SB1163 - 562R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 32-2901, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2901. 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 Diagnosing and treating ailments according to the systematic principles of traditional Asian medicine.

(b) The diagnosis and treatment of Diagnosing and treating pain, neuromuscular disorders and other ailments based on the body's biophysics and neuroanatomic structure.

(c) The use of Using 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 foreign country":

(a) Means Australia, Hong Kong, Canada, Ireland, The United Kingdom, Israel, New Zealand, Singapore, South Africa, India, Switzerland, France or Germany.

(b) Includes any country the board votes to add to the list in subdivision (a) of this paragraph at the board's annual meeting.

3. 4. "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. 5. "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.

6. "Approved training program", for a person who is seeking licensure pursuant to section 32-2912, subsection B, means a program that requires the person to both:

(a) Successfully complete one of the following:

(i) A program that would qualify an applicant to become certified or licensed to practice pursuant to chapter 8, 14, 19 or 39 of this title.

(ii) Training and testing by the United States armed forces at a level comparable to the national standards for emergency medical care technicians.

(iii) A program to receive a degree or other certification from a medical or osteopathic medical school approved by the board in an approved foreign country.

(b) Meet one of the following:

(i) Hold, or pass the examination to hold, a certification from the council for homeopathic certification or its successor as designated by the board.

(ii) Complete a program that is approved or accredited by the accreditation commission for homeopathic education in North America, or its successor organization, or any similar board-approved body that accredits this course of study.

(iii) Complete a program that is approved by the board and that is designed to prepare the person for the practice of homeopathic medicine.

5. 7. "Board" means the board of homeopathic and integrated medicine examiners.

6. 8. "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. 9. "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. 10. "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 diagnosing, curing, mitigating, treating or preventing human diseases.

9. 11. "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. 12. "Homeopathic microdosage" means a substance prepared so that it is diluted from ten to the minus one to ten to the minus ten thousandth ten-thousandth or higher of its original concentration.

11. 13. "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. 14. "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. 15. "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. 16. "Licensee" means a person who is licensed pursuant to this chapter.

15. 17. "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 or doctor of integrated medicine 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. 18. "Medical incompetence" 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 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. 19. "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. 20. "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. 21. "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. 22. "Orthomolecular therapy" 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 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. 23. "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. 24. "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 the 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.

25. "Practice of integrated medicine", for the purposes of a person who is licensed pursuant to section 32-2912, subsection A, means the practice of medicine in which the person purports to diagnose, treat or correct actual or imagined human diseases, injuries, ailments, infirmities and deformities of a physical or mental origin using treatment modalities that include acupuncture, chelation therapy, homeopathy, minor surgery, neuromuscular integration, nutrition, orthomolecular therapy and pharmaceutical medicine.

23. 26. "Preceptorship" means an extended period of individual study with one or more experienced homeopathic physicians or institutions.

24. 27. "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.

(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. 28. "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. 29. "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. END_STATUTE

Sec. 2. Section 32-2903, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2903. Board meetings; organization; compensation

A. The board shall hold an annual meeting each September in Maricopa county. At this meeting the board shall elect from its membership a president, vice-president and secretary-treasurer and a vice president.

B. The board by majority vote may also establish an annual schedule of regular meetings at times and places prescribed by the board.

C. The board may hold a special meeting if the president determines that this is necessary to carry out the board's functions. The vice-president vice president may call a special meeting if the president is unable to do so. At these meetings the board may use communications equipment that allows all participants to hear each other.

D. The executive director shall give each board member ten days' written notice of the date and time of each board meeting. On request of the president, the board by majority vote may waive this notification requirement. If the president is absent, the vice-president vice president may request that the board take this action.

E. A majority of board members constitutes a quorum. However, only a majority of the full board may issue a license.

F. Board members are eligible to receive compensation in the amount of not more than one hundred fifty dollars $150 for each day of actual service in the business of the board. Board members are eligible to receive compensation for all expenses necessarily and properly incurred in attending board meetings.

G. Medical consultants and agents appointed under section 32-2904 are eligible to receive compensation of not more than two hundred dollars $200 for each day of service. END_STATUTE

Sec. 3. Section 32-2904, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2904. Powers and duties

A. The board shall:

1. Conduct all examinations for applicants for a license under this chapter, issue licenses, conduct hearings, regulate the conduct of licensees and administer and enforce this chapter.

2. Enforce the standards of practice prescribed by this chapter and board rules.

3. Collect and account for all fees under this chapter and deposit, pursuant to sections 35-146 and 35-147, the monies in the appropriate fund.

4. Maintain a record of its acts and proceedings, including the issuance, refusal to issue, a license or the issuance, renewal, suspension or revocation of licenses to practice according to this chapter.

5. Maintain a roster of all persons who are licensed pursuant to this chapter that includes:

(a) The licensee's name.

(b) The current professional office address.

(d) Whether the licensee is in good standing.

6. Adopt and use a seal, the imprint of which, together with the signatures of the president or vice-president of the board and the secretary-treasurer, shall is evidence its of the board's official acts.

