements for the particular business, occupation, or profession regulated. Existing law also requires these boards to consult with the Department of Veterans Affairs and the Military Department before adopting these rules and regulations.
This bill would require that the naturopathic medical program, pursuant to those provisions, evaluate an applicants education, training, and experience obtained in the armed services, and provide course credit where applicable.
Existing law requires that a person be licensed to use the professional abbreviation N.D. or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor, except as specified. Existing law makes a violation of this provision a crime. Existing law also specifies that the Naturopathic Doctors Act permits, and does not restrict the use of, the titles naturopath, naturopathic practitioner, and traditional naturopathic practitioner by persons who are educated and trained for those positions. Existing law specifies that the Naturopathic Doctors Act permits, and does not restrict, the education of these persons, and does not require these persons to be licensed under the act.
This bill would repeal the provisions restricting the scope of the act, and instead would require that a person be licensed to use the title naturopath, naturopathic practitioner, or traditional naturopathic practitioner with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor, except as specified. By expanding the definition a crime, this bill would impose a state-mandated local program.
Existing law, the Respiratory Care Practice Act, establishes the Respiratory Care Board of California for the licensure and regulation of respiratory care practitioners. Existing law specifies that the board is subject to review by the appropriate policy committees of the Legislature upon repeal of the provision establishing the board. Existing law also authorizes the board to employ an executive officer. Existing law repeals these provisions on January 1, 2018.
This bill would instead repeal those provisions on January 1, 2022.
Existing law establishes the Respiratory Care Fund in the State Treasury to carry out the purposes of the act, and requires all collections from persons licensed or seeking to be licensed under the Respiratory Care Act to be paid into the fund, as specified.
This bill would make the availability of the moneys in the fund contingent upon appropriation by the Legislature.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Naturopathic Doctors Act, establishes the Naturopathic Medicine Committee within the Osteopathic Medical Board of California for the licensure and regulation of naturopathic doctors. Existing law requires the committee to consist of 9 members appointed by the Governor, including 2 public members. Existing law requires a public member to be a citizen of the state for at least 5 years preceding his or her appointment.
This bill would instead require 7 professional members to be appointed by the Governor, one public member to be appointed by the Senate Committee on Rules, and one public member to be appointed by the Assembly Committee on Rules. The bill would instead require a public member to be a resident of the state for at least 5 years preceding his or her appointment.
Existing law repeals the act on January 1, 2018. Existing law also specifies that the committee is subject to review by the appropriate policy committees of the Legislature on January 1, 2018.
This bill would instead repeal the act and subject the committee to legislative review on January 1, 2022.
Existing law requires an applicant for a license as a naturopathic doctor to file a written application with the committee, as specified. Existing law requires the committee to establish the amount of the fee assessed to conduct activities of the committee, including the amount of fees for applicant licensure, licensure renewal, late renewal, and childbirth certification. Existing law requires the committee to require the satisfactory completion of 60 hours of approved continuing education biennially, as specified, for licensure renewal.
This bill would remove the requirement that an application be written. The bill would specify the amount or maximum amount for each of the fees. The bill would require a licensee to retain certificates of continuing education course completion for 6 years. The bill would authorize the committee to audit licensees continuing education records to ensure that continuing education requirements are met. The bill would specify that furnishing false or misleading information to the committee regarding continuing education constitutes unprofessional conduct.
Existing law requires the committee to approve a specified naturopathic medical education program. Existing law requires boards within the Department of Consumer Affairs to adopt rules and regulations to provide for methods of evaluating education, training, and experience obtained in the armed services, if applicable to the requirements of the business, occupation, or profession regulated, and to specify how this education, training, and experience may be used to meet the licensure requirements for the particular business, occupation, or profession regulated. Existing law also requires these boards to consult with the Department of Veterans Affairs and the Military Department before adopting these rules and regulations.
This bill would require that the naturopathic medical program, pursuant to those provisions, evaluate an applicants education, training, and experience obtained in the armed services, and provide course credit where applicable.
Existing law requires that a person be licensed to use the professional abbreviation N.D. or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor, except as specified. Existing law makes a violation of this provision a crime. Existing law also specifies that the Naturopathic Doctors Act permits, and does not restrict the use of, the titles naturopath, naturopathic practitioner, and traditional naturopathic practitioner by persons who are educated and trained for those positions. Existing law specifies that the Naturopathic Doctors Act permits, and does not restrict, the education of these persons, and does not require these persons to be licensed under the act.
This bill would repeal the provisions restricting the scope of the act, and instead would require that a person be licensed to use the title naturopath, naturopathic practitioner, or traditional naturopathic practitioner with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor, except as specified. By expanding the definition a crime, this bill would impose a state-mandated local program.
Existing law, the Respiratory Care Practice Act, establishes the Respiratory Care Board of California for the licensure and regulation of respiratory care practitioners. Existing law specifies that the board is subject to review by the appropriate policy committees of the Legislature upon repeal of the provision establishing the board. Existing law also authorizes the board to employ an executive officer. Existing law repeals these provisions on January 1, 2018.
This bill would instead repeal those provisions on January 1, 2022.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law, the Naturopathic Doctors Act, establishes the Naturopathic Medicine Committee within the Osteopathic Medical Board of California for the licensure and regulation of naturopathic doctors. Existing law repeals the act on January 1, 2018. Existing law also specifies that the committee is subject to review by the appropriate policy committees of the Legislature on January 1, 2018.
This bill would instead repeal the act and subject the committee to legislative review on January 1, 2022.
Existing law, the Respiratory Care Practice Act, establishes the Respiratory Care Board of California for the licensure and regulation of respiratory care practitioners. Existing law specifies that the board is subject to review by the appropriate policy committees of the Legislature upon repeal of the provision establishing the board. Existing law also authorizes the board to employ an executive officer. Existing law repeals these provisions on January 1, 2018.
This bill would instead repeal those provisions on January 1, 2022.
(a)For the purpose of determining uniform standards that will be used by healing arts boards in dealing with substance-abusing licensees, there is established in the Department of Consumer Affairs the Substance Abuse Coordination Committee. The committee shall be comprised of the executive officers of the departments healing arts boards established pursuant to Division 2 (commencing with Section 500), the State Board of Chiropractic Examiners, the Osteopathic Medical Board of California, and a designee of the State Department of Health Care Services. The Director of Consumer Affairs shall chair the committee and may invite individuals or stakeholders who have particular expertise in the area of substance abuse to advise the committee.
(b)The committee shall be subject to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Division 3 of Title 2 of the Government Code).
(c)By January 1, 2010, the committee shall formulate uniform and specific standards in each of the following areas that each healing arts board shall use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program:
(1)Specific requirements for a clinical diagnostic evaluation of the licensee, including, but not limited to, required qualifications for the providers evaluating the licensee.
(2)Specific requirements for the temporary removal of the licensee from practice, in order to enable the licensee to undergo the clinical diagnostic evaluation described in paragraph (1) and any treatment recommended by the evaluator described in paragraph (1) and approved by the board, and specific criteria that the licensee must meet before being permitted to return to practice on a full-time or part-time basis.
(3)Specific requirements that govern the ability of the licensing board to communicate with the licensees employer about the licensees status and condition.
(4)Standards governing all aspects of required testing, including, but not limited to, frequency of testing, randomness, method of notice to the licensee, number of hours between the provision of notice and the test, standards for specimen collectors, procedures used by specimen collectors, the permissible locations of testing, whether the collection process must be observed by the collector, backup testing requirements when the licensee is on vacation or otherwise unavailable for local testing, requirements for the laboratory that analyzes the specimens, and the required maximum timeframe from the test to the receipt of the result of the test.
(5)Standards governing all aspects of group meeting attendance requirements, including, but not limited to, required qualifications for group meeting facilitators, frequency of required meeting attendance, and methods of documenting and reporting attendance or nonattendance by licensees.
(6)Standards used in determining whether inpatient, outpatient, or other type of treatment is necessary.
(7)Worksite monitoring requirements and standards, including, but not limited to, required qualifications of worksite monitors, required methods of monitoring by worksite monitors, and required reporting by worksite monitors.
(8)Procedures to be followed when a licensee tests positive for a banned substance.
(9)Procedures to be followed when a licensee is confirmed to have ingested a banned substance.
(10)Specific consequences for major violations and minor violations. In particular, the committee shall consider the use of a deferred prosecution stipulation similar to the stipulation described in Section 1000 of the Penal Code, in which the licensee admits to self-abuse of drugs or alcohol and surrenders his or her license. That agreement is deferred by the agency unless or until the licensee commits a major violation, in which case it is revived and the license is surrendered.
(11)Criteria that a licensee must meet in order to petition for return to practice on a full-time basis.
(12)Criteria that a licensee must meet in order to petition for reinstatement of a full and unrestricted license.
(13)If a board uses a private-sector vendor that provides diversion services, standards for immediate reporting by the vendor to the board of any and all noncompliance with any term of the diversion contract or probation; standards for the vendors approval process for providers or contractors that provide diversion services, including, but not limited to, specimen collectors, group meeting facilitators, and worksite monitors; standards requiring the vendor to disapprove and discontinue the use of providers or contractors that fail to provide effective or timely diversion services; and standards for a licensees termination from the program and referral to enforcement.
(14)If a board uses a private-sector vendor that provides diversion services, the extent to which licensee participation in that program shall be kept confidential from the public.
(15)If a board uses a private-sector vendor that provides diversion services, a schedule for external independent audits of the vendors performance in adhering to the standards adopted by the committee.
(16)Measurable criteria and standards to determine whether each boards method of dealing with substance-abusing licensees protects patients from harm and is effective in assisting its licensees in recovering from substance abuse in the long term.
(d)Notwithstanding any other law, by January 1, 2019, the committee shall review the existing criteria for Uniform Standard #4 established pursuant to paragraph (4) of subdivision (c). The committees review and findings shall determine whether the existing criteria for Uniform Standard #4 should be updated to reflect recent developments in testing research and technology. The committee shall consider information from, but not limited to, the American Society of Addiction Medicine, and other sources of best practices.
SEC. 2.Section 2450.3 of the Business and Professions Code is amended to read:2450.3.There is within the jurisdiction of the Osteopathic Medical Board of California a Naturopathic Medicine Committee authorized under the Naturopathic Doctors Act (Chapter 8.2 (commencing with Section 3610)). This section shall become inoperative on January 1, 2022, and as of that date is repealed. Notwithstanding any other provision of law, the repeal of this section renders the Naturopathic Medicine Committee subject to review by the appropriate policy committees of the Legislature.
SEC. 3.Section 3621 of the Business and Professions Code is amended to read:3621.(a)The committee shall consist of nine members, consisting of seven professional members appointed by the Governor, one public member appointed by the Senate Committee on Rules, and one public member appointed by the Speaker of the Assembly. Members of the committee shall include five members who are California licensed naturopathic doctors, two members who are California licensed physicians and surgeons, and two public members.
(b)A member of the committee shall be appointed for a four-year term. A person shall not serve as a member of the committee for more than two consecutive terms. A member shall hold office until the appointment and qualification of his or her successor, or until one year from the expiration of the term for which the member was appointed, whichever first occurs. Vacancies shall be filled by appointment for unexpired terms.
(c)(1)A public member of the committee shall be a resident of this state for at least five years preceding his or her appointment.
(2)A person shall not be appointed as a public member if the person or the persons immediate family in any manner owns an interest in a college, school, or institution engaged in naturopathic education, or the person or the persons immediate family has an economic interest in naturopathy or has any other conflict of interest. Immediate family means the public members spouse, parents, children, or his or her childrens spouses.
(d)Each member of the committee shall receive a per diem and expenses as provided in Section 103.
(e)The committee may appoint a person exempt from civil service who shall be designated as an executive officer and who shall exercise the powers and perform the duties delegated by the committee and vested in him or her by this chapter.
SEC. 4.Section 3623 of the Business and Professions Code is amended to read:3623.(a)The committee 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 bachelors degree from a regionally accredited or preaccredited college or university or the equivalency, as determined by the council.
(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. Of the total requisite hours, not less than 2,500 hours shall consist of academic instruction, and not less than 1,200 hours shall consist of supervised clinical training approved by the naturopathic medical school.
(b)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 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 equivalent federally recognized accrediting body for naturopathic doctor education.
(c)To qualify as an approved naturopathic medical school, a naturopathic medical program located in Canada or the United States shall offer a full-time, doctoral-level, naturopathic medical education program with its graduates being eligible to apply to the committee for licensure and to the North American Board of Naturopathic Examiners that administers the naturopathic licensing examination.
(d)The naturopathic medical program shall evaluate an applicants education, training, and experience obtained in the armed services, pursuant to Section 35, and provide course credit where applicable.
SEC. 5.Section 3630 of the Business and Professions Code is amended to read:3630.An applicant for a license as a naturopathic doctor shall file an application with the committee on a form provided by the committee that shows, to the committees satisfaction, compliance with all of the following requirements:
(a)The applicant has not committed an act or crime that constitutes grounds for denial of a license under Section 480, and has complied with the requirements of Section 144.
(b)The applicant has received a degree in naturopathic medicine from an approved naturopathic medical school where the degree substantially meets the educational requirements in paragraph (2) of subdivision (a) of Section 3623.
SEC. 6.Section 3635 of the Business and Professions Code is amended to read:3635.(a)In addition to any other qualifications and requirements for licensure renewal, the committee shall require the satisfactory completion of 60 hours of approved continuing education biennially. This requirement is waived for the initial license renewal. The continuing education shall meet the following requirements:
(1)At least 20 hours shall be in pharmacotherapeutics.
(2)No more than 15 hours may be in naturopathic medical journals or osteopathic or allopathic medical journals, or audio or videotaped presentations, slides, programmed instruction, or computer-assisted instruction or preceptorships.
(3)No more than 20 hours may be in any single topic.
(4)No more than 15 hours of the continuing education requirements for the specialty certificate in naturopathic childbirth attendance shall apply to the 60 hours of continuing education requirement.
(5)Course content shall pertain to the practice of naturopathic, osteopathic, or allopathic medicine.
(b)The continuing education requirements of this section may be met through continuing education courses approved by the committee, the California Naturopathic Doctors Association, the American Association of Naturopathic Physicians, the California State Board of Pharmacy, the State Board of Chiropractic Examiners, or other courses that meet the standards for continuing education for licensed physicians and surgeons in California. All continuing education providers shall comply with Section 3635.2. Continuing education providers shall submit an annual declaration to the committee that their educational activities satisfy the requirements described in Section 3635.2 and the committee shall maintain a list of these providers on its Internet Web site.
SEC. 7.Section 3635.1 is added to the Business and Professions Code, to read:3635.1.(a)A licensee shall retain certificates of continuing education course completion for six years.
(b)The committee may audit licensees continuing education records to ensure that continuing education requirements are met.
(c)It shall be unprofessional conduct for a licensee to furnish false or misleading information to the committee regarding continuing education.
SEC. 8.Section 3635.2 is added to the Business and Professions Code, to read:3635.2.In addition to complying with subdivision (b) of Section 3635, the following shall apply to providers of continuing education:
(a)The content of continuing education courses and related materials shall provide balance, independence, objectivity, and scientific rigor. All patient care recommendations from continuing education courses involving clinical medicine shall be based on evidence accepted by naturopathic doctors. All scientific research used to support patient care recommendations shall conform to generally accepted standards of experimental design, data collection, and analysis.
(b)A conflict of interest is created when an individual in a position to control the content of a continuing education course, or his or her spouse or partner, has a relevant personal financial relationship within the past 12 months with a commercial entity that produces, markets, resells, or distributes health care goods or services consumed by, or used on patients that benefits the individual in any financial amount and therefore, may bias his or her opinions and teachings with respect to the content of continuing education courses. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest such as stocks, stock options or other ownership interest, excluding diversified mutual funds, or other financial benefit. Financial benefits are generally associated with roles such as employment, a management position, or an independent contractor position, including contracted research and clinical trials, consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected.
(c)Prior to a course being presented, continuing education providers shall identify, disclose, and resolve all conflicts of interest. Individuals who fail or refuse to disclose relevant financial relationships shall not be approved as a provider of continuing education as described in subdivision (b) of Section 3635.
(d)Conflicts of interests shall be resolved by one of the following mechanisms:
(1)Altering financial relationships. Individuals may change their relationships with commercial interests, such as discontinuance of contracted services, thereby eliminating any conflict of interest related to the continuing education content.
(2)Altering control over content. An individuals control of continuing education content may be altered in several ways to remove the opportunity to affect content related to the products and services of a commercial interest. These include the following:
(A)Choose someone else to control that part of the content. If a proposed presenter or planner has a conflict of interest related to the content, someone else who does not have a relationship to the commercial interests related to the content may present or plan that part of the content.
(B)Change the focus of the continuing education activity so that the content is not about products or services of the commercial interest that is the basis of the conflict of interest.
(C)Change the content of the individuals assignment so that it is no longer about products or services of the commercial interest. For example, an individual with a conflict of interest regarding products for treatment of a condition could address the pathophysiology or diagnosis of the condition, rather than therapeutics.
(D)Limit the content to a report without recommendations. If an individual has been funded by a commercial entity to perform research, the individuals presentation may be limited to the data and results of the research. Someone else may be assigned to address broader implications and recommendations.
(E)Limit the sources for recommendations. Rather than having a person with a conflict of interest present personal recommendations or personally select the evidence to be presented, limit the role of the person to reporting recommendations based on formal structured reviews of the literature with the inclusion and exclusion criteria stated evidence-based.
(3)Conflict of interest may be resolved if the continuing education material is peer reviewed and both of the following are met:
(A)All the recommendations involving clinical medicine are based on evidence that is accepted within the profession of naturopathic medicine as adequate justification for indications and contraindications in the care of patients.
(B)All scientific research referred to, reported, or used in the continuing education activity in support or justification of patient care recommendations conforms to the generally accepted standards of experimental design, data collection, and analysis.
SEC. 9.Section 3644 of the Business and Professions Code is amended to read:3644.This chapter does not prevent or restrict the practice, services, or activities of any of the following:
(a)A person licensed, certified, or otherwise recognized in this state by any other law or regulation if that person is engaged in the profession or occupation for which he or she is licensed, certified, or otherwise recognized.
(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 rendering aid to a family member or in an emergency, if no fee or other consideration for the service is charged, received, expected, or contemplated.
(d)(1)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.
(2)An unlicensed person described in this subdivision may represent that he or she practices naturopathy if he or she complies with Section 2053.6. However, an unlicensed person may not use the title naturopathic doctor unless he or she has been issued a license by the committee.
(e)A person engaged in good faith in the practice of the religious tenets of any church or religious belief without using prescription drugs.
(f)A person acting in good faith for religious reasons as a matter of conscience or based on a personal belief, while obtaining or providing information regarding health care and the use of any product described in subdivision (d).
(g)A person who provides the following recommendations regarding the human body and its function:
(1)Nonprescription products.
(2)Natural elements such as air, heat, water, and light.
(3)Class I or class II nonprescription, approved medical devices, as defined in Section 360c of Title 21 of the United States Code.
(4)Vitamins, minerals, herbs, homeopathics, natural food products and their extracts, and nutritional supplements.
(h)A person who is licensed in another state, territory, or the District of Columbia to practice naturopathic medicine if the person is incidentally called into this state for consultation with a naturopathic doctor.
(i)A student enrolled in an approved naturopathic medical program whose services are performed pursuant to a course of instruction under the supervision of a naturopathic doctor.
SEC. 10.Section 3645 of the Business and Professions Code is amended to read:3645.(a)This chapter permits, and does not restrict, the use of the following titles by persons who are educated and trained as any of the following:
(1)Naturopath.
(2)Naturopathic practitioner.
(3)Traditional naturopathic practitioner.
(b)This chapter permits, and does not restrict, the education of persons as described in paragraphs (1) to (3), inclusive, of subdivision (a). Those persons are not required to be licensed under this chapter.
SEC. 11.Section 3660 of the Business and Professions Code is amended to read:3660.Except as provided in subdivision (h) of Section 3644, a person shall have a valid, unrevoked, or unsuspended license issued under this chapter to do any of the following:
(a)To claim to be a naturopathic doctor, licensed naturopathic doctor, doctor of naturopathic medicine, doctor of naturopathy, or naturopathic medical doctor.
(b)To use the professional designation N.D. or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor.
SEC. 12.Section 3680 of the Business and Professions Code is amended to read:3680.(a)The application fee for a doctor of naturopathic medicine shall be no more than four hundred dollars ($400).
(b)The initial license fee shall be no more than eight hundred dollars ($800).
(c)The renewal fee for a license shall be no more than eight hundred dollars ($800).
(d)The late renewal fee for a license shall be no more than one hundred fifty dollars ($150).
(e)The fee for processing fingerprint cards shall be the current fee charged by the Department of Justice.
(f)The fee for a duplicate or replacement license shall be no more than twenty-five dollars ($25).
SEC. 13.Section 3686 of the Business and Professions Code is amended to read:3686.This chapter shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 14.Section 3710 of the Business and Professions Code is amended to read:3710.(a)The Respiratory Care Board of California, hereafter referred to as the board, shall enforce and administer this chapter.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed. Notwithstanding any other law, the repeal of this section renders the board subject to review by the appropriate policy committees of the Legislature.
SEC. 15.Section 3716 of the Business and Professions Code is amended to read:3716.(a)The board may employ an executive officer exempt from civil service and, subject to the provisions of law relating to civil service, clerical assistants and, except as provided in Section 159.5, other employees as it may deem necessary to carry out its powers and duties.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 16.Section 3772 of the Business and Professions Code is amended to read:3772.There is established in the State Treasury the Respiratory Care Fund. All collections from persons licensed or seeking to be licensed under this chapter shall be paid by the board into the fund after the report to the Controller at the beginning of each month of the amount and source of the collections. Moneys in the fund shall be available to the board, upon appropriation by the Legislature.
