•  Summary 
  •  
  •  Actions 
  •  
  •  Committee Votes 
  •  
  •  Floor Votes 
  •  
  •  Memo 
  •  
  •  Text 
  •  
  •  LFIN 
  •  
  •  Chamber Video/Transcript 

S04297 Summary:

BILL NOS04297
 
SAME ASSAME AS A05913
 
SPONSORLAVALLE
 
COSPNSRLARKIN, RITCHIE
 
MLTSPNSR
 
Add Art 138 6850 - 6862, Ed L; amd 1203, 1207 & 1301, Lim Lil L; amd 121-1500 & 121-1502, Partn L; amd 413, Soc Serv L; amd 571 & 585, Pub Health L
 
Regulates the practice of naturopathic medicine; establishes a state board for naturopathic medicine; establishes requirements to receive a limited permit in naturopathic medicine; establishes mandatory continuing education for the practice of naturopathic medicine; requires licensed naturopathic doctors to report suspected child abuse.
Go to top    

S04297 Actions:

BILL NOS04297
 
02/08/2017REFERRED TO HIGHER EDUCATION
01/03/2018REFERRED TO HIGHER EDUCATION
Go to top

S04297 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          4297
 
                               2017-2018 Regular Sessions
 
                    IN SENATE
 
                                    February 8, 2017
                                       ___________
 
        Introduced  by  Sens. LAVALLE, LARKIN, RITCHIE -- 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; 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.
                                                                   LBD09636-01-7

        S. 4297                             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. 4297                             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    §  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. 4297                             4
 
     1    § 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    § 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. 4297                             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. 4297                             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. 4297                             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    §  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    § 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    §  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. 4297                             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    § 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. 4297                             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,  the  naturopathic doctor shall not hold herself or himself
    51  out as practicing any such other profession or use a title of  any  such
    52  other profession, unless otherwise authorized under this title.
    53    §  6856.  State  board for naturopathic medicine. 1. A state board for
    54  naturopathic medicine shall be appointed by the board of regents on  the
    55  recommendation  of  the  commissioner  for  the purpose of assisting the
    56  board of regents and the department on matters of professional licensing

        S. 4297                            10
 
     1  and professional conduct in accordance with section  sixty-five  hundred
     2  eight of this title. The board shall be composed of two public represen-
     3  tatives  who  do  not  hold  interests in the organization, financing or
     4  delivery  of  naturopathic  services,  one  licensed  physician who is a
     5  doctor of medicine or a doctor of osteopathy,  and  not  less  than  six
     6  naturopathic  doctors.  A  naturopathic doctor member of the board shall
     7  have been licensed under this article for at least two  years  prior  to
     8  being  appointed,  which  two year license requirement is waived for the
     9  initial board and replaced with  a  requirement  that  the  naturopathic
    10  doctor  obtain  a license under this article within one year of appoint-
    11  ment or one year of the effective date of this article, whichever  comes
    12  later.  The  terms  of the first appointed members shall be staggered so
    13  that three are appointed for three years, three are appointed  for  four
    14  years,  and four are appointed for five years. An executive secretary of
    15  the board shall be appointed by the board of regents on the  recommenda-
    16  tion of the commissioner.
    17    2. Examinations selected or prepared by the board pursuant to subdivi-
    18  sion two of section sixty-five hundred eight of this title shall conform
    19  whenever  possible  to  nationally recognized test development standards
    20  and test competencies for naturopathic medicine.
    21    § 6857. Qualifications for licensure. To  qualify  for  a  license  to
    22  practice  the  profession  of  naturopathic medicine, an applicant shall
    23  fulfill the following requirements:
    24    1. file an application with the department;
    25    2. have received an education, including a doctoral degree in  naturo-
    26  pathic  medicine,  granted  on  the  basis of completion of a program of
    27  naturopathic medicine registered with the department or the  substantial
    28  equivalent thereof, in accordance with the commissioner's regulations;
    29    3.  for  applicants  applying  more than two years after the effective
    30  date of this article,  have  satisfactorily  completed  a  post-graduate
    31  residency  program  of  naturopathic  medicine of at least twelve months
    32  duration approved by the department, or the substantial equivalent ther-
    33  eof, and in accordance with the commissioner's regulations;
    34    4. pass an examination satisfactory to the  board  and  in  accordance
    35  with the commissioner's regulations;
    36    5. be at least twenty-one years of age;
    37    6. be of good moral character as determined by the department; and
    38    7.  pay  a fee of three hundred fifty dollars to the department for an
    39  initial license and a fee of five hundred  dollars  for  each  triennial
    40  registration period.
    41    §  6858. Special conditions. 1. An applicant having received, prior to
    42  nineteen hundred eighty-eight, an education, including a doctoral degree
    43  in naturopathic medicine, granted  on  the  basis  of  completion  of  a
    44  program  of  naturopathic medicine registered with the department or the
    45  substantial equivalent thereof, may substitute for  the  experience  and
    46  examination qualifications of section sixty-eight hundred fifty-seven of
    47  this  article, either of: (i) satisfactory evidence of practice of natu-
    48  ropathic medicine of not less than three years  during  the  five  years
    49  preceding the filing of the application; or (ii) practice under a limit-
    50  ed permit for at least two of the three years prior to application under
    51  this article.
    52    2.  An  applicant having received, prior to two years after the effec-
    53  tive date of this article, an education, including a doctoral degree  in
    54  naturopathic  medicine,  granted on the basis of completion of a program
    55  of naturopathic medicine registered with the department or the  substan-
    56  tial equivalent thereof, may substitute for the experience qualification