7. Contract with the department of administration for administrative and record keeping recordkeeping services.

8. Charge additional fees that do not exceed the cost of the services for services the board deems necessary to carry out its intent and purposes.

9. Adopt rules regarding the regulation and the qualifications of medical assistants.

10. Keep board records open to public inspection during normal business hours.

11. Meet each January with the acupuncture board of examiners to set financial compensation for staff and operating expense sharing.

B. The board may:

1. Adopt rules necessary or proper for the administration of to administer this chapter.

2. Subject to title 41, chapter 4, article 4, hire personnel to carry out the purposes of this chapter.

3. Hire investigators subject to title 41, chapter 4, article 4 or contract with investigators to assist in the investigation of investigating violations of this chapter and contract with other state agencies if required to carry out this chapter.

4. Appoint one of its members to the jurisdiction arbitration panel pursuant to section 32-2907, subsection B.

5. Subject to title 41, chapter 4, article 4, employ consultants to perform duties the board determines are necessary to implement this chapter.

6. Appoint from its membership a temporary secretary to perform the duties of the executive director if that office is vacant. The temporary secretary is eligible to receive compensation pursuant to section 38-611.

7. 6. Compile and publish an annual directory.

8. 7. Adopt rules to establish competency or professional review standards for any minor surgical procedure.

9. 8. Appoint two or more board members to a subcommittee that reviews and approves applications and issues permits pertaining to homeopathic medical assistants and associated practical educational programs, pursuant to board rules.

10. 9. Appoint two or more board members to a subcommittee that reviews and approves applications and issues permits pertaining to drugs and device dispensing practices, pursuant to board rules. END_STATUTE

Sec. 4. Section 32-2905, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2905. Executive director; duties

A. Subject to title 41, chapter 4, article 4, the board shall appoint an executive director from outside its membership. The executive director serves at the pleasure of the board and is eligible to receive compensation determined pursuant to section 38-611.

A. The executive director of the acupuncture board of examiners shall serve as the executive director of the board of homeopathic and integrated medicine examiners. The staff of the acupuncture board of examiners shall carry out the administrative responsibilities of the board of homeopathic and integrated medicine examiners.

B. The executive director shall:

1. Collect all monies due and payable to the board.

2. Deposit, pursuant to sections 35-146 and 35-147, all monies received by the board in the appropriate fund.

3. Prepare bills for authorized expenditures of the board and obtain warrants from the department of administration for payment of bills certified by the president or vice-president and secretary-treasurer of the board.

4. Act as custodian of the seal, books, records, minutes and proceedings of the board.

5. Perform all duties prescribed by the board.

6. Perform all administrative duties of the board.

7. Subject to title 41, chapter 4, article 4, employ personnel necessary to carry out board functions. END_STATUTE

Sec. 5. Section 32-2912, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2912. Qualifications of applicant; applications; scope of practice

A. The board shall grant a license to practice pursuant to this chapter to an applicant who meets all of the following requirements:

1. Holds a degree from an approved school of medicine or has received a medical education that the board determines is of equivalent quality.

2. Holds a license in good standing to practice medicine or osteopathic medicine that is issued under chapter 13 or 17 of this title or by another state, district or territory of the United States.

3. Has a professional record that indicates that the applicant has not had a license to practice medicine refused, revoked, suspended or restricted in any way by any state, territory, district or country for reasons that relate to the applicant's ability to competently and safely practice medicine.

4. Has a professional record that indicates that the applicant has not committed any act or engaged in any conduct that would constitute grounds for disciplinary action against a licensee under this chapter.

5. Has the physical and mental capacity to safely engage in the practice of medicine.

6. Pays all fees and costs required by the board.

7. Completes the application required by the board.

B. Notwithstanding subsection A, paragraphs 1 and 2 of this section, the board shall issue a license pursuant to this chapter to an applicant who meets the requirements of subsection A, paragraphs 3, 4, 5, 6 and 7 of this section and who either holds a degree from an approved school of medicine or has completed an approved training program.

C. The board may require an applicant to submit additional written or oral information and may conduct additional investigations if it determines that this is necessary to adequately inform itself of the applicant's ability to meet the requirements of this chapter. If an applicant has had a license revoked by or has surrendered a license to another jurisdiction, the applicant may attempt to demonstrate to the board's satisfaction that the applicant is completely rehabilitated with respect to the conduct that was the basis for the revocation or surrender of the license.

D. The board shall vacate its previous order to deny or revoke a license if that denial or revocation was based on the applicant's conviction of a felony or an offense involving moral turpitude and that conviction has been reversed on appeal. The applicant may resubmit an application for licensure as soon as the court enters the reversal.

E. If the board finds that an applicant has committed an act or engaged in conduct that would constitute grounds for disciplinary action, the board shall determine to its satisfaction that the conduct has been corrected, monitored and resolved. If the matter has not been resolved, before it issues a license the board shall determine to its satisfaction that mitigating circumstances exist that prevent its resolution.

F. Except as provided in subsection D of this section, a person shall not submit an application for reinstatement or a new application within five years after the person has completely corrected the conduct and made full legal restitution to the board's satisfaction.

