2014 -- S 2874

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LC005332

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2014

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A N   A C T

RELATING TO HEALTH AND SAFETY - THE NATUROPATHIC PHYSICIANS ACT OF

2014

     

     Introduced By: Senators Picard, and Goodwin

     Date Introduced: April 09, 2014

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby

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amended by adding thereto the following chapter:

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CHAPTER 93

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THE NATUROPATHIC PHYSICIANS ACT OF 2014

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     23-93-1. Short title. – This chapter shall be known and may be cited as "The

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Naturopathic Physicians Act of 2014."

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     23-93-2. Definitions. – The following words and phrases as used in this chapter shall

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have the following meanings:

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     (1) "Approved naturopathic medical college" means a college which grants a degree of

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doctor of naturopathic medicine or doctor of naturopathy; and:

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     (i) Is accredited by the Council on Naturopathic Medical Education (CNME), its

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successor or other accrediting agency recognized by the United States Department of Education;

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or

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     (ii) Is a naturopathic medical education program in the United States providing the degree

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of doctor of naturopathy or doctor of naturopathic medicine. Such program shall offer graduate-

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level full-time didactic and supervised clinical training and shall be accredited, or has achieved

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candidacy status for accreditation by the CNME or an equivalent federally recognized accrediting

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body for naturopathic medical programs also recognized by the board. Additionally, the program

 

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shall be an institution, or part of an institution of higher education that is either accredited or is a

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candidate for accreditation by a regional or national institutional accrediting agency recognized

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by the United States Secretary of Education; or

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     (iii) Is a degree granting college or university that, prior to the existence of the CNME,

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offered a full-time structured curriculum in basic sciences and supervised patient care comprising

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a doctoral naturopathic medical education; such course, as a prerequisite to graduation therefrom,

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having been not less than one hundred thirty-two (132) weeks in duration and which required

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completion within a period of not less than thirty-five (35) months; such college of naturopathic

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medicine shall have been reputable and in good standing in the judgment of the board; and if still

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in existence has current programmatic accreditation by the CNME or federally-recognized

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equivalent accrediting agency; or

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     (iv) Is a diploma granting, degree-equivalent college or university, that, if in Canada, and

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prior to accreditation by the CNME, had provincial approval for participation in government-

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funded student aid programs, that offered a full-time structured curriculum in basic sciences and

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supervised patient care comprising a doctoral naturopathic medical education; such course, as a

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prerequisite to graduation therefrom, having been not less than one hundred thirty-two (132)

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weeks in duration and which required completion within a period of not less than thirty-five (35)

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months; such college of liberal arts and naturopathic medicine shall have been reputable and in

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good standing in the judgment of the board; and if still in existence has current programmatic

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accreditation by the CNME or federally recognized equivalent accrediting agency. Additionally,

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this college or university currently must have provincial approval for participation in government-

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funded student aide programs; or

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     (v) A diploma granting, degree-equivalent college or university in Canada that offers

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graduate-level full-time didactic and supervised clinical training and shall be accredited, or has

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achieved candidacy status for accreditation by the CNME or an equivalent federally-recognized

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accrediting body for naturopathic medical programs also recognized by the board. Additionally,

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this college or university has provincial approval for participation in government-funded student

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aid programs.

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     (2) "Board" means the North American Board of Naturopathic Examiners.

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     (3) "CNME" or "Council" is the Council on Naturopathic Medical Education.

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     (4) "Department" means the Rhode Island department of health.

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     (5) "Disciplinary action" means any action taken by an administrative law officer

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established against a licensee or applicant on a finding of unprofessional conduct by the licensee

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or applicant. "Disciplinary action" includes issuance of warnings and all sanctions including

 

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denial, suspension, revocation, limitation or restriction of licenses and other similar limitations.

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     (6) "Director" means the director of the Rhode Island department of health.

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     (7) "Natural" means present in, produced by, or derived from nature.

