S T A T E O F N E W Y O R K ________________________________________________________________________ 4917 2015-2016 Regular Sessions I N S E N A T E April 23, 2015 ___________ Introduced by Sens. LAVALLE, LARKIN, SEWARD -- read twice and ordered printed, and when printed to be committed 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: 1 Section 1. Legislative intent. 1. The legislature recognizes that in 2 spite of advances in science and technology that have resulted in the 3 American healthcare system excelling at triage and in responding to 4 acute emergent conditions, there is an epidemic of chronic disease and 5 an unacceptable degree of iatrogenic disease in America. The legislature 6 recognizes that the economics of healthcare and the pursuit of scientif- 7 ic advancement have led to an occupational preference among physicians 8 for specialization, resulting in a shortage of primary care physicians. 9 The legislature finds that licensure of the profession of naturopathic 10 medicine favorably addresses such problems, and agrees with U.S. Senate 11 Resolution 221 of the 113th Congress in finding that naturopathic 12 doctors are skilled in preventing and treating chronic disease; that 13 naturopathic medicine is a safe, effective, and affordable means of 14 health care; and that licensure of naturopathic doctors helps address 15 the shortage of primary care physicians in the United States, while also 16 providing people with more choice in health care. 17 2. The legislature recognizes that naturopathic medicine, although 18 encompassing primary and secondary care services, including many of the 19 same diagnostic tools and assessment techniques as the medical profes- 20 sion, and having certain Hippocratic principles in common with the 21 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. LBD05295-02-5 S. 4917 2 1 plated by article 131 of the education law, and intends that naturopath- 2 ic medicine be a distinct profession with its own state board. 3 3. The legislature recognizes that naturopathic medicine is a modern, 4 evolved form of naturopathy that is practiced by naturopathic doctors; 5 that the early form, today sometimes called traditional naturopathy, is 6 characterized by its vitalistic philosophy, and by its foundation of 7 hygiene and nature cure (i.e., the use of natural agents such as air, 8 light, water, food, and herbs to stimulate the body's own natural heal- 9 ing powers); and that such early form is practiced in some states by 10 traditional naturopaths without licensure, by lay persons in their own 11 self care, and to some extent in health spas. This bill is not intended 12 to change the legality or illegality of activities relating to such 13 hygiene and nature cure; nor to limit the scope of naturopathic medicine 14 to such traditional naturopathy. 15 4. The legislature recognizes that the naturopathic doctor has a 16 primary mission of facilitating optimum health and wellness for patients 17 of any age; relies on the scientific method in implementing vitalistic, 18 functional, and evidence-based strategies for assessing and treating 19 patients; and works with patients of good or ill health having acute and 20 chronic conditions, including serious medical conditions. 21 5. The legislature intends that the authorized activities within the 22 scope of practice of a naturopathic doctor are those activities within 23 the meanings of naturopathic assessment, common office procedures, phys- 24 ical naturopathy, approved substances, approved routes of adminis- 25 tration, and noninvasive naturopathic therapies, as per sections sixty- 26 eight hundred fifty and sixty-eight hundred fifty-one of article 138 of 27 the education law as proposed in this act. For naturopathic doctors 28 having the injection therapy privilege the authorized activities further 29 include injection therapy, as per section sixty-eight hundred fifty-four 30 of article 138 of the education law, as proposed in this act. The scope 31 of such practice activities however are limited by section sixty-eight 32 hundred fifty-five of article 138 of the education law, as proposed in 33 this act, which provides boundaries of professional competence. The 34 legislature provides a list of broad clinical objectives included within 35 the meaning of "facilitating optimum health and wellness," as defined in 36 section sixty-eight hundred fifty-one of article 138 of the education 37 law as proposed in this act, which list, while relevant to professional 38 conduct, is not intended to expand upon the authorized activities. The 39 legislature intends that invasive procedures other than diagnostic imag- 40 ing be impermissible, and that the definitions of the terms "invasive 41 procedures" and "noninvasive" be construed independent of each other. 42 6. The legislature intends that the education qualification for natu- 43 ropathic medicine emphasizes the basic sciences and clinical sciences, 44 such as has been established by the Council on Naturopathic Medical 45 Education (CNME) and the Association of Accredited Naturopathic Medical 46 Colleges (AANMC), and so distinguish over traditional naturopathy. 47 7. The legislature intends that the education qualification for natu- 48 ropathic medicine insofar as including a substantial equivalent of a 49 program of naturopathic medicine registered with the department require 50 that such substantial equivalent, among other factors determined by the 51 department, also require that the substantial equivalent emphasize the 52 naturopathic principles and the therapeutic order in clinical training, 53 such as in programs accredited by the Council on Naturopathic Medical 54 Education (CNME) or in the naturopathic medical programs offered by the 55 Association of Accredited Naturopathic Medical Colleges (AANMC), and so 56 distinguish over a doctoral degree in medicine or osteopathy. S. 4917 3 1 8. The legislature intends that the professional conduct of the natu- 2 ropathic doctor be informed by the naturopathic principles and the ther- 3 apeutic order, and so distinguish over professional conduct for the 4 practice of the profession of medicine. 5 9. The legislature recognizes that in the practice of naturopathic 6 medicine the healing power of nature principle is viewed as being an 7 inherent property in a living organism to heal itself, and is an 8 acknowledgment that synergy results from the coordination of the many 9 chemical and physical reactions of the living system through varied and 10 circuitous feedback pathways making the whole function as more than the 11 sum of its parts. The number of reactions and the resulting complexity 12 and synergy is viewed in the profession of naturopathic medicine as 13 being why treatment of a given physiological process may result in 14 unforeseen nonlocal consequences, including iatrogenic disease; and is 15 why naturopathic doctors investigate and treat the patient as a whole 16 living system, find and remove the cause, and prefer less invasive ther- 17 apies and substances with fewer side effects. It also is why the naturo- 18 pathic doctor prefers to intervene early to prevent occurrence of 19 disease. 20 10. The legislature intends that licensed naturopathic doctors, while 21 being permitted to practice in solo and among other naturopathic 22 doctors, also be permitted to practice naturopathic medicine in many of 23 the current patient care venue types in the healthcare system; that 24 there be referral among naturopathic doctors, physicians, and other 25 health care providers as based on the interests of the patient; and that 26 integrative care settings and the advancement of public health and safe- 27 ty be realized through collaboration among naturopathic doctors, physi- 28 cians, and other health care providers. 29 11. Naturopathic doctors add to the health care system by bringing 30 their naturopathic approach to patient care; and by bringing their 31 expertise on the determinants of health, diet and nutrient therapy, 32 phytotherapy, therapeutic use of physical agents, and drug/herb 33 drug/nutrient interactions. Therefore, to improve the public health, 34 safety and welfare of its citizens, the legislature finds it is desira- 35 ble to regulate the profession of naturopathic medicine, and intends 36 that admission to practice and regulation of such practice, including 37 professional conduct, shall be supervised by the board of regents and 38 administered by the state education department, assisted by a state 39 board of naturopathic medicine. 40 S 2. The Education Law is amended by adding a new article 138 to read 41 as follows: 42 ARTICLE 138 43 NATUROPATHIC MEDICINE 44 SECTION 6850. INTRODUCTION. 45 6851. DEFINITIONS. 46 6852. DEFINITION OF THE PRACTICE OF NATUROPATHIC MEDICINE. 47 6853. TITLE AND DESIGNATION. 48 6854. INJECTION THERAPY AND INJECTION THERAPY PRIVILEGE. 49 6855. BOUNDARIES OF PROFESSIONAL COMPETENCE. 50 6856. STATE BOARD FOR NATUROPATHIC MEDICINE. 51 6857. QUALIFICATIONS FOR LICENSURE. 52 6858. SPECIAL CONDITIONS. 53 6859. EXEMPT PERSONS AND EXEMPTIONS. 54 6860. LIMITED RESIDENCY PERMITS. 55 6861. LIMITED PERMITS. 56 6862. MANDATORY CONTINUING EDUCATION. S. 4917 4 1 S 6850. INTRODUCTION. THIS ARTICLE APPLIES TO THE LICENSURE AND REGU- 2 LATION OF NATUROPATHIC DOCTORS TO PRACTICE NATUROPATHIC MEDICINE IN THIS 3 STATE. THE GENERAL PROVISIONS FOR ALL PROFESSIONS CONTAINED IN ARTICLE 4 ONE HUNDRED THIRTY, AS ADDED BY CHAPTER NINE HUNDRED EIGHTY-SEVEN OF THE 5 LAWS OF NINETEEN HUNDRED SEVENTY-ONE, OF THIS TITLE APPLY TO THIS ARTI- 6 CLE. 7 S 6851. DEFINITIONS. FOR THE PURPOSES OF THIS ARTICLE: 8 1. "APPROVED CLIA WAIVED TESTS" MEAN LABORATORY TESTS CATEGORIZED 9 UNDER THE FEDERAL CLINICAL LABORATORY IMPROVEMENT ACT (CLIA) OF 1988 AS 10 BEING WAIVED TESTS, AND WHICH ARE IDENTIFIED BY THE DEPARTMENT UPON THE 11 RECOMMENDATION OF THE BOARD, AND UPDATED AS NEEDED OR UPON TRIENNIAL 12 REVIEW, AS BEING APPROPRIATE IN THE PRACTICE OF NATUROPATHIC MEDICINE. 13 2. "APPROVED ROUTES OF ADMINISTRATION" MEANS ORAL, SUBLINGUAL, NASAL, 14 AURICULAR, OCULAR, RECTAL, VAGINAL, AND TRANSDERMAL. FOR NATUROPATHIC 15 DOCTORS HAVING INJECTION THERAPY PRIVILEGE UNDER SECTION SIXTY-EIGHT 16 HUNDRED FIFTY-FOUR OF THIS ARTICLE, "APPROVED ROUTES OF ADMINISTRATION" 17 FURTHER INCLUDE INJECTION ROUTES, NAMELY, INTRAVENOUS, INTRAMUSCULAR, 18 SUBCUTANEOUS, AND INTRADERMAL. 19 3. "APPROVED SUBSTANCES" MEANS OVER-THE-COUNTER SUBSTANCES; FOOD 20 CONCENTRATES, FOOD EXTRACTS, AND OTHER DIETARY INGREDIENTS; VITAMINS, 21 MINERALS, AND OTHER DIETARY SUPPLEMENTS; BOTANICAL AND HOMEOPATHIC PREP- 22 ARATIONS; AND A LIMITED FORMULARY OF LEGEND DRUGS. THE LIMITED FORMULARY 23 OF LEGEND DRUGS INCLUDES THYROID HORMONES, ESTROGEN HORMONES, PROGESTER- 24 ONE HORMONE, DHEA, AND HOMEOPATHIC PREPARATIONS OF HOMEOPATHIC DRUGS 25 LISTED IN THE OFFICIAL HOMEOPATHIC PHARMACOPOEIA OF THE UNITED STATES. 26 FOR NATUROPATHIC DOCTORS HAVING INJECTION THERAPY PRIVILEGE UNDER 27 SECTION SIXTY-EIGHT HUNDRED FIFTY-FOUR OF THIS ARTICLE, THE LIMITED 28 FORMULARY FURTHER INCLUDES IMMUNIZATIONS AND INJECTABLE FORMS OF THE 29 APPROVED SUBSTANCES. LEGEND DRUGS IN THE LIMITED FORMULARY MAY BE ADMIN- 30 ISTERED AND PRESCRIBED, AND THE OTHER APPROVED SUBSTANCES AND HOMEOPATH- 31 IC PREPARATIONS MAY BE ADMINISTERED, PRESCRIBED, AND DISPENSED. 32 4. "BOARD" MEANS THE STATE BOARD FOR NATUROPATHIC MEDICINE. 33 5. "COMMON OFFICE PROCEDURES" MEANS ADMINISTERING APPROVED CLIA WAIVED 34 TESTS; ADMINISTERING ULTRASONOGRAPHIC AND THERMOGRAPHIC IMAGING; 35 PRESCRIBING, INSTALLING, REMOVING, AND ADJUSTING BARRIER CONTRACEPTIVE 36 DEVICES; PROCEDURES FOR TREATING SUPERFICIAL LACERATIONS AND ABRASIONS 37 AND FOR THE REMOVAL OF FOREIGN BODIES LOCATED IN SUPERFICIAL STRUCTURES 38 NOT TO INCLUDE THE EYE, EXCLUDING BY INCISION AND SUTURING; ADMINISTER- 39 ING CRYOTHERAPY, LIGATION, AND FULGURATION; ADMINISTERING APPROVED 40 SUBSTANCES VIA APPROVED ROUTES OF ADMINISTRATION; PROCEDURES FOR OBTAIN- 41 ING SAMPLES OF BODILY FLUIDS, BODILY EXCRETIONS, BODILY SECRETIONS, AND 42 BODILY TISSUES; AND OTHER PROCEDURES FOR ASSESSMENT OR THERAPY THAT ARE 43 NONINVASIVE. COMMON OFFICE PROCEDURES FOR OBTAINING SAMPLES ARE LIMITED 44 TO: VENIPUNCTURE AND PHLEBOTOMY, PAP SMEAR, SCRAPING, AND FOR HAIR 45 CUTTING. 46 6. "CONTROLLED SUBSTANCE" MEANS CONTROLLED SUBSTANCES AS DEFINED IN 47 THE FEDERAL CONTROLLED SUBSTANCES ACT. 48 7. "DIAGNOSTIC IMAGING" MEANS RADIOGRAPHY, TOMOGRAPHY, MAGNETIC RESO- 49 NANCE IMAGING, ULTRASONOGRAPHY, AND THERMOGRAPHY, AND EXCLUDES NUCLEAR 50 MEDICINE, FLUOROSCOPY, AND RADIOLOGICAL PROCEDURES FOR TREATING A 51 MEDICAL CONDITION. 