Colorado department of regulatory agencies
Division of Professions and Occupations
 Office of Naturopathic Doctor Registration Program
4 CCR 749-1
rules regulating naturopathic doctors registration, practice, and discipline
Authority
Basis:  These rules are promulgated pursuant to § 12-37.3-104(1)(a), C.R.S. The registration and regulation of Naturopathic Doctors is found in Title 12 (“Professions and Occupations”), Article 37.3 (“Naturopathic Doctors”) of the Colorado Revised Statutes. 
Scope and Purpose
These rules were promulgated in order to carry out the powers and duties of the Division Director of the Division of Professions and Occupations, Department of Regulatory Agencies (“Director”) pursuant to § 12-37.3-104(1)(a), C.R.S. These rules affect every person who practices as a Naturopathic Doctor in the State of Colorado.
Rule 5 - Inactive registration status (§ 12-37.3-118, C.R.S.) 
The purpose of this rule is to clarify the requirements governing inactive registration status pursuant to § 12-37.3-118, C.R.S. 
A.	A registered naturopathic doctor shall request inactive registration status by completing and submitting the appropriate application for inactive status. 
B.	A naturopathic doctor with an inactive registration shall not engage in any act or conduct that constitutes the practice of naturopathic medicine. 
C.	A naturopathic doctor with an inactive registration is exempt from the continuing professional competency requirements of § 12-37.3-108, C.R.S., and Rule 13, except as described in this Rule.
D.	Inactive registration status does not: 
1.	Prevent the Director from investigating complaints or imposing discipline against a naturopathic doctor in accordance with Title 12, Article 37.3 of the Colorado Revised Statutes; or, 
2.	Limit or restrict the Director’s functions, duties, or obligations, under Title 12, Article 37.3 of the Colorado Revised Statutes. 
E.	Except as otherwise provided by this rule, a naturopathic doctor with an inactive registration remains subject to all provisions of these rules and all provisions of Title 12, Article 37.3 of the Colorado Revised Statutes. 
F.	A naturopathic doctor seeking to reactivate an inactive registration must: 
1.	Submit a completed application for reactivation, pay a reactivation fee, and attest to complying with the professional liability insurance coverage requirements of § 12-37.3-114, C.R.S.
2.	If inactive for less than two years, demonstrate continuing professional competency by providing documentation of completion, within the two years immediately preceding the application for reactivation, of twenty-five Professional Development Activities, as defined in Rule 13, for each year or portion thereof that the registration was inactive.
3.	If inactive for at least two years but less than five years, demonstrate continuing professional competency, by providing one of the following:
 a.	Verification of licensure, registration, or certification in good standing from another state or jurisdiction along with proof of active practice in that state or jurisdiction for two of the previous five years from the date of the reactivation application; or
b.	Documentation of completion, within the two years immediately preceding the application for reactivation, of twenty-five Professional Development Activities, as defined in Rule 13, for each year or portion thereof that the registration was inactive; or
c.	Proof of continuing professional competency by any other means approved by the Director.
4.	If inactive for five or more years, demonstrate continuing professional competency, by providing either: 
	a.	All of the following:
i.	Verification of licensure, registration, or certification in good standing from another state or jurisdiction, along with proof of active practice in that state or jurisdiction for two of the previous five years from the date of the reactivation application;
ii.	Evidence of supervised practice for a period of no less than six months, subject to the terms established by the Director; and
iii.	Completion of an additional thirteen Professional Development Activities in Coursework, as defined in Rule 13, for each year or portion thereof the registration has been inactive.
-OR-
b.	Proof of continuing professional competency by any other means approved by the Director.
Rule 13 - Continuing Professional Competency (§ 12-37.3-108, C.R.S.)
The purpose of this rule is to establish a program of ongoing continuing professional competency as set forth in § 12-37.3-108, C.R.S., wherein a registered naturopathic doctor shall maintain and demonstrate continuing professional competency in order to renew, reinstate, or reactivate a registration to practice naturopathic medicine in the state of Colorado.
A.	Definitions
1.	Continuing Professional Competency: The ongoing ability of a naturopathic doctor to learn, integrate, and apply the knowledge, skill, and judgment to practice as a naturopathic doctor according to generally accepted standards and professional ethical standards.
2.	Continuing Professional Development (CPD): The Director’s program through which a registrant can satisfy the continuing professional competency requirements in order to renew, reinstate, or reactivate a registration.
3.	Deemed Status: A registrant who satisfies the continuing professional competency requirements of a state department or accrediting body or entity as approved by the Director pursuant to § 12-37.3-108(1)(c), C.R.S., may qualify for “Deemed Status.”
4.	Learning Plan: The Director-approved form through which a registrant documents the registrant’s goals and plans of learning that were developed from the registrant’s reflective self-assessment (RSAT), which is defined below. A registrant shall execute the registrant’s learning plan by completing Professional Development Activities (PDA) as required before a registration is renewed.
5.	Military Exemption: As set forth in § 12-70-102, C.R.S., a registrant who has been called to federally funded active duty for more than 120 days for the purpose of serving in a war, emergency or contingency may request an exemption from the continuing professional competency requirements for the renewal period that falls within the period of service or within the six months following the completion of service.