        S. 4297                            11

     1  of  section  sixty-eight hundred fifty-seven of this article, either of:
     2  (i) satisfactory evidence of practice of naturopathic  medicine  of  not
     3  less  than three years during the five years preceding the filing of the
     4  application; or (ii) practice under a limited permit for at least two of
     5  the three years prior to application under this article.
     6    3.  The  "practice  of  naturopathic medicine" as used in this section
     7  includes the practice of naturopathy or naturopathic medicine in a state
     8  or territory of the United States, including New York state, or a  Cana-
     9  dian  province,  while maintaining a professional license in naturopathy
    10  or naturopathic medicine issued by the same or another state or territo-
    11  ry or a Canadian province; and includes practice  performed  before  and
    12  after the effective date of this article.
    13    4.  Practice demonstrated by satisfactory evidence of practice or by a
    14  limited permit, as provided in subdivisions one and two of this section,
    15  must be complete within eighteen years after the effective date of  this
    16  article.  Applicants  having  completed  the  practice requirements of a
    17  special condition under this section  must  submit  an  application  for
    18  license  by  nineteen years after the effective date of this article and
    19  must cure defects, if any, in  the  application  as  identified  by  the
    20  department within a time period indicated by the department.
    21    § 6859. Exempt persons and exemptions. Nothing contained in this arti-
    22  cle shall be construed to affect or prevent the following:
    23    1.  a.  A  licensed physician from practicing his or her profession as
    24  defined in articles one hundred thirty-one, as  added  by  chapter  nine
    25  hundred  eighty-seven  of  the  laws  of  nineteen  seventy-one, and one
    26  hundred thirty-one-b of this title; a registered professional nurse or a
    27  certified nurse practitioner practicing his or her profession as defined
    28  under article one hundred thirty-nine of this title; or
    29    b. Qualified members of other professions licensed  under  this  title
    30  from  performing  the  practice  of  their professions; except that such
    31  persons may not hold themselves out under the title naturopath or  natu-
    32  ropathic doctor, or as performing naturopathy or naturopathic medicine.
    33    2. A student from engaging in clinical practice under supervision of a
    34  licensed  naturopathic doctor as part of a program of naturopathic medi-
    35  cine registered by the department or the substantial equivalent thereof.
    36    3. The practice of naturopathic medicine by a salaried employee of the
    37  government of the United States while the individual is engaged  in  the
    38  performance  of  duties  prescribed  by  the laws and regulations of the
    39  United States.
    40    4. The domestic care of the sick, disabled or injured  by  any  family
    41  member,  household  member  or friend, or person employed primarily in a
    42  domestic capacity who does not hold himself or herself  out,  or  accept
    43  employment  as a person licensed to practice naturopathic medicine under
    44  the provisions of this article.
    45    5. The care of the sick when done in connection with the  practice  of
    46  the religious tenets of any church.
    47    6. The marketing, sale or use of substances or devices governed by the
    48  Federal  Food, Drug, and Cosmetic Act that do not require a prescription
    49  from a qualified healthcare provider.
    50    7. The conduct, activities,  or  services  of  individuals,  churches,
    51  schools,   teachers,  organizations,  or  not-for-profit  businesses  in
    52  providing instruction, advice, support, encouragement, or information to
    53  individuals, families, and relational groups.
    54    § 6860. Limited residency permits. 1. For issuance of a limited  resi-
    55  dency permit, the applicant shall fulfill the following requirements:
    56    a. file an application with the department;

