S.F. _____ Section 1. Section 147.1, subsections 3 and 6, Code 2014, 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 orthotist, prosthetist, pedorthist, respiratory care 10 practitioner, practitioner of cosmetology arts and sciences, 11 practitioner of barbering, funeral director, dietitian, marital 12 and family therapist, mental health counselor, social worker, 13 massage therapist, athletic trainer, acupuncturist, nursing 14 home administrator, hearing aid dispenser, or sign language 15 interpreter or transliterator means a person licensed under 16 this subtitle . 17 6. “Profession” means medicine and surgery, podiatry, 18 osteopathic medicine and surgery, naturopathic medicine, 19 practice as a physician assistant, psychology, chiropractic, 20 nursing, dentistry, dental hygiene, dental assisting, 21 optometry, speech pathology, audiology, pharmacy, physical 22 therapy, physical therapist assisting, occupational therapy, 23 occupational therapy assisting, respiratory care, cosmetology 24 arts and sciences, barbering, mortuary science, marital 25 and family therapy, mental health counseling, social work, 26 dietetics, massage therapy, athletic training, acupuncture, 27 nursing home administration, hearing aid dispensing, sign 28 language interpreting or transliterating, orthotics, 29 prosthetics, or pedorthics. 30 Sec. 2. Section 147.2, subsection 1, Code 2014, is amended 31 to read as follows: 32 1. A person shall not engage in the practice of medicine 33 and surgery, naturopathic medicine, podiatry, osteopathic 34 medicine and surgery, psychology, chiropractic, physical 35 -1- LSB 5098XC (2) 85 jr/nh 1/ 11

S.F. _____ therapy, physical therapist assisting, nursing, dentistry, 1 dental hygiene, dental assisting, optometry, speech pathology, 2 audiology, occupational therapy, occupational therapy 3 assisting, orthotics, prosthetics, pedorthics, respiratory 4 care, pharmacy, cosmetology arts and sciences, barbering, 5 social work, dietetics, marital and family therapy or mental 6 health counseling, massage therapy, mortuary science, athletic 7 training, acupuncture, nursing home administration, hearing aid 8 dispensing, or sign language interpreting or transliterating, 9 or shall not practice as a physician assistant, unless the 10 person has obtained a license for that purpose from the board 11 for the profession. 12 Sec. 3. Section 147.13, subsection 1, Code 2014, is amended 13 to read as follows: 14 1. For medicine and surgery, osteopathic medicine and 15 surgery, and acupuncture, and naturopathic medicine, the board 16 of medicine. 17 Sec. 4. Section 147.74, Code 2014, is amended by adding the 18 following new subsection: 19 NEW SUBSECTION . 23A. A naturopathic physician licensed 20 under chapter 148G may use the words “naturopathic physician”, 21 “naturopathic doctor”, “doctor of naturopathy”, “naturopathic 22 medical doctor”, “doctor of naturopathic medicine”, 23 “naturopath” or the initials “N.D.” or “N.M.D.” after the 24 person’s name. 25 Sec. 5. Section 147.107, Code 2014, is amended by adding the 26 following new subsection: 27 NEW SUBSECTION . 8A. A licensed naturopathic physician 28 may prescribe all substances and devices consistent with the 29 level of training of the naturopathic physician unless added 30 to the exclusionary naturopathic formulary by the naturopathic 31 advisory council. 32 Sec. 6. Section 148E.3, subsection 1, Code 2014, is amended 33 to read as follows: 34 1. A person otherwise licensed to practice medicine and 35 -2- LSB 5098XC (2) 85 jr/nh 2/ 11