(a)For the purpose of determining uniform standards that will be used by healing arts boards in dealing with substance-abusing licensees, there is established in the Department of Consumer Affairs the Substance Abuse Coordination Committee. The committee shall be comprised of the executive officers of the departments healing arts boards established pursuant to Division 2 (commencing with Section 500), the State Board of Chiropractic Examiners, the Osteopathic Medical Board of California, and a designee of the State Department of Health Care Services. The Director of Consumer Affairs shall chair the committee and may invite individuals or stakeholders who have particular expertise in the area of substance abuse to advise the committee.
(b)The committee shall be subject to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Division 3 of Title 2 of the Government Code).
(c)By January 1, 2010, the committee shall formulate uniform and specific standards in each of the following areas that each healing arts board shall use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program:
(1)Specific requirements for a clinical diagnostic evaluation of the licensee, including, but not limited to, required qualifications for the providers evaluating the licensee.
(2)Specific requirements for the temporary removal of the licensee from practice, in order to enable the licensee to undergo the clinical diagnostic evaluation described in paragraph (1) and any treatment recommended by the evaluator described in paragraph (1) and approved by the board, and specific criteria that the licensee must meet before being permitted to return to practice on a full-time or part-time basis.
(3)Specific requirements that govern the ability of the licensing board to communicate with the licensees employer about the licensees status and condition.
(4)Standards governing all aspects of required testing, including, but not limited to, frequency of testing, randomness, method of notice to the licensee, number of hours between the provision of notice and the test, standards for specimen collectors, procedures used by specimen collectors, the permissible locations of testing, whether the collection process must be observed by the collector, backup testing requirements when the licensee is on vacation or otherwise unavailable for local testing, requirements for the laboratory that analyzes the specimens, and the required maximum timeframe from the test to the receipt of the result of the test.
(5)Standards governing all aspects of group meeting attendance requirements, including, but not limited to, required qualifications for group meeting facilitators, frequency of required meeting attendance, and methods of documenting and reporting attendance or nonattendance by licensees.
(6)Standards used in determining whether inpatient, outpatient, or other type of treatment is necessary.
(7)Worksite monitoring requirements and standards, including, but not limited to, required qualifications of worksite monitors, required methods of monitoring by worksite monitors, and required reporting by worksite monitors.
(8)Procedures to be followed when a licensee tests positive for a banned substance.
(9)Procedures to be followed when a licensee is confirmed to have ingested a banned substance.
(10)Specific consequences for major violations and minor violations. In particular, the committee shall consider the use of a deferred prosecution stipulation similar to the stipulation described in Section 1000 of the Penal Code, in which the licensee admits to self-abuse of drugs or alcohol and surrenders his or her license. That agreement is deferred by the agency unless or until the licensee commits a major violation, in which case it is revived and the license is surrendered.
(11)Criteria that a licensee must meet in order to petition for return to practice on a full-time basis.
(12)Criteria that a licensee must meet in order to petition for reinstatement of a full and unrestricted license.
(13)If a board uses a private-sector vendor that provides diversion services, standards for immediate reporting by the vendor to the board of any and all noncompliance with any term of the diversion contract or probation; standards for the vendors approval process for providers or contractors that provide diversion services, including, but not limited to, specimen collectors, group meeting facilitators, and worksite monitors; standards requiring the vendor to disapprove and discontinue the use of providers or contractors that fail to provide effective or timely diversion services; and standards for a licensees termination from the program and referral to enforcement.
(14)If a board uses a private-sector vendor that provides diversion services, the extent to which licensee participation in that program shall be kept confidential from the public.
(15)If a board uses a private-sector vendor that provides diversion services, a schedule for external independent audits of the vendors performance in adhering to the standards adopted by the committee.
(16)Measurable criteria and standards to determine whether each boards method of dealing with substance-abusing licensees protects patients from harm and is effective in assisting its licensees in recovering from substance abuse in the long term.
(d)Notwithstanding any other law, by January 1, 2019, the committee shall review the existing criteria for Uniform Standard #4 established pursuant to paragraph (4) of subdivision (c). The committees review and findings shall determine whether the existing criteria for Uniform Standard #4 should be updated to reflect recent developments in testing research and technology. The committee shall consider information from, but not limited to, the American Society of Addiction Medicine, and other sources of best practices.
SEC. 2.Section 2450.3 of the Business and Professions Code is amended to read:2450.3.There is within the jurisdiction of the Osteopathic Medical Board of California a Naturopathic Medicine Committee authorized under the Naturopathic Doctors Act (Chapter 8.2 (commencing with Section 3610)). This section shall become inoperative on January 1, 2022, and as of that date is repealed. Notwithstanding any other provision of law, the repeal of this section renders the Naturopathic Medicine Committee subject to review by the appropriate policy committees of the Legislature.
SEC. 3.Section 3621 of the Business and Professions Code is amended to read:3621.(a)The committee shall consist of nine members, consisting of seven professional members appointed by the Governor, one public member appointed by the Senate Committee on Rules, and one public member appointed by the Speaker of the Assembly. Members of the committee shall include five members who are California licensed naturopathic doctors, two members who are California licensed physicians and surgeons, and two public members.
(b)A member of the committee shall be appointed for a four-year term. A person shall not serve as a member of the committee for more than two consecutive terms. A member shall hold office until the appointment and qualification of his or her successor, or until one year from the expiration of the term for which the member was appointed, whichever first occurs. Vacancies shall be filled by appointment for unexpired terms.
(c)(1)A public member of the committee shall be a resident of this state for at least five years preceding his or her appointment.
(2)A person shall not be appointed as a public member if the person or the persons immediate family in any manner owns an interest in a college, school, or institution engaged in naturopathic education, or the person or the persons immediate family has an economic interest in naturopathy or has any other conflict of interest. Immediate family means the public members spouse, parents, children, or his or her childrens spouses.
(d)Each member of the committee shall receive a per diem and expenses as provided in Section 103.
(e)The committee may appoint a person exempt from civil service who shall be designated as an executive officer and who shall exercise the powers and perform the duties delegated by the committee and vested in him or her by this chapter.
SEC. 4.Section 3623 of the Business and Professions Code is amended to read:3623.(a)The committee 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 bachelors degree from a regionally accredited or preaccredited college or university or the equivalency, as determined by the council.
(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. Of the total requisite hours, not less than 2,500 hours shall consist of academic instruction, and not less than 1,200 hours shall consist of supervised clinical training approved by the naturopathic medical school.
(b)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 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 equivalent federally recognized accrediting body for naturopathic doctor education.
(c)To qualify as an approved naturopathic medical school, a naturopathic medical program located in Canada or the United States shall offer a full-time, doctoral-level, naturopathic medical education program with its graduates being eligible to apply to the committee for licensure and to the North American Board of Naturopathic Examiners that administers the naturopathic licensing examination.
(d)The naturopathic medical program shall evaluate an applicants education, training, and experience obtained in the armed services, pursuant to Section 35, and provide course credit where applicable.
SEC. 5.Section 3630 of the Business and Professions Code is amended to read:3630.An applicant for a license as a naturopathic doctor shall file an application with the committee on a form provided by the committee that shows, to the committees satisfaction, compliance with all of the following requirements:
(a)The applicant has not committed an act or crime that constitutes grounds for denial of a license under Section 480, and has complied with the requirements of Section 144.
(b)The applicant has received a degree in naturopathic medicine from an approved naturopathic medical school where the degree substantially meets the educational requirements in paragraph (2) of subdivision (a) of Section 3623.
SEC. 6.Section 3635 of the Business and Professions Code is amended to read:3635.(a)In addition to any other qualifications and requirements for licensure renewal, the committee shall require the satisfactory completion of 60 hours of approved continuing education biennially. This requirement is waived for the initial license renewal. The continuing education shall meet the following requirements:
(1)At least 20 hours shall be in pharmacotherapeutics.
(2)No more than 15 hours may be in naturopathic medical journals or osteopathic or allopathic medical journals, or audio or videotaped presentations, slides, programmed instruction, or computer-assisted instruction or preceptorships.
(3)No more than 20 hours may be in any single topic.
(4)No more than 15 hours of the continuing education requirements for the specialty certificate in naturopathic childbirth attendance shall apply to the 60 hours of continuing education requirement.
(5)Course content shall pertain to the practice of naturopathic, osteopathic, or allopathic medicine.
(b)The continuing education requirements of this section may be met through continuing education courses approved by the committee, the California Naturopathic Doctors Association, the American Association of Naturopathic Physicians, the California State Board of Pharmacy, the State Board of Chiropractic Examiners, or other courses that meet the standards for continuing education for licensed physicians and surgeons in California. All continuing education providers shall comply with Section 3635.2. Continuing education providers shall submit an annual declaration to the committee that their educational activities satisfy the requirements described in Section 3635.2 and the committee shall maintain a list of these providers on its Internet Web site.
SEC. 7.Section 3635.1 is added to the Business and Professions Code, to read:3635.1.(a)A licensee shall retain certificates of continuing education course completion for six years.
(b)The committee may audit licensees continuing education records to ensure that continuing education requirements are met.
(c)It shall be unprofessional conduct for a licensee to furnish false or misleading information to the committee regarding continuing education.
SEC. 8.Section 3635.2 is added to the Business and Professions Code, to read:3635.2.In addition to complying with subdivision (b) of Section 3635, the following shall apply to providers of continuing education:
(a)The content of continuing education courses and related materials shall provide balance, independence, objectivity, and scientific rigor. All patient care recommendations from continuing education courses involving clinical medicine shall be based on evidence accepted by naturopathic doctors. All scientific research used to support patient care recommendations shall conform to generally accepted standards of experimental design, data collection, and analysis.
(b)A conflict of interest is created when an individual in a position to control the content of a continuing education course, or his or her spouse or partner, has a relevant personal financial relationship within the past 12 months with a commercial entity that produces, markets, resells, or distributes health care goods or services consumed by, or used on patients that benefits the individual in any financial amount and therefore, may bias his or her opinions and teachings with respect to the content of continuing education courses. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest such as stocks, stock options or other ownership interest, excluding diversified mutual funds, or other financial benefit. Financial benefits are generally associated with roles such as employment, a management position, or an independent contractor position, including contracted research and clinical trials, consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected.
(c)Prior to a course being presented, continuing education providers shall identify, disclose, and resolve all conflicts of interest. Individuals who fail or refuse to disclose relevant financial relationships shall not be approved as a provider of continuing education as described in subdivision (b) of Section 3635.
(d)Conflicts of interests shall be resolved by one of the following mechanisms:
(1)Altering financial relationships. Individuals may change their relationships with commercial interests, such as discontinuance of contracted services, thereby eliminating any conflict of interest related to the continuing education content.
(2)Altering control over content. An individuals control of continuing education content may be altered in several ways to remove the opportunity to affect content related to the products and services of a commercial interest. These include the following:
(A)Choose someone else to control that part of the content. If a proposed presenter or planner has a conflict of interest related to the content, someone else who does not have a relationship to the commercial interests related to the content may present or plan that part of the content.
(B)Change the focus of the continuing education activity so that the content is not about products or services of the commercial interest that is the basis of the conflict of interest.
(C)Change the content of the individuals assignment so that it is no longer about products or services of the commercial interest. For example, an individual with a conflict of interest regarding products for treatment of a condition could address the pathophysiology or diagnosis of the condition, rather than therapeutics.
(D)Limit the content to a report without recommendations. If an individual has been funded by a commercial entity to perform research, the individuals presentation may be limited to the data and results of the research. Someone else may be assigned to address broader implications and recommendations.
(E)Limit the sources for recommendations. Rather than having a person with a conflict of interest present personal recommendations or personally select the evidence to be presented, limit the role of the person to reporting recommendations based on formal structured reviews of the literature with the inclusion and exclusion criteria stated evidence-based.
(3)Conflict of interest may be resolved if the continuing education material is peer reviewed and both of the following are met:
(A)All the recommendations involving clinical medicine are based on evidence that is accepted within the profession of naturopathic medicine as adequate justification for indications and contraindications in the care of patients.
(B)All scientific research referred to, reported, or used in the continuing education activity in support or justification of patient care recommendations conforms to the generally accepted standards of experimental design, data collection, and analysis.
SEC. 9.Section 3644 of the Business and Professions Code is amended to read:3644.This chapter does not prevent or restrict the practice, services, or activities of any of the following:
(a)A person licensed, certified, or otherwise recognized in this state by any other law or regulation if that person is engaged in the profession or occupation for which he or she is licensed, certified, or otherwise recognized.
(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 rendering aid to a family member or in an emergency, if no fee or other consideration for the service is charged, received, expected, or contemplated.
(d)(1)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.
(2)An unlicensed person described in this subdivision may represent that he or she practices naturopathy if he or she complies with Section 2053.6. However, an unlicensed person may not use the title naturopathic doctor unless he or she has been issued a license by the committee.
(e)A person engaged in good faith in the practice of the religious tenets of any church or religious belief without using prescription drugs.
(f)A person acting in good faith for religious reasons as a matter of conscience or based on a personal belief, while obtaining or providing information regarding health care and the use of any product described in subdivision (d).
(g)A person who provides the following recommendations regarding the human body and its function:
(1)Nonprescription products.
(2)Natural elements such as air, heat, water, and light.
(3)Class I or class II nonprescription, approved medical devices, as defined in Section 360c of Title 21 of the United States Code.
(4)Vitamins, minerals, herbs, homeopathics, natural food products and their extracts, and nutritional supplements.
(h)A person who is licensed in another state, territory, or the District of Columbia to practice naturopathic medicine if the person is incidentally called into this state for consultation with a naturopathic doctor.
(i)A student enrolled in an approved naturopathic medical program whose services are performed pursuant to a course of instruction under the supervision of a naturopathic doctor.
SEC. 10.Section 3645 of the Business and Professions Code is amended to read:3645.(a)This chapter permits, and does not restrict, the use of the following titles by persons who are educated and trained as any of the following:
(1)Naturopath.
(2)Naturopathic practitioner.
(3)Traditional naturopathic practitioner.
(b)This chapter permits, and does not restrict, the education of persons as described in paragraphs (1) to (3), inclusive, of subdivision (a). Those persons are not required to be licensed under this chapter.
SEC. 11.Section 3660 of the Business and Professions Code is amended to read:3660.Except as provided in subdivision (h) of Section 3644, a person shall have a valid, unrevoked, or unsuspended license issued under this chapter to do any of the following:
(a)To claim to be a naturopathic doctor, licensed naturopathic doctor, doctor of naturopathic medicine, doctor of naturopathy, or naturopathic medical doctor.
(b)To use the professional designation N.D. or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor.
SEC. 12.Section 3680 of the Business and Professions Code is amended to read:3680.(a)The application fee for a doctor of naturopathic medicine shall be no more than four hundred dollars ($400).
(b)The initial license fee shall be no more than eight hundred dollars ($800).
(c)The renewal fee for a license shall be no more than eight hundred dollars ($800).
(d)The late renewal fee for a license shall be no more than one hundred fifty dollars ($150).
(e)The fee for processing fingerprint cards shall be the current fee charged by the Department of Justice.
(f)The fee for a duplicate or replacement license shall be no more than twenty-five dollars ($25).
SEC. 13.Section 3686 of the Business and Professions Code is amended to read:3686.This chapter shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 14.Section 3710 of the Business and Professions Code is amended to read:3710.(a)The Respiratory Care Board of California, hereafter referred to as the board, shall enforce and administer this chapter.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed. Notwithstanding any other law, the repeal of this section renders the board subject to review by the appropriate policy committees of the Legislature.
SEC. 15.Section 3716 of the Business and Professions Code is amended to read:3716.(a)The board may employ an executive officer exempt from civil service and, subject to the provisions of law relating to civil service, clerical assistants and, except as provided in Section 159.5, other employees as it may deem necessary to carry out its powers and duties.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 16.Section 3772 of the Business and Professions Code is amended to read:3772.There is established in the State Treasury the Respiratory Care Fund. All collections from persons licensed or seeking to be licensed under this chapter shall be paid by the board into the fund after the report to the Controller at the beginning of each month of the amount and source of the collections. Moneys in the fund shall be available to the board, upon appropriation by the Legislature.
(a)For the purpose of determining uniform standards that will be used by healing arts boards in dealing with substance-abusing licensees, there is established in the Department of Consumer Affairs the Substance Abuse Coordination Committee. The committee shall be comprised of the executive officers of the departments healing arts boards established pursuant to Division 2 (commencing with Section 500), the State Board of Chiropractic Examiners, the Osteopathic Medical Board of California, and a designee of the State Department of Health Care Services. The Director of Consumer Affairs shall chair the committee and may invite individuals or stakeholders who have particular expertise in the area of substance abuse to advise the committee.
(b)The committee shall be subject to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Division 3 of Title 2 of the Government Code).
(c)By January 1, 2010, the committee shall formulate uniform and specific standards in each of the following areas that each healing arts board shall use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program:
(1)Specific requirements for a clinical diagnostic evaluation of the licensee, including, but not limited to, required qualifications for the providers evaluating the licensee.
(2)Specific requirements for the temporary removal of the licensee from practice, in order to enable the licensee to undergo the clinical diagnostic evaluation described in paragraph (1) and any treatment recommended by the evaluator described in paragraph (1) and approved by the board, and specific criteria that the licensee must meet before being permitted to return to practice on a full-time or part-time basis.
(3)Specific requirements that govern the ability of the licensing board to communicate with the licensees employer about the licensees status and condition.
(4)Standards governing all aspects of required testing, including, but not limited to, frequency of testing, randomness, method of notice to the licensee, number of hours between the provision of notice and the test, standards for specimen collectors, procedures used by specimen collectors, the permissible locations of testing, whether the collection process must be observed by the collector, backup testing requirements when the licensee is on vacation or otherwise unavailable for local testing, requirements for the laboratory that analyzes the specimens, and the required maximum timeframe from the test to the receipt of the result of the test.
(5)Standards governing all aspects of group meeting attendance requirements, including, but not limited to, required qualifications for group meeting facilitators, frequency of required meeting attendance, and methods of documenting and reporting attendance or nonattendance by licensees.
(6)Standards used in determining whether inpatient, outpatient, or other type of treatment is necessary.
(7)Worksite monitoring requirements and standards, including, but not limited to, required qualifications of worksite monitors, required methods of monitoring by worksite monitors, and required reporting by worksite monitors.
(8)Procedures to be followed when a licensee tests positive for a banned substance.
(9)Procedures to be followed when a licensee is confirmed to have ingested a banned substance.
(10)Specific consequences for major violations and minor violations. In particular, the committee shall consider the use of a deferred prosecution stipulation similar to the stipulation described in Section 1000 of the Penal Code, in which the licensee admits to self-abuse of drugs or alcohol and surrenders his or her license. That agreement is deferred by the agency unless or until the licensee commits a major violation, in which case it is revived and the license is surrendered.
(11)Criteria that a licensee must meet in order to petition for return to practice on a full-time basis.
(12)Criteria that a licensee must meet in order to petition for reinstatement of a full and unrestricted license.
(13)If a board uses a private-sector vendor that provides diversion services, standards for immediate reporting by the vendor to the board of any and all noncompliance with any term of the diversion contract or probation; standards for the vendors approval process for providers or contractors that provide diversion services, including, but not limited to, specimen collectors, group meeting facilitators, and worksite monitors; standards requiring the vendor to disapprove and discontinue the use of providers or contractors that fail to provide effective or timely diversion services; and standards for a licensees termination from the program and referral to enforcement.
(14)If a board uses a private-sector vendor that provides diversion services, the extent to which licensee participation in that program shall be kept confidential from the public.
(15)If a board uses a private-sector vendor that provides diversion services, a schedule for external independent audits of the vendors performance in adhering to the standards adopted by the committee.
(16)Measurable criteria and standards to determine whether each boards method of dealing with substance-abusing licensees protects patients from harm and is effective in assisting its licensees in recovering from substance abuse in the long term.
(d)Notwithstanding any other law, by January 1, 2019, the committee shall review the existing criteria for Uniform Standard #4 established pursuant to paragraph (4) of subdivision (c). The committees review and findings shall determine whether the existing criteria for Uniform Standard #4 should be updated to reflect recent developments in testing research and technology. The committee shall consider information from, but not limited to, the American Society of Addiction Medicine, and other sources of best practices.
SEC. 2.Section 2450.3 of the Business and Professions Code is amended to read:2450.3.There is within the jurisdiction of the Osteopathic Medical Board of California a Naturopathic Medicine Committee authorized under the Naturopathic Doctors Act (Chapter 8.2 (commencing with Section 3610)). This section shall become inoperative on January 1, 2022, and as of that date is repealed. Notwithstanding any other provision of law, the repeal of this section renders the Naturopathic Medicine Committee subject to review by the appropriate policy committees of the Legislature.
SEC. 3.Section 3621 of the Business and Professions Code is amended to read:3621.(a)The committee shall consist of nine members, consisting of seven professional members appointed by the Governor, one public member appointed by the Senate Committee on Rules, and one public member appointed by the Speaker of the Assembly. Members of the committee shall include five members who are California licensed naturopathic doctors, two members who are California licensed physicians and surgeons, and two public members.
(b)A member of the committee shall be appointed for a four-year term. A person shall not serve as a member of the committee for more than two consecutive terms. A member shall hold office until the appointment and qualification of his or her successor, or until one year from the expiration of the term for which the member was appointed, whichever first occurs. Vacancies shall be filled by appointment for unexpired terms.
(c)(1)A public member of the committee shall be a resident of this state for at least five years preceding his or her appointment.
(2)A person shall not be appointed as a public member if the person or the persons immediate family in any manner owns an interest in a college, school, or institution engaged in naturopathic education, or the person or the persons immediate family has an economic interest in naturopathy or has any other conflict of interest. Immediate family means the public members spouse, parents, children, or his or her childrens spouses.
(d)Each member of the committee shall receive a per diem and expenses as provided in Section 103.
(e)The committee may appoint a person exempt from civil service who shall be designated as an executive officer and who shall exercise the powers and perform the duties delegated by the committee and vested in him or her by this chapter.
SEC. 4.Section 3623 of the Business and Professions Code is amended to read:3623.(a)The committee 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 bachelors degree from a regionally accredited or preaccredited college or university or the equivalency, as determined by the council.
(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. Of the total requisite hours, not less than 2,500 hours shall consist of academic instruction, and not less than 1,200 hours shall consist of supervised clinical training approved by the naturopathic medical school.
