S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4825
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 5, 2019
                                ___________
 
 Introduced  by  M. of A. ORTIZ, BENEDETTO -- Multi-Sponsored by -- M. of
   A. ENGLEBRIGHT -- read once and referred to the  Committee  on  Higher
   Education
 
 AN  ACT  to  amend the education law, the limited liability company law,
   the partnership law and the public health  law,  in  relation  to  the
   practice  of  naturopathy;  and  to  amend the social services law, in
   relation to the reporting of child abuse
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. Legislative intent.  1. The legislature recognizes that in
 spite of advances in science and technology that have  resulted  in  the
 American  healthcare  system  excelling  at  triage and in responding to
 acute emergent conditions, there is an epidemic of chronic  disease  and
 an unacceptable degree of iatrogenic disease in America. The legislature
 recognizes that the economics of healthcare and the pursuit of scientif-
 ic  advancement  have led to an occupational preference among physicians
 for specialization, resulting in a shortage of primary care  physicians.
 The  legislature  finds that licensure of the profession of naturopathic
 medicine favorably addresses such problems, and agrees with U.S.  Senate
 Resolution  221  of  the  113th  Congress  in  finding that naturopathic
 doctors are skilled in preventing and  treating  chronic  disease;  that
 naturopathic  medicine  is  a  safe,  effective, and affordable means of
 health care; and that licensure of naturopathic  doctors  helps  address
 the shortage of primary care physicians in the United States, while also
 providing people with more choice in health care.
   2.  The  legislature  recognizes  that naturopathic medicine, although
 encompassing primary and secondary care services, including many of  the
 same  diagnostic  tools and assessment techniques as the medical profes-
 sion, and having certain  Hippocratic  principles  in  common  with  the
 medical profession, is not part of the profession of medicine as contem-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08497-01-9
              

 A. 4825                             2
 
 plated by article 131 of the education law, and intends that naturopath-
 ic medicine be a distinct profession with its own state board.
   3.  The legislature recognizes that naturopathic medicine is a modern,
 evolved form of naturopathy that is practiced by  naturopathic  doctors;
 that  the early form, today sometimes called traditional naturopathy, is
 characterized by its vitalistic philosophy, and  by  its  foundation  of
 hygiene  and  nature  cure (i.e., the use of natural agents such as air,
 light, water, food, and herbs to stimulate the body's own natural  heal-
 ing  powers);  and  that  such early form is practiced in some states by
 traditional naturopaths without licensure, by lay persons in  their  own
 self  care, and to some extent in health spas. This bill is not intended
 to change the legality or illegality  of  activities  relating  to  such
 hygiene and nature cure; nor to limit the scope of naturopathic medicine
 to such traditional naturopathy.
   4.  The  legislature  recognizes  that  the  naturopathic doctor has a
 primary mission of facilitating optimum health and wellness for patients
 of any age; relies on the scientific method in implementing  vitalistic,
 functional,  and  evidence-based  strategies  for assessing and treating
 patients; and works with patients of good or ill health having acute and
 chronic conditions, including serious medical conditions.
   5. The legislature intends that the authorized activities  within  the
 scope  of  practice of a naturopathic doctor are those activities within
 the meanings of naturopathic assessment, common office procedures, phys-
 ical naturopathy,  approved  substances,  approved  routes  of  adminis-
 tration,  and noninvasive naturopathic therapies, as per sections sixty-
 eight hundred fifty and sixty-eight hundred fifty-one of article 138  of
 the  education  law  as  proposed  in this act. For naturopathic doctors
 having the injection therapy privilege the authorized activities further
 include injection therapy, as per section sixty-eight hundred fifty-four
 of article 138 of the education law, as proposed in this act. The  scope
 of  such  practice activities however are limited by section sixty-eight
 hundred fifty-five of article 138 of the education law, as  proposed  in
 this  act,  which  provides  boundaries  of professional competence. The
 legislature provides a list of broad clinical objectives included within
 the meaning of "facilitating optimum health and wellness," as defined in
 section sixty-eight hundred fifty-one of article 138  of  the  education
 law  as proposed in this act, which list, while relevant to professional
 conduct, is not intended to expand upon the authorized  activities.  The
 legislature intends that invasive procedures other than diagnostic imag-
 ing  be  impermissible,  and that the definitions of the terms "invasive
 procedures" and "noninvasive" be construed independent of each other.
   6. The legislature intends that the education qualification for  natu-
 ropathic  medicine  emphasizes the basic sciences and clinical sciences,
 such as has been established by  the  Council  on  Naturopathic  Medical
 Education  (CNME) and the Association of Accredited Naturopathic Medical
 Colleges (AANMC), and so distinguish over traditional naturopathy.
   7. The legislature intends that the education qualification for  natu-
 ropathic  medicine  insofar  as  including a substantial equivalent of a
 program of naturopathic medicine registered with the department  require
 that  such substantial equivalent, among other factors determined by the
 department, also require that the substantial equivalent  emphasize  the
 naturopathic  principles and the therapeutic order in clinical training,
 such as in programs accredited by the Council  on  Naturopathic  Medical
 Education  (CNME) or in the naturopathic medical programs offered by the
 Association of Accredited Naturopathic Medical Colleges (AANMC), and  so
 distinguish over a doctoral degree in medicine or osteopathy.

 A. 4825                             3
 
   8.  The legislature intends that the professional conduct of the natu-
 ropathic doctor be informed by the naturopathic principles and the ther-
 apeutic order, and so distinguish  over  professional  conduct  for  the
 practice of the profession of medicine.
   9.  The  legislature  recognizes  that in the practice of naturopathic
 medicine the healing power of nature principle is  viewed  as  being  an
 inherent  property  in  a  living  organism  to  heal  itself, and is an
 acknowledgment that synergy results from the coordination  of  the  many
 chemical  and physical reactions of the living system through varied and
 circuitous feedback pathways making the whole function as more than  the
 sum  of its parts.  The number of reactions and the resulting complexity
 and synergy is viewed in the  profession  of  naturopathic  medicine  as
 being  why  treatment  of  a  given  physiological process may result in
 unforeseen nonlocal consequences, including iatrogenic disease;  and  is
 why  naturopathic  doctors  investigate and treat the patient as a whole
 living system, find and remove the cause, and prefer less invasive ther-
 apies and substances with fewer side effects. It also is why the naturo-
 pathic doctor prefers  to  intervene  early  to  prevent  occurrence  of
 disease.
   10.  The legislature intends that licensed naturopathic doctors, while
 being permitted  to  practice  in  solo  and  among  other  naturopathic
 doctors,  also be permitted to practice naturopathic medicine in many of
 the current patient care venue types  in  the  healthcare  system;  that
 there  be  referral  among  naturopathic  doctors, physicians, and other
 health care providers as based on the interests of the patient; and that
 integrative care settings and the advancement of public health and safe-
 ty be realized through collaboration among naturopathic doctors,  physi-
 cians, and other health care providers.
   11.  Naturopathic  doctors  add  to the health care system by bringing
 their naturopathic approach to  patient  care;  and  by  bringing  their
 expertise  on  the  determinants  of  health, diet and nutrient therapy,
 phytotherapy,  therapeutic  use  of  physical  agents,   and   drug/herb
 drug/nutrient  interactions.  Therefore,  to  improve the public health,
 safety and welfare of its citizens, the legislature finds it is  desira-
 ble  to  regulate  the  profession of naturopathic medicine, and intends
 that admission to practice and regulation of  such  practice,  including
 professional  conduct,  shall  be supervised by the board of regents and
 administered by the state education  department,  assisted  by  a  state
 board of naturopathic medicine.
   §  2. The education law is amended by adding a new article 138 to read
 as follows:
                                ARTICLE 138
                           NATUROPATHIC MEDICINE
 SECTION 6850. INTRODUCTION.
         6851. DEFINITIONS.
         6852. DEFINITION OF THE PRACTICE OF NATUROPATHIC MEDICINE.
         6853. TITLE AND DESIGNATION.
         6854. INJECTION THERAPY AND INJECTION THERAPY PRIVILEGE.
         6855. BOUNDARIES OF PROFESSIONAL COMPETENCE.
         6856. STATE BOARD FOR NATUROPATHIC MEDICINE.
         6857. QUALIFICATIONS FOR LICENSURE.
         6858. SPECIAL CONDITIONS.
         6859. EXEMPT PERSONS AND EXEMPTIONS.
         6860. LIMITED RESIDENCY PERMITS.
         6861. LIMITED PERMITS.
         6862. MANDATORY CONTINUING EDUCATION.

 A. 4825                             4
 
   § 6850. INTRODUCTION. THIS ARTICLE APPLIES TO THE LICENSURE AND  REGU-
 LATION OF NATUROPATHIC DOCTORS TO PRACTICE NATUROPATHIC MEDICINE IN THIS
 STATE.   THE GENERAL PROVISIONS FOR ALL PROFESSIONS CONTAINED IN ARTICLE
 ONE HUNDRED THIRTY, AS ADDED BY CHAPTER NINE HUNDRED EIGHTY-SEVEN OF THE
 LAWS  OF NINETEEN HUNDRED SEVENTY-ONE, OF THIS TITLE APPLY TO THIS ARTI-
 CLE.
   § 6851. DEFINITIONS. FOR THE PURPOSES OF THIS ARTICLE:
   1. "APPROVED CLIA WAIVED  TESTS"  MEAN  LABORATORY  TESTS  CATEGORIZED
 UNDER  THE FEDERAL CLINICAL LABORATORY IMPROVEMENT ACT (CLIA) OF 1988 AS
 BEING WAIVED TESTS, AND WHICH ARE IDENTIFIED BY THE DEPARTMENT UPON  THE
 RECOMMENDATION  OF  THE  BOARD,  AND UPDATED AS NEEDED OR UPON TRIENNIAL
 REVIEW, AS BEING APPROPRIATE IN THE PRACTICE OF NATUROPATHIC MEDICINE.
   2. "APPROVED ROUTES OF ADMINISTRATION" MEANS ORAL, SUBLINGUAL,  NASAL,
 AURICULAR,  OCULAR,  RECTAL,  VAGINAL, AND TRANSDERMAL. FOR NATUROPATHIC
 DOCTORS HAVING INJECTION THERAPY  PRIVILEGE  UNDER  SECTION  SIXTY-EIGHT
 HUNDRED  FIFTY-FOUR OF THIS ARTICLE, "APPROVED ROUTES OF ADMINISTRATION"
 FURTHER INCLUDE INJECTION ROUTES,  NAMELY,  INTRAVENOUS,  INTRAMUSCULAR,
 SUBCUTANEOUS, AND INTRADERMAL.
   3.  "APPROVED  SUBSTANCES"  MEANS  OVER-THE-COUNTER  SUBSTANCES;  FOOD
 CONCENTRATES, FOOD EXTRACTS, AND OTHER  DIETARY  INGREDIENTS;  VITAMINS,
 MINERALS, AND OTHER DIETARY SUPPLEMENTS; BOTANICAL AND HOMEOPATHIC PREP-
 ARATIONS; AND A LIMITED FORMULARY OF LEGEND DRUGS. THE LIMITED FORMULARY
 OF LEGEND DRUGS INCLUDES THYROID HORMONES, ESTROGEN HORMONES, PROGESTER-
 ONE  HORMONE,  DHEA,  AND  HOMEOPATHIC PREPARATIONS OF HOMEOPATHIC DRUGS
 LISTED IN THE OFFICIAL HOMEOPATHIC PHARMACOPOEIA OF THE  UNITED  STATES.
 FOR  NATUROPATHIC  DOCTORS  HAVING  INJECTION  THERAPY  PRIVILEGE  UNDER
 SECTION SIXTY-EIGHT HUNDRED FIFTY-FOUR  OF  THIS  ARTICLE,  THE  LIMITED
 FORMULARY  FURTHER  INCLUDES  IMMUNIZATIONS  AND INJECTABLE FORMS OF THE
 APPROVED SUBSTANCES. LEGEND DRUGS IN THE LIMITED FORMULARY MAY BE ADMIN-
 ISTERED AND PRESCRIBED, AND THE OTHER APPROVED SUBSTANCES AND HOMEOPATH-
 IC PREPARATIONS MAY BE ADMINISTERED, PRESCRIBED, AND DISPENSED.
   4. "BOARD" MEANS THE STATE BOARD FOR NATUROPATHIC MEDICINE.
   5. "COMMON OFFICE PROCEDURES" MEANS ADMINISTERING APPROVED CLIA WAIVED
 TESTS;  ADMINISTERING  ULTRASONOGRAPHIC   AND   THERMOGRAPHIC   IMAGING;
 PRESCRIBING,  INSTALLING,  REMOVING, AND ADJUSTING BARRIER CONTRACEPTIVE
 DEVICES; PROCEDURES FOR TREATING SUPERFICIAL LACERATIONS  AND  ABRASIONS
 AND  FOR THE REMOVAL OF FOREIGN BODIES LOCATED IN SUPERFICIAL STRUCTURES
 NOT TO INCLUDE THE EYE, EXCLUDING BY INCISION AND SUTURING;  ADMINISTER-
 ING  CRYOTHERAPY,  LIGATION,  AND  FULGURATION;  ADMINISTERING  APPROVED
 SUBSTANCES VIA APPROVED ROUTES OF ADMINISTRATION; PROCEDURES FOR OBTAIN-
 ING SAMPLES OF BODILY FLUIDS, BODILY EXCRETIONS, BODILY SECRETIONS,  AND
 BODILY  TISSUES; AND OTHER PROCEDURES FOR ASSESSMENT OR THERAPY THAT ARE
 NONINVASIVE. COMMON OFFICE PROCEDURES FOR OBTAINING SAMPLES ARE  LIMITED
 TO:  VENIPUNCTURE  AND  PHLEBOTOMY,  PAP  SMEAR,  SCRAPING, AND FOR HAIR
 CUTTING.
   6. "CONTROLLED SUBSTANCE" MEANS CONTROLLED SUBSTANCES  AS  DEFINED  IN
 THE FEDERAL CONTROLLED SUBSTANCES ACT.
   7.  "DIAGNOSTIC IMAGING" MEANS RADIOGRAPHY, TOMOGRAPHY, MAGNETIC RESO-
 NANCE IMAGING, ULTRASONOGRAPHY, AND THERMOGRAPHY, AND  EXCLUDES  NUCLEAR
 MEDICINE,  FLUOROSCOPY,  AND  RADIOLOGICAL  PROCEDURES  FOR  TREATING  A
 MEDICAL CONDITION.
   8. "DIETARY INGREDIENT" MEANS A DIETARY INGREDIENT AS DEFINED  IN  THE
 FEDERAL DIETARY SUPPLEMENT HEALTH AND EDUCATION ACT OF 1994 (DSHEA).
   9.  "DIETARY  SUPPLEMENT" MEANS A DIETARY SUPPLEMENT AS DEFINED IN THE
 FEDERAL DIETARY SUPPLEMENT HEALTH AND EDUCATION ACT OF 1994 (DSHEA).