        S. 4297                            12
 
     1    b.  have received an education, including a doctoral degree in naturo-
     2  pathic medicine, granted on the basis of  completion  of  a  program  of
     3  naturopathic  medicine registered with the department or the substantial
     4  equivalent thereof;
     5    c.  have been accepted into a post-graduate residency program of natu-
     6  ropathic medicine approved by the department;
     7    d. be of good moral character as determined by the department;
     8    e. be at least twenty-one years of age; and
     9    f. pay a fee to the department  of  one  hundred  dollars,  or  for  a
    10  renewal a fee of fifty dollars.
    11    2.  Such  permit  shall allow the permit holder to perform such activ-
    12  ities that are required  for  successful  completion  of  the  residency
    13  program  under the administrative supervision of a licensed naturopathic
    14  doctor serving as the residency director. Practice  activities  under  a
    15  limited  residency  permit shall be limited to facilities encompassed by
    16  the post-graduate residency program of the  permit  holder,  such  as  a
    17  hospital,  an  incorporated  hospital  or clinic, a licensed proprietary
    18  hospital, a licensed nursing home, a public health agency, a  recognized
    19  public  or  non-public  school setting, the office of a licensed naturo-
    20  pathic doctor, or in the civil service of the state or political  subdi-
    21  vision  thereof.    Practice  supervision  of a permit holder's practice
    22  activities shall be  on-site  supervision  by  a  licensed  naturopathic
    23  doctor,  except  for injection therapy procedures, which shall be direct
    24  personal supervision by a licensed physician or a licensed  naturopathic
    25  doctor having injection therapy privilege. "Direct personal supervision"
    26  for  the  purposes  of this section means supervision of a procedure for
    27  injection therapy based on instructions given directly by the  supervis-
    28  ing  physician  or  supervising  naturopathic doctor who remains on site
    29  when and where the procedure  is  being  performed,  but  shall  not  be
    30  construed  as  necessarily requiring the physical presence of the super-
    31  vising physician or supervising naturopathic  doctor  in  the  immediate
    32  area at the time when the injection therapy procedure is performed.
    33    3.  Such permit shall be issued for one year and may be renewed at the
    34  discretion of the department for one or two additional years when neces-
    35  sary to permit the completion of an approved post-graduate residency  in
    36  naturopathic medicine.
    37    §  6861.  Limited  permits.  1.  For issuance of a limited permit, the
    38  applicant shall fulfill the following requirements:
    39    a. file an application with the department;
    40    b. have received an education, including a doctoral degree in  naturo-
    41  pathic  medicine,  granted  on  the  basis of completion of a program of
    42  naturopathic medicine registered with the department or the  substantial
    43  equivalent thereof;
    44    c.  indicate  exercising option to attain qualifications for licensure
    45  using a limited  permit  special  condition  under  section  sixty-eight
    46  hundred fifty-eight of this article;
    47    d. be of good moral character as determined by the department;
    48    e. be at least twenty-one years of age; and
    49    f. pay a fee of two hundred dollars to the department.
    50    2.  Such  limited  permit shall authorize the practice of naturopathic
    51  medicine only under the supervision of a licensed  naturopathic  doctor.
    52  Supervision  of the limited permit holder's practice activities shall be
    53  on-site supervision by a licensed naturopathic doctor.
    54    3. A limited permit shall be issued for a period of two years, and may
    55  be renewed under circumstances and for a time period and fee in  accord-
    56  ance with the commissioner's regulations.

        S. 4297                            13
 
     1    4.  The  last day for applying for a limited permit under this section
     2  is fifteen years after the effective date of this section.
     3    § 6862. Mandatory continuing education. 1. a. Each naturopathic doctor
     4  licensed pursuant to this article, required to register triennially with
     5  the  department  to  practice  in  this  state  shall  comply  with  the
     6  provisions of the mandatory continuing education requirements prescribed
     7  in subdivision two of this section, except as provided in  paragraphs  b
     8  and  c  of this subdivision. Naturopathic doctors who do not satisfy the
     9  mandatory continuing education requirements  shall  not  practice  until
    10  they  have  met such requirements, and they have been issued a registra-
    11  tion certificate, except that a naturopathic doctor may practice without
    12  having met such requirements if he or she is issued a conditional regis-
    13  tration pursuant to subdivision three of this section.
    14    b. Naturopathic doctors shall be exempt from the mandatory  continuing
    15  education requirement for the triennial registration period during which
    16  they  are  first  licensed.  In  accord with the intent of this section,
    17  adjustments to the mandatory continuing education  requirements  may  be
    18  granted  by  the department for reasons of health certified by an appro-
    19  priate health care professional, for extended active duty with the armed
    20  forces of the United States, or for other good cause acceptable  to  the
    21  department, which may prevent compliance.
    22    c.  A  licensed  naturopathic doctor not engaged in professional prac-
    23  tice, as determined by the department, shall be exempt from the mandato-
    24  ry continuing education requirement upon the filing of a statement  with
    25  the  department  declaring  such status. Any licensee who returns to the
    26  practice of naturopathic  medicine  during  the  triennial  registration
    27  period  shall  notify  the department prior to reentering the profession
    28  and shall  meet  such  mandatory  education  requirements  as  shall  be
    29  prescribed by regulations of the commissioner.
    30    2.  During  each triennial registration period an applicant for regis-
    31  tration shall complete  sixty  hours  of  acceptable  formal  continuing
    32  education.  Any  licensed  naturopathic  doctor whose first registration
    33  date following the effective date of this section occurs less than three
    34  years from such effective  date,  shall  complete  continuing  education
    35  hours  on  a  prorated  basis  at the rate of one and one-half hours per
    36  month for the number of months between the effective date and the  first
    37  registration  date.    Thereafter,  a licensee who has not satisfied the
    38  mandatory continuing education requirements shall not be issued a trien-
    39  nial registration certificate by the department and shall  not  practice
    40  unless  and  until  a  conditional registration certificate is issued as
    41  provided in subdivision three of this section.  The individual  licensee
    42  shall  determine  the selection of courses or programs of study pursuant
    43  to subdivision four of this section. Continuing  education  hours  taken
    44  during  one  triennium  may not be carried over or otherwise credited or
    45  transferred to a subsequent triennium.
    46    3. The department, in its discretion, may issue a  conditional  regis-
    47  tration  to  a  licensee  who  fails  to  meet  the continuing education
    48  requirements established in subdivision two  of  this  section  but  who
    49  agrees  to  make  up  any deficiencies and take any additional education
    50  which the department may require. The fee for such a conditional  regis-
    51  tration shall be the same as, and in addition to, the fee for the trien-
    52  nial  registration.  The duration of such conditional registration shall
    53  be determined by the department but  shall  not  exceed  one  year.  Any
    54  licensee  who  is  notified of the denial of registration for failure to
    55  complete the required continued education and who continues to  practice
    56  naturopathic  medicine  without  such  registration, shall be subject to

