PROPOSED
HOUSE OF REPRESENTATIVES AMENDMENTS TO H.B. 2739
(Reference to printed bill)
Strike everything after the enacting clause and insert:
"Section 1. Section 32-1505, Arizona Revised Statutes, is amended to read:
32-1505. Naturopathic physicians medical board fund
A. The naturopathic physicians medical board fund is established. The board shall administer the fund. Pursuant to sections 35-146 and 35-147, the board shall deposit ten per cent percent of all monies from whatever collected pursuant to this chapter, chapter 29 of this title and any other source that come into the possession of the board in the state general fund and deposit the remaining ninety per cent percent in the naturopathic physicians medical board fund.
B. Monies deposited in the naturopathic physicians medical board fund are subject to section 35-143.01.
Sec. 2. Section 32-2901, Arizona Revised Statutes, is amended to read:
32-2901. Definitions
In this chapter, unless the context otherwise requires:
1. "Acupuncture" means a medical therapy in which ailments are diagnosed and treated by the specific application of needles, heat or physical and electromagnetic impulses or currents to specific anatomic points on the body through any of the following:
(a) The diagnosis and treatment of ailments according to the systematic principles of traditional Asian medicine.
(b) The diagnosis and treatment of pain, neuromuscular disorders and other ailments based on the body's biophysics and neuroanatomic structure.
(c) The use of devices to determine the biologic electrical response pattern of acupuncture points as a guide to diagnose bodily ailments and to guide the prescription of homeopathic substances, orthomolecular therapy or pharmaceutical medicine.
2. "Adequate records" means legible medical records that contain at a minimum sufficient information to identify the patient, support the diagnosis, document the treatment, accurately describe the results, indicate advice, cautionary warnings and informed consent discussions with the patient and provide sufficient information for another licensed health care practitioner to assume continuity of the patient's care and to continue or modify the treatment plan.
3. "Approved internship" means that the applicant has completed training in a hospital that was approved for internship, fellowship or residency training by the council on medical education in hospitals of the American medical association, the association of American medical colleges, the royal college of physicians and surgeons of Canada, the American osteopathic association or any board approved board-approved similar body in the United States or Canada that approves hospitals for internship, fellowship or residency training.
4. "Approved school of medicine":
(a) As it relates to a person who is seeking licensure pursuant to section 32-2912, subsection A, means a school or college that offers a course of study that on successful conclusion results in a degree of doctor of medicine or doctor of osteopathic medicine and that offers a course of study that is approved or accredited by the association of American medical colleges, the association of Canadian medical colleges, the American medical association, the American osteopathic association or any board-approved similar body in the United States or Canada that accredits this course of study.
(b) As it relates to a person who is seeking licensure pursuant to section 32-2912, subsection B, means a school or college that on successful completion results in a degree of doctor of homeopathy and that is approved or accredited by the accreditation commission for homeopathic education in North America or any board-approved similar body that accredits this course of study.
5. "Board" means the board of homeopathic and integrated medicine examiners naturopathic physicians medical board established by section 32-1502.
6. "Chelation therapy" means an experimental medical therapy to restore cellular homeostasis through the use of intravenous, metal-binding and bioinorganic agents such as ethylene diamine tetraacetic acid. Chelation therapy is not an experimental therapy if it is used to treat heavy metal poisoning.
7. "Controlled substance" means a drug or substance or a drug's or substance's immediate precursor that is defined or listed in title 36, chapter 27, article 2 or the rules adopted pursuant to title 36, chapter 27, article 2.
8. "Drug" means a medication or substance that is any of the following:
(a) Recognized in the official compendia or for which standards or specifications are prescribed in the official compendia.
(b) Intended for use in the diagnosis, cure, mitigation, treatment or prevention of human diseases.
(c) Articles other than food that are intended to affect the structure or function of the human body.
9. "Homeopathic medication" means a substance of animal, vegetable or mineral origin that is prepared according to homeopathic pharmacology and that is given usually in a homeopathic microdosage.
10. "Homeopathic microdosage" means a substance prepared so that it is diluted from ten to the minus one to ten to the minus ten thousandth or higher of its original concentration.
11. "Homeopathy" means a system of medicine that employs homeopathic medication in accordance with the principle that a substance that produces symptoms in a healthy person can cure those symptoms in an ill person.
12. "Immediate family" means a person's spouse, natural or adopted children, parents and siblings and the natural or adopted children, parents and siblings of the person's spouse.
13. "Letter of concern" means an advisory letter to notify a licensee that, while there is insufficient evidence to support disciplinary action, the board believes the licensee should modify or eliminate certain practices.
14. "Licensee" means a person who is licensed pursuant to this chapter.
15. "Medical assistant" means an unlicensed person who has completed an educational program approved by the board, who assists in a homeopathic practice under the supervision of a doctor of homeopathy and who performs delegated procedures commensurate with the assistant's education and training but who does not diagnose, interpret, design or modify established treatment programs or violate any statute.
16. "Medical incompetence":
(a) Means the lack of sufficient medical knowledge or skill by a licensee to a degree that is likely to endanger a patient's health. Medical incompetence
(b) Includes the range of knowledge expected for basic licensure pursuant to this chapter or as a medical or osteopathic physician in any professional regulatory jurisdiction of the United States and additional knowledge of homeopathic treatments and modalities expected of persons who are licensed pursuant to this chapter.