 A. 4825                             5
 
   10. "DRUG" MEANS A DRUG AS DEFINED IN  THE  FEDERAL  FOOD,  DRUG,  AND
 COSMETIC ACT, 21 USC 321.
   11.  "FACILITATING OPTIMUM HEALTH AND WELLNESS" MEANS FACILITATING THE
 ESTABLISHMENT AND MAINTENANCE OF A HEALTHY PATIENT LIFESTYLE AND  NUTRI-
 TIONAL  FOUNDATION;  EDUCATING  THE PATIENT ABOUT THEIR CIRCUMSTANCES OF
 HEALTH AND ILLNESS AND STEPS FOR ESTABLISHING  AND  MAINTAINING  OPTIMUM
 HEALTH AND WELLNESS; FACILITATING AND AUGMENTING SELF-HEALING PROCESSES;
 SUPPORTING   AND  MODULATING  PHYSIOLOGICAL  PROCESSES;  SUPPORTING  AND
 CORRECTING INTEGRITY OF ANATOMICAL STRUCTURES; IDENTIFYING AND  REMOVING
 UNDERLYING  CAUSES  OF ILLNESS; AND IDENTIFYING, PREVENTING, MITIGATING,
 MONITORING, AND TREATING ILLNESS.
   12. "FOOD" MEANS FOOD AS  DEFINED  IN  THE  FEDERAL  FOOD,  DRUG,  AND
 COSMETIC ACT, 21 USC 321.
   13.  "ILLNESS"  MEANS  PAIN,  INJURY, DEFORMITY, SYNDROME, DISEASE, OR
 OTHER UNHEALTHY CONDITION.
   14. "INVASIVE PROCEDURE" MEANS ANY MEDICAL PROCEDURE  IN  WHICH  BONE,
 VISCERA,  THE  EYEBALL,  THE  INNER  EAR, THE DORSAL BODY CAVITY, OR THE
 VENTRAL BODY CAVITY IS PENETRATED BY A PHYSICAL DEVICE  OR  BY  IONIZING
 RADIATION ABOVE BACKGROUND LEVELS.
   15. "INJECTION THERAPY" MEANS THE INJECTION OF APPROVED SUBSTANCES.
   16.  "INJECTION  THERAPY PRIVILEGE" MEANS THE SCOPE OF PRACTICE PRIVI-
 LEGE TO PRACTICE  INJECTION  THERAPY,  IN  ACCORDANCE  WITH  REGULATIONS
 PROMULGATED BY THE COMMISSIONER.
   17.  "LEGEND  DRUG"  MEANS A DRUG FOR WHICH A PRESCRIPTION IS REQUIRED
 UNDER THE FEDERAL FOOD, DRUG AND COSMETIC ACT.
   18. "NATUROPATHIC ASSESSMENT" MEANS THE IDENTIFICATION AND  EVALUATION
 OF  A PATIENT'S CIRCUMSTANCES OF HEALTH AND ILLNESS BY INVESTIGATING THE
 PATIENT'S HEALTH, HISTORY, LIFE STYLE, AND DETERMINANTS  OF  HEALTH;  BY
 COMPREHENSIVE  PHYSICAL  EXAMINATION;  BY  COMMON  OFFICE PROCEDURES FOR
 ASSESSMENT; BY ORDERING AND PRESCRIBING LABORATORY TESTS AND PROCEDURES,
 INCLUDING SUBMITTING SPECIMENS FOR TESTING  TO  LABORATORIES  THAT  HOLD
 PERMITS  OR  LICENSES  PURSUANT  TO UNDER TITLE V OF ARTICLE FIVE OF THE
 PUBLIC HEALTH LAW; BY ORDERING AND PRESCRIBING DIAGNOSTIC  IMAGING;  AND
 BY  OTHER  ASSESSMENT  TECHNIQUES  THAT ARE NONINVASIVE.   SPECIMENS FOR
 TESTING MAY BE OBTAINED BY COMMON  OFFICE  PROCEDURES  AS  DESCRIBED  IN
 SUBDIVISION  FIVE  OF  THIS  SECTION OR BY PATIENT SUBMISSION (E.G., FOR
 STOOL, URINE, HAIR, SALIVA).
   19. "NATUROPATHIC PRINCIPLES" MEANS THE  FOLLOWING  PRINCIPLES,  WHICH
 ARE  WEIGHED  BY  THE  NATUROPATHIC DOCTOR TO INFLUENCE THE SELECTION OF
 NATUROPATHIC ASSESSMENT ACTIVITIES, COMMON OFFICE PROCEDURES, AND TREAT-
 MENTS ADMINISTERED, ORDERED OR REFERRED:
   A. "THE HEALING POWER OF NATURE," WHICH MEANS THE INHERENT ABILITY  OF
 A LIVING ORGANISM FOR SELF-HEALING;
   B.  "IDENTIFY  AND  TREAT THE CAUSES," WHICH MEANS IDENTIFY AND REMOVE
 THE UNDERLYING CAUSES OF ILLNESS  SO  THAT  SELF-HEALING  PROCESSES  MAY
 FUNCTION EFFECTIVELY;
   C.  "FIRST  DO  NO  HARM," WHICH MEANS APPLY THE LEAST FORCE OR INTER-
 VENTION TO IDENTIFY ILLNESS AND RESTORE HEALTH, SUCH  AS  REFERENCED  IN
 THE  THERAPEUTIC ORDER; AND WHENEVER POSSIBLE, AVOID SYMPTOM SUPPRESSION
 THAT INTERFERES WITH THE DYNAMICS OF SELF-HEALING;
   D. "DOCTOR AS TEACHER," WHICH MEANS EDUCATE PATIENTS AS TO  STEPS  FOR
 ACHIEVING  AND MAINTAINING HEALTH, AND ENCOURAGE SELF-RESPONSIBILITY FOR
 HEALTH;
   E. "TREAT THE WHOLE PERSON," WHICH MEANS ASSESS AND TREAT THE  PATIENT
 AS AN INTEGRATED WHOLE HAVING MANY PHYSICAL, MENTAL, EMOTIONAL, SPIRITU-
 AL, AND SOCIAL ASPECTS; AND

 A. 4825                             6
 
   F.  "PREVENTION,"  WHICH  MEANS  ASSESS  LIFE  STYLE,  DETERMINANTS OF
 HEALTH, AND GENETIC AND ENVIRONMENTAL SUSCEPTIBILITY TO ILLNESS;  RECOM-
 MEND  APPROPRIATE  INTERVENTIONS  TO REDUCE RISKS OF DISEASE OCCURRENCE;
 AND FACILITATE THE ESTABLISHMENT AND MAINTENANCE  OF  POSITIVE  EMOTION,
 THOUGHT AND ACTION.
   20.  "NONINVASIVE" MEANS NO BREAK IS CREATED IN THE SKIN OR MUCOSA, NO
 INFILTRATION OF THE SKIN OR MUCOSA IS MADE BY IONIZING  RADIATION  ABOVE
 BACKGROUND  LEVELS,  NO ENDOSCOPY IS PERFORMED BETWEEN THE ESOPHAGUS AND
 COLON, INCLUSIVE, AND NO RADIOGRAPHY, TOMOGRAPHY, OR MAGNETIC  RESONANCE
 IMAGING IS ADMINISTERED.
   21.  "NONINVASIVE  NATUROPATHIC  THERAPIES"  MEANS  DIET AND LIFESTYLE
 COUNSELING, PATIENT EDUCATION AS TO CIRCUMSTANCES OF HEALTH AND ILLNESS,
 WELLNESS COUNSELING, BIOFEEDBACK, HYPNOTHERAPY, AND TOUCH AND/OR TAPPING
 THERAPIES WITH AND WITHOUT A VERBAL COMMUNICATION COMPONENT. NONINVASIVE
 NATUROPATHIC THERAPIES EXCLUDE THE PRACTICE OF MARITAL AND FAMILY THERA-
 PY, PSYCHOANALYSIS, AND CREATIVE ARTS THERAPY ON A  CONTINUED  SUSTAINED
 BASIS,  AND  IS  FURTHER LIMITED IN APPLICATION BY A BOUNDARY OF PROFES-
 SIONAL  COMPETENCE  RESTRICTING  PSYCHOTHERAPEUTIC   INTERVENTION   WITH
 PATIENTS  HAVING  SYMPTOMATIC,  INTELLECTUALLY,  SOCIALLY OR EMOTIONALLY
 MALADAPTIVE BEHAVIOR SUFFICIENT TO BE A  MENTAL,  EMOTIONAL,  COGNITIVE,
 ADDICTIVE OR BEHAVIORAL DISORDER AS PER DSM CRITERIA OR PER DIAGNOSIS BY
 A  QUALIFIED  HEALTHCARE  PROVIDER,  AS  PROVIDED IN SECTION SIXTY-EIGHT
 HUNDRED FIFTY-FIVE OF THIS ARTICLE.
   22. "OPTIMUM HEALTH" MEANS  A  PERSON'S  DESIRED,  MAINTAINABLE,  BEST
 DEGREE  OF  HEALTH,  GIVEN  THE  PERSON'S  CIRCUMSTANCES  OF  HEALTH AND
 ILLNESS, THE THERAPEUTIC GOALS, AND THE PERSON'S DEGREE OF  SELF-RESPON-
 SIBILITY FOR HEALING.
   23.  "OVER  THE  COUNTER  SUBSTANCES"  MEANS SUBSTANCES THAT HAVE BEEN
 APPROVED OR CLEARED BY THE FOOD AND DRUG ADMINISTRATION  OF  THE  UNITED
 STATES  DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR SALE OR DISTRIBUTION
 TO  THE  PUBLIC  ON  A  DIRECT  OR  OVER-THE-COUNTER  BASIS  WITHOUT   A
 PRESCRIPTION FROM A QUALIFIED HEALTH CARE PRACTITIONER.
   24. "PHYSICAL NATUROPATHY" MEANS MANUAL THERAPY, THERAPEUTIC EXERCISE,
 HYDROTHERAPY,  COLONIC  THERAPY,  SAUNA,  MICROWAVE DIATHERMY, SHORTWAVE
 DIATHERMY, ULTRASONIC DIATHERMY, MUSCLE STIMULATION, BIOFEEDBACK, INFRA-
 RED LIGHT THERAPY, ULTRAVIOLET LIGHT  THERAPY,  VISIBLE  LIGHT  THERAPY,
 IONTOPHORESIS,  AND THE THERAPEUTIC USE OF PHYSICAL MEDICINE THERAPEUTIC
 DEVICES THAT ARE EXEMPT OR ARE CLASS I OR CLASS  II  DEVICES  IDENTIFIED
 UNDER  THE  CODE OF FEDERAL REGULATIONS, TITLE 21, CHAPTER I, SUBCHAPTER
 H, PART 890, SUBPART F.
   25. "RADIOLOGICAL PROCEDURES" MEANS RADIOLOGICAL PROCEDURES AS DEFINED
 IN SECTION EIGHTY-SEVEN HUNDRED ONE OF THIS TITLE.
   26. "SUPERFICIAL" MEANS THE DERMAL AND SUBCUTANEOUS LAYERS OF THE BODY
 EXTERIOR, THE MUCOSAL LAYER OF THE BODY  ORIFICES,  AND  THE  UNDERLYING
 FASCIA AND ADIPOSE.
   27.  "SURGERY" MEANS A MEDICAL PROCEDURE FOR STRUCTURALLY ALTERING THE
 HUMAN BODY BY CUTTING INTO LIVE HUMAN TISSUE FOR THE PURPOSE  OF  LOCAL-
 IZED  ALTERATION,  TRANSPORTATION,  OR  DESTRUCTION OF LIVE HUMAN TISSUE
 USING IONIZING RADIATION OR AN INSTRUMENT, SUCH AS A LASER, SCALPEL,  OR
 PROBE;  AND  DOES  NOT  INCLUDE  PUNCTURES,  INJECTIONS,  DRY  NEEDLING,
 ACUPUNCTURE, OR REMOVAL OF DEAD TISSUE.
   28. "THERAPEUTIC ORDER" MEANS  THE  HIERARCHY  OF  THERAPEUTIC  INTER-
 VENTION,  AS  FOLLOWS,  ORDERED ACCORDING TO DEGREE OF INTERVENTION, AND
 USED BY DETERMINING THE LOWEST DEGREE  OF  INTERVENTION  FOR  WHICH  THE
 SPECIFIC  PATIENT'S  CIRCUMSTANCES  OF  HEALTH AND ILLNESS CAN BE EFFEC-
 TIVELY ADDRESSED TO RESTORE AND FACILITATE OPTIMUM HEALTH, WHEREIN THER-