S.F. _____ surgery, osteopathic medicine and surgery, naturopathic 1 medicine, chiropractic, podiatry, or dentistry who is 2 exclusively engaged in the practice of the person’s profession. 3 Sec. 7. NEW SECTION . 148G.1 Definitions. 4 As used in this chapter, unless the context otherwise 5 requires: 6 1. “Approved naturopathic medical program” means any of the 7 following: 8 a. A naturopathic medical education program in the 9 United States providing the degree of doctor of naturopathy 10 or doctor of naturopathic medicine. Such program shall 11 offer graduate-level, full-time didactic and supervised 12 clinical training and shall be accredited, or shall have 13 achieved candidacy status for accreditation by the council 14 on naturopathic medical education or by an equivalent 15 federally recognized accrediting body for naturopathic medical 16 programs also recognized by the board. Additionally, the 17 program shall be an institution, or part of an institution of 18 higher education that is either accredited or is a candidate 19 for accreditation by a regional or national institutional 20 accrediting agency recognized by the United States secretary 21 of education. 22 b. A diploma-granting, degree-equivalent college or 23 university in Canada that offers graduate-level, full-time 24 didactic and supervised clinical training and is accredited, or 25 has achieved candidacy status for accreditation by the council 26 on naturopathic medical education or an equivalent federally 27 recognized accrediting body for naturopathic medical programs 28 also recognized by the board; and the college or university 29 has provincial approval for participation in government-funded 30 student aid. 31 2. “Board” means the board of medicine established in 32 section 147.13. 33 3. “Director” means the executive director of the board of 34 medicine. 35 -3- LSB 5098XC (2) 85 jr/nh 3/ 11

S.F. _____ 4. “Exclusionary naturopathic formulary” means the 1 exclusionary list of medicines, nonprescription and 2 prescription, which naturopathic physicians may not use in the 3 practice of their profession, as determined by the naturopathic 4 advisory council. 5 5. “Minor office procedures” means methods for the repair 6 and care incidental to superficial lacerations and abrasions, 7 superficial lesions, and the removal of foreign bodies located 8 in the superficial tissues. 9 6. “Naturopathic advisory council” means the naturopathic 10 advisory council established under this chapter. 11 7. “Naturopathic medicine” means a system of primary health 12 care for the prevention, diagnosis, and treatment of human 13 health conditions, injury, and disease, and the promotion or 14 restoration of health. “Naturopathic medicine” includes the use 15 of physiological, psychological, or mechanical methods, and the 16 use of natural medicines, prescription or legend drugs, foods, 17 herbs, or other natural remedies. 18 8. “Naturopathic physician” means a practitioner of 19 naturopathic medicine who has been properly licensed for that 20 purpose by the board of medicine under this chapter, who may 21 diagnose, treat, and help prevent diseases using a system 22 of practice that is based on the natural healing capacity 23 of individuals, and may use physiological, psychological, 24 or mechanical methods, and may use natural medicines, 25 prescription, or legend drugs, foods, herbs, or other natural 26 remedies. 27 9. “Prescription drug” means any drug described in section 28 503(b) of the federal Food, Drug and Cosmetic Act, 21 U.S.C. 29 §353, if its label is required to bear the symbol “RX only”. 30 Sec. 8. NEW SECTION . 148G.2 Licensure —— naturopathic 31 medicine. 32 1. Qualifications for licensure. An applicant for a license 33 to practice naturopathic medicine shall be granted a license 34 by the board if the applicant satisfies all of the following 35 -4- LSB 5098XC (2) 85 jr/nh 4/ 11

