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Merger of the Bureau of Naturopathic Medicine into the Osteopathic Medical Board of California
 
Background on combining licensing boards
Governor Schwarzenegger has long held the belief that California maintains far too many licensing boards, which should be combined wherever possible. Several years ago he attempted to merge the osteopathic licensing board into the Medical Board of California – an attempt that OPSC successfully fought. 
 
ND licensure
The state law that authorized licensure of naturopathic doctors (NDs) and establishes their licensing board was scheduled to become inoperative on July 1, 2010. This would have effectively eliminated the naturopathic profession in California. Because of this threat to their profession, NDs have been actively trying to find another board to absorb them. Earlier this year, several OPSC leaders received phone calls from NDs expressing an interest in merging with the osteopathic licensing board. In every case, OPSC’s leaders informed the NDs that this action was unacceptable. 
 
The legislative process
Normally, legislation is required to go through a thorough process with multiple opportunities for voicing support or opposition, including legislative committee hearings, floor votes, etc. That did not happen in this case. 
 
On Monday, June 15, 2009, OPSC received a call notifying us that an informational legislative committee hearing would be held that very afternoon. Though no legislative bills would be presented, the hearing would address, among other things, the possibility of merging the naturopathic licensing board with the osteopathic licensing board. A legislative staff member had changed the proposal over the weekend from “abolish the naturopathic licensing board” to “merge the naturopathic licensing board into the Osteopathic Medical Board”. The naturopaths were out in force, as they knew all along the hearing was dealing with an issue vital to their survival. Due to the last minute change to affect the osteopathic profession, no osteopathic physicians were available to testify. OPSC’s Executive Director, Kathleen Creason, provided testimony focusing on public safety, public perception, and the autonomy of the osteopathic licensing board. The OMBC Acting Executive Director testified in opposition as well (the Executive Director was unable to attend – or be involved in any of these discussion – as he’d had an aortic dissection and has been on medical leave). Unfortunately, the committee recommended support of the merger. 
 
OPSC immediately took action in an effort to avert further action on this issue, including meeting with key staff members in the office of legislative leaders, sending letters to these leaders vehemently opposing the concept, seeking support from the California Medical Association and keeping regular communications with members of Governor Schwarzenegger’s staff. 
 
What happened?
As the panic about California’s state budget escalated and legislators felt immense pressure to take action, the language to merge the naturopathic licensing board into the osteopathic licensing board was slipped into “urgency” budget bill legislation, AB X4 20, the very afternoon that the full legislature voted on this and 30 other bills in the Budget package; http://www.leginfo.ca.gov/pub/09-10/bill/asm/ab_0001-0050/abx4_20_bill_20090728_chaptered.html. There was no notice, no hearings, no opportunity for opposition. This was construed as a money saving measure and a consolidation of resources, thereby enabling its designation as an urgent matter which circumvents the requirement for due process. Governor Schwarzenegger signed the legislation into law on July 28. Because of its “urgent” designation, the bill was given the minimum time frame of 90 days for implementation, making the action effective on October 23, 2009. 
 
What have we done since then?
Once this worst case scenario transpired, OPSC immediately began investigating options to reverse this unconscionable action. We consulted with legal counsel from multiple law firms including Greenberg Traurig (a Sacramento law firm well versed in initiatives and legislative activities), the Center for Public Interest Law (the lawyer for whom was the chief consultant of the legislative committee that managed the OMBC’s most recent renewal), and an individual attorney who works with a past OPSC President. Additionally, OPSC sought – and received – the support of the American Osteopathic Association’s legal counsel and staff. OPSC leaders and the AOA have sought support of OPSC’s position from the Federation of State Medical Boards, other individual state licensing boards, the new US Surgeon General, and other influential individuals. OPSC’s leaders held (and continue to hold) frequent and lengthy conference calls and e-mail communication in an effort to develop the most appropriate reversal strategy. 
 
The following were identified as potential strategies:
  1. Legislative – Although this would be an optimal resolution, there is no opportunity in the near future to reverse the merger. Even if strong support existed in the legislature, Governor Schwarzenegger has said he will not sign legislation that unravels the agreement reached on the budget bills. 
  2. Regulatory – A potential strategy for at least delaying the implementation would be the requirement for regulatory hearings prior to the merger taking place. OPSC leaders had high hopes for this strategy until we met with Governor Schwarzenegger’s cabinet secretary, Fred Aguiar, who informed OPSC that the merger would take place as scheduled. 
  3. Legal – Taking legal action the State of California is the single remaining option that appears to be somewhat viable. Advice from legal counsel indicates that a legal challenge would be difficult, and such action would be quite costly. In addition, this action might spark further action by the Governor, such as removal of sufficient OMBC members (and replacing them with naturopaths) to give the Board ND control, and veto of OPSC’s sponsored legislation (including the bill that will add DOs to the physician loan repayment program). However, it is an alternative that is being actively considered.   
 
OPSC’s Board of Directors is giving full consideration to the alternative courses of action to ensure the efforts of members and the organization are maximally effective.

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