(b)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 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 equivalent federally recognized accrediting body for naturopathic doctor education.
(c)To qualify as an approved naturopathic medical school, a naturopathic medical program located in Canada or the United States shall offer a full-time, doctoral-level, naturopathic medical education program with its graduates being eligible to apply to the committee for licensure and to the North American Board of Naturopathic Examiners that administers the naturopathic licensing examination.
(d)The naturopathic medical program shall evaluate an applicants education, training, and experience obtained in the armed services, pursuant to Section 35, and provide course credit where applicable.
SEC. 5.Section 3630 of the Business and Professions Code is amended to read:3630.An applicant for a license as a naturopathic doctor shall file an application with the committee on a form provided by the committee that shows, to the committees satisfaction, compliance with all of the following requirements:
(a)The applicant has not committed an act or crime that constitutes grounds for denial of a license under Section 480, and has complied with the requirements of Section 144.
(b)The applicant has received a degree in naturopathic medicine from an approved naturopathic medical school where the degree substantially meets the educational requirements in paragraph (2) of subdivision (a) of Section 3623.
SEC. 6.Section 3635 of the Business and Professions Code is amended to read:3635.(a)In addition to any other qualifications and requirements for licensure renewal, the committee shall require the satisfactory completion of 60 hours of approved continuing education biennially. This requirement is waived for the initial license renewal. The continuing education shall meet the following requirements:
(1)At least 20 hours shall be in pharmacotherapeutics.
(2)No more than 15 hours may be in naturopathic medical journals or osteopathic or allopathic medical journals, or audio or videotaped presentations, slides, programmed instruction, or computer-assisted instruction or preceptorships.
(3)No more than 20 hours may be in any single topic.
(4)No more than 15 hours of the continuing education requirements for the specialty certificate in naturopathic childbirth attendance shall apply to the 60 hours of continuing education requirement.
(5)Course content shall pertain to the practice of naturopathic, osteopathic, or allopathic medicine.
(b)The continuing education requirements of this section may be met through continuing education courses approved by the committee, the California Naturopathic Doctors Association, the American Association of Naturopathic Physicians, the California State Board of Pharmacy, the State Board of Chiropractic Examiners, or other courses that meet the standards for continuing education for licensed physicians and surgeons in California. All continuing education providers shall comply with Section 3635.2. Continuing education providers shall submit an annual declaration to the committee that their educational activities satisfy the requirements described in Section 3635.2 and the committee shall maintain a list of these providers on its Internet Web site.
SEC. 7.Section 3635.1 is added to the Business and Professions Code, to read:3635.1.(a)A licensee shall retain certificates of continuing education course completion for six years.
(b)The committee may audit licensees continuing education records to ensure that continuing education requirements are met.
(c)It shall be unprofessional conduct for a licensee to furnish false or misleading information to the committee regarding continuing education.
SEC. 8.Section 3635.2 is added to the Business and Professions Code, to read:3635.2.In addition to complying with subdivision (b) of Section 3635, the following shall apply to providers of continuing education:
(a)The content of continuing education courses and related materials shall provide balance, independence, objectivity, and scientific rigor. All patient care recommendations from continuing education courses involving clinical medicine shall be based on evidence accepted by naturopathic doctors. All scientific research used to support patient care recommendations shall conform to generally accepted standards of experimental design, data collection, and analysis.
(b)A conflict of interest is created when an individual in a position to control the content of a continuing education course, or his or her spouse or partner, has a relevant personal financial relationship within the past 12 months with a commercial entity that produces, markets, resells, or distributes health care goods or services consumed by, or used on patients that benefits the individual in any financial amount and therefore, may bias his or her opinions and teachings with respect to the content of continuing education courses. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest such as stocks, stock options or other ownership interest, excluding diversified mutual funds, or other financial benefit. Financial benefits are generally associated with roles such as employment, a management position, or an independent contractor position, including contracted research and clinical trials, consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected.
(c)Prior to a course being presented, continuing education providers shall identify, disclose, and resolve all conflicts of interest. Individuals who fail or refuse to disclose relevant financial relationships shall not be approved as a provider of continuing education as described in subdivision (b) of Section 3635.
(d)Conflicts of interests shall be resolved by one of the following mechanisms:
(1)Altering financial relationships. Individuals may change their relationships with commercial interests, such as discontinuance of contracted services, thereby eliminating any conflict of interest related to the continuing education content.
(2)Altering control over content. An individuals control of continuing education content may be altered in several ways to remove the opportunity to affect content related to the products and services of a commercial interest. These include the following:
(A)Choose someone else to control that part of the content. If a proposed presenter or planner has a conflict of interest related to the content, someone else who does not have a relationship to the commercial interests related to the content may present or plan that part of the content.
(B)Change the focus of the continuing education activity so that the content is not about products or services of the commercial interest that is the basis of the conflict of interest.
(C)Change the content of the individuals assignment so that it is no longer about products or services of the commercial interest. For example, an individual with a conflict of interest regarding products for treatment of a condition could address the pathophysiology or diagnosis of the condition, rather than therapeutics.
(D)Limit the content to a report without recommendations. If an individual has been funded by a commercial entity to perform research, the individuals presentation may be limited to the data and results of the research. Someone else may be assigned to address broader implications and recommendations.
(E)Limit the sources for recommendations. Rather than having a person with a conflict of interest present personal recommendations or personally select the evidence to be presented, limit the role of the person to reporting recommendations based on formal structured reviews of the literature with the inclusion and exclusion criteria stated evidence-based.
(3)Conflict of interest may be resolved if the continuing education material is peer reviewed and both of the following are met:
(A)All the recommendations involving clinical medicine are based on evidence that is accepted within the profession of naturopathic medicine as adequate justification for indications and contraindications in the care of patients.
(B)All scientific research referred to, reported, or used in the continuing education activity in support or justification of patient care recommendations conforms to the generally accepted standards of experimental design, data collection, and analysis.
SEC. 9.Section 3644 of the Business and Professions Code is amended to read:3644.This chapter does not prevent or restrict the practice, services, or activities of any of the following:
(a)A person licensed, certified, or otherwise recognized in this state by any other law or regulation if that person is engaged in the profession or occupation for which he or she is licensed, certified, or otherwise recognized.
(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 rendering aid to a family member or in an emergency, if no fee or other consideration for the service is charged, received, expected, or contemplated.
(d)(1)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.
(2)An unlicensed person described in this subdivision may represent that he or she practices naturopathy if he or she complies with Section 2053.6. However, an unlicensed person may not use the title naturopathic doctor unless he or she has been issued a license by the committee.
(e)A person engaged in good faith in the practice of the religious tenets of any church or religious belief without using prescription drugs.
(f)A person acting in good faith for religious reasons as a matter of conscience or based on a personal belief, while obtaining or providing information regarding health care and the use of any product described in subdivision (d).
(g)A person who provides the following recommendations regarding the human body and its function:
(1)Nonprescription products.
(2)Natural elements such as air, heat, water, and light.
(3)Class I or class II nonprescription, approved medical devices, as defined in Section 360c of Title 21 of the United States Code.
(4)Vitamins, minerals, herbs, homeopathics, natural food products and their extracts, and nutritional supplements.
(h)A person who is licensed in another state, territory, or the District of Columbia to practice naturopathic medicine if the person is incidentally called into this state for consultation with a naturopathic doctor.
(i)A student enrolled in an approved naturopathic medical program whose services are performed pursuant to a course of instruction under the supervision of a naturopathic doctor.
SEC. 10.Section 3645 of the Business and Professions Code is amended to read:3645.(a)This chapter permits, and does not restrict, the use of the following titles by persons who comply with subdivision (c) and are educated and trained as any of the following:
(1)Naturopath.
(2)Naturopathic practitioner.
(3)Traditional naturopathic practitioner.
(b)This chapter permits, and does not restrict, the education of persons as described in paragraphs (1) to (3), inclusive, of subdivision (a). Those persons are not required to be licensed under this chapter.
(c)An unlicensed person may use the titles specified in subdivision (a) if the unlicensed person does all of the following:(1)Complies with Section 2053.6.(2)Provides a conspicuous disclosure in all marketing, advertisements, and other related materials that states, in plain language, that the person is not licensed by the Naturopathic Medicine Committee as a naturopathic doctor.(3)Obtains verbal confirmation that the client understands that the person is not licensed as a naturopathic doctor prior to providing advice or arranging for services related to the practice of naturopathy over the phone.SEC. 11.Section 3660 of the Business and Professions Code is amended to read:3660.Except as provided in subdivision (h) of Section 3644, a person shall have a valid, unrevoked, or unsuspended license issued under this chapter to do any of the following:
(a)To claim to be a naturopathic doctor, licensed naturopathic doctor, doctor of naturopathic medicine, doctor of naturopathy, or naturopathic medical doctor.
(b)To use the professional designation N.D. or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor.
SEC. 12.Section 3680 of the Business and Professions Code is amended to read:3680.(a)The application fee for a doctor of naturopathic medicine shall be no more than four hundred dollars ($400).
(b)The initial license fee shall be no more than eight hundred dollars ($800).
(c)The renewal fee for a license shall be no more than eight hundred dollars ($800).
(d)The late renewal fee for a license shall be no more than one hundred fifty dollars ($150).
(e)The fee for processing fingerprint cards shall be the current fee charged by the Department of Justice.
(f)The fee for a duplicate or replacement license shall be no more than twenty-five dollars ($25).
SEC. 13.Section 3686 of the Business and Professions Code is amended to read:3686.This chapter shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 14.Section 3710 of the Business and Professions Code is amended to read:3710.(a)The Respiratory Care Board of California, hereafter referred to as the board, shall enforce and administer this chapter.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed. Notwithstanding any other law, the repeal of this section renders the board subject to review by the appropriate policy committees of the Legislature.
SEC. 15.Section 3716 of the Business and Professions Code is amended to read:3716.(a)The board may employ an executive officer exempt from civil service and, subject to the provisions of law relating to civil service, clerical assistants and, except as provided in Section 159.5, other employees as it may deem necessary to carry out its powers and duties.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 16.Section 3772 of the Business and Professions Code is amended to read:3772.There is established in the State Treasury the Respiratory Care Fund. All collections from persons licensed or seeking to be licensed under this chapter shall be paid by the board into the fund after the report to the Controller at the beginning of each month of the amount and source of the collections. Moneys in the fund shall be available to the board, upon appropriation by the Legislature.
SEC. 17.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.(a)For the purpose of determining uniform standards that will be used by healing arts boards in dealing with substance-abusing licensees, there is established in the Department of Consumer Affairs the Substance Abuse Coordination Committee. The committee shall be comprised of the executive officers of the departments healing arts boards established pursuant to Division 2 (commencing with Section 500), the State Board of Chiropractic Examiners, the Osteopathic Medical Board of California, and a designee of the State Department of Health Care Services. The Director of Consumer Affairs shall chair the committee and may invite individuals or stakeholders who have particular expertise in the area of substance abuse to advise the committee.
(b)The committee shall be subject to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Division 3 of Title 2 of the Government Code).
(c)By January 1, 2010, the committee shall formulate uniform and specific standards in each of the following areas that each healing arts board shall use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program:
(1)Specific requirements for a clinical diagnostic evaluation of the licensee, including, but not limited to, required qualifications for the providers evaluating the licensee.
(2)Specific requirements for the temporary removal of the licensee from practice, in order to enable the licensee to undergo the clinical diagnostic evaluation described in paragraph (1) and any treatment recommended by the evaluator described in paragraph (1) and approved by the board, and specific criteria that the licensee must meet before being permitted to return to practice on a full-time or part-time basis.
(3)Specific requirements that govern the ability of the licensing board to communicate with the licensees employer about the licensees status and condition.
(4)Standards governing all aspects of required testing, including, but not limited to, frequency of testing, randomness, method of notice to the licensee, number of hours between the provision of notice and the test, standards for specimen collectors, procedures used by specimen collectors, the permissible locations of testing, whether the collection process must be observed by the collector, backup testing requirements when the licensee is on vacation or otherwise unavailable for local testing, requirements for the laboratory that analyzes the specimens, and the required maximum timeframe from the test to the receipt of the result of the test.
(5)Standards governing all aspects of group meeting attendance requirements, including, but not limited to, required qualifications for group meeting facilitators, frequency of required meeting attendance, and methods of documenting and reporting attendance or nonattendance by licensees.
(6)Standards used in determining whether inpatient, outpatient, or other type of treatment is necessary.
(7)Worksite monitoring requirements and standards, including, but not limited to, required qualifications of worksite monitors, required methods of monitoring by worksite monitors, and required reporting by worksite monitors.
(8)Procedures to be followed when a licensee tests positive for a banned substance.
(9)Procedures to be followed when a licensee is confirmed to have ingested a banned substance.
(10)Specific consequences for major violations and minor violations. In particular, the committee shall consider the use of a deferred prosecution stipulation similar to the stipulation described in Section 1000 of the Penal Code, in which the licensee admits to self-abuse of drugs or alcohol and surrenders his or her license. That agreement is deferred by the agency unless or until the licensee commits a major violation, in which case it is revived and the license is surrendered.
(11)Criteria that a licensee must meet in order to petition for return to practice on a full-time basis.
(12)Criteria that a licensee must meet in order to petition for reinstatement of a full and unrestricted license.
(13)If a board uses a private-sector vendor that provides diversion services, standards for immediate reporting by the vendor to the board of any and all noncompliance with any term of the diversion contract or probation; standards for the vendors approval process for providers or contractors that provide diversion services, including, but not limited to, specimen collectors, group meeting facilitators, and worksite monitors; standards requiring the vendor to disapprove and discontinue the use of providers or contractors that fail to provide effective or timely diversion services; and standards for a licensees termination from the program and referral to enforcement.
(14)If a board uses a private-sector vendor that provides diversion services, the extent to which licensee participation in that program shall be kept confidential from the public.
(15)If a board uses a private-sector vendor that provides diversion services, a schedule for external independent audits of the vendors performance in adhering to the standards adopted by the committee.
(16)Measurable criteria and standards to determine whether each boards method of dealing with substance-abusing licensees protects patients from harm and is effective in assisting its licensees in recovering from substance abuse in the long term.
(d)Notwithstanding any other law, by January 1, 2019, the committee shall review the existing criteria for Uniform Standard #4 established pursuant to paragraph (4) of subdivision (c). The committees review and findings shall determine whether the existing criteria for Uniform Standard #4 should be updated to reflect recent developments in testing research and technology. The committee shall consider information from, but not limited to, the American Society of Addiction Medicine, and other sources of best practices.
SEC. 2.Section 2450.3 of the Business and Professions Code is amended to read:2450.3.There is within the jurisdiction of the Osteopathic Medical Board of California a Naturopathic Medicine Committee authorized under the Naturopathic Doctors Act (Chapter 8.2 (commencing with Section 3610)). This section shall become inoperative on January 1, 2022, and as of that date is repealed. Notwithstanding any other provision of law, the repeal of this section renders the Naturopathic Medicine Committee subject to review by the appropriate policy committees of the Legislature.
SEC. 3.Section 3621 of the Business and Professions Code is amended to read:3621.(a)The committee shall consist of nine members, consisting of seven professional members appointed by the Governor, one public member appointed by the Senate Committee on Rules, and one public member appointed by the Speaker of the Assembly. Members of the committee shall include five members who are California licensed naturopathic doctors, two members who are California licensed physicians and surgeons, and two public members.
(b)A member of the committee shall be appointed for a four-year term. A person shall not serve as a member of the committee for more than two consecutive terms. A member shall hold office until the appointment and qualification of his or her successor, or until one year from the expiration of the term for which the member was appointed, whichever first occurs. Vacancies shall be filled by appointment for unexpired terms.
(c)(1)A public member of the committee shall be a resident of this state for at least five years preceding his or her appointment.
(2)A person shall not be appointed as a public member if the person or the persons immediate family in any manner owns an interest in a college, school, or institution engaged in naturopathic education, or the person or the persons immediate family has an economic interest in naturopathy or has any other conflict of interest. Immediate family means the public members spouse, parents, children, or his or her childrens spouses.
(d)Each member of the committee shall receive a per diem and expenses as provided in Section 103.
(e)The committee may appoint a person exempt from civil service who shall be designated as an executive officer and who shall exercise the powers and perform the duties delegated by the committee and vested in him or her by this chapter.
SEC. 4.Section 3623 of the Business and Professions Code is amended to read:3623.(a)The committee 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 bachelors degree from a regionally accredited or preaccredited college or university or the equivalency, as determined by the council.
(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. Of the total requisite hours, not less than 2,500 hours shall consist of academic instruction, and not less than 1,200 hours shall consist of supervised clinical training approved by the naturopathic medical school.
(b)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 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 equivalent federally recognized accrediting body for naturopathic doctor education.
(c)To qualify as an approved naturopathic medical school, a naturopathic medical program located in Canada or the United States shall offer a full-time, doctoral-level, naturopathic medical education program with its graduates being eligible to apply to the committee for licensure and to the North American Board of Naturopathic Examiners that administers the naturopathic licensing examination.
(d)The naturopathic medical program shall evaluate an applicants education, training, and experience obtained in the armed services, pursuant to Section 35, and provide course credit where applicable.
SEC. 5.Section 3630 of the Business and Professions Code is amended to read:3630.An applicant for a license as a naturopathic doctor shall file an application with the committee on a form provided by the committee that shows, to the committees satisfaction, compliance with all of the following requirements:
(a)The applicant has not committed an act or crime that constitutes grounds for denial of a license under Section 480, and has complied with the requirements of Section 144.
(b)The applicant has received a degree in naturopathic medicine from an approved naturopathic medical school where the degree substantially meets the educational requirements in paragraph (2) of subdivision (a) of Section 3623.
SEC. 6.Section 3635 of the Business and Professions Code is amended to read:3635.(a)In addition to any other qualifications and requirements for licensure renewal, the committee shall require the satisfactory completion of 60 hours of approved continuing education biennially. This requirement is waived for the initial license renewal. The continuing education shall meet the following requirements:
(1)At least 20 hours shall be in pharmacotherapeutics.
(2)No more than 15 hours may be in naturopathic medical journals or osteopathic or allopathic medical journals, or audio or videotaped presentations, slides, programmed instruction, or computer-assisted instruction or preceptorships.
(3)No more than 20 hours may be in any single topic.
(4)No more than 15 hours of the continuing education requirements for the specialty certificate in naturopathic childbirth attendance shall apply to the 60 hours of continuing education requirement.
(5)Course content shall pertain to the practice of naturopathic, osteopathic, or allopathic medicine.
(b)The continuing education requirements of this section may be met through continuing education courses approved by the committee, the California Naturopathic Doctors Association, the American Association of Naturopathic Physicians, the California State Board of Pharmacy, the State Board of Chiropractic Examiners, or other courses that meet the standards for continuing education for licensed physicians and surgeons in California. All continuing education providers shall comply with Section 3635.2. Continuing education providers shall submit an annual declaration to the committee that their educational activities satisfy the requirements described in Section 3635.2 and the committee shall maintain a list of these providers on its Internet Web site.
SEC. 7.Section 3635.1 is added to the Business and Professions Code, to read:3635.1.(a)A licensee shall retain certificates of continuing education course completion for six years.
(b)The committee may audit licensees continuing education records to ensure that continuing education requirements are met.
(c)It shall be unprofessional conduct for a licensee to furnish false or misleading information to the committee regarding continuing education.
SEC. 8.Section 3635.2 is added to the Business and Professions Code, to read:3635.2.In addition to complying with subdivision (b) of Section 3635, the following shall apply to providers of continuing education:
(a)The content of continuing education courses and related materials shall provide balance, independence, objectivity, and scientific rigor. All patient care recommendations from continuing education courses involving clinical medicine shall be based on evidence accepted by naturopathic doctors. All scientific research used to support patient care recommendations shall conform to generally accepted standards of experimental design, data collection, and analysis.
(b)A conflict of interest is created when an individual in a position to control the content of a continuing education course, or his or her spouse or partner, has a relevant personal financial relationship within the past 12 months with a commercial entity that produces, markets, resells, or distributes health care goods or services consumed by, or used on patients that benefits the individual in any financial amount and therefore, may bias his or her opinions and teachings with respect to the content of continuing education courses. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest such as stocks, stock options or other ownership interest, excluding diversified mutual funds, or other financial benefit. Financial benefits are generally associated with roles such as employment, a management position, or an independent contractor position, including contracted research and clinical trials, consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected.
(c)Prior to a course being presented, continuing education providers shall identify, disclose, and resolve all conflicts of interest. Individuals who fail or refuse to disclose relevant financial relationships shall not be approved as a provider of continuing education as described in subdivision (b) of Section 3635.
(d)Conflicts of interests shall be resolved by one of the following mechanisms:
(1)Altering financial relationships. Individuals may change their relationships with commercial interests, such as discontinuance of contracted services, thereby eliminating any conflict of interest related to the continuing education content.
(2)Altering control over content. An individuals control of continuing education content may be altered in several ways to remove the opportunity to affect content related to the products and services of a commercial interest. These include the following:
(A)Choose someone else to control that part of the content. If a proposed presenter or planner has a conflict of interest related to the content, someone else who does not have a relationship to the commercial interests related to the content may present or plan that part of the content.
(B)Change the focus of the continuing education activity so that the content is not about products or services of the commercial interest that is the basis of the conflict of interest.
(C)Change the content of the individuals assignment so that it is no longer about products or services of the commercial interest. For example, an individual with a conflict of interest regarding products for treatment of a condition could address the pathophysiology or diagnosis of the condition, rather than therapeutics.
(D)Limit the content to a report without recommendations. If an individual has been funded by a commercial entity to perform research, the individuals presentation may be limited to the data and results of the research. Someone else may be assigned to address broader implications and recommendations.
(E)Limit the sources for recommendations. Rather than having a person with a conflict of interest present personal recommendations or personally select the evidence to be presented, limit the role of the person to reporting recommendations based on formal structured reviews of the literature with the inclusion and exclusion criteria stated evidence-based.