52 8. "DIETARY INGREDIENT" MEANS A DIETARY INGREDIENT AS DEFINED IN THE 53 FEDERAL DIETARY SUPPLEMENT HEALTH AND EDUCATION ACT OF 1994 (DSHEA). 54 9. "DIETARY SUPPLEMENT" MEANS A DIETARY SUPPLEMENT AS DEFINED IN THE 55 FEDERAL DIETARY SUPPLEMENT HEALTH AND EDUCATION ACT OF 1994 (DSHEA). S. 4917 5 1 10. "DRUG" MEANS A DRUG AS DEFINED IN THE FEDERAL FOOD, DRUG, AND 2 COSMETIC ACT, 21 USC 321. 3 11. "FACILITATING OPTIMUM HEALTH AND WELLNESS" MEANS FACILITATING THE 4 ESTABLISHMENT AND MAINTENANCE OF A HEALTHY PATIENT LIFESTYLE AND NUTRI- 5 TIONAL FOUNDATION; EDUCATING THE PATIENT ABOUT THEIR CIRCUMSTANCES OF 6 HEALTH AND ILLNESS AND STEPS FOR ESTABLISHING AND MAINTAINING OPTIMUM 7 HEALTH AND WELLNESS; FACILITATING AND AUGMENTING SELF-HEALING PROCESSES; 8 SUPPORTING AND MODULATING PHYSIOLOGICAL PROCESSES; SUPPORTING AND 9 CORRECTING INTEGRITY OF ANATOMICAL STRUCTURES; IDENTIFYING AND REMOVING 10 UNDERLYING CAUSES OF ILLNESS; AND IDENTIFYING, PREVENTING, MITIGATING, 11 MONITORING, AND TREATING ILLNESS. 12 12. "FOOD" MEANS FOOD AS DEFINED IN THE FEDERAL FOOD, DRUG, AND 13 COSMETIC ACT, 21 USC 321. 14 13. "ILLNESS" MEANS PAIN, INJURY, DEFORMITY, SYNDROME, DISEASE, OR 15 OTHER UNHEALTHY CONDITION. 16 14. "INVASIVE PROCEDURE" MEANS ANY MEDICAL PROCEDURE IN WHICH BONE, 17 VISCERA, THE EYEBALL, THE INNER EAR, THE DORSAL BODY CAVITY, OR THE 18 VENTRAL BODY CAVITY IS PENETRATED BY A PHYSICAL DEVICE OR BY IONIZING 19 RADIATION ABOVE BACKGROUND LEVELS. 20 15. "INJECTION THERAPY" MEANS THE INJECTION OF APPROVED SUBSTANCES. 21 16. "INJECTION THERAPY PRIVILEGE" MEANS THE SCOPE OF PRACTICE PRIVI- 22 LEGE TO PRACTICE INJECTION THERAPY, IN ACCORDANCE WITH REGULATIONS 23 PROMULGATED BY THE COMMISSIONER. 24 17. "LEGEND DRUG" MEANS A DRUG FOR WHICH A PRESCRIPTION IS REQUIRED 25 UNDER THE FEDERAL FOOD, DRUG AND COSMETIC ACT. 26 18. "NATUROPATHIC ASSESSMENT" MEANS THE IDENTIFICATION AND EVALUATION 27 OF A PATIENT'S CIRCUMSTANCES OF HEALTH AND ILLNESS BY INVESTIGATING THE 28 PATIENT'S HEALTH, HISTORY, LIFE STYLE, AND DETERMINANTS OF HEALTH; BY 29 COMPREHENSIVE PHYSICAL EXAMINATION; BY COMMON OFFICE PROCEDURES FOR 30 ASSESSMENT; BY ORDERING AND PRESCRIBING LABORATORY TESTS AND PROCEDURES, 31 INCLUDING SUBMITTING SPECIMENS FOR TESTING TO LABORATORIES THAT HOLD 32 PERMITS OR LICENSES PURSUANT TO UNDER TITLE V OF ARTICLE FIVE OF THE 33 PUBLIC HEALTH LAW; BY ORDERING AND PRESCRIBING DIAGNOSTIC IMAGING; AND 34 BY OTHER ASSESSMENT TECHNIQUES THAT ARE NONINVASIVE. SPECIMENS FOR 35 TESTING MAY BE OBTAINED BY COMMON OFFICE PROCEDURES AS DESCRIBED IN 36 SUBDIVISION FIVE OF THIS SECTION OR BY PATIENT SUBMISSION (E.G., FOR 37 STOOL, URINE, HAIR, SALIVA). 38 19. "NATUROPATHIC PRINCIPLES" MEANS THE FOLLOWING PRINCIPLES, WHICH 39 ARE WEIGHED BY THE NATUROPATHIC DOCTOR TO INFLUENCE THE SELECTION OF 40 NATUROPATHIC ASSESSMENT ACTIVITIES, COMMON OFFICE PROCEDURES, AND TREAT- 41 MENTS ADMINISTERED, ORDERED OR REFERRED: 42 A. "THE HEALING POWER OF NATURE," WHICH MEANS THE INHERENT ABILITY OF 43 A LIVING ORGANISM FOR SELF-HEALING; 44 B. "IDENTIFY AND TREAT THE CAUSES," WHICH MEANS IDENTIFY AND REMOVE 45 THE UNDERLYING CAUSES OF ILLNESS SO THAT SELF-HEALING PROCESSES MAY 46 FUNCTION EFFECTIVELY; 47 C. "FIRST DO NO HARM," WHICH MEANS APPLY THE LEAST FORCE OR INTER- 48 VENTION TO IDENTIFY ILLNESS AND RESTORE HEALTH, SUCH AS REFERENCED IN 49 THE THERAPEUTIC ORDER; AND WHENEVER POSSIBLE, AVOID SYMPTOM SUPPRESSION 50 THAT INTERFERES WITH THE DYNAMICS OF SELF-HEALING; 51 D. "DOCTOR AS TEACHER," WHICH MEANS EDUCATE PATIENTS AS TO STEPS FOR 52 ACHIEVING AND MAINTAINING HEALTH, AND ENCOURAGE SELF-RESPONSIBILITY FOR 53 HEALTH; 54 E. "TREAT THE WHOLE PERSON," WHICH MEANS ASSESS AND TREAT THE PATIENT 55 AS AN INTEGRATED WHOLE HAVING MANY PHYSICAL, MENTAL, EMOTIONAL, SPIRITU- 56 AL, AND SOCIAL ASPECTS; AND S. 4917 6 1 F. "PREVENTION," WHICH MEANS ASSESS LIFE STYLE, DETERMINANTS OF 2 HEALTH, AND GENETIC AND ENVIRONMENTAL SUSCEPTIBILITY TO ILLNESS; RECOM- 3 MEND APPROPRIATE INTERVENTIONS TO REDUCE RISKS OF DISEASE OCCURRENCE; 4 AND FACILITATE THE ESTABLISHMENT AND MAINTENANCE OF POSITIVE EMOTION, 5 THOUGHT AND ACTION. 6 20. "NONINVASIVE" MEANS NO BREAK IS CREATED IN THE SKIN OR MUCOSA, NO 7 INFILTRATION OF THE SKIN OR MUCOSA IS MADE BY IONIZING RADIATION ABOVE 8 BACKGROUND LEVELS, NO ENDOSCOPY IS PERFORMED BETWEEN THE ESOPHAGUS AND 9 COLON, INCLUSIVE, AND NO RADIOGRAPHY, TOMOGRAPHY, OR MAGNETIC RESONANCE 10 IMAGING IS ADMINISTERED. 11 21. "NONINVASIVE NATUROPATHIC THERAPIES" MEANS DIET AND LIFESTYLE 12 COUNSELING, PATIENT EDUCATION AS TO CIRCUMSTANCES OF HEALTH AND ILLNESS, 13 WELLNESS COUNSELING, BIOFEEDBACK, HYPNOTHERAPY, AND TOUCH AND/OR TAPPING 14 THERAPIES WITH AND WITHOUT A VERBAL COMMUNICATION COMPONENT. NONINVASIVE 15 NATUROPATHIC THERAPIES EXCLUDE THE PRACTICE OF MARITAL AND FAMILY THERA- 16 PY, PSYCHOANALYSIS, AND CREATIVE ARTS THERAPY ON A CONTINUED SUSTAINED 17 BASIS, AND IS FURTHER LIMITED IN APPLICATION BY A BOUNDARY OF PROFES- 18 SIONAL COMPETENCE RESTRICTING PSYCHOTHERAPEUTIC INTERVENTION WITH 19 PATIENTS HAVING SYMPTOMATIC, INTELLECTUALLY, SOCIALLY OR EMOTIONALLY 20 MALADAPTIVE BEHAVIOR SUFFICIENT TO BE A MENTAL, EMOTIONAL, COGNITIVE, 21 ADDICTIVE OR BEHAVIORAL DISORDER AS PER DSM CRITERIA OR PER DIAGNOSIS BY 22 A QUALIFIED HEALTHCARE PROVIDER, AS PROVIDED IN SECTION SIXTY-EIGHT 23 HUNDRED FIFTY-FIVE OF THIS ARTICLE. 24 22. "OPTIMUM HEALTH" MEANS A PERSON'S DESIRED, MAINTAINABLE, BEST 25 DEGREE OF HEALTH, GIVEN THE PERSON'S CIRCUMSTANCES OF HEALTH AND 26 ILLNESS, THE THERAPEUTIC GOALS, AND THE PERSON'S DEGREE OF SELF-RESPON- 27 SIBILITY FOR HEALING. 28 23. "OVER THE COUNTER SUBSTANCES" MEANS SUBSTANCES THAT HAVE BEEN 29 APPROVED OR CLEARED BY THE FOOD AND DRUG ADMINISTRATION OF THE UNITED 30 STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR SALE OR DISTRIBUTION 31 TO THE PUBLIC ON A DIRECT OR OVER-THE-COUNTER BASIS WITHOUT A 32 PRESCRIPTION FROM A QUALIFIED HEALTH CARE PRACTITIONER. 33 24. "PHYSICAL NATUROPATHY" MEANS MANUAL THERAPY, THERAPEUTIC EXERCISE, 34 HYDROTHERAPY, COLONIC THERAPY, SAUNA, MICROWAVE DIATHERMY, SHORTWAVE 35 DIATHERMY, ULTRASONIC DIATHERMY, MUSCLE STIMULATION, BIOFEEDBACK, INFRA- 36 RED LIGHT THERAPY, ULTRAVIOLET LIGHT THERAPY, VISIBLE LIGHT THERAPY, 37 IONTOPHORESIS, AND THE THERAPEUTIC USE OF PHYSICAL MEDICINE THERAPEUTIC 38 DEVICES THAT ARE EXEMPT OR ARE CLASS I OR CLASS II DEVICES IDENTIFIED 39 UNDER THE CODE OF FEDERAL REGULATIONS, TITLE 21, CHAPTER I, SUBCHAPTER 40 H, PART 890, SUBPART F. 41 25. "RADIOLOGICAL PROCEDURES" MEANS RADIOLOGICAL PROCEDURES AS DEFINED 42 IN ARTICLE EIGHTY-SEVEN HUNDRED ONE OF THIS TITLE. 43 26. "SUPERFICIAL" MEANS THE DERMAL AND SUBCUTANEOUS LAYERS OF THE BODY 44 EXTERIOR, THE MUCOSAL LAYER OF THE BODY ORIFICES, AND THE UNDERLYING 45 FASCIA AND ADIPOSE. 46 27. "SURGERY" MEANS A MEDICAL PROCEDURE FOR STRUCTURALLY ALTERING THE 47 HUMAN BODY BY CUTTING INTO LIVE HUMAN TISSUE FOR THE PURPOSE OF LOCAL- 48 IZED ALTERATION, TRANSPORTATION, OR DESTRUCTION OF LIVE HUMAN TISSUE 49 USING IONIZING RADIATION OR AN INSTRUMENT, SUCH AS A LASER, SCALPEL, OR 50 PROBE; AND DOES NOT INCLUDE PUNCTURES, INJECTIONS, DRY NEEDLING, 51 ACUPUNCTURE, OR REMOVAL OF DEAD TISSUE. 52 28. "THERAPEUTIC ORDER" MEANS THE HIERARCHY OF THERAPEUTIC INTER- 53 VENTION, AS FOLLOWS, ORDERED ACCORDING TO DEGREE OF INTERVENTION, AND 54 USED BY DETERMINING THE LOWEST DEGREE OF INTERVENTION FOR WHICH THE 55 SPECIFIC PATIENT'S CIRCUMSTANCES OF HEALTH AND ILLNESS CAN BE EFFEC- 56 TIVELY ADDRESSED TO RESTORE AND FACILITATE OPTIMUM HEALTH, WHEREIN THER- S. 4917 7 1 APEUTIC INTERVENTION OUTSIDE THE BOUNDARIES OF PROFESSIONAL COMPETENCE 2 IS INTENDED TO BE REFERRED: 3 A. ESTABLISH THE CONDITIONS FOR HEALTH (E.G., IDENTIFY AND REMOVE 4 DISTURBING FACTORS; INSTITUTE A MORE HEALTHFUL REGIMEN); 5 B. STIMULATE THE SELF-HEALING PROCESSES; 6 C. ADDRESS WEAKENED OR DAMAGED SYSTEMS OR ORGANS (E.G., STRENGTHEN THE 7 IMMUNE SYSTEM; DECREASE TOXICITY; NORMALIZE INFLAMMATORY FUNCTION; OPTI- 8 MIZE METABOLIC FUNCTION; BALANCE REGULATORY SYSTEMS; ENHANCE REGENER- 9 ATION; CULTIVATE SENSORY AND MINDFUL AWARENESS OF THE INTEGRATION OF 10 PSYCHE AND SOMA); 11 D. CORRECT STRUCTURAL INTEGRITY; 12 E. ADDRESS PATHOLOGY USING SPECIFIC NATURAL SUBSTANCES, MODALITIES, OR 13 INTERVENTIONS; 14 F. ADDRESS PATHOLOGY USING SPECIFIC PHARMACOLOGIC OR SYNTHETIC 15 SUBSTANCES; AND 16 G. SUPPRESS OR SURGICALLY REMOVE PATHOLOGY. 17 29. "VERTEBRAL ADJUSTMENT" MEANS A HIGH VELOCITY, LOW AMPLITUDE THRUST 18 APPLIED TO A VERTEBRA AT THE END OF ITS RANGE OF MOTION UTILIZING PARTS 19 OF THE VERTEBRA AND CONTIGUOUS STRUCTURES AS LEVERS TO DIRECTIONALLY 20 CORRECT ARTICULATE MALPOSITION, AND EXCLUDES MOTION THAT MOVES THE 21 VERTEBRA TO THE END OF ITS RANGE OF MOTION. 22 30. "WELLNESS" MEANS A STATE OF BEING ABLE TO PREVENT ILLNESS AND 23 PROLONG LIFE. 24 31. "WELLNESS COUNSELING" MEANS PATIENT DOCTOR DIALOGUE FOR FACILITAT- 25 ING POSITIVE EMOTION, THOUGHT, AND ACTION PROVIDED WITHIN A MULTIMODAL 26 HOLISTIC FRAMEWORK OF THERAPY INFORMED BY THE NATUROPATHIC PRINCIPLES 27 AND THE THERAPEUTIC ORDER. 28 S 6852. DEFINITION OF THE PRACTICE OF NATUROPATHIC MEDICINE. THE 29 PRACTICE OF NATUROPATHIC MEDICINE IS DEFINED AS FACILITATING OPTIMUM 30 HEALTH AND WELLNESS FOR PATIENTS OF ANY AGE USING NATUROPATHIC ASSESS- 31 MENT, COMMON OFFICE PROCEDURES, PHYSICAL NATUROPATHY, APPROVED 32 SUBSTANCES, AND NONINVASIVE NATUROPATHIC THERAPIES IN A HOLISTIC FRAME- 33 WORK INFORMED BY NATUROPATHIC PRINCIPLES AND A THERAPEUTIC ORDER. 34 S 6853. TITLE AND DESIGNATION. ONLY A PERSON LICENSED UNDER THIS ARTI- 35 CLE MAY USE THE TITLE "NATUROPATHIC DOCTOR", "LICENSED NATUROPATH" OR 36 "PROFESSIONAL NATUROPATH" AND HOLD HERSELF OR HIMSELF OUT AS PRACTICING 37 NATUROPATHIC MEDICINE; PROVIDED, HOWEVER, THAT NONE OF SUCH TITLES NOR 38 ANY COMBINATION OF SUCH TITLES SHALL BE USED TO CONVEY THE IDEA THAT THE 39 INDIVIDUAL WHO USES SUCH TITLE PRACTICES ANYTHING OTHER THAN NATUROPATHY 40 AND NATUROPATHIC MEDICINE. A LICENSED NATUROPATHIC DOCTOR MAY NOT USE 41 THE TITLE "PHYSICIAN" UNLESS OTHERWISE AUTHORIZED UNDER TITLE VIII OF 42 THE EDUCATION LAW. 43 S 6854. INJECTION THERAPY AND INJECTION THERAPY PRIVILEGE. 1. FOR 44 ISSUANCE OF INJECTION THERAPY PRIVILEGE, THE APPLICANT SHALL FULFILL THE 45 FOLLOWING REQUIREMENTS: 46 A. FILE AN APPLICATION WITH THE DEPARTMENT; 47 B. BE LICENSED AS A NATUROPATHIC DOCTOR IN THE STATE, INCLUDING A 48 LIMITED PERMIT HOLDER, OR BE AN APPLICANT FOR LICENSURE UNDER THIS ARTI- 49 CLE MEETING THE QUALIFICATIONS FOR LICENSURE OR FOR A LIMITED PERMIT; 50 C. HAVE SUCCESSFULLY COMPLETED A CERTIFICATION COURSE IN INJECTION 51 THERAPY FROM A COURSE PROVIDER APPROVED BY THE DEPARTMENT OR AS PART OF 52 A PROGRAM OF NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE 53 SUBSTANTIAL EQUIVALENT THEREOF; 54 D. PAY A FEE TO THE DEPARTMENT OF TWO HUNDRED DOLLARS FOR THE ISSUANCE 55 AND INITIAL REGISTRATION OF THE INJECTION THERAPY PRIVILEGE. S. 4917 8 1 2. AN INJECTION THERAPY PRIVILEGE ISSUED UNDER THIS SECTION SHALL BE 2 VALID FOR THE LIFE OF THE HOLDER, UNLESS REVOKED, ANNULLED, OR SUSPENDED 3 BY THE BOARD OF REGENTS. DURING EACH TRIENNIAL REGISTRATION PERIOD, A 4 NATUROPATHIC DOCTOR HAVING INJECTION THERAPY PRIVILEGE SHALL COMPLETE 5 EIGHT HOURS OF ACCEPTABLE FORMAL CONTINUING EDUCATION AS PART OF THEIR 6 MANDATORY CONTINUING EDUCATION REQUIREMENT, IN CONFORMANCE WITH THE 7 PROVISIONS OF SECTION SIXTY-EIGHT HUNDRED SIXTY-TWO OF THIS ARTICLE, ON 8 THE SUBJECT OF INJECTION THERAPY, INCLUDING FORMAL CONTINUING EDUCATION 9 THAT CONTRIBUTES TO THE ENHANCEMENT OF CLINICAL INJECTION THERAPY 10 SKILLS, PURSUANT TO THE REGULATION OF THE COMMISSIONER. FAILURE TO 11 COMPLETE THE REQUIRED CONTINUING EDUCATION UNDER THIS SUBSECTION SHALL 12 RESULT IN SUSPENSION OF THE INJECTION THERAPY PRIVILEGE UNTIL SUCH TIME 13 AS THE REQUIRED CONTINUING EDUCATION IS COMPLETE. A SUSPENSION OF THE 14 INJECTION THERAPY PRIVILEGE FOR LACK OF COMPLETION OF THE REQUIRED 15 CONTINUING EDUCATION THAT EXCEEDS TWELVE MONTHS IN DURATION SHALL RESULT 16 IN A REVOCATION OF THE INJECTION THERAPY PRIVILEGE, AND REQUIRE RE-AP- 17 PLICATION, RECERTIFICATION OR OTHER EDUCATION SATISFACTORY TO THE 18 COMMISSIONER, AND THE FEE AS PER SECTION SIXTY-EIGHT HUNDRED FIFTY-SEVEN 19 OF THIS ARTICLE FOR RE-ISSUANCE OF THE INJECTION THERAPY PRIVILEGE. THIS 20 CONTINUING EDUCATION REQUIREMENT IS EFFECTIVE AS OF THE SAME EFFECTIVE 21 DATE AS SECTION SIXTY-EIGHT HUNDRED FIFTY-SEVEN OF THIS ARTICLE. 