        S. 4297                            14
 
     1  disciplinary proceedings pursuant to section sixty-five hundred  ten  of
     2  this title.
     3    4.  As  used in this section, "acceptable formal continuing education"
     4  shall mean formal programs of  learning  which  contain  subject  matter
     5  which meet the following requirements: contributes to the enhancement of
     6  professional  and  clinical skills of the naturopathic doctor; meets the
     7  standards prescribed by regulations of the commissioner in  consultation
     8  with  the  board  to fulfill the mandatory continuing education require-
     9  ment; and is sponsored or presented by a state or  a  Canadian  province
    10  naturopathic   medicine  professional  organization  acceptable  to  the
    11  department, a United States or Canadian national  naturopathic  medicine
    12  professional  organization  acceptable to the department, an institution
    13  of higher learning having an accreditation acceptable to the department,
    14  or another sponsor approved by the department,  pursuant  to  the  regu-
    15  lation  of  the commissioner. Continuing education courses must be taken
    16  from a provider who has been approved by the department, based  upon  an
    17  application  and  fee,  pursuant to the regulations of the commissioner.
    18  The department may, in its discretion and as needed to contribute to the
    19  health and welfare of the public, require the completion  of  continuing
    20  education  activities  in  specific  subjects  to fulfill this mandatory
    21  continuing education requirement.
    22    5. Licensed naturopathic doctors shall maintain adequate documentation
    23  of completion  of  acceptable  formal  continuing  education  and  shall
    24  provide  such  documentation  to the department upon request. Failure to
    25  provide such documentation upon request of the department  shall  be  an
    26  act  of  misconduct  subject  to  disciplinary  proceedings  pursuant to
    27  section sixty-five hundred ten of this title.
    28    6. The mandatory continuing education  fee  shall  be  fifty  dollars,
    29  shall  be payable on or before the first day of each triennial registra-
    30  tion period, and shall be in addition to the triennial registration  fee
    31  required by section sixty-eight hundred fifty-seven of this article.
    32    §  3. Subdivision (a) of section 1203 of the limited liability company
    33  law, as amended by chapter 475 of the laws of 2014, is amended  to  read
    34  as follows:
    35    (a)  Notwithstanding  the education law or any other provision of law,
    36  one or more professionals each of whom is authorized by law to render  a
    37  professional  service within the state, or one or more professionals, at
    38  least one of whom is authorized by law to render a professional  service
    39  within  the  state,  may  form,  or  cause  to be formed, a professional
    40  service limited liability company for pecuniary profit under this  arti-
    41  cle for the purpose of rendering the professional service or services as
    42  such  professionals  are  authorized  to  practice.    With respect to a
    43  professional service limited liability company formed to provide medical
    44  services as such services are defined in article 131  of  the  education
    45  law,  each  member  of  such  limited liability company must be licensed
    46  pursuant to article 131 of the education law  to  practice  medicine  in
    47  this  state.    With respect to a professional service limited liability
    48  company formed to provide naturopathic services  as  such  services  are
    49  defined in article 138 of the education law, each member of such limited
    50  liability company must be licensed pursuant to article 138 of the educa-
    51  tion  law  to  practice  naturopathy  in  this  state. With respect to a
    52  professional service limited liability company formed to provide  dental
    53  services  as  such  services are defined in article 133 of the education
    54  law, each member of such limited  liability  company  must  be  licensed
    55  pursuant  to  article  133 of the education law to practice dentistry in
    56  this state. With respect to a  professional  service  limited  liability