 A. 4825                             7
 
 APEUTIC INTERVENTION OUTSIDE THE BOUNDARIES OF  PROFESSIONAL  COMPETENCE
 IS INTENDED TO BE REFERRED:
   A.  ESTABLISH  THE  CONDITIONS  FOR  HEALTH (E.G., IDENTIFY AND REMOVE
 DISTURBING FACTORS; INSTITUTE A MORE HEALTHFUL REGIMEN);
   B. STIMULATE THE SELF-HEALING PROCESSES;
   C. ADDRESS WEAKENED OR DAMAGED SYSTEMS OR ORGANS (E.G., STRENGTHEN THE
 IMMUNE SYSTEM; DECREASE TOXICITY; NORMALIZE INFLAMMATORY FUNCTION; OPTI-
 MIZE METABOLIC FUNCTION; BALANCE REGULATORY  SYSTEMS;  ENHANCE  REGENER-
 ATION;  CULTIVATE  SENSORY  AND  MINDFUL AWARENESS OF THE INTEGRATION OF
 PSYCHE AND SOMA);
   D. CORRECT STRUCTURAL INTEGRITY;
   E. ADDRESS PATHOLOGY USING SPECIFIC NATURAL SUBSTANCES, MODALITIES, OR
 INTERVENTIONS;
   F.  ADDRESS  PATHOLOGY  USING  SPECIFIC  PHARMACOLOGIC  OR   SYNTHETIC
 SUBSTANCES; AND
   G. SUPPRESS OR SURGICALLY REMOVE PATHOLOGY.
   29. "VERTEBRAL ADJUSTMENT" MEANS A HIGH VELOCITY, LOW AMPLITUDE THRUST
 APPLIED  TO A VERTEBRA AT THE END OF ITS RANGE OF MOTION UTILIZING PARTS
 OF THE VERTEBRA AND CONTIGUOUS STRUCTURES  AS  LEVERS  TO  DIRECTIONALLY
 CORRECT  ARTICULATE  MALPOSITION,  AND  EXCLUDES  MOTION  THAT MOVES THE
 VERTEBRA TO THE END OF ITS RANGE OF MOTION.
   30. "WELLNESS" MEANS A STATE OF BEING  ABLE  TO  PREVENT  ILLNESS  AND
 PROLONG LIFE.
   31. "WELLNESS COUNSELING" MEANS PATIENT DOCTOR DIALOGUE FOR FACILITAT-
 ING  POSITIVE  EMOTION, THOUGHT, AND ACTION PROVIDED WITHIN A MULTIMODAL
 HOLISTIC FRAMEWORK OF THERAPY INFORMED BY  THE  NATUROPATHIC  PRINCIPLES
 AND THE THERAPEUTIC ORDER.
   §  6852.  DEFINITION  OF  THE PRACTICE OF NATUROPATHIC MEDICINE.   THE
 PRACTICE OF NATUROPATHIC MEDICINE IS  DEFINED  AS  FACILITATING  OPTIMUM
 HEALTH  AND  WELLNESS FOR PATIENTS OF ANY AGE USING NATUROPATHIC ASSESS-
 MENT,  COMMON  OFFICE   PROCEDURES,   PHYSICAL   NATUROPATHY,   APPROVED
 SUBSTANCES,  AND NONINVASIVE NATUROPATHIC THERAPIES IN A HOLISTIC FRAME-
 WORK INFORMED BY NATUROPATHIC PRINCIPLES AND A THERAPEUTIC ORDER.
   § 6853. TITLE AND DESIGNATION. ONLY A PERSON LICENSED UNDER THIS ARTI-
 CLE MAY USE THE TITLE "NATUROPATHIC DOCTOR",  "LICENSED  NATUROPATH"  OR
 "PROFESSIONAL  NATUROPATH" AND HOLD HERSELF OR HIMSELF OUT AS PRACTICING
 NATUROPATHIC MEDICINE; PROVIDED, HOWEVER, THAT NONE OF SUCH  TITLES  NOR
 ANY COMBINATION OF SUCH TITLES SHALL BE USED TO CONVEY THE IDEA THAT THE
 INDIVIDUAL WHO USES SUCH TITLE PRACTICES ANYTHING OTHER THAN NATUROPATHY
 AND  NATUROPATHIC  MEDICINE.  A LICENSED NATUROPATHIC DOCTOR MAY NOT USE
 THE TITLE "PHYSICIAN" UNLESS OTHERWISE AUTHORIZED UNDER  TITLE  VIII  OF
 THE EDUCATION LAW.
   §  6854.  INJECTION  THERAPY  AND INJECTION THERAPY PRIVILEGE. 1.  FOR
 ISSUANCE OF INJECTION THERAPY PRIVILEGE, THE APPLICANT SHALL FULFILL THE
 FOLLOWING REQUIREMENTS:
   A. FILE AN APPLICATION WITH THE DEPARTMENT;
   B. BE LICENSED AS A NATUROPATHIC DOCTOR  IN  THE  STATE,  INCLUDING  A
 LIMITED PERMIT HOLDER, OR BE AN APPLICANT FOR LICENSURE UNDER THIS ARTI-
 CLE MEETING THE QUALIFICATIONS FOR LICENSURE OR FOR A LIMITED PERMIT;
   C.  HAVE  SUCCESSFULLY  COMPLETED  A CERTIFICATION COURSE IN INJECTION
 THERAPY FROM A COURSE PROVIDER APPROVED BY THE DEPARTMENT OR AS PART  OF
 A PROGRAM OF NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE
 SUBSTANTIAL EQUIVALENT THEREOF;
   D. PAY A FEE TO THE DEPARTMENT OF TWO HUNDRED DOLLARS FOR THE ISSUANCE
 AND INITIAL REGISTRATION OF THE INJECTION THERAPY PRIVILEGE.

 A. 4825                             8
 
   2.  AN  INJECTION THERAPY PRIVILEGE ISSUED UNDER THIS SECTION SHALL BE
 VALID FOR THE LIFE OF THE HOLDER, UNLESS REVOKED, ANNULLED, OR SUSPENDED
 BY THE BOARD OF REGENTS. DURING EACH TRIENNIAL  REGISTRATION  PERIOD,  A
 NATUROPATHIC  DOCTOR  HAVING  INJECTION THERAPY PRIVILEGE SHALL COMPLETE
 EIGHT  HOURS  OF ACCEPTABLE FORMAL CONTINUING EDUCATION AS PART OF THEIR
 MANDATORY CONTINUING EDUCATION  REQUIREMENT,  IN  CONFORMANCE  WITH  THE
 PROVISIONS  OF SECTION SIXTY-EIGHT HUNDRED SIXTY-TWO OF THIS ARTICLE, ON
 THE SUBJECT OF INJECTION THERAPY, INCLUDING FORMAL CONTINUING  EDUCATION
 THAT  CONTRIBUTES  TO  THE  ENHANCEMENT  OF  CLINICAL  INJECTION THERAPY
 SKILLS, PURSUANT TO THE  REGULATION  OF  THE  COMMISSIONER.  FAILURE  TO
 COMPLETE  THE  REQUIRED CONTINUING EDUCATION UNDER THIS SUBSECTION SHALL
 RESULT IN SUSPENSION OF THE INJECTION THERAPY PRIVILEGE UNTIL SUCH  TIME
 AS  THE  REQUIRED  CONTINUING EDUCATION IS COMPLETE. A SUSPENSION OF THE
 INJECTION THERAPY PRIVILEGE FOR  LACK  OF  COMPLETION  OF  THE  REQUIRED
 CONTINUING EDUCATION THAT EXCEEDS TWELVE MONTHS IN DURATION SHALL RESULT
 IN  A  REVOCATION OF THE INJECTION THERAPY PRIVILEGE, AND REQUIRE RE-AP-
 PLICATION,  RECERTIFICATION  OR  OTHER  EDUCATION  SATISFACTORY  TO  THE
 COMMISSIONER, AND THE FEE AS PER SECTION SIXTY-EIGHT HUNDRED FIFTY-SEVEN
 OF THIS ARTICLE FOR RE-ISSUANCE OF THE INJECTION THERAPY PRIVILEGE. THIS
 CONTINUING  EDUCATION  REQUIREMENT IS EFFECTIVE AS OF THE SAME EFFECTIVE
 DATE AS SECTION SIXTY-EIGHT HUNDRED FIFTY-SEVEN OF THIS ARTICLE.
   3. A STUDENT IN A DOCTORAL PROGRAM OF NATUROPATHIC MEDICINE REGISTERED
 WITH THE DEPARTMENT OR THE SUBSTANTIAL EQUIVALENT  THEREOF  MAY  PERFORM
 INJECTION  THERAPY  IN  AN  INTERNSHIP  OR  PRECEPTORSHIP  SETTING  WHEN
 REQUIRED AS PART OF SUCH PROGRAM FOR  THE  PURPOSE  OF  FULFILLING  SUCH
 PROGRAM REQUIREMENT ONLY UNDER THE IMMEDIATE DIRECT PERSONAL SUPERVISION
 OF  A  PHYSICIAN  LICENSED  UNDER  THIS  TITLE  OR A NATUROPATHIC DOCTOR
 LICENSED UNDER THIS ARTICLE HAVING INJECTION THERAPY PRIVILEGE. "IMMEDI-
 ATE DIRECT PERSONAL SUPERVISION" FOR THE PURPOSES OF THIS SECTION  MEANS
 SUPERVISION  OF  A PROCEDURE FOR INJECTION THERAPY BASED ON INSTRUCTIONS
 GIVEN DIRECTLY BY THE SUPERVISING PHYSICIAN OR SUPERVISING  NATUROPATHIC
 DOCTOR  WHO  REMAINS  PHYSICALLY  PRESENT IN THE IMMEDIATE AREA WHEN THE
 INJECTION THERAPY PROCEDURE IS PERFORMED.
   § 6855. BOUNDARIES OF PROFESSIONAL COMPETENCE. THE  ACTIVITIES  ENCOM-
 PASSED  WITHIN  THE  DEFINITION OF THE PRACTICE OF NATUROPATHIC MEDICINE
 UNDER SECTIONS SIXTY-EIGHT HUNDRED  FIFTY-TWO  AND  SIXTY-EIGHT  HUNDRED
 FIFTY-FOUR  OF THIS ARTICLE ARE LIMITED BY THE PROHIBITIONS, BOUNDARIES,
 AND RESTRICTIONS OF THIS SECTION.
   1. THE PRACTICE OF THE PROFESSION OF NATUROPATHIC  MEDICINE  DOES  NOT
 INCLUDE:    ADMINISTERING OR PRESCRIBING CONTROLLED SUBSTANCES; ADMINIS-
 TERING INVASIVE  PROCEDURES;  ADMINISTERING  ELECTROCONVULSIVE  THERAPY;
 ADMINISTERING  NEEDLE-TYPE  ELECTROMYOGRAPHY;  PERFORMING  SURGERY OTHER
 THAN CRYOTHERAPY, LIGATION AND FULGURATION;  ADMINISTERING  RADIOLOGICAL
 PROCEDURES USING IONIZING RADIATION ABOVE BACKGROUND LEVELS; ADMINISTER-
 ING GENERAL OR SPINAL ANESTHETIC DRUGS; ADMINISTERING OBSTETRIC SERVICES
 OTHER  THAN  COMPLEMENTARY  NATUROPATHIC PRENATAL AND POSTNATAL WELLNESS
 CARE; ADMINISTERING ACUPUNCTURE; AND SETTING FRACTURES.
   2. A. (I) IT SHALL BE DEEMED  PRACTICING  OUTSIDE  THE  BOUNDARIES  OF
 PROFESSIONAL  COMPETENCE  FOR A NATUROPATHIC DOCTOR TO PROVIDE EMERGENCY
 CARE SERVICES FOR TREATING INJURIES OR TRAUMA FROM A SERIOUS ACCIDENT OR
 A VIOLENT CRIME, EXCEPT AS PERMITTED BY ARTICLE  THIRTY  OF  THE  PUBLIC
 HEALTH LAW.
   (II)  IT  SHALL  BE  DEEMED PROFESSIONAL MISCONDUCT FOR A NATUROPATHIC
 DOCTOR TO HOLD HERSELF  OR  HIMSELF  OUT  AS  PROVIDING  EMERGENCY  CARE
 SERVICES  ON  A CONTINUED SUSTAINED BASIS; OR TO TREAT AN ACUTE EMERGENT