22 3. A STUDENT IN A DOCTORAL PROGRAM OF NATUROPATHIC MEDICINE REGISTERED 23 WITH THE DEPARTMENT OR THE SUBSTANTIAL EQUIVALENT THEREOF MAY PERFORM 24 INJECTION THERAPY IN AN INTERNSHIP OR PRECEPTORSHIP SETTING WHEN 25 REQUIRED AS PART OF SUCH PROGRAM FOR THE PURPOSE OF FULFILLING SUCH 26 PROGRAM REQUIREMENT ONLY UNDER THE IMMEDIATE DIRECT PERSONAL SUPERVISION 27 OF A PHYSICIAN LICENSED UNDER THIS TITLE OR A NATUROPATHIC DOCTOR 28 LICENSED UNDER THIS ARTICLE HAVING INJECTION THERAPY PRIVILEGE. "IMMEDI- 29 ATE DIRECT PERSONAL SUPERVISION" FOR THE PURPOSES OF THIS SECTION MEANS 30 SUPERVISION OF A PROCEDURE FOR INJECTION THERAPY BASED ON INSTRUCTIONS 31 GIVEN DIRECTLY BY THE SUPERVISING PHYSICIAN OR SUPERVISING NATUROPATHIC 32 DOCTOR WHO REMAINS PHYSICALLY PRESENT IN THE IMMEDIATE AREA WHEN THE 33 INJECTION THERAPY PROCEDURE IS PERFORMED. 34 S 6855. BOUNDARIES OF PROFESSIONAL COMPETENCE. THE ACTIVITIES ENCOM- 35 PASSED WITHIN THE DEFINITION OF THE PRACTICE OF NATUROPATHIC MEDICINE 36 UNDER SECTIONS SIXTY-EIGHT HUNDRED FIFTY-TWO AND SIXTY-EIGHT HUNDRED 37 FIFTY-FOUR OF THIS ARTICLE ARE LIMITED BY THE PROHIBITIONS, BOUNDARIES, 38 AND RESTRICTIONS OF THIS SECTION. 39 1. THE PRACTICE OF THE PROFESSION OF NATUROPATHIC MEDICINE DOES NOT 40 INCLUDE: ADMINISTERING OR PRESCRIBING CONTROLLED SUBSTANCES; ADMINIS- 41 TERING INVASIVE PROCEDURES; ADMINISTERING ELECTROCONVULSIVE THERAPY; 42 ADMINISTERING NEEDLE-TYPE ELECTROMYOGRAPHY; PERFORMING SURGERY OTHER 43 THAN CRYOTHERAPY, LIGATION AND FULGURATION; ADMINISTERING RADIOLOGICAL 44 PROCEDURES USING IONIZING RADIATION ABOVE BACKGROUND LEVELS; ADMINISTER- 45 ING GENERAL OR SPINAL ANESTHETIC DRUGS; ADMINISTERING OBSTETRIC SERVICES 46 OTHER THAN COMPLEMENTARY NATUROPATHIC PRENATAL AND POSTNATAL WELLNESS 47 CARE; ADMINISTERING ACUPUNCTURE; AND SETTING FRACTURES. 48 2. A. (I) IT SHALL BE DEEMED PRACTICING OUTSIDE THE BOUNDARIES OF 49 PROFESSIONAL COMPETENCE FOR A NATUROPATHIC DOCTOR TO PROVIDE EMERGENCY 50 CARE SERVICES FOR TREATING INJURIES OR TRAUMA FROM A SERIOUS ACCIDENT OR 51 A VIOLENT CRIME, EXCEPT AS PERMITTED BY ARTICLE 30 OF THE PUBLIC HEALTH 52 LAW OF NEW YORK. 53 (II) IT SHALL BE DEEMED PROFESSIONAL MISCONDUCT FOR A NATUROPATHIC 54 DOCTOR TO HOLD HERSELF OR HIMSELF OUT AS PROVIDING EMERGENCY CARE 55 SERVICES ON A CONTINUED SUSTAINED BASIS; OR TO TREAT AN ACUTE EMERGENT S. 4917 9 1 CONDITION OF SIGNIFICANT THREAT TO LIFE OR LIMB WITHOUT ALSO SUMMONING 2 EMERGENCY MEDICAL RESPONSE. 3 B. (I) IT SHALL BE DEEMED PRACTICING OUTSIDE THE BOUNDARIES OF PROFES- 4 SIONAL COMPETENCE FOR A NATUROPATHIC DOCTOR TO ADMINISTER PHYSICAL NATU- 5 ROPATHY ON A PATIENT ON A CONTINUED SUSTAINED BASIS UNDER EITHER OF THE 6 FOLLOWING CIRCUMSTANCES: TO ASSIST THE PATIENT TO COMPENSATE FOR DEVEL- 7 OPMENTAL DEFICITS AFFECTING PHYSICAL MOVEMENT AND MOBILITY THAT CANNOT 8 BE REVERSED; AND TO RESTORE, FOR PURPOSES OF PATIENT REINTEGRATION BACK 9 INTO THE HOME, COMMUNITY, OR WORK, SOME OR ALL OF THE PATIENT'S PATHOME- 10 CHANICAL DEFICITS AFFECTING PHYSICAL MOVEMENT AND MOBILITY THAT WERE 11 LOST DUE TO INJURY OR DISEASE CAUSING ONGOING SEPARATION FROM HOME, 12 COMMUNITY OR WORK. 13 (II) A NATUROPATHIC DOCTOR MAY CORRECT VERTEBRAL ALIGNMENT USING 14 VERTEBRAL ADJUSTMENT IN COMBINATION WITH NATUROPATHIC MUSCLE RELEASE 15 TECHNIQUES AND SOFT TISSUE MANIPULATION WITHIN A MULTIMODAL HOLISTIC 16 TREATMENT PLAN, BUT OTHERWISE MAY NOT PRACTICE VERTEBRAL ADJUSTMENT. 17 C. FOR PATIENTS HAVING SYMPTOMATIC, INTELLECTUALLY, SOCIALLY OR 18 EMOTIONALLY MALADAPTIVE BEHAVIOR SUFFICIENT TO BE A MENTAL, EMOTIONAL, 19 COGNITIVE, ADDICTIVE OR BEHAVIORAL DISORDER AS PER DSM (DIAGNOSTIC AND 20 STATISTICAL MANUAL OF MENTAL DISORDERS) CRITERIA OR AN EQUIVALENT THERE- 21 OF, OR PER DIAGNOSIS BY A QUALIFIED HEALTHCARE PROVIDER, IT SHALL BE 22 DEEMED PRACTICING OUTSIDE THE BOUNDARIES OF PROFESSIONAL COMPETENCE FOR 23 A NATUROPATHIC DOCTOR TO FACILITATE CHANGES IN THE PATIENT'S PERSONALITY 24 AND BEHAVIOR FOR THE PURPOSE OF ELIMINATING SUCH SYMPTOMATIC MALADAPTIVE 25 BEHAVIOR CORRESPONDING TO SUCH DISORDER THROUGH THE USE OF VERBAL, 26 COGNITIVE, AND EMOTIONAL INTERPERSONAL COMMUNICATION METHODS OF 27 PSYCHOTHERAPEUTIC INTERVENTION ON A CONTINUED SUSTAINED BASIS. SUCH 28 RESTRICTION ON PSYCHOTHERAPEUTIC INTERVENTION DOES NOT RESTRICT A NATU- 29 ROPATHIC DOCTOR FROM PROVIDING DIETARY AND LIFESTYLE ADVICE AND 30 INSTRUCTIONS TO THE PATIENT, NOR FROM EDUCATING THE PATIENT ABOUT THEIR 31 CIRCUMSTANCES OF HEALTH AND ILLNESS. SUCH RESTRICTION ON PSYCHOTHERAPEU- 32 TIC INTERVENTION EXCLUDES HYPNOTHERAPY APPLIED AS PART OF A MULTIMODE 33 HOLISTIC TREATMENT PLAN (E.G., NUTRIENT THERAPY AND HYPNOTHERAPY) TO 34 TREAT TOBACCO ADDICTION OR OBESITY. ALTHOUGH A NATUROPATHIC DOCTOR 35 CANNOT PROVIDE A PSYCHOLOGICAL DIAGNOSIS, A NATUROPATHIC DOCTOR MAY 36 APPLY AND DOCUMENT SUCH DSM OR EQUIVALENT CRITERIA, OR THE ABSENCE THER- 37 EOF TO DISCERN THIS BOUNDARY OF PROFESSIONAL COMPETENCE, WHICH DISCERN- 38 MENT SHALL DEFER TO A DIAGNOSIS BY A QUALIFIED HEALTHCARE PROVIDER. 39 D. ALTHOUGH THE IDENTIFICATION OF AN ILLNESS IS PART OF A NATUROPATHIC 40 ASSESSMENT, A NATUROPATHIC DOCTOR MAY NOT EQUATE SUCH ASSESSMENT TO A 41 MEDICAL OR PSYCHOLOGICAL DIAGNOSIS, NOR HOLD HIMSELF OR HERSELF OUT AS 42 MAKING A MEDICAL OR PSYCHOLOGICAL DIAGNOSIS. A NATUROPATHIC DOCTOR, 43 HOWEVER, MAY USE COMMON DIAGNOSTIC CODES (E.G., ICD-10 CODES; DSM-V 44 CODES) AND MAY REFER TO AN IDENTIFIED ILLNESS IN DISCUSSIONS WITH THE 45 PATIENT, IN PATIENT HEALTH RECORDS, AND IN COMMUNICATIONS COMPLIANT WITH 46 THE FEDERAL HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 47 (HIPAA). 48 3. WHILE THE SCOPE OF ACTIVITIES INCLUDED WITHIN THE PRACTICE OF NATU- 49 ROPATHIC MEDICINE OVERLAPS IN PART WITH OTHER PROFESSIONS LICENSED UNDER 50 THIS TITLE, A NATUROPATHIC DOCTOR'S ACTIVITIES ARE TO BE PERFORMED WITH- 51 IN A HOLISTIC FRAMEWORK OF ASSESSING AND TREATING MULTIPLE ASPECTS OF 52 THE PATIENT, AS INFORMED BY THE NATUROPATHIC PRINCIPLES AND THE THERA- 53 PEUTIC ORDER. IN THE PERFORMANCE OF ANY OVERLAPPING SCOPE ACTIVITIES, 54 THE NATUROPATHIC DOCTOR SHALL NOT HOLD HERSELF OR HIMSELF OUT AS PRAC- 55 TICING ANY SUCH OTHER PROFESSION OR USE A TITLE OF ANY SUCH OTHER 56 PROFESSION, UNLESS OTHERWISE AUTHORIZED UNDER THIS TITLE. S. 4917 10 1 S 6856. STATE BOARD FOR NATUROPATHIC MEDICINE. 1. A STATE BOARD FOR 2 NATUROPATHIC MEDICINE SHALL BE APPOINTED BY THE BOARD OF REGENTS ON THE 3 RECOMMENDATION OF THE COMMISSIONER FOR THE PURPOSE OF ASSISTING THE 4 BOARD OF REGENTS AND THE DEPARTMENT ON MATTERS OF PROFESSIONAL LICENSING 5 AND PROFESSIONAL CONDUCT IN ACCORDANCE WITH SECTION SIXTY-FIVE HUNDRED 6 EIGHT OF THIS TITLE. THE BOARD SHALL BE COMPOSED OF TWO PUBLIC REPRESEN- 7 TATIVES WHO DO NOT HOLD INTERESTS IN THE ORGANIZATION, FINANCING OR 8 DELIVERY OF NATUROPATHIC SERVICES, ONE LICENSED PHYSICIAN WHO IS A 9 DOCTOR OF MEDICINE OR A DOCTOR OF OSTEOPATHY, AND NOT LESS THAN SIX 10 NATUROPATHIC DOCTORS. A NATUROPATHIC DOCTOR MEMBER OF THE BOARD SHALL 11 HAVE BEEN LICENSED UNDER THIS ARTICLE FOR AT LEAST TWO YEARS PRIOR TO 12 BEING APPOINTED, WHICH TWO YEAR LICENSE REQUIREMENT IS WAIVED FOR THE 13 INITIAL BOARD AND REPLACED WITH A REQUIREMENT THAT THE NATUROPATHIC 14 DOCTOR OBTAIN A LICENSE UNDER THIS ARTICLE WITHIN ONE YEAR OF APPOINT- 15 MENT OR ONE YEAR OF THE EFFECTIVE DATE OF THIS ARTICLE, WHICHEVER COMES 16 LATER. THE TERMS OF THE FIRST APPOINTED MEMBERS SHALL BE STAGGERED SO 17 THAT THREE ARE APPOINTED FOR THREE YEARS, THREE ARE APPOINTED FOR FOUR 18 YEARS, AND FOUR ARE APPOINTED FOR FIVE YEARS. AN EXECUTIVE SECRETARY OF 19 THE BOARD SHALL BE APPOINTED BY THE BOARD OF REGENTS ON THE RECOMMENDA- 20 TION OF THE COMMISSIONER. 21 2. EXAMINATIONS SELECTED OR PREPARED BY THE BOARD PURSUANT TO SUBDIVI- 22 SION TWO OF SECTION SIXTY-FIVE HUNDRED EIGHT OF THIS TITLE SHALL CONFORM 23 WHENEVER POSSIBLE TO NATIONALLY RECOGNIZED TEST DEVELOPMENT STANDARDS 24 AND TEST COMPETENCIES FOR NATUROPATHIC MEDICINE. 25 S 6857. QUALIFICATIONS FOR LICENSURE. TO QUALIFY FOR A LICENSE TO 26 PRACTICE THE PROFESSION OF NATUROPATHIC MEDICINE, AN APPLICANT SHALL 27 FULFILL THE FOLLOWING REQUIREMENTS: 28 1. FILE AN APPLICATION WITH THE DEPARTMENT; 29 2. HAVE RECEIVED AN EDUCATION, INCLUDING A DOCTORAL DEGREE IN NATURO- 30 PATHIC MEDICINE, GRANTED ON THE BASIS OF COMPLETION OF A PROGRAM OF 31 NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE SUBSTANTIAL 32 EQUIVALENT THEREOF, IN ACCORDANCE WITH THE COMMISSIONER'S REGULATIONS; 33 3. FOR APPLICANTS APPLYING MORE THAN TWO YEARS AFTER THE EFFECTIVE 34 DATE OF THIS ARTICLE, HAVE SATISFACTORILY COMPLETED A POST-GRADUATE 35 RESIDENCY PROGRAM OF NATUROPATHIC MEDICINE OF AT LEAST TWELVE MONTHS 36 DURATION APPROVED BY THE DEPARTMENT, OR THE SUBSTANTIAL EQUIVALENT THER- 37 EOF, AND IN ACCORDANCE WITH THE COMMISSIONER'S REGULATIONS; 38 4. PASS AN EXAMINATION SATISFACTORY TO THE BOARD AND IN ACCORDANCE 39 WITH THE COMMISSIONER'S REGULATIONS; 40 5. BE AT LEAST TWENTY-ONE YEARS OF AGE; 41 6. BE OF GOOD MORAL CHARACTER AS DETERMINED BY THE DEPARTMENT; AND 42 7. PAY A FEE OF THREE HUNDRED FIFTY DOLLARS TO THE DEPARTMENT FOR AN 43 INITIAL LICENSE AND A FEE OF FIVE HUNDRED DOLLARS FOR EACH TRIENNIAL 44 REGISTRATION PERIOD. 45 S 6858. SPECIAL CONDITIONS. 1. AN APPLICANT HAVING RECEIVED, PRIOR TO 46 NINETEEN HUNDRED EIGHTY-EIGHT, AN EDUCATION, INCLUDING A DOCTORAL DEGREE 47 IN NATUROPATHIC MEDICINE, GRANTED ON THE BASIS OF COMPLETION OF A 48 PROGRAM OF NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE 49 SUBSTANTIAL EQUIVALENT THEREOF, MAY SUBSTITUTE FOR THE EXPERIENCE AND 50 EXAMINATION QUALIFICATIONS OF SECTION SIXTY-EIGHT HUNDRED FIFTY-SEVEN OF 51 THIS ARTICLE, EITHER OF: (I) SATISFACTORY EVIDENCE OF PRACTICE OF NATU- 52 ROPATHIC MEDICINE OF NOT LESS THAN THREE YEARS DURING THE FIVE YEARS 53 PRECEDING THE FILING OF THE APPLICATION; OR (II) PRACTICE UNDER A LIMIT- 54 ED PERMIT FOR AT LEAST TWO OF THE THREE YEARS PRIOR TO APPLICATION UNDER 55 THIS ARTICLE. S. 4917 11 1 2. AN APPLICANT HAVING RECEIVED, PRIOR TO TWO YEARS AFTER THE EFFEC- 2 TIVE DATE OF THIS ARTICLE, AN EDUCATION, INCLUDING A DOCTORAL DEGREE IN 3 NATUROPATHIC MEDICINE, GRANTED ON THE BASIS OF COMPLETION OF A PROGRAM 4 OF NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE SUBSTAN- 5 TIAL EQUIVALENT THEREOF, MAY SUBSTITUTE FOR THE EXPERIENCE QUALIFICATION 6 OF SECTION SIXTY-EIGHT HUNDRED FIFTY-SEVEN OF THIS ARTICLE, EITHER OF: 7 (I) SATISFACTORY EVIDENCE OF PRACTICE OF NATUROPATHIC MEDICINE OF NOT 8 LESS THAN THREE YEARS DURING THE FIVE YEARS PRECEDING THE FILING OF THE 9 APPLICATION; OR (II) PRACTICE UNDER A LIMITED PERMIT FOR AT LEAST TWO OF 10 THE THREE YEARS PRIOR TO APPLICATION UNDER THIS ARTICLE. 11 3. THE "PRACTICE OF NATUROPATHIC MEDICINE" AS USED IN THIS SECTION 12 INCLUDES THE PRACTICE OF NATUROPATHY OR NATUROPATHIC MEDICINE IN A STATE 13 OR TERRITORY OF THE UNITED STATES, INCLUDING NEW YORK STATE, OR A CANA- 14 DIAN PROVINCE, WHILE MAINTAINING A PROFESSIONAL LICENSE IN NATUROPATHY 15 OR NATUROPATHIC MEDICINE ISSUED BY THE SAME OR ANOTHER STATE OR TERRITO- 16 RY OR A CANADIAN PROVINCE; AND INCLUDES PRACTICE PERFORMED BEFORE AND 17 AFTER THE EFFECTIVE DATE OF THIS ARTICLE. 18 4. PRACTICE DEMONSTRATED BY SATISFACTORY EVIDENCE OF PRACTICE OR BY A 19 LIMITED PERMIT, AS PROVIDED IN SUBDIVISIONS ONE AND TWO OF THIS SECTION, 20 MUST BE COMPLETE WITHIN EIGHTEEN YEARS AFTER THE EFFECTIVE DATE OF THIS 21 ARTICLE. APPLICANTS HAVING COMPLETED THE PRACTICE REQUIREMENTS OF A 22 SPECIAL CONDITION UNDER THIS SECTION MUST SUBMIT AN APPLICATION FOR 23 LICENSE BY NINETEEN YEARS AFTER THE EFFECTIVE DATE OF THIS ARTICLE AND 24 MUST CURE DEFECTS, IF ANY, IN THE APPLICATION AS IDENTIFIED BY THE 25 DEPARTMENT WITHIN A TIME PERIOD INDICATED BY THE DEPARTMENT. 26 S 6859. EXEMPT PERSONS AND EXEMPTIONS. NOTHING CONTAINED IN THIS ARTI- 27 CLE SHALL BE CONSTRUED TO AFFECT OR PREVENT THE FOLLOWING: 28 1. A. A LICENSED PHYSICIAN FROM PRACTICING HIS OR HER PROFESSION AS 29 DEFINED IN ARTICLES ONE HUNDRED THIRTY-ONE, AS ADDED BY CHAPTER NINE 30 HUNDRED EIGHTY-SEVEN OF THE LAWS OF NINETEEN SEVENTY-ONE, AND ONE 31 HUNDRED THIRTY-ONE-B OF THIS TITLE; A REGISTERED PROFESSIONAL NURSE OR A 32 CERTIFIED NURSE PRACTITIONER PRACTICING HIS OR HER PROFESSION AS DEFINED 33 UNDER ARTICLE ONE HUNDRED THIRTY-NINE OF THIS TITLE; OR 34 B. QUALIFIED MEMBERS OF OTHER PROFESSIONS LICENSED UNDER THIS TITLE 35 FROM PERFORMING THE PRACTICE OF THEIR PROFESSIONS; EXCEPT THAT SUCH 36 PERSONS MAY NOT HOLD THEMSELVES OUT UNDER THE TITLE NATUROPATH OR NATU- 37 ROPATHIC DOCTOR, OR AS PERFORMING NATUROPATHY OR NATUROPATHIC MEDICINE. 38 2. A STUDENT FROM ENGAGING IN CLINICAL PRACTICE UNDER SUPERVISION OF A 39 LICENSED NATUROPATHIC DOCTOR AS PART OF A PROGRAM OF NATUROPATHIC MEDI- 40 CINE REGISTERED BY THE DEPARTMENT OR THE SUBSTANTIAL EQUIVALENT THEREOF. 