S.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 1801XC (3) 84 jr/nh 1/ 12

S.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”, 20 “naturopath” or the initials “N.D.” or “N.M.D.” after the 21 person’s name. 22 Sec. 5. Section 147.107, Code 2011, is amended by adding the 23 following new subsection: 24 NEW SUBSECTION . 8A. Notwithstanding provisions of this 25 section to the contrary, a licensed naturopathic physician may 26 prescribe all substances and devices consistent within the 27 level of training of the naturopathic physician unless added 28 to the exclusionary naturopathic formulary by the naturopathic 29 advisory council. 30 Sec. 6. Section 148E.3, subsection 1, Code 2011, is amended 31 to read as follows: 32 1. A person otherwise licensed to practice medicine and 33 surgery, osteopathic medicine and surgery, naturopathic 34 medicine, chiropractic, podiatry, or dentistry who is 35 -2- LSB 1801XC (3) 84 jr/nh 2/ 12

S.F. _____ exclusively engaged in the practice of the person’s profession. 1 Sec. 7. NEW SECTION . 148F.1 Definitions. 2 As used in this chapter, unless the context otherwise 3 requires: 4 1. “Approved naturopathic medical program” means any of the 5 following: 6 a. A naturopathic medical education program in the 7 United States providing the degree of doctor of naturopathy 8 or doctor of naturopathic medicine. Such program shall 9 offer graduate-level, full-time didactic and supervised 10 clinical training and shall be accredited, or shall have 11 achieved candidacy status for accreditation by the council 12 on naturopathic medical education or by an equivalent 13 federally recognized accrediting body for naturopathic medical 14 programs also recognized by the board. Additionally, the 15 program shall be an institution, or part of an institution of 16 higher education that is either accredited or is a candidate 17 for accreditation by a regional or national institutional 18 accrediting agency recognized by the United States secretary 19 of education. 20 b. A degree-granting college or university that, prior 21 to the existence of the council on naturopathic medicinal 22 education, offered a full-time, structured curriculum in 23 basic sciences and supervised patient care comprising a 24 doctoral naturopathic medical education; such curriculum, as 25 a prerequisite to graduation, consisted of not less than one 26 hundred thirty-two weeks of study and required completion 27 within a period of not less than thirty-five months; such 28 college or university of naturopathic medicine shall have been 29 reputable and in good standing in the judgment of the board, 30 and if still in existence, shall have current programmatic 31 accreditation by the council on naturopathic medical education 32 or an equivalent federally recognized accrediting agency. 33 c. A diploma-granting, degree-equivalent college or 34 university in Canada, that prior to accreditation by the 35 -3- LSB 1801XC (3) 84 jr/nh 3/ 12

S.F. _____ council on naturopathic medical education, had provincial 1 approval for participation in government-funded student aid 2 programs, and that offered a full-time, structured curriculum 3 in basic sciences and supervised patient care comprising a 4 doctoral naturopathic medical education; such curriculum, as 5 a prerequisite to graduation, consisted of not less than one 6 hundred thirty-two weeks of study and required completion 7 within a period of not less than thirty-five months; such 8 college or university of liberal arts and naturopathic medicine 9 shall have been reputable and in good standing in the judgment 10 of the board and, if still in existence, shall have current 11 programmatic accreditation by the council of naturopathic 12 medical education or an equivalent federally recognized 13 accrediting agency. Additionally, the college or university 14 currently shall have provincial approval for participation in 15 government-funded student aid programs. 16 d. A diploma-granting, degree-equivalent college or 17 university in Canada that offers graduate-level, full-time 18 didactic and supervised clinical training and is accredited, or 19 has achieved candidacy status for accreditation by the council 20 on naturopathic medical education or an equivalent federally 21 recognized accrediting body for naturopathic medical programs 22 also recognized by the board; and the college or university 23 has provincial approval for participation in government-funded 24 student aid. 25 2. “Board” means the board of medicine established in 26 section 147.13. 27 3. “Director” means the executive director of the board of 28 medicine. 29 4. “Exclusionary naturopathic formulary” means the 30 exclusionary list of medicines, nonprescription and 31 prescription, which naturopathic physicians may not use in the 32 practice of their profession, as determined by the naturopathic 33 advisory council. 34 5. “Minor office procedures” means methods for the repair 35 -4- LSB 1801XC (3) 84 jr/nh 4/ 12