G. An applicant shall submit a verified completed application to the board in a form and within a period of time prescribed by the board. The application shall include:

1. The application fee.

2. Affidavits from three persons who are actively licensed to practice allopathic, osteopathic, integrated or homeopathic medicine in any state or district of the United States and who are able to attest to the applicant's fitness to practice pursuant to this chapter.

3. A diploma or certificate issued by an approved training program, a homeopathic college or any other educational institution approved by the board or documentation of the applicant's successful completion of preceptorships or formal postgraduate courses approved by the board.

4. If the person is applying for licensure pursuant to subsection A of this section, proof that the applicant has served a board-approved internship.

5. The applicant's oath that:

(a) All of the information contained in the application and the accompanying evidence or other credentials is correct.

(b) The applicant submitted the credentials without fraud or misrepresentation and that the applicant is the lawful holder of the credentials.

(c) The applicant authorizes the release to the board of any information from any source that the board determines is necessary for it to act on the application.

H. The board shall promptly inform an applicant in writing of any deficiency in the application that prevents the board from acting on it.

I. The board shall consider an application withdrawn if any of the following is true:

1. The applicant submits a written request to withdraw the application.

2. The applicant without good cause fails to appear for a board interview.

3. The applicant fails to submit information to the board within one year after the board's request for that information.

4. The applicant fails to complete the required examination or personal interview within one year after submitting the application.

J. A person who is issued a license pursuant to subsection B of this section shall practice only within the scope of practice as prescribed by this chapter. A licensee who acts outside that scope of practice commits an act of unprofessional conduct. In addition to all other available remedies, the board may seek injunctive relieve pursuant to section 32-2940. END_STATUTE

Sec. 6. Section 32-2913, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2913. Examination; reexamination

A. An applicant for licensure shall successfully pass an examination prescribed by the board.

B. If a person is seeking licensure pursuant to section 32-2912, subsection A, the examination for a license to practice under this chapter shall include all subjects that are generally accepted as necessary for a thorough knowledge of the practice of homeopathic integrated medicine. The board shall prescribe rules for conducting the examination and shall set the passing grade. If a person is seeking licensure pursuant to section 32-2912, subsection A, the examination may include subjects that are unique to that scope of practice.

C. If a person is seeking licensure pursuant to section 32-2912, subsection B, the examination for a license to practice under this chapter shall include all subjects that are generally accepted as necessary for a thorough knowledge of the practice of homeopathic medicine. The board shall prescribe rules for conducting the examination and shall set the passing grade.

C. D. The board shall review the examination of any applicant on the applicant's request. A grade on an examination reviewed by the board may be changed only by the majority vote of the members of the board. A person who fails to pass the initial licensure examination may be reexamined within one year after the date of the receipt of the original application fee without payment of additional fees. However, the applicant shall pay all additional fees associated with board prescribed board-prescribed investigatory examinations such as the special purpose licensing examination.

D. E. In a written examination, applicants shall be designated by numbers only and the corresponding names shall be kept secret until after the grading of the examinations.

F. The board shall issue a license without examination to an applicant who is seeking licensure pursuant to section 32-2912, subsection B if the applicant holds, or has passed the examination to hold, a certification from the council for homeopathic certification, or its equivalent. END_STATUTE

Sec. 7. Section 32-2914, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2914. Fees

A. The board by formal vote at its annual meeting shall establish fees and penalties that do not exceed the following:

1. Five hundred fifty dollars $550 for an application for a license to practice homeopathic medicine or integrated medicine pursuant to section 32-2912, subsection G, paragraph 1.

2. Two hundred fifty dollars $250 for issuance of an initial license.

3. Fifty dollars $50 for issuance of a duplicate license.

4. One thousand dollars $1,000 for annual renewal of a license.

5. Three hundred fifty dollars $350 for late renewal of a license.

6. Two hundred dollars $200 for initial and annual renewal of a permit to dispense drugs and devices.

7. Five hundred dollars $500 for an application for a locum tenens registration.

8. Two hundred fifty dollars $250 for issuance of a locum tenens registration.

9. Two hundred dollars $200 for annual renewal of a homeopathic medical assistant registration.

10. Twenty-five cents $.25 per page for copying board records, documents, letters, minutes, applications and files.

11. Thirty-five dollars $35 for a copy of an audiotape.

12. One hundred dollars $100 for the sale of computerized tapes or diskettes that do not require programming.

13. Two hundred dollars $200 for supervising a homeopathic medical assistant.

14. Three hundred dollars $300 for each initial application and annual renewal of a registration to conduct a practical educational program for supervised medical assistants.

B. The board may charge a licensee with the board's costs to administer a special purpose licensing examination related to its investigation of the licensee's competence.

C. The board may charge the actual cost of completing a professional conduct investigation to the licensee who is the subject of the investigation if the board determines that the licensee violated this chapter or a board rule.