41 3. THE PRACTICE OF NATUROPATHIC MEDICINE BY A SALARIED EMPLOYEE OF THE 42 GOVERNMENT OF THE UNITED STATES WHILE THE INDIVIDUAL IS ENGAGED IN THE 43 PERFORMANCE OF DUTIES PRESCRIBED BY THE LAWS AND REGULATIONS OF THE 44 UNITED STATES. 45 4. THE DOMESTIC CARE OF THE SICK, DISABLED OR INJURED BY ANY FAMILY 46 MEMBER, HOUSEHOLD MEMBER OR FRIEND, OR PERSON EMPLOYED PRIMARILY IN A 47 DOMESTIC CAPACITY WHO DOES NOT HOLD HIMSELF OR HERSELF OUT, OR ACCEPT 48 EMPLOYMENT AS A PERSON LICENSED TO PRACTICE NATUROPATHIC MEDICINE UNDER 49 THE PROVISIONS OF THIS ARTICLE. 50 5. THE CARE OF THE SICK WHEN DONE IN CONNECTION WITH THE PRACTICE OF 51 THE RELIGIOUS TENETS OF ANY CHURCH. 52 6. THE MARKETING, SALE OR USE OF SUBSTANCES OR DEVICES GOVERNED BY THE 53 FEDERAL FOOD, DRUG, AND COSMETIC ACT THAT DO NOT REQUIRE A PRESCRIPTION 54 FROM A QUALIFIED HEALTHCARE PROVIDER. 55 7. THE CONDUCT, ACTIVITIES, OR SERVICES OF INDIVIDUALS, CHURCHES, 56 SCHOOLS, TEACHERS, ORGANIZATIONS, OR NOT-FOR-PROFIT BUSINESSES IN S. 4917 12 1 PROVIDING INSTRUCTION, ADVICE, SUPPORT, ENCOURAGEMENT, OR INFORMATION TO 2 INDIVIDUALS, FAMILIES, AND RELATIONAL GROUPS. 3 S 6860. LIMITED RESIDENCY PERMITS. 1. FOR ISSUANCE OF A LIMITED RESI- 4 DENCY PERMIT, THE APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS: 5 A. FILE AN APPLICATION WITH THE DEPARTMENT; 6 B. HAVE RECEIVED AN EDUCATION, INCLUDING A DOCTORAL DEGREE IN NATURO- 7 PATHIC MEDICINE, GRANTED ON THE BASIS OF COMPLETION OF A PROGRAM OF 8 NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE SUBSTANTIAL 9 EQUIVALENT THEREOF; 10 C. HAVE BEEN ACCEPTED INTO A POST-GRADUATE RESIDENCY PROGRAM OF NATU- 11 ROPATHIC MEDICINE APPROVED BY THE DEPARTMENT; 12 D. BE OF GOOD MORAL CHARACTER AS DETERMINED BY THE DEPARTMENT; 13 E. BE AT LEAST TWENTY-ONE YEARS OF AGE; AND 14 F. PAY A FEE TO THE DEPARTMENT OF ONE HUNDRED DOLLARS, OR FOR A 15 RENEWAL A FEE OF FIFTY DOLLARS. 16 2. SUCH PERMIT SHALL ALLOW THE PERMIT HOLDER TO PERFORM SUCH ACTIV- 17 ITIES THAT ARE REQUIRED FOR SUCCESSFUL COMPLETION OF THE RESIDENCY 18 PROGRAM UNDER THE ADMINISTRATIVE SUPERVISION OF A LICENSED NATUROPATHIC 19 DOCTOR SERVING AS THE RESIDENCY DIRECTOR. PRACTICE ACTIVITIES UNDER A 20 LIMITED RESIDENCY PERMIT SHALL BE LIMITED TO FACILITIES ENCOMPASSED BY 21 THE POST-GRADUATE RESIDENCY PROGRAM OF THE PERMIT HOLDER, SUCH AS A 22 HOSPITAL, AN INCORPORATED HOSPITAL OR CLINIC, A LICENSED PROPRIETARY 23 HOSPITAL, A LICENSED NURSING HOME, A PUBLIC HEALTH AGENCY, A RECOGNIZED 24 PUBLIC OR NON-PUBLIC SCHOOL SETTING, THE OFFICE OF A LICENSED NATURO- 25 PATHIC DOCTOR, OR IN THE CIVIL SERVICE OF THE STATE OR POLITICAL SUBDI- 26 VISION THEREOF. PRACTICE SUPERVISION OF A PERMIT HOLDER'S PRACTICE 27 ACTIVITIES SHALL BE ON-SITE SUPERVISION BY A LICENSED NATUROPATHIC 28 DOCTOR, EXCEPT FOR INJECTION THERAPY PROCEDURES, WHICH SHALL BE DIRECT 29 PERSONAL SUPERVISION BY A LICENSED PHYSICIAN OR A LICENSED NATUROPATHIC 30 DOCTOR HAVING INJECTION THERAPY PRIVILEGE. "DIRECT PERSONAL SUPERVISION" 31 FOR THE PURPOSES OF THIS SECTION MEANS SUPERVISION OF A PROCEDURE FOR 32 INJECTION THERAPY BASED ON INSTRUCTIONS GIVEN DIRECTLY BY THE SUPERVIS- 33 ING PHYSICIAN OR SUPERVISING NATUROPATHIC DOCTOR WHO REMAINS ON SITE 34 WHEN AND WHERE THE PROCEDURE IS BEING PERFORMED, BUT SHALL NOT BE 35 CONSTRUED AS NECESSARILY REQUIRING THE PHYSICAL PRESENCE OF THE SUPER- 36 VISING PHYSICIAN OR SUPERVISING NATUROPATHIC DOCTOR IN THE IMMEDIATE 37 AREA AT THE TIME WHEN THE INJECTION THERAPY PROCEDURE IS PERFORMED. 38 3. SUCH PERMIT SHALL BE ISSUED FOR ONE YEAR AND MAY BE RENEWED AT THE 39 DISCRETION OF THE DEPARTMENT FOR ONE OR TWO ADDITIONAL YEARS WHEN NECES- 40 SARY TO PERMIT THE COMPLETION OF AN APPROVED POST-GRADUATE RESIDENCY IN 41 NATUROPATHIC MEDICINE. 42 S 6861. LIMITED PERMITS. 1. FOR ISSUANCE OF A LIMITED PERMIT, THE 43 APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS: 44 A. FILE AN APPLICATION WITH THE DEPARTMENT; 45 B. HAVE RECEIVED AN EDUCATION, INCLUDING A DOCTORAL DEGREE IN NATURO- 46 PATHIC MEDICINE, GRANTED ON THE BASIS OF COMPLETION OF A PROGRAM OF 47 NATUROPATHIC MEDICINE REGISTERED WITH THE DEPARTMENT OR THE SUBSTANTIAL 48 EQUIVALENT THEREOF; 49 C. INDICATE EXERCISING OPTION TO ATTAIN QUALIFICATIONS FOR LICENSURE 50 USING A LIMITED PERMIT SPECIAL CONDITION UNDER SECTION SIXTY-EIGHT 51 HUNDRED FIFTY-EIGHT OF THIS ARTICLE; 52 D. BE OF GOOD MORAL CHARACTER AS DETERMINED BY THE DEPARTMENT; 53 E. BE AT LEAST TWENTY-ONE YEARS OF AGE; AND 54 F. PAY A FEE OF TWO HUNDRED DOLLARS TO THE DEPARTMENT. 55 2. SUCH LIMITED PERMIT SHALL AUTHORIZE THE PRACTICE OF NATUROPATHIC 56 MEDICINE ONLY UNDER THE SUPERVISION OF A LICENSED NATUROPATHIC DOCTOR. S. 4917 13 1 SUPERVISION OF THE LIMITED PERMIT HOLDER'S PRACTICE ACTIVITIES SHALL BE 2 ON-SITE SUPERVISION BY A LICENSED NATUROPATHIC DOCTOR. 3 3. A LIMITED PERMIT SHALL BE ISSUED FOR A PERIOD OF TWO YEARS, AND MAY 4 BE RENEWED UNDER CIRCUMSTANCES AND FOR A TIME PERIOD AND FEE IN ACCORD- 5 ANCE WITH THE COMMISSIONER'S REGULATIONS. 6 4. THE LAST DAY FOR APPLYING FOR A LIMITED PERMIT UNDER THIS SECTION 7 IS FIFTEEN YEARS AFTER THE EFFECTIVE DATE OF THIS SECTION. 8 S 6862. MANDATORY CONTINUING EDUCATION. 1. A. EACH NATUROPATHIC DOCTOR 9 LICENSED PURSUANT TO THIS ARTICLE, REQUIRED TO REGISTER TRIENNIALLY WITH 10 THE DEPARTMENT TO PRACTICE IN THIS STATE SHALL COMPLY WITH THE 11 PROVISIONS OF THE MANDATORY CONTINUING EDUCATION REQUIREMENTS PRESCRIBED 12 IN SUBDIVISION TWO OF THIS SECTION, EXCEPT AS PROVIDED IN PARAGRAPHS B 13 AND C OF THIS SUBDIVISION. NATUROPATHIC DOCTORS WHO DO NOT SATISFY THE 14 MANDATORY CONTINUING EDUCATION REQUIREMENTS SHALL NOT PRACTICE UNTIL 15 THEY HAVE MET SUCH REQUIREMENTS, AND THEY HAVE BEEN ISSUED A REGISTRA- 16 TION CERTIFICATE, EXCEPT THAT A NATUROPATHIC DOCTOR MAY PRACTICE WITHOUT 17 HAVING MET SUCH REQUIREMENTS IF HE OR SHE IS ISSUED A CONDITIONAL REGIS- 18 TRATION PURSUANT TO SUBDIVISION THREE OF THIS SECTION. 19 B. NATUROPATHIC DOCTORS SHALL BE EXEMPT FROM THE MANDATORY CONTINUING 20 EDUCATION REQUIREMENT FOR THE TRIENNIAL REGISTRATION PERIOD DURING WHICH 21 THEY ARE FIRST LICENSED. IN ACCORD WITH THE INTENT OF THIS SECTION, 22 ADJUSTMENTS TO THE MANDATORY CONTINUING EDUCATION REQUIREMENTS MAY BE 23 GRANTED BY THE DEPARTMENT FOR REASONS OF HEALTH CERTIFIED BY AN APPRO- 24 PRIATE HEALTH CARE PROFESSIONAL, FOR EXTENDED ACTIVE DUTY WITH THE ARMED 25 FORCES OF THE UNITED STATES, OR FOR OTHER GOOD CAUSE ACCEPTABLE TO THE 26 DEPARTMENT, WHICH MAY PREVENT COMPLIANCE. 27 C. A LICENSED NATUROPATHIC DOCTOR NOT ENGAGED IN PROFESSIONAL PRAC- 28 TICE, AS DETERMINED BY THE DEPARTMENT, SHALL BE EXEMPT FROM THE MANDATO- 29 RY CONTINUING EDUCATION REQUIREMENT UPON THE FILING OF A STATEMENT WITH 30 THE DEPARTMENT DECLARING SUCH STATUS. ANY LICENSEE WHO RETURNS TO THE 31 PRACTICE OF NATUROPATHIC MEDICINE DURING THE TRIENNIAL REGISTRATION 32 PERIOD SHALL NOTIFY THE DEPARTMENT PRIOR TO REENTERING THE PROFESSION 33 AND SHALL MEET SUCH MANDATORY EDUCATION REQUIREMENTS AS SHALL BE 34 PRESCRIBED BY REGULATIONS OF THE COMMISSIONER. 35 2. DURING EACH TRIENNIAL REGISTRATION PERIOD AN APPLICANT FOR REGIS- 36 TRATION SHALL COMPLETE SIXTY HOURS OF ACCEPTABLE FORMAL CONTINUING 37 EDUCATION. ANY LICENSED NATUROPATHIC DOCTOR WHOSE FIRST REGISTRATION 38 DATE FOLLOWING THE EFFECTIVE DATE OF THIS SECTION OCCURS LESS THAN THREE 39 YEARS FROM SUCH EFFECTIVE DATE, SHALL COMPLETE CONTINUING EDUCATION 40 HOURS ON A PRORATED BASIS AT THE RATE OF ONE AND ONE-HALF HOURS PER 41 MONTH FOR THE NUMBER OF MONTHS BETWEEN THE EFFECTIVE DATE AND THE FIRST 42 REGISTRATION DATE. THEREAFTER, A LICENSEE WHO HAS NOT SATISFIED THE 43 MANDATORY CONTINUING EDUCATION REQUIREMENTS SHALL NOT BE ISSUED A TRIEN- 44 NIAL REGISTRATION CERTIFICATE BY THE DEPARTMENT AND SHALL NOT PRACTICE 45 UNLESS AND UNTIL A CONDITIONAL REGISTRATION CERTIFICATE IS ISSUED AS 46 PROVIDED IN SUBDIVISION THREE OF THIS SECTION. THE INDIVIDUAL LICENSEE 47 SHALL DETERMINE THE SELECTION OF COURSES OR PROGRAMS OF STUDY PURSUANT 48 TO SUBDIVISION FOUR OF THIS SECTION. CONTINUING EDUCATION HOURS TAKEN 49 DURING ONE TRIENNIUM MAY NOT BE CARRIED OVER OR OTHERWISE CREDITED OR 50 TRANSFERRED TO A SUBSEQUENT TRIENNIUM. 51 3. THE DEPARTMENT, IN ITS DISCRETION, MAY ISSUE A CONDITIONAL REGIS- 52 TRATION TO A LICENSEE WHO FAILS TO MEET THE CONTINUING EDUCATION 53 REQUIREMENTS ESTABLISHED IN SUBDIVISION TWO OF THIS SECTION BUT WHO 54 AGREES TO MAKE UP ANY DEFICIENCIES AND TAKE ANY ADDITIONAL EDUCATION 55 WHICH THE DEPARTMENT MAY REQUIRE. THE FEE FOR SUCH A CONDITIONAL REGIS- 56 TRATION SHALL BE THE SAME AS, AND IN ADDITION TO, THE FEE FOR THE TRIEN- S. 4917 14 1 NIAL REGISTRATION. THE DURATION OF SUCH CONDITIONAL REGISTRATION SHALL 2 BE DETERMINED BY THE DEPARTMENT BUT SHALL NOT EXCEED ONE YEAR. ANY 3 LICENSEE WHO IS NOTIFIED OF THE DENIAL OF REGISTRATION FOR FAILURE TO 4 COMPLETE THE REQUIRED CONTINUED EDUCATION AND WHO CONTINUES TO PRACTICE 5 NATUROPATHIC MEDICINE WITHOUT SUCH REGISTRATION, SHALL BE SUBJECT TO 6 DISCIPLINARY PROCEEDINGS PURSUANT TO SECTION SIXTY-FIVE HUNDRED TEN OF 7 THIS TITLE. 8 4. AS USED IN THIS SECTION, "ACCEPTABLE FORMAL CONTINUING EDUCATION" 9 SHALL MEAN FORMAL PROGRAMS OF LEARNING WHICH CONTAIN SUBJECT MATTER 10 WHICH MEET THE FOLLOWING REQUIREMENTS: CONTRIBUTES TO THE ENHANCEMENT OF 11 PROFESSIONAL AND CLINICAL SKILLS OF THE NATUROPATHIC DOCTOR; MEETS THE 12 STANDARDS PRESCRIBED BY REGULATIONS OF THE COMMISSIONER IN CONSULTATION 13 WITH THE BOARD TO FULFILL THE MANDATORY CONTINUING EDUCATION REQUIRE- 14 MENT; AND IS SPONSORED OR PRESENTED BY A STATE OR A CANADIAN PROVINCE 15 NATUROPATHIC MEDICINE PROFESSIONAL ORGANIZATION ACCEPTABLE TO THE 16 DEPARTMENT, A UNITED STATES OR CANADIAN NATIONAL NATUROPATHIC MEDICINE 17 PROFESSIONAL ORGANIZATION ACCEPTABLE TO THE DEPARTMENT, AN INSTITUTION 18 OF HIGHER LEARNING HAVING AN ACCREDITATION ACCEPTABLE TO THE DEPARTMENT, 19 OR ANOTHER SPONSOR APPROVED BY THE DEPARTMENT, PURSUANT TO THE REGU- 20 LATION OF THE COMMISSIONER. CONTINUING EDUCATION COURSES MUST BE TAKEN 21 FROM A PROVIDER WHO HAS BEEN APPROVED BY THE DEPARTMENT, BASED UPON AN 22 APPLICATION AND FEE, PURSUANT TO THE REGULATIONS OF THE COMMISSIONER. 23 THE DEPARTMENT MAY, IN ITS DISCRETION AND AS NEEDED TO CONTRIBUTE TO THE 24 HEALTH AND WELFARE OF THE PUBLIC, REQUIRE THE COMPLETION OF CONTINUING 25 EDUCATION ACTIVITIES IN SPECIFIC SUBJECTS TO FULFILL THIS MANDATORY 26 CONTINUING EDUCATION REQUIREMENT. 27 5. LICENSED NATUROPATHIC DOCTORS SHALL MAINTAIN ADEQUATE DOCUMENTATION 28 OF COMPLETION OF ACCEPTABLE FORMAL CONTINUING EDUCATION AND SHALL 29 PROVIDE SUCH DOCUMENTATION TO THE DEPARTMENT UPON REQUEST. FAILURE TO 30 PROVIDE SUCH DOCUMENTATION UPON REQUEST OF THE DEPARTMENT SHALL BE AN 31 ACT OF MISCONDUCT SUBJECT TO DISCIPLINARY PROCEEDINGS PURSUANT TO 32 SECTION SIXTY-FIVE HUNDRED TEN OF THIS TITLE. 33 6. THE MANDATORY CONTINUING EDUCATION FEE SHALL BE FIFTY DOLLARS, 34 SHALL BE PAYABLE ON OR BEFORE THE FIRST DAY OF EACH TRIENNIAL REGISTRA- 35 TION PERIOD, AND SHALL BE IN ADDITION TO THE TRIENNIAL REGISTRATION FEE 36 REQUIRED BY SECTION SIXTY-EIGHT HUNDRED FIFTY-SEVEN OF THIS ARTICLE. 