S.F. _____ requirements: 1 a. Submits an application for licensure designed and 2 approved by the naturopathic advisory council. 3 b. Pays an application fee established by the board. 4 c. Has graduated from an approved naturopathic medical 5 program. 6 d. Has passed a competency-based national naturopathic 7 licensing examination administered by the north American board 8 of naturopathic examiners or successor agency, that has been 9 nationally recognized to administer a naturopathic examination 10 representing federal standards of education and training. For 11 applicants who completed an approved naturopathic medical 12 program located in Canada, eligibility for licensure may be 13 granted with evidence of successful passage of a Canadian 14 provincial competency examination. 15 e. Provides evidence that the applicant is of good ethical 16 and professional reputation. An applicant shall not have had 17 a license to practice naturopathic medicine or other health 18 care license, registration, or certificate refused, revoked, 19 or suspended by this state or any other jurisdiction for 20 reasons that relate to the applicant’s ability to skillfully 21 and safely practice naturopathic medicine unless that license, 22 registration, or certification has been restored to good 23 standing. 24 f. Provides evidence that the applicant is physically and 25 mentally capable of safely practicing naturopathic medicine 26 with or without reasonable accommodation. 27 2. Term of license. A license granted pursuant to this 28 section shall be renewed every two years. 29 Sec. 9. NEW SECTION . 148G.3 Use of title —— exceptions. 30 1. A person shall not represent that the person is a 31 naturopathic physician, a doctor of naturopathic medicine, a 32 doctor of naturopathy, a naturopath, or as being otherwise 33 authorized to practice naturopathic medicine in this state, or 34 use the titles “N.D.” or “N.M.D.” or any other titles, words, 35 -5- LSB 5098XC (2) 85 jr/nh 5/ 11

S.F. _____ letters, abbreviations, or insignia indicating or implying that 1 the individual is a licensed naturopathic physician unless 2 the individual has been licensed as a naturopathic physician 3 pursuant to this chapter without first obtaining from the board 4 a license to practice naturopathic medicine pursuant to the 5 provisions of this chapter. 6 2. The practice of naturopathic medicine by a naturopathic 7 physician licensed pursuant to this chapter does not constitute 8 the practice of medicine and surgery under chapter 148, the 9 practice of osteopathic medicine and surgery under chapter 148, 10 or the practice of nursing under chapter 152. 11 3. This chapter and chapter 147 do not prevent qualified 12 members of other professions including but not limited 13 to individuals licensed under chapter 148, 150, 150A, or 14 152 from providing services consistent with the nature of 15 naturopathic medicine, but these persons shall not use a title 16 or description denoting that they are licensed naturopathic 17 physicians. 18 Sec. 10. NEW SECTION . 148G.4 Duties of board. 19 The board shall adopt rules consistent with this chapter, 20 chapter 147, and as recommended by the naturopathic advisory 21 council which are necessary for the performance of the board’s 22 duties. 23 Sec. 11. NEW SECTION . 148G.5 Naturopathic advisory council. 24 1. A naturopathic advisory council is established, 25 consisting of the following members, appointed by the governor: 26 a. Prior to July 1, 2016, four members who are naturopathic 27 physicians who are residents of the state of Iowa and who are 28 currently licensed in good standing in another state. On 29 and after July 1, 2016, such members shall be naturopathic 30 physicians licensed under this chapter. 31 b. One member who is a pharmacist licensed in Iowa. 32 c. One member who is a medical or osteopathic physician 33 licensed in Iowa, who has expertise in integrative medicine. 34 d. One member representing the general public. 35 -6- LSB 5098XC (2) 85 jr/nh 6/ 11

S.F. _____ 2. Members shall not receive per diem or expense payments. 1 3. Members shall serve two-year terms, and shall serve until 2 their successors have been appointed. 3 4. The council shall select a chairperson from its 4 membership. 5 Sec. 12. NEW SECTION . 148G.6 Council powers and duties. 6 The naturopathic advisory council shall do all of the 7 following: 8 1. Advise the board regarding standards for licensed 9 naturopathic physicians. 10 2. Provide for distribution of information regarding 11 licensed naturopathic physician standards. 12 3. Advise the board on enforcement issues. 13 4. Review applications for licensure and license renewal 14 and recommend the granting or denial thereof. 15 5. Advise the board on issues related to receiving and 16 investigating complaints, conducting hearings, and imposing 17 disciplinary action in relation to complaints against licensed 18 naturopathic physicians. 19 6. Review naturopathic education and training for and 20 make specific recommendations to the board regarding the 21 qualifications to practice naturopathic childbirth attendance. 22 7. Recommend to the board any prescription drugs which 23 should be included on the exclusionary naturopathic formulary. 24 8. Advise the board regarding approval of continuing 25 education programs specific to naturopathic practice. 26 Sec. 13. NEW SECTION . 148G.7 Scope of practice. 27 A naturopathic physician may do any of the following: 28 1. Order and perform physical and laboratory examinations 29 consistent with naturopathic education and training for 30 diagnostic purposes, including but not limited to phlebotomy, 31 clinical laboratory tests, orificial examinations, and 32 physiological function tests. 33 2. Order diagnostic imaging studies consistent with 34 naturopathic training. All diagnostic tests not consistent 35 -7- LSB 5098XC (2) 85 jr/nh 7/ 11