 A. 4825                             9
 
 CONDITION OF SIGNIFICANT THREAT TO LIFE OR LIMB WITHOUT  ALSO  SUMMONING
 EMERGENCY MEDICAL RESPONSE.
   B. (I) IT SHALL BE DEEMED PRACTICING OUTSIDE THE BOUNDARIES OF PROFES-
 SIONAL COMPETENCE FOR A NATUROPATHIC DOCTOR TO ADMINISTER PHYSICAL NATU-
 ROPATHY  ON A PATIENT ON A CONTINUED SUSTAINED BASIS UNDER EITHER OF THE
 FOLLOWING CIRCUMSTANCES:  TO ASSIST THE PATIENT TO COMPENSATE FOR DEVEL-
 OPMENTAL DEFICITS AFFECTING PHYSICAL MOVEMENT AND MOBILITY  THAT  CANNOT
 BE  REVERSED; AND TO RESTORE, FOR PURPOSES OF PATIENT REINTEGRATION BACK
 INTO THE HOME, COMMUNITY, OR WORK, SOME OR ALL OF THE PATIENT'S PATHOME-
 CHANICAL DEFICITS AFFECTING PHYSICAL MOVEMENT  AND  MOBILITY  THAT  WERE
 LOST  DUE  TO  INJURY  OR  DISEASE CAUSING ONGOING SEPARATION FROM HOME,
 COMMUNITY OR WORK.
   (II) A NATUROPATHIC  DOCTOR  MAY  CORRECT  VERTEBRAL  ALIGNMENT  USING
 VERTEBRAL  ADJUSTMENT  IN  COMBINATION  WITH NATUROPATHIC MUSCLE RELEASE
 TECHNIQUES AND SOFT TISSUE MANIPULATION  WITHIN  A  MULTIMODAL  HOLISTIC
 TREATMENT PLAN, BUT OTHERWISE MAY NOT PRACTICE VERTEBRAL ADJUSTMENT.
   C.  FOR  PATIENTS  HAVING  SYMPTOMATIC,  INTELLECTUALLY,  SOCIALLY  OR
 EMOTIONALLY MALADAPTIVE BEHAVIOR SUFFICIENT TO BE A  MENTAL,  EMOTIONAL,
 COGNITIVE,  ADDICTIVE  OR BEHAVIORAL DISORDER AS PER DSM (DIAGNOSTIC AND
 STATISTICAL MANUAL OF MENTAL DISORDERS) CRITERIA OR AN EQUIVALENT THERE-
 OF, OR PER DIAGNOSIS BY A QUALIFIED HEALTHCARE  PROVIDER,  IT  SHALL  BE
 DEEMED  PRACTICING OUTSIDE THE BOUNDARIES OF PROFESSIONAL COMPETENCE FOR
 A NATUROPATHIC DOCTOR TO FACILITATE CHANGES IN THE PATIENT'S PERSONALITY
 AND BEHAVIOR FOR THE PURPOSE OF ELIMINATING SUCH SYMPTOMATIC MALADAPTIVE
 BEHAVIOR CORRESPONDING TO SUCH  DISORDER  THROUGH  THE  USE  OF  VERBAL,
 COGNITIVE,   AND   EMOTIONAL   INTERPERSONAL  COMMUNICATION  METHODS  OF
 PSYCHOTHERAPEUTIC INTERVENTION ON  A  CONTINUED  SUSTAINED  BASIS.  SUCH
 RESTRICTION  ON PSYCHOTHERAPEUTIC INTERVENTION DOES NOT RESTRICT A NATU-
 ROPATHIC  DOCTOR  FROM  PROVIDING  DIETARY  AND  LIFESTYLE  ADVICE   AND
 INSTRUCTIONS  TO THE PATIENT, NOR FROM EDUCATING THE PATIENT ABOUT THEIR
 CIRCUMSTANCES OF HEALTH AND ILLNESS. SUCH RESTRICTION ON PSYCHOTHERAPEU-
 TIC INTERVENTION EXCLUDES HYPNOTHERAPY APPLIED AS PART  OF  A  MULTIMODE
 HOLISTIC  TREATMENT  PLAN  (E.G.,  NUTRIENT THERAPY AND HYPNOTHERAPY) TO
 TREAT TOBACCO ADDICTION  OR  OBESITY.  ALTHOUGH  A  NATUROPATHIC  DOCTOR
 CANNOT  PROVIDE  A  PSYCHOLOGICAL  DIAGNOSIS,  A NATUROPATHIC DOCTOR MAY
 APPLY AND DOCUMENT SUCH DSM OR EQUIVALENT CRITERIA, OR THE ABSENCE THER-
 EOF TO DISCERN THIS BOUNDARY OF PROFESSIONAL COMPETENCE, WHICH  DISCERN-
 MENT SHALL DEFER TO A DIAGNOSIS BY A QUALIFIED HEALTHCARE PROVIDER.
   D. ALTHOUGH THE IDENTIFICATION OF AN ILLNESS IS PART OF A NATUROPATHIC
 ASSESSMENT,  A  NATUROPATHIC  DOCTOR MAY NOT EQUATE SUCH ASSESSMENT TO A
 MEDICAL OR PSYCHOLOGICAL DIAGNOSIS, NOR HOLD HIMSELF OR HERSELF  OUT  AS
 MAKING  A  MEDICAL  OR PSYCHOLOGICAL DIAGNOSIS.   A NATUROPATHIC DOCTOR,
 HOWEVER, MAY USE COMMON DIAGNOSTIC  CODES  (E.G.,  ICD-10  CODES;  DSM-V
 CODES)  AND  MAY  REFER TO AN IDENTIFIED ILLNESS IN DISCUSSIONS WITH THE
 PATIENT, IN PATIENT HEALTH RECORDS, AND IN COMMUNICATIONS COMPLIANT WITH
 THE FEDERAL HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF  1996
 (HIPAA).
   3. WHILE THE SCOPE OF ACTIVITIES INCLUDED WITHIN THE PRACTICE OF NATU-
 ROPATHIC MEDICINE OVERLAPS IN PART WITH OTHER PROFESSIONS LICENSED UNDER
 THIS  TITLE,  THE  NATUROPATHIC DOCTOR SHALL NOT HOLD HERSELF OR HIMSELF
 OUT AS PRACTICING ANY SUCH OTHER PROFESSION OR USE A TITLE OF  ANY  SUCH
 OTHER PROFESSION, UNLESS OTHERWISE AUTHORIZED UNDER THIS TITLE.
   §  6856.  STATE  BOARD FOR NATUROPATHIC MEDICINE. 1. A STATE BOARD FOR
 NATUROPATHIC MEDICINE SHALL BE APPOINTED BY THE BOARD OF REGENTS ON  THE
 RECOMMENDATION  OF  THE  COMMISSIONER  FOR  THE PURPOSE OF ASSISTING THE
 BOARD OF REGENTS AND THE DEPARTMENT ON MATTERS OF PROFESSIONAL LICENSING