37 S 3. Subdivision (a) of section 1203 of the limited liability company 38 law, as amended by chapter 554 of the laws of 2013, is amended to read 39 as follows: 40 (a) Notwithstanding the education law or any other provision of law, 41 one or more professionals each of whom is authorized by law to render a 42 professional service within the state, or one or more professionals, at 43 least one of whom is authorized by law to render a professional service 44 within the state, may form, or cause to be formed, a professional 45 service limited liability company for pecuniary profit under this arti- 46 cle for the purpose of rendering the professional service or services as 47 such professionals are authorized to practice. With respect to a profes- 48 sional service limited liability company formed to provide medical 49 services as such services are defined in article 131 of the education 50 law, each member of such limited liability company must be licensed 51 pursuant to article 131 of the education law to practice medicine in 52 this state. WITH RESPECT TO A PROFESSIONAL SERVICE LIMITED LIABILITY 53 COMPANY FORMED TO PROVIDE NATUROPATHIC SERVICES AS SUCH SERVICES ARE 54 DEFINED IN ARTICLE 138 OF THE EDUCATION LAW, EACH MEMBER OF SUCH LIMITED 55 LIABILITY COMPANY MUST BE LICENSED PURSUANT TO ARTICLE 138 OF THE EDUCA- 56 TION LAW TO PRACTICE NATUROPATHY IN THIS STATE. With respect to a S. 4917 15 1 professional service limited liability company formed to provide dental 2 services as such services are defined in article 133 of the education 3 law, each member of such limited liability company must be licensed 4 pursuant to article 133 of the education law to practice dentistry in 5 this state. With respect to a professional service limited liability 6 company formed to provide veterinary services as such services are 7 defined in article 135 of the education law, each member of such limited 8 liability company must be licensed pursuant to article 135 of the educa- 9 tion law to practice veterinary medicine in this state. With respect to 10 a professional service limited liability company formed to provide 11 professional engineering, land surveying, architectural and/or landscape 12 architectural services as such services are defined in article 145, 13 article 147 and article 148 of the education law, each member of such 14 limited liability company must be licensed pursuant to article 145, 15 article 147 and/or article 148 of the education law to practice one or 16 more of such professions in this state. With respect to a professional 17 service limited liability company formed to provide licensed clinical 18 social work services as such services are defined in article 154 of the 19 education law, each member of such limited liability company shall be 20 licensed pursuant to article 154 of the education law to practice 21 licensed clinical social work in this state. With respect to a profes- 22 sional service limited liability company formed to provide creative arts 23 therapy services as such services are defined in article 163 of the 24 education law, each member of such limited liability company must be 25 licensed pursuant to article 163 of the education law to practice crea- 26 tive arts therapy in this state. With respect to a professional service 27 limited liability company formed to provide marriage and family therapy 28 services as such services are defined in article 163 of the education 29 law, each member of such limited liability company must be licensed 30 pursuant to article 163 of the education law to practice marriage and 31 family therapy in this state. With respect to a professional service 32 limited liability company formed to provide mental health counseling 33 services as such services are defined in article 163 of the education 34 law, each member of such limited liability company must be licensed 35 pursuant to article 163 of the education law to practice mental health 36 counseling in this state. With respect to a professional service limited 37 liability company formed to provide psychoanalysis services as such 38 services are defined in article 163 of the education law, each member of 39 such limited liability company must be licensed pursuant to article 163 40 of the education law to practice psychoanalysis in this state. With 41 respect to a professional service limited liability company formed to 42 provide applied behavior analysis services as such services are defined 43 in article 167 of the education law, each member of such limited liabil- 44 ity company must be licensed or certified pursuant to article 167 of the 45 education law to practice applied behavior analysis in this state. In 46 addition to engaging in such profession or professions, a professional 47 service limited liability company may engage in any other business or 48 activities as to which a limited liability company may be formed under 49 section two hundred one of this chapter. Notwithstanding any other 50 provision of this section, a professional service limited liability 51 company (i) authorized to practice law may only engage in another 52 profession or business or activities or (ii) which is engaged in a 53 profession or other business or activities other than law may only 54 engage in the practice of law, to the extent not prohibited by any other 55 law of this state or any rule adopted by the appropriate appellate divi- 56 sion of the supreme court or the court of appeals. S. 4917 16 1 S 3-a. Subdivision (a) of section 1203 of the limited liability compa- 2 ny law, as amended by chapter 475 of the laws of 2014, is amended to 3 read as follows: 4 (a) Notwithstanding the education law or any other provision of law, 5 one or more professionals each of whom is authorized by law to render a 6 professional service within the state, or one or more professionals, at 7 least one of whom is authorized by law to render a professional service 8 within the state, may form, or cause to be formed, a professional 9 service limited liability company for pecuniary profit under this arti- 10 cle for the purpose of rendering the professional service or services as 11 such professionals are authorized to practice. With respect to a 12 professional service limited liability company formed to provide medical 13 services as such services are defined in article 131 of the education 14 law, each member of such limited liability company must be licensed 15 pursuant to article 131 of the education law to practice medicine in 16 this state. WITH RESPECT TO A PROFESSIONAL SERVICE LIMITED LIABILITY 17 COMPANY FORMED TO PROVIDE NATUROPATHIC SERVICES AS SUCH SERVICES ARE 18 DEFINED IN ARTICLE 138 OF THE EDUCATION LAW, EACH MEMBER OF SUCH LIMITED 19 LIABILITY COMPANY MUST BE LICENSED PURSUANT TO ARTICLE 138 OF THE EDUCA- 20 TION LAW TO PRACTICE NATUROPATHY IN THIS STATE. With respect to a 21 professional service limited liability company formed to provide dental 22 services as such services are defined in article 133 of the education 23 law, each member of such limited liability company must be licensed 24 pursuant to article 133 of the education law to practice dentistry in 25 this state. With respect to a professional service limited liability 26 company formed to provide veterinary services as such services are 27 defined in article 135 of the education law, each member of such limited 28 liability company must be licensed pursuant to article 135 of the educa- 29 tion law to practice veterinary medicine in this state. With respect to 30 a professional service limited liability company formed to provide 31 professional engineering, land surveying, architectural, landscape 32 architectural and/or geological services as such services are defined in 33 article 145, article 147 and article 148 of the education law, each 34 member of such limited liability company must be licensed pursuant to 35 article 145, article 147 and/or article 148 of the education law to 36 practice one or more of such professions in this state. With respect to 37 a professional service limited liability company formed to provide 38 licensed clinical social work services as such services are defined in 39 article 154 of the education law, each member of such limited liability 40 company shall be licensed pursuant to article 154 of the education law 41 to practice licensed clinical social work in this state. With respect to 42 a professional service limited liability company formed to provide crea- 43 tive arts therapy services as such services are defined in article 163 44 of the education law, each member of such limited liability company must 45 be licensed pursuant to article 163 of the education law to practice 46 creative arts therapy in this state. With respect to a professional 47 service limited liability company formed to provide marriage and family 48 therapy services as such services are defined in article 163 of the 49 education law, each member of such limited liability company must be 50 licensed pursuant to article 163 of the education law to practice 51 marriage and family therapy in this state. With respect to a profes- 52 sional service limited liability company formed to provide mental health 53 counseling services as such services are defined in article 163 of the 54 education law, each member of such limited liability company must be 55 licensed pursuant to article 163 of the education law to practice mental 56 health counseling in this state. With respect to a professional service S. 4917 17 1 limited liability company formed to provide psychoanalysis services as 2 such services are defined in article 163 of the education law, each 3 member of such limited liability company must be licensed pursuant to 4 article 163 of the education law to practice psychoanalysis in this 5 state. With respect to a professional service limited liability company 6 formed to provide applied behavior analysis services as such services 7 are defined in article 167 of the education law, each member of such 8 limited liability company must be licensed or certified pursuant to 9 article 167 of the education law to practice applied behavior analysis 10 in this state. In addition to engaging in such profession or 11 professions, a professional service limited liability company may engage 12 in any other business or activities as to which a limited liability 13 company may be formed under section two hundred one of this chapter. 14 Notwithstanding any other provision of this section, a professional 15 service limited liability company (i) authorized to practice law may 16 only engage in another profession or business or activities or (ii) 17 which is engaged in a profession or other business or activities other 18 than law may only engage in the practice of law, to the extent not 19 prohibited by any other law of this state or any rule adopted by the 20 appropriate appellate division of the supreme court or the court of 21 appeals. 22 S 4. Subdivision (b) of section 1207 of the limited liability company 23 law, as amended by chapter 554 of the laws of 2013, is amended to read 24 as follows: 25 (b) With respect to a professional service limited liability company 26 formed to provide medical services as such services are defined in arti- 27 cle 131 of the education law, each member of such limited liability 28 company must be licensed pursuant to article 131 of the education law to 29 practice medicine in this state. WITH RESPECT TO A PROFESSIONAL SERVICE 30 LIMITED LIABILITY COMPANY FORMED TO PROVIDE NATUROPATHIC SERVICES AS 31 SUCH SERVICES ARE DEFINED IN ARTICLE 138 OF THE EDUCATION LAW, EACH 32 MEMBER OF SUCH LIMITED LIABILITY COMPANY MUST BE LICENSED PURSUANT TO 33 ARTICLE 138 OF THE EDUCATION LAW TO PRACTICE NATUROPATHY IN THIS STATE. 34 With respect to a professional service limited liability company formed 35 to provide dental services as such services are defined in article 133 36 of the education law, each member of such limited liability company must 37 be licensed pursuant to article 133 of the education law to practice 38 dentistry in this state. With respect to a professional service limited 39 liability company formed to provide veterinary services as such services 40 are defined in article 135 of the education law, each member of such 41 limited liability company must be licensed pursuant to article 135 of 42 the education law to practice veterinary medicine in this state. With 43 respect to a professional service limited liability company formed to 44 provide professional engineering, land surveying, architectural and/or 45 landscape architectural services as such services are defined in article 46 145, article 147 and article 148 of the education law, each member of 47 such limited liability company must be licensed pursuant to article 145, 48 article 147 and/or article 148 of the education law to practice one or 49 more of such professions in this state. With respect to a professional 50 service limited liability company formed to provide licensed clinical 51 social work services as such services are defined in article 154 of the 52 education law, each member of such limited liability company shall be 53 licensed pursuant to article 154 of the education law to practice 54 licensed clinical social work in this state. With respect to a profes- 55 sional service limited liability company formed to provide creative arts 56 therapy services as such services are defined in article 163 of the S. 4917 18 1 education law, each member of such limited liability company must be 2 licensed pursuant to article 163 of the education law to practice crea- 3 tive arts therapy in this state. With respect to a professional service 4 limited liability company formed to provide marriage and family therapy 5 services as such services are defined in article 163 of the education 6 law, each member of such limited liability company must be licensed 7 pursuant to article 163 of the education law to practice marriage and 8 family therapy in this state. With respect to a professional service 9 limited liability company formed to provide mental health counseling 10 services as such services are defined in article 163 of the education 11 law, each member of such limited liability company must be licensed 12 pursuant to article 163 of the education law to practice mental health 13 counseling in this state. With respect to a professional service limited 14 liability company formed to provide psychoanalysis services as such 15 services are defined in article 163 of the education law, each member of 16 such limited liability company must be licensed pursuant to article 163 17 of the education law to practice psychoanalysis in this state. With 18 respect to a professional service limited liability company formed to 19 provide applied behavior analysis services as such services are defined 20 in article 167 of the education law, each member of such limited liabil- 21 ity company must be licensed or certified pursuant to article 167 of the 22 education law to practice applied behavior analysis in this state. 