S.F. _____ with naturopathic medical education and training must be 1 referred for performance and interpretation to an appropriately 2 licensed health care professional. 3 3. Dispense, administer, order, and prescribe, provide, or 4 perform the following, as applicable: 5 a. Food, extracts of food, nutraceuticals, vitamins, amino 6 acids, minerals, enzymes, botanicals and their extracts, 7 botanical medicines, homeopathic medicines, and all dietary 8 supplements and nonprescription drugs as defined by the federal 9 Food, Drug, and Cosmetic Act, 21 U.S.C. §301 et seq. 10 b. Prescription or legend drugs and hormonal replacement. 11 c. Hot or cold hydrotherapy, naturopathic physical medicine, 12 and therapeutic exercise. 13 d. Devices, including but not limited to therapeutic 14 devices, barrier contraception, and durable medical equipment. 15 e. Health education and health counseling. 16 f. Repair and care incidental to superficial lacerations and 17 abrasions. 18 g. Removal of foreign bodies located in the superficial 19 tissues. 20 h. Musculoskeletal manipulation consistent with 21 naturopathic education and training. 22 4. Utilize routes of administration that include oral, 23 nasal, auricular, ocular, rectal, vaginal, transdermal, 24 intradermal, subcutaneous, intravenous, and intramuscular 25 consistent with the education and training of a naturopathic 26 physician. 27 5. Perform all therapies as trained and educated, which are 28 approved by the naturopathic advisory council. 29 Sec. 14. NEW SECTION . 148G.8 Prohibitions. 30 A naturopathic physician licensed under this chapter shall 31 not do any of the following: 32 1. Perform or induce abortions. 33 2. Perform surgical procedures except those minor office 34 procedures authorized by this chapter. 35 -8- LSB 5098XC (2) 85 jr/nh 8/ 11

S.F. _____ 3. Practice or claim to practice as a medical or osteopathic 1 physician, dentist, pharmacist, podiatrist, optometrist, 2 psychologist, advanced practice registered nurse, physician 3 assistant, chiropractor, physical therapist, acupuncturist, or 4 any other health care provider not authorized in this chapter 5 unless licensed by the state of Iowa as such. 6 4. Use general or spinal anesthetics. 7 5. Administer ionizing radioactive substances for 8 therapeutic purposes. 9 6. Administer or prescribe chemotherapeutic medications for 10 the purpose of cancer treatment. 11 7. Perform surgical procedures of the eye, ear, nerves, 12 veins, or arteries extending beyond superficial tissue. 13 Sec. 15. NEW SECTION . 148G.9 Exemptions. 14 Nothing in this chapter shall be construed to prohibit or 15 restrict: 16 1. The practice of a profession by an individual who is 17 licensed, certified, or registered under another law of this 18 state who is performing services within the individual’s 19 authorized scope of practice. 20 2. The practice of naturopathic medicine by an individual 21 employed by the government of the United States while the 22 individual is engaged in the performance of duties prescribed 23 by the laws and regulations of the United States. 24 3. The practice of naturopathic medicine by students 25 enrolled in an approved naturopathic medical program. The 26 performance of services shall be pursuant to a course of 27 instruction or assignments from an instructor and under the 28 supervision of the instructor. The instructor shall be a 29 naturopathic physician licensed pursuant to this chapter or a 30 duly licensed professional in the instructed field. 31 4. Persons from treating themselves and family members 32 based on religious or health beliefs. 33 5. Persons who sell vitamins and herbs from providing 34 information about their products. 35 -9- LSB 5098XC (2) 85 jr/nh 9/ 11