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     (8) "Naturopathic medicine" or "the practice of naturopathic medicine" means a system

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of health care that utilizes education, natural medicines and natural therapies to support and

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stimulate a patient's intrinsic self-healing processes and to prevent, diagnose and treat human

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health conditions and injuries. In connection with such system of health care, an individual

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licensed under this chapter may:

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     (i) Administer or provide for preventative and therapeutic purposes nonprescription

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medicines, topical medicines, botanical medicines, homeopathic medicines, counseling,

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nutritional and dietary therapy, and naturopathic physical medicine authorized by this chapter;

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     (ii) Use diagnostic procedures commonly used by physicians in general practice,

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including physical and orificial examinations, diagnostic imaging techniques, phlebotomy,

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clinical laboratory tests and examinations, and physiological function tests.

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     (9) "Naturopathic physical medicine" means the use of the physical agents of air, water,

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heat, cold, sound and light, and the physical modalities of naturopathic manipulation and

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mobilization therapy, electrotherapy, biofeedback, diathermy, ultraviolet light, ultrasound,

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hydrotherapy, and exercise. Naturopathic medicine does not include the practice of physical

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therapy, physical rehabilitation, or chiropractic medicine.

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     (10) "Naturopathic physician" means a person who practices naturopathic medicine and is

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licensed pursuant to the provisions of this chapter.

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     23-93-3. Prohibitions and penalties. – (a) No person shall perform the following acts:

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     (1) Practice naturopathic medicine in this state without a valid license issued in

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accordance with this chapter except as provided in § 23-93-4.

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     (2) Use, in connection with the person's name any letters, words or insignia indicating or

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implying that the person is a naturopathic physician unless the person is licensed in accordance

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with this chapter. A person licensed under this chapter may use the designations "N.D."

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(naturopathic doctor), "N.M.D." (naturopathic medical doctor), "doctor of naturopathic

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medicine," "naturopathic doctor," "doctor of naturopathy" or "naturopathic physician."

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     (b) A person licensed under this chapter shall not perform any of the following acts:

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     (1) Prescribe, dispense, or administer any prescription medicines except those medicines

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authorized by this chapter.

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     (2) Use for therapeutic purposes, any device regulated by the United States Food and

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Drug Administration (FDA) that has not been approved by the FDA.

 

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     (3) A person who violates any of the provisions of this section shall be subject to the

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penalties provided in § 23-93-13.

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     23-93-4. Exemptions. – (a) Nothing in this chapter shall be construed to prohibit any of

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the following:

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     (1) The practice of a profession by a person who is licensed, certified, or registered under

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other laws of this state and is performing services within the authorized scope of practice of that

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profession.

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     (2) The practice of naturopathic medicine by a person duly licensed to engage in the

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practice of naturopathic medicine in another state, territory or the District of Columbia who is

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called into this state for consultation with a naturopathic physician licensed under this chapter.

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     (3) The practice of naturopathic medicine by a student enrolled in an approved

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naturopathic medical college. The performance of services shall be pursuant to a course of

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instruction and under the supervision of an instructor, who shall be a naturopathic physician

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licensed in accordance with this chapter.

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     (4) The use or administration of over-the-counter medicines or other nonprescription

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agents, regardless of whether the over-the-counter medicine or agent is on the naturopathic

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formulary.

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      (b) The provisions of this chapter relating to the practice of naturopathic medicine, shall

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not be construed to limit or restrict in any manner the right of a practitioner of another health care

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profession from carrying on in the usual manner any of the functions related to that profession.

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     23-93-5. Reporting contagious and infectious diseases – Death certificates. –

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Naturopathic physicians are subject to the provisions of the law relating to contagious and

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infectious diseases and to the issuance of birth and death certificates.

