H.F. _____ Section 1. Section 147.1, subsections 3 and 6, Code 2011, 1 are amended to read as follows: 2 3. “Licensed” or “certified” , when applied to a physician 3 and surgeon, podiatric physician, osteopathic physician 4 and surgeon, naturopathic physician, physician assistant, 5 psychologist, chiropractor, nurse, dentist, dental hygienist, 6 dental assistant, optometrist, speech pathologist, audiologist, 7 pharmacist, physical therapist, physical therapist assistant, 8 occupational therapist, occupational therapy assistant, 9 respiratory care practitioner, practitioner of cosmetology 10 arts and sciences, practitioner of barbering, funeral 11 director, dietitian, marital and family therapist, mental 12 health counselor, social worker, massage therapist, athletic 13 trainer, acupuncturist, nursing home administrator, hearing aid 14 dispenser, or sign language interpreter or transliterator means 15 a person licensed under this subtitle. 16 6. “Profession” means medicine and surgery, podiatry, 17 osteopathic medicine and surgery, naturopathic medicine, 18 practice as a physician assistant, psychology, chiropractic, 19 nursing, dentistry, dental hygiene, dental assisting, 20 optometry, speech pathology, audiology, pharmacy, physical 21 therapy, physical therapist assisting, occupational therapy, 22 occupational therapy assisting, respiratory care, cosmetology 23 arts and sciences, barbering, mortuary science, marital 24 and family therapy, mental health counseling, social work, 25 dietetics, massage therapy, athletic training, acupuncture, 26 nursing home administration, hearing aid dispensing, or sign 27 language interpreting or transliterating. 28 Sec. 2. Section 147.2, subsection 1, Code 2011, is amended 29 to read as follows: 30 1. A person shall not engage in the practice of medicine 31 and surgery, podiatry, osteopathic medicine and surgery, 32 naturopathic medicine, psychology, chiropractic, physical 33 therapy, physical therapist assisting, nursing, dentistry, 34 dental hygiene, dental assisting, optometry, speech pathology, 35 -1- LSB 5036YC (3) 84 jr/nh 1/ 11

H.F. _____ audiology, occupational therapy, occupational therapy 1 assisting, respiratory care, pharmacy, cosmetology arts and 2 sciences, barbering, social work, dietetics, marital and 3 family therapy or mental health counseling, massage therapy, 4 mortuary science, athletic training, acupuncture, nursing 5 home administration, hearing aid dispensing, or sign language 6 interpreting or transliterating, or shall not practice as a 7 physician assistant, unless the person has obtained a license 8 for that purpose from the board for the profession. 9 Sec. 3. Section 147.13, subsection 1, Code 2011, is amended 10 to read as follows: 11 1. For medicine and surgery, osteopathic medicine and 12 surgery, and acupuncture, and naturopathic medicine, the board 13 of medicine. 14 Sec. 4. Section 147.74, Code 2011, is amended by adding the 15 following new subsection: 16 NEW SUBSECTION . 22A. A naturopathic physician licensed 17 under chapter 148F may use the words “naturopathic physician” , 18 “naturopathic doctor” , “doctor of naturopathy” , “naturopathic 19 medical doctor” , “doctor of naturopathic medicine” , “naturopath” 20 or the initials “N.D.” or “N.M.D.” after the person’s name. 21 Sec. 5. Section 147.107, Code Supplement 2011, is amended by 22 adding the following new subsection: 23 NEW SUBSECTION . 8A. A licensed naturopathic physician 24 may prescribe all substances and devices consistent with the 25 level of training of the naturopathic physician unless added 26 to the exclusionary naturopathic formulary by the naturopathic 27 advisory council. 28 Sec. 6. Section 148E.3, subsection 1, Code 2011, is amended 29 to read as follows: 30 1. A person otherwise licensed to practice medicine and 31 surgery, osteopathic medicine and surgery, naturopathic 32 medicine, chiropractic, podiatry, or dentistry who is 33 exclusively engaged in the practice of the person’s profession. 34 Sec. 7. NEW SECTION . 148F.1 Definitions. 35 -2- LSB 5036YC (3) 84 jr/nh 2/ 11