S.F. _____ and care incidental to superficial lacerations and abrasions, 1 superficial lesions, and the removal of foreign bodies located 2 in the superficial tissues. 3 6. “Naturopathic advisory council” means the naturopathic 4 advisory council as established under this chapter. 5 7. “Naturopathic childbirth attendance” means the specialty 6 practice of natural childbirth by a naturopathic physician that 7 includes the management of normal pregnancy, normal labor and 8 delivery, and the normal postpartum period, including normal 9 newborn care. 10 8. “Naturopathic medicine” means a system of primary health 11 care for the prevention, diagnosis, and treatment of human 12 health conditions, injury, and disease, and the promotion or 13 restoration of health. “Naturopathic medicine” includes the use 14 of physiological, psychological, or mechanical methods, and the 15 use of natural medicines, prescription or legend drugs, foods, 16 herbs, or other natural remedies. 17 9. “Naturopathic physician” means a practitioner of 18 naturopathic medicine who has been properly licensed for that 19 purpose by the board of medicine under this chapter, who may 20 diagnose, treat, and help prevent diseases using a system 21 of practice that is based on the natural healing capacity 22 of individuals, and may use physiological, psychological, 23 or mechanical methods, and may use natural medicines, 24 prescription, or legend drugs, foods, herbs, or other natural 25 remedies. 26 10. “Prescription drug” means any drug described in section 27 503(b) of the federal Food, Drug and Cosmetic Act, 21 U.S.C. § 28 353, if its label is required to bear the symbol “RX only”. 29 Sec. 8. NEW SECTION . 148F.2 Licensure —— naturopathic 30 medicine. 31 1. Qualifications for licensure. An applicant for a license 32 to practice naturopathic medicine shall be granted a license 33 by the board if the applicant satisfies all of the following 34 requirements: 35 -5- LSB 1801XC (3) 84 jr/nh 5/ 12

S.F. _____ a. Submits an application for licensure designed and 1 approved by the naturopathic advisory council. 2 b. Pays an application fee established by the board. 3 c. Has graduated from an approved naturopathic medical 4 program. 5 d. Has passed a competency-based national naturopathic 6 licensing examination administered by the north American board 7 of naturopathic examiners or successor agency, that has been 8 nationally recognized to administer a naturopathic examination 9 representing federal standards of education and training. For 10 applicants who completed an approved naturopathic medical 11 program located in Canada, eligibility for licensure may be 12 granted with evidence of successful passage of a Canadian 13 provincial competency examination. 14 e. Provides evidence that the applicant is of good ethical 15 and professional reputation. An applicant shall not have had 16 a license to practice naturopathic medicine or other health 17 care license registration or certificate refused, revoked, 18 or suspended by this state or any other jurisdiction for 19 reasons that relate to the applicant’s ability to skillfully 20 and safely practice naturopathic medicine unless that license, 21 registration, or certification has been restored to good 22 standing. 23 f. Provides evidence that the applicant is physically and 24 mentally capable of safely practicing naturopathic medicine 25 with or without reasonable accommodation. 26 2. Term of license. A license granted pursuant to this 27 section shall be renewed every two years. 28 3. Natural childbirth attendance privileges. An applicant 29 seeking privileges to perform natural childbirth attendance 30 shall satisfy all of the additional requirements: 31 a. Graduation from a naturopathic midwifery or naturopathic 32 obstetrics program that is offered by an approved naturopathic 33 medical program. 34 b. Passage of the north American registry of midwives 35 -6- LSB 1801XC (3) 84 jr/nh 6/ 12