(3)Conflict of interest may be resolved if the continuing education material is peer reviewed and both of the following are met:
(A)All the recommendations involving clinical medicine are based on evidence that is accepted within the profession of naturopathic medicine as adequate justification for indications and contraindications in the care of patients.
(B)All scientific research referred to, reported, or used in the continuing education activity in support or justification of patient care recommendations conforms to the generally accepted standards of experimental design, data collection, and analysis.
SEC. 9.Section 3644 of the Business and Professions Code is amended to read:3644.This chapter does not prevent or restrict the practice, services, or activities of any of the following:
(a)A person licensed, certified, or otherwise recognized in this state by any other law or regulation if that person is engaged in the profession or occupation for which he or she is licensed, certified, or otherwise recognized.
(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 rendering aid to a family member or in an emergency, if no fee or other consideration for the service is charged, received, expected, or contemplated.
(d)(1)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.
(2)An unlicensed person described in this subdivision may represent that he or she practices naturopathy if he or she complies with Section 2053.6. However, an unlicensed person may not use the title naturopathic doctor unless he or she has been issued a license by the committee.
(e)A person engaged in good faith in the practice of the religious tenets of any church or religious belief without using prescription drugs.
(f)A person acting in good faith for religious reasons as a matter of conscience or based on a personal belief, while obtaining or providing information regarding health care and the use of any product described in subdivision (d).
(g)A person who provides the following recommendations regarding the human body and its function:
(1)Nonprescription products.
(2)Natural elements such as air, heat, water, and light.
(3)Class I or class II nonprescription, approved medical devices, as defined in Section 360c of Title 21 of the United States Code.
(4)Vitamins, minerals, herbs, homeopathics, natural food products and their extracts, and nutritional supplements.
(h)A person who is licensed in another state, territory, or the District of Columbia to practice naturopathic medicine if the person is incidentally called into this state for consultation with a naturopathic doctor.
(i)A student enrolled in an approved naturopathic medical program whose services are performed pursuant to a course of instruction under the supervision of a naturopathic doctor.
SEC. 10.Section 3645 of the Business and Professions Code is repealed.SEC. 10.Section 3645 of the Business and Professions Code is amended to read:3645.(a)This chapter permits, and does not restrict restrict, the use of, of the following titles by persons who comply with subdivision (c) and are educated and trained as any of the following:
(1)Naturopath.
(2)Naturopathic practitioner.
(3)Traditional naturopathic practitioner.
(b)This chapter permits, and does not restrict, the education of persons as described in paragraphs (1) to (3), inclusive, of subdivision (a). Those persons are not required to be licensed under this chapter.
(c)An unlicensed person may use the titles specified in subdivision (a) if the unlicensed person does all of the following:
(1)Complies with Section 2053.6.
(2)Provides a conspicuous disclosure in all marketing, advertisements, and other related materials that states, in plain language, that the person is not licensed by the Naturopathic Medicine Committee as a naturopathic doctor.
(3)Obtains verbal confirmation that the client understands that the person is not licensed as a naturopathic doctor prior to providing advice or arranging for services related to the practice of naturopathy over the phone.
SEC. 11.Section 3660 of the Business and Professions Code is amended to read:3660.Except as provided in subdivision (h) of Section 3644, a person shall have a valid, unrevoked, or unsuspended license issued under this chapter to do any of the following:
(a)To claim to be a naturopathic doctor, licensed naturopathic doctor, doctor of naturopathic medicine, doctor of naturopathy, or naturopathic medical doctor.
(b)To use the professional designation N.D., naturopath, naturopathic practitioner, traditional naturopathic practitioner, N.D. or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor.
(c)Until January 1, 2020, the use of the terms naturopath, naturopathic practitioner, and traditional naturopathic practitioner may be used in marketing, advertisements, and other related materials by persons who are educated and trained, but not licensed, to practice naturopathy pursuant to this chapter. Individuals shall not be disciplined for the misuse of titles not under their control.SEC. 12.Section 3680 of the Business and Professions Code is amended to read:3680.(a)The application fee for a doctor of naturopathic medicine shall be no more than four hundred dollars ($400).
(b)The initial license fee shall be no more than eight hundred dollars ($800).
(c)The renewal fee for a license shall be no more than eight hundred dollars ($800).
(d)The late renewal fee for a license shall be no more than one hundred fifty dollars ($150).
(e)The fee for processing fingerprint cards shall be the current fee charged by the Department of Justice.
(f)The fee for a duplicate or replacement license shall be no more than twenty-five dollars ($25).
SEC. 13.Section 3686 of the Business and Professions Code is amended to read:3686.This chapter shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 14.Section 3710 of the Business and Professions Code is amended to read:3710.(a)The Respiratory Care Board of California, hereafter referred to as the board, shall enforce and administer this chapter.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed. Notwithstanding any other law, the repeal of this section renders the board subject to review by the appropriate policy committees of the Legislature.
SEC. 15.Section 3716 of the Business and Professions Code is amended to read:3716.(a)The board may employ an executive officer exempt from civil service and, subject to the provisions of law relating to civil service, clerical assistants and, except as provided in Section 159.5, other employees as it may deem necessary to carry out its powers and duties.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 16.Section 3772 of the Business and Professions Code is amended to read:3772.There is established in the State Treasury the Respiratory Care Fund. All collections from persons licensed or seeking to be licensed under this chapter shall be paid by the board into the fund after the report to the Controller at the beginning of each month of the amount and source of the collections. Moneys in the fund shall be available to the board, upon appropriation by the Legislature.
SEC. 17.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
(a)For the purpose of determining uniform standards that will be used by healing arts boards in dealing with substance-abusing licensees, there is established in the Department of Consumer Affairs the Substance Abuse Coordination Committee. The committee shall be comprised of the executive officers of the departments healing arts boards established pursuant to Division 2 (commencing with Section 500), the State Board of Chiropractic Examiners, the Osteopathic Medical Board of California, and a designee of the State Department of Health Care Services. The Director of Consumer Affairs shall chair the committee and may invite individuals or stakeholders who have particular expertise in the area of substance abuse to advise the committee.
(b)The committee shall be subject to the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Division 3 of Title 2 of the Government Code).
(c)By January 1, 2010, the committee shall formulate uniform and specific standards in each of the following areas that each healing arts board shall use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program:
(1)Specific requirements for a clinical diagnostic evaluation of the licensee, including, but not limited to, required qualifications for the providers evaluating the licensee.
(2)Specific requirements for the temporary removal of the licensee from practice, in order to enable the licensee to undergo the clinical diagnostic evaluation described in paragraph (1) and any treatment recommended by the evaluator described in paragraph (1) and approved by the board, and specific criteria that the licensee must meet before being permitted to return to practice on a full-time or part-time basis.
(3)Specific requirements that govern the ability of the licensing board to communicate with the licensees employer about the licensees status and condition.
(4)Standards governing all aspects of required testing, including, but not limited to, frequency of testing, randomness, method of notice to the licensee, number of hours between the provision of notice and the test, standards for specimen collectors, procedures used by specimen collectors, the permissible locations of testing, whether the collection process must be observed by the collector, backup testing requirements when the licensee is on vacation or otherwise unavailable for local testing, requirements for the laboratory that analyzes the specimens, and the required maximum timeframe from the test to the receipt of the result of the test.
(5)Standards governing all aspects of group meeting attendance requirements, including, but not limited to, required qualifications for group meeting facilitators, frequency of required meeting attendance, and methods of documenting and reporting attendance or nonattendance by licensees.
(6)Standards used in determining whether inpatient, outpatient, or other type of treatment is necessary.
(7)Worksite monitoring requirements and standards, including, but not limited to, required qualifications of worksite monitors, required methods of monitoring by worksite monitors, and required reporting by worksite monitors.
(8)Procedures to be followed when a licensee tests positive for a banned substance.
(9)Procedures to be followed when a licensee is confirmed to have ingested a banned substance.
(10)Specific consequences for major violations and minor violations. In particular, the committee shall consider the use of a deferred prosecution stipulation similar to the stipulation described in Section 1000 of the Penal Code, in which the licensee admits to self-abuse of drugs or alcohol and surrenders his or her license. That agreement is deferred by the agency unless or until the licensee commits a major violation, in which case it is revived and the license is surrendered.
(11)Criteria that a licensee must meet in order to petition for return to practice on a full-time basis.
(12)Criteria that a licensee must meet in order to petition for reinstatement of a full and unrestricted license.
(13)If a board uses a private-sector vendor that provides diversion services, standards for immediate reporting by the vendor to the board of any and all noncompliance with any term of the diversion contract or probation; standards for the vendors approval process for providers or contractors that provide diversion services, including, but not limited to, specimen collectors, group meeting facilitators, and worksite monitors; standards requiring the vendor to disapprove and discontinue the use of providers or contractors that fail to provide effective or timely diversion services; and standards for a licensees termination from the program and referral to enforcement.
(14)If a board uses a private-sector vendor that provides diversion services, the extent to which licensee participation in that program shall be kept confidential from the public.
(15)If a board uses a private-sector vendor that provides diversion services, a schedule for external independent audits of the vendors performance in adhering to the standards adopted by the committee.
(16)Measurable criteria and standards to determine whether each boards method of dealing with substance-abusing licensees protects patients from harm and is effective in assisting its licensees in recovering from substance abuse in the long term.
(d)Notwithstanding any other law, by January 1, 2019, the committee shall review the existing criteria for Uniform Standard #4 established pursuant to paragraph (4) of subdivision (c). The committees review and findings shall determine whether the existing criteria for Uniform Standard #4 should be updated to reflect recent developments in testing research and technology. The committee shall consider information from, but not limited to, the American Society of Addiction Medicine, and other sources of best practices.
SECTION 1.SEC. 2.Section 2450.3 of the Business and Professions Code is amended to read:2450.3.There is within the jurisdiction of the Osteopathic Medical Board of California a Naturopathic Medicine Committee authorized under the Naturopathic Doctors Act (Chapter 8.2 (commencing with Section 3610)). This section shall become inoperative on January 1, 2022, and as of that date is repealed. Notwithstanding any other provision of law, the repeal of this section renders the Naturopathic Medicine Committee subject to review by the appropriate policy committees of the Legislature.
SEC. 2.SEC. 3.Section 3621 of the Business and Professions Code is amended to read:3621.(a)The committee shall consist of nine members, consisting of seven professional members appointed by the Governor, one public member appointed by the Senate Committee on Rules, and one public member appointed by the Assembly Committee on Rules. Speaker of the Assembly. Members of the committee shall include five members who are California licensed naturopathic doctors, or have met the requirements for licensure pursuant to this chapter, two members who are California licensed physicians and surgeons, and two public members.
(b)A member of the committee shall be appointed for a four-year term. A person shall not serve as a member of the committee for more than two consecutive terms. A member shall hold office until the appointment and qualification of his or her successor, or until one year from the expiration of the term for which the member was appointed, whichever first occurs. Vacancies shall be filled by appointment for unexpired terms.
(c)(1)A public member of the committee shall be a resident of this state for at least five years preceding his or her appointment.
(2)A person shall not be appointed as a public member if the person or the persons immediate family in any manner owns an interest in a college, school, or institution engaged in naturopathic education, or the person or the persons immediate family has an economic interest in naturopathy or has any other conflict of interest. Immediate family means the public members spouse, parents, children, or his or her childrens spouses.
(d)Each member of the committee shall receive a per diem and expenses as provided in Section 103.
(e)The committee may appoint a person exempt from civil service who shall be designated as an executive officer and who shall exercise the powers and perform the duties delegated by the committee and vested in him or her by this chapter.
SEC. 3.SEC. 4.Section 3623 of the Business and Professions Code is amended to read:3623.(a)The committee 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 bachelors degree from a regionally accredited or preaccredited college or university or the equivalency, as determined by the council.
(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. Of the total requisite hours, not less than 2,500 hours shall consist of academic instruction, and not less than 1,200 hours shall consist of supervised clinical training approved by the naturopathic medical school.
(b)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 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 equivalent federally recognized accrediting body for naturopathic doctor education.
(c)To qualify as an approved naturopathic medical school, a naturopathic medical program located in Canada or the United States shall offer a full-time, doctoral-level, naturopathic medical education program with its graduates being eligible to apply to the committee for licensure and to the North American Board of Naturopathic Examiners that administers the naturopathic licensing examination.
(d)The naturopathic medical program shall evaluate an applicants education, training, and experience obtained in the armed services, pursuant to Section 35, and provide course credit where applicable.
SEC. 4.SEC. 5.Section 3630 of the Business and Professions Code is amended to read:3630.An applicant for a license as a naturopathic doctor shall file an application with the committee on a form provided by the committee that shows, to the committees satisfaction, compliance with all of the following requirements:
(a)The applicant has not committed an act or crime that constitutes grounds for denial of a license under Section 480, and has complied with the requirements of Section 144.
(b)The applicant has received a degree in naturopathic medicine from an approved naturopathic medical school where the degree substantially meets the educational requirements in paragraph (2) of subdivision (a) of Section 3623.
SEC. 6.Section 3635 of the Business and Professions Code is amended to read:3635.(a)In addition to any other qualifications and requirements for licensure renewal, the committee shall require the satisfactory completion of 60 hours of approved continuing education biennially. This requirement is waived for the initial license renewal. The continuing education shall meet the following requirements:
(1)At least 20 hours shall be in pharmacotherapeutics.
(2)No more than 15 hours may be in naturopathic medical journals or osteopathic or allopathic medical journals, or audio or videotaped presentations, slides, programmed instruction, or computer-assisted instruction or preceptorships.
(3)No more than 20 hours may be in any single topic.
(4)No more than 15 hours of the continuing education requirements for the specialty certificate in naturopathic childbirth attendance shall apply to the 60 hours of continuing education requirement.
(5)Course content shall pertain to the practice of naturopathic, osteopathic, or allopathic medicine.
(b)The continuing education requirements of this section may be met through continuing education courses approved by the committee, the California Naturopathic Doctors Association, the American Association of Naturopathic Physicians, the California State Board of Pharmacy, the State Board of Chiropractic Examiners, or other courses that meet the standards for continuing education for licensed physicians and surgeons in California. All continuing education providers shall comply with Section 3635.2. Continuing education providers shall submit an annual declaration to the committee that their educational activities satisfy the requirements described in Section 3635.2 and the committee shall maintain a list of these providers on its Internet Web site.
SEC. 5.SEC. 7.Section 3635.1 is added to the Business and Professions Code, to read:3635.1.(a)A licensee shall retain certificates of continuing education course completion for six years.
(b)The committee may audit licensees continuing education records to ensure that continuing education requirements are met.
(c)It shall be unprofessional conduct for a licensee to furnish false or misleading information to the committee regarding continuing education.
SEC. 8.Section 3635.2 is added to the Business and Professions Code, to read:3635.2.In addition to complying with subdivision (b) of Section 3635, the following shall apply to providers of continuing education:
(a)The content of continuing education courses and related materials shall provide balance, independence, objectivity, and scientific rigor. All patient care recommendations from continuing education courses involving clinical medicine shall be based on evidence accepted by naturopathic doctors. All scientific research used to support patient care recommendations shall conform to generally accepted standards of experimental design, data collection, and analysis.
(b)A conflict of interest is created when an individual in a position to control the content of a continuing education course, or his or her spouse or partner, has a relevant personal financial relationship within the past 12 months with a commercial entity that produces, markets, resells, or distributes health care goods or services consumed by, or used on patients that benefits the individual in any financial amount and therefore, may bias his or her opinions and teachings with respect to the content of continuing education courses. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest such as stocks, stock options or other ownership interest, excluding diversified mutual funds, or other financial benefit. Financial benefits are generally associated with roles such as employment, a management position, or an independent contractor position, including contracted research and clinical trials, consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected.
(c)Prior to a course being presented, continuing education providers shall identify, disclose, and resolve all conflicts of interest. Individuals who fail or refuse to disclose relevant financial relationships shall not be approved as a provider of continuing education as described in subdivision (b) of Section 3635.
(d)Conflicts of interests shall be resolved by one of the following mechanisms:
(1)Altering financial relationships. Individuals may change their relationships with commercial interests, such as discontinuance of contracted services, thereby eliminating any conflict of interest related to the continuing education content.
(2)Altering control over content. An individuals control of continuing education content may be altered in several ways to remove the opportunity to affect content related to the products and services of a commercial interest. These include the following:
(A)Choose someone else to control that part of the content. If a proposed presenter or planner has a conflict of interest related to the content, someone else who does not have a relationship to the commercial interests related to the content may present or plan that part of the content.
(B)Change the focus of the continuing education activity so that the content is not about products or services of the commercial interest that is the basis of the conflict of interest.
(C)Change the content of the individuals assignment so that it is no longer about products or services of the commercial interest. For example, an individual with a conflict of interest regarding products for treatment of a condition could address the pathophysiology or diagnosis of the condition, rather than therapeutics.
(D)Limit the content to a report without recommendations. If an individual has been funded by a commercial entity to perform research, the individuals presentation may be limited to the data and results of the research. Someone else may be assigned to address broader implications and recommendations.
(E)Limit the sources for recommendations. Rather than having a person with a conflict of interest present personal recommendations or personally select the evidence to be presented, limit the role of the person to reporting recommendations based on formal structured reviews of the literature with the inclusion and exclusion criteria stated evidence-based.
(3)Conflict of interest may be resolved if the continuing education material is peer reviewed and both of the following are met:
(A)All the recommendations involving clinical medicine are based on evidence that is accepted within the profession of naturopathic medicine as adequate justification for indications and contraindications in the care of patients.
(B)All scientific research referred to, reported, or used in the continuing education activity in support or justification of patient care recommendations conforms to the generally accepted standards of experimental design, data collection, and analysis.
SEC. 9.Section 3644 of the Business and Professions Code is amended to read:3644.This chapter does not prevent or restrict the practice, services, or activities of any of the following:
(a)A person licensed, certified, or otherwise recognized in this state by any other law or regulation if that person is engaged in the profession or occupation for which he or she is licensed, certified, or otherwise recognized.
(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 rendering aid to a family member or in an emergency, if no fee or other consideration for the service is charged, received, expected, or contemplated.
(d)(1)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.
(2)An unlicensed person described in this subdivision may represent that he or she practices naturopathy if he or she complies with Section 2053.6. However, an unlicensed person may not use the title naturopathic doctor unless he or she has been issued a license by the committee.
(e)A person engaged in good faith in the practice of the religious tenets of any church or religious belief without using prescription drugs.
(f)A person acting in good faith for religious reasons as a matter of conscience or based on a personal belief, while obtaining or providing information regarding health care and the use of any product described in subdivision (d).
(g)A person who provides the following recommendations regarding the human body and its function:
(1)Nonprescription products.
(2)Natural elements such as air, heat, water, and light.
(3)Class I or class II nonprescription, approved medical devices, as defined in Section 360c of Title 21 of the United States Code.
(4)Vitamins, minerals, herbs, homeopathics, natural food products and their extracts, and nutritional supplements.
(h)A person who is licensed in another state, territory, or the District of Columbia to practice naturopathic medicine if the person is incidentally called into this state for consultation with a naturopathic doctor.
(i)A student enrolled in an approved naturopathic medical program whose services are performed pursuant to a course of instruction under the supervision of a naturopathic doctor.
SEC. 6.SEC. 10.Section 3645 of the Business and Professions Code is repealed.SEC. 7.SEC. 11.Section 3660 of the Business and Professions Code is amended to read:3660.Except as provided in subdivision (h) of Section 3644, a person shall have a valid, unrevoked, or unsuspended license issued under this chapter to do any of the following:
(a)To claim to be a naturopathic doctor, licensed naturopathic doctor, doctor of naturopathic medicine, doctor of naturopathy, or naturopathic medical doctor.
(b)To use the professional abbreviation designation N.D., naturopath, naturopathic practitioner, traditional naturopathic practitioner, or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor.
(c)Until January 1, 2020, the use of the terms naturopath, naturopathic practitioner, and traditional naturopathic practitioner may be used in marketing, advertisements, and other related materials by persons who are educated and trained, but not licensed, to practice naturopathy pursuant to this chapter. Individuals shall not be disciplined for the misuse of titles not under their control.
SEC. 8.SEC. 12.Section 3680 of the Business and Professions Code is amended to read:3680.(a)The application fee for a doctor of naturopathic medicine shall be no more than four hundred dollars ($400).
(b)The initial license fee shall be no more than eight hundred dollars ($800).
(c)The renewal fee for a license shall be no more than eight hundred dollars ($800).
(d)The late renewal fee for a license shall be no more than one hundred fifty dollars ($150).
(e)The fee for processing fingerprint cards shall be the current fee charged by the Department of Justice.
(f)The fee for a duplicate or replacement license shall be no more than twenty-five dollars ($25).
SEC. 9.SEC. 13.Section 3686 of the Business and Professions Code is amended to read:3686.This chapter shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 10.SEC. 14.Section 3710 of the Business and Professions Code is amended to read:3710.(a)The Respiratory Care Board of California, hereafter referred to as the board, shall enforce and administer this chapter.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed. Notwithstanding any other law, the repeal of this section renders the board subject to review by the appropriate policy committees of the Legislature.
SEC. 11.SEC. 15.Section 3716 of the Business and Professions Code is amended to read:3716.(a)The board may employ an executive officer exempt from civil service and, subject to the provisions of law relating to civil service, clerical assistants and, except as provided in Section 159.5, other employees as it may deem necessary to carry out its powers and duties.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 12.SEC. 16.Section 3772 of the Business and Professions Code is amended to read:3772.There is established in the State Treasury the Respiratory Care Fund. All collections from persons licensed or seeking to be licensed under this chapter shall be paid by the board into the fund after the report to the Controller at the beginning of each month of the amount and source of the collections. Moneys in the fund shall be available to the board, upon appropriation by the Legislature.
SEC. 13.SEC. 17.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
There is within the jurisdiction of the Osteopathic Medical Board of California a Naturopathic Medicine Committee authorized under the Naturopathic Doctors Act (Chapter 8.2 (commencing with Section 3610)). This section shall become inoperative on January 1, 2022. 2022, and as of that date is repealed. Notwithstanding any other provision of law, the repeal of this section renders the Naturopathic Medicine Committee subject to review by the appropriate policy committees of the Legislature.
