A.R.S. tit. 32 ch. 14 — Arizona Revised Statutes Title 32 Chapter 14 — Naturopathic Medicine

32-1501. Definitions (Paragraph 31, subdivision (yy) was added with a 1998 Prop. 105 clause pursuant to L15, Ch. 256) In this chapter, unless the context otherwise requires: 1. "Accepted therapeutic purpose" means treatment of a disease, injury, ailment or infirmity that is competent and generally recognized as safe and effective. 2. "Active license" means a current valid license to practice naturopathic medicine. 3. "Adequate medical records" means legible medical records containing, at a minimum, sufficient information to identify the patient, support the diagnosis, describe the treatment, accurately document the results, indicate advice and cautionary warning provided to the patient and provide sufficient information for a similarly qualified practitioner to assume continuity of the patient's care at any point in the course of treatment. 4. "Approved clinical training program" or "clinical training program" means a program for naturopathic medical students in which the training occurred or is being conducted by or in conjunction with an approved school of naturopathic medicine. 5. "Approved internship program" or "internship" means that the program in which the training occurred or is being conducted has been approved for internship training for physicians or for graduates of a school of naturopathic medicine by the board or was approved or accredited by an educational or professional association recognized by the board or by another state's or country's licensing agency recognized by the board. 6. "Approved postdoctoral training" or "postdoctoral training" means that the program in which the training occurred or is being conducted has been approved for specialty training or for graduate medical education in naturopathic medicine by the board or approved or accredited by an educational or professional association recognized by the board or by another state's or country's licensing agency recognized by the board. 7. "Approved preceptorship program" or "preceptorship" means that the program in which the training occurred or is being conducted has been approved for preceptorship training for physicians or for graduates of a school of naturopathic medicine by the board or was approved or accredited by an educational or professional association recognized by the board or by another state's or country's licensing agency recognized by the board. 8. "Approved school of naturopathic medicine" or "school of naturopathic medicine" means a school, college or university determined by the board to have an educational program that meets standards prescribed by the council on naturopathic medical education, or its successor agency, and that offers a course of study that, on successful completion, results in the awarding of the degree of doctor of naturopathic medicine and whose course of study is either of the following: (a) Accredited or a candidate for accreditation by an accrediting agency recognized by the United States secretary of education as a specialized accrediting agency for schools of naturopathic medicine or its successor. (b) Accredited or a candidate for accreditation by an accrediting agency recognized by the council for higher education accreditation or its successor. 9. "Board" means the naturopathic physicians medical board. 10. "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 does not include experimental therapy used to treat heavy metal poisoning. 11. "Completed application" means that the applicant paid the required fees and supplied all documents and information as requested by the board and in a manner acceptable to the board. 12. "Controlled substance" means a drug, substance or immediate precursor in schedules I through V of title 36, chapter 27, article 2 or the rules adopted pursuant to title 36, chapter 27, article 2. 13. "Direct supervision" means that a physician who is licensed pursuant to this chapter or chapter 13, 17 or 29 of this title: (a) Is physically present and within sight or sound of the person supervised and is available for consultation regarding procedures that the physician has authorized and for which the physician remains responsible. (b) Has designated a person licensed pursuant to this chapter or chapter 13, 17 or 29 of this title to provide direct supervision in the physician's absence. 14. "Doctor of naturopathic medicine" or "doctor" means a natural person who is licensed to practice naturopathic medicine under this chapter. 15. "Drug" has the same meaning prescribed in section 32-1901 but does not include: (a) Intravenous administration of legend drugs, except for: (i) Vitamins, chelation therapy and drugs used in emergency resuscitation and stabilization. (ii) Minerals. (iii) Nutrients. For the purposes of this item, "nutrient" means a substance that provides nourishment for growth or metabolism and that is manufactured and supplied for intravenous use by a manufacturer registered with the United States food and drug administration or compounded by a pharmacy licensed by the Arizona state board of pharmacy. (b) Controlled substances listed as schedule I or II controlled substances as defined in the federal controlled substances act of 1970 (21 United States Code section 802), except morphine, any drug that is reclassified from schedule III to schedule II after January 1, 2014 and any homeopathic preparations that are also controlled substances. (c) Cancer chemotherapeutics classified as legend drugs. (d) Antipsychotics. 16. "General supervision" means that the physician is available for consultation regarding procedures that the physician has authorized and for which the physician remains responsible. 17. "Legend drug" means any drug that is defined by section 503(b) of the federal food, drug, and cosmetic act and under which definition its label is required to bear the statement "Rx only". 18. "Letter of concern" means a nondisciplinary advisory letter that is issued by the board to a person who is regulated under this chapter and that states that while there is insufficient evidence to support disciplinary action the board believes that the person should modify or eliminate certain practices and that continuation of the activities that led to the information being submitted to the board may result in action against the person's license, certificate or registration. 19. "Letter of reprimand" means a disciplinary letter that is issued by the board and that informs a person who is regulated under this chapter that the person's conduct violates state or federal law but does not require the board to restrict the person's license, certificate or registration because the person's conduct did not result in harm to a patient or to the public. 20. "Limit" means taking a nondisciplinary action that alters the physician's practice or professional activities if the board determines that there is evidence that the physician is or may be mentally or physically unable to safely engage in the practice of medicine. 21. "Medical assistant" or "naturopathic medical assistant" means a person who is certified by the board as a medical assistant, who assists a doctor of naturopathic medicine and who may perform delegated procedures that are commensurate with the assistant's education and training under the direct supervision of a doctor of naturopathic medicine and that do not include diagnosing, designing or modifying established treatment programs or those procedures prohibited by the board or by this chapter. 