        S. 4297                            15
 
     1  company  formed  to  provide  veterinary  services  as such services are
     2  defined in article 135 of the education law, each member of such limited
     3  liability company must be licensed pursuant to article 135 of the educa-
     4  tion  law to practice veterinary medicine in this state. With respect to
     5  a professional service  limited  liability  company  formed  to  provide
     6  professional   engineering,  land  surveying,  architectural,  landscape
     7  architectural and/or geological services as such services are defined in
     8  article 145, article 147 and article 148  of  the  education  law,  each
     9  member  of  such  limited liability company must be licensed pursuant to
    10  article 145, article 147 and/or article 148  of  the  education  law  to
    11  practice  one or more of such professions in this state. With respect to
    12  a professional service  limited  liability  company  formed  to  provide
    13  licensed  clinical  social work services as such services are defined in
    14  article 154 of the education law, each member of such limited  liability
    15  company  shall  be licensed pursuant to article 154 of the education law
    16  to practice licensed clinical social work in this state. With respect to
    17  a professional service limited liability company formed to provide crea-
    18  tive arts therapy services as such services are defined in  article  163
    19  of the education law, each member of such limited liability company must
    20  be  licensed  pursuant  to  article 163 of the education law to practice
    21  creative arts therapy in this state.  With  respect  to  a  professional
    22  service  limited liability company formed to provide marriage and family
    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
    26  marriage  and  family  therapy  in this state. With respect to a profes-
    27  sional service limited liability company formed to provide mental health
    28  counseling services as such services are defined in article 163  of  the
    29  education  law,  each  member  of such limited liability company must be
    30  licensed pursuant to article 163 of the education law to practice mental
    31  health counseling in this state. With respect to a professional  service
    32  limited  liability  company formed to provide psychoanalysis services as
    33  such services are defined in article 163  of  the  education  law,  each
    34  member  of  such  limited liability company must be licensed pursuant to
    35  article 163 of the education law  to  practice  psychoanalysis  in  this
    36  state.  With respect to a professional service limited liability company
    37  formed to provide applied behavior analysis services  as  such  services
    38  are  defined  in  article  167 of the education law, each member of such
    39  limited liability company must be  licensed  or  certified  pursuant  to
    40  article  167  of the education law to practice applied behavior analysis
    41  in  this  state.  In  addition  to  engaging  in  such   profession   or
    42  professions, a professional service limited liability company may engage
    43  in  any  other  business  or  activities as to which a limited liability
    44  company may be formed under section two hundred  one  of  this  chapter.
    45  Notwithstanding  any  other  provision  of  this section, a professional
    46  service limited liability company (i) authorized  to  practice  law  may
    47  only  engage  in  another  profession  or business or activities or (ii)
    48  which is engaged in a profession or other business or  activities  other
    49  than  law  may  only  engage  in  the practice of law, to the extent not
    50  prohibited by any other law of this state or any  rule  adopted  by  the
    51  appropriate  appellate  division  of  the  supreme court or the court of
    52  appeals.
    53    § 4. Subdivision (b) of section 1207 of the limited liability  company
    54  law,  as  amended by chapter 475 of the laws of 2014, is amended to read
    55  as follows:

        S. 4297                            16
 
     1    (b) With respect to a professional service limited  liability  company
     2  formed to provide medical services as such services are defined in arti-
     3  cle  131  of  the  education  law, each member of such limited liability
     4  company must be licensed pursuant to article 131 of the education law to
     5  practice medicine in this state.  With respect to a professional service
     6  limited  liability  company  formed  to provide naturopathic services as
     7  such services are defined in article 138  of  the  education  law,  each
     8  member  of  such  limited liability company must be licensed pursuant to
     9  article 138 of the education law to practice naturopathy in this  state.
    10  With  respect to a professional service limited liability company formed
    11  to provide dental services as such services are defined in  article  133
    12  of the education law, each member of such limited liability company must
    13  be  licensed  pursuant  to  article 133 of the education law to practice
    14  dentistry in this state. With respect to a professional service  limited
    15  liability company formed to provide veterinary services as such services
    16  are  defined  in  article  135 of the education law, each member of such
    17  limited liability company must be licensed pursuant to  article  135  of
    18  the  education  law  to practice veterinary medicine in this state. With
    19  respect to a professional service limited liability  company  formed  to
    20  provide  professional  engineering, land surveying, architectural, land-
    21  scape architectural and/or geological  services  as  such  services  are
    22  defined  in  article  145,  article 147 and article 148 of the education
    23  law, each member of such limited  liability  company  must  be  licensed
    24  pursuant to article 145, article 147 and/or article 148 of the education
    25  law  to  practice  one  or  more of such professions in this state. With
    26  respect to a professional service limited liability  company  formed  to
    27  provide  licensed  clinical  social  work  services as such services are
    28  defined in article 154 of the education law, each member of such limited
    29  liability company shall be licensed  pursuant  to  article  154  of  the
    30  education  law  to practice licensed clinical social work in this state.
    31  With respect to a professional service limited liability company  formed
    32  to  provide  creative arts therapy services as such services are defined
    33  in article 163 of the education law, each member of such limited liabil-
    34  ity company must be licensed pursuant to article 163  of  the  education
    35  law  to  practice creative arts therapy in this state. With respect to a
    36  professional  service  limited  liability  company  formed  to   provide
    37  marriage  and  family  therapy  services as such services are defined in
    38  article 163 of the education law, each member of such limited  liability
    39  company must be licensed pursuant to article 163 of the education law to
    40  practice  marriage  and  family therapy in this state. With respect to a
    41  professional service limited liability company formed to provide  mental
    42  health  counseling  services as such services are defined in article 163
    43  of the education law, each member of such limited liability company must
    44  be licensed pursuant to article 163 of the  education  law  to  practice
    45  mental  health  counseling in this state. With respect to a professional
    46  service limited  liability  company  formed  to  provide  psychoanalysis
    47  services  as  such  services are defined in article 163 of the education
    48  law, each member of such limited  liability  company  must  be  licensed
    49  pursuant  to article 163 of the education law to practice psychoanalysis
    50  in this state. With respect to a professional service limited  liability
    51  company  formed  to  provide  applied behavior analysis services as such
    52  services are defined in article 167 of the education law, each member of
    53  such limited liability company must be licensed or certified pursuant to
    54  article 167 of the education law to practice applied  behavior  analysis
    55  in this state.