S.F. _____ 6. Persons or practitioners from advising in the use 1 of a therapy including but not limited to herbal medicine, 2 homeopathy, nutrition, or other nondrug or nonsurgical therapy 3 that is within the scope of practice of naturopathic physicians 4 as provided in this chapter as long as such therapy is lawful, 5 or, if a licensed health care provider, within the scope of 6 practice of the profession; and provided that such person is 7 not using a title protected pursuant to this chapter or holding 8 themselves out to be a naturopathic physician. 9 7. The practice of naturopathic medicine by persons who 10 are licensed to practice in any other state as practicing 11 naturopathic physicians, who enter this state to consult with 12 a licensed naturopathic physician in this state; provided, 13 however, that the consultation is to be limited to examination, 14 recommendation, or testimony in litigation. 15 Sec. 16. FUNDING. The board of medicine shall apply 16 to the department of administrative services to request an 17 allocation of moneys from the IowAccess revolving fund to fund 18 the estimated costs for expansion of the advanced Maryland 19 automatic network disk archiver (AMANDA) system to allow 20 licensure of naturopathic physicians in the AMANDA system. 21 The board shall not implement a fee increase to make this 22 adjustment to the AMANDA system for naturopathic physicians. 23 EXPLANATION 24 The inclusion of this explanation does not constitute agreement with 25 the explanation’s substance by the members of the general assembly. 26 This bill requires the licensing of naturopathic physicians 27 and makes the provisions of Code chapter 147, including 28 penalty and other regulatory provisions, applicable to other 29 health professions applicable to the practice of naturopathic 30 medicine. The bill provides that the practice of naturopathic 31 medicine means the provision of naturopathic services defined 32 as a system of primary health care for the prevention, 33 diagnosis, and treatment of human health conditions, injury, 34 and disease, and the promotion or restoration of health. 35 -10- LSB 5098XC (2) 85 jr/nh 10/ 11

S.F. _____ Naturopathic medicine includes the use of physiological, 1 psychological, or mechanical methods, and the use of natural 2 medicines, prescription or legend drugs, foods, herbs, or 3 other natural remedies. The bill specifies qualifications 4 for licensure and the scope of practice for a naturopathic 5 physician, and details functions that a naturopathic physician 6 may not perform. 7 The practice of naturopathic medicine is regulated by the 8 board of medicine, with the advice of a naturopathic advisory 9 council. The council consists of seven members, four of 10 whom are naturopathic physicians, one medical or osteopathic 11 physician, a pharmacist, and one member representing the 12 general public. The council does not receive a per diem or 13 expenses. 14 The bill provides that qualified members of other 15 professions, including physicians and nurses, are not prevented 16 from providing services consistent with naturopathic medicine, 17 but these persons shall not use a title or description denoting 18 that they are naturopathic physicians. The bill sets out these 19 titles. 20 The bill provides for inclusion of licensed naturopathic 21 physicians in the AMANDA system. This system is a network 22 disk archiver system currently used by the boards of nursing, 23 dentistry, and medicine. 24 Code section 422.7(27) provides an income tax exemption for 25 payments received by an individual providing unskilled in-home 26 health-related care services to a member of the individual 27 caregiver’s family. This exemption is not available to health 28 care professionals licensed by the board of medicine. Under 29 the bill, naturopathic physicians are to be licensed by the 30 board of medicine, making them ineligible for this exemption. 31 -11- LSB 5098XC (2) 85 jr/nh 11/ 11