22. "Medically incompetent" means a person who is licensed, certified or registered pursuant to this chapter and who lacks sufficient naturopathic medical knowledge or skills, or both, to a degree that is likely to endanger the health of patients. 23. "Natural substance" means a homeopathic, botanical, nutritional or other supplement that does not require a prescription pursuant to federal law before it is prescribed, dispensed or otherwise furnished to a patient and that is prescribed by a physician who is licensed pursuant to this chapter to enhance health, prevent disease or treat a medical condition diagnosed by the physician. 24. "Naturopathic medical student" means a person who is enrolled in a course of study at an approved school of naturopathic medicine. 25. "Naturopathic medicine" means medicine as taught in approved schools of naturopathic medicine and in clinical, internship, preceptorship and postdoctoral training programs approved by the board and practiced by a recipient of a degree of doctor of naturopathic medicine licensed pursuant to this chapter. 26. "Nurse" means a person who is licensed pursuant to chapter 15 of this title. 27. "Physician" means a doctor of naturopathic medicine who is licensed pursuant to this chapter. 28. "Practice of naturopathic medicine" means a medical system of diagnosing and treating diseases, injuries, ailments, infirmities and other conditions of the human mind and body, including by natural means, drugless methods, drugs, nonsurgical methods, devices, physical, electrical, hygienic and sanitary measures and all forms of physical agents and modalities. 29. "Restrict" means taking a disciplinary action that alters the physician's practice or professional activities if the board determines that there is evidence that the physician is or may be medically incompetent or guilty of unprofessional conduct. 30. "Specialist" means a physician who has successfully completed approved postdoctoral training, who is certified by a specialty board of examiners recognized by the board and who is certified by the board to practice the specialty pursuant to this chapter. 31. "Unprofessional conduct" includes the following, whether occurring in this state or elsewhere: (a) Intentionally disclosing a professional secret or intentionally disclosing a privileged communication except as either of these may otherwise be required by law. (b) Engaging in any dishonorable conduct reflecting unfavorably on the profession. (c) 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 conclusive evidence of the commission of the felony or misdemeanor. (d) Habitual intemperance in the use of alcohol or any substance abuse. (e) Engaging in the illegal use of any narcotic or hypnotic drugs, or illegal substances. (f) Engaging in conduct that the board determines is gross malpractice, repeated malpractice or any malpractice resulting in the death of a patient. (g) Impersonating another doctor of naturopathic medicine or any other practitioner of the healing arts. (h) Falsely acting or assuming to act as a member, an employee or an authorized agent of the board. (i) Procuring or attempting to procure a license or a certificate pursuant to this chapter by fraud, by misrepresentation or by knowingly taking advantage of the mistake of another person or agency. (j) Having professional connection with or lending one's name to enhance or continue the activities of an illegal physician or an illegal practitioner of any healing art. (k) Representing that a manifestly incurable disease, injury, ailment or infirmity can be permanently cured, or falsely or fraudulently representing that a curable disease, injury, ailment or infirmity can be cured within a stated time. (l) Offering, undertaking or agreeing to cure or treat a disease, injury, ailment or infirmity by a secret means, method, treatment, medicine, substance, device or instrumentality. (m) Refusing to divulge to the board on demand the means, method, treatment, medicine, substance, device or instrumentality used in the treatment of a disease, injury, ailment or infirmity. (n) Giving or receiving, or aiding or abetting the giving or receiving of, rebates, either directly or indirectly. (o) Knowingly making any false or fraudulent statement, written or oral, in connection with the practice of naturopathic medicine or any naturopathic treatment method. (p) Engaging in immorality or misconduct that tends to discredit the naturopathic profession. (q) Having a license refused, revoked or suspended by any other state, district or territory of the United States or any other country, unless it can be shown that this action was not due to reasons that relate to the ability to safely and skillfully practice as a doctor of naturopathic medicine or to any act of unprofessional conduct in this paragraph. (r) Engaging in any conduct or practice that is contrary to recognized standards of ethics of the naturopathic 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 safely and skillfully practice as a doctor of naturopathic medicine. (s) Failing to observe any federal, state, county or municipal law relating to public health as a physician in this state. (t) Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate this chapter or board rules. (u) Committing false, fraudulent, deceptive or misleading advertising or advertising the quality of a medical or health care service by a physician or by the physician's staff, employer or representative. (v) Failing or refusing to maintain adequate medical records on a patient or failing or refusing to make medical records in the physician's possession promptly available to another physician or health care provider who is licensed pursuant to chapter 7, 8, 13, 15, 17 or 29 of this title on request and receipt of proper authorization to do so from the patient, a minor patient's parent, the patient's legal guardian or the patient's authorized representative or failing to comply with title 12, chapter 13, article 7.1. (w) Referring a patient to a diagnostic or treatment facility or prescribing goods and services without disclosing in writing to the patient that the physician has a pecuniary interest in the facility, goods or services to which the patient is referred or prescribed. This subdivision does not apply to a referral by one physician or practitioner to another physician or practitioner within a group of physicians or practitioners practicing together. (x) Engaging in sexual intimacies with a patient in the course of direct treatment. (y) Failing to dispense drugs and devices in compliance with article 4 of this chapter. (z) Administering, dispensing or prescribing any drug or a device for other than an accepted therapeutic purpose. (aa) Falsely representing or holding oneself out as being a specialist or representation by a doctor of naturopathic medicine or the doctor's staff, employer or representative that the doctor is boarded or board certified if this is not true or that standing is not current. (bb) Delegating professional duties and responsibilities to a person if the person has not been approved