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     23-93-6. Oversight and duties by director of health. – The director of health, with the

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advice of the advisory appointees, shall:

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     (1) Provide general information to applicants for licensure as naturopathic physicians;

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     (2) Administer fees collected under this chapter;

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     (3) Administer examinations;

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     (4) Explain appeal procedures to naturopathic physicians and applicants for licensure and

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complaint procedures to the public;

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     (5) Receive applications for licensure under this chapter, issue and renew licenses and

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revoke, suspend, reinstate or condition licenses as ordered by an administrative law officer; and

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     (6) Refer all disciplinary matters to an appropriate administrative law hearing officer.

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     23-93-7. Advisory appointees. – (a) The secretary of state shall appoint two (2)

 

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naturopathic physicians licensed under this chapter to serve as advisors to the director in matters

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relating to naturopathic physicians. They shall be appointed as set forth in this section and serve

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at the pleasure of the secretary. One of the initial appointments shall be for a term of three (3)

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years and one of the initial appointments shall be for a term of two (2) years.

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     (b) The persons appointed pursuant to subsection (a) of this section shall have at least

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three (3) years of experience as a naturopathic physician during the period immediately preceding

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the appointment, and shall be actively practicing naturopathic medicine and remain in good

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standing during their period as advisors.

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     (c) The director shall seek the advice of the advisor appointees under this section in

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carrying out the provisions of this chapter. The advisor appointees shall be entitled to

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compensation and necessary expenses for attendance at any meetings called by the director for

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this purpose.

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     (d) When an advisor appointee is unable to serve as an administrative law officer by

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reason of disqualification or necessary absence, the secretary of state may appoint a suitable

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person to serve as the administrative law officer in lieu of the advisor appointee.

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     23-93-8. Eligibility for licensure. – (a) To be eligible for licensure as a naturopathic

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physician, an applicant shall satisfy all the following:

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     (1) Have been granted a degree of doctor of naturopathic medicine, from a CNME-

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approved naturopathic medical college;

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     (2) Be physically and mentally fit to practice naturopathic medicine with or without

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reasonable accommodation; and

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     (3) Pass an examination approved by the director, such examination being a competency-

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based national naturopathic licensing examination administered by the North American Board of

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Naturopathic Examiners, or successor agency that has been nationally recognized to administer a

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naturopathic examination that represents federal standards of education and training. For

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graduates of approved naturopathic schools, eligibility for licensure may be granted with

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evidence of successful passage of a board-approved state competency examination or Canadian

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provincial examination.

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     23-93-9. Application for licensure. – A person shall apply for a license under this

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chapter by filing with the director an application provided by the director accompanied by the

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required fees and evidence of eligibility.

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     23-93-10. Examination – Waiver of examination. – The director, or designee, shall

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administer any examination required to obtain licensure in the state of Rhode Island to applicants

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for licensure at least two (2) times each year if applications are pending. Examinations

 

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administered by the director and the procedures of administration shall be fair and reasonable and

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shall be designed and implemented to ensure that all applicants are granted a license if they

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demonstrate that they possess minimal professional qualifications that are consistent with the

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public health, safety, and welfare. The examinations shall not be designed or implemented for the

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purpose of limiting the number of licenses issued.

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      23-93-11. Biennial license renewal – Continuing education. – (a) The license to

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practice naturopathic medicine shall be renewed every two (2) years by filing a renewal

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application on a form provided by the director. The application shall be accompanied by the

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required fee and evidence of compliance with subsection (b) of this section.

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     (b) As a condition of renewal, a naturopathic physician shall complete a program of

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continuing education, approved by the director, during the preceding two (2) years. The director

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shall not require more than thirty (30) hours of continuing education biennially.

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     23-93-12. Refusal or revocation of licensure - Complaints. – The following conduct,

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and conduct set forth by the department of health, by a person licensed under this chapter or an

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applicant for licensure constitutes unprofessional conduct:

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     (1) Failing to use a complete or accurate title in professional activity.