D. The board shall charge additional fees for services that it is not required to provide under this chapter but that it determines are necessary to carry out its purpose. The board shall charge only the actual cost of providing these services. END_STATUTE

Sec. 8. Section 32-2915, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2915. Licensure; issuance; duplicate licenses; renewal; continuing education; expiration; cancellation

A. The board shall issue a license to practice homeopathic medicine or integrated medicine in this state if the applicant meets all board requirements for licensure and pays the licensure fee.

B. The board may issue a duplicate license to a person who holds a license under this chapter on payment of the duplicate license fee.

C. At least thirty days before the first day of the month in which a license was initially issued, the executive director shall notify the licensee of the renewal date and provide a renewal form. The executive director shall send this notice by first class mail to the address the licensee most recently provided to the board.

D. Each licensee shall include with the renewal form a statement that the licensee has completed at least twenty hours of board-approved continuing education in the preceding year. The board shall not renew a license if the licensee does not fully document compliance with this subsection. The board may waive the continuing education requirements of this subsection for a period prescribed by the board if the licensee's noncompliance was due to disability, military service, absence from the United States or circumstances beyond the control of the licensee. If a licensee fails to complete the continuing education requirements of this subsection for any other reason, the board may grant an extension of not more than sixty days. A licensee who fails to comply with the continuing education requirements of this subsection and who has not been granted a waiver pursuant to this subsection commits an act of unprofessional conduct and is subject to probation or licensure suspension or revocation.

E. A licensee shall submit a completed application for license renewal and the renewal fee each year on or before the last day of the month in which the license was initially issued. A license expires if it is not renewed within sixty days. A licensee who fails to do this by the first day of the following month must also submit a late fee as prescribed by the board. A person who practices homeopathic medicine or integrated medicine after a license has expired is in violation of this chapter.

F. The board may issue a license to a person whose license has expired only if that person applies for a license as prescribed in sections 32-2912 and 32-2913.

G. With each application for licensure renewal, the licensee shall include a report of disciplinary actions, restriction and any other action placed on or against the license or practice by any other state regulatory board or agency of the federal government, including the denial of a license for failing a special purpose licensing examination. The report shall include the name and address of the sanctioning agency, the nature of the action taken and a general statement of the charges leading to the action taken.

H. On request of a licensee, the board shall cancel that person's license to practice homeopathic medicine or integrated medicine if the licensee is not the subject of a board investigation or disciplinary proceeding. The board may cancel the license of a person who is under investigation for violating this chapter or board rules if the licensee admits to the violations in writing and on the board record. END_STATUTE

Sec. 9. Section 32-2916, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2916. 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 or the practice of integrated medicine.

6. A list of approved schools of medicine and approved training programs.

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, personal email address, home telephone number, office address, work email 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' fund. END_STATUTE

Sec. 10. Section 32-2917, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2917. Locum tenens registration

A. The board president or a person designated by the board may issue locum tenens registration to a person who meets all of the following requirements:

1. Submits proof satisfactory to the board that the applicant for registration holds an unrestricted license to practice allopathic, osteopathic, integrated or homeopathic medicine in another state, district or territory of the United States, that the license has not been revoked or suspended for any reason and that there are no unresolved complaints or formal charges filed against the applicant with any licensing board.

2. Submits an application as prescribed by section 32-2912.

3. The licensee for whom the applicant for registration under this section is substituting or assisting provides the board with a written request for the applicant's registration.

4. Submits the fees required under section 32-2914.

B. The board may authorize the applicant to provide locum tenens services if it is satisfied that the applicant has met the requirements of subsection A of this section.

C. Locum tenens registration granted under this section is valid for thirty days. The board may extend registration for an additional thirty days on written request by the person who made the original request for registration. This request shall explain why the extension is necessary and shall include prescribed fees and other information requested by the board. END_STATUTE

Sec. 11. Section 32-2931, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2931. Violations; classification

A. The following acts are class 5 felonies:

1. Practicing medicine as a homeopathic doctor, doctor of integrated medicine or advanced homeopathic practitioner pursuant to this chapter without being licensed or exempt from licensure pursuant to this chapter.

2. Securing a license to engage in the practice of homeopathic medicine or the practice of integrated medicine pursuant to this chapter by fraud or deceit.

3. Impersonating a member of the board.

B. The following acts are class 2 misdemeanors:

1. Using the designation "doctor of homeopathy", "homeopathic doctor", "medical doctor-homeopathic", "doctor of osteopathy-homeopathic osteopathic medicine (homeopathic)", "homeopathic practitioner", "doctor of integrated medicine" or "homeopathic physician" without being licensed pursuant to this chapter.

2. Using any words, initials or symbols that lead the public to believe that a person is licensed to engage in the practice of homeopathic medicine or integrated medicine in this state if this is not true.END_STATUTE

Sec. 12. Section 32-2932, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2932. Use of title or abbreviation by licensees

A. A person who is licensed pursuant to this chapter section 32-2912, subsection A may use the designation and sign the licensee's name, wherever required, in any capacity, as "homeopathic doctor", "homeopathic physician" or "doctor of integrated medicine". If the licensee is a graduate of a board approved board-approved allopathic school of medicine, the licensee may also use the designation "medical doctor- (homeopathic)" or "homeopathic physician". If the licensee is a graduate of a board approved board-approved osteopathic school of medicine, the licensee may also use the designation "doctor of osteopathy- homeopathic" or "homeopathic physician". If the licensee is a graduate of a board approved homeopathic medical school, the licensee shall only use the designation "homeopathic doctor" or "doctor of homeopathy" osteopathic medicine (homeopathic)".