H.F. _____ As used in this chapter, unless the context otherwise 1 requires: 2 1. “Approved naturopathic medical program” means any of the 3 following: 4 a. A naturopathic medical education program in the 5 United States providing the degree of doctor of naturopathy 6 or doctor of naturopathic medicine. Such program shall 7 offer graduate-level, full-time didactic and supervised 8 clinical training and shall be accredited, or shall have 9 achieved candidacy status for accreditation by the council 10 on naturopathic medical education or by an equivalent 11 federally recognized accrediting body for naturopathic medical 12 programs also recognized by the board. Additionally, the 13 program shall be an institution, or part of an institution of 14 higher education that is either accredited or is a candidate 15 for accreditation by a regional or national institutional 16 accrediting agency recognized by the United States secretary 17 of education. 18 b. A diploma-granting, degree-equivalent college or 19 university in Canada that offers graduate-level, full-time 20 didactic and supervised clinical training and is accredited, or 21 has achieved candidacy status for accreditation by the council 22 on naturopathic medical education or an equivalent federally 23 recognized accrediting body for naturopathic medical programs 24 also recognized by the board; and the college or university 25 has provincial approval for participation in government-funded 26 student aid. 27 2. “Board” means the board of medicine established in 28 section 147.13. 29 3. “Director” means the executive director of the board of 30 medicine. 31 4. “Exclusionary naturopathic formulary” means the 32 exclusionary list of medicines, nonprescription and 33 prescription, which naturopathic physicians may not use in the 34 practice of their profession, as determined by the naturopathic 35 -3- LSB 5036YC (3) 84 jr/nh 3/ 11

H.F. _____ advisory council. 1 5. “Minor office procedures” means methods for the repair 2 and care incidental to superficial lacerations and abrasions, 3 superficial lesions, and the removal of foreign bodies located 4 in the superficial tissues. 5 6. “Naturopathic advisory council” means the naturopathic 6 advisory council as established under this chapter. 7 7. “Naturopathic medicine” means a system of primary health 8 care for the prevention, diagnosis, and treatment of human 9 health conditions, injury, and disease, and the promotion or 10 restoration of health. “Naturopathic medicine” includes the use 11 of physiological, psychological, or mechanical methods, and the 12 use of natural medicines, prescription or legend drugs, foods, 13 herbs, or other natural remedies. 14 8. “Naturopathic physician” means a practitioner of 15 naturopathic medicine who has been properly licensed for that 16 purpose by the board of medicine under this chapter, who may 17 diagnose, treat, and help prevent diseases using a system 18 of practice that is based on the natural healing capacity 19 of individuals, and may use physiological, psychological, 20 or mechanical methods, and may use natural medicines, 21 prescription, or legend drugs, foods, herbs, or other natural 22 remedies. 23 9. “Prescription drug” means any drug described in section 24 503(b) of the federal Food, Drug and Cosmetic Act, 21 U.S.C. § 25 353, if its label is required to bear the symbol “RX only”. 26 Sec. 8. NEW SECTION . 148F.2 Licensure —— naturopathic 27 medicine. 28 1. Qualifications for licensure. An applicant for a license 29 to practice naturopathic medicine shall be granted a license 30 by the board if the applicant satisfies all of the following 31 requirements: 32 a. Submits an application for licensure designed and 33 approved by the naturopathic advisory council. 34 b. Pays an application fee established by the board. 35 -4- LSB 5036YC (3) 84 jr/nh 4/ 11