23 S 4-a. Subdivision (b) of section 1207 of the limited liability compa- 24 ny law, as amended by chapter 475 of the laws of 2014, is amended to 25 read as follows: 26 (b) With respect to a professional service limited liability company 27 formed to provide medical services as such services are defined in arti- 28 cle 131 of the education law, each member of such limited liability 29 company must be licensed pursuant to article 131 of the education law to 30 practice medicine in this state. WITH RESPECT TO A PROFESSIONAL SERVICE 31 LIMITED LIABILITY COMPANY FORMED TO PROVIDE NATUROPATHIC SERVICES AS 32 SUCH SERVICES ARE DEFINED IN ARTICLE 138 OF THE EDUCATION LAW, EACH 33 MEMBER OF SUCH LIMITED LIABILITY COMPANY MUST BE LICENSED PURSUANT TO 34 ARTICLE 138 OF THE EDUCATION LAW TO PRACTICE NATUROPATHY IN THIS STATE. 35 With respect to a professional service limited liability company formed 36 to provide dental services as such services are defined in article 133 37 of the education law, each member of such limited liability company must 38 be licensed pursuant to article 133 of the education law to practice 39 dentistry in this state. With respect to a professional service limited 40 liability company formed to provide veterinary services as such services 41 are defined in article 135 of the education law, each member of such 42 limited liability company must be licensed pursuant to article 135 of 43 the education law to practice veterinary medicine in this state. With 44 respect to a professional service limited liability company formed to 45 provide professional engineering, land surveying, architectural, land- 46 scape architectural and/or geological services as such services are 47 defined in article 145, article 147 and article 148 of the education 48 law, each member of such limited liability company must be licensed 49 pursuant to article 145, article 147 and/or article 148 of the education 50 law to practice one or more of such professions in this state. With 51 respect to a professional service limited liability company formed to 52 provide licensed clinical social work services as such services are 53 defined in article 154 of the education law, each member of such limited 54 liability company shall be licensed pursuant to article 154 of the 55 education law to practice licensed clinical social work in this state. 56 With respect to a professional service limited liability company formed S. 4917 19 1 to provide creative arts therapy services as such services are defined 2 in article 163 of the education law, each member of such limited liabil- 3 ity company must be licensed pursuant to article 163 of the education 4 law to practice creative arts therapy in this state. With respect to a 5 professional service limited liability company formed to provide 6 marriage and family therapy services as such services are defined in 7 article 163 of the education law, each member of such limited liability 8 company must be licensed pursuant to article 163 of the education law to 9 practice marriage and family therapy in this state. With respect to a 10 professional service limited liability company formed to provide mental 11 health counseling services as such services are defined in article 163 12 of the education law, each member of such limited liability company must 13 be licensed pursuant to article 163 of the education law to practice 14 mental health counseling in this state. With respect to a professional 15 service limited liability company formed to provide psychoanalysis 16 services as such services are defined in article 163 of the education 17 law, each member of such limited liability company must be licensed 18 pursuant to article 163 of the education law to practice psychoanalysis 19 in this state. With respect to a professional service limited liability 20 company formed to provide applied behavior analysis services as such 21 services are defined in article 167 of the education law, each member of 22 such limited liability company must be licensed or certified pursuant to 23 article 167 of the education law to practice applied behavior analysis 24 in this state. 25 S 5. Subdivision (a) of section 1301 of the limited liability company 26 law, as amended by chapter 554 of the laws of 2013, is amended to read 27 as follows: 28 (a) "Foreign professional service limited liability company" means a 29 professional service limited liability company, whether or not denomi- 30 nated as such, organized under the laws of a jurisdiction other than 31 this state, (i) each of whose members and managers, if any, is a profes- 32 sional authorized by law to render a professional service within this 33 state and who is or has been engaged in the practice of such profession 34 in such professional service limited liability company or a predecessor 35 entity, or will engage in the practice of such profession in the profes- 36 sional service limited liability company within thirty days of the date 37 such professional becomes a member, or each of whose members and manag- 38 ers, if any, is a professional at least one of such members is author- 39 ized by law to render a professional service within this state and who 40 is or has been engaged in the practice of such profession in such 41 professional service limited liability company or a predecessor entity, 42 or will engage in the practice of such profession in the professional 43 service limited liability company within thirty days of the date such 44 professional becomes a member, or (ii) authorized by, or holding a 45 license, certificate, registration or permit issued by the licensing 46 authority pursuant to, the education law to render a professional 47 service within this state; except that all members and managers, if any, 48 of a foreign professional service limited liability company that 49 provides health services in this state shall be licensed in this state. 50 WITH RESPECT TO A PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY FORMED 51 TO PROVIDE NATUROPATHIC SERVICES AS SUCH SERVICES ARE DEFINED IN ARTICLE 52 138 OF THE EDUCATION LAW, EACH MEMBER OF SUCH LIMITED LIABILITY COMPANY 53 MUST BE LICENSED PURSUANT TO ARTICLE 138 OF THE EDUCATION LAW TO PRAC- 54 TICE NATUROPATHY IN THIS STATE. With respect to a foreign professional 55 service limited liability company which provides veterinary services as 56 such services are defined in article 135 of the education law, each S. 4917 20 1 member of such foreign professional service limited liability company 2 shall be licensed pursuant to article 135 of the education law to prac- 3 tice veterinary medicine. With respect to a foreign professional service 4 limited liability company which provides medical services as such 5 services are defined in article 131 of the education law, each member of 6 such foreign professional service limited liability company must be 7 licensed pursuant to article 131 of the education law to practice medi- 8 cine in this state. With respect to a foreign professional service 9 limited liability company which provides dental services as such 10 services are defined in article 133 of the education law, each member of 11 such foreign professional service limited liability company must be 12 licensed pursuant to article 133 of the education law to practice 13 dentistry in this state. With respect to a foreign professional service 14 limited liability company which provides professional engineering, land 15 surveying, architectural and/or landscape architectural services as such 16 services are defined in article 145, article 147 and article 148 of the 17 education law, each member of such foreign professional service limited 18 liability company must be licensed pursuant to article 145, article 147 19 and/or article 148 of the education law to practice one or more of such 20 professions in this state. With respect to a foreign professional 21 service limited liability company which provides licensed clinical 22 social work services as such services are defined in article 154 of the 23 education law, each member of such foreign professional service limited 24 liability company shall be licensed pursuant to article 154 of the 25 education law to practice clinical social work in this state. With 26 respect to a foreign professional service limited liability company 27 which provides creative arts therapy services as such services are 28 defined in article 163 of the education law, each member of such foreign 29 professional service limited liability company must be licensed pursuant 30 to article 163 of the education law to practice creative arts therapy in 31 this state. With respect to a foreign professional service limited 32 liability company which provides marriage and family therapy services as 33 such services are defined in article 163 of the education law, each 34 member of such foreign professional service limited liability company 35 must be licensed pursuant to article 163 of the education law to prac- 36 tice marriage and family therapy in this state. With respect to a 37 foreign professional service limited liability company which provides 38 mental health counseling services as such services are defined in arti- 39 cle 163 of the education law, each member of such foreign professional 40 service limited liability company must be licensed pursuant to article 41 163 of the education law to practice mental health counseling in this 42 state. With respect to a foreign professional service limited liability 43 company which provides psychoanalysis services as such services are 44 defined in article 163 of the education law, each member of such foreign 45 professional service limited liability company must be licensed pursuant 46 to article 163 of the education law to practice psychoanalysis in this 47 state. With respect to a foreign professional service limited liability 48 company which provides applied behavior analysis services as such 49 services are defined in article 167 of the education law, each member of 50 such foreign professional service limited liability company must be 51 licensed or certified pursuant to article 167 of the education law to 52 practice applied behavior analysis in this state. 53 S 5-a. Subdivision (a) of section 1301 of the limited liability compa- 54 ny law, as amended by chapter 475 of the laws of 2014, is amended to 55 read as follows: S. 4917 21 1 (a) "Foreign professional service limited liability company" means a 2 professional service limited liability company, whether or not denomi- 3 nated as such, organized under the laws of a jurisdiction other than 4 this state, (i) each of whose members and managers, if any, is a profes- 5 sional authorized by law to render a professional service within this 6 state and who is or has been engaged in the practice of such profession 7 in such professional service limited liability company or a predecessor 8 entity, or will engage in the practice of such profession in the profes- 9 sional service limited liability company within thirty days of the date 10 such professional becomes a member, or each of whose members and manag- 11 ers, if any, is a professional at least one of such members is author- 12 ized by law to render a professional service within this state and who 13 is or has been engaged in the practice of such profession in such 14 professional service limited liability company or a predecessor entity, 15 or will engage in the practice of such profession in the professional 16 service limited liability company within thirty days of the date such 17 professional becomes a member, or (ii) authorized by, or holding a 18 license, certificate, registration or permit issued by the licensing 19 authority pursuant to, the education law to render a professional 20 service within this state; except that all members and managers, if any, 21 of a foreign professional service limited liability company that 22 provides health services in this state shall be licensed in this state. 