B. A person who is licensed pursuant to section 32-2912, subsection B may use the designation "homeopathic practitioner", "doctor of homeopathy" or "homeopathic doctor". A person may use the designation "homeopathic practitioner" or "doctor of homeopathy" only if the person holds a doctorate and is licensed pursuant to chapter 8, 14, 19 or 39 of this title.

C. The board may adopt in rule abbreviations for the titles listed in subsections A and B of this section. END_STATUTE

Sec. 13. Section 32-2933, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2933. Definition of unprofessional conduct

A. In this chapter, unless the context otherwise requires, "unprofessional conduct" includes the following acts, whether occurring in this state or elsewhere:

1. Performing an invasive surgical procedure that is not specifically permitted allowed by this chapter or by board rules or pursuant to a license issued under chapter 13 or 17 of this title.

2. Wilfully betraying a professional secret or wilfully violating a privileged communication except as either of these may otherwise be required by law. This paragraph does not prevent members of the board from the full and free exchange of information with the licensing and disciplinary boards of other states, territories or districts of the United States or with foreign countries or with the Arizona homeopathic and integrative medical association or any of its component organizations or with the homeopathic medical organizations of other states, counties, districts or territories or with those of foreign countries.

3. Committing a felony, whether or not involving moral turpitude, or a misdemeanor involving moral turpitude. In either case, conviction by any court of competent jurisdiction or a plea of no contest is deemed conclusive evidence of guilt.

4. Exhibiting habitual intemperance in the use of alcohol or habitual substance abuse.

5. Violating federal, state, county or municipal laws or regulations applicable to the practice of medicine or relating to public health.

6. Prescribing a controlled substance for other than accepted therapeutic purposes.

7. Committing conduct that the board determines is gross professional negligence, repeated professional negligence or any negligence that causes the death of a patient.

8. Impersonating another person licensed pursuant to this chapter.

9. Acting or assuming to act as a member of the board if this is not true.

10. Procuring or attempting to procure a license to practice homeopathic medicine or INTEGRATED medicine by fraud, by misrepresentation or by knowingly taking advantage of the mistake of another.

11. Having professional connection with or lending one's name to an illegal practitioner of homeopathic medicine or integrated medicine or of any of the other healing arts.

12. Representing that a manifestly incurable disease, injury, ailment or infirmity can be permanently cured or that a curable disease, injury, ailment or infirmity can be cured within a stated time if this is not true.

13. Offering, undertaking or agreeing to cure or treat a disease, injury, ailment or infirmity by a secret means, method, device or instrumentality.

14. Refusing to divulge to the board on demand the means, method, device or instrumentality used in the treatment of treating a disease, injury, ailment or infirmity.

15. Giving or receiving or aiding or abetting the giving or receiving of rebates, either directly or indirectly.

16. Knowingly making any false or fraudulent statement, written or oral, in connection with the practice of homeopathic medicine or the practice of integrated medicine except as the same may be necessary for accepted therapeutic purposes.

17. Exhibiting immorality or misconduct that tends to discredit the profession.

18. Being disciplined by another regulatory jurisdiction because of the licensee's mental or physical inability to engage safely in the practice of medicine, medical incompetence or unprofessional conduct as defined by that jurisdiction and that corresponds directly or indirectly with an act of unprofessional conduct prescribed by this section. The disciplinary action may include refusing, denying, revoking or suspending a license, issuing a formal reprimand, issuing a decree of censure or otherwise limiting, restricting or monitoring the licensee or placing the licensee on probation.

19. Committing any conduct or practice contrary to recognized standards of ethics of the homeopathic medical medicine or integrated medicine profession, any conduct or practice that does or might constitute a danger to the health, welfare or safety of the patient or the public or any conduct, practice or condition that does or might impair the ability to practice homeopathic medicine or integrated medicine safely and skillfully.

20. Failing or refusing to maintain adequate records on a patient or to make patient records promptly available to another licensee on request and receipt of proper authorization.

21. Advertising in a false, deceptive or misleading manner.

22. Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate this chapter or any board rule.

23. Using a controlled substance unless it is prescribed by a physician for use during a prescribed course of treatment.

24. Prescribing, dispensing or administering anabolic androgenic steroids for other than therapeutic purposes.

25. Prescribing or dispensing controlled substances to members of the licensee's immediate family.

26. Prescribing, dispensing or administering schedule II controlled substances as prescribed by section 36-2513 or the rules adopted pursuant to section 36-2513, including amphetamines and similar schedule II sympathomimetic drugs in the treatment of treating exogenous obesity for a period in excess of thirty days in any one year, or the nontherapeutic use of injectable amphetamines.