or qualified by licensure or by certification to perform these duties or responsibilities. (cc) Failing to appropriately supervise a naturopathic medical student, a nurse, a medical assistant, a health care provider or a technician who is employed by or assigned to the physician during the performance of delegated professional duties and responsibilities. (dd) Using experimental forms of diagnosis or treatment without adequate informed consent of the patient or the patient's legal guardian and without conforming to experimental criteria, including protocols, detailed records, periodic analysis of results and periodic review by a medical peer review committee as approved by the United States food and drug administration or its successor agency. (ee) Failing to furnish information in a timely manner to the board or investigators or representatives of the board if this information is legally requested by the board and failing to allow properly authorized board personnel on demand to examine and have access to documents, reports and records maintained by the physician that relate to the physician's medical practice or medically related activities. (ff) Failing to report in writing to the board evidence that a person who is licensed, certified or registered pursuant to this chapter is or may be medically incompetent, guilty of unprofessional conduct or mentally or physically unable to safely practice or assist in the practice of naturopathic medicine. (gg) Conducting or engaging in an internship or preceptorship in naturopathic medicine without being approved and registered by the board for that internship or preceptorship. (hh) Signing a blank, undated or predated prescription form. (ii) Engaging in conduct that the board determines is gross negligence, repeated negligence or negligence resulting in harm or death to a patient. (jj) Knowingly making a false or misleading statement in oral testimony to the board on a form required by the board or in written correspondence to the board, including attachments to that correspondence. (kk) The failure of a physician who is the chief medical officer, the executive officer or the chief of staff of an internship, a preceptorship or a clinical training program to report in writing to the board that the privileges of a doctor of naturopathic medicine, a naturopathic medical student or a medical assistant have been denied, limited, revoked or suspended because that doctor's, student's or assistant's actions appear to indicate that the person is or may be medically incompetent, is or may be guilty of unprofessional conduct or is or may be unable to safely engage or assist in the practice of naturopathic medicine. (ll) Having action taken against a doctor of naturopathic medicine by a licensing or regulatory board in another jurisdiction due to that doctor's mental or physical inability to engage safely in the practice of naturopathic medicine or the doctor's medical incompetence or for unprofessional conduct as defined by that licensing or regulatory board and that corresponds directly or indirectly to an act of unprofessional conduct prescribed by this paragraph. The action taken may include refusing, denying, revoking or suspending a license, otherwise limiting, restricting or monitoring a licensee or placing a licensee on probation by that licensing or regulatory board. (mm) Having sanctions imposed by an agency of the federal government, including restricting, suspending, limiting or removing a person from the practice of naturopathic medicine or restricting that person's ability to obtain financial remuneration. (nn) Violating any formal order, probation, consent agreement or stipulation issued or entered into by the board pursuant to this chapter. (oo) Refusing to submit to a body fluid examination pursuant to a board investigation of alleged substance abuse by a doctor of naturopathic medicine. (pp) Charging a fee for services not rendered or dividing a professional fee for patient referrals among health care providers or health care institutions or between these providers and institutions or a contractual arrangement that has this effect. (qq) Obtaining a fee by fraud, deceit or misrepresentation. (rr) Charging or collecting a clearly excessive fee. In determining whether a fee is clearly excessive, the board shall consider the fee or range of fees customarily charged in this state for similar services, in light of modifying factors such as the time required, the complexity of the service and the skill required to perform the service properly. This subdivision does not apply if there is a clear written contract for a fixed fee between the physician and the patient that was entered into before the service was provided. (ss) With the exception of heavy metal poisoning, using chelation therapy in the treatment of arteriosclerosis or as any other form of therapy without adequate informed patient consent and without conforming to generally accepted experimental criteria, including protocols, detailed records, periodic analysis of results and periodic review by a medical peer review committee. (tt) Using a controlled substance unless it is prescribed by another physician for use during a prescribed course of treatment. (uu) Prescribing, dispensing or administering anabolic androgenic steroids for other than therapeutic purposes. (vv) Except in an emergency or urgent care situation, prescribing or dispensing a controlled substance to a member of the naturopathic physician's immediate family. (ww) 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 physical examination of that person or has previously established a doctor-patient relationship. The physical examination may be conducted through telehealth as defined in section 36-3601 unless the examination is for the purpose of obtaining a written certification from the physician for the purposes of title 36, chapter 28.1. This subdivision does not apply to: (i) A licensee who provides temporary patient supervision on behalf of the patient's regular treating licensed health care professional. (ii) An emergency medical situation as defined in section 41-1831. (iii) Prescriptions written to prepare a patient for a medical examination. (iv) 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 item, "bioterrorism" has the same meaning prescribed in section 36-781. (v) Prescriptions written or antimicrobials dispensed to a contact as defined in section 36-661 who is believed to have had significant exposure risk as defined in section 36-661 with another person who has been diagnosed with a communicable disease as defined in section 36-661 by the prescribing or dispensing physician. (vi) Prescriptions written by a licensee through a telehealth program that is covered by the policies and procedures adopted by the administrator of a hospital or outpatient treatment center. (xx) If medical treatment is considered experimental or investigational, failing to include in a patient's record a consent to treatment document that is signed by the patient or the patient's parent or legal guardian and that indicates that the patient or the patient's parent or legal guardian has been informed of the risk of any treatment to be provided and the expected cost of that treatment. (yy) When issuing a written certification as defined in section 36-2801, failing or refusing to include in the adequate medical records of a patient a copy of all of the following: (i) The medical records relied on by the physician to support the diagnosis or confirmed diagnosis of the patient's debilitating medical condition. (ii) The written certification. (iii) The patient's profile on the Arizona board of pharmacy controlled substances prescription monitoring program database. (zz) Dispensing a schedule II controlled substance that is an opioid. 