SEC. 2.Section 3621 of the Business and Professions Code is amended to read:3621.(a)The committee shall consist of nine members, consisting of seven professional members appointed by the Governor, one member appointed by the Senate Committee on Rules, and one member appointed by the Assembly Committee on Rules. Members of the committee shall include five members who are California licensed naturopathic doctors, or have met the requirements for licensure pursuant to this chapter, two members who are California licensed physicians and surgeons, and two public members.
(b)A member of the committee shall be appointed for a four-year term. A person shall not serve as a member of the committee for more than two consecutive terms. A member shall hold office until the appointment and qualification of his or her successor, or until one year from the expiration of the term for which the member was appointed, whichever first occurs. Vacancies shall be filled by appointment for unexpired terms.
(c)(1)A public member of the committee shall be a resident of this state for at least five years preceding his or her appointment.
(2)A person shall not be appointed as a public member if the person or the persons immediate family in any manner owns an interest in a college, school, or institution engaged in naturopathic education, or the person or the persons immediate family has an economic interest in naturopathy or has any other conflict of interest. Immediate family means the public members spouse, parents, children, or his or her childrens spouses.
(d)Each member of the committee shall receive a per diem and expenses as provided in Section 103.
(e)The committee may appoint a person exempt from civil service who shall be designated as an executive officer and who shall exercise the powers and perform the duties delegated by the committee and vested in him or her by this chapter.
SEC. 3.Section 3623 of the Business and Professions Code is amended to read:3623.(a)The committee 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 bachelors degree from a regionally accredited or preaccredited college or university or the equivalency, as determined by the council.
(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. Of the total requisite hours, not less than 2,500 hours shall consist of academic instruction, and not less than 1,200 hours shall consist of supervised clinical training approved by the naturopathic medical school.
(b)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 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 equivalent federally recognized accrediting body for naturopathic doctor education.
(c)To qualify as an approved naturopathic medical school, a naturopathic medical program located in Canada or the United States shall offer a full-time, doctoral-level, naturopathic medical education program with its graduates being eligible to apply to the committee for licensure and to the North American Board of Naturopathic Examiners that administers the naturopathic licensing examination.
(d)The naturopathic medical program shall evaluate an applicants education, training, and experience obtained in the armed services, pursuant to Section 35, and provide course credit where applicable.
SEC. 4.Section 3630 of the Business and Professions Code is amended to read:3630.An applicant for a license as a naturopathic doctor shall file an application with the committee on a form provided by the committee that shows, to the committees satisfaction, compliance with all of the following requirements:
(a)The applicant has not committed an act or crime that constitutes grounds for denial of a license under Section 480, and has complied with the requirements of Section 144.
(b)The applicant has received a degree in naturopathic medicine from an approved naturopathic medical school where the degree substantially meets the educational requirements in paragraph (2) of subdivision (a) of Section 3623.
SEC. 5.Section 3635.1 is added to the Business and Professions Code, to read:3635.1.(a)A licensee shall retain certificates of continuing education course completion for six years.
(b)The committee may audit licensees continuing education records to ensure that continuing education requirements are met.
(c)It shall be unprofessional conduct for a licensee to furnish false or misleading information to the committee regarding continuing education.
SEC. 6.Section 3645 of the Business and Professions Code is repealed.SEC. 7.Section 3660 of the Business and Professions Code is amended to read:3660.Except as provided in subdivision (h) of Section 3644, a person shall have a valid, unrevoked, or unsuspended license issued under this chapter to do any of the following:
(a)To claim to be a naturopathic doctor, licensed naturopathic doctor, doctor of naturopathic medicine, doctor of naturopathy, or naturopathic medical doctor.
(b)To use the professional abbreviation N.D., naturopath, naturopathic practitioner, traditional naturopathic practitioner, or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor.
SEC. 8.Section 3680 of the Business and Professions Code is amended to read:3680.(a)The application fee for a doctor of naturopathic medicine shall be no more than four hundred dollars ($400).
(b)The initial license fee shall be no more than eight hundred dollars ($800).
(c)The renewal fee for a license shall be no more than eight hundred dollars ($800).
(d)The late renewal fee for a license shall be no more than one hundred fifty dollars ($150).
(e)The fee for processing fingerprint cards shall be the current fee charged by the Department of Justice.
(f)The fee for a duplicate or replacement license shall be no more than twenty-five dollars ($25).
SEC. 9.Section 3686 of the Business and Professions Code is amended to read:3686.This chapter shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 10.Section 3710 of the Business and Professions Code is amended to read:3710.(a)The Respiratory Care Board of California, hereafter referred to as the board, shall enforce and administer this chapter.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed. Notwithstanding any other law, the repeal of this section renders the board subject to review by the appropriate policy committees of the Legislature.
SEC. 11.Section 3716 of the Business and Professions Code is amended to read:3716.(a)The board may employ an executive officer exempt from civil service and, subject to the provisions of law relating to civil service, clerical assistants and, except as provided in Section 159.5, other employees as it may deem necessary to carry out its powers and duties.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 12.Section 3772 of the Business and Professions Code is amended to read:3772.(a)There is established in the State Treasury the Respiratory Care Fund. All collections from persons licensed or seeking to be licensed under this chapter shall be paid by the board into the fund after the report to the Controller at the beginning of each month of the amount and source of the collections. Moneys in the fund shall be available to the board, upon appropriation by the Legislature.
SEC. 12.SEC. 13.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
There is within the jurisdiction of the Osteopathic Medical Board of California a Naturopathic Medicine Committee authorized under the Naturopathic Doctors Act (Chapter 8.2 (commencing with Section 3610)). This section shall become inoperative on January 1, 2022. Notwithstanding any other provision of law, the repeal of this section renders the Naturopathic Medicine Committee subject to review by the appropriate policy committees of the Legislature.
SEC. 2.Section 3621 of the Business and Professions Code is amended to read:3621.(a)The committee shall consist of nine members appointed by the Governor. members, consisting of seven professional members appointed by the Governor, one member appointed by the Senate Committee on Rules, and one member appointed by the Assembly Committee on Rules. Members of the committee shall include five members who are California licensed naturopathic doctors, or have met the requirements for licensure pursuant to this chapter, two members who are California licensed physicians and surgeons, and two public members.
(b)A member of the committee shall be appointed for a four-year term. A person shall not serve as a member of the committee for more than two consecutive terms. A member shall hold office until the appointment and qualification of his or her successor, or until one year from the expiration of the term for which the member was appointed, whichever first occurs. Vacancies shall be filled by appointment for unexpired terms.
(c)(1)A public member of the committee shall be a citizen resident of this state for at least five years preceding his or her appointment.
(2)A person shall not be appointed as a public member if the person or the persons immediate family in any manner owns an interest in a college, school, or institution engaged in naturopathic education, or the person or the persons immediate family has an economic interest in naturopathy or has any other conflict of interest. Immediate family means the public members spouse, parents, children, or his or her childrens spouses.
(d)Each member of the committee shall receive a per diem and expenses as provided in Section 103.
(e)The committee may appoint a person exempt from civil service who shall be designated as an executive officer and who shall exercise the powers and perform the duties delegated by the committee and vested in him or her by this chapter.
SEC. 3.Section 3623 of the Business and Professions Code is amended to read:3623.(a)The committee 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 bachelors degree from a regionally accredited or preaccredited college or university or the equivalency, as determined by the council.
(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. Of the total requisite hours, not less than 2,500 hours shall consist of academic instruction, and not less than 1,200 hours shall consist of supervised clinical training approved by the naturopathic medical school.
(b)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 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 equivalent federally recognized accrediting body for naturopathic doctor education.
(c)To qualify as an approved naturopathic medical school, a naturopathic medical program located in Canada or the United States shall offer a full-time, doctoral-level, naturopathic medical education program with its graduates being eligible to apply to the committee for licensure and to the North American Board of Naturopathic Examiners that administers the naturopathic licensing examination.
(d)The naturopathic medical program shall evaluate an applicants education, training, and experience obtained in the armed services, pursuant to Section 35, and provide course credit where applicable.
SEC. 4.Section 3630 of the Business and Professions Code is amended to read:3630.An applicant for a license as a naturopathic doctor shall file an application with the committee a written application on a form provided by the committee that shows, to the committees satisfaction, compliance with all of the following requirements:
(a)The applicant has not committed an act or crime that constitutes grounds for denial of a license under Section 480, and has complied with the requirements of Section 144.
(b)The applicant has received a degree in naturopathic medicine from an approved naturopathic medical school where the degree substantially meets the educational requirements in paragraph (2) of subdivision (a) of Section 3623.
SEC. 5.Section 3635.1 is added to the Business and Professions Code, to read:3635.1.(a)A licensee shall retain certificates of continuing education course completion for six years.
(b)The committee may audit licensees continuing education records to ensure that continuing education requirements are met.
(c)It shall be unprofessional conduct for a licensee to furnish false or misleading information to the committee regarding continuing education.
SEC. 6.Section 3645 of the Business and Professions Code is repealed.3645.(a)This chapter permits, and does not restrict the use of, the following titles by persons who are educated and trained as any of the following:(1)Naturopath.(2)Naturopathic practitioner.(3)Traditional naturopathic practitioner.(b)This chapter permits, and does not restrict, the education of persons as described in paragraphs (1) to (3), inclusive, of subdivision (a). Those persons are not required to be licensed under this chapter.SEC. 7.Section 3660 of the Business and Professions Code is amended to read:3660.Except as provided in subdivision (h) of Section 3644, a person shall have a valid, unrevoked, or unsuspended license issued under this chapter to do any of the following:
(a)To claim to be a naturopathic doctor, licensed naturopathic doctor, doctor of naturopathic medicine, doctor of naturopathy, or naturopathic medical doctor.
(b)To use the professional abbreviation N.D. N.D., naturopath, naturopathic practitioner, traditional naturopathic practitioner, or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor.
SEC. 8.Section 3680 of the Business and Professions Code is amended to read:3680.The committee shall establish the amount of the fee assessed to conduct activities of the committee, including the amount of fees for applicant licensure, licensure examination, licensure renewal, late renewal, and childbirth certification.3680.(a)The application fee for a doctor of naturopathic medicine shall be no more than four hundred dollars ($400).
(b)The initial license fee shall be no more than eight hundred dollars ($800).
(c)The renewal fee for a license shall be no more than eight hundred dollars ($800).
(d)The late renewal fee for a license shall be no more than one hundred fifty dollars ($150).
(e)The fee for processing fingerprint cards shall be the current fee charged by the Department of Justice.
(f)The fee for a duplicate or replacement license shall be no more than twenty-five dollars ($25).
SEC. 2.SEC. 9.Section 3686 of the Business and Professions Code is amended to read:3686.This chapter shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 3.SEC. 10.Section 3710 of the Business and Professions Code is amended to read:3710.(a)The Respiratory Care Board of California, hereafter referred to as the board, shall enforce and administer this chapter.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed. Notwithstanding any other law, the repeal of this section renders the board subject to review by the appropriate policy committees of the Legislature.
SEC. 4.SEC. 11.Section 3716 of the Business and Professions Code is amended to read:3716.(a)The board may employ an executive officer exempt from civil service and, subject to the provisions of law relating to civil service, clerical assistants and, except as provided in Section 159.5, other employees as it may deem necessary to carry out its powers and duties.
(b)This section shall remain in effect only until January 1, 2022, and as of that date is repealed.
SEC. 12.No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
There is within the jurisdiction of the Osteopathic Medical Board of California a Naturopathic Medicine Committee authorized under the Naturopathic Doctors Act (Chapter 8.2 (commencing with Section 3610)). This section shall become inoperative on January 1, 2018, and, as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2018, deletes or extends that date. 2022. Notwithstanding any other provision of law, the repeal of this section renders the Naturopathic Medicine Committee subject to review by the appropriate policy committees of the Legislature.
SEC. 2.Section 3686 of the Business and Professions Code is amended to read:3686.This chapter shall remain in effect only until January 1, 2018, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2018, deletes or extends that date. 2022, and as of that date is repealed.
SEC. 3.Section 3710 of the Business and Professions Code is amended to read:3710.(a)The Respiratory Care Board of California, hereafter referred to as the board, shall enforce and administer this chapter.
(b)This section shall remain in effect only until January 1, 2018, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2018, deletes or extends that date. 2022, and as of that date is repealed. Notwithstanding any other law, the repeal of this section renders the board subject to review by the appropriate policy committees of the Legislature.
SEC. 4.Section 3716 of the Business and Professions Code is amended to read:3716.(a)The board may employ an executive officer exempt from civil service and, subject to the provisions of law relating to civil service, clerical assistants and, except as provided in Section 159.5, other employees as it may deem necessary to carry out its powers and duties.
This(b)This section shall remain in effect only until January 1, 2018, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2018, deletes or extends that date. 2022, and as of that date is repealed.
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Date
|
Status
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|---|---|
| Oct 8, 2017 | Chaptered by Secretary of State. Chapter 600, Statutes of 2017. |
| Oct 8, 2017 | Approved by the Governor. |
| Sep 21, 2017 | Enrolled and presented to the Governor at 5:30 p.m. |
| Sep 14, 2017 | Assembly amendments concurred in. (Ayes 40. Noes 0.) Ordered to engrossing and enrolling. |
| Sep 14, 2017 | In Senate. Concurrence in Assembly amendments pending. |
| Sep 13, 2017 | Read third time. Passed. Ordered to the Senate. |
| Sep 6, 2017 | Read second time. Ordered to third reading. |
| Sep 5, 2017 | Read second time and amended. Ordered to second reading. |
| Sep 1, 2017 | From committee: Do pass as amended. (Ayes 16. Noes 0.) (September 1). |
| Aug 23, 2017 | August 23 set for first hearing. Placed on suspense file. |
| Jul 17, 2017 | Read second time and amended. Re-referred to Com. on APPR. |
| Jul 13, 2017 | From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (July 11). |
| Jul 3, 2017 | From committee with author's amendments. Read second time and amended. Re-referred to Com. on B. & P. |
| Jun 15, 2017 | Referred to Com. on B. & P. |
| Jun 1, 2017 | In Assembly. Read first time. Held at Desk. |
| May 31, 2017 | Read third time. Passed. (Ayes 40. Noes 0. Page 1336.) Ordered to the Assembly. |
| May 26, 2017 | Read second time and amended. Ordered to third reading. |
| May 25, 2017 | From committee: Do pass as amended. (Ayes 7. Noes 0. Page 1190.) (May 25). |
| May 19, 2017 | Set for hearing May 25. |
| May 15, 2017 | May 15 hearing: Placed on APPR. suspense file. |
| May 4, 2017 | Set for hearing May 15. |
| Apr 25, 2017 | From committee: Do pass and re-refer to Com. on APPR. (Ayes 8. Noes 0. Page 825.) (April 24). Re-referred to Com. on APPR. |
| Apr 17, 2017 | From committee with author's amendments. Read second time and amended. Re-referred to Com. on B., P. & E.D. |
| Mar 31, 2017 | Set for hearing April 24. |
| Mar 9, 2017 | Referred to Com. on B., P. & E.D. |
| Feb 21, 2017 | From printer. May be acted upon on or after March 23. |
| Feb 17, 2017 | Introduced. Read first time. To Com. on RLS. for assignment. To print. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Sep 14, 2017 | Unfinished Business SB796 Hill Concurrence | Senate Floor |
Passed |
|
| Sep 13, 2017 | SB 796 Hill Senate Third Reading By LOW | Assembly Floor |
Passed |
|
| Sep 1, 2017 | Do pass as amended. | Assembly Standing Committee on Appropriations |
Passed |
|
| Jul 11, 2017 | Do pass as amended and be re-referred to the Committee on [Appropriations] | Assembly Standing Committee on Business and Professions |
Passed |
|
| May 31, 2017 | Senate 3rd Reading SB796 Hill | Senate Floor |
Passed |
|
| May 25, 2017 | Do pass as amended | Senate Standing Committee on Appropriations |
Passed |
|
| May 15, 2017 | Placed on suspense file | Senate Standing Committee on Appropriations |
Passed |
|
| Apr 24, 2017 | Do pass, but first be re-referred to the Committee on [Appropriations] | Senate Standing Committee on Business, Professions and Economic Development |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| american naturopathic medical association | ** Against | Sep 14, 2017 |
| Bastyr University | ** Support | Sep 14, 2017 |
| California Naturopathic Doctors Association | ** Support | Sep 14, 2017 |
| California Society For Respiratory Care | ** Support | May 27, 2017 |
| National Health Freedom Action | ** Against | May 27, 2017 |
| Naturopathic Medicine Committee | ** Support | Sep 14, 2017 |
| Respiratory Care Board of California | ** Support | Sep 14, 2017 |
| Southern California University of Health Sciences | ** Support | Sep 14, 2017 |
| State Of Washington Board Of Naturopathy | ** Support | Sep 14, 2017 |
| The Naturopathic Medicine Committee | ** Support | Apr 20, 2017 |
| the naturopathic medicine committee of california | ** Support | May 27, 2017 |
| The Respiratory Care Board of California | ** Support | May 27, 2017 |
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | SB |
UNFINISHED BUSINESS
Bill No: SB 796
:
SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 8-0, 4/24/17
AYES: Hill, Fuller, Galgiani, Glazer, Hernandez, Newman, Pan, Wilk
NO VOTE RECORDED: Dodd
SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/25/17
AYES: Lara, Bates, Beall, Bradford, Hill, Nielsen, Wiener
SENATE FLOOR: 40-0, 5/31/17
AYES: Allen, Anderson, Atkins, Bates, Beall, Berryhill, Bradford, Cannella, De León, Dodd, Fuller, Gaines, Galgiani, Glazer, Hernandez, Hertzberg, Hill, Hueso, Jackson, Lara, Leyva, McGuire, Mendoza, Mitchell, Monning, Moorlach, Morrell, Newman, Nguyen, Nielsen, Pan, Portantino, Roth, Skinner, Stern, Stone, Vidak, Wieckowski, Wiener, Wilk
ASSEMBLY FLOOR: 76-1, 9/13/17 - See last page for vote
DIGEST:
This bill extends the sunset dates of the Naturopathic Medicine Committee (NMC) and Respiratory Care Board of California (RCB) until 2022, makes various changes to the Naturopathic Doctors Act and Respiratory Care Practice Act, and requires the Department of Consumer Affairs (DCA) to review the existing criteria establishing substance abuse testing schedules.
Assembly Amendments
require DCA to review the existing criteria establishing substance abuse testing schedules; require naturopathic medicine continuing education (CE) courses to pertain to the practice of naturopathic, osteopathic, or allopathic medicine; establish a CE conflict of interest policy; remove specified title protections; and make technical amendments.
Existing law:
- Establishes the Substance Abuse Coordination Committee (SACC) within DCA to determining uniform standards that will be used by healing arts boards in dealing with substance-abusing licensees. (Business and Professions Code (BPC) § 315)
- Requires the SACC to establish standards governing all aspects of required testing, including, but not limited to, frequency of testing, randomness, method of notice to the licensee, number of hours between the provision of notice and the test, standards for specimen collectors, procedures used by specimen collectors, the permissible locations of testing, whether the collection process must be observed by the collector, backup testing requirements when the licensee is on vacation or otherwise unavailable for local testing, requirements for the laboratory that analyzes the specimens, and the required maximum timeframe from the test to the receipt of the result of the test. (BPC § 315 (c)(4))
- Establishes the NMC within the Osteopathic Medical Board of California to enforce and administer the Naturopathic Doctors Act (Act). (BPC §§ 3612, 3620)
- Repeals the Act on January 1, 2018. (BPC § 2450.3)
- Establishes the NMC as consisting of nine members appointed by the Governor, including two public members. Requires a public member to be a citizen of the state for at least five years preceding his or her appointment. (BPC § 3621)
- Requires the NMC to establish the amount of the fee assessed to conduct activities of the NMC, including the amount of fees for applicant licensure, licensure renewal, late renewal, and childbirth certification. (BPC § 3680)
- Establishes the RCB to administer and enforce the Respiratory Care Practice Act. (BPC §§ 3700, 3710)
- Defines “respiratory care” as a health care profession performed under the supervision of a medical director in the therapy, management, rehabilitation, diagnostic evaluation, and care of patients with deficiencies and abnormalities which affect the pulmonary system and associated aspects of cardiopulmonary and other systems functions. (BPC § 3702)
- Repeals the Respiratory Care Practice Act on January 1, 2018. (BPC § 3710)
This bill:
- Requires SACC to review the existing substance abuse testing criteria for testing by January 2, 2019, to determine whether they should be updated to reflect recent developments in testing research and technology.
- Extends the sunset date, until January 1, 2022, for the NMC and RCB.
- Requires that the two public members be appointed by the Senate Committee on Rules and the Speaker of the Assembly, respectively.
- Requires a public member to be a resident of the state, rather than a citizen, for at least five years preceding his or her appointment.
- Requires that the NMC approve only those naturopathic medical programs that evaluate an applicant’s education, training, experience obtained in the armed services, and provide course credit where applicable.
- Requires NMC CEs to pertain to the practice of naturopathic, osteopathic, or allopathic medicine.
- Requires CE providers to comply with NMC’s conflict of interest policy and submit an annual compliance declaration to the NMC that the NMC shall post on its Web site.
- Establishes a conflict of interest policy for NMC CEs.
- States that an unlicensed practitioner of naturopathic services may represent that he or she practices naturopathy if he or she complies with existing disclosure requirements.
- Requires a licensee to retain certificates of CE course completion for six years.
- Authorizes the NMC to audit licensees’ CE records to ensure that CE requirements are met.
- Declares that furnishing false or misleading information to the NMC regarding CE constitutes unprofessional conduct.
- Codifies existing NMC licensing fees.
- States that monies in the Respiratory Care Fund be available to the RCB upon appropriation of the Legislature for the purposes of the Respiratory Care Practice Act.
- Makes technical changes to the Act.
Background
Uniform Standards. SB 1441 (Ridley-Thomas, Chapter 548, Statutes of 2008) required DCA to develop uniform and specific standards to be used by healing arts boards’ diversion programs. These standards would cover 16 areas, including requirements for substance abuse testing. The DCA convened SACC to develop these standards (“Uniform Standards”), which were adopted by March 2011.