23 WITH RESPECT TO A PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY FORMED 24 TO PROVIDE NATUROPATHIC SERVICES AS SUCH SERVICES ARE DEFINED IN ARTICLE 25 138 OF THE EDUCATION LAW, EACH MEMBER OF SUCH LIMITED LIABILITY COMPANY 26 MUST BE LICENSED PURSUANT TO ARTICLE 138 OF THE EDUCATION LAW TO PRAC- 27 TICE NATUROPATHY IN THIS STATE. With respect to a foreign professional 28 service limited liability company which provides veterinary services as 29 such services are defined in article 135 of the education law, each 30 member of such foreign professional service limited liability company 31 shall be licensed pursuant to article 135 of the education law to prac- 32 tice veterinary medicine. With respect to a foreign professional service 33 limited liability company which provides medical services as such 34 services are defined in article 131 of the education law, each member of 35 such foreign professional service limited liability company must be 36 licensed pursuant to article 131 of the education law to practice medi- 37 cine in this state. With respect to a foreign professional service 38 limited liability company which provides dental services as such 39 services are defined in article 133 of the education law, each member of 40 such foreign professional service limited liability company must be 41 licensed pursuant to article 133 of the education law to practice 42 dentistry in this state. With respect to a foreign professional service 43 limited liability company which provides professional engineering, land 44 surveying, geologic, architectural and/or landscape architectural 45 services as such services are defined in article 145, article 147 and 46 article 148 of the education law, each member of such foreign profes- 47 sional service limited liability company must be licensed pursuant to 48 article 145, article 147 and/or article 148 of the education law to 49 practice one or more of such professions in this state. With respect to 50 a foreign professional service limited liability company which provides 51 licensed clinical social work services as such services are defined in 52 article 154 of the education law, each member of such foreign profes- 53 sional service limited liability company shall be licensed pursuant to 54 article 154 of the education law to practice clinical social work in 55 this state. With respect to a foreign professional service limited 56 liability company which provides creative arts therapy services as such S. 4917 22 1 services are defined in article 163 of the education law, each member of 2 such foreign professional service limited liability company must be 3 licensed pursuant to article 163 of the education law to practice crea- 4 tive arts therapy in this state. With respect to a foreign professional 5 service limited liability company which provides marriage and family 6 therapy services as such services are defined in article 163 of the 7 education law, each member of such foreign professional service limited 8 liability company must be licensed pursuant to article 163 of the educa- 9 tion law to practice marriage and family therapy in this state. With 10 respect to a foreign professional service limited liability company 11 which provides mental health counseling services as such services are 12 defined in article 163 of the education law, each member of such foreign 13 professional service limited liability company must be licensed pursuant 14 to article 163 of the education law to practice mental health counseling 15 in this state. With respect to a foreign professional service limited 16 liability company which provides psychoanalysis services as such 17 services are defined in article 163 of the education law, each member of 18 such foreign professional service limited liability company must be 19 licensed pursuant to article 163 of the education law to practice 20 psychoanalysis in this state. With respect to a foreign professional 21 service limited liability company which provides applied behavior analy- 22 sis services as such services are defined in article 167 of the educa- 23 tion law, each member of such foreign professional service limited 24 liability company must be licensed or certified pursuant to article 167 25 of the education law to practice applied behavior analysis in this 26 state. 27 S 6. Subdivision (q) of section 121-1500 of the partnership law, as 28 amended by chapter 554 of the laws of 2013, is amended to read as 29 follows: 30 (q) Each partner of a registered limited liability partnership formed 31 to provide medical services in this state must be licensed pursuant to 32 article 131 of the education law to practice medicine in this state and 33 each partner of a registered limited liability partnership formed to 34 provide dental services in this state must be licensed pursuant to arti- 35 cle 133 of the education law to practice dentistry in this state. EACH 36 PARTNER OF A REGISTERED LIMITED LIABILITY PARTNERSHIP FORMED TO PROVIDE 37 NATUROPATHIC SERVICES IN THIS STATE MUST BE LICENSED PURSUANT TO ARTICLE 38 138 OF THE EDUCATION LAW TO PRACTICE NATUROPATHY IN THIS STATE. Each 39 partner of a registered limited liability partnership formed to provide 40 veterinary services in this state must be licensed pursuant to article 41 135 of the education law to practice veterinary medicine in this state. 42 Each partner of a registered limited liability partnership formed to 43 provide professional engineering, land surveying, architectural and/or 44 landscape architectural services in this state must be licensed pursuant 45 to article 145, article 147 and/or article 148 of the education law to 46 practice one or more of such professions in this state. Each partner of 47 a registered limited liability partnership formed to provide licensed 48 clinical social work services in this state must be licensed pursuant to 49 article 154 of the education law to practice clinical social work in 50 this state. Each partner of a registered limited liability partnership 51 formed to provide creative arts therapy services in this state must be 52 licensed pursuant to article 163 of the education law to practice crea- 53 tive arts therapy in this state. Each partner of a registered limited 54 liability partnership formed to provide marriage and family therapy 55 services in this state must be licensed pursuant to article 163 of the 56 education law to practice marriage and family therapy in this state. S. 4917 23 1 Each partner of a registered limited liability partnership formed to 2 provide mental health counseling services in this state must be licensed 3 pursuant to article 163 of the education law to practice mental health 4 counseling in this state. Each partner of a registered limited liability 5 partnership formed to provide psychoanalysis services in this state must 6 be licensed pursuant to article 163 of the education law to practice 7 psychoanalysis in this state. Each partner of a registered limited 8 liability partnership formed to provide applied behavior analysis 9 service in this state must be licensed or certified pursuant to article 10 167 of the education law to practice applied behavior analysis in this 11 state. 12 S 6-a. Subdivision (q) of section 121-1500 of the partnership law, as 13 amended by chapter 475 of the laws of 2014, is amended to read as 14 follows: 15 (q) Each partner of a registered limited liability partnership formed 16 to provide medical services in this state must be licensed pursuant to 17 article 131 of the education law to practice medicine in this state and 18 each partner of a registered limited liability partnership formed to 19 provide dental services in this state must be licensed pursuant to arti- 20 cle 133 of the education law to practice dentistry in this state. EACH 21 PARTNER OF A REGISTERED LIMITED LIABILITY PARTNERSHIP FORMED TO PROVIDE 22 NATUROPATHIC SERVICES IN THIS STATE MUST BE LICENSED PURSUANT TO ARTICLE 23 138 OF THE EDUCATION LAW TO PRACTICE NATUROPATHY IN THIS STATE. Each 24 partner of a registered limited liability partnership formed to provide 25 veterinary services in this state must be licensed pursuant to article 26 135 of the education law to practice veterinary medicine in this state. 27 Each partner of a registered limited liability partnership formed to 28 provide professional engineering, land surveying, geological services, 29 architectural and/or landscape architectural services in this state must 30 be licensed pursuant to article 145, article 147 and/or article 148 of 31 the education law to practice one or more of such professions in this 32 state. Each partner of a registered limited liability partnership formed 33 to provide licensed clinical social work services in this state must be 34 licensed pursuant to article 154 of the education law to practice clin- 35 ical social work in this state. Each partner of a registered limited 36 liability partnership formed to provide creative arts therapy services 37 in this state must be licensed pursuant to article 163 of the education 38 law to practice creative arts therapy in this state. Each partner of a 39 registered limited liability partnership formed to provide marriage and 40 family therapy services in this state must be licensed pursuant to arti- 41 cle 163 of the education law to practice marriage and family therapy in 42 this state. Each partner of a registered limited liability partnership 43 formed to provide mental health counseling services in this state must 44 be licensed pursuant to article 163 of the education law to practice 45 mental health counseling in this state. Each partner of a registered 46 limited liability partnership formed to provide psychoanalysis services 47 in this state must be licensed pursuant to article 163 of the education 48 law to practice psychoanalysis in this state. Each partner of a regis- 49 tered limited liability partnership formed to provide applied behavior 50 analysis service in this state must be licensed or certified pursuant to 51 article 167 of the education law to practice applied behavior analysis 52 in this state. 53 S 7. Subdivision (q) of section 121-1502 of the partnership law, as 54 amended by chapter 554 of the laws of 2013, is amended to read as 55 follows: S. 4917 24 1 (q) Each partner of a foreign limited liability partnership which 2 provides medical services in this state must be licensed pursuant to 3 article 131 of the education law to practice medicine in the state and 4 each partner of a foreign limited liability partnership which provides 5 dental services in the state must be licensed pursuant to article 133 of 6 the education law to practice dentistry in this state. EACH PARTNER OF 7 A FOREIGN LIMITED LIABILITY PARTNERSHIP WHICH PROVIDES NATUROPATHIC 8 SERVICES IN THIS STATE MUST BE LICENSED PURSUANT TO ARTICLE 138 OF THE 9 EDUCATION LAW TO PRACTICE NATUROPATHY IN THIS STATE. Each partner of a 10 foreign limited liability partnership which provides veterinary service 11 in the state shall be licensed pursuant to article 135 of the education 12 law to practice veterinary medicine in this state. Each partner of a 13 foreign limited liability partnership which provides professional engi- 14 neering, land surveying, architectural and/or landscape architectural 15 services in this state must be licensed pursuant to article 145, article 16 147 and/or article 148 of the education law to practice one or more of 17 such professions. Each partner of a foreign limited liability partner- 18 ship which provides licensed clinical social work services in this state 19 must be licensed pursuant to article 154 of the education law to prac- 20 tice licensed clinical social work in this state. Each partner of a 21 foreign limited liability partnership which provides creative arts ther- 22 apy services in this state must be licensed pursuant to article 163 of 23 the education law to practice creative arts therapy in this state. Each 24 partner of a foreign limited liability partnership which provides 25 marriage and family therapy services in this state must be licensed 26 pursuant to article 163 of the education law to practice marriage and 27 family therapy in this state. Each partner of a foreign limited liabil- 28 ity partnership which provides mental health counseling services in this 29 state must be licensed pursuant to article 163 of the education law to 30 practice mental health counseling in this state. Each partner of a 31 foreign limited liability partnership which provides psychoanalysis 32 services in this state must be licensed pursuant to article 163 of the 33 education law to practice psychoanalysis in this state. Each partner of 34 a foreign limited liability partnership which provides applied behavior 35 analysis services in this state must be licensed or certified pursuant 36 to article 167 of the education law to practice applied behavior analy- 37 sis in this state. 