23.0696.01000
Sixty-eighth
Legislative Assembly SENATE BILL NO. 2221
of North Dakota
Introduced by
Senators Dwyer, Hogue, K. Roers
Representatives Lefor, Rohr, Weisz
1 A BILL for an Act to create and enact section 43-58-08.1 and three new sections to chapter
2 43-58 of the North Dakota Century Code, relating to the regulation of the practice of
3 naturopathic medicine; to amend and reenact section 43-17-03, subsection 2 of section
4 43-57-01, section 43-57-03, subsection 1 of section 43-57-06, subsection 2 of section 43-57-07,
5 section 43-57-11, subsection 2 of section 43-58-01, and sections 43-58-05, 43-58-08, and
6 43-58-09 of the North Dakota Century Code, relating to the regulation of the practice of
7 naturopathic medicine; and to provide a penalty.
8 BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
9 SECTION 1. AMENDMENT. Section 43-17-03 of the North Dakota Century Code is
10 amended and reenacted as follows:
11 43-17-03. North Dakota board of medicine - How appointed - Qualifications.
12 1. The governor shall appoint a North Dakota board of medicine consisting of
13 thirteenfifteen members, ten physicians, nine of whom are doctors of medicine, and
14 one of whom is a doctor of osteopathy, one of whom is atwo physician
15 assistantassistants, one naturopath, and two of whom are designated as public
16 members. If no osteopathic physician is qualified and willing to serve, any qualified
17 physician may be appointed in place of the osteopathic physician.
18 2. Each physician member must:
19 a. Be a practicing physician of integrity and ability.
20 b. Be a resident of and duly licensed to practice medicine in this state.
21 c. Be a graduate of a medical or osteopathic school of high educational
22 requirements and standing.
23 d. Have been engaged in the active practice of the physician's profession within this
24 state for a period of at least five years.
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1 3. Each public member of the board must:
2 a. Be a resident of this state.
3 b. Be at least twenty-one years of age.
4 c. Not be affiliated with any group or profession that provides or regulates health
5 care in any form.
6 4. TheEach physician assistant member of the board must:
7 a. Be a practicing physician assistant of integrity and ability.
8 b. Be a resident of and be duly licensed to practice as a physician assistant in this
9 state.
10 c. Have been engaged in the active practice as a physician assistant within this
11 state for a period of at least five years.
12 5. The naturopath member must:
13 a. Be a practicing naturopath of integrity and ability.
14 b. Be a resident of and duly licensed to practice as a naturopath in this state.
15 c. Have been engaged in the active practice as a naturopath within this state for a
16 period of at least two years.
17 6. An individual appointed to the board shall qualify by taking the oath required of civil
18 officers.
19 SECTION 2. AMENDMENT. Subsection 2 of section 43-57-01 of the North Dakota Century
20 Code is amended and reenacted as follows:
21 2. "Licensee" means an individual licensed by the board under this chapter and under
22 chapter 43-58, 43-59, 43-61, or 43-64.
23 SECTION 3. AMENDMENT. Section 43-57-03 of the North Dakota Century Code is
24 amended and reenacted as follows:
25 43-57-03. Powers and duties of board.
26 1. The board shall adopt rules:
27 a. To administer and enforce this chapter and chapters 43-58, 43-59, 43-61, and
28 43-64;
29 b. That specify the scope of practice, which must be consistent with the required
30 education for each profession regulated by the board;
31 c. To establish any exemptions from licensure;
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1 d. That endorse equivalent licensure examinations of another state or foreign
2 country and which may include licensure by reciprocity;
3 e. That establish educational standards for each profession regulated by the board
4 as appropriate; and
5 f. That set fees for licensure, which may include:
6 (1) Application fee;
7 (2) License fee;
8 (3) Renewal fee;
9 (4) Late fee;
10 (5) Administrative fees; and
11 (6) Continuing education fees.
12 2. The board shall produce an annual list of the names and level of licensure of all
13 individuals licensed by the board and make the list available upon request.
14 3. The board may employ staff and provide for staff compensation.
15 4. The board shall receive all moneys collected under this chapter and chapters 43-58,
16 43-59, 43-61, and 43-64 and shall deposit and disburse all fees and moneys collected
17 in accordance with section 54-44-12.
18 5. The board may establish continuing education requirements for license renewal.
19 6. The board may adopt a code of ethics for each profession regulated by the board.
20 7. The board may adopt rules allowing students to practice under licensed supervision.