MAXIMUS, Inc. manages DCA boards’ diversion programs. The most recent audit of MAXIMUS found that, while MAXIMUS is effectively and efficiently managing the various diversion programs, cost of participation is an issue for many participants and is often a barrier to successful completion.
Participants’ costs vary by program due to boards’ subsidies, but an average cost for 5-year participation runs from $19,000 to $61,000 for a BRN participant to $30,000 to $104,000 for others. These costs are borne by the licensee, and a substantial portion of this is due to drug testing.
The Uniform Standards dictate that random testing must occur between 52-104 times in the first year of program participation, and 36-104 times in subsequent years. At $100 per test, this costs participants upwards of $10,000 per year. Although these aggressive testing schedules were established with the best of intentions, drug testing and addiction research has since evolved to suggest that less frequent, but more strategic testing may have the same detection and deterrence effects while being less burdensome on participants. Reducing testing frequency could protect consumers more effectively by enabling impaired licensees to seek affordable treatment.
Naturopathic medicine. The NMC is charged with licensing and regulating naturopathic doctors (NDs). NMC’s 2016 Strategic Plan states that its mission is “To protect health care consumers through the proper licensing and regulation of NDs utilizing the vigorous, objective enforcement of the Naturopathic Doctors Act, and to promote access to quality naturopathic medical care.”
According to the NMC, naturopathic medicine is a distinct and comprehensive system of primary health care that uses natural methods and substances to support and stimulate the body’s self-healing process.
NDs attend four year, graduate-level, accredited naturopathic medical schools; are trained as primary care providers; and take a national, standardized licensing examination.
Veterans’ military experience. The NMC does not itself evaluate schools for approval, but rather is required to approve schools that are accredited by the Council on Naturopathic Medical Education (CNME) or other equivalent accrediting body that meets certain minimum requirements. However, current law requires boards and bureaus to provide for methods of evaluating military education, training, and experience towards licensure.
Board appointments and fees. The NMC currently functions as an independent entity, but was originally designed as a dependent committee within the Osteopathic Medical Board of California. In that structure, full gubernatorial appointment authority for NMC was immaterial, since the NMC’s parent body had public appointments by the Legislature, ensuring ultimate input into both entities.
This bill maintains the professional and public makeup of the NMC, but designates appointing authority for the two public members to the Legislature, similar to that of other healing arts boards. This bill also establishes the NMC’s fees in statute, so that they must request periodic increases from the Legislature, as other boards do.
CE. NMC does not currently have a CE conflict of interest policy, and one of the members of the Senate Business, Professions and Economic Development Committee, Senator Pan, requested during the policy hearing of this bill that one be developed. This CE policy is based on the University of California, San Diego School of Medicine’s CE conflict of interest policy.
Respiratory care. The RCB is responsible for enforcing state laws pertaining to the practice of respiratory care and regulates a single category of health care workers – respiratory care practitioners (RCPs). RCPs are specialized health care workers, who work under the supervision of medical directors and are involved in the prevention, diagnosis, treatment, management, and rehabilitation of problems affecting the heart and lungs and other disorders, as well as providing diagnostic, educational, and rehabilitation services. RCPs provide treatments for patients who have breathing difficulties and care for those who are dependent upon life support and cannot breathe on their own.
This bill states that monies in the Respiratory Care Fund be available to the RCB upon appropriation of the Legislature for the purposes of the Respiratory Care Practice Act, in conformance with similar clauses in other practice acts.
FISCAL EFFECT: Appropriation: Fiscal Com.: Local:
According to the Assembly Appropriations Committee:
- The new requirements of this bill are not expected to result in significant costs.
- By extending their sunsets, DCA will continue to incur annual fee-supported special fund costs associated with continued operation of the following regulatory entities, as follows: NMC: $400,000 annually (Naturopathic Doctors Fund); Respiratory Care Board: $3.6 million annually (Respiratory Care Fund).
Bastyr University
California Naturopathic Doctors Association
Naturopathic Medicine Committee
Respiratory Care Board of California
Southern California University of Health Sciences
State of Utah Division of Occupational and Professional Licensing
State of Washington Board of Naturopathy
OPPOSITION: (Verified 9/12/17)
American Naturopathic Medical Association
ARGUMENTS IN SUPPORT: The California Naturopathic Doctors Association writes, “Licensure and regulation of the California naturopathic doctor profession by the Naturopathic Medicine Committee provides the citizens of California safe access to well-trained primary care providers that specialize in affordable, effective healthcare.”
ARGUMENTS IN OPPOSITION: The American Naturopathic Medical Association oppose ND licensure, stating, “The state of California already regulates primary care doctors and these naturopathic physicians could not possibly meet those requirements so they have come to you seeking a back door into practicing as primary care physicians without going to a real medical school. The cost to the citizens of California for administration of such a board could possibly be their lives or that of a loved one.”
ASSEMBLY FLOOR: 76-1, 9/13/17
AYES: Acosta, Aguiar-Curry, Arambula, Baker, Berman, Bigelow, Bloom, Bocanegra, Bonta, Brough, Burke, Caballero, Calderon, Cervantes, Chau, Chávez, Chen, Chiu, Choi, Chu, Cooley, Cooper, Cunningham, Dababneh, Dahle, Daly, Eggman, Flora, Fong, Frazier, Friedman, Gallagher, Cristina Garcia, Eduardo Garcia, Gipson, Gloria, Gonzalez Fletcher, Gray, Grayson, Harper, Holden, Irwin, Jones-Sawyer, Kalra, Kiley, Lackey, Levine, Limón, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Muratsuchi, Obernolte, O'Donnell, Quirk, Quirk-Silva, Reyes, Ridley-Thomas, Rodriguez, Rubio, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Voepel, Waldron, Weber, Wood, Rendon
NOES: Travis Allen
NO VOTE RECORDED: Nazarian, Patterson
9/14/17 10:06:24
**** END ****
SENATE THIRD READING
STR Bill Id:SB 796
Author:(Hill)
As Amended Ver:September 5, 2017
Majority vote
SENATE VOTE: 40-0
Committee | Votes | Ayes | Noes |
Business & Professions | 16-0 | Low, Brough, Arambula, Baker, Bloom, Chiu, Cunningham, Dahle, Eggman, Gipson, Grayson, Holden, Irwin, Mullin, Steinorth, Ting | |
Appropriations | 16-0 | Gonzalez Fletcher, Bigelow, Bloom, Bocanegra, Bonta, Brough, Calderon, Chau, Eggman, Fong, Friedman, Gallagher, Eduardo Garcia, Jones-Sawyer, Obernolte, Reyes |
|
SUMMARY: Requires the Department of Consumer Affairs (DCA) to review and update its uniform standards for substance-abusing healing arts licensees; extends the Respiratory Care Board (RCB) until January 1, 2022; extends the Naturopathic Medicine Committee (NMC) until January 1, 2022; updates continuing education (CE) requirements for Naturopathic Doctors (NDs) and CE providers; requires naturopathic medical programs to evaluate an ND applicant's military training for credit; and codifies the NMC's fees established in regulation. Specifically, this bill:
- Requires the DCA to review the existing criteria set for Uniform Standard 4 regarding substance testing and determine whether the existing criteria should be updated to reflect recent developments in testing research and technology.
- Extends the RCB's sunset date from January 1, 2018 to January 1, 2022 and subjects the RCB's funds to appropriation by the Legislature.
- Amends the Naturopathic Medicine Act as follows:
- Requires that two of the NMC public members be appointed by the Senate Committee on Rules and the Assembly Committee on Rules, aligning the board appointments to mirror other DCA boards.
- Requires, for NMC approval, that a naturopathic medical program evaluate an applicant's education, training, experience obtained in the armed services, and provide course credit where applicable.
- Requires a naturopathic medicine licensee to retain certificates of continuing education course completion for six years.
- Authorizes the NMC to audit licensees' continuing education records to ensure that CE requirements are met.
- Establishes a conflict-of-interest code for CE providers.
- Codifies existing licensing fees regulations into the Naturopathic Doctors Act.
- Extends the NMC's sunset date from January 1, 2018 until January 1, 2022.
FISCAL EFFECT: According to the Assembly Appropriations Committee:
- The new requirements of this bill are not expected to result in significant costs.
- By extending their sunsets, DCA will continue to incur annual fee-supported special fund costs associated with continued operation of the following regulatory entities, as follows:
- NMC: $400,000 annually (Naturopathic Doctors Fund).
- Respiratory Care Board: $3.6 million annually (Respiratory Care Fund).
COMMENTS:
Purpose. This bill is sponsored by the author. According to the author, "To best serve the highest interests of Californians, their safety, health, and well-being, it is imperative to continue the regulation of the Naturopathic Medicine and Respiratory Care Board."
Background. In February and March of this year, the Assembly Business and Professions Committee and the Senate Business, Professions and Economic Development Committee (Committees) conducted joint oversight hearings to review various regulatory entities. During the sunset review hearings, the Committees take testimony from the entities and stakeholders and evaluate entities scheduled to be repealed the following year. The reviewed entities will sunset unless the Legislature enacts a law to extend them. This bill is one of the several sunset bills intended to implement legislative changes recommended in the respective background reports drafted by the Committees for the entities reviewed.
DCA Uniform Standards. The Substance Abuse Coordination Committee is created, within the DCA, for the purpose of determining uniform standards that will be used by healing arts boards in dealing with substance-abusing licensees. According to current law, the committee is required to complete their formulation of uniform and specific standards for testing aspect that every heating arts board will then be required to use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program, by 2010.
Respiratory Care. The RCB is required by statute to enforce and administer laws, as well as implement regulations, pertaining to the protection of the public from respiratory care matters. Existing law only extends the authority of the Respiratory Care Board of California to January 1, 2018. This bill extends the date to January 1, 2022.
Naturopathic Medicine. The Naturopathic Medicine Committee is charged with licensing and regulating Naturopathic Doctors (NDs). NMC's 2016 Strategic Plan states that its mission is "To protect health care consumers through the proper licensing and regulation of NDs utilizing the vigorous, objective enforcement of the Naturopathic Doctors Act, and to promote access to quality naturopathic medical care." According to the Committee, Naturopathic medicine is a distinct and comprehensive system of primary health care that uses natural methods and substances to support and stimulate the body's self-healing process. It is distinguished by the principles on which its practice is based.
Naturopathic medicine includes the combination of a variety of natural medicines and treatments. NDs are clinically trained in both natural and conventional approaches to medicine and can prescribe all natural and synthetic hormones, epinephrine, and vitamins, minerals, and amino acids independent of physician supervision. California NDs complete 72 pharmacology course hours in school and are required to complete a minimum of 20 hours of pharmacotherapeutic training every two years as part of their 60-hour continuing education requirement.
NDs attend four year, graduate-level, accredited naturopathic medical schools, are trained as primary care providers, and take a national, standardized licensing examination. NDs have limited opportunities to complete hospital residencies, but perform at least 1500 hours of clinical rotations at clinics and private doctors' offices during their education program. California is one of 17 states that license NDs, and over 500 ND licenses have been issued to date. There is one naturopathic medicine school in California, located in San Diego.
NMC Military Credit. Existing law requires "rules and regulations of boards provided for in [the BPC] shall provide for methods of evaluating education, training, and experience obtained in the armed services, if applicable to the requirements of the business, occupation, or profession regulated." The NMC asserts that it has not made any regulatory changes to conform to this law because "the military does not offer educational credits which can be applied towards obtaining a Naturopathic Doctor's degree; therefore regulatory changes are not necessary."
The intent of this law is not to merely inquire as to whether the military issues a naturopathic degree, but to what extent basic biology or anatomy courses, or clinical training or experience may contribute to the transfer or credits earned in beginning a ND program. This bill addresses this issue by requiring the naturopathic medical program to evaluate an applicant's education, training, and experience obtained in the armed services, pursuant to BPC Section 35, and provide course credit where applicable.
Analysis Prepared by: Vincent Chee / B. & P. / (916) 319-3301 FN: 0001734
Date of Hearing: August 23, 2017
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez Fletcher, Chair
SBPCA Bill Id:SB 796
Author:(Hill) – As Amended Ver:July 17, 2017
Policy Committee: | Business and Professions | Vote: | 16 - 0 |
Urgency: No State Mandated Local Program: Yes Reimbursable: No
SUMMARY:
This bill extends the sunset of the Respiratory Care Board (RCB) and the Naturopathic Medicine Committee (NMC), and implements recommendations that emerged from the legislative sunset review of these Department of Consumer Affairs (DCA) regulatory entities. Specifically, this bill:
- Extends until January 1, 2022, relevant sunset dates for the NMC and the RCB.
- Requires the NMC to evaluate an applicant’s education, training, and experience obtained in the armed services and to provide course credit where applicable.
- Updates continuing education requirements for naturopathic doctors.
- Clarifies when unlicensed persons may use terms including “Naturopath” and “Naturopathic practitioner.”
- Codifies existing NMC fees established by regulation, and eliminates the committee's authority to establish fees.
- Specifies monies in the Respiratory Care Board are available upon appropriation by the Legislature.
FISCAL EFFECT:
- The new requirements of this bill are not expected to result in significant costs.
- By extending their sunsets, DCA will continue to incur annual fee-supported special fund costs associated with continued operation of the following regulatory entities, as follows:
- NMC: $400,000 annually (Naturopathic Doctors Fund).
- Respiratory Care Board: $3.6 million annually (Respiratory Care Fund).
COMMENTS:
- Purpose. This bill extends the sunset on provisions establishing the above regulatory entities for four years, and makes other minor changes that emerged from legislative sunset review hearings. Most DCA entities are thoroughly reviewed every four years on a regular schedule, at which point their sunsets are extended and necessary changes are made.
- Background. The Respiratory Care Board licenses respiratory care practitioners, also known as respiratory therapists. Licensees are health care workers who specialize in monitoring and treatment of patients with pulmonary disease. The Board licenses approximately 23,000 practitioners.
The Naturopathic Medicine Committee regulates over 500 naturopathic doctors (NDs), who practice a combination of natural medicines and treatments. NDs attend four-year, graduate-level, accredited naturopathic medical schools, are trained as primary care providers, receive clinical training, and take a national, standardized licensing examination. California is one of 17 states that license NDs and there is one naturopathic medicine school in California, located in San Diego.
One of the major issues considered in the NMC sunset review was the prevalence of unlicensed personnel who practice "naturopathy," which makes use of natural and traditional treatments, but is not regulated. Prior versions of this bill included restriction of the ability of unlicensed personnel to use terms related to "naturopathy," but the current version of this bill allows unlicensed personnel to use these terms, provided specified disclosures are made.
- Prior Legislation. SB 305 (Lieu), Chapter 516, Statutes of 2013, contained the prior sunset extension for the RCB and the NMC.
Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081
Date of Hearing:
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Evan Low, Chair
SBPCA Bill Id:
Author:() – As Ver:
SENATE VOTE:
SUBJECT:
SUMMARY: Requires the Department of Consumer Affairs (DCA) to review and update its uniform standards for substance-abusing healing arts licensees; extends the Respiratory Care Board (RCB) until January 1, 2022; extends the Naturopathic Medicine Committee (NMC) until January 1, 2022; updates continuing education (CE) requirements for Naturopathic Doctors (NDs) and CE providers; requires naturopathic medical programs to evaluate an ND applicant’s military training for credit; codified the NMC’s fees established in regulation; prohibits, on January 1, 2020, the use of the terms “naturopath,” “naturopathic practitioner,” and “traditional naturopathic practitioner,” as specified; and makes technical and clarifying changes.
EXISTING LAW:
- Establishes within the DCA the Substance Abuse Coordination Committee to determine uniform standards that will be used by healing arts boards in dealing with substance-abusing licensees. (BPC § 315)
- Establishes the RCB within the DCA to administer and enforce the Respiratory Care Practice Act. (BPC §§ 3700-3779)
- Repeals the RCB on January 1, 2018. (BPC §§ 3710, 3716)
- Establishes, until January 1, 2018, the Naturopathic Medicine Committee (NMC) within the Osteopathic Medical Board to enforce and administer the Naturopathic Doctors Act. (Business and Professions Code (BPC) §§ 2450.3, 3610-3686)
- Repeals the Naturopathic Doctors Act on January 1, 2018. (BPC § 3686)
- Specifies that the NMC to consist of 9 members appointed by the Governor, including 2 public members. Requires a public member to be a citizen of the state for at least 5 years preceding his or her appointment. (BPC § 3621)
- Requires the NMC to approve a specified naturopathic medical education programs. (BPC § 3623)
- Requires that the NMC require the satisfactory completion of 60 hours of approved continuing education biennially. This requirement is waived for the initial license renewal. (BPC § 3635)
- Permits, and does not restrict the use of, the titles “naturopath,” “naturopathic practitioner,” and “traditional naturopathic practitioner” by persons who are educated and trained for those positions. Specifies that the Naturopathic Doctors Act permits, and does not restrict, the education of these persons, and does not require these persons to be licensed under the act. (BPC § 3645)
- Requires that a person be licensed to use the professional abbreviation “N.D.” (BPC § 3660)
- Requires the NMC to establish the amount of the fee assessed to conduct activities of the NMC, including the amount of fees for applicant licensure, licensure renewal, late renewal, and childbirth certification. (BPC § 3680)
- Requires an applicant for a license as an ND to file a written application with the NMC, as specified. (BPC § 3690)
THIS BILL:
- Requires the DCA to review the existing criteria set for Uniform Standard 4 regarding substance testing and determine whether the existing criteria should be updated to reflect recent developments in testing research and technology.
- Extends the RCB’s sunset date from January 1, 2018 to January 1, 2022 and subjects the RCB’s funds to appropriation by the Legislature.
- Amends the Naturopathic Medicine Act as follows:
- Requires that two of the NMC public members be appointed by the Senate Committee on Rules and the Assembly Committee on Rules, aligning the board appointments to mirror other DCA boards.
- Requires, for NMC approval, that a naturopathic medical program evaluate an applicant's education, training, experience obtained in the armed services, and provide course credit where applicable.
- Requires a naturopathic medicine licensee to retain certificates of continuing education course completion for 6 years.
- Authorizes the NMC to audit licensees’ continuing education records to ensure that CE requirements are met.
- Establishes a conflict-of-interest code for CE providers.
- Prohibits the use of the terms “naturopath,” “naturopathic practitioner,” and “traditional naturopathic practitioner” after January 1, 2020, unless licensed by the NMC.
- Provides that an unlicensed person may represent that the person “practices naturopathy” if in compliance with existing written disclosure requirements.
- Codifies existing licensing fees regulations into the Naturopathic Doctors Act.
- Extends the NMC's sunset date from January 1, 2018 until January 1, 2022.
FISCAL EFFECT: According to the Senate Appropriations Committee:
- Ongoing costs of $400,000 per year for the continued operation of the Naturopathic Medicine Committee (Naturopathic Doctors Fund).
- Likely ongoing fine revenue in the tens of thousands per year from disciplinary action against unlicensed practice (Naturopathic Doctors Fund). Based on historic workload, the Committee anticipates that fine revenues could range from $50,000 per year (assuming all fines are first time fines) up to $800,000 per year (assuming all fines are third occurrence fines). In practice, the ability to assess fines for unlicensed practice will likely create a deterrent for unlicensed practice. Therefore, future fine revenues are likely to be closer to the low end estimate.
- No significant costs are anticipated by the Senate Appropriations Committee due to any of the other changes in the bill.
- Ongoing costs of $3.7 million per year for the continued operation of the Respiratory Care Board (Respiratory Care Fund).
COMMENTS:
Purpose. This bill is sponsored by the author. According to the author, “To best serve the highest interests of Californians, their safety, health, and well-being, it is imperative to continue the regulation of the Naturopathic Medicine and Respiratory Care Board.”
Background. In February and March of this year, the Assembly Business and Professions Committee and the Senate Business, Professions and Economic Development Committee (Committees) conducted joint oversight hearings to review various regulatory entities. During the sunset review hearings, the Committees take testimony from the entities and stakeholders and evaluate entities scheduled to be repealed the following year. The reviewed entities will sunset unless the Legislature enacts a law to extend them. This bill is one of the several sunset bills intended to implement legislative changes recommended in the respective background reports drafted by the Committees for the entities reviewed.
DCA Uniform Standards. The Substance Abuse Coordination Committee is created, within the DCA, for the purpose of determining uniform standards that will be used by healing arts boards in dealing with substance-abusing licensees. According to current law, the committee is required to complete their formulation of uniform and specific standards for testing aspect that every heating arts board will then be required to use in dealing with substance-abusing licensees, whether or not a board chooses to have a formal diversion program, by 2010.
Respiratory Care. The RCB is required by statute to enforce and administer laws, as well as implement regulations, pertaining to the protection of the public from respiratory care matters. Existing law only extends the authority of the Respiratory Care Board of California to January 1, 2018. This bill extends the date to January 1, 2022.
Naturopathic Medicine. The Naturopathic Medicine Committee is charged with licensing and regulating Naturopathic Doctors (NDs). NMC’s 2016 Strategic Plan states that its mission is “To protect health care consumers through the proper licensing and regulation of NDs utilizing the vigorous, objective enforcement of the Naturopathic Doctors Act, and to promote access to quality naturopathic medical care.” According to the Committee, Naturopathic medicine is a distinct and comprehensive system of primary health care that uses natural methods and substances to support and stimulate the body’s self-healing process. It is distinguished by the principles on which its practice is based.
Naturopathic medicine includes the combination of a variety of natural medicines and treatments. NDs are clinically trained in both natural and conventional approaches to medicine and can prescribe all natural and synthetic hormones, epinephrine, and vitamins, minerals, and amino acids independent of physician supervision. California NDs complete 72 pharmacology course hours in school and are required to complete a minimum of 20 hours of pharmacotherapeutic training every two years as part of their 60-hour continuing education requirement.
NDs attend four year, graduate-level, accredited naturopathic medical schools, are trained as primary care providers, and take a national, standardized licensing examination. NDs have limited opportunities to complete hospital residencies, but perform at least 1500 hours of clinical rotations at clinics and private doctors’ offices during their education program. California is one of 17 states that license NDs, and over 500 ND licenses have been issued to date. There is one naturopathic medicine school in California, located in San Diego.