38 S 7-a. Subdivision (q) of section 121-1500 of the partnership law, as 39 amended by chapter 475 of the laws of 2014, is amended to read as 40 follows: 41 (q) Each partner of a foreign limited liability partnership which 42 provides medical services in this state must be licensed pursuant to 43 article 131 of the education law to practice medicine in the state and 44 each partner of a foreign limited liability partnership which provides 45 dental services in the state must be licensed pursuant to article 133 of 46 the education law to practice dentistry in this state. EACH PARTNER OF A 47 FOREIGN LIMITED LIABILITY PARTNERSHIP WHICH PROVIDES NATUROPATHIC 48 SERVICES IN THIS STATE MUST BE LICENSED PURSUANT TO ARTICLE 138 OF THE 49 EDUCATION LAW TO PRACTICE NATUROPATHY IN THIS STATE. Each partner of a 50 foreign limited liability partnership which provides veterinary service 51 in the state shall be licensed pursuant to article 135 of the education 52 law to practice veterinary medicine in this state. Each partner of a 53 foreign limited liability partnership which provides professional engi- 54 neering, land surveying, geological services, architectural and/or land- 55 scape architectural services in this state must be licensed pursuant to 56 article 145, article 147 and/or article 148 of the education law to S. 4917 25 1 practice one or more of such professions. Each partner of a foreign 2 limited liability partnership which provides licensed clinical social 3 work services in this state must be licensed pursuant to article 154 of 4 the education law to practice licensed clinical social work in this 5 state. Each partner of a foreign limited liability partnership which 6 provides creative arts therapy services in this state must be licensed 7 pursuant to article 163 of the education law to practice creative arts 8 therapy in this state. Each partner of a foreign limited liability part- 9 nership which provides marriage and family therapy services in this 10 state must be licensed pursuant to article 163 of the education law to 11 practice marriage and family therapy in this state. Each partner of a 12 foreign limited liability partnership which provides mental health coun- 13 seling services in this state must be licensed pursuant to article 163 14 of the education law to practice mental health counseling in this state. 15 Each partner of a foreign limited liability partnership which provides 16 psychoanalysis services in this state must be licensed pursuant to arti- 17 cle 163 of the education law to practice psychoanalysis in this state. 18 Each partner of a foreign limited liability partnership which provides 19 applied behavior analysis services in this state must be licensed or 20 certified pursuant to article 167 of the education law to practice 21 applied behavior analysis in this state. 22 S 8. Paragraph (a) of subdivision 1 of section 413 of the social 23 services law, as amended by chapter 126 of the laws of 2014, is amended 24 to read as follows: 25 (a) The following persons and officials are required to report or 26 cause a report to be made in accordance with this title when they have 27 reasonable cause to suspect that a child coming before them in their 28 professional or official capacity is an abused or maltreated child, or 29 when they have reasonable cause to suspect that a child is an abused or 30 maltreated child where the parent, guardian, custodian or other person 31 legally responsible for such child comes before them in their profes- 32 sional or official capacity and states from personal knowledge facts, 33 conditions or circumstances which, if correct, would render the child an 34 abused or maltreated child: any physician; registered physician assist- 35 ant; surgeon; medical examiner; coroner; dentist; dental hygienist; 36 osteopath; optometrist; chiropractor; podiatrist; NATUROPATHIC DOCTOR; 37 resident; intern; psychologist; registered nurse; social worker; emer- 38 gency medical technician; licensed creative arts therapist; licensed 39 marriage and family therapist; licensed mental health counselor; 40 licensed psychoanalyst; licensed behavior analyst; certified behavior 41 analyst assistant; hospital personnel engaged in the admission, examina- 42 tion, care or treatment of persons; a Christian Science practitioner; 43 school official, which includes but is not limited to school teacher, 44 school guidance counselor, school psychologist, school social worker, 45 school nurse, school administrator or other school personnel required to 46 hold a teaching or administrative license or certificate; social 47 services worker; director of a children's overnight camp, summer day 48 camp or traveling summer day camp, as such camps are defined in section 49 thirteen hundred ninety-two of the public health law; day care center 50 worker; school-age child care worker; provider of family or group family 51 day care; employee or volunteer in a residential care facility for chil- 52 dren that is licensed, certified or operated by the office of children 53 and family services; or any other child care or foster care worker; 54 mental health professional; substance abuse counselor; alcoholism coun- 55 selor; all persons credentialed by the office of alcoholism and 56 substance abuse services; peace officer; police officer; district attor- S. 4917 26 1 ney or assistant district attorney; investigator employed in the office 2 of a district attorney; or other law enforcement official. 3 S 8-a. Paragraph (a) of subdivision 1 of section 413 of the social 4 services law, as separately amended by chapters 126 and 205 of the laws 5 of 2014, is amended to read as follows: 6 (a) The following persons and officials are required to report or 7 cause a report to be made in accordance with this title when they have 8 reasonable cause to suspect that a child coming before them in their 9 professional or official capacity is an abused or maltreated child, or 10 when they have reasonable cause to suspect that a child is an abused or 11 maltreated child where the parent, guardian, custodian or other person 12 legally responsible for such child comes before them in their profes- 13 sional or official capacity and states from personal knowledge facts, 14 conditions or circumstances which, if correct, would render the child an 15 abused or maltreated child: any physician; registered physician assist- 16 ant; surgeon; medical examiner; coroner; dentist; dental hygienist; 17 osteopath; optometrist; chiropractor; podiatrist; NATUROPATHIC DOCTOR; 18 resident; intern; psychologist; registered nurse; social worker; emer- 19 gency medical technician; licensed creative arts therapist; licensed 20 marriage and family therapist; licensed mental health counselor; 21 licensed psychoanalyst; licensed behavior analyst; certified behavior 22 analyst assistant; hospital personnel engaged in the admission, examina- 23 tion, care or treatment of persons; a Christian Science practitioner; 24 school official, which includes but is not limited to school teacher, 25 school guidance counselor, school psychologist, school social worker, 26 school nurse, school administrator or other school personnel required to 27 hold a teaching or administrative license or certificate; full or part- 28 time compensated school employee required to hold a temporary coaching 29 license or professional coaching certificate; social services worker; 30 director of a children's overnight camp, summer day camp or traveling 31 summer day camp, as such camps are defined in section thirteen hundred 32 ninety-two of the public health law; day care center worker; school-age 33 child care worker; provider of family or group family day care; employee 34 or volunteer in a residential care facility for children that is 35 licensed, certified or operated by the office of children and family 36 services; or any other child care or foster care worker; mental health 37 professional; substance abuse counselor; alcoholism counselor; all 38 persons credentialed by the office of alcoholism and substance abuse 39 services; peace officer; police officer; district attorney or assistant 40 district attorney; investigator employed in the office of a district 41 attorney; or other law enforcement official. 42 S 9. Subdivision 6 of section 571 of the public health law, as amended 43 by chapter 444 of the laws of 2013, is amended to read as follows: 44 6. "Qualified health care professional" means a physician, dentist, 45 podiatrist, NATUROPATHIC DOCTOR, optometrist performing a clinical labo- 46 ratory test that does not use an invasive modality as defined in section 47 seventy-one hundred one of the education law, physician assistant, 48 specialist assistant, nurse practitioner, or midwife, who is licensed 49 and registered with the state education department. 50 S 10. Subdivision 1 of section 585 of the public health law, as added 51 by chapter 803 of the laws of 1992, is amended to read as follows: 52 1. "Health services purveyor" means any person, firm, partnership, 53 group, association, corporation or professional corporation, or any 54 agent, employee, fiduciary, employer or representative thereof, includ- 55 ing but not limited to a physician, dentist, podiatrist, NATUROPATHIC 56 DOCTOR or chiropractor, either in individual practice, group practice or S. 4917 27 1 employed in a facility owned by any person, group, association, firm, 2 partnership or corporation hiring any of the aforementioned practition- 3 ers, who provide health or health related services. 4 S 11. This act shall take effect on the five hundred fortieth day 5 after it shall have become a law; provided however, that: 6 a. section eight of this act shall take effect immediately; provided 7 however that; 8 b. section eight-a of this act shall take effect on the same date and 9 in the same manner as section 1 of chapter 205 of the laws of 2014, 10 takes effect; 11 c. the amendments to subdivision (a) of section 1203 of the limited 12 liability company law made by section three-a of this act shall take 13 effect on the same date and in the same manner as section twenty-one of 14 chapter 475 of the laws of 2014, takes effect; 15 d. the amendments to subdivision (a) of section 1207 of the limited 16 liability company law made by section four-a of this act shall take 17 effect on the same date and in the same manner as section twenty-two of 18 chapter 475 of the laws of 2014, takes effect; 19 e. the amendments to subdivision (a) of section 1301 of the limited 20 liability company law made by section five-a of this act shall take 21 effect on the same date and in the same manner as section twenty-three 22 of chapter 475 of the laws of 2014, takes effect; 23 f. the amendments to subdivision (q) of section 121-1500 of the part- 24 nership law made by section six-a of this act shall take effect on the 25 same date and in the same manner as section twenty-six of chapter 475 of 26 the laws of 2014, takes effect; 27 g. the amendments to subdivision (q) of section 121-1502 of the part- 28 nership law made by section seven-a of this act shall take effect on the 29 same date and in the same manner as section twenty-seven of chapter 475 30 of the laws of 2014, takes effect; 31 h. the provisions of section 6854 of the education law, as added by 32 section two of this act, shall take effect two years after the effective 33 date of this act; 34 i. the provisions of section 6856 of the education law, as added by 35 section two of this act, shall expire and be deemed repealed ten years 36 after the effective date of this act; 37 j. the provisions of sections 6858 and 6861 of the education law, as 38 added by section two of this act, shall expire and be deemed repealed 39 twenty years after the effective date of this act; 40 k. the provisions of section 6862 of the education law, as added by 41 section two of this act, shall take effect three years after the effec- 42 tive date of this act; and 43 l. effective immediately, the addition, amendment and/or repeal of any 44 rule or regulation necessary for the implementation of this act on its 45 effective date is authorized and directed to be made and completed by 46 the commissioner of education and the board of regents on or before such 47 effective date.