32-1502. Naturopathic physicians medical board; appointment; qualifications; term of office; immunity A. The naturopathic physicians medical board is established consisting of the following members: 1. Four physician members appointed by the governor. Each physician member shall be: (a) A resident of this state for at least five years immediately preceding the appointment. (b) A doctor of naturopathic medicine with a degree from a naturopathic school or college approved by the board who has engaged in full-time practice of naturopathic medicine for at least five years immediately preceding the appointment. 2. Three public members appointed by the governor. Each public member shall: (a) Be a resident of this state for at least five years immediately preceding the appointment. (b) Not be connected, in any manner, with or have any interest in a school of medicine, a health care institution or any person practicing any form of healing or treatment of bodily or mental ailments. (c) Demonstrate an interest in the health problems in this state. B. Before appointment by the governor, a prospective member of the board shall submit a full set of fingerprints to the governor for the purpose of obtaining a state and federal criminal records check pursuant to section 41-1750 and Public Law 92-544. The department of public safety may exchange this fingerprint data with the federal bureau of investigation. C. The terms of office of the physician members and the public members are five years to begin and end on June 30. Each physician member and each public member continue to hold office until the appointment and qualification of their successors, subject to the following exceptions: 1. A member of the board may be removed from office if the governor finds the member was guilty of malfeasance, misfeasance or dishonorable conduct. 2. The term of any member automatically ends on resignation, permanent removal from this state or removal from this state for a period of more than six months. D. There shall be no monetary liability on the part of and no cause of action shall arise against the members of the board, the secretary-treasurer or permanent or temporary personnel of the board for any act done or proceeding undertaken or performed in good faith and in furtherance of the purposes of this chapter. 32-1503. Board organization; meetings; compensation; committees A. The board shall annually elect, from among its membership, a chairman, a vice-chairman and a secretary-treasurer, who shall hold their respective offices at the pleasure of the board. B. The board shall hold a regular meeting at least semiannually on a date and at a time and place it designates. In addition, the board may hold special meetings it deems necessary. C. A majority of the members of the board constitutes a quorum, and a majority vote of a quorum present at any meeting governs all actions taken by the board, except as provided in section 32-1525, subsection I and section 32-1526, subsection A. D. Members of the board are eligible to receive compensation established by the board of not more than one hundred fifty dollars for each day of actual service in the business of the board. E. In order to carry out the board's duties and functions, the chairman may establish committees from the board membership and define the duties of these committees. 32-1504. Powers and duties A. The board shall: 1. Adopt rules that are necessary or proper for the administration of this chapter. 2. Administer and enforce all provisions of this chapter and all rules adopted by the board under the authority granted by this chapter. 3. Adopt rules regarding the qualifications of medical assistants who assist doctors of naturopathic medicine and shall determine the qualifications of medical assistants who are not otherwise regulated. 4. Adopt rules for the approval of schools of naturopathic medicine. The board may incorporate by reference the accrediting standards for naturopathic medical schools published by accrediting agencies recognized by the United States department of education or recognized by the council for higher education accreditation. 5. Adopt rules relating to clinical, internship, preceptorship and postdoctoral training programs, naturopathic graduate medical education and naturopathic continuing medical education programs. The rules for naturopathic continuing medical education programs shall require at least ten hours each year directly related to pharmacotherapeutics. 6. Periodically inspect and evaluate clinical, internship, preceptorship and postdoctoral training programs and naturopathic graduate medical education programs and randomly evaluate naturopathic continuing medical education programs. 7. Adopt rules relating to the dispensing of natural substances, drugs and devices. 8. Adopt rules necessary for the safe administration of intravenous nutrients. These rules shall identify and exclude substances that do not meet the criteria of nutrients suitable for intravenous administration. 9. Adopt and use a seal. 10. Have the full and free exchange of information with the licensing and disciplinary boards of other states and countries and with the American association of naturopathic physicians, the Arizona naturopathic medical association, the association of naturopathic medical colleges, the federation of naturopathic medical licensing boards and the naturopathic medical societies of other states, districts and territories of the United States or other countries. B. The board may: 1. Adopt rules that prescribe annual continuing medical education for the renewal of licenses issued under this chapter. 2. Employ permanent or temporary personnel it deems necessary to carry out the purposes of this chapter and designate their duties. 3. Adopt rules relating to naturopathic medical specialties and determine the qualifications of doctors of naturopathic medicine who may represent or hold themselves out as being specialists. 4. If reasonable cause exists to believe that the competency of an applicant or a person who is regulated by the board is in question, require that person to undergo any combination of physical, mental, biological fluid and laboratory tests. 5. Be a dues paying member of national organizations that support licensing agencies in their licensing and regulatory duties and pay the travel expenses involved for a designated board member or the executive director to represent the board at the annual meeting of these organizations. 6. Adopt rules for conducting licensing examinations required by this chapter. 7. Delegate to the executive director the board's authority pursuant to sections 32-1509 and 32-1551. 