S.F. _____ examination or the American college of naturopathic 1 obstetricians examination. 2 c. The board may adopt other requirements by rule, based on 3 recommendations of the naturopathic advisory council. 4 Sec. 9. NEW SECTION . 148F.3 Use of title —— exceptions. 5 1. A person shall not represent that the person is a 6 naturopathic physician, a doctor of naturopathic medicine, a 7 doctor of naturopathy, a naturopath, or as being otherwise 8 authorized to practice naturopathic medicine in this state, or 9 use the titles “N.D.” or “N.M.D.” or any other titles, words, 10 letters, abbreviations, or insignia indicating or implying that 11 the individual is a licensed naturopathic physician unless 12 the individual has been licensed as a naturopathic physician 13 pursuant to this chapter without first obtaining from the board 14 a license to practice naturopathic medicine pursuant to the 15 provisions of this chapter. 16 2. The practice of naturopathic medicine by a naturopathic 17 physician licensed pursuant to this chapter does not constitute 18 the practice of medicine and surgery under chapter 148, the 19 practice of osteopathic medicine and surgery under chapter 148, 20 or the practice of nursing under chapter 152. 21 3. This chapter and chapter 147 do not prevent qualified 22 members of other professions including but not limited 23 to individuals licensed under chapter 148, 150, 150A, or 24 152 from providing services consistent with the nature of 25 naturopathic medicine, but these persons shall not use a title 26 or description denoting that they are licensed naturopathic 27 physicians. 28 Sec. 10. NEW SECTION . 148F.4 Duties of board. 29 The board shall adopt rules consistent with this chapter, 30 chapter 147, and as recommended by the naturopathic advisory 31 council which are necessary for the performance of its duties. 32 Sec. 11. NEW SECTION . 148F.5 Naturopathic advisory council. 33 1. A naturopathic advisory council is established, 34 consisting of the following members: 35 -7- LSB 1801XC (3) 84 jr/nh 7/ 12

S.F. _____ a. Three members who are naturopathic physicians eligible 1 for licensure, appointed by the governor. 2 b. One member who is a pharmacist licensed in Iowa, 3 appointed by the governor. 4 c. One member who is a medical or osteopathic physician 5 licensed in Iowa, who has expertise in natural or integrative 6 medicine. 7 2. Members shall not receive per diem or expense payments. 8 3. Members shall serve two-year terms, and shall serve until 9 their successors have been appointed. 10 4. The council shall select a chairperson from its 11 membership. 12 Sec. 12. NEW SECTION . 148F.6 Council powers and duties. 13 The naturopathic advisory council shall do all of the 14 following: 15 1. Advise the board regarding standards for licensed 16 naturopathic physicians. 17 2. Provide for distribution of information regarding 18 licensed naturopathic physician standards. 19 3. Advise the board on enforcement issues. 20 4. Review applications for licensure and license renewal 21 and recommend the granting or denial thereof. 22 5. Advise the board on issues related to receiving and 23 investigating complaints, conducting hearings, and imposing 24 disciplinary action in relation to complaints against licensed 25 naturopathic physicians. 26 6. Review naturopathic education and training for and 27 make specific recommendations to the board regarding the 28 qualifications to practice naturopathic childbirth attendance. 29 7. Recommend to the board any prescription drugs which 30 should be included on the exclusionary naturopathic formulary. 31 8. Advise the board regarding approval of continuing 32 education programs specific to naturopathic practice. 33 Sec. 13. NEW SECTION . 148F.7 Scope of practice. 34 A naturopathic physician may do any of the following: 35 -8- LSB 1801XC (3) 84 jr/nh 8/ 12

S.F. _____ 1. Order and perform physical and laboratory examinations 1 consistent with naturopathic education and training for 2 diagnostic purposes, including but not limited to phlebotomy, 3 clinical laboratory tests, orificial examinations, and 4 physiological function tests. 5 2. Order diagnostic imaging studies consistent with 6 naturopathic training. All diagnostic tests not consistent 7 with naturopathic medical education and training must be 8 referred for performance and interpretation to an appropriately 9 licensed health care professional. 10 3. Dispense, administer, order, and prescribe, provide, or 11 perform the following, as applicable: 12 a. Food, extracts of food, nutraceuticals, vitamins, amino 13 acids, minerals, enzymes, botanicals and their extracts, 14 botanical medicines, homeopathic medicines, and all dietary 15 supplements and nonprescription drugs as defined by the federal 16 Food, Drug, and Cosmetic Act, 21 U.S.C. § 301 et seq. 17 b. Prescription or legend drugs and hormonal replacement. 18 c. Hot or cold hydrotherapy, naturopathic physical medicine, 19 and therapeutic exercise. 20 d. Devices, including but not limited to therapeutic 21 devices, barrier contraception, and durable medical equipment. 22 e. Health education and health counseling. 23 f. Repair and care incidental to superficial lacerations and 24 abrasions. 25 g. Removal of foreign bodies located in the superficial 26 tissues. 27 h. Musculoskeletal manipulation consistent with 28 naturopathic education and training. 29 4. Utilize routes of administration that include oral, 30 nasal, auricular, ocular, rectal, vaginal, transdermal, 31 intradermal, subcutaneous, intravenous, and intramuscular 32 consistent with the education and training of a naturopathic 33 physician. 34 5. Perform all therapies as trained and educated, and 35 -9- LSB 1801XC (3) 84 jr/nh 9/ 12

