Fiscal Estimate and Economic Impact Analysis:
The Fiscal Estimate and Economic Impact Analysis are attached.
Effect on small business:
These proposed rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department’s Regulatory Review Coordinator may be contacted by email at Jennifer.Garrett@wisconsin.gov, or by calling (608) 266-2112. Agency contact person:
Sofia Anderson, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, Wisconsin 53708-8366; email at DSPSAdminRules@wisconsin.gov. Place where comments are to be submitted and deadline for submission:
Comments may be submitted to Sofia Anderson, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Policy Development, P.O. Box 8366, Madison, Wisconsin 53708-8366, or by email to DSPSAdminRules@wisconsin.gov. Comments must be received on or before the public hearing, held on February 16, 2024, to be included in the record of rule-making proceedings. ------------------------------------------------------------------------------------------------------------
TEXT OF RULE
Section 1. Nat Med 1 to 6 are created to read:
Nat Med 1
Authority and definitions
Nat Med 1.01 Authority. The rules in chs. Nat Med 1 to 6 are adopted by the naturopathic medicine examining board pursuant to the authority delegated by ss. 15.08 (5) (b), 227.11 (2), and 466.03, Stats. Nat Med 1.02 Definitions. As used in chs. Nat Med 1 to 6: (1) “Board” means the naturopathic medicine examining board.
(2) “Department” means the department of safety and professional services.
(3) “Jurisprudence exam” means the board approved examination on the state law related to the practice of naturopathic medicine.
(4) “Licensee” means a person licensed to practice as a naturopathic doctor or limited-scope naturopathic doctor in this state.
(5) “Limited-scope naturopathic doctor” means a person licensed under s. 466.04 (2), Stats. (6) “Modes of treatment” means treatment, including diagnostic procedures, generally considered to be within the scope of current and acceptable standards of care.
(7) “NABNE” means the North American Board of Naturopathic Examiners.
(8) “Naturopathic doctor” means a person licensed under s. 466.04 (1), Stats. (9) “Naturopathic medicine” has the meaning given in s. 466.01 (6), Stats. (10) “Naturopathic physical medicine” has the meaning given in s. 466.01 (7), Stats. (11) “NPLEX” means the Naturopathic Physicians Licensing Examination administered by the North American Board of Naturopathic Examiners.
Nat Med 2
Scope of Practice
Nat Med 2.01 Informed consent. (1) Any naturopathic doctor who treats a patient shall inform the patient about the availability of reasonable alternate modes of treatment and about the benefits and risks of these treatments. The reasonable naturopathic doctor standard is the standard for informing a patient. The reasonable naturopathic doctor standard requires disclosure only of information that a reasonable naturopathic doctor in the same or a similar medical specialty would know and disclose under the circumstances.
(2) Under this section, a naturopathic doctor’s duty to inform the patient does not require disclosure of any of the following:
(a) Detailed technical information that in all probability a patient would not understand.
(b) Risks apparent or known to the patient.
(c) Extremely remote possibilities that might falsely or detrimentally alarm the patient.
(d) Information in cases where the patient is incapable of consenting.
(e) Information about alternate modes of treatment for any condition the naturopathic doctor has not included in the diagnosis at the time the naturopathic doctor informs the patient.
(f) In an emergency, a naturopathic doctor is not required to communicate alternate modes of treatment to a patient if failure to provide immediate treatment would be more harmful to a patient than immediate treatment.
(g) A naturopathic doctor may not be held responsible for failure to inform a patient of a possible complication or benefit not generally known to reasonably well−qualified naturopathic doctors in a similar medical classification.
(3) When informed consent is refused or withdrawn, no retaliation may be threatened or carried out.
(4) A patient may withdraw informed consent at any time.
Nat Med 2.02 Recordkeeping. (1) A naturopathic doctor shall maintain complete and accurate patient health care records on every patient for a period of not less than 5 years after the date of the last entry, or for a longer period as may be otherwise required by law.
(2) A patient health care record prepared by a naturopathic doctor shall contain, at a minimum, the following clinical health care information:
(a) Pertinent patient history.
(b) Pertinent objective findings related to examination and test results.
(c) Assessment or diagnosis.
(d) Plan of treatment for the patient.
(e) Any written documentation of informed consent.
(3) Each patient health care record entry shall be dated, identify the practitioner, and be sufficiently legible to allow interpretation by other practitioners for the benefit of the patient.
Nat Med 2.04 Prohibited practices. A naturopathic doctor may not engage in any practices specified in ss. 466.01 (6) (c) and (7) (b), Stats. Nat Med 2.05 Telehealth practice. (1) A naturopathic doctor who uses telehealth in the diagnosis and treatment of a patient located in this state shall be licensed to practice as a naturopathic doctor by the board under s. 466.04 (1), Stats. (2) A naturopathic doctor shall be held to the same standards of practice and conduct including patient confidentiality and recordkeeping, regardless of whether health care services are provided in person or by telehealth.
Nat Med 2.06 Advertising. Any advertisement, marketing, or other public representation by or referring to a licensee shall clearly state the licensee’s authorized scope of practice, including the specific license held by the provider.
Nat Med 3
Licensure requirements and renewal
Nat Med 3.01. License not required. Pursuant s. 466.02 (2), Stats., certain individuals are not required to obtain a license under this chapter to engage in practice or activities relating to naturopathic medicine. Nat Med 3.02 Licensure requirements. An applicant for licensure as a naturopathic doctor shall submit all of the following requirements:
(1) A complete application for the license on a form provided by the department including any information required by the board to determine an applicant’s minimal competency to practice.
Note: Instructions for initial licensure applications can be found on the department of safety and professional services’ website at http://dsps.wi.gov. (3) Subject to ss. 111.321, 111.322 and 111.335, Stats, evidence satisfactory to the board that the applicant does not have an arrest or a conviction record.
(4) Verified documentary evidence that the applicant has complied with at least one of the educational requirements specified in s. 466.04 (1) (d), Stats. (5) Evidence satisfactory to the board that the applicant has satisfied the examination requirements under s. Nat Med 3.04. (6) If required by the board, completion of an oral examination as specified in s. Nat Med 3.05. Nat Med 3.03. Reciprocal credentials for service members, former service members, and their spouses. A reciprocal license to practice naturopathic medicine shall be granted to a service member, former service member, or the spouse of a service member or former service member who the board determines meets all of the requirements under s. 440.09 (2), Stats. Subject to s. 440.09 (2m), Stats., the board may request verification necessary to make a determination under this section. Note: Instructions for applications can be found on the department of safety and professional services’ website at http://dsps.wi.gov. Nat Med 3.04. Examinations.
(1) Examinations required. Each applicant for licensure under this chapter must provide evidence satisfactory to the board that the applicant has passed all of the following:
(a) One of the following for the competency-based examination:
1. Part I Biomedical Science Examination and Part II Core Clinical Science Examination of the NPLEX.
2. For graduates of approved naturopathic medical programs prior to 1978, a competency−based state naturopathic medicine licensing examination or equivalent Canadian provincial licensing examination for the practice of naturopathic medicine approved by the board.