 A. 4825                            10
 
 AND PROFESSIONAL CONDUCT IN ACCORDANCE WITH SECTION  SIXTY-FIVE  HUNDRED
 EIGHT OF THIS TITLE. THE BOARD SHALL BE COMPOSED OF TWO PUBLIC REPRESEN-
 TATIVES  WHO  DO  NOT  HOLD  INTERESTS IN THE ORGANIZATION, FINANCING OR
 DELIVERY  OF  NATUROPATHIC  SERVICES,  ONE  LICENSED  PHYSICIAN WHO IS A
 DOCTOR OF MEDICINE OR A DOCTOR OF OSTEOPATHY,  AND  NOT  LESS  THAN  SIX
 NATUROPATHIC  DOCTORS.  A  NATUROPATHIC DOCTOR MEMBER OF THE BOARD SHALL
 HAVE BEEN LICENSED UNDER THIS ARTICLE FOR AT LEAST TWO  YEARS  PRIOR  TO
 BEING  APPOINTED,  WHICH  TWO YEAR LICENSE REQUIREMENT IS WAIVED FOR THE
 INITIAL BOARD AND REPLACED WITH  A  REQUIREMENT  THAT  THE  NATUROPATHIC
 DOCTOR  OBTAIN  A LICENSE UNDER THIS ARTICLE WITHIN ONE YEAR OF APPOINT-
 MENT OR ONE YEAR OF THE EFFECTIVE DATE OF THIS ARTICLE, WHICHEVER  COMES
 LATER.  THE  TERMS  OF THE FIRST APPOINTED MEMBERS SHALL BE STAGGERED SO
 THAT THREE ARE APPOINTED FOR THREE YEARS, THREE ARE APPOINTED  FOR  FOUR
 YEARS,  AND FOUR ARE APPOINTED FOR FIVE YEARS. AN EXECUTIVE SECRETARY OF
 THE BOARD SHALL BE APPOINTED BY THE BOARD OF REGENTS ON THE  RECOMMENDA-
 TION OF THE COMMISSIONER.
   2. EXAMINATIONS SELECTED OR PREPARED BY THE BOARD PURSUANT TO SUBDIVI-
 SION TWO OF SECTION SIXTY-FIVE HUNDRED EIGHT OF THIS TITLE SHALL CONFORM
 WHENEVER  POSSIBLE  TO  NATIONALLY RECOGNIZED TEST DEVELOPMENT STANDARDS
 AND TEST COMPETENCIES FOR NATUROPATHIC MEDICINE.
   § 6857. QUALIFICATIONS FOR LICENSURE. TO  QUALIFY  FOR  A  LICENSE  TO
 PRACTICE  THE  PROFESSION  OF  NATUROPATHIC MEDICINE, AN APPLICANT SHALL
 FULFILL THE FOLLOWING REQUIREMENTS:
   1. FILE AN APPLICATION WITH THE DEPARTMENT;
   2. HAVE RECEIVED AN EDUCATION, INCLUDING A DOCTORAL DEGREE IN  NATURO-
 PATHIC  MEDICINE,  GRANTED  ON  THE  BASIS OF COMPLETION OF A PROGRAM OF
 NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE  SUBSTANTIAL
 EQUIVALENT THEREOF, IN ACCORDANCE WITH THE COMMISSIONER'S REGULATIONS;
   3.  FOR  APPLICANTS  APPLYING  MORE THAN TWO YEARS AFTER THE EFFECTIVE
 DATE OF THIS ARTICLE,  HAVE  SATISFACTORILY  COMPLETED  A  POST-GRADUATE
 RESIDENCY  PROGRAM  OF  NATUROPATHIC  MEDICINE OF AT LEAST TWELVE MONTHS
 DURATION APPROVED BY THE DEPARTMENT, OR THE SUBSTANTIAL EQUIVALENT THER-
 EOF, AND IN ACCORDANCE WITH THE COMMISSIONER'S REGULATIONS;
   4. PASS AN EXAMINATION SATISFACTORY TO THE  BOARD  AND  IN  ACCORDANCE
 WITH THE COMMISSIONER'S REGULATIONS;
   5. BE AT LEAST TWENTY-ONE YEARS OF AGE;
   6. BE OF GOOD MORAL CHARACTER AS DETERMINED BY THE DEPARTMENT; AND
   7.  PAY  A FEE OF THREE HUNDRED FIFTY DOLLARS TO THE DEPARTMENT FOR AN
 INITIAL LICENSE AND A FEE OF FIVE HUNDRED  DOLLARS  FOR  EACH  TRIENNIAL
 REGISTRATION PERIOD.
   §  6858. SPECIAL CONDITIONS. 1. AN APPLICANT HAVING RECEIVED, PRIOR TO
 NINETEEN HUNDRED EIGHTY-EIGHT, AN EDUCATION, INCLUDING A DOCTORAL DEGREE
 IN NATUROPATHIC MEDICINE, GRANTED  ON  THE  BASIS  OF  COMPLETION  OF  A
 PROGRAM  OF  NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE
 SUBSTANTIAL EQUIVALENT THEREOF, MAY SUBSTITUTE FOR  THE  EXPERIENCE  AND
 EXAMINATION QUALIFICATIONS OF SECTION SIXTY-EIGHT HUNDRED FIFTY-SEVEN OF
 THIS  ARTICLE, EITHER OF: (I) SATISFACTORY EVIDENCE OF PRACTICE OF NATU-
 ROPATHIC MEDICINE OF NOT LESS THAN THREE YEARS  DURING  THE  FIVE  YEARS
 PRECEDING THE FILING OF THE APPLICATION; OR (II) PRACTICE UNDER A LIMIT-
 ED PERMIT FOR AT LEAST TWO OF THE THREE YEARS PRIOR TO APPLICATION UNDER
 THIS ARTICLE.
   2.  AN  APPLICANT HAVING RECEIVED, PRIOR TO TWO YEARS AFTER THE EFFEC-
 TIVE DATE OF THIS ARTICLE, AN EDUCATION, INCLUDING A DOCTORAL DEGREE  IN
 NATUROPATHIC  MEDICINE,  GRANTED ON THE BASIS OF COMPLETION OF A PROGRAM
 OF NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE  SUBSTAN-
 TIAL EQUIVALENT THEREOF, MAY SUBSTITUTE FOR THE EXPERIENCE QUALIFICATION

 A. 4825                            11

 OF  SECTION  SIXTY-EIGHT HUNDRED FIFTY-SEVEN OF THIS ARTICLE, EITHER OF:
 (I) SATISFACTORY EVIDENCE OF PRACTICE OF NATUROPATHIC  MEDICINE  OF  NOT
 LESS  THAN THREE YEARS DURING THE FIVE YEARS PRECEDING THE FILING OF THE
 APPLICATION; OR (II) PRACTICE UNDER A LIMITED PERMIT FOR AT LEAST TWO OF
 THE THREE YEARS PRIOR TO APPLICATION UNDER THIS ARTICLE.
   3.  THE  "PRACTICE  OF  NATUROPATHIC MEDICINE" AS USED IN THIS SECTION
 INCLUDES THE PRACTICE OF NATUROPATHY OR NATUROPATHIC MEDICINE IN A STATE
 OR TERRITORY OF THE UNITED STATES, INCLUDING NEW YORK STATE, OR A  CANA-
 DIAN  PROVINCE,  WHILE MAINTAINING A PROFESSIONAL LICENSE IN NATUROPATHY
 OR NATUROPATHIC MEDICINE ISSUED BY THE SAME OR ANOTHER STATE OR TERRITO-
 RY OR A CANADIAN PROVINCE; AND INCLUDES PRACTICE  PERFORMED  BEFORE  AND
 AFTER THE EFFECTIVE DATE OF THIS ARTICLE.
   4.  PRACTICE DEMONSTRATED BY SATISFACTORY EVIDENCE OF PRACTICE OR BY A
 LIMITED PERMIT, AS PROVIDED IN SUBDIVISIONS ONE AND TWO OF THIS SECTION,
 MUST BE COMPLETE WITHIN EIGHTEEN YEARS AFTER THE EFFECTIVE DATE OF  THIS
 ARTICLE.  APPLICANTS  HAVING  COMPLETED  THE  PRACTICE REQUIREMENTS OF A
 SPECIAL CONDITION UNDER THIS SECTION  MUST  SUBMIT  AN  APPLICATION  FOR
 LICENSE  BY  NINETEEN YEARS AFTER THE EFFECTIVE DATE OF THIS ARTICLE AND
 MUST CURE DEFECTS, IF ANY, IN  THE  APPLICATION  AS  IDENTIFIED  BY  THE
 DEPARTMENT WITHIN A TIME PERIOD INDICATED BY THE DEPARTMENT.
   § 6859. EXEMPT PERSONS AND EXEMPTIONS. NOTHING CONTAINED IN THIS ARTI-
 CLE SHALL BE CONSTRUED TO AFFECT OR PREVENT THE FOLLOWING:
   1.  A.  A  LICENSED PHYSICIAN FROM PRACTICING HIS OR HER PROFESSION AS
 DEFINED IN ARTICLES ONE HUNDRED THIRTY-ONE AND ONE HUNDRED  THIRTY-ONE-B
 OF  THIS  TITLE;  A  REGISTERED  PROFESSIONAL NURSE OR A CERTIFIED NURSE
 PRACTITIONER PRACTICING HIS OR HER PROFESSION AS DEFINED  UNDER  ARTICLE
 ONE HUNDRED THIRTY-NINE OF THIS TITLE; OR
   B.  QUALIFIED  MEMBERS  OF OTHER PROFESSIONS LICENSED UNDER THIS TITLE
 FROM PERFORMING THE PRACTICE OF  THEIR  PROFESSIONS;  EXCEPT  THAT  SUCH
 PERSONS  MAY NOT HOLD THEMSELVES OUT UNDER THE TITLE NATUROPATH OR NATU-
 ROPATHIC DOCTOR, OR AS PERFORMING NATUROPATHY OR NATUROPATHIC MEDICINE.
   2. A STUDENT FROM ENGAGING IN CLINICAL PRACTICE UNDER SUPERVISION OF A
 LICENSED NATUROPATHIC DOCTOR AS PART OF A PROGRAM OF NATUROPATHIC  MEDI-
 CINE REGISTERED BY THE DEPARTMENT OR THE SUBSTANTIAL EQUIVALENT THEREOF.
   3. THE PRACTICE OF NATUROPATHIC MEDICINE BY A SALARIED EMPLOYEE OF THE
 GOVERNMENT  OF  THE UNITED STATES WHILE THE INDIVIDUAL IS ENGAGED IN THE
 PERFORMANCE OF DUTIES PRESCRIBED BY THE  LAWS  AND  REGULATIONS  OF  THE
 UNITED STATES.
   4.  THE  DOMESTIC  CARE OF THE SICK, DISABLED OR INJURED BY ANY FAMILY
 MEMBER, HOUSEHOLD MEMBER OR FRIEND, OR PERSON EMPLOYED  PRIMARILY  IN  A
 DOMESTIC  CAPACITY  WHO  DOES NOT HOLD HIMSELF OR HERSELF OUT, OR ACCEPT
 EMPLOYMENT AS A PERSON LICENSED TO PRACTICE NATUROPATHIC MEDICINE  UNDER
 THE PROVISIONS OF THIS ARTICLE.
   5.  THE  CARE OF THE SICK WHEN DONE IN CONNECTION WITH THE PRACTICE OF
 THE RELIGIOUS TENETS OF ANY CHURCH.
   6. THE MARKETING, SALE OR USE OF SUBSTANCES OR DEVICES GOVERNED BY THE
 FEDERAL FOOD, DRUG, AND COSMETIC ACT THAT DO NOT REQUIRE A  PRESCRIPTION
 FROM A QUALIFIED HEALTHCARE PROVIDER.
   7.  THE  CONDUCT,  ACTIVITIES,  OR  SERVICES OF INDIVIDUALS, CHURCHES,
 SCHOOLS,  TEACHERS,  ORGANIZATIONS,  OR  NOT-FOR-PROFIT  BUSINESSES   IN
 PROVIDING INSTRUCTION, ADVICE, SUPPORT, ENCOURAGEMENT, OR INFORMATION TO
 INDIVIDUALS, FAMILIES, AND RELATIONAL GROUPS.
   §  6860. LIMITED RESIDENCY PERMITS. 1. FOR ISSUANCE OF A LIMITED RESI-
 DENCY PERMIT, THE APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS:
   A. FILE AN APPLICATION WITH THE DEPARTMENT;