NMC Military Credit. Existing law requires “rules and regulations of boards provided for in [the BPC] shall provide for methods of evaluating education, training, and experience obtained in the armed services, if applicable to the requirements of the business, occupation, or profession regulated.” The NMC asserts that it has not made any regulatory changes to conform to this law because "the military does not offer educational credits which can be applied towards obtaining a Naturopathic Doctor's degree; therefore regulatory changes are not necessary.”
The intent of this law is not to merely inquire as to whether the military issues a naturopathic degree, but to what extent basic biology or anatomy courses, or clinical training or experience may contribute to the transfer or credits earned in beginning a ND program. This bill addresses this issue by requiring the naturopathic medical program to evaluate an applicant's education, training, and experience obtained in the armed services, pursuant to BPC § 35, and provide course credit where applicable.
ARGUMENTS IN SUPPORT:
The California Naturopathic Doctors Association writes in support: “Licensure and regulation of naturopathic doctors ensures that only those individuals who meet all the education and competency standards explicit in SB 907 are eligible for a license. The NMC also verifies that those who are granted a license continue to meet the ongoing continuing medical education requirements outlined in statute as well as practice naturopathic medicine according to the scope requirements of SB 907, thereby assuring public safety.”
The Naturopathic Medicine Committee writes in support, “Consumers who choose to use naturopathic medicine for their healthcare needs are unknowingly being treated by unlicensed ‘traditional naturopaths.’ In most cases where consumer harm was inflicted, the consumers were not advised that they were being treated by an unlicensed provider. In the majority of the cases these ‘naturopaths’ were withholding the fact that they were providing unlicensed healing arts as Business and Professions Code section 2053.6 requires. Additionally, the ‘naturopaths’ are taking blood and other biological fluids, providing diagnoses, and in some instances advising the consumer to stop taking medications prescribed to them by their primary care physicians. On several occasions, the unlicensed individuals were also administering injections to the consumers; all of which is in direct violation of Business and Professions Code section 2053.5.
“Unfortunately, the NMC has found these violations to be the normal practice of the ‘naturopaths’ and not a small fraction of isolated incidents. Complaints for the misuse of title and the practice of naturopathic medicine without the benefit of a license constitute 87% of all enforcement cases submitted to the NMC. To ignore these statistics would be negligent of the NMC and those who are willing to allow the continued use of the ‘naturopath and naturopathic’ titles.”
ARGUMENTS IN OPPOSITION:
The California Health Freedom Coalition writes in opposition: “Last year tragically, a patient died after receiving an intravenous drip containing turmeric from a medicalized naturopath. The medicalized naturopaths now argue that the solution to protect the public is to prevent any traditional naturopath—those who do not perform risky medical procedure—from using the name ‘traditional naturopath’ and from describing their works as ‘traditional naturopathy.’ This doesn’t make sense.
We want the public to know who is treating them and why, including traditional naturopaths– taking the name naturopathy and naturopath out of the public domain will confuse Californians and strip traditional practitioners of our title, which has been used for 115 years.
If [this bill] passes as written, traditional naturopaths, including Mexican-American curanderos, Chinese herbalists, and Indian Ayurvedists, to name a few, and many other groups who practice a form of traditional naturopathy will no longer be able to simply and clearly explain their work to their patients. It is an insult to cultures that have practiced naturopathy for hundreds, if not thousands of years. Most of these practitioners are small business women who serve their communities at a low cost compared to the medicalized naturopaths.”
California Naturopathic Association writes in opposition: “Traditional naturopaths serve all cultural and financial groups within the state and for the most part do not have a wealthy clientele. They serve a large part of the California population, bringing naturopathy to middle and lower income families and there is no just cause for denying their right to use the titles. This would greatly interfere with the good will they have built up over the past fifteen years as they built their practices according to the established law. Not to mention the freedom of choice that is being restricted, and of course the tremendous number of jobs and costs that are involved.”
Sunshine Health Freedom Foundation writes in opposition that the “amendment that was added regarding traditional titles would endanger many of our distributors in their businesses and practices of traditional naturopathy. The amendment would end the use of these traditional titles and terms that have been used for decades by traditional practitioners.”
POLICY ISSUES:
This bill aims to reduce consumer confusion “due to the interchangeable use of ‘naturopath’ and ‘naturopathic doctors’ by laypersons.” This bill does this by prohibiting the use of the titles “naturopath,” “naturopathic practitioner,” or “traditional naturopathic practitioner” by unlicensed individuals.
In the NMC’s 2016 Sunset Review Report, the NMC continues to report issues with unlicensed activity and the underground economy of naturopathic medicine (pages 58-59). Specifically, while the NMC was “lobbying for [SB 538 (Hueso) of 2015 (which would have expanded the ND scope of practice)], we noticed that there is a mass misconception in the public between individuals calling themselves ‘naturopaths,’ and licensed [NDs].” According to the NMC, the confusion “causes consumers to unknowingly seek out ‘naturopaths,’ not realizing these individuals are unlicensed and do not meet the extensive education and training that NDs are required to have for licensure.”
The NMC also noted that most of its cases are for unlicensed practice. It believes that “this type of violation significantly increase[s] the risk of harm to the consumers in California” and “takes away potential patients from licensed Naturopathic Doctors (NDs). Additionally, this causes a potential loss of income for California NDs, causing yet, another workforce issue.” To address this issue, the NMC “plans to do more to utilize the cite and fine program and will work towards ‘naturopath’ title protection to fully protect the consumers.”
However, as with any consumer protection measure, the demonstrable harm must be weighed against the potential burdens on the practitioner. Further, the protectionist nature of any registration, title protection, or licensure request should be scrutinized as well (see Government Code §§ 9148-9148.8). A potential loss of income due to fair competition from the market is not a strong policy justification. Instead, the proponents should demonstrate patient harm or unfair business practices.
In this case data is limited. According to the NMC’s 2016 Sunset Review Report, the NMC’s FY 2013/14 enforcement workload was as follows:
Unprofessional Conduct | 1 | (01%) |
Advertising Violations | 11 | (08%) |
Unlicensed Activity | 126 | (91%) |
Total Cases | 138 | |
The NMC notes that the “investigative costs associated with these cases was $30,077, which is 9.6% of our total budget.” Further, the “126 ‘unlicensed activity’ cases were mostly misuse of title.” Being relatively simple cases, the NMC can complete these cases through research during desk investigations by an enforcement analyst. The NMC notes that “[m]ost of the violators comply with the cease orders and the cases can be closed.”
The following is a breakdown of the complaints by source, but it is unclear what proportion of each complaint source fell under each of the provided cases:
Source of Complaint | FY 2013-14 | FY 2014-15 | FY 2015-16 |
Public | 158 | 170 | 154 |
Lic. / Prof. Groups | 23 | 16 | 31 |
Gov. Agencies | 4 | 7 | 11 |
Other/Internal | 23 | 12 | 21 |
It is also unclear how many of these cases are serious violations. The NMC’s 2016 Sunset Review Report noted that there was a total of 4 pending “sworn investigations” (requiring a peace officer) at the end of FY 15/16.
According to the NMC, its “reports in BreEZe have been problematic with providing the correct data. Some of this was due to the conversion from legacy systems, and some was programming issues. Once BreEZe went into production, current staff resources could no longer enter data into both the new BreEZe system and the legacy database, as such we do not have some of the information that was requested.” However, the NMC notes that this has now been corrected.
Given this, it is unclear whether the patient harm or potential unfair business practices are serious enough to warrant title protection. Therefore, rather than moving straight to title protection, it may be beneficial to explore alternative methods of consumer protections.
IMPLEMENTATION ISSUES:
Practice of Naturopathy vs Naturopathic Practitioner. This bill prohibits the use of the title “naturopathic practitioner” but expressly authorizes an unlicensed person to represent that the person “practices naturopathy.” This may be confusing to consumers.
AMENDMENTS:
- Based on the available data, the necessity and urgency for the title restriction is not clear. Therefore, the author should amend the bill to delete the January 1, 2020 restriction on the title “naturopath,” terms “naturopath,” “naturopathic practitioner,” and “traditional naturopathic practitioner”:
SEC. 11. Section 3660 of the Business and Professions Code is amended to read:
3660. Except as provided in subdivision (h) of Section 3644, a person shall have a valid, unrevoked, or unsuspended license issued under this chapter to do any of the following:
(a) To claim to be a naturopathic doctor, licensed naturopathic doctor, doctor of naturopathic medicine, doctor of naturopathy, or naturopathic medical doctor.
(b) To use the professional designation “N.D.,” “naturopath,” “naturopathic practitioner,” “traditional naturopathic practitioner,” or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor.
(c) Until January 1, 2020, the use of the terms “naturopath,” “naturopathic practitioner,” and “traditional naturopathic practitioner” may be used in marketing, advertisements, and other related materials by persons who are educated and trained, but not licensed, to practice naturopathy pursuant to this chapter. Individuals shall not be disciplined for the misuse of titles not under their control.
- Until the NMC’s data tracking through BreEZe can demonstrate harm requiring the elimination of the title “naturopath” from the marketplace, alternative methods to prevent consumer confusion should be tested. Therefore, the author should instead strengthen the existing disclosure requirements to require an unlicensed naturopath to include disclosures on any advertising or listing and over the phone prior to providing advice or arranging to provide services:
SEC. 10. Section 3645 of the Business and Professions Code is repealed. amended to read:
3645. (a) This chapter permits, and does not restrict the use of, the following titles by persons who comply with subdivision (c) of this section and are educated and trained as any of the following:
(1) “Naturopath.”
(2) “Naturopathic practitioner.”
(3) “Traditional naturopathic practitioner.”
(b) This chapter permits, and does not restrict, the education of persons as described in paragraphs (1) to (3), inclusive, of subdivision (a). Those persons are not required to be licensed under this chapter.
(c) An unlicensed person may use the titles described under subdivision (a) if the unlicensed person does all of the following:
(1) Complies with Section 2053.6.
(2) Provides a conspicuous disclosure in all marketing, advertisements, and other related materials that states, in plain language, that the person is not licensed by the California Naturopathic Medicine Committee as a Naturopathic Doctor.
(3) Obtains verbal confirmation that client understands that the person is not licensed as a Naturopathic Doctor prior to providing advice or arranging for services related to the practice of naturopathy over the phone.
REGISTERED SUPPORT:
Bastyr University
California Naturopathic Doctors Association
Respiratory Care Board of California
Naturopathic Medicine Committee
Southern California University of Health Sciences
State of Utah Division of Occupational and Professional Licensing
State of Washington Board of Naturopathy
REGISTERED OPPOSITION:
American Naturopathic Medical Association
California Health Freedom Coalition
California Naturopathic Association
Natural Health Freedom Action
Natural Healing Institute of Naturopathy, Inc.
Sunshine Health Freedom Foundation
Numerous individuals
Analysis Prepared by: Vincent Chee / B. & P. / (916) 319-3301
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | SB |
THIRD READING
Bill No: SB 796
:
SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 8-0, 4/24/17
AYES: Hill, Fuller, Galgiani, Glazer, Hernandez, Newman, Pan, Wilk
NO VOTE RECORDED: Dodd
SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/25/17
AYES: Lara, Bates, Beall, Bradford, Hill, Nielsen, Wiener
DIGEST:
This bill extends the sunset dates of the Naturopathic Medicine Committee (NMC) and Respiratory Care Board of California (RCB) until 2022 and makes various changes to the Naturopathic Doctors Act (Act) and Respiratory Care Practice Act.
Existing law:
- Establishes the NMC within the Osteopathic Medical Board of California to enforce and administer the Act. (Business and Professions Code (BPC) §§ 3612, 3620)
- Repeals the Act on January 1, 2018. (BPC § 2450.3)
- Establishes the NMC as consisting of 9 members appointed by the Governor, including 2 public members. Requires a public member to be a citizen of the state for at least 5 years preceding his or her appointment. (BPC § 3621)
- Requires the NMC to approve naturopathic medical education programs.
(BPC § 3623) - Requires licensees to complete 60 hours of approved continuing education (CE) biennially. (BPC § 3635)
- Permits use of the titles “naturopath,” “naturopathic practitioner,” and “traditional naturopathic practitioner” by persons educated and trained as such, but not licensed in California. (BPC § 3645)
- Permits only licensed individuals to claim to be a naturopathic doctor (ND), licensed ND, doctor of naturopathic medicine, doctor of naturopathy, or naturopathic medical doctor, use the professional abbreviation “N.D.”, or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a ND. (BPC § 3660)
- Requires the NMC to establish the amount of the fee assessed to conduct activities of the NMC, including the amount of fees for applicant licensure, licensure renewal, late renewal, and childbirth certification. (BPC § 3680)
- Requires an applicant for a license as a ND to file a written application with the NMC. (BPC § 3690)
- Establishes the RCB to administer and enforce the Respiratory Care Practice Act. (BPC §§ 3700, 3710)
- Defines “respiratory care” as a health care profession performed under the supervision of a medical director in the therapy, management, rehabilitation, diagnostic evaluation, and care of patients with deficiencies and abnormalities which affect the pulmonary system and associated aspects of cardiopulmonary and other systems functions. (BPC § 3702)
- Repeals the Respiratory Care Practice Act on January 1, 2018. (BPC § 3710)
This bill:
- Extends the sunset date, until January 1, 2022, for the NMC and RCB.
- Requires that the two public members be appointed by the Senate Committee on Rules and the Assembly Committee on Rules, respectively.
- Requires a public member to be a resident of the state, rather than a citizen, for at least five years preceding his or her appointment.
- Requires that the NMC approve only those naturopathic medical programs that evaluate an applicant’s education, training, experience obtained in the armed services, and provide course credit where applicable.
- Requires a licensee to retain certificates of CE course completion for six years.
- Authorizes the NMC to audit licensees’ CE records to ensure that CE requirements are met.
- Declares that furnishing false or misleading information to the NMC regarding CE constitutes unprofessional conduct.
- Permits only a licensee to use the terms “naturopath,” “naturopathic practitioner,” and “traditional naturopathic practitioner.”
- Codifies existing NMC licensing fees.
- States that monies in the Respiratory Care Fund be available to the RCB upon appropriation of the Legislature for the purposes of the Respiratory Care Practice Act.
- Makes technical changes to the Act.
Background
Naturopathic medicine. The NMC is charged with licensing and regulating NDs. NMC’s 2016 Strategic Plan states that its mission is “To protect health care consumers through the proper licensing and regulation of NDs utilizing the vigorous, objective enforcement of the Naturopathic Doctors Act, and to promote access to quality naturopathic medical care.”
According to the NMC, naturopathic medicine is a distinct and comprehensive system of primary health care that uses natural methods and substances to support and stimulate the body’s self-healing process. It is distinguished by the principles on which its practice is based. These principles include:
- The Healing Power of Nature: NDs trust in the body’s inherent wisdom to heal itself.
- Identify and Treat the Cause: Look beyond the symptoms to effectively address the underlying cause(s) of illness.
- First Do No Harm: Seek to utilize the most natural, least invasive and least toxic therapies first.
- Doctor as Teacher: The primary role of an ND is a teacher who educates and encourages people to take responsibility for their own health and to take steps to achieve and maintain optimal health.
- Treat the Whole Person: Total health includes physical, emotional, mental, genetic, environmental, social, spiritual, and other factors.
- Prevention: Encourage and emphasize disease prevention and focus on promoting health and wellness.
Naturopathic medicine includes the combination of a variety of natural medicines and treatments. NDs are clinically trained in both natural and conventional approaches to medicine and can prescribe all natural and synthetic hormones, epinephrine, and vitamins, minerals, and amino acids independent of physician supervision. California NDs complete 72 pharmacology course hours in school and are required to complete a minimum of 20 hours of pharmacotherapeutic training every two years as part of their 60 hour CE requirement.
NDs attend four year, graduate-level, accredited naturopathic medical schools, are trained as primary care providers, and take a national, standardized licensing examination. NDs have limited opportunities to complete hospital residencies, but perform at least 1500 hours of clinical rotations at clinics and private doctors’ offices during their education program. California is one of 17 states that license NDs, and over 500 ND licenses have been issued to date. There is one naturopathic medicine school in California, located in San Diego.
Additional title protection. NMC staff reports the majority of enforcement resources are used policing unlicensed practice. Cases primarily involve misuse of the ND title, or practice within the protected scope of an ND without a license.
To avoid consumer confusion and possible harm, the NMC advocates for only a licensee to be able to use the terms “naturopath,” “naturopathic practitioner,” and “traditional naturopathic practitioner.”
Veterans’ military experience. The NMC does not itself evaluate schools for approval, but rather is required to approve schools that are accredited by the Council on Naturopathic Medical Education (CNME) or other equivalent accrediting body that meets certain minimum requirements. However, current law requires boards and bureaus to provide for methods of evaluating military education, training, and experience towards licensure.
The NMC asserts that it has not made any regulatory changes to conform to this law because “the military does not offer educational credits which can be applied towards obtaining a Naturopathic Doctor’s degree; therefore regulatory changes are not necessary.” The intent of this law is not to merely inquire as to whether the military issues a naturopathic degree, but to what extent basic biology or anatomy courses, or clinical training or experience may contribute to the transfer or credits earned in beginning a ND program.
For this reason, this bill requires the NMC to only approve those programs that, in addition to accreditation, evaluate an applicant’s education, training, and experience obtained in the armed services, and provide course credit where available.
Board appointments and fees. The NMC currently functions as an independent entity, but was originally designed as a dependent committee within the Osteopathic Medical Board of California. In that structure, full gubernatorial appointment authority for NMC was immaterial, since the NMC’s parent body had public appointments by the Legislature, ensuring ultimate input into both entities.
This bill maintains the professional and public makeup of the NMC, but designates appointing authority for the two public members to the Legislature, similar to that of other healing arts boards. This bill also establishes the NMC’s fees in statute, so that they must request periodic increases from the Legislature, as other boards do.
Respiratory care. The RCB is responsible for enforcing state laws pertaining to the practice of respiratory care and regulates a single category of health care workers – respiratory care practitioners (RCPs). RCPs are specialized health care workers, who work under the supervision of medical directors and are involved in the prevention, diagnosis, treatment, management, and rehabilitation of problems affecting the heart and lungs and other disorders, as well as providing diagnostic, educational, and rehabilitation services. RCPs provide treatments for patients who have breathing difficulties and care for those who are dependent upon life support and cannot breathe on their own.
This bill states that monies in the Respiratory Care Fund be available to the RCB upon appropriation of the Legislature for the purposes of the Respiratory Care Practice Act, in conformance with similar clauses in other practice acts.
FISCAL EFFECT: Appropriation: Fiscal Com.: Local:
According to the Senate Appropriations Committee:
- Ongoing costs of $400,000 per year for the continued operation of the NMC (Naturopathic Doctors fund).
- Likely ongoing fine revenue in the tens of thousands per year from disciplinary action against unlicensed practice (Naturopathic Doctors Fund). Based on historic workload, the NMC anticipates that fine revenues could range from $50,000 per year (assuming all fines are first time fines) up to $800,000 per year (assuming all fines are third occurrence fines). In practice, the ability to assess fines for unlicensed practice will likely create a deterrent for unlicensed practice. Therefore, future fine revenues are likely to be closer to the low end estimate.
- No significant costs are anticipated by the NMC due to any of the other changes in this bill.
- Ongoing costs of $3.7 million per year for the continued operation of the RCB (Respiratory Care Fund).
California Naturopathic Doctors Association
California Society for Respiratory Care
The Naturopathic Medicine Committee of California
The Respiratory Care Board of California
OPPOSITION: (Verified 5/26/17)
American Naturopathic Medical Association
National Health Freedom Action
One individual
ARGUMENTS IN SUPPORT: The California Naturopathic Doctors Association writes, “Licensure and regulation of the California naturopathic doctor profession by the Naturopathic Medicine Committee provides the citizens of California safe access to well-trained primary care providers that specialize in affordable, effective healthcare.”
The Naturopathic Medicine Committee writes in support stating that “the legislative changes proposed by SB 796 strengthen enforcement and public safety. The additional authority to perform random audits of continuing education will assist in tracking compliance of our licensees and will streamline the license renewal process. Furthermore, the changes to B&P Code section 3660(b) will provide a level of consumer protection by protecting the ‘naturopath’ and ‘naturopathic’ titles, alleviating dire confusion to the consumers.”
ARGUMENTS IN OPPOSITION: The American Naturopathic Medical Association oppose ND licensure, stating, “The state of California already regulates primary care doctors and these naturopathic physicians could not possibly meet those requirements so they have come to you seeking a back door into practicing as primary care physicians without going to a real medical school. The cost to the citizens of California for administration of such a board could possibly be their lives or that of a loved one.”
National Health Freedom Action opposes the extension of title protection to include the terms “naturopath,” “naturopathic practitioner,” and “traditional naturopathic practitioner.”
5/27/17 18:27:29
**** END ****
SENATE COMMITTEE ON
Senator Ricardo Lara, Chair
2017 - 2018 Regular Session
SB 796 (Hill) - Healing arts: boards
Version: | Policy Vote: |
Urgency: | Mandate: |
Hearing Date: | Consultant: |
*********** ANALYSIS ADDENDUM – SUSPENSE FILE ***********
The following information is revised to reflect amendments
adopted by the committee on May 25, 2017
Bill Summary:
SB 796 would extend the operation of the Naturopathic Medicine Committee until January 1, 2022 and would make specified changes to the practice of naturopathic medicine and the operations of the Committee. The bill would also extend the operation of the Respiratory Care Board until January 1, 2022.
Fiscal Impact:
- Ongoing costs of $400,000 per year for the continued operation of the Naturopathic Medicine Committee (Naturopathic Doctors fund).
- Likely ongoing fine revenue in the tens of thousands per year from disciplinary action against unlicensed practice (Naturopathic Doctors Fund). Based on historic workload, the Committee anticipates that fine revenues could range from $50,000 per year (assuming all fines are first time fines) up to $800,000 per year (assuming all fines are third occurrence fines). In practice, the ability to assess fines for unlicensed practice will likely create a deterrent for unlicensed practice. Therefore, future fine revenues are likely to be closer to the low end estimate.