H.F. _____ c. Has graduated from an approved naturopathic medical 1 program. 2 d. Has passed a competency-based national naturopathic 3 licensing examination administered by the north American board 4 of naturopathic examiners or successor agency, that has been 5 nationally recognized to administer a naturopathic examination 6 representing federal standards of education and training. For 7 applicants who completed an approved naturopathic medical 8 program located in Canada, eligibility for licensure may be 9 granted with evidence of successful passage of a Canadian 10 provincial competency examination. 11 e. Provides evidence that the applicant is of good ethical 12 and professional reputation. An applicant shall not have had 13 a license to practice naturopathic medicine or other health 14 care license registration or certificate refused, revoked, 15 or suspended by this state or any other jurisdiction for 16 reasons that relate to the applicant’s ability to skillfully 17 and safely practice naturopathic medicine unless that license, 18 registration, or certification has been restored to good 19 standing. 20 f. Provides evidence that the applicant is physically and 21 mentally capable of safely practicing naturopathic medicine 22 with or without reasonable accommodation. 23 2. Term of license. A license granted pursuant to this 24 section shall be renewed every two years. 25 Sec. 9. NEW SECTION . 148F.3 Use of title —— exceptions. 26 1. A person shall not represent that the person is a 27 naturopathic physician, a doctor of naturopathic medicine, a 28 doctor of naturopathy, a naturopath, or as being otherwise 29 authorized to practice naturopathic medicine in this state, or 30 use the titles “N.D.” or “N.M.D.” or any other titles, words, 31 letters, abbreviations, or insignia indicating or implying that 32 the individual is a licensed naturopathic physician unless 33 the individual has been licensed as a naturopathic physician 34 pursuant to this chapter without first obtaining from the board 35 -5- LSB 5036YC (3) 84 jr/nh 5/ 11

H.F. _____ a license to practice naturopathic medicine pursuant to the 1 provisions of this chapter. 2 2. The practice of naturopathic medicine by a naturopathic 3 physician licensed pursuant to this chapter does not constitute 4 the practice of medicine and surgery under chapter 148, the 5 practice of osteopathic medicine and surgery under chapter 148, 6 or the practice of nursing under chapter 152. 7 3. This chapter and chapter 147 do not prevent qualified 8 members of other professions including but not limited 9 to individuals licensed under chapter 148, 150, 150A, or 10 152 from providing services consistent with the nature of 11 naturopathic medicine, but these persons shall not use a title 12 or description denoting that they are licensed naturopathic 13 physicians. 14 Sec. 10. NEW SECTION . 148F.4 Duties of board. 15 The board shall adopt rules consistent with this chapter, 16 chapter 147, and as recommended by the naturopathic advisory 17 council which are necessary for the performance of its duties. 18 Sec. 11. NEW SECTION . 148F.5 Naturopathic advisory council. 19 1. A naturopathic advisory council is established, 20 consisting of the following members, appointed by the governor: 21 a. Four members who are naturopathic physicians who are 22 residents of the state of Iowa and who are currently licensed 23 in good standing in another state. 24 b. One member who is a pharmacist licensed in Iowa. 25 c. One member who is a medical or osteopathic physician 26 licensed in Iowa, who has expertise in integrative medicine. 27 d. One member representing the general public. 28 2. Members shall not receive per diem or expense payments. 29 3. Members shall serve two-year terms, and shall serve until 30 their successors have been appointed. 31 4. The council shall select a chairperson from its 32 membership. 33 Sec. 12. NEW SECTION . 148F.6 Council powers and duties. 34 The naturopathic advisory council shall do all of the 35 -6- LSB 5036YC (3) 84 jr/nh 6/ 11

