Board advances 2026 sunset review draft; flags scope, licensing and online-practice issues

The California Board of Naturopathic Medicine spent the bulk of its Oct. 8 meeting reviewing the draft 2026 sunset review, focusing on how statutes, examination authority and online unlicensed activity affect the state licensing population and board operations.

Board staff led members through a color‑coded draft and tables that, staff said, link the licensing population to historical legislative milestones. Rebecca, a board staff member, described a new table titled “naturopathic doctor licensee population and legislative milestones” and said it showed a notable increase in license applications during the legislative push around SB 538 (scope expansion), followed by declines in later years. “It does show a big increase… in 02/1516 when the SB 538 was introduced,” she said, and staff agreed to keep the table while survey results are completed.

The board has commissioned a survey of licensees who allowed their California licenses to lapse. Rebecca said the survey “closes on the 20 second, the evening of the 20 second. So by the 20 third, I’ll have the results,” and she said results will be included in the final sunset report. Board members said that collecting reasons for leaving — including whether limited California scope drives departures to other states — is a central purpose of the study.

On examinations, Rebecca revised text to state that the National Naturopathic Physician Licensing Examination (NPLEX) undergoes occupational analyses by independent psychometric experts on behalf of the North American Board of Naturopathic Examiners. She wrote the board will ask the legislature to recognize the NPLEX analysis to satisfy Business and Professions Code section 139 requirements, because commissioning a separate state occupational analysis through the Department of Consumer Affairs’ Office of Professional Examination Services would duplicate work and “impose unnecessary costs to the board as estimated to exceed $50,000.” That language was approved for inclusion in the draft.

The draft also addresses online practice and unlicensed activity. Rebecca told members that most unlicensed‑practice complaints are discovered through the internet and social media, and that “I would say at least 90% of those unlicensed violations are found online.” The board discussed the difficulty of regulating practitioners based outside California who nonetheless reach California residents through telehealth or online advertising; staff said the board has used cease‑and‑desist communications where out‑of‑state providers appear to be treating Californians.

Board composition and advisory‑committee membership also drew discussion. Staff recounted the board’s historical membership mix — five naturopathic doctors, two physicians and two public members — and explained the arrangement originated when the Naturopathic Committee was separated from another medical board and retained physician representation to provide clinical perspective. Members praised the physician members’ contributions while acknowledging that the arrangement is unusual among DCA boards.

The draft lists additional issues the board plans to raise with the Legislature, including (1) lack of statutory authority to charge fees for continuing education review and approval — a resource‑intensive activity other boards recover with dedicated fees; (2) limitations in some California forms and labor‑code references that prevent naturopathic physicians from completing certain state forms (for example, some DMV or state disability forms) even when they would be primary‑care providers in other states; and (3) the board’s inability under current statute to cancel a license at the licensee’s request (license cancellation is currently handled by lapse/delinquency rules).

Rebecca set a timeline for finalizing the report: staff expect to complete most remaining narrative and data work by the end of the following week, circulate the draft to an advisory subgroup for review, bring the draft to the full board for final edits at the Nov. 19 meeting, and seek board approval of the publication design at the Dec. 3 meeting so the report can be delivered to the Legislature by early January.

No formal statutory changes were adopted at the meeting; the board directed staff to incorporate the items above into the sunset report for legislative consideration.