S.F. _____ approved by the naturopathic advisory council. 1 Sec. 14. NEW SECTION . 148F.8 Prohibitions. 2 A naturopathic physician licensed under this chapter shall 3 not do any of the following: 4 1. Perform or induce abortions. 5 2. Perform surgical procedures except those minor office 6 procedures authorized by this chapter. 7 3. Practice or claim to practice as a medical or osteopathic 8 physician, dentist, podiatrist, optometrist, psychologist, 9 advanced practice registered nurse, physician assistant, 10 chiropractor, physical therapist, acupuncturist, or any other 11 health care provider not authorized in this chapter unless 12 licensed by the state of Iowa as such. 13 4. Use general or spinal anesthetics. 14 5. Administer ionizing radioactive substances for 15 therapeutic purposes. 16 6. Administer or prescribe chemotherapeutic medications for 17 the purpose of cancer treatment. 18 7. Perform surgical procedures of the eye, ear, nerves, 19 veins, or arteries extending beyond superficial tissue. 20 Sec. 15. NEW SECTION . 148F.9 Exemptions. 21 Nothing in this chapter shall be construed to prohibit or 22 restrict: 23 1. The practice of a profession by individuals who are 24 licensed, certified, or registered under other laws of this 25 state who are performing services within their authorized scope 26 of practice. 27 2. The practice of naturopathic medicine by an individual 28 employed by the government of the United States while the 29 individual is engaged in the performance of duties prescribed 30 by the laws and regulations of the United States. 31 3. The practice of naturopathic medicine by students 32 enrolled in an approved naturopathic medical program. The 33 performance of services shall be pursuant to a course of 34 instruction or assignments from an instructor and under the 35 -10- LSB 1801XC (3) 84 jr/nh 10/ 12

S.F. _____ supervision of the instructor. The instructor shall be a 1 naturopathic physician licensed pursuant to this chapter or a 2 duly licensed professional in the instructed field. 3 4. Persons from treating themselves and family members 4 based on religious or health beliefs. 5 5. Persons who sell vitamins and herbs from providing 6 information about their products. 7 6. Persons or practitioners from advising in the use of 8 a therapy, including but not limited to: herbal medicine, 9 homeopathy, nutrition, or other nondrug or nonsurgical therapy 10 that is within the scope of practice of naturopathic physicians 11 as outlined in this chapter as long as such therapy is lawful, 12 or, if a licensed health care provider, within the scope of 13 practice of the profession; and provided that such person is 14 not using a title protected pursuant to this chapter or holding 15 themselves out to be a naturopathic physician. 16 7. The practice of naturopathic medicine by persons who 17 are licensed to practice in any other state as practicing 18 naturopathic physicians, who enter this state to consult with 19 a licensed naturopathic physician in this state; provided, 20 however, that the consultation is to be limited to examination, 21 recommendation, or testimony in litigation. 22 EXPLANATION 23 This bill requires the licensing of naturopathic physicians. 24 The bill provides that the practice of naturopathic medicine 25 means the provision of naturopathic services defined as a 26 system of primary health care for the prevention, diagnosis, 27 and treatment of human health conditions, injury, and disease, 28 and the promotion or restoration of health. Naturopathic 29 medicine includes the use of physiological, psychological, 30 or mechanical methods, and the use of natural medicines, 31 prescription or legend drugs, foods, herbs, or other natural 32 remedies. The bill specifies qualifications for licensure and 33 the scope of practice for a naturopathic physician, and details 34 functions that a naturopathic physician may not perform. 35 -11- LSB 1801XC (3) 84 jr/nh 11/ 12

S.F. _____ The practice of naturopathic medicine is regulated by the 1 board of medicine, with the advice of a naturopathic advisory 2 council. The council consists of five members, three of 3 whom are naturopathic physicians, one medical or osteopathic 4 physician, and a pharmacist. The council does not receive per 5 diem or expenses. 6 The bill provides that qualified members of other 7 professions, including physicians and nurses, are not prevented 8 from providing services consistent with naturopathic medicine, 9 but these persons shall not use a title or description denoting 10 that they are naturopathic physicians. The bill sets out these 11 titles. 12 -12- LSB 1801XC (3) 84 jr/nh 12/ 12