21 SECTION 4. AMENDMENT. Subsection 1 of section 43-57-06 of the North Dakota Century
22 Code is amended and reenacted as follows:
23 1. If the board determines an applicant possesses the qualifications required under this
24 chapter and under chapter 43-58, 43-59, 43-61, or 43-64, the board shall issue a
25 license to the applicant.
26 SECTION 5. AMENDMENT. Subsection 2 of section 43-57-07 of the North Dakota Century
27 Code is amended and reenacted as follows:
28 2. A license issued under chapter 43-58 or 43-59 expires on December thirty-first of
29 every odd-numbered year. A license issued under chapter 43-61 or 43-64 expires on
30 December thirty-first of every even-numbered year.
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1 SECTION 6. AMENDMENT. Section 43-57-11 of the North Dakota Century Code is
2 amended and reenacted as follows:
3 43-57-11. Enforcement - Penalty.
4 A person that violates this chapter or chapter 43-58, 43-59, 43-61, or 43-64 is guilty of a
5 class B misdemeanor. In addition to the criminal penalties provided under this section, the civil
6 remedy of injunction is available to restrain and enjoin any violation of this chapter or chapter
7 43-58, 43-59, 43-61, or 43-64 without proof of actual damages sustained by any person.
8 SECTION 7. AMENDMENT. Subsection 2 of section 43-58-01 of the North Dakota Century
9 Code is amended and reenacted as follows:
10 2. "Board" means the stateNorth Dakota board of integrative health caremedicine
11 created under chapter 43-5743-17.
12 SECTION 8. AMENDMENT. Section 43-58-05 of the North Dakota Century Code is
13 amended and reenacted as follows:
14 43-58-05. Application for licensure.
15 1. An applicant for naturopathic licensure shall file an application on forms provided by
16 the board showing to the board's satisfaction that the applicant is of good moral
17 character andhas satisfied all of the requirements of this chapter and chapter 43-57set
18 by rule of the board, including:
19 a. Successful graduation of an approved naturopathic medical college;
20 b. Successful completion of an examination prescribed or endorsed by the board,
21 such as part I and part II of the naturopathic physicians licensing examinations;
22 c. Physical, mental, and professional capability for the practice of naturopathic
23 medicine in a manner acceptable to the board; and
24 d. A history free of any finding by the board, any other state licensure board, or any
25 court of competent jurisdiction of the commission of any act that would constitute
26 grounds for disciplinary action under this chapter and chapter 43-57set by rule of
27 the board. The board may modify this restriction for cause.
28 2. The application must be accompanied by the board-established license fees and
29 application fees and by the documents, affidavits, and certificates necessary to
30 establish that the applicant possesses the necessary qualifications.
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1 SECTION 9. AMENDMENT. Section 43-58-08 of the North Dakota Century Code is
2 amended and reenacted as follows:
3 43-58-08. Practice of naturopathic health care.
4 1. A naturopath may practice naturopathic medicine as a limited practice of the healing
5 arts as exempted under section 43-17-02. A naturopath may not:
6 a. Prescribe, dispense, or administer any prescription drug without obtaining a
7 license endorsement under this chapter;
8 b. Administer ionizing radioactive substances for therapeutic purposes;
9 c. Perform a surgical procedure; or
10 d. Claim to practice any licensed health care profession or system of treatment
11 other than naturopathic medicine unless holding a separate license in that
12 profession. A naturopath may not hold out to the public that the naturopath is a
13 primary care provider.
14 2. A naturopath may prescribe and administer for preventive and therapeutic purposes a
15 prescriptive device and the following nonprescriptive natural therapeutic substances,
16 drugs, and therapies:
17 a. Food, vitamins, minerals, dietary supplements, enzymes, botanical medicines,
18 and homeopathic preparations;
19 b. Topical drugs, health care counseling, nutritional counseling and dietary therapy,
20 naturopathic physical applications, and therapeutic devices; and
21 c. Barrier devices for contraception.
22 3. A naturopath:
23 a. May prescribe, dispense, administer, and procure drugs and medical devices as
24 authorized under this chapter.
25 b. May plan and initiate a therapeutic regimen of ordering and prescribing
26 nonpharmacological interventions.
27 c. May not prescribe or dispense schedule I through V substances as designated by
28 the federal drug enforcement administration except for testosterone and may
29 prescribe and dispense all other legend drugs authorized by a formulary
30 approved by the board and set forth in rule.
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1 d. May not dispense a drug as authorized under this chapter unless pharmacy
2 services are not available or if an emergency exists.