6.	Professional Development Activities (PDA): Learning activities undertaken to increase the registrant’s knowledge and skill or hone existing knowledge and skill for the purpose of continuing professional competency. PDA are equivalent to clock hours; one PDA is equal to one clock hour.
7.	Program Manual: An instructional guide to assist the registrant in understanding the continuing professional competency requirements and the CPD program.
8.	Reflective Self-assessment Tool (RSAT): A reflective practice tool in which a registrant can reflect upon the registrant’s knowledge and skills as a naturopathic doctor taking into account the registrant’s current level and area of practice.
B.	Continuing Professional Competency Requirements
1.	Effective after the 2015 renewal of a registration, or upon the completion of any renewal of a registration thereafter, the registrant shall demonstrate continuing professional competency in order to renew by:
a.	Participation in the Continuing Professional Development (CPD) program;
b.	Participation in a program of continuing professional competency through a state agency or an accrediting body or entity as approved by the Director as set forth in § 12-37.3-108(1)(c), C.R.S. This status is hereafter known as “Deemed Status” as defined herein; or
c.	Receiving an exemption for military service as defined in § 12-70-102, C.R.S. Military exemptions must be approved by the Director. A registrant seeking a military exemption shall submit a request in writing with evidence that the registrant’s military service meets the criteria established in § 12-70-102, C.R.S., and section F of this rule.
2.	A registrant shall attest at the time of the renewal of a registration to compliance with continuing professional competency requirements.
C.	Continuing Professional Development (CPD) Program
1.	The CPD Program entails the following:
a.	The registrant shall complete the Reflective Self-Assessment Tool (RSAT) once per renewal period. A registrant shall use the form approved by the Director;
b.	The execution of a Learning Plan once per renewal period that is based upon the registrant’s RSAT. The registrant shall use the form approved by the Director; and
c.	Accrual of twenty-five Professional Development Activities per year of each renewal period, to include: 
i.	If treating a child who is less than age eight, three hours of Coursework or Mentoring per year solely related to pediatrics, and; 
ii.	If treating a child who is less than age two, two additional hours of Coursework or Mentoring per year solely related to pediatrics, to include subject matter related to recognizing a sick infant and when to refer an infant for more intensive care.
2.	Professional Development Activities (PDA)
a.	PDA must be relevant to the registrant’s practice as a naturopathic doctor and pertinent to the registrant’s learning plan. The Director will not pre-approve specific courses or providers. The registrant shall determine which activities and topics will meet the registrant’s Learning Plan, and select an appropriate course and provider.
b.	PDA are organized into the following seven categories as detailed below. One PDA is granted per one clock hour of qualifying activity with the exception of the category, Presenting, in which two PDA are credited for every one hour of presentation delivery. This 2:1 ratio acknowledges the preparation of the presentation. PDAs are credited only once per presentation.
i.	Coursework; 
ii. 	Group Study; 
iii.	Independent Learning;
iv.	Mentoring;
v. 	Presenting;
vi.	Publishing; and 
vii.	Volunteer Service.
c.	PDA earned must include a minimum of thirteen hours from the category of Coursework; however, all twenty-five PDA can be earned within this category.  With the exception of the category of Coursework, no more than five PDA can be credited in any one category.  
d.	PDA will be accepted if the activity is included in the current Program Manual. The current Program Manual will be available to all registrants through the program and will set forth accepted PDA within each category. The Director has sole discretion to accept or reject PDA that are not identified in the current Program Manual.
e.	The total required annual PDA must be earned within the same year in which credit is requested. PDA will be credited toward only one renewal period.
D.	Audit of Compliance
1.	The following documentation is required for an audit of compliance of a registrant’s participation in the CPD program:
a.	A signed Learning Plan that contains the registrant’s goals in the form and manner set forth in the current Program Manual as approved by the Director;
b.	Documentation of the required PDA in compliance with the current Program Manual and this Rule; and 
c.	The Director has sole discretion to accept or reject PDA that do not meet the criteria established by the Director as defined in the current Program Manual and this Rule.
2.	As set forth in § 12-37.3-108(2), C.R.S., records of assessments or other documentation developed or submitted in connection with the continuing professional competency program are confidential and not subject to inspection by the public or discovery in connection with a civil action against a naturopathic doctor.  Neither the Director nor any other person shall use the records or documents unless used by the Director to determine whether a naturopathic doctor is maintaining continuing professional competency to engage in the profession.
3.	The current Program Manual will set forth the documentation methods and standards for compliance with this Rule.
E.	Deemed Status
1.	Qualification. In order to qualify for Deemed Status upon renewal, the registrant shall:
a.	Attest to the registrant’s Deemed Status; and
b.	Attest that the requested continuing professional competency program is substantially equivalent to the CPD program administered by the Director and must include, at a minimum each renewal period, the following components:
i.	An assessment of knowledge and skills;
ii.	Twenty-five contact hours of continuing education or learning activities per year of the renewal period, to include:
(1)	If treating a child who is less than age eight, three hours of education or practicum training per year solely related to pediatrics; and 
(2)	If treating a child who is less than age two, two additional hours of education or practicum training per year solely related to pediatrics, to include subject matter related to recognizing a sick infant and when to refer an infant for more intensive care; and
iii.	Demonstration of completion of continuing competency activities.