- No significant costs are anticipated by the Committee due to any of the other changes in the bill.
- Ongoing costs of $3.7 million per year for the continued operation of the Respiratory Care Board (Respiratory Care Fund).
Committee Amendments:
make the Respiratory Care Fund subject to appropriation by the Legislature.
-- END --
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2017 - 2018 Regular Session
SB 796 (Hill) - Healing arts: boards
Version: April 17, 2017 | Policy Vote: B., P. & E.D. 8 - 0 |
Urgency: No | Mandate: Yes |
Hearing Date: May 15, 2017 | Consultant: Brendan McCarthy |
This bill meets the criteria for referral to the Suspense File.
Bill Summary:
SB 796 would extend the operation of the Naturopathic Medicine Committee until January 1, 2022 and would make specified changes to the practice of naturopathic medicine and the operations of the Committee. The bill would also extend the operation of the Respiratory Care Board until January 1, 2022.
Fiscal Impact:
- Ongoing costs of $400,000 per year for the continued operation of the Naturopathic Medicine Committee (Naturopathic Doctors fund).
- Likely ongoing fine revenue in the tens of thousands per year from disciplinary action against unlicensed practice (Naturopathic Doctors Fund). Based on historic workload, the Committee anticipates that fine revenues could range from $50,000 per year (assuming all fines are first time fines) up to $800,000 per year (assuming all fines are third occurrence fines). In practice, the ability to assess fines for unlicensed practice will likely create a deterrent for unlicensed practice. Therefore, future fine revenues are likely to be closer to the low end estimate.
- No significant costs are anticipated by the Committee due to any of the other changes in the bill.
- Ongoing costs of $3.7 million per year for the continued operation of the Respiratory Care Board (Respiratory Care Fund).
Background:
Under current law, the Naturopathic Medicine Committee (under the Osteopathic Medical Board) licenses and regulates the practice of Naturopathic Medicine. Current law sunsets the operation of the Committee on January 1, 2018.
Naturopathic doctors are required to complete a four-year, graduate level training program. Naturopathic doctors are authorized to prescribe natural and synthetic hormones, epinephrine, vitamins, minerals, and amino acids independent of physician supervision. Current law requires an individual to be a licensed naturopathic physician to use the abbreviation “N.D.” or other words to represent that he or she is a licensed naturopathic doctor. However, current law does not restrict the use of terms such as “naturopath”, “naturopathic practitioner”, or “traditional naturopathic practitioner” to licensed individuals.
Thus, under current law, the Committee does not have the power to fine individuals who are using terminology similar to naturopathic doctor or N.D., unless they use those specific terms.
Under current law, the Respiratory Care Board licenses respiratory care practitioners and regulates their practice. Current law sunsets the operation of the Board on January 1, 2018.
Proposed Law:
SB 796 would extend the operation of the Naturopathic Medicine Committee until January 1, 2022 and would make specified changes to the practice of naturopathic medicine and the operations of the Committee. The bill would also extend the operation of the Respiratory Care Board until January 1, 2022.
Specific provisions of the bill would:
- Extend the operation of the Naturopathic Medicine Committee until January 1, 2022;
- Require the Committee to be made up of seven professional members appointed by the Governor and two public members appointed by the Senate Rules Committee and the Assembly Rules Committee;
- Require the Committee to evaluate an applicant’s military training and experience, if any, and provide course credit where applicable;
- Delete the requirement that an applicant complete a written application for licensure;
- Make certain changes to the requirements for continuing education for Naturopathic Doctors;
- Require individuals to be licensed to use the terms “naturopath”, naturopathic practitioner”, or “traditional naturopathic practitioner”;
- Extend the operation of the Respiratory Care Board until January 1, 2022.
Related Legislation:
This bill is one of several “sunset review” bills authored by the chairs of the Senate and Assembly Business and Professions Committees.
Staff Comments:
In recent years, the Naturopathic Medicine Committee has received about 100 complaints per year alleging unlicensed practice. In most of those cases, however, the individual was not using the title “Naturopathic Doctor” without a license which is prohibited under current law. Rather, in most cases, the individual was using a title such as “naturopathic practitioner”. Under this bill, use of such similar titles would be prohibited. Initially, there may be a significant amount of enforcement activity against individuals using titles that would be restricted under the bill. In the long-run, however, the ability for the Committee to issue fines for such unlicensed practice is likely to provide a deterrent against using protected titles without a license. Therefore, any fine revenues are likely to decline over time.
The only costs that may be incurred by a local agency relate to crimes and infractions. Under the California Constitution, such costs are not reimbursable by the state.
-- END --
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2017 - 2018 Regular
Bill No: Hearing Date: April 24, 2017
Author: | |||
Version: | April 17, 2017 | ||
Urgency: | No | Fiscal: | Yes |
Consultant: | Mark Mendoza/Sarah Huchel | ||
Subject:
SUMMARY:
Adds a four year sunset date to the Naturopathic Medicine Committee and Respiratory Care Board of California; mirrors the NMC composition requirements to mirror that of other allied health care committees; requires that the naturopathic medical program evaluate an applicant’s education, training, experience obtained in the armed services, and provide course credit where applicable; requires a naturopathic medicine licensee to retain certificates of continuing education course completion for 6 years; requires only a licensee to use the terms “ND”, “naturopaths”, “naturopathic practitioners”, and “traditional naturopathic practitioners”; and makes other technical and clarifying changes.
Existing law:
- Establishes the Naturopathic Medicine Committee (NMC) within the Osteopathic Medical Board to enforce and administer the Naturopathic Doctors Act. (Business and Professions Code (BPC) §§ 3612 and 3620)
- Repeals the Naturopathic Doctors Act on January 1, 2018. (BPC § 2450.3)
- Requires the NMC to consist of 9 members appointed by the Governor, including 2 public members. Requires a public member to be a citizen of the state for at least 5 years preceding his or her appointment. (BPC § 3621)
- Requires the NMC to approve a specified naturopathic medical education program. (BPC § 3623)
- Requires that the NMC require the satisfactory completion of 60 hours of approved continuing education biennially. This requirement is waived for the initial license renewal. (BPC § 3635)
- Specifies that the Naturopathic Doctors Act permits, and does not restrict the use of, the titles “naturopath,” “naturopathic practitioner,” and “traditional naturopathic practitioner” by persons who are educated and trained for those positions. Specifies that the Naturopathic Doctors Act permits, and does not restrict, the education of these persons, and does not require these persons to be licensed under the act. (BPC § 3645)
- Requires that a person be licensed to use the professional abbreviation “N.D.”
(BPC § 3660) - Requires the NMC to establish the amount of the fee assessed to conduct activities of the NMC, including the amount of fees for applicant licensure, licensure renewal, late renewal, and childbirth certification. (BPC § 3680)
- Requires an applicant for a license as a naturopathic doctor to file a written application with the NMC, as specified. (BPC § 3690)
- Establishes the Respiratory Care Board of California (Board or RCB) to administer and enforce the Respiratory Care Practice Act. (BPC §§ 3700 and 3710)
- Defines “respiratory care” as a health care profession performed under the supervision of a medical director in the therapy, management, rehabilitation, diagnostic evaluation, and care of patients with deficiencies and abnormalities which affect the pulmonary system and associated aspects of cardiopulmonary and other systems functions. (BPC § 3702)
- Repeals the Respiratory Care Practice Act on January 1, 2018. (BPC § 3710)
This bill:
- Adds a four year sunset date, until January 1, 2022, to the NMC.
- Requires that the NMC consist of seven professional members to be appointed by the Governor, one public member to be appointed by the Senate Committee on Rules, and one public member to be appointed by the Assembly Committee on Rules.
- Requires a public member to be a resident of the state for at least five years preceding his or her appointment.
- Requires that the naturopathic medical program evaluate an applicant’s education, training, experience obtained in the armed services, and provide course credit where applicable.
- Removes the requirement that an application for licensure be written.
- Requires a naturopathic medicine licensee to retain certificates of continuing education course completion for 6 years.
- Authorizes the NMC to audit licensees’ continuing education records to ensure that continuing education requirements are met.
- Declares that furnishing false or misleading information to the committee regarding continuing education constitutes unprofessional conduct.
- Permits only a licensee to use the terms “ND”, “naturopaths”, “naturopathic practitioners”, and “traditional naturopathic practitioners”.
- Codifies existing licensing fees regulations into the Naturopathic Doctors Act.
- Aligns the board composition to mirror other allied professional healthcare boards.
FISCAL EFFECT: Unknown. This bill is keyed “fiscal” by Legislative Counsel.
COMMENTS:
- Purpose. This bill is sponsored by the Author. This bill is one of four “sunset review bills” the Author is sponsoring this session. According to the Author, this bill is necessary to add sunset dates for the Naturopathic Medicine Committee and Respiratory Care Board of California in order to ensure oversight over the naturopathic and respiratory professions. The health, safety, and welfare of consumers are protected by a well-regulated naturopathic and respiratory profession. The Naturopathic Medicine Committee and Respiratory Care Board of California have shown over the years a strong commitment to improve its overall efficiency and effectiveness and has worked cooperatively with the Legislature and this policy committee to bring about necessary changes. While the Naturopathic Medicine Committee needs to review some of its administrative practices, both the Naturopathic Medicine Committee and Respiratory Care Board of California should both be given a four-year extension of their sunset date so that this policy committee may review, once again, if the issues and recommendations in the background paper and others of this policy committee have been addressed.
- Oversight Hearings and Sunset Review of Licensing Boards and Programs. Beginning in 2017, the Senate Business and Professions Committee and the Assembly Business and Professions Committee (Committees) conducted joint oversight hearings to review 14 regulatory entities: DCA, Chiropractic Board, Physical Therapy Board, Optometry and Registered Dispensing Optician’s Board, Medical Board of California, Osteopathic Medical Board of California, Board of Guide Dogs for the Blind, Naturopathic Committee, Respiratory Care Board, Board of Registered Nurses, Speech Language, Audiology & Hearing Aid Dispensers Board, Occupational Therapy Board, Board of Vocational Nurses and Psychiatric Technicians, and the California Council for Interior Design Certification.
The Committees conducted three hearings in March. This bill and the accompanying sunset bills are intended to implement legislative changes as recommended by staff of the Committees and which are reflected in the background papers prepared by Committee staff for each agency and program reviewed this year.
- Naturopathic Medicine. The Naturopathic Medicine Committee is charged with licensing and regulating Naturopathic Doctors (NDs). NMC’s 2016 Strategic Plan states that its mission is “To protect health care consumers through the proper licensing and regulation of NDs utilizing the vigorous, objective enforcement of the Naturopathic Doctors Act, and to promote access to quality naturopathic medical care.”
According to the Committee, Naturopathic medicine is a distinct and comprehensive system of primary health care that uses natural methods and substances to support and stimulate the body’s self-healing process. It is distinguished by the principles on which its practice is based. These principles include:
- The Healing Power of Nature: NDs trust in the body’s inherent wisdom to heal itself.
- Identify and Treat the Cause: Look beyond the symptoms to effectively address the underlying cause(s) of illness.
- First Do No Harm: Seek to utilize the most natural, least invasive and least toxic therapies first.
- Doctor as Teacher: The primary role of an ND is a teacher who educates and encourages people to take responsibility for their own health and to take steps to achieve and maintain optimal health.
- Treat the Whole Person: Total health includes physical, emotional, mental, genetic, environmental, social, spiritual, and other factors.
- Prevention: Encourage and emphasize disease prevention and focus on promoting health and wellness.
Naturopathic medicine includes the combination of a variety of natural medicines and treatments. NDs are clinically trained in both natural and conventional approaches to medicine and can prescribe all natural and synthetic hormones, epinephrine, and vitamins, minerals, and amino acids independent of physician supervision. California NDs complete 72 pharmacology course hours in school and are required to complete a minimum of 20 hours of pharmacotherapeutic training every two years as part of their 60 hour continuing education requirement.
NDs attend four year, graduate-level, accredited naturopathic medical schools, are trained as primary care providers, and take a national, standardized licensing examination. NDs have limited opportunities to complete hospital residencies, but perform at least 1500 hours of clinical rotations at clinics and private doctors’ offices during their education program. California is one of 17 states that license NDs, and over 500 ND licenses have been issued to date. There is one naturopathic medicine school in California, located in San Diego.
- Respiratory Care. The Respiratory Care Board, originally established as the Respiratory Care Examining Committee, was created by the Legislature in 1982 to protect a vulnerable patient population from the unqualified practice of respiratory care. The Board is responsible for enforcing state laws pertaining to the practice of respiratory care and regulates a single category of health care workers – respiratory care practitioners (RCPs). RCPs are specialized health care workers, who work under the supervision of medical directors and are involved in the prevention, diagnosis, treatment, management, and rehabilitation of problems affecting the heart and lungs and other disorders, as well as providing diagnostic, educational, and rehabilitation services. RCPs provide treatments for patients who have breathing difficulties and care for those who are dependent upon life support and cannot breathe on their own. RCPs treat patients with acute and chronic diseases, including Chronic Obstructive Pulmonary Disease (COPD), trauma victims and surgery patients. They are typically employed in hospitals, however, a growing number of RCPs work in alternative settings like skilled nursing facilities, physician’s offices, hyperbaric oxygen therapy facilities and sleep laboratories, to name a few.
The law governing RCPs, the Respiratory Care Practice Act requires licensure for individuals performing respiratory care. In carrying out its mandate to ensure that protection of the public shall be highest priority in exercising its licensing, regulatory and disciplinary functions, the Board:
- Screens each application for licensure to ensure minimum education and competency standards are met and conducts a thorough criminal background check on each applicant.
- Investigates complaints against licensees, including those generated from updated criminal history reports and mandatory reporting of violations by licensees and employers.
- Aggressively monitors RCPs placed on probation.
- Exercises its authority to penalize or discipline applicants and licensees which may include issuing a citation and fine, issuing a public reprimand, placing the licensee on probation (which may include license suspension), denying an application for licensure or revoking a license.
- Addresses current issues related to the unlicensed and/or unqualified practice of respiratory care.
- Promotes public awareness of its mandate and function, as well as current issues affecting patient care.
The practice of respiratory care is regulated through licensure in all states except for Alaska.
The current Board mission which guides Board members and the Board’s 18 employees, is as follows:
The Respiratory Care Board of California’s mission is to protect and serve consumers by licensing qualified respiratory care practitioners, enforcing the provisions of the Respiratory Care Practice Act, expanding the availability of respiratory care services, increasing public awareness of the profession, and supporting the development and education of respiratory care practitioners.
The Board is comprised of nine members, four RCPs, four public members and one physician and surgeon member. Two public members and one RCP are appointed by the Governor. One public member and two RCPs are appointed by the Speaker of the Assembly. One public member, one RCP and one physician are appointed by the Senate Committee on Rules.
- Review of the Naturopathic Medicine Committee – Issues Identified and Recommended Changes. The following are some of the major issues pertaining to the NMC along with background information concerning the particular issue. Recommendations were made by Committee staff regarding the particular issue areas which needed to be addressed.
- Issue: Additional Title Protection
Background: Board staff reports the majority of enforcement time is spent policing unlicensed practice. Individuals who misuse the title of ND, or practice within the protected scope of an ND without a license are either issued a cease and desist letter (C&D) or an “educational letter.” An “educational letter” advises the individual that they should not use the ND title and provides information of the Naturopathic Doctors Act and also provides further information of the Medical Act for those individuals providing unlicensed healing arts.
Staff indicates that due to the interchangeable use of “naturopath” and “naturopathic doctors” by lay persons, this issue causes a considerable amount of confusion for the consumer. Consumers see a “naturopath” who is not qualified for licensure and assumes that the individual is a competent licensed ND and is at a high risk for physical harm as seen in two recent criminal cases of an unlicensed individual acting in the capacity of an ND. In both cases there was great bodily harm to consumers.
Recommendation and Proposed Statutory Change: The Committee may wish to permit only a licensee to use the terms “ND”, “naturopaths”, “naturopathic practitioners”, and “traditional naturopathic practitioners”.
The bill makes the following changes to the Naturopathic Doctors Act. Specifically, BPC § 3660 will now read:
Except as provided in subdivision (h) of Section 3644, a person shall have a valid, unrevoked, or unsuspended license issued under this chapter to do any of the following:
- To claim to be a naturopathic doctor, licensed naturopathic doctor, doctor of naturopathic medicine, doctor of naturopathy, or naturopathic medical doctor.
- To use the professional abbreviation “N.D.,” “naturopath,” “naturopathic practitioner,” “traditional naturopathic practitioner,” or other titles, words, letters, or symbols with the intent to represent that he or she practices, is authorized to practice, or is able to practice naturopathic medicine as a naturopathic doctor.
- Issue: Veterans’ Military Experience
Background: The NMC does not itself evaluate schools for approval, but rather is required to approve schools that are accredited by the Council on Naturopathic Medical Education (CNME) or other equivalent accrediting body that meets certain minimum requirements. Current law requires boards and bureaus to provide for methods of evaluating military education, training, and experience towards licensure.
Business and Professions Code Section 35 states:
It is the policy of this state that, consistent with the provision of high-quality services, persons with skills, knowledge, and experience obtained in the armed services of the United States should be permitted to apply this learning and contribute to the employment needs of the state at the maximum level of responsibility and skill for which they are qualified. To this end, rules and regulations of boards provided for in this code shall provide for methods of evaluating education, training, and experience obtained in the armed services, if applicable to the requirements of the business, occupation, or profession regulated. These rules and regulations shall also specify how this education, training, and experience may be used to meet the licensure requirements for the particular business, occupation, or profession regulated. Each board shall consult with the Department of Veterans Affairs and the Military Department before adopting these rules and regulations. Each board shall perform the duties required by this section within existing budgetary resources of the agency within which the board operates.
The NMC asserts that it has not made any regulatory changes to conform to this law because “the military does not offer educational credits which can be applied towards obtaining a Naturopathic Doctor’s degree; therefore regulatory changes are not necessary.” It is unclear whether the Committee has evaluated every military educational program available, especially those that train personnel toward licensure as physician assistants, and come to the conclusion that not a single credit for academic or experiential experience is transferable.
The intent of this law is not to merely inquire as to whether the military issues a naturopathic degree, but to what extent basic biology or anatomy courses, or clinical training or experience may contribute to the transfer or credits earned in beginning a ND program.
Recommendation and Proposed Statutory Change: The NMC may wish to evaluate an applicant’s education, training, and experience obtained in the armed services, and provide course credit where available.
The bill makes the following changes to the Naturopathic Doctors Act. Specifically, BPC § 3623 will now read:
- The committee 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:
- Admission requirements that include a minimum of three-quarters of the credits required for a bachelor’s degree from a regionally accredited or preaccredited college or university or the equivalency, as determined by the council.
- 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. Of the total requisite hours, not less than 2,500 hours shall consist of academic instruction, and not less than 1,200 hours shall consist of supervised clinical training approved by the naturopathic medical school.
(b) 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 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 equivalent federally recognized accrediting body for naturopathic doctor education.
(c) To qualify as an approved naturopathic medical school, a naturopathic medical program located in Canada or the United States shall offer a full-time, doctoral-level, naturopathic medical education program with its graduates being eligible to apply to the committee for licensure and to the North American Board of Naturopathic Examiners that administers the naturopathic licensing examination.
(d) The naturopathic medical program shall evaluate an applicant’s education, training, and experience obtained in the armed services, pursuant to Section 35, and provide course credit where applicable.
- Arguments in Support. The California Naturopathic Doctors Association (CDNA) writes in support stating that “licensure and regulation of the California naturopathic doctor profession by the Naturopathic Medicine Committee provides the citizens of California safe access to well-trained primary care providers that specialize in affordable, effective healthcare.”
Respiratory Care Board of California writes that “the Board continually strives to increase consumer protection in the most efficient manner through its licensing and enforcement programs. For these reasons, the Board strongly supports the extended regulation of licensed respiratory care practitioners in California.”
The Naturopathic Medicine Committee writes in support stating that “the legislative changes proposed by SB 796 strengthen enforcement and public safety. The additional authority to perform random audits of continuing education will assist in tracking compliance of our licensees and will streamline the license renewal process. Furthermore, the changes to B&P Code section 3660(b) will provide a level of consumer protection by protecting the ‘naturopath’ and ‘naturopathic’ titles, alleviating dire confusion to the consumers.”
- Related Legislation. SB 797 (Hill, 2016) permits the Board of Vocational Nursing and Psychiatric Technicians to delegate to its executive officer the authority to adopt a decision entered by default and a stipulation for surrender of a license. (Status: This bill is currently set to be heard in front of this policy committee on April 24, 2017.)
SB 798 (Hill, 2016) extends the operation of the Medical Board of California (MBC) and Medical Practice Act (MBC Act) until 2022 and subjects the Osteopathic Medical Board of California (OMBC) and Osteopathic Act (OMBC Act) to review by the appropriate policy committees of the Legislature to be performed as if the OMBC Act were scheduled to be repealed as of 2022 and makes various changes to the MBC Act and OMBC Act intended to improve oversight of physicians and surgeons and osteopathic physicians and surgeons. (Status: This bill is currently set to be heard in front of this policy committee on April 24, 2017.)
SB 799 (Hill, 2016) extends the sunset date on the Board of Registered Nursing (BRN) and makes other changes discussed in the BRN’s Background Paper. (Status: This bill is currently set to be heard in front of this policy committee on April 24, 2017.)
SUPPORT AND OPPOSITION:
Support:
California Naturopathic Doctors Association (CDNA)
Respiratory Care Board of California
The Naturopathic Medicine Committee
Opposition:
None on file as of April 18, 2017.
-- END --
Discussed in Hearing
1MIN
Senate Floor
55SEC
Assembly Floor
1H
Assembly Standing Committee on Appropriations
4MIN
Assembly Standing Committee on Business and Professions
1MIN
Senate Floor
48MIN
Senate Standing Committee on Appropriations
6MIN
Senate Standing Committee on Business, Professions and Economic Development
Bill Author
Bill Co-Author(s):