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     (2) Repeated acts of immorality or repeated acts of gross misconduct in the practice of his

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or her profession or gross or repeated malpractice or the failure to practice naturopathic medicine

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with that level of care, skill, and treatment that is recognized by a reasonably prudent similar

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naturopathic physician as being acceptable under similar conditions and circumstances.

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     (3) Harassing, intimidating, or abusing a patient.

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     (4) Agreeing with any other person or organization, or subscribing to any code of ethics

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or organizational bylaws, when the intent or primary effect of that agreement, code or bylaw is to

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restrict or limit the flow of information concerning alleged or suspected unprofessional conduct to

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the board.

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     (5) Abandonment of a patient.

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     (6) Gross overcharging for professional services on repeated occasions, including filing

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of false statements for collection of fees for which services were not rendered.

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     (7) Sexual harassment of a patient.

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     (8) Engaging in an inappropriate sexual act with a patient.

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     (9) Willful misrepresentation in treatments.

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     (10) Practicing naturopathic medicine in an area or areas of specialty in which the

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licensee is not trained to practice.

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     (11) Violation of any law of the state involving moral turpitude.

 

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     23-93-13. Refusal or revocation of a license - Process. – (a) The division of

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professional regulation of the department of health may, after notice and hearings, in its discretion

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refuse to grant the license provided for in this chapter to any naturopathic physician who has

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violated any of the laws of the state involving moral turpitude or affecting the ability of any

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naturopathic physician to practice naturopathic medicine, or who had been guilty of

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unprofessional conduct or conduct of a character likely to deceive or defraud the public, and may,

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after notice and hearing, revoke or suspend any license issued or granted by it for like causes or

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for any fraud or deception committed in obtaining the license.

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     (b) The division of professional regulation of the department of health may refuse to

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accept the return of a license tendered by the subject of a disciplinary investigation and may

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notify relevant state, federal and local agencies and appropriate bodies in other states of the status

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of any pending or completed disciplinary case against the licensee, provided that notice of

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charges against the licensee has been served or disciplinary action against that person has been

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taken.

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     (c) The division of professional regulation of the department of health shall serve a copy

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of its decision or ruling upon any person whose certificate has been revoked or refused.

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     (d) The burden of proof in a disciplinary action shall be on the state to show by a

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preponderance of the evidence that the person has engaged in unprofessional conduct.

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     23-93-14. Complaints. – (a) Any person may report to the division of professional

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regulation in writing any information the person has reason to believe indicates that a

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naturopathic physician is or may be medically or legally incompetent, engaged in the

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unauthorized practice of naturopathic medicine, guilty of unprofessional conduct, or mentally or

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physically unable to engage safely in the practice of naturopathic medicine.

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     (b) Upon receiving a credible complaint or report concerning a licensee, or on its own

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motion, the division of professional regulation may investigate any evidence that appears to show

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a licensee may be medically incompetent, guilty of unprofessional conduct, or mentally or

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physically unable to engage safely in the practice of medicine.

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     (c) Within ten (10) days of receipt thereof, the division of professional regulation shall

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acknowledge receipt of all reports required by this section and any complaint against a licensee.

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Within ten (10) days thereafter, the division shall inform any person or entity whose report has

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resulted in action by the division of the final disposition of the matter.

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     (d) Any person aggrieved by the decision or ruling of the department of health, or of the

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division of professional regulation, in regard to any of the provisions of this chapter, may appeal

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to the superior court in the manner provided for in chapter 35 of title 42.

 

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     SECTION 2. This act shall take effect upon passage.

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LC005332

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY - THE NATUROPATHIC PHYSICIANS ACT OF

2014

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     This act would establish procedures for the licensing of naturopathic physicians, and

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defines the practice of naturopathic medicine. This practice includes the use of botanical and

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homeopathic medicines, as well as counseling and nutrition. The practice of naturopathic

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medicine would be subject to oversight by the director of the Rhode Island department of health.

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     This act would take effect upon passage.

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