17. "Minor surgery":
(a) Means surgical procedures that are conducted by a licensee who is licensed pursuant to section 32-2912, subsection A in an outpatient setting and that involve the removal or repair of lesions or injuries to the skin, mucous membranes and subcutaneous tissues, the use of topical, local or regional anesthetic agents, the treatment by stabilizing or casting nondisplaced and uncomplicated fractures of the extremities and diagnostic endoscopies of the intestinal tract, nasopharynx and vagina. Minor surgery also
(b) Includes diagnostic aspiration of joints and subcutaneous cysts, therapeutic injections of muscular trigger points, tendons, ligaments and scars and the subcutaneous implantation of medical therapeutic agents. Minor surgery
(c) Does not include the use of general, spinal or epidural anesthesia, the opening of body cavities, the repair of blood vessels and nerves or the biopsy by incision, excision or needle aspiration of internal organs, the breast or the prostate.
18. "Neuromuscular integration" means musculoskeletal therapy that uses any combination of manual methods, physical agents and physical medicine procedures and devices to improve physiological function by normalizing body structure.
19. "Nutrition" means the recommendation by a licensee of therapeutic or preventative dietary measures, food factor concentrates, fasting and cleansing regimens and the rebalancing by a licensee of digestive system function to correct diseases of malnutrition, to resolve conditions of metabolic imbalance and to support optimal vitality.
20. "Orthomolecular therapy":
(a) Means therapy to provide the optimum concentration of substances normally present in the human body such as vitamins, minerals, amino acids and enzymes. Orthomolecular therapy
(b) Includes the diagnosis of ailments or physiologic stresses that occur as a result of genetic or environmental influences as well as acquired or inherited allergy and hypersensitivity responses.
21. "Pharmaceutical medicine" means a drug therapy that uses prescription-only and nonprescription pharmaceutical agents as well as medicinal agents of botanical, biological or mineral origin and that is based on current scientific indications or traditional or historical usage indications.
22. "Practice of homeopathic medicine":
(a) For the purposes of a person who is licensed pursuant to section 32-2912, subsection A, means the practice of medicine in which a person purports to diagnose, treat or correct real or imagined human diseases, injuries, ailments, infirmities and deformities of a physical or mental origin and includes acupuncture, chelation therapy, homeopathy, minor surgery, neuromuscular integration, nutrition, orthomolecular therapy and pharmaceutical medicine.
(b) For the purposes of a person who is licensed pursuant to section 32-2912, subsection B, means the practice of medicine in which a person purports to diagnose, treat or correct real or imagined human diseases, injuries, ailments, infirmities and deformities of a physical or mental origin by means of homeopathy or nutrition.
23. "Preceptorship" means an extended period of individual study with one or more experienced homeopathic physicians or institutions.
24. "Prescription-only drug" does not include a controlled substance but does include:
(a) A drug that is generally regarded by medical experts to be unsafe if its use and dosage are not supervised by a medical practitioner.
(b) A drug that is approved for use under the supervision of a medical practitioner pursuant to the federal new drug application law or section 32-1962.
(c) A potentially harmful drug if its labeling does not contain full directions for its use by the patient.
(d) A drug that is required by federal law to bear on its label the following words: "Caution: Federal law prohibits dispensing without prescription."
25. "Professional negligence" means any of the following:
(a) That a licensee administers treatment to a patient in a manner that is contrary to accepted practices and that harms the patient if it can be shown to the board's satisfaction that accepted practices are inherently less hazardous.
(b) That a licensee commits an act of unprofessional conduct or displays an unreasonable lack of professional skill or fidelity.
(c) That a licensee's negligence, carelessness or disregard of established principles or practice results in a patient's injury, unnecessary suffering or death.
26. "Special purpose licensing examination" means an examination developed by the national board of medical examiners on behalf of the federation of state medical boards for use by state licensing boards to test the basic medical competence of physicians who are applying for licensure and who have been in practice in another jurisdiction of the United States and to determine the competence of a physician under investigation by a state licensing board.
Sec. 3. Repeal
Sections 32-2902 and 32-2903, Arizona Revised Statutes, are repealed.
Sec. 4. Repeal; transfer of monies
A. Section 32-2906, Arizona Revised Statutes, is repealed.
B. All unexpended and unencumbered monies remaining in the board of homeopathic and integrated medicine examiners' fund established by section 32-2906, Arizona Revised Statutes, as repealed by subsection A of this section, are transferred to the naturopathic physicians medical board fund established by section 32-1505, Arizona Revised Statutes, as amended by this act, on the effective date of this section.
Sec. 5. Section 32-2916, Arizona Revised Statutes, is amended to read:
32-2916. Directory; change of address; civil penalty; fees
A. The board may publish an annual directory containing the following:
1. The names and addresses of the officers and members of the board.
2. The names and addresses of all persons who are certified, licensed or registered by the board.
3. The current certified board rules.
4. A copy of this chapter.
5. A list of approved postgraduate and continuing education courses in the treatment modalities pertinent to the practice of homeopathic medicine.
6. A list of approved schools of medicine.
7. Additional information that the board determines is of interest and importance to licensees.
B. Each licensee shall inform the board in writing of the licensee's home address, home telephone number, office address and office telephone number as requested by the board and within forty-five days of after a change in any of this information. The board shall keep a licensee's home address and home telephone number confidential. The board may assess a licensee who fails to comply with this subsection with the board's costs to locate the licensee. The board may also impose a civil penalty on that licensee of not more than one hundred dollars $100.
C. The board shall provide each licensee with one copy of the directory free of charge. The board may provide additional copies to the public and licensee for a cost of not more than twenty-five dollars $25 for each directory.
D. The board shall deposit, pursuant to sections 35-146 and 35-147, monies collected under this section in the board of homeopathic and integrated medicine examiners' naturopathic physicians medical board fund established by section 32-1505.
Sec. 6. Conforming legislation
The legislative council staff shall prepare proposed legislation conforming the Arizona Revised Statutes to the provisions of this act for consideration in the fifty-seventh legislature, first regular session."
Amend title to conform