32-1505. Naturopathic physicians medical board fund (L24, Ch. 222, sec. 17. Eff. until 7/1/28) A. The naturopathic physicians medical board fund is established. The board shall administer the fund. Pursuant to sections 35-146 and 35-147, the board shall deposit fifteen percent of all monies from whatever source that come into the possession of the board in the state general fund and deposit the remaining eighty-five percent in the naturopathic physicians medical board fund. B. Monies deposited in the naturopathic physicians medical board fund are subject to section 35-143.01. 32-1505. Naturopathic physicians medical board fund (L24, Ch. 222, sec. 18. Eff. 7/1/28) A. The naturopathic physicians medical board fund is established. The board shall administer the fund. Pursuant to sections 35-146 and 35-147, the board shall deposit ten percent of all monies from whatever source that come into the possession of the board in the state general fund and deposit the remaining ninety percent in the naturopathic physicians medical board fund. B. Monies deposited in the naturopathic physicians medical board fund are subject to section 35-143.01. 32-1507. Change in status; assessment of costs A. Each person who holds a license or certificate pursuant to this chapter shall inform the board in writing, within thirty days, of any change in status of that person's initial application including any change of name, residence, practice address and telephone number and of each subsequent change of status. A licensee's or a certificate holder's residential address and residential telephone number or numbers are not available to the public unless they are the only address and numbers of record. B. The board may assess the costs incurred by the board in locating a person who is licensed or certified pursuant to this chapter to that person. C. The board shall deposit, pursuant to sections 35-146 and 35-147, monies collected pursuant to this section in the naturopathic physicians medical board fund. 32-1508. Display of licenses and certificates A. A person who holds a license or certificate pursuant to this chapter shall display that document in a conspicuous place that is accessible to view by the public. B. A person who practices, conducts affairs or is employed at more than one location and who maintains a continuing activity as authorized by the license or certificate shall display a duplicate of that document issued by the board at each location. 32-1509. Executive director; compensation; duties A. Subject to title 41, chapter 4, article 4, the board shall appoint an executive director who serves at the pleasure of the board. The executive director shall not be a board member and shall not have any financial interests in the practice of naturopathic medicine or the training of naturopathic physicians. The board may authorize the executive director to represent the board and to vote on behalf of the board at meetings of national organizations of which the board is a dues paying member. B. The executive director and other board staff are eligible to receive compensation as determined pursuant to section 38-611. C. The executive director or that person's designee shall: 1. Subject to title 41, chapter 4, article 4 and, as applicable, articles 5 and 6, employ, evaluate, dismiss, discipline and direct professional, clerical, technical, investigative and administrative personnel necessary to carry on the work of the board. 2. As directed by the board, prepare and submit recommendations to the board for amendments to this chapter for consideration by the legislature. 3. Subject to title 41, chapter 4, article 4, employ medical consultants and agents necessary to conduct investigations, gather information and perform those duties the executive director determines are necessary and appropriate to enforce this chapter. 4. Issue licenses and certificates pursuant to section 32-1526 to applicants who meet the requirements of this chapter. 5. Maintain a record of board actions and proceedings, including the issuance, denial, renewal, suspension or revocation of licenses and certificates. 6. Manage the board's offices. 7. Prepare minutes, records, reports, registries, directories, books and newsletters and record all board transactions and orders. 8. Collect all monies due and payable to the board. 9. Pay all bills for authorized expenditures of the board and its staff. 10. Prepare an annual budget. 11. Submit a copy of the budget each year to the governor, the speaker of the house of representatives and the president of the senate. 12. Initiate an investigation if evidence appears to demonstrate that a person licensed or certified by the board may be engaged in unprofessional conduct or may be medically incompetent or mentally or physically unable to safely practice medicine. 13. Issue subpoenas if necessary to compel the attendance and testimony of witnesses and the production of books, records, documents and other evidence. 14. Sign and execute and provide assistance to the attorney general in preparing disciplinary orders, rehabilitative orders and notices of hearings as directed by the board. 15. Enter into contracts for goods and services pursuant to title 41, chapter 23 that are necessary to carry out board policies and directives. 16. Execute board directives. 17. Represent the board with the federal government, other states or jurisdictions of the United States, this state, political subdivisions of this state, the news media and the public. 18. Maintain a roster of all persons who are licensed or certified under this chapter that indicates: (a) The person's name. (b) The person's current address of record. (c) The date of issuance and the number of the person's license or certificate. (d) The status of the person's license or certificate. 19. Maintain an accurate account of all receipts, expenditures and refunds granted pursuant to this chapter. 20. Report dispensing and prescribing restrictions imposed by the board against doctors of naturopathic medicine to other state and federal regulatory agencies. 21. Affix the seal of the board to necessary documents. The imprint of the seal with the signature of the executive director is evidence of official board action. 22. On behalf of the board, enter into stipulated agreements with persons who are under the jurisdiction of the board for the treatment, rehabilitation and monitoring of chemical substance abuse or misuse. 23. Review all complaints filed pursuant to section 32-1551. If delegated by the board, the executive director may dismiss complaints. 24. If delegated by the board, refer cases directly to a formal interview or a formal hearing. 25. If delegated by the board, enter into a consent agreement if there is evidence of danger to the public health and safety. 26. If delegated by the board, grant uncontested requests for retired status or cancellation of a license. 27. Perform all other duties required by the board. D. Medical consultants and agents appointed pursuant to subsection C, paragraph 3 of this section are eligible to receive compensation determined by the executive director of not more than $200 for each day of service. E. A person who is aggrieved by an action taken by the executive director may request a board review of that action by filing with the board a written request within thirty days after that person has been notified of the action. Notification shall be by personal delivery or certified mail to the person's last known address on file with the board. The board shall review the decision at its next regularly scheduled meeting and either approve, modify or reject the executive director's action. 