H.F. _____ following: 1 1. Advise the board regarding standards for licensed 2 naturopathic physicians. 3 2. Provide for distribution of information regarding 4 licensed naturopathic physician standards. 5 3. Advise the board on enforcement issues. 6 4. Review applications for licensure and license renewal 7 and recommend the granting or denial thereof. 8 5. Advise the board on issues related to receiving and 9 investigating complaints, conducting hearings, and imposing 10 disciplinary action in relation to complaints against licensed 11 naturopathic physicians. 12 6. Review naturopathic education and training for and 13 make specific recommendations to the board regarding the 14 qualifications to practice naturopathic childbirth attendance. 15 7. Recommend to the board any prescription drugs which 16 should be included on the exclusionary naturopathic formulary. 17 8. Advise the board regarding approval of continuing 18 education programs specific to naturopathic practice. 19 Sec. 13. NEW SECTION . 148F.7 Scope of practice. 20 A naturopathic physician may do any of the following: 21 1. Order and perform physical and laboratory examinations 22 consistent with naturopathic education and training for 23 diagnostic purposes, including but not limited to phlebotomy, 24 clinical laboratory tests, orificial examinations, and 25 physiological function tests. 26 2. Order diagnostic imaging studies consistent with 27 naturopathic training. All diagnostic tests not consistent 28 with naturopathic medical education and training must be 29 referred for performance and interpretation to an appropriately 30 licensed health care professional. 31 3. Dispense, administer, order, and prescribe, provide, or 32 perform the following, as applicable: 33 a. Food, extracts of food, nutraceuticals, vitamins, amino 34 acids, minerals, enzymes, botanicals and their extracts, 35 -7- LSB 5036YC (3) 84 jr/nh 7/ 11

H.F. _____ botanical medicines, homeopathic medicines, and all dietary 1 supplements and nonprescription drugs as defined by the federal 2 Food, Drug, and Cosmetic Act, 21 U.S.C. § 301 et seq. 3 b. Prescription or legend drugs and hormonal replacement. 4 c. Hot or cold hydrotherapy, naturopathic physical medicine, 5 and therapeutic exercise. 6 d. Devices, including but not limited to therapeutic 7 devices, barrier contraception, and durable medical equipment. 8 e. Health education and health counseling. 9 f. Repair and care incidental to superficial lacerations and 10 abrasions. 11 g. Removal of foreign bodies located in the superficial 12 tissues. 13 h. Musculoskeletal manipulation consistent with 14 naturopathic education and training. 15 4. Utilize routes of administration that include oral, 16 nasal, auricular, ocular, rectal, vaginal, transdermal, 17 intradermal, subcutaneous, intravenous, and intramuscular 18 consistent with the education and training of a naturopathic 19 physician. 20 5. Perform all therapies as trained and educated, and 21 approved by the naturopathic advisory council. 22 Sec. 14. NEW SECTION . 148F.8 Prohibitions. 23 A naturopathic physician licensed under this chapter shall 24 not do any of the following: 25 1. Perform or induce abortions. 26 2. Perform surgical procedures except those minor office 27 procedures authorized by this chapter. 28 3. Practice or claim to practice as a medical or osteopathic 29 physician, dentist, pharmacist, podiatrist, optometrist, 30 psychologist, advanced practice registered nurse, physician 31 assistant, chiropractor, physical therapist, acupuncturist, or 32 any other health care provider not authorized in this chapter 33 unless licensed by the state of Iowa as such. 34 4. Use general or spinal anesthetics. 35 -8- LSB 5036YC (3) 84 jr/nh 8/ 11