3 e. May request, receive, and sign for a professional sample of a drug authorized to
4 be prescribed under this chapter and may distribute the sample to a patient.
5 f. If prescribing or dispensing a drug as authorized by this chapter, shall register, if
6 appropriate, with the federal drug enforcement administration and shall comply
7 with appropriate state and federal laws, including participating in the prescription
8 drug monitoring program under chapter 19-03.5.
9 4. A naturopath may perform or order for diagnostic purposes a physical or orificial
10 examination, ultrasound, phlebotomy, clinical laboratory test or examination,
11 physiological function test, and any other noninvasive diagnostic procedure commonly
12 used by physicians in general practice and as authorized by the board.
13 SECTION 10. Section 43-58-08.1 of the North Dakota Century Code is created and enacted
14 as follows:
15 43-58-08.1. Endorsement for prescribing authority.
16 1. A naturopath may not prescribe, dispense, or administer a prescription medication
17 without first obtaining an endorsement for licensure.
18 2. The naturopath first must apply for a limited endorsement with the board in which the
19 naturopath enters a written collaborative agreement with a supervising physician
20 licensed under chapter 43-17, who will review the first one hundred prescriptions
21 issued by the naturopath or twelve months of prescribing, whichever occurs first. The
22 supervising physician shall possess an unencumbered license and have been
23 prescribing and administering prescription drugs without limitation for at least five
24 years in the state. The supervising physician shall evaluate the naturopath's ability to
25 safely prescribe and administer prescription drugs within the naturopath's scope of
26 practice and to comply with federal and state laws. The written collaborative
27 agreement must address the requirements of this subsection and be provided to the
28 board along with the application for endorsement. The board, by rule, further shall
29 define the terms of the supervising physician's role in reviewing the naturopath's
30 prescribing practices.
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1 3. A naturopath who satisfies the requirements of subsection 2 shall notify the board in
2 writing with verification from the supervising physician that this requirement has been
3 met. Upon verification subsection 2 has been met, and the naturopath successfully
4 completed the pharmacology elective examination approved by the board, the board
5 shall issue the naturopath an endorsement to prescribe independently.
6 4. The board may waive the requirements of section 2 and examination under section 3 if
7 a naturopath shows the naturopath has substantial experience in prescribing
8 prescription medications under the laws of another jurisdiction that has standards and
9 qualifications for a naturopath to prescribe prescription medications at least equal to
10 those required under this chapter.
11 5. To maintain the endorsements provided under this section, the naturopath shall obtain
12 five hours of continuing education hours annually regarding pharmacology of
13 testosterone and legend drugs.
14 SECTION 11. AMENDMENT. Section 43-58-09 of the North Dakota Century Code is
15 amended and reenacted as follows:
16 43-58-09. Public health duties.
17 A naturopath has the same powers and duties as a licensed physician with regard to public
18 health laws, reportable diseases and conditions, communicable disease control and prevention,
19 recording of vital statistics, health and physical examinations, and local boards of health, except
20 that the authority and responsibility are limited to activities consistent with the scope of practice
21 established under this chapter and chapter 43-57.
22 SECTION 12. A new section to chapter 43-58 of the North Dakota Century Code is created
23 and enacted as follows:
24 Powers and duties of the board.
25 1. The board shall adopt rules:
26 a. To administer and enforce this chapter;
27 b. To specify the scope of practice, which must be consistent with the required
28 education;
29 c. To establish any exemptions from licensure;
30 d. That endorse equivalent licensure examinations of another state or foreign
31 country and which may include licensure by reciprocity;
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1 e. That establish appropriate educational standards;
2 f. To establish renewal requirements; and
3 g. That set required fees, including:
4 (1) An application fee;
5 (2) A license fee;
6 (3) A renewal fee;
7 (4) A late fee;
8 (5) Administrative fees; and
9 (6) Continued education fees.
10 2. The board may establish continuing education requirements for license renewal.
11 3. The board may adopt a code of ethics for naturopaths.
12 4. If the number of naturopath licensees in the state increases to at least one hundred,
13 the board shall consider whether to introduce legislation creating an independent
14 board to regulate the profession.
15 SECTION 13. A new section to chapter 43-58 of the North Dakota Century Code is created
16 and enacted as follows:
17 Discipline.
18 1. The board may take disciplinary action against a licensee by any of the following
19 means:
20 a. Revocation of license;
21 b. Suspension of license;
22 c. Probation;
23