32-1521. Persons and acts not affected by this chapter This chapter does not apply to: 1. The lawful practice of any other method, system or science of healing by a person licensed under the laws of this state. 2. Any student of naturopathic medicine in the course of taking an approved clinical training program. This exemption does not exempt the student from article 3 of this chapter. 3. Any out-of-state physician licensed by another state or country, if in consultation requested by a doctor of naturopathic medicine. 4. A person who is not licensed or certified by the board and who sells food articles to supplement the diet of a person or who sells a natural substance that does not require a prescription. 5. A person who is a graduate of an approved school of naturopathic medicine and has been awarded the degree of doctor of naturopathic medicine and who, in the course of taking an approved internship training program, an approved preceptorship training program or an approved postdoctoral training program under the direct supervision of a physician, complies with the application requirements of this chapter for the training program and pays the required fees. This exemption does not exempt that person from article 3 of this chapter. 32-1522. Basic qualifications for license A. To be eligible for a license to practice naturopathic medicine pursuant to this chapter, the applicant shall: 1. Be a graduate of an approved school of naturopathic medicine. 2. Have satisfactorily completed an approved internship, preceptorship or clinical training program in naturopathic medicine. 3. Be physically and mentally fit to practice as a doctor of naturopathic medicine. 4. Not be guilty of any act of unprofessional conduct or any other conduct that would be grounds for refusal, suspension or revocation of a license under this chapter. 5. Not have had a license to practice any profession refused, revoked or suspended by any other state, district or territory of the United States or another country for reasons that relate to the applicant's ability to skillfully and safely practice as a physician in this state. 6. File a completed application pursuant to section 32-1524 and meet the examination requirements provided for in section 32-1525. B. The board may: 1. Require an applicant to submit credentials or other written or oral proof. 2. Make investigations it deems proper to adequately advise itself with respect to the qualifications of an applicant. C. Within ninety days after it receives a completed application for initial licensure, the board shall issue a license if the application demonstrates to the board's satisfaction that the applicant complies with this chapter and board rules. 32-1522.01. Temporary licenses; duration of license A. The executive director may issue a temporary license to any applicant who is seeking licensure, whose application is complete and who has applied in writing for a temporary license. The executive director may issue a temporary license to an applicant only once. B. A temporary license issued pursuant to this section is effective from the date that the application is approved until the last day of the month in which the board meets to consider the application for licensure. C. A temporary license shall not be extended, renewed, reissued or allowed to continue in effect beyond the period authorized by this section. 32-1523. Qualifications for license to practice by endorsement; restrictions A. To be eligible for a license to practice naturopathic medicine pursuant to this chapter by endorsement, the applicant shall: 1. Qualify under section 32-1522. 2. Be licensed to practice as a doctor of naturopathic medicine by either: (a) Another state, district or territory of the United States. (b) Another country that requires a written examination that is substantially equivalent to the written examination provided for in section 32-1525. 3. Be active, for at least three years immediately preceding the application, in one or more of the following: (a) Active practice as a doctor of naturopathic medicine. (b) An approved internship, preceptorship or clinical training program in naturopathic medicine. (c) An approved postdoctoral training program in naturopathic medicine. (d) The resident study of naturopathic medicine at an approved school of naturopathic medicine. 4. Pass the examinations provided for in section 32-1525. B. If an applicant for licensure pursuant to this section is licensed in another state, district or territory of the United States or another country that does not require that competency be shown in the same elective practice areas as this state, the applicant shall be required to successfully complete examinations in these elective practice areas or, if otherwise qualified, be issued a license that does not include these elective practice areas. 32-1523.01. Foreign graduates; additional qualifications A. An applicant for a license to practice as a doctor of naturopathic medicine who received naturopathic medical training from an institution outside of the United States or Canada and who is not licensed by any other state, district or territory of the United States shall meet all of the following requirements: 1. Be a graduate of an approved school of naturopathic medicine. 2. Have successfully completed a clinical training program. 3. Be physically and mentally fit to practice as a doctor of naturopathic medicine. 4. Not be guilty of an act of unprofessional conduct or any other conduct that is grounds for refusal, suspension or revocation of a license under this chapter. 5. Not have had a license to practice any profession refused, revoked or suspended by any other state, district or territory of the United States or another country for reasons that relate to that person's ability to skillfully and safely practice as a doctor of naturopathic medicine. 6. Have successfully completed either a two-year internship training program approved by the board or a postdoctoral training program approved by the board. B. The applicant shall file a complete application and pay the required fees as provided in section 32-1527 and, in addition, shall pay for any costs incurred by the board for investigations or verification of an applicant's credentials and qualifications. C. The applicant shall pass the examination as required pursuant to section 32-1525, subsection B. D. The board may: 1. Require the applicant to submit credentials or other written or oral proof that the applicant meets the requirements of this section. 2. Make investigations it deems proper to adequately determine the qualifications of the applicant. 