H.F. _____ 5. Administer ionizing radioactive substances for 1 therapeutic purposes. 2 6. Administer or prescribe chemotherapeutic medications for 3 the purpose of cancer treatment. 4 7. Perform surgical procedures of the eye, ear, nerves, 5 veins, or arteries extending beyond superficial tissue. 6 Sec. 15. NEW SECTION . 148F.9 Exemptions. 7 Nothing in this chapter shall be construed to prohibit or 8 restrict: 9 1. The practice of a profession by individuals who are 10 licensed, certified, or registered under other laws of this 11 state who are performing services within their authorized scope 12 of practice. 13 2. The practice of naturopathic medicine by an individual 14 employed by the government of the United States while the 15 individual is engaged in the performance of duties prescribed 16 by the laws and regulations of the United States. 17 3. The practice of naturopathic medicine by students 18 enrolled in an approved naturopathic medical program. The 19 performance of services shall be pursuant to a course of 20 instruction or assignments from an instructor and under the 21 supervision of the instructor. The instructor shall be a 22 naturopathic physician licensed pursuant to this chapter or a 23 duly licensed professional in the instructed field. 24 4. Persons from treating themselves and family members 25 based on religious or health beliefs. 26 5. Persons who sell vitamins and herbs from providing 27 information about their products. 28 6. Persons or practitioners from advising in the use of 29 a therapy, including but not limited to: herbal medicine, 30 homeopathy, nutrition, or other nondrug or nonsurgical therapy 31 that is within the scope of practice of naturopathic physicians 32 as outlined in this chapter as long as such therapy is lawful, 33 or, if a licensed health care provider, within the scope of 34 practice of the profession; and provided that such person is 35 -9- LSB 5036YC (3) 84 jr/nh 9/ 11

H.F. _____ not using a title protected pursuant to this chapter or holding 1 themselves out to be a naturopathic physician. 2 7. The practice of naturopathic medicine by persons who 3 are licensed to practice in any other state as practicing 4 naturopathic physicians, who enter this state to consult with 5 a licensed naturopathic physician in this state; provided, 6 however, that the consultation is to be limited to examination, 7 recommendation, or testimony in litigation. 8 Sec. 16. FUNDING. The board of medicine shall apply 9 to the department of administrative services to request an 10 allocation of moneys from the IowAccess revolving fund to fund 11 the estimated seventy-five thousand dollars for expansion 12 of the advanced Maryland automatic network disk archiver 13 (AMANDA) system to allow licensure of naturopathic physicians 14 in the AMANDA system currently being developed for the boards 15 of dentistry, nursing, and medicine. The board shall not 16 implement a fee increase to make this adjustment to the AMANDA 17 system for naturopathic physicians. Until such changes are 18 made to the electronic licensing system the board shall license 19 naturopathic physicians under the current procedures used to 20 license medical and osteopathic physicians. 21 EXPLANATION 22 This bill requires the licensing of naturopathic physicians 23 and makes the provisions of Code chapter 147, including 24 penalty and other regulatory provisions, applicable to other 25 health professions applicable to the practice of naturopathic 26 medicine. The bill provides that the practice of naturopathic 27 medicine means the provision of naturopathic services defined 28 as a system of primary health care for the prevention, 29 diagnosis, and treatment of human health conditions, injury, 30 and disease, and the promotion or restoration of health. 31 Naturopathic medicine includes the use of physiological, 32 psychological, or mechanical methods, and the use of natural 33 medicines, prescription or legend drugs, foods, herbs, or 34 other natural remedies. The bill specifies qualifications 35 -10- LSB 5036YC (3) 84 jr/nh 10/ 11

H.F. _____ for licensure and the scope of practice for a naturopathic 1 physician, and details functions that a naturopathic physician 2 may not perform. 3 The practice of naturopathic medicine is regulated by the 4 board of medicine, with the advice of a naturopathic advisory 5 council. The council consists of seven members, four of 6 whom are naturopathic physicians, one medical or osteopathic 7 physician, a pharmacist, and one member representing the 8 general public. The council does not receive a per diem or 9 expenses. 10 The bill provides that qualified members of other 11 professions, including physicians and nurses, are not prevented 12 from providing services consistent with naturopathic medicine, 13 but these persons shall not use a title or description denoting 14 that they are naturopathic physicians. The bill sets out these 15 titles. 16 The bill provides for inclusion of licensed naturopathic 17 physicians in the AMANDA system. This system is a network 18 disk archiver system currently used by the boards of nursing, 19 dentistry, and medicine. 20 -11- LSB 5036YC (3) 84 jr/nh 11/ 11