        S. 4297                            17
 
     1    §  5. Subdivision (a) of section 1301 of the limited liability company
     2  law, as amended by chapter 475 of the laws of 2014, is amended  to  read
     3  as follows:
     4    (a)  "Foreign  professional service limited liability company" means a
     5  professional service limited liability company, whether or  not  denomi-
     6  nated  as  such,  organized  under the laws of a jurisdiction other than
     7  this state, (i) each of whose members and managers, if any, is a profes-
     8  sional authorized by law to render a professional  service  within  this
     9  state  and who is or has been engaged in the practice of such profession
    10  in such professional service limited liability company or a  predecessor
    11  entity, or will engage in the practice of such profession in the profes-
    12  sional  service limited liability company within thirty days of the date
    13  such professional becomes a member, or each of whose members and  manag-
    14  ers,  if  any, is a professional at least one of such members is author-
    15  ized by law to render a professional service within this state  and  who
    16  is  or  has  been  engaged  in  the  practice of such profession in such
    17  professional service limited liability company or a predecessor  entity,
    18  or  will  engage  in the practice of such profession in the professional
    19  service limited liability company within thirty days of  the  date  such
    20  professional  becomes  a  member,  or  (ii)  authorized by, or holding a
    21  license, certificate, registration or permit  issued  by  the  licensing
    22  authority  pursuant  to,  the  education  law  to  render a professional
    23  service within this state; except that all members and managers, if any,
    24  of  a  foreign  professional  service  limited  liability  company  that
    25  provides  health services in this state shall be licensed in this state.
    26  With respect to a professional service limited liability company  formed
    27  to provide naturopathic services as such services are defined in article
    28  138  of the education law, each member of such limited liability company
    29  must be licensed pursuant to article 138 of the education law  to  prac-
    30  tice  naturopathy  in this state. With respect to a foreign professional
    31  service limited liability company which provides veterinary services  as
    32  such  services  are  defined  in  article 135 of the education law, each
    33  member of such foreign professional service  limited  liability  company
    34  shall  be licensed pursuant to article 135 of the education law to prac-
    35  tice veterinary medicine. With respect to a foreign professional service
    36  limited liability  company  which  provides  medical  services  as  such
    37  services are defined in article 131 of the education law, each member of
    38  such  foreign  professional  service  limited  liability company must be
    39  licensed pursuant to article 131 of the education law to practice  medi-
    40  cine  in  this  state.    With respect to a foreign professional service
    41  limited  liability  company  which  provides  dental  services  as  such
    42  services are defined in article 133 of the education law, each member of
    43  such  foreign  professional  service  limited  liability company must be
    44  licensed pursuant to article  133  of  the  education  law  to  practice
    45  dentistry  in this state. With respect to a foreign professional service
    46  limited liability company which provides professional engineering,  land
    47  surveying,   geologic,   architectural  and/or  landscape  architectural
    48  services as such services are defined in article 145,  article  147  and
    49  article  148  of  the education law, each member of such foreign profes-
    50  sional service limited liability company must be  licensed  pursuant  to
    51  article  145,  article  147  and/or  article 148 of the education law to
    52  practice one or more of such professions in this state. With respect  to
    53  a  foreign professional service limited liability company which provides
    54  licensed clinical social work services as such services are  defined  in
    55  article  154  of  the education law, each member of such foreign profes-
    56  sional service limited liability company shall be licensed  pursuant  to