 A. 4825                            12
 
   B. HAVE RECEIVED AN EDUCATION, INCLUDING A DOCTORAL DEGREE IN  NATURO-
 PATHIC  MEDICINE,  GRANTED  ON  THE  BASIS OF COMPLETION OF A PROGRAM OF
 NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE  SUBSTANTIAL
 EQUIVALENT THEREOF;
   C.  HAVE BEEN ACCEPTED INTO A POST-GRADUATE RESIDENCY PROGRAM OF NATU-
 ROPATHIC MEDICINE APPROVED BY THE DEPARTMENT;
   D. BE OF GOOD MORAL CHARACTER AS DETERMINED BY THE DEPARTMENT;
   E. BE AT LEAST TWENTY-ONE YEARS OF AGE; AND
   F. PAY A FEE TO THE DEPARTMENT  OF  ONE  HUNDRED  DOLLARS,  OR  FOR  A
 RENEWAL A FEE OF FIFTY DOLLARS.
   2.  SUCH  PERMIT  SHALL ALLOW THE PERMIT HOLDER TO PERFORM SUCH ACTIV-
 ITIES THAT ARE REQUIRED  FOR  SUCCESSFUL  COMPLETION  OF  THE  RESIDENCY
 PROGRAM  UNDER THE ADMINISTRATIVE SUPERVISION OF A LICENSED NATUROPATHIC
 DOCTOR SERVING AS THE RESIDENCY DIRECTOR. PRACTICE  ACTIVITIES  UNDER  A
 LIMITED  RESIDENCY  PERMIT SHALL BE LIMITED TO FACILITIES ENCOMPASSED BY
 THE POST-GRADUATE RESIDENCY PROGRAM OF THE  PERMIT  HOLDER,  SUCH  AS  A
 HOSPITAL,  AN  INCORPORATED  HOSPITAL  OR CLINIC, A LICENSED PROPRIETARY
 HOSPITAL, A LICENSED NURSING HOME, A PUBLIC HEALTH AGENCY, A  RECOGNIZED
 PUBLIC  OR  NON-PUBLIC  SCHOOL SETTING, THE OFFICE OF A LICENSED NATURO-
 PATHIC DOCTOR, OR IN THE CIVIL SERVICE OF THE STATE OR POLITICAL  SUBDI-
 VISION  THEREOF.    PRACTICE  SUPERVISION  OF A PERMIT HOLDER'S PRACTICE
 ACTIVITIES SHALL BE  ON-SITE  SUPERVISION  BY  A  LICENSED  NATUROPATHIC
 DOCTOR,  EXCEPT  FOR INJECTION THERAPY PROCEDURES, WHICH SHALL BE DIRECT
 PERSONAL SUPERVISION BY A LICENSED PHYSICIAN OR A LICENSED  NATUROPATHIC
 DOCTOR HAVING INJECTION THERAPY PRIVILEGE. "DIRECT PERSONAL SUPERVISION"
 FOR  THE  PURPOSES  OF THIS SECTION MEANS SUPERVISION OF A PROCEDURE FOR
 INJECTION THERAPY BASED ON INSTRUCTIONS GIVEN DIRECTLY BY THE  SUPERVIS-
 ING  PHYSICIAN  OR  SUPERVISING  NATUROPATHIC DOCTOR WHO REMAINS ON SITE
 WHEN AND WHERE THE PROCEDURE  IS  BEING  PERFORMED,  BUT  SHALL  NOT  BE
 CONSTRUED  AS  NECESSARILY REQUIRING THE PHYSICAL PRESENCE OF THE SUPER-
 VISING PHYSICIAN OR SUPERVISING NATUROPATHIC  DOCTOR  IN  THE  IMMEDIATE
 AREA AT THE TIME WHEN THE INJECTION THERAPY PROCEDURE IS PERFORMED.
   3.  SUCH PERMIT SHALL BE ISSUED FOR ONE YEAR AND MAY BE RENEWED AT THE
 DISCRETION OF THE DEPARTMENT FOR ONE OR TWO ADDITIONAL YEARS WHEN NECES-
 SARY TO PERMIT THE COMPLETION OF AN APPROVED POST-GRADUATE RESIDENCY  IN
 NATUROPATHIC MEDICINE.
   §  6861.  LIMITED  PERMITS.  1.  FOR ISSUANCE OF A LIMITED PERMIT, THE
 APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS:
   A. FILE AN APPLICATION WITH THE DEPARTMENT;
   B. HAVE RECEIVED AN EDUCATION, INCLUDING A DOCTORAL DEGREE IN  NATURO-
 PATHIC  MEDICINE,  GRANTED  ON  THE  BASIS OF COMPLETION OF A PROGRAM OF
 NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE  SUBSTANTIAL
 EQUIVALENT THEREOF;
   C.  INDICATE  EXERCISING OPTION TO ATTAIN QUALIFICATIONS FOR LICENSURE
 USING A LIMITED  PERMIT  SPECIAL  CONDITION  UNDER  SECTION  SIXTY-EIGHT
 HUNDRED FIFTY-EIGHT OF THIS ARTICLE;
   D. BE OF GOOD MORAL CHARACTER AS DETERMINED BY THE DEPARTMENT;
   E. BE AT LEAST TWENTY-ONE YEARS OF AGE; AND
   F. PAY A FEE OF TWO HUNDRED DOLLARS TO THE DEPARTMENT.
   2.  SUCH  LIMITED  PERMIT SHALL AUTHORIZE THE PRACTICE OF NATUROPATHIC
 MEDICINE ONLY UNDER THE SUPERVISION OF A LICENSED  NATUROPATHIC  DOCTOR.
 SUPERVISION  OF THE LIMITED PERMIT HOLDER'S PRACTICE ACTIVITIES SHALL BE
 ON-SITE SUPERVISION BY A LICENSED NATUROPATHIC DOCTOR.
   3. A LIMITED PERMIT SHALL BE ISSUED FOR A PERIOD OF TWO YEARS, AND MAY
 BE RENEWED UNDER CIRCUMSTANCES AND FOR A TIME PERIOD AND FEE IN  ACCORD-
 ANCE WITH THE COMMISSIONER'S REGULATIONS.

 A. 4825                            13
 
   4.  THE  LAST DAY FOR APPLYING FOR A LIMITED PERMIT UNDER THIS SECTION
 IS FIFTEEN YEARS AFTER THE EFFECTIVE DATE OF THIS SECTION.
   § 6862. MANDATORY CONTINUING EDUCATION. 1. A. EACH NATUROPATHIC DOCTOR
 LICENSED PURSUANT TO THIS ARTICLE, REQUIRED TO REGISTER TRIENNIALLY WITH
 THE  DEPARTMENT  TO  PRACTICE  IN  THIS  STATE  SHALL  COMPLY  WITH  THE
 PROVISIONS OF THE MANDATORY CONTINUING EDUCATION REQUIREMENTS PRESCRIBED
 IN SUBDIVISION TWO OF THIS SECTION, EXCEPT AS PROVIDED IN  PARAGRAPHS  B
 AND  C  OF THIS SUBDIVISION. NATUROPATHIC DOCTORS WHO DO NOT SATISFY THE
 MANDATORY CONTINUING EDUCATION REQUIREMENTS  SHALL  NOT  PRACTICE  UNTIL
 THEY  HAVE  MET SUCH REQUIREMENTS, AND THEY HAVE BEEN ISSUED A REGISTRA-
 TION CERTIFICATE, EXCEPT THAT A NATUROPATHIC DOCTOR MAY PRACTICE WITHOUT
 HAVING MET SUCH REQUIREMENTS IF HE OR SHE IS ISSUED A CONDITIONAL REGIS-
 TRATION PURSUANT TO SUBDIVISION THREE OF THIS SECTION.
   B. NATUROPATHIC DOCTORS SHALL BE EXEMPT FROM THE MANDATORY  CONTINUING
 EDUCATION REQUIREMENT FOR THE TRIENNIAL REGISTRATION PERIOD DURING WHICH
 THEY  ARE  FIRST  LICENSED.  IN  ACCORD WITH THE INTENT OF THIS SECTION,
 ADJUSTMENTS TO THE MANDATORY CONTINUING EDUCATION  REQUIREMENTS  MAY  BE
 GRANTED  BY  THE DEPARTMENT FOR REASONS OF HEALTH CERTIFIED BY AN APPRO-
 PRIATE HEALTH CARE PROFESSIONAL, FOR EXTENDED ACTIVE DUTY WITH THE ARMED
 FORCES OF THE UNITED STATES, OR FOR OTHER GOOD CAUSE ACCEPTABLE  TO  THE
 DEPARTMENT, WHICH MAY PREVENT COMPLIANCE.
   C.  A  LICENSED  NATUROPATHIC DOCTOR NOT ENGAGED IN PROFESSIONAL PRAC-
 TICE, AS DETERMINED BY THE DEPARTMENT, SHALL BE EXEMPT FROM THE MANDATO-
 RY CONTINUING EDUCATION REQUIREMENT UPON THE FILING OF A STATEMENT  WITH
 THE  DEPARTMENT  DECLARING  SUCH STATUS. ANY LICENSEE WHO RETURNS TO THE
 PRACTICE OF NATUROPATHIC  MEDICINE  DURING  THE  TRIENNIAL  REGISTRATION
 PERIOD  SHALL  NOTIFY  THE DEPARTMENT PRIOR TO REENTERING THE PROFESSION
 AND SHALL  MEET  SUCH  MANDATORY  EDUCATION  REQUIREMENTS  AS  SHALL  BE
 PRESCRIBED BY REGULATIONS OF THE COMMISSIONER.
   2.  DURING  EACH TRIENNIAL REGISTRATION PERIOD AN APPLICANT FOR REGIS-
 TRATION SHALL COMPLETE  SIXTY  HOURS  OF  ACCEPTABLE  FORMAL  CONTINUING
 EDUCATION.  ANY  LICENSED  NATUROPATHIC  DOCTOR WHOSE FIRST REGISTRATION
 DATE FOLLOWING THE EFFECTIVE DATE OF THIS SECTION OCCURS LESS THAN THREE
 YEARS FROM SUCH EFFECTIVE  DATE,  SHALL  COMPLETE  CONTINUING  EDUCATION
 HOURS  ON  A  PRORATED  BASIS  AT THE RATE OF ONE AND ONE-HALF HOURS PER
 MONTH FOR THE NUMBER OF MONTHS BETWEEN THE EFFECTIVE DATE AND THE  FIRST
 REGISTRATION  DATE.    THEREAFTER,  A LICENSEE WHO HAS NOT SATISFIED THE
 MANDATORY CONTINUING EDUCATION REQUIREMENTS SHALL NOT BE ISSUED A TRIEN-
 NIAL REGISTRATION CERTIFICATE BY THE DEPARTMENT AND SHALL  NOT  PRACTICE
 UNLESS  AND  UNTIL  A  CONDITIONAL REGISTRATION CERTIFICATE IS ISSUED AS
 PROVIDED IN SUBDIVISION THREE OF THIS SECTION.  THE INDIVIDUAL  LICENSEE
 SHALL  DETERMINE  THE SELECTION OF COURSES OR PROGRAMS OF STUDY PURSUANT
 TO SUBDIVISION FOUR OF THIS SECTION. CONTINUING  EDUCATION  HOURS  TAKEN
 DURING  ONE  TRIENNIUM  MAY NOT BE CARRIED OVER OR OTHERWISE CREDITED OR
 TRANSFERRED TO A SUBSEQUENT TRIENNIUM.
   3. THE DEPARTMENT, IN ITS DISCRETION, MAY ISSUE A  CONDITIONAL  REGIS-
 TRATION  TO  A  LICENSEE  WHO  FAILS  TO  MEET  THE CONTINUING EDUCATION
 REQUIREMENTS ESTABLISHED IN SUBDIVISION TWO  OF  THIS  SECTION  BUT  WHO
 AGREES  TO  MAKE  UP  ANY DEFICIENCIES AND TAKE ANY ADDITIONAL EDUCATION
 WHICH THE DEPARTMENT MAY REQUIRE. THE FEE FOR SUCH A CONDITIONAL  REGIS-
 TRATION SHALL BE THE SAME AS, AND IN ADDITION TO, THE FEE FOR THE TRIEN-
 NIAL  REGISTRATION.  THE DURATION OF SUCH CONDITIONAL REGISTRATION SHALL
 BE DETERMINED BY THE DEPARTMENT BUT  SHALL  NOT  EXCEED  ONE  YEAR.  ANY
 LICENSEE  WHO  IS  NOTIFIED OF THE DENIAL OF REGISTRATION FOR FAILURE TO
 COMPLETE THE REQUIRED CONTINUED EDUCATION AND WHO CONTINUES TO  PRACTICE
 NATUROPATHIC  MEDICINE  WITHOUT  SUCH  REGISTRATION, SHALL BE SUBJECT TO