2.	Administrative Approval. The Director has sole discretion to administratively approve a state agency and accrediting body and/or entity meeting the criteria established in this section. Once an accrediting body and/or entity is approved, such approval will be publically published.
3.	Compliance Audit. A registrant claiming Deemed Status is subject to an audit of compliance. To satisfy an audit of compliance, the registrant shall submit appropriate evidence of participation in a qualifying program through submission of:
a.	A letter from a state agency, accrediting body or entity as approved by the Director specifying that the registrant has completed the registrant’s continuing professional competency program, or
b.	Other documentation approved by the Director which reflects the registrant’s completion of a program of continuing professional competency.
F.	Military Exemption.
1.	Military exemptions must be approved by the Director. A registrant seeking a military exemption shall submit a request in writing with evidence that the registrant’s military service meets the criteria established in § 12-70-102, C.R.S.
2.	After being granted a military exemption, in order to complete the renewal process, a registrant shall attest to the registrant’s military exemption.
G.	Records Retention. A registrant shall retain documentation demonstrating the registrant’s compliance for either two complete renewal periods or four years, whichever period is longer.
H.	Non-Compliance. Falsifying an attestation or other documentation regarding the registrant’s compliance with continuing professional competency requirements constitutes the falsification of information in an application and may be grounds for discipline pursuant to § 12-37.3-112(1)(b), C.R.S.
I.	Reinstatement and Reactivation. A registrant seeking to reinstate or reactivate a registration shall meet the continuing professional competency requirements detailed in Rule 5 and Rule 15.
Rule  14 - Renewal of Registration (§ 12-37.3-107, C.R.S)
The purpose of this rule is to establish the requirements for renewing a registration pursuant to § 12-37.3-107, C.R.S.
A.	Failure to Receive Renewal Notice.  Failure to receive notice for renewal of registration from the Director does not excuse a registrant from the requirement for renewal under the Naturopathic Doctor Act and this Rule.
B.  	Grace period.  Registrants shall have a sixty-day grace period after the expiration of a registration to renew such registration without the imposition of a disciplinary sanction for practicing on an expired registration. During this grace period, a delinquency fee will be charged for late renewals. A registrant who does not renew a registration within the sixty-day grace period shall be treated as having an expired registration and shall be ineligible to practice until such registration is reinstated.
C.	Continuing Professional Competence.  Pursuant to § 12-37.3-108, C.R.S. and Rule 13, naturopathic doctors shall demonstrate continuing professional competence in order to renew.
D.  	Military Exemption.  As set forth in § 12-70-102, C.R.S., a registrant who has been called to federally funded active duty for more than 120 days for the purpose of serving in a war, emergency or contingency may request an exemption from payment of the renewal registration fee and from completion of continuing professional competency requirements for the renewal of a registration for the renewal period that falls within the period of service or within the six months following the completion of service.
Rule  15 - Reinstatement of Expired Registration (§ 12-37.3-107, 24-34-102(8) and 24-34-105, C.R.S)
The purpose of this rule is to establish the requirements for reinstatement of a registration that has expired.
A.	An applicant seeking reinstatement of an expired registration must complete a reinstatement application, pay a reinstatement fee, and attest to complying with the professional liability insurance coverage requirements of § 12-37.3-114, C.R.S.
B.	An applicant seeking to reinstate a registration that has been expired less than two years shall be required to demonstrate continuing professional competency as described in § 12-37.3-108, C.R.S., and Rule 13. 
C.	An applicant seeking to reinstate a registration that has been expired for at least two years but less than five years must demonstrate competency to practice under § 24-34-102(8), C.R.S., by providing one of the following:
1.	Verification of licensure, registration, or certification in good standing from another state or jurisdiction along with proof of active practice in that state or jurisdiction for two of the previous five years from the date of the reinstatement application; or
2.	Documentation of completion, within the two years immediately preceding the application for reinstatement, of twenty-five Professional Development Activities, as defined in Rule 13, for each year or portion thereof that the registration was expired; or
3.	Proof of competency to practice by any other means approved by the Director.
D.	An applicant seeking to reinstate a registration that has been expired for five or more years must demonstrate competency to practice under § 24-34-102(8), by demonstrating either: 
1.	All of the following:
a.	Verification of licensure, registration, or certification in good standing from another state or jurisdiction, along with proof of active practice in that state or jurisdiction for two of the previous five years from the date of the reinstatement application;
b.	Evidence of supervised practice for a period of no less than six months, subject to the terms established by the Director; and
c.	Completion of an additional thirteen Professional Development Activities in Coursework, as defined in Rule 13, for each year or portion thereof the registration has been expired.
-OR-
2.	Proof of competency to practice by any other means approved by the Director.