PROPOSED RULES
(Board of Naturopathy)
Original Notice.
Preproposal statement of inquiry was filed as WSR 11-23-108.
Title of Rule and Other Identifying Information: Chapter 246-836 WAC, amending sections to change the regulatory authority to the board of naturopathy, update the scope of practice, general housekeeping, and amend requirements to approve naturopathic medical education institutions.
Hearing Location(s): Department of Health, 20435 72nd Avenue South, Suite 200, Kent, WA 98032, on May 11, 2012, at 9:00 a.m.
Date of Intended Adoption: May 11, 2012.
Submit Written Comments to: Susan Gragg, Department of Health, P.O. Box 47852, Olympia, WA 98504-7852, web site http://www3.doh.wa.gov/policyreview/, fax (360) 236-2901, by May 11, 2012.
Assistance for Persons with Disabilities: Contact Susan Gragg by May 7, 2012, TTY (800) 833-6388 or 711.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed rules amend existing rules to implement HB 1181 (chapter 41, Laws of 2011), which created the board of naturopathy; and SSB 5152 (chapter 40, Laws of 2011), which modified portions of naturopathic scope of practice. The proposed rules make general housekeeping edits and, because of the change in authority, add language for temporary practice permits and sexual misconduct. The proposed rules also update the education program standards and accept accreditation from national organizations as meeting the approval standards. This would allow on-site evaluations by national organizations, thereby eliminating duplication and inefficiencies.
Reasons Supporting Proposal: The proposed rules reflect the change of regulatory authority from the secretary of health to the board of naturopathy and the modification to scope of practice. In addition, the changes to education standards provide flexibility for evolving educational institutions to continue to meet Washington standards.
Statutory Authority for Adoption: RCW 18.36A.160, HB 1181 (2011), SSB 5152 (2011).
Statute Being Implemented: Chapter 18.36A RCW.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of health, board of naturopathy, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Susan Gragg, Program Manager, P.O. Box 47852, Olympia, WA 98504-7852, (360) 236-4941.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rule would not impose more than minor costs on businesses in an industry.
A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Susan Gragg, Department of Health, P.O. Box 47852, Olympia, WA 98504-7852, phone (360) 236-4941, fax (360) 236-2901, e-mail susan.gragg@doh.wa.gov.
March 30, 2012
Susan Teil Boyer
Executive Director
OTS-4680.1
AMENDATORY SECTION(Amending Order 224, filed 12/23/91,
effective 1/23/92)
WAC 246-836-010
Definitions.
((For the purposes of this
chapter, the following words and phrases shall have the
following meanings unless the context clearly indicates
otherwise.)) The definitions in this section apply throughout
this chapter unless the context clearly requires otherwise.
(1) "((Department)) Board" means the ((department of
health)) board of naturopathy, whose address is:
Department of Health
((Professional Licensing Service))
P.O. Box 1099
Olympia, Washington 98507-1099
(2) "Department" means the department of health.
(3) "Hospital" means any health care institution licensed pursuant to chapter 70.41 RCW.
(((3) "Mentally or physically disabled naturopath" means
a naturopath who is currently mentally incompetent or mentally
ill as determined by a court, or who is unable to practice
naturopathy with reasonable skill and safety to patients by
reason of any mental or physical condition and who continues
to practice while so impaired.))
(4) "Naturopath" or "naturopathic physician" means a person licensed pursuant to chapter 18.36A RCW.
(5) "Nursing home" means any health care institution which comes under chapter 18.51 RCW.
(6) "Unprofessional conduct" means the conduct described in RCW 18.130.180.
[Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-010, filed 12/23/91, effective 1/23/92.]
(2) All applicants shall file with the ((department))
board a completed application, with the required fee, at least
((60)) sixty days prior to the exam.
(3) Applicants shall request that the college of
naturopathic medicine send official transcripts directly to
the ((department)) board.
(4) Applicants who have filed the required applications,
whose official transcript has been received by the
((department)) board, and who meet all qualifications shall be
notified of their eligibility, and only such applicants will
be admitted to the exam.
[Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-020, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-020, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060. 88-14-009 (Order PM 742), § 308-34-110, filed 6/24/88.]
(a) Basic science component which may include but not be limited to tests in the following subjects: Pathology, anatomy, physiology, microbiology and biochemistry.
(b) Clinical science component which may include but not be limited to tests in the following subjects: Physical diagnosis; nutrition; physical medicine; botanical medicines and toxicology; psychological and lifestyle counseling; emergency medicine, basic skills and public health; lab and X-ray diagnosis.
(c) Law of the state and administrative regulations as they relate to the practice of naturopathic medicine.
(d) The ((department)) board, at its discretion, may
require tests in other subjects. Candidates will receive
information concerning additional tests prior to the
examination.
(2) Candidates may take the basic science component of the exam after two years of training. A candidate who has achieved a passing score on the basic science component after two years of training must achieve a passing score on the clinical science component and the state law test within twenty-seven months after graduation; otherwise, the candidate's basic science component exam results will be null and void and the candidate must again take the basic science component of the exam. All exam candidates are required to obtain a passing score on all tests before a license is issued. A candidate who takes the basic science component of the exam after two years of training must submit an application for reexamination, along with reexamination fees, to take the clinical science component and the state law test at a later exam administration.
(3) Examinations shall be conducted twice a year.
(4) The minimum passing score for each test in the examination is seventy-five.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-030, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060. 88-14-009 (Order PM 742), § 308-34-120, filed 6/24/88.]
(2) A candidate must retake the entire basic science component if he or she failed to achieve a passing score in