 A. 4825                            14
 
 DISCIPLINARY PROCEEDINGS PURSUANT TO SECTION SIXTY-FIVE HUNDRED  TEN  OF
 THIS TITLE.
   4.  AS  USED IN THIS SECTION, "ACCEPTABLE FORMAL CONTINUING EDUCATION"
 SHALL MEAN FORMAL PROGRAMS OF  LEARNING  WHICH  CONTAIN  SUBJECT  MATTER
 WHICH MEET THE FOLLOWING REQUIREMENTS: CONTRIBUTES TO THE ENHANCEMENT OF
 PROFESSIONAL  AND  CLINICAL SKILLS OF THE NATUROPATHIC DOCTOR; MEETS THE
 STANDARDS PRESCRIBED BY REGULATIONS OF THE COMMISSIONER IN  CONSULTATION
 WITH  THE  BOARD  TO FULFILL THE MANDATORY CONTINUING EDUCATION REQUIRE-
 MENT; AND IS SPONSORED OR PRESENTED BY A STATE OR  A  CANADIAN  PROVINCE
 NATUROPATHIC   MEDICINE  PROFESSIONAL  ORGANIZATION  ACCEPTABLE  TO  THE
 DEPARTMENT, A UNITED STATES OR CANADIAN NATIONAL  NATUROPATHIC  MEDICINE
 PROFESSIONAL  ORGANIZATION  ACCEPTABLE TO THE DEPARTMENT, AN INSTITUTION
 OF HIGHER LEARNING HAVING AN ACCREDITATION ACCEPTABLE TO THE DEPARTMENT,
 OR ANOTHER SPONSOR APPROVED BY THE DEPARTMENT,  PURSUANT  TO  THE  REGU-
 LATION  OF  THE COMMISSIONER. CONTINUING EDUCATION COURSES MUST BE TAKEN
 FROM A PROVIDER WHO HAS BEEN APPROVED BY THE DEPARTMENT, BASED  UPON  AN
 APPLICATION  AND  FEE,  PURSUANT TO THE REGULATIONS OF THE COMMISSIONER.
 THE DEPARTMENT MAY, IN ITS DISCRETION AND AS NEEDED TO CONTRIBUTE TO THE
 HEALTH AND WELFARE OF THE PUBLIC, REQUIRE THE COMPLETION  OF  CONTINUING
 EDUCATION  ACTIVITIES  IN  SPECIFIC  SUBJECTS  TO FULFILL THIS MANDATORY
 CONTINUING EDUCATION REQUIREMENT.
   5. LICENSED NATUROPATHIC DOCTORS SHALL MAINTAIN ADEQUATE DOCUMENTATION
 OF COMPLETION  OF  ACCEPTABLE  FORMAL  CONTINUING  EDUCATION  AND  SHALL
 PROVIDE  SUCH  DOCUMENTATION  TO THE DEPARTMENT UPON REQUEST. FAILURE TO
 PROVIDE SUCH DOCUMENTATION UPON REQUEST OF THE DEPARTMENT  SHALL  BE  AN
 ACT  OF  MISCONDUCT  SUBJECT  TO  DISCIPLINARY  PROCEEDINGS  PURSUANT TO
 SECTION SIXTY-FIVE HUNDRED TEN OF THIS TITLE.
   6. THE MANDATORY CONTINUING EDUCATION  FEE  SHALL  BE  FIFTY  DOLLARS,
 SHALL  BE PAYABLE ON OR BEFORE THE FIRST DAY OF EACH TRIENNIAL REGISTRA-
 TION PERIOD, AND SHALL BE IN ADDITION TO THE TRIENNIAL REGISTRATION  FEE
 REQUIRED BY SECTION SIXTY-EIGHT HUNDRED FIFTY-SEVEN OF THIS ARTICLE.
   §  3. Subdivision (a) of section 1203 of the limited liability company
 law, as amended by chapter 475 of the laws of 2014, is amended  to  read
 as follows:
   (a)  Notwithstanding  the education law or any other provision of law,
 one or more professionals each of whom is authorized by law to render  a
 professional  service within the state, or one or more professionals, at
 least one of whom is authorized by law to render a professional  service
 within  the  state,  may  form,  or  cause  to be formed, a professional
 service limited liability company for pecuniary profit under this  arti-
 cle for the purpose of rendering the professional service or services as
 such  professionals  are  authorized  to  practice.    With respect to a
 professional service limited liability company formed to provide medical
 services as such services are defined in article 131  of  the  education
 law,  each  member  of  such  limited liability company must be licensed
 pursuant to article 131 of the education law  to  practice  medicine  in
 this  state.    WITH RESPECT TO A PROFESSIONAL SERVICE LIMITED LIABILITY
 COMPANY FORMED TO PROVIDE NATUROPATHIC SERVICES  AS  SUCH  SERVICES  ARE
 DEFINED IN ARTICLE 138 OF THE EDUCATION LAW, EACH MEMBER OF SUCH LIMITED
 LIABILITY COMPANY MUST BE LICENSED PURSUANT TO ARTICLE 138 OF THE EDUCA-
 TION  LAW  TO  PRACTICE  NATUROPATHY  IN  THIS  STATE. With respect to a
 professional service limited liability company formed to provide  dental
 services  as  such  services are defined in article 133 of the education
 law, each member of such limited  liability  company  must  be  licensed
 pursuant  to  article  133 of the education law to practice dentistry in
 this state. With respect to a  professional  service  limited  liability

 A. 4825                            15
 
 company  formed  to  provide  veterinary  services  as such services are
 defined in article 135 of the education law, each member of such limited
 liability company must be licensed pursuant to article 135 of the educa-
 tion  law to practice veterinary medicine in this state. With respect to
 a professional service  limited  liability  company  formed  to  provide
 professional   engineering,  land  surveying,  architectural,  landscape
 architectural and/or geological services as such services are defined in
 article 145, article 147 and article 148  of  the  education  law,  each
 member  of  such  limited liability company must be licensed pursuant to
 article 145, article 147 and/or article 148  of  the  education  law  to
 practice  one or more of such professions in this state. With respect to
 a professional service  limited  liability  company  formed  to  provide
 licensed  clinical  social work services as such services are defined in
 article 154 of the education law, each member of such limited  liability
 company  shall  be licensed pursuant to article 154 of the education law
 to practice licensed clinical social work in this state. With respect to
 a professional service limited liability company formed to provide crea-
 tive arts therapy services as such services are defined in  article  163
 of the education law, each member of such limited liability company must
 be  licensed  pursuant  to  article 163 of the education law to practice
 creative arts therapy in this state.  With  respect  to  a  professional
 service  limited liability company formed to provide marriage and family
 therapy services as such services are defined  in  article  163  of  the
 education  law,  each  member  of such limited liability company must be
 licensed pursuant to article  163  of  the  education  law  to  practice
 marriage  and  family  therapy  in this state. With respect to a profes-
 sional service limited liability company formed to provide mental health
 counseling services as such services are defined in article 163  of  the
 education  law,  each  member  of such limited liability company must be
 licensed pursuant to article 163 of the education law to practice mental
 health counseling in this state. With respect to a professional  service
 limited  liability  company formed to provide psychoanalysis services as
 such services are defined in article 163  of  the  education  law,  each
 member  of  such  limited liability company must be licensed pursuant to
 article 163 of the education law  to  practice  psychoanalysis  in  this
 state.  With respect to a professional service limited liability company
 formed to provide applied behavior analysis services  as  such  services
 are  defined  in  article  167 of the education law, each member of such
 limited liability company must be  licensed  or  certified  pursuant  to
 article  167  of the education law to practice applied behavior analysis
 in  this  state.  In  addition  to  engaging  in  such   profession   or
 professions, a professional service limited liability company may engage
 in  any  other  business  or  activities as to which a limited liability
 company may be formed under section two hundred  one  of  this  chapter.
 Notwithstanding  any  other  provision  of  this section, a professional
 service limited liability company (i) authorized  to  practice  law  may
 only  engage  in  another  profession  or business or activities or (ii)
 which is engaged in a profession or other business or  activities  other
 than  law  may  only  engage  in  the practice of law, to the extent not
 prohibited by any other law of this state or any  rule  adopted  by  the
 appropriate  appellate  division  of  the  supreme court or the court of
 appeals.
   § 4. Subdivision (b) of section 1207 of the limited liability  company
 law,  as  amended by chapter 475 of the laws of 2014, is amended to read
 as follows:

 A. 4825                            16
 
   (b) With respect to a professional service limited  liability  company
 formed to provide medical services as such services are defined in arti-
 cle  131  of  the  education  law, each member of such limited liability
 company must be licensed pursuant to article 131 of the education law to
 practice medicine in this state.  WITH RESPECT TO A PROFESSIONAL SERVICE
 LIMITED  LIABILITY  COMPANY  FORMED  TO PROVIDE NATUROPATHIC SERVICES AS
 SUCH SERVICES ARE DEFINED IN ARTICLE 138  OF  THE  EDUCATION  LAW,  EACH
 MEMBER  OF  SUCH  LIMITED LIABILITY COMPANY MUST BE LICENSED PURSUANT TO
 ARTICLE 138 OF THE EDUCATION LAW TO PRACTICE NATUROPATHY IN THIS  STATE.
 With  respect to a professional service limited liability company formed
 to provide dental services as such services are defined in  article  133
 of the education law, each member of such limited liability company must
 be  licensed  pursuant  to  article 133 of the education law to practice
 dentistry in this state. With respect to a professional service  limited
 liability company formed to provide veterinary services as such services
 are  defined  in  article  135 of the education law, each member of such
 limited liability company must be licensed pursuant to  article  135  of
 the  education  law  to practice veterinary medicine in this state. With
 respect to a professional service limited liability  company  formed  to
 provide  professional  engineering, land surveying, architectural, land-
 scape architectural and/or geological  services  as  such  services  are
 defined  in  article  145,  article 147 and article 148 of the education
 law, each member of such limited  liability  company  must  be  licensed
 pursuant to article 145, article 147 and/or article 148 of the education
 law  to  practice  one  or  more of such professions in this state. With
 respect to a professional service limited liability  company  formed  to
 provide  licensed  clinical  social  work  services as such services are
 defined in article 154 of the education law, each member of such limited
 liability company shall be licensed  pursuant  to  article  154  of  the
 education  law  to practice licensed clinical social work in this state.
 With respect to a professional service limited liability company  formed
 to  provide  creative arts therapy services as such services are defined
 in article 163 of the education law, each member of such limited liabil-
 ity company must be licensed pursuant to article 163  of  the  education
 law  to  practice creative arts therapy in this state. With respect to a
 professional  service  limited  liability  company  formed  to   provide
 marriage  and  family  therapy  services as such services are defined in
 article 163 of the education law, each member of such limited  liability
 company must be licensed pursuant to article 163 of the education law to
 practice  marriage  and  family therapy in this state. With respect to a
 professional service limited liability company formed to provide  mental
 health  counseling  services as such services are defined in article 163
 of the education law, each member of such limited liability company must
 be licensed pursuant to article 163 of the  education  law  to  practice
 mental  health  counseling in this state. With respect to a professional
 service limited  liability  company  formed  to  provide  psychoanalysis
 services  as  such  services are defined in article 163 of the education
 law, each member of such limited  liability  company  must  be  licensed
 pursuant  to article 163 of the education law to practice psychoanalysis
 in this state. With respect to a professional service limited  liability
 company  formed  to  provide  applied behavior analysis services as such
 services are defined in article 167 of the education law, each member of
 such limited liability company must be licensed or certified pursuant to
 article 167 of the education law to practice applied  behavior  analysis
 in this state.

 A. 4825                            17
 
   §  5. Subdivision (a) of section 1301 of the limited liability company
 law, as amended by chapter 475 of the laws of 2014, is amended  to  read
 as follows:
   (a)  "Foreign  professional service limited liability company" means a
 professional service limited liability company, whether or  not  denomi-
 nated  as  such,  organized  under the laws of a jurisdiction other than
 this state, (i) each of whose members and managers, if any, is a profes-
 sional authorized by law to render a professional  service  within  this
 state  and who is or has been engaged in the practice of such profession
 in such professional service limited liability company or a  predecessor
 entity, or will engage in the practice of such profession in the profes-
 sional  service limited liability company within thirty days of the date
 such professional becomes a member, or each of whose members and  manag-
 ers,  if  any, is a professional at least one of such members is author-
 ized by law to render a professional service within this state  and  who
 is  or  has  been  engaged  in  the  practice of such profession in such
 professional service limited liability company or a predecessor  entity,
 or  will  engage  in the practice of such profession in the professional
 service limited liability company within thirty days of  the  date  such
 professional  becomes  a  member,  or  (ii)  authorized by, or holding a
 license, certificate, registration or permit  issued  by  the  licensing
 authority  pursuant  to,  the  education  law  to  render a professional
 service within this state; except that all members and managers, if any,
 of  a  foreign  professional  service  limited  liability  company  that
 provides  health services in this state shall be licensed in this state.
 WITH RESPECT TO A PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY  FORMED
 TO PROVIDE NATUROPATHIC SERVICES AS SUCH SERVICES ARE DEFINED IN ARTICLE
 138  OF THE EDUCATION LAW, EACH MEMBER OF SUCH LIMITED LIABILITY COMPANY
 MUST BE LICENSED PURSUANT TO ARTICLE 138 OF THE EDUCATION LAW  TO  PRAC-
 TICE  NATUROPATHY  IN THIS STATE. With respect to a foreign professional
 service limited liability company which provides veterinary services  as
 such  services  are  defined  in  article 135 of the education law, each
 member of such foreign professional service  limited  liability  company
 shall  be licensed pursuant to article 135 of the education law to prac-
 tice veterinary medicine. With respect to a foreign professional service
 limited liability  company  which  provides  medical  services  as  such
 services are defined in article 131 of the education law, each member of
 such  foreign  professional  service  limited  liability company must be
 licensed pursuant to article 131 of the education law to practice  medi-
 cine  in  this  state.    With respect to a foreign professional service
 limited  liability  company  which  provides  dental  services  as  such
 services are defined in article 133 of the education law, each member of
 such  foreign  professional  service  limited  liability company must be
 licensed pursuant to article  133  of  the  education  law  to  practice
 dentistry  in this state. With respect to a foreign professional service
 limited liability company which provides professional engineering,  land
 surveying,   geologic,   architectural  and/or  landscape  architectural
 services as such services are defined in article 145,  article  147  and
 article  148  of  the education law, each member of such foreign profes-
 sional service limited liability company must be  licensed  pursuant  to
 article  145,  article  147  and/or  article 148 of the education law to
 practice one or more of such professions in this state. With respect  to
 a  foreign professional service limited liability company which provides
 licensed clinical social work services as such services are  defined  in
 article  154  of  the education law, each member of such foreign profes-
 sional service limited liability company shall be licensed  pursuant  to