32-1524. Application; deficiencies in application; interview; withdrawal; release of information A. Each applicant for licensure or certification shall file a verified completed application in the form and style required and supplied by the board and accompanied by the appropriate application fee prescribed in section 32-1527. The filing of an application grants the board the authority to obtain information from any licensing board or agency in any state, district, territory or county of the United States or another country, from the Arizona criminal justice information system in the department of public safety and from the federal bureau of investigation. The fingerprints submitted shall be used to obtain a state and federal criminal records check pursuant to section 41-1750 and Public Law 92-544. The department of public safety is authorized to exchange this fingerprint data with the federal bureau of investigation. B. The application shall require the applicant to submit evidence, credentials and other proof necessary to satisfy the board that the applicant meets the requirements of a completed application. C. The application shall contain the oath of the applicant that: 1. All information contained in the application and evidence submitted with it are true and correct. 2. The credentials submitted were not procured by fraud or misrepresentation or any mistake of which the applicant is aware. 3. The applicant is the lawful holder of the credentials. D. All applications submitted to the board and any attendant evidence, credentials or other proof submitted with an application are the property of the board and part of the permanent record of the board and shall not be returned to a withdrawing applicant. E. The board shall promptly inform an applicant, in writing, of the deficiencies, if any, in the application that prevent it from being considered by the board as a completed application. F. The board may interview the applicant to determine whether the application is sufficient or whether the applicant otherwise qualifies for licensure or for a certificate. G. Applications are considered withdrawn on the occurrence of any of the following: 1. The request of the applicant. 2. Failure of the applicant to appear for an interview with the board except for good cause. 3. Failure of the applicant to submit a completed application within one year after the date of the mailing by the board of a statement to the applicant of the deficiencies in the application under subsection E of this section. 4. Failure of the applicant to show, within one year after the interview provided for in subsection F of this section, that the completed application is true and correct. H. Applicants for a license or for a certificate to engage in a preceptorship training program or an internship training program shall submit a fingerprint card in the manner required by the board. 32-1525. Examinations A. The board shall use the naturopathic physicians licensing examination conducted by the North American board of naturopathic examiners, or its successor agency, for the national examinations required under sections 32-1522, 32-1523 and 32-1523.01. The board may administer its own examination only for those areas that are determined by the board to be necessary for the safe practice of naturopathic medicine and not covered on the naturopathic physicians licensing examination. The board must accept the grade issued by the North American board of naturopathic examiners without adjustment. A board member or staff member shall not have any financial interest in the North American board of naturopathic examiners or the naturopathic physicians licensing examination. B. An individual who is applying for licensure under section 32-1522 or 32-1523.01 shall take and pass the following portions of the naturopathic physicians licensing examinations or other examinations: 1. Part I basic biomedical science examination. 2. Part II core science and core clinical science examinations. 3. Clinical elective examinations of minor surgery and acupuncture. C. An individual who is applying for licensure under section 32-1523: 1. Shall take and pass both: (a) Part I basic biomedical science examination. (b) Part II core science and core clinical science examinations. 2. Shall take and pass the clinical elective examinations of minor surgery and acupuncture if the person is applying for a license that includes those elective practice areas. D. An individual who is applying for a license by endorsement pursuant to section 32-1523 and who was licensed in another state or a Canadian province before January 1, 2005, in addition to meeting the requirements of subsection C of this section, shall take and pass an additional sixty-hour course and examination in pharmacotherapeutics. E. The examinations required for a license under section 32-1522, 32-1523 or 32-1523.01 shall include an examination in Arizona naturopathic jurisprudence that is administered by the board. F. Examinations for licensure under this chapter shall: 1. Be practical in character and consist of multiple choice and true and false questions. 2. Be designed to ascertain the applicant's knowledge of naturopathic medicine and the applicant's ability to practice naturopathic medicine. 3. Include examination questions that are generally accepted as necessary for a competent knowledge of the practice of naturopathic medicine. G. The board by rule shall prescribe any subjects on which the applicant must be tested in addition to those required by this section. The board may prescribe rules for conducting its own examinations. H. An applicant shall obtain a passing score on the national examination and shall obtain a grade of seventy-five percent or more in each subject administered by the board that is not covered on the national examination. I. An applicant may challenge the applicant's grade on an examination conducted by the board by submitting a written request to the board within sixty days of receiving the grade. If the board upholds the applicant's challenge, it may change, within one hundred twenty days of the challenge, the grade on the examination on the vote of a majority of the full board. J. An individual applying for licensure under section 32-1522 or 32-1523.01 shall take and complete all of the examinations required by this section within a five-year period immediately preceding the submission of an application for licensure. Each time an applicant files a request with the board to retake any part of an examination, the applicant shall pay the examination fee pursuant to section 32-1527. K. All examination materials and records of examination grading are confidential and are not public records. 32-1526. Licenses; certificates; issuance; renewal; failure to renew A. The board shall issue licenses and certificates to applicants who are qualified under this chapter. The board shall only issue licenses under this chapter on the vote of a majority of the full board. Subject to review by the board at its next board meeting, the executive director may issue temporary licenses pursuant to section 32-1522.01, license renewals and certificates to qualified applicants. B. Except as provided in section 32-4301, a license or certificate issued by the board expires unless renewed each year. C. Each physician who holds an active license to practice naturopathic medicine in this state shall renew the license on or before January 1 of each year by supplying the executive director with information the board determines is necessary and payment of the annual renewal fee prescribed in section 32-1527. D. A person who holds a certificate issued by the board shall renew the certificate on or before July 1 of each year by supplying the executive director with information the board determines is necessary and payment of the annual fee prescribed