        S. 4297                            18
 
     1  article  154  of  the  education law to practice clinical social work in
     2  this state. With respect  to  a  foreign  professional  service  limited
     3  liability  company which provides creative arts therapy services as such
     4  services are defined in article 163 of the education law, each member of
     5  such  foreign  professional  service  limited  liability company must be
     6  licensed pursuant to article 163 of the education law to practice  crea-
     7  tive  arts therapy in this state. With respect to a foreign professional
     8  service limited liability company which  provides  marriage  and  family
     9  therapy  services  as  such  services  are defined in article 163 of the
    10  education law, each member of such foreign professional service  limited
    11  liability company must be licensed pursuant to article 163 of the educa-
    12  tion  law  to  practice  marriage and family therapy in this state. With
    13  respect to a foreign  professional  service  limited  liability  company
    14  which  provides  mental  health counseling services as such services are
    15  defined in article 163 of the education law, each member of such foreign
    16  professional service limited liability company must be licensed pursuant
    17  to article 163 of the education law to practice mental health counseling
    18  in this state. With respect to a foreign  professional  service  limited
    19  liability   company  which  provides  psychoanalysis  services  as  such
    20  services are defined in article 163 of the education law, each member of
    21  such foreign professional service  limited  liability  company  must  be
    22  licensed  pursuant  to  article  163  of  the  education law to practice
    23  psychoanalysis in this state. With respect  to  a  foreign  professional
    24  service limited liability company which provides applied behavior analy-
    25  sis  services  as such services are defined in article 167 of the educa-
    26  tion law, each member  of  such  foreign  professional  service  limited
    27  liability  company must be licensed or certified pursuant to article 167
    28  of the education law to  practice  applied  behavior  analysis  in  this
    29  state.
    30    §  6.  Subdivision  (q) of section 121-1500 of the partnership law, as
    31  amended by chapter 475 of the laws  of  2014,  is  amended  to  read  as
    32  follows:
    33    (q)  Each partner of a registered limited liability partnership formed
    34  to provide medical services in this state must be licensed  pursuant  to
    35  article  131 of the education law to practice medicine in this state and
    36  each partner of a registered limited  liability  partnership  formed  to
    37  provide dental services in this state must be licensed pursuant to arti-
    38  cle  133 of the education law to practice dentistry in this state.  Each
    39  partner of a registered limited liability partnership formed to  provide
    40  naturopathic services in this state must be licensed pursuant to article
    41  138  of  the  education  law to practice naturopathy in this state. Each
    42  partner of a registered limited liability partnership formed to  provide
    43  veterinary  services  in this state must be licensed pursuant to article
    44  135 of the education law to practice veterinary medicine in this  state.
    45  Each  partner  of  a  registered limited liability partnership formed to
    46  provide professional engineering, land surveying,  geological  services,
    47  architectural and/or landscape architectural services in this state must
    48  be  licensed  pursuant to article 145, article 147 and/or article 148 of
    49  the education law to practice one or more of such  professions  in  this
    50  state. Each partner of a registered limited liability partnership formed
    51  to  provide licensed clinical social work services in this state must be
    52  licensed pursuant to article 154 of the education law to practice  clin-
    53  ical  social  work  in  this state. Each partner of a registered limited
    54  liability partnership formed to provide creative arts  therapy  services
    55  in  this state must be licensed pursuant to article 163 of the education
    56  law to practice creative arts therapy in this state. Each partner  of  a

        S. 4297                            19
 
     1  registered  limited liability partnership formed to provide marriage and
     2  family therapy services in this state must be licensed pursuant to arti-
     3  cle 163 of the education law to practice marriage and family therapy  in
     4  this  state.  Each partner of a registered limited liability partnership
     5  formed to provide mental health counseling services in this  state  must
     6  be  licensed  pursuant  to  article 163 of the education law to practice
     7  mental health counseling in this state. Each  partner  of  a  registered
     8  limited  liability partnership formed to provide psychoanalysis services
     9  in this state must be licensed pursuant to article 163 of the  education
    10  law  to  practice psychoanalysis in this state. Each partner of a regis-
    11  tered limited liability partnership formed to provide  applied  behavior
    12  analysis service in this state must be licensed or certified pursuant to
    13  article  167  of the education law to practice applied behavior analysis
    14  in this state.
    15    § 7. Subdivision (q) of section 121-1502 of the  partnership  law,  as
    16  amended  by  chapter  475  of  the  laws  of 2014, is amended to read as
    17  follows:
    18    (q) Each partner of a  foreign  limited  liability  partnership  which
    19  provides  medical  services  in  this state must be licensed pursuant to
    20  article 131 of the education law to practice medicine in the  state  and
    21  each  partner  of a foreign limited liability partnership which provides
    22  dental services in the state must be licensed pursuant to article 133 of
    23  the education law to practice dentistry in this state. Each partner of a
    24  foreign  limited  liability  partnership  which  provides   naturopathic
    25  services  in  this state must be licensed pursuant to article 138 of the
    26  education law to practice naturopathy in this state. Each partner  of  a
    27  foreign  limited liability partnership which provides veterinary service
    28  in the state shall be licensed pursuant to article 135 of the  education
    29  law  to  practice  veterinary medicine in this state.  Each partner of a
    30  foreign limited liability partnership which provides professional  engi-
    31  neering, land surveying, geological services, architectural and/or land-
    32  scape  architectural services in this state must be licensed pursuant to
    33  article 145, article 147 and/or article 148  of  the  education  law  to
    34  practice  one  or  more  of  such professions. Each partner of a foreign
    35  limited liability partnership which provides  licensed  clinical  social
    36  work  services in this state must be licensed pursuant to article 154 of
    37  the education law to practice licensed  clinical  social  work  in  this
    38  state.  Each  partner  of  a foreign limited liability partnership which
    39  provides creative arts therapy services in this state must  be  licensed
    40  pursuant  to  article 163 of the education law to practice creative arts
    41  therapy in this state. Each partner of a foreign limited liability part-
    42  nership which provides marriage and  family  therapy  services  in  this
    43  state  must  be licensed pursuant to article 163 of the education law to
    44  practice marriage and family therapy in this state. Each  partner  of  a
    45  foreign limited liability partnership which provides mental health coun-
    46  seling  services  in this state must be licensed pursuant to article 163
    47  of the education law to practice mental health counseling in this state.
    48  Each partner of a foreign limited liability partnership  which  provides
    49  psychoanalysis services in this state must be licensed pursuant to arti-
    50  cle  163  of the education law to practice psychoanalysis in this state.
    51  Each partner of a foreign limited liability partnership  which  provides
    52  applied  behavior  analysis  services  in this state must be licensed or
    53  certified pursuant to article 167  of  the  education  law  to  practice
    54  applied behavior analysis in this state.

        S. 4297                            20
 
     1    §  8.  Paragraph  (a)  of  subdivision  1 of section 413 of the social
     2  services law, as separately amended by chapters 126 and 205 of the  laws
     3  of 2014, is amended to read as follows:
     4    (a)  The  following  persons  and  officials are required to report or
     5  cause a report to be made in accordance with this title when  they  have
     6  reasonable  cause  to  suspect  that a child coming before them in their
     7  professional or official capacity is an abused or maltreated  child,  or
     8  when  they have reasonable cause to suspect that a child is an abused or
     9  maltreated child where the parent, guardian, custodian or  other  person
    10  legally  responsible  for  such child comes before them in their profes-
    11  sional or official capacity and states from  personal  knowledge  facts,
    12  conditions or circumstances which, if correct, would render the child an
    13  abused  or maltreated child: any physician; registered physician assist-
    14  ant; surgeon; medical  examiner;  coroner;  dentist;  dental  hygienist;
    15  osteopath;  optometrist;  chiropractor; podiatrist; naturopathic doctor;
    16  resident; intern; psychologist; registered nurse; social  worker;  emer-
    17  gency  medical  technician;  licensed  creative arts therapist; licensed
    18  marriage  and  family  therapist;  licensed  mental  health   counselor;
    19  licensed  psychoanalyst;  licensed  behavior analyst; certified behavior
    20  analyst assistant; hospital personnel engaged in the admission, examina-
    21  tion, care or treatment of persons; a  Christian  Science  practitioner;
    22  school  official,  which  includes but is not limited to school teacher,
    23  school guidance counselor, school psychologist,  school  social  worker,
    24  school nurse, school administrator or other school personnel required to
    25  hold  a teaching or administrative license or certificate; full or part-
    26  time compensated school employee required to hold a  temporary  coaching
    27  license  or  professional  coaching certificate; social services worker;
    28  director of a children's overnight camp, summer day  camp  or  traveling
    29  summer  day  camp, as such camps are defined in section thirteen hundred
    30  ninety-two of the public health law; day care center worker;  school-age
    31  child care worker; provider of family or group family day care; employee
    32  or  volunteer  in  a  residential  care  facility  for  children that is
    33  licensed, certified or operated by the office  of  children  and  family
    34  services;  or  any other child care or foster care worker; mental health
    35  professional;  substance  abuse  counselor;  alcoholism  counselor;  all
    36  persons  credentialed  by  the  office of alcoholism and substance abuse
    37  services; peace officer; police officer; district attorney or  assistant
    38  district  attorney;  investigator  employed  in the office of a district
    39  attorney; or other law enforcement official.
    40    § 9. Subdivision 6 of section 571 of the public health law, as amended
    41  by chapter 444 of the laws of 2013, is amended to read as follows:
    42    6. "Qualified health care professional" means  a  physician,  dentist,
    43  podiatrist, naturopathic doctor, optometrist performing a clinical labo-
    44  ratory test that does not use an invasive modality as defined in section
    45  seventy-one  hundred  one  of  the  education  law, physician assistant,
    46  specialist assistant, nurse practitioner, or midwife,  who  is  licensed
    47  and registered with the state education department.
    48    §  10. Subdivision 1 of section 585 of the public health law, as added
    49  by chapter 803 of the laws of 1992, is amended to read as follows:
    50    1. "Health services purveyor" means  any  person,  firm,  partnership,
    51  group,  association,  corporation  or  professional  corporation, or any
    52  agent, employee, fiduciary, employer or representative thereof,  includ-
    53  ing  but  not  limited to a physician, dentist, podiatrist, naturopathic
    54  doctor or chiropractor, either in individual practice, group practice or
    55  employed in a facility owned by any person,  group,  association,  firm,

        S. 4297                            21
 
     1  partnership  or corporation hiring any of the aforementioned practition-
     2  ers, who provide health or health related services.
     3    § 11. This act shall take effect immediately; provided that:
     4    a.  sections  one, two, three, four, five, six, seven, nine and ten of
     5  this act shall take effect on the five hundred  fortieth  day  after  it
     6  shall have become a law; and
     7    b. effective immediately, the addition, amendment and/or repeal of any
     8  rule  or  regulation necessary for the implementation of this act on its
     9  effective date are authorized and directed to be made and  completed  by
    10  the commissioner of education and the board of regents on or before such
    11  effective date.
Go to top