 A. 4825                            18
 
 article  154  of  the  education law to practice clinical social work in
 this state. With respect  to  a  foreign  professional  service  limited
 liability  company which provides creative arts therapy services as such
 services are defined in article 163 of the education law, each member of
 such  foreign  professional  service  limited  liability company must be
 licensed pursuant to article 163 of the education law to practice  crea-
 tive  arts therapy in this state. With respect to a foreign professional
 service limited liability company which  provides  marriage  and  family
 therapy  services  as  such  services  are defined in article 163 of the
 education law, each member of such foreign professional service  limited
 liability company must be licensed pursuant to article 163 of the educa-
 tion  law  to  practice  marriage and family therapy in this state. With
 respect to a foreign  professional  service  limited  liability  company
 which  provides  mental  health counseling services as such services are
 defined in article 163 of the education law, each member of such foreign
 professional service limited liability company must be licensed pursuant
 to article 163 of the education law to practice mental health counseling
 in this state. With respect to a foreign  professional  service  limited
 liability   company  which  provides  psychoanalysis  services  as  such
 services are defined in article 163 of the education law, each member of
 such foreign professional service  limited  liability  company  must  be
 licensed  pursuant  to  article  163  of  the  education law to practice
 psychoanalysis in this state. With respect  to  a  foreign  professional
 service limited liability company which provides applied behavior analy-
 sis  services  as such services are defined in article 167 of the educa-
 tion law, each member  of  such  foreign  professional  service  limited
 liability  company must be licensed or certified pursuant to article 167
 of the education law to  practice  applied  behavior  analysis  in  this
 state.
   §  6.  Subdivision  (q) of section 121-1500 of the partnership law, as
 amended by chapter 475 of the laws  of  2014,  is  amended  to  read  as
 follows:
   (q)  Each partner of a registered limited liability partnership formed
 to provide medical services in this state must be licensed  pursuant  to
 article  131 of the education law to practice medicine in this state and
 each partner of a registered limited  liability  partnership  formed  to
 provide dental services in this state must be licensed pursuant to arti-
 cle  133 of the education law to practice dentistry in this state.  EACH
 PARTNER OF A REGISTERED LIMITED LIABILITY PARTNERSHIP FORMED TO  PROVIDE
 NATUROPATHIC SERVICES IN THIS STATE MUST BE LICENSED PURSUANT TO ARTICLE
 138  OF  THE  EDUCATION  LAW TO PRACTICE NATUROPATHY IN THIS STATE. Each
 partner of a registered limited liability partnership formed to  provide
 veterinary  services  in this state must be licensed pursuant to article
 135 of the education law to practice veterinary medicine in this  state.
 Each  partner  of  a  registered limited liability partnership formed to
 provide professional engineering, land surveying,  geological  services,
 architectural and/or landscape architectural services in this state must
 be  licensed  pursuant to article 145, article 147 and/or article 148 of
 the education law to practice one or more of such  professions  in  this
 state. Each partner of a registered limited liability partnership formed
 to  provide licensed clinical social work services in this state must be
 licensed pursuant to article 154 of the education law to practice  clin-
 ical  social  work  in  this state. Each partner of a registered limited
 liability partnership formed to provide creative arts  therapy  services
 in  this state must be licensed pursuant to article 163 of the education
 law to practice creative arts therapy in this state. Each partner  of  a

 A. 4825                            19
 
 registered  limited liability partnership formed to provide marriage and
 family therapy services in this state must be licensed pursuant to arti-
 cle 163 of the education law to practice marriage and family therapy  in
 this  state.  Each partner of a registered limited liability partnership
 formed to provide mental health counseling services in this  state  must
 be  licensed  pursuant  to  article 163 of the education law to practice
 mental health counseling in this state. Each  partner  of  a  registered
 limited  liability partnership formed to provide psychoanalysis services
 in this state must be licensed pursuant to article 163 of the  education
 law  to  practice psychoanalysis in this state. Each partner of a regis-
 tered limited liability partnership formed to provide  applied  behavior
 analysis service in this state must be licensed or certified pursuant to
 article  167  of the education law to practice applied behavior analysis
 in this state.
   § 7. Subdivision (q) of section 121-1502 of the  partnership  law,  as
 amended  by  chapter  475  of  the  laws  of 2014, is amended to read as
 follows:
   (q) Each partner of a  foreign  limited  liability  partnership  which
 provides  medical  services  in  this state must be licensed pursuant to
 article 131 of the education law to practice medicine in the  state  and
 each  partner  of a foreign limited liability partnership which provides
 dental services in the state must be licensed pursuant to article 133 of
 the education law to practice dentistry in this state. EACH PARTNER OF A
 FOREIGN  LIMITED  LIABILITY  PARTNERSHIP  WHICH  PROVIDES   NATUROPATHIC
 SERVICES  IN  THIS STATE MUST BE LICENSED PURSUANT TO ARTICLE 138 OF THE
 EDUCATION LAW TO PRACTICE NATUROPATHY IN THIS STATE. Each partner  of  a
 foreign  limited liability partnership which provides veterinary service
 in the state shall be licensed pursuant to article 135 of the  education
 law  to  practice  veterinary medicine in this state.  Each partner of a
 foreign limited liability partnership which provides professional  engi-
 neering, land surveying, geological services, architectural and/or land-
 scape  architectural services in this state must be licensed pursuant to
 article 145, article 147 and/or article 148  of  the  education  law  to
 practice  one  or  more  of  such professions. Each partner of a foreign
 limited liability partnership which provides  licensed  clinical  social
 work  services in this state must be licensed pursuant to article 154 of
 the education law to practice licensed  clinical  social  work  in  this
 state.  Each  partner  of  a foreign limited liability partnership which
 provides creative arts therapy services in this state must  be  licensed
 pursuant  to  article 163 of the education law to practice creative arts
 therapy in this state. Each partner of a foreign limited liability part-
 nership which provides marriage and  family  therapy  services  in  this
 state  must  be licensed pursuant to article 163 of the education law to
 practice marriage and family therapy in this state. Each  partner  of  a
 foreign limited liability partnership which provides mental health coun-
 seling  services  in this state must be licensed pursuant to article 163
 of the education law to practice mental health counseling in this state.
 Each partner of a foreign limited liability partnership  which  provides
 psychoanalysis services in this state must be licensed pursuant to arti-
 cle  163  of the education law to practice psychoanalysis in this state.
 Each partner of a foreign limited liability partnership  which  provides
 applied  behavior  analysis  services  in this state must be licensed or
 certified pursuant to article 167  of  the  education  law  to  practice
 applied behavior analysis in this state.

 A. 4825                            20
 
   §  8.  Paragraph  (a)  of  subdivision  1 of section 413 of the social
 services law, as amended by section 7 of part C of  chapter  57  of  the
 laws of 2018, is amended to read as follows:
   (a)  The  following  persons  and  officials are required to report or
 cause a report to be made in accordance with this title when  they  have
 reasonable  cause  to  suspect  that a child coming before them in their
 professional or official capacity is an abused or maltreated  child,  or
 when  they have reasonable cause to suspect that a child is an abused or
 maltreated child where the parent, guardian, custodian or  other  person
 legally  responsible  for  such child comes before them in their profes-
 sional or official capacity and states from  personal  knowledge  facts,
 conditions or circumstances which, if correct, would render the child an
 abused  or maltreated child: any physician; registered physician assist-
 ant; surgeon; medical  examiner;  coroner;  dentist;  dental  hygienist;
 osteopath;  optometrist;  chiropractor; podiatrist; NATUROPATHIC DOCTOR;
 resident; intern; psychologist; registered nurse; social  worker;  emer-
 gency  medical  technician;  licensed  creative arts therapist; licensed
 marriage  and  family  therapist;  licensed  mental  health   counselor;
 licensed  psychoanalyst;  licensed  behavior analyst; certified behavior
 analyst assistant; hospital personnel engaged in the admission, examina-
 tion, care or treatment of persons; a  Christian  Science  practitioner;
 school  official,  which  includes but is not limited to school teacher,
 school guidance counselor, school psychologist,  school  social  worker,
 school nurse, school administrator or other school personnel required to
 hold  a teaching or administrative license or certificate; full or part-
 time compensated school employee required to hold a  temporary  coaching
 license  or  professional  coaching certificate; social services worker;
 employee of a publicly-funded emergency shelter for families with  chil-
 dren;  director of a children's overnight camp, summer day camp or trav-
 eling summer day camp, as such camps are  defined  in  section  thirteen
 hundred  ninety-two  of  the  public health law; day care center worker;
 school-age child care worker; provider of family  or  group  family  day
 care;  employee or volunteer in a residential care facility for children
 that is licensed, certified or operated by the office  of  children  and
 family  services;  or any other child care or foster care worker; mental
 health professional; substance abuse  counselor;  alcoholism  counselor;
 all persons credentialed by the office of alcoholism and substance abuse
 services;  employees,  who  are expected to have regular and substantial
 contact with children, of a health home or health home  care  management
 agency contracting with a health home as designated by the department of
 health  and  authorized under section three hundred sixty-five-l of this
 chapter or such employees who provide home and community based  services
 under a demonstration program pursuant to section eleven hundred fifteen
 of  the federal social security act who are expected to have regular and
 substantial  contact  with  children;  peace  officer;  police  officer;
 district  attorney or assistant district attorney; investigator employed
 in the office of a district attorney; or other law enforcement official.
   § 9. Subdivision 6 of section 571 of the public health law, as amended
 by chapter 444 of the laws of 2013, is amended to read as follows:
   6. "Qualified health care professional" means  a  physician,  dentist,
 podiatrist, NATUROPATHIC DOCTOR, optometrist performing a clinical labo-
 ratory test that does not use an invasive modality as defined in section
 seventy-one  hundred  one  of  the  education  law, physician assistant,
 specialist assistant, nurse practitioner, or midwife,  who  is  licensed
 and registered with the state education department.

 A. 4825                            21
 
   §  10. Subdivision 1 of section 585 of the public health law, as added
 by chapter 803 of the laws of 1992, is amended to read as follows:
   1.  "Health  services  purveyor"  means any person, firm, partnership,
 group, association, corporation  or  professional  corporation,  or  any
 agent,  employee, fiduciary, employer or representative thereof, includ-
 ing but not limited to a physician,  dentist,  podiatrist,  NATUROPATHIC
 DOCTOR or chiropractor, either in individual practice, group practice or
 employed  in  a  facility owned by any person, group, association, firm,
 partnership or corporation hiring any of the aforementioned  practition-
 ers, who provide health or health related services.
   § 11. This act shall take effect immediately; provided that:
   a.  sections  one, two, three, four, five, six, seven, nine and ten of
 this act shall take effect on the five hundred  fortieth  day  after  it
 shall have become a law; and
   b. effective immediately, the addition, amendment and/or repeal of any
 rule  or  regulation necessary for the implementation of this act on its
 effective date are authorized and directed to be made and  completed  by
 the commissioner of education and the board of regents on or before such
 effective date.