in section 32-1527. E. A licensee or certificate holder whose license or certificate is current and who is not currently the subject of a probationary order or licensure suspension by the board may request, at any time, and shall be granted cancellation of the license or certificate. F. A person who fails to renew a license or certificate by the due date shall pay a late renewal fee as prescribed in section 32-1527. Except as provided in section 32-4301, a license or certificate automatically expires if not renewed within sixty days after the due date. G. The board may reinstate a license or certificate on payment of all renewal and penalty fees as prescribed in section 32-1527 and, if requested by the board, presentation of evidence satisfactory to the board that the applicant for reinstatement of an expired license is professionally able to engage or assist in the practice of naturopathic medicine and still possesses the professional knowledge required. If an applicant for reinstatement of an expired license has not been licensed and actively practicing in a jurisdiction of the United States or Canada in the three years immediately preceding the application, the board may issue a limited license that requires a period of general supervision by another licensed naturopathic physician not to exceed one year. H. After a hearing, the board may refuse to reinstate a license or certificate for any grounds prescribed in section 32-1551. I. The board and the executive director may prorate initial annual fees when a new application is approved by dividing the annual amount by twelve and multiplying the results by the number of months remaining until the next annual renewal date. 32-1527. Fees A. The board by a formal vote at an open public meeting shall establish fees, except as provided in section 32-1530, that the board determines are necessary to provide monies to conduct its business and that do not exceed the following: 1. For application for a license to practice naturopathic medicine and for certification to practice as a specialist, $400. 2. For application for a certificate to dispense, $400. 3. For issuance of a duplicate license or certificate, $100. 4. For endorsement of an Arizona license or certificate for the purpose of applying for a license, certificate or registration in another state or country, $50. 5. For initial issuance of a license or a certificate, $50. 6. For any annual renewal of a license or a certificate, $400. 7. For any late renewal of a license or an additional certificate, $200. 8. For an initial application to conduct or engage in an internship, a preceptorship or a postdoctoral training program, $100. 9. For examination of applicants, the cost of giving the examination to each applicant. 10. For an initial application to be certified as a naturopathic medical assistant, $100. 11. For a copy of the minutes of board meetings during the calendar year, $25 for each set of minutes. 12. For copying records, documents, letters, minutes, applications and files, $.25 per page. 13. For a copy of tapes or computerized diskettes not requiring programming, $100. 14. For written verification of a certificate or license, $5. 15. For submitting fingerprint cards to the department of public safety, the cost required by that department. B. The board may charge a fee for services that it is not required to provide pursuant to this chapter but that the board determines are appropriate to carry out the intent and purpose of this chapter. A fee imposed pursuant to this subsection shall not exceed the board's costs of rendering the service. 32-1528. Retired licensee; waiver of fees; reinstatement A. The board may waive a physician's annual renewal fee if the physician has paid all past fees and presents an affidavit to the board that the physician has permanently retired from the practice of naturopathic medicine. B. A physician whose annual renewal fee has been waived by the board and who is permanently retired from the practice of naturopathic medicine is not required to comply with any continuing medical education requirements of this chapter. C. If a retired physician who has had the annual renewal fee waived by the board engages in the practice of naturopathic medicine, the physician is subject to the same penalties that are imposed under this chapter on a person who practices naturopathic medicine without a license or without being exempt from licensure. D. The board may reinstate a retired physician to active practice on payment of the annual renewal fee as prescribed in section 32-1527 and, if requested by the board, on presentation of evidence satisfactory to the board that the applicant for reinstatement of a retired license is professionally able to engage or assist in the practice of naturopathic medicine and possesses the professional knowledge required. E. If an applicant for reinstatement of a retired license has not been licensed and actively practicing in a jurisdiction of the United States or Canada in the three years immediately preceding the application, the board may issue a limited license that requires a period of general or direct supervision by another licensed naturopathic physician not to exceed one year. 32-1529. Specialists; certification; qualifications A. To be eligible for a certificate to practice as a specialist, an applicant shall: 1. Hold a current valid license to practice naturopathic medicine under this chapter. 2. Have satisfactorily completed an approved postdoctoral training program in the specialty. 3. Be board certified in the specialty by a specialty board of examiners that is recognized by the board. 4. Be physically and mentally fit to practice the specialty. 5. Not be guilty of any act of unprofessional conduct or any other conduct that would be grounds for refusal, suspension or revocation of a license under this chapter. 6. Not have had any license to practice any profession refused, revoked or suspended by any other state, district or territory of the United States or another country for reasons that relate to the person's ability to skillfully and safely practice as a physician in this state. 7. File a completed application pursuant to section 32-1524. B. The board may: 1. Require an applicant to submit credentials or other written or oral proof. 2. Make investigations it deems necessary to adequately advise it with respect to an applicant's qualifications. C. A certificate issued to a physician pursuant to this section shall be concurrently renewed, suspended or revoked with that physician's license to practice naturopathic medicine. 32-1530. Exemptions from certificate to dispense fees A. A physician who practices at a public health facility operated by this state or a county or at a facility operated by a qualifying community health center established pursuant to section 36-2907.06 and who is exempt from paying registration fees pursuant to section 32-1921, subsection D for a certificate to dispense issued by the board if involved in the dispensing of devices and medications shall annually renew a certificate to dispense pursuant to section 32-1526 but is exempt from the annual renewal fee to dispense under section 32-1527. B. A physician who is employed by and dispenses devices and medications at a facility that is operated by a not-for-profit corpora