27. Dispensing a schedule II controlled substance that is an opioid.

28. Using experimental forms of diagnosis and treatment without adequate informed patient consent, without a board approved board-approved written disclosure that the form of diagnosis and treatment to be used is experimental and without conforming to generally accepted experimental criteria, including protocols, detailed records, periodic analysis of results and periodic review by a peer review committee.

29. Engaging in sexual intimacies with a patient.

30. Using the designation "M.D." or "D.O." in a way that would lead the public to believe that a person is licensed by the Arizona medical board or the Arizona board of osteopathic examiners in medicine and surgery in this state if this is not the case.

31. Falsely or fraudulently representing or holding oneself out as being a homeopathic or integrated medical specialist.

32. Failing to dispense drugs and devices in compliance with article 4 of this chapter.

33. Violating a formal board order, terms of probation or a stipulation issued or entered into by the board or its designee under this chapter.

34. Charging a fee for services not rendered or charging and collecting a clearly unreasonable fee. In determining the reasonableness of the fee, the board shall consider the fee customarily charged in this state for similar services in relation to modifying factors such as the time required, the complexity of the service and the skill required to perform the service properly. This paragraph does not apply if there is a clearly written contract for a fixed fee between the licensee and the patient that is entered into before the licensee provides the service.

35. Failing to appropriately direct, collaborate with or supervise a licensed, certified or registered health care provider, a homeopathic medical assistant or office personnel employed or assigned to the licensee to assist in the medical care of patients.

36. Knowingly making a false or misleading statement on a form required by the board or in written correspondence with the board.

37. Failing to furnish legally requested information in a timely manner to the board or its investigators or representatives.

38. Failing to allow properly authorized board personnel to examine or have access to a licensee's documents, reports or records that relate to the licensee's medical practice or medically related activities.

39. Signing a blank, undated or predated prescription form.

40. Refusing to submit to a body fluid examination required under section 32-2941 or pursuant to a board investigation into the licensee's substance abuse.

41. Prescribing, dispensing or furnishing a prescription medication or a prescription-only device as defined in section 32-1901 to a person unless the licensee first conducts a comprehensive physical or mental health status examination of that person or has previously established a doctor-patient relationship. This paragraph does not apply to:

(a) A licensee who provides temporary patient supervision on behalf of the patient's regular treating licensed health care professional.

(b) Emergency medical situations as defined in section 41-1831.

(d) Prescriptions written or prescription medications issued for use by a county or tribal public health department for immunization programs or emergency treatment or in response to an infectious disease investigation, a public health emergency, an infectious disease outbreak or an act of bioterrorism. For the purposes of this subdivision, "bioterrorism" has the same meaning prescribed in section 36-781.

42. Failing to obtain from a patient before an examination or treatment a signed informed consent that includes language that makes it clear the licensee is providing homeopathic or integrated medical treatment instead of or in addition to standard conventional allopathic or osteopathic treatment.

B. If a person is licensed pursuant to section 32-2912, subsection B, unprofessional conduct also includes the following:

1. Performing an invasive procedure, including performing intravenous therapy, drawing bodily fluids or ordering genetic testing.

2. Prescribing, dispensing or administering any controlled substance.

3. Prescribing, dispensing or administering a prescription drug.

4. Using the title "physician", "medical doctor-homeopathic", "doctor of osteopathy-homeopathic osteopathic medicine-homeopathic", "doctor of medicine (homeopathic)" or "homeopathic physician" or otherwise implying that the licensee is a licensed allopathic or osteopathic physician.

5. Failing to correct a known misunderstanding regarding the licensee's licensure status.

6. Failing to obtain from a patient before an examination or treatment a signed informed consent that includes language that makes it clear the licensee is not an allopathic or osteopathic physician and is providing homeopathic or integrated medical treatment under the limited scope of practice of homeopathic medicine or practice of integrated medicine pursuant to this chapter.

7. Failing to consult with or refer patients to other health care providers when appropriate.

8. Discontinuing or advising a patient to discontinue a physician's treatment or medicine without first consulting the prescribing or treating physician.

9. Failing to refer a patient with a life threatening life-threatening illness to a licensed allopathic or osteopathic physician currently practicing homeopathic, allopathic or osteopathic medicine. END_STATUTE

Sec. 14. Section 32-2934, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2934. Grounds for suspension or revocation of license; duty to report; unprofessional conduct hearing; decision of board

A. The board on its own motion may investigate any evidence that appears to show that a licensee is or may be medically incompetent, guilty of unprofessional conduct or mentally or physically unable to engage safely in the practice of homeopathic medicine or the practice of integrated medicine. Any licensee, the Arizona homeopathic and integrative medical association or any health care institution as defined in section 36-401 shall, and any other person may, report to the board any information the person may have that appears to show that a licensee is or may be medically incompetent, guilty of unprofessional conduct or mentally or physically unable to engage safely in the practice of homeopathic medicine or the practice of integrated medicine. The board shall notify the licensee about whom information is received as to the content of the information within one hundred twenty days after receipt of the information. Any person who reports or provides information to the board in good faith is not subject to an action for civil damages as a result of reporting or providing the information. The board may not open an investigation if identifying information regarding the complainant is not provided to the board. It is an act of unprofessional conduct for any licensee to fail to report as required by this section. Any health care institution that fails to report as required by this section shall be reported by the board to the institution's licensing agency.

B. If a complainant wishes to have the complainant's identifying information withheld from the licensee against whom the allegation of unprofessional conduct is being made, the board shall enter into a written agreement with the complainant stating that the complainant's identifying information will not be provided to the licensee against whom the allegation of unprofessional conduct is being made to the extent consistent with the administrative appeals process. The board shall post this policy on the board's website where a person would submit a complaint online.

C. A health care institution shall inform the board if the privileges of a licensee to practice in the health care institution are denied, revoked, suspended or limited because of actions by the licensee that jeopardized patient health and welfare or if the licensee resigns during pending proceedings for revocation, suspension or limitation of privileges. A report to the board pursuant to this subsection shall contain a general statement of the reasons the health care institution denied or took action to revoke, suspend or limit a licensee's privileges.

D. The board may conduct investigations necessary to fully inform itself with respect to any evidence filed with the board under subsection A of this section. As part of this investigation, the board may require the licensee under investigation to be interviewed by board representatives or, at the licensee's expense, to undergo any combination of mental, physical, oral or written medical competency examinations.

E. If the information gathered under subsections A and C of this section indicates that the protection of public health requires that the board take emergency action, it the board may order the summary suspension of a license pending the outcome of a formal disciplinary hearing pursuant to title 41, chapter 6, article 10. The board shall serve the suspended licensee with a written notice of the specific charges and the time and place of the formal hearing. The board shall hold this hearing within sixty days after the suspension unless the board for good reason shown by the licensee grants an extension on the hearing date.

F. If, after completing its investigation, the board finds that the information provided pursuant to subsection A of this section is not of sufficient seriousness to merit direct action against the license, it may take any of the following actions:

1. Dismiss if, in the opinion of the board, the information is without merit.

2. File a letter of concern.

3. Issue a nondisciplinary order requiring the licensee to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee with the necessary understanding of current developments, skills, procedures or treatment.

G. If after completing its initial investigation under subsection A of this section the board determines that rehabilitative or disciplinary action can be taken without the presence of the licensee at an informal interview, the board and the licensee may enter into a stipulated agreement to limit or restrict the licensee's practice or to rehabilitate the licensee, protect the public and ensure the licensee's ability to safely engage in the practice of homeopathic medicine or the practice of integrated medicine.

H. If after completing its investigation the board believes that this information is or may be true, the board may request an informal interview with the licensee. If the licensee refuses the invitation or accepts the invitation and the results of the interview indicate that suspension or revocation of the license may be in order, the board shall issue a formal complaint and conduct a formal hearing pursuant to title 41, chapter 6, article 10. If after completing the informal interview the board finds that the information provided under subsection A of this section is not of sufficient seriousness to merit suspension or revocation of the license, it may take the following actions:

1. Dismiss if, in the opinion of the board, the information is without merit.

2. File a letter of concern.

3. Issue a decree of censure. A decree of censure constitutes an official action against the license and may include a requirement for restitution of fees to a patient resulting from violations of this chapter or board rules.

4. Fix a period and terms of probation best adapted to protect the public health and safety and rehabilitate or educate the licensee. The probation, if deemed necessary, may include temporary suspension of the license for not to exceed more than twelve months, restriction of the license to practice homeopathic medicine or integrated medicine or a requirement for restitution of fees to a patient resulting from violations of this chapter or board rules. If a licensee fails to comply with the terms of probation, the board may file a summons, complaint and notice of hearing pursuant to title 41, chapter 6, article 10 based on the information considered by the board at the informal interview and any other acts or conduct alleged to be in violation of this chapter or board rules.

5. Enter into an agreement with the licensee to restrict or limit the licensee's practice or medical activities in order to rehabilitate the licensee, protect the public and ensure the licensee's ability to safely engage in the practice of homeopathic medicine or the practice of integrated medicine.

6. Issue a nondisciplinary order requiring the licensee to complete a prescribed number of hours of continuing education in an area or areas prescribed by the board to provide the licensee with the necessary understanding of current developments, skills, procedures or treatment.

I. In an informal interview or a formal hearing the board, in addition to any other action that it may take, may impose an administrative penalty in an amount of not less than five hundred dollars at least $500 but not to exceed two thousand dollars more than $2,000 on a licensee who violates this chapter or a board rule. Actions to enforce the collection of these penalties shall be brought in the name of this state by the attorney general or the county attorney in the justice court or the superior court in the county in which the violation occurred. Penalties imposed under this section are in addition to and not in limitation of other penalties imposed pursuant to this chapter.

J. If in the opinion of the board it appears that the allegations concerning a licensee are of a magnitude as to warrant suspension or revocation of the license, the board shall serve on the licensee a summons and a complaint fully setting forth the conduct or inability concerned and setting a date, time and place for a hearing pursuant to title 41, chapter 6, article 10 to be held before the board in not less than at least sixty days from after the date of the notice.

K. A licensee who wishes to be present at the hearing in person or by representation, or both, shall file a verified answer with the board within twenty days after receiving service of the summons and complaint. The licensee may present witnesses at this hearing. A licensee who has been notified of a complaint pursuant to this section shall file with the board a written response not more than twenty days after service of the complaint and the notice of hearing. If the licensee fails to file an answer in writing, it is deemed an admission of the act or acts charged in the complaint and notice of hearing and the board may take disciplinary action pursuant to this chapter without a hearing.

L. The board shall issue subpoenas for witnesses as it may need and for witnesses as the licensee may request. Any person refusing to obey a subpoena shall be certified by the board to the superior court in the county in which service was made, and the court may institute proceedings for contempt of court.

M. Service of the summons and complaint shall be as required in civil cases.

N. Service of subpoenas for witnesses shall be as provided by law for the service of subpoenas generally.

O. A licensee who after a hearing is found to be guilty of unprofessional conduct or is found to be mentally or physically unable to engage safely in the practice of homeopathic medicine or the practice of integrated medicine is subject to any combination of censure, probation or suspension of license or revocation of the license for a prescribed period of time or permanently and under conditions that the board deems appropriate for the protection of the public health and safety and just in the circumstances.

P. If the board acts to modify any licensee's prescription writing privileges, it shall immediately notify the Arizona state board of pharmacy of the modification.

Q. Notwithstanding section 32-2906, subsection A, the board shall deposit, pursuant to sections 35-146 and 35-147, all monies collected from administrative penalties paid pursuant to this section in the state general fund.

R. A letter of concern is a nondisciplinary public document that the board may use in future disciplinary actions. END_STATUTE

Sec. 15. Section 32-2935, Arizona Revised Statutes, is amended to read:

START_STATUTE32-2935. Right to examine and copy evidence; summoning witnesses and documents; taking testimony; right to counsel; confidentiality

A. In connection with the investigation by the board on its own motion or as the result of information received pursuant to section 32-2934, subsection A, the board or its authorized agents or employees shall at all reasonable times have access to, for the purpose of examination, and the right to copy any documents, reports, records or any other physical evidence of any person being investigated, or the reports, records and any other documents maintained by and in possession of any hospital, clinic, office, laboratory, pharmacy or any other public or private agency, and any health care institution as defined in section 36-401, if these documents, reports, records or evidence relate to medical competence, unprofessional conduct or the mental or physical ability of a licensee to practice homeopathic medicine or integrated medicine safely.

B. For the purpose of all investigations and proceedings conducted by the board:

1. The board on its own initiative, or on application of any person involved in the investigation, may issue subpoenas compelling the attendance and testimony of witnesses, or demanding the production for examination or copying of documents or any other physical evidence if the evidence relates to medical competence, unprofessional conduct or the mental or physical ability of a licensee to practice homeopathic medicine or integrated medicine safely. Within five days after the service of a subpoena on any person requiring the production of any evidence in that person's possession or under that person's control, the person may petition the board to revoke, limit or modify the subpoena. The board shall revoke, limit or modify the subpoena if in its opinion the evidence required does not relate to unlawful practices covered by this chapter, is not relevant to the charge that is the subject matter of the hearing or investigation or does not describe with sufficient particularity the physical evidence whose production is required. Any member of the board or any agent designated by the board may administer oaths or affirmations, examine witnesses and receive evidence.

2. Any person appearing before the board has the right to be represented by counsel.

C. The superior court, on application by the board or by the person subpoenaed, may issue an order:

1. Requiring the person to appear before the board or the duly authorized agent to produce evidence relating to the matter under investigation. Any failure to obey the order of the court may be punished by the court as a contempt.

2. Revoking, limiting or modifying the subpoena if in the court's opinion the evidence demanded does not relate to unlawful practices covered by this chapter, is not relevant to the charge that is the subject matter of the hearing or investigation, or does not describe with sufficient particularity the evidence whose production is required.

D. Patient records, including clinical records, medical reports, laboratory statements and reports, any file, film, any other report or oral statement relating to diagnostic findings or treatment of patients, any information from which a patient or the patient's family might be identified or information received and records kept by the board as a result of investigation procedures are not available to the public.

E. This section or any other provision of law making communications between a licensee and a patient a privileged communication does not apply to investigations or proceedings conducted pursuant to this chapter. The board and its employees, agents and representatives shall keep in confidence the names of any patients whose records are reviewed during the course of investigations and proceedings pursuant to this chapter.

F. Hospital records, medical staff records, medical staff review committee records and testimony concerning these records, and proceedings related to the creation of these records, are not available to the public, shall be kept confidential by the board and are subject to the same provisions concerning discovery and use in legal actions as are the original records in the possession and control of hospitals, their medical staffs and their medical staff review committees. The board shall use records and testimony during the course of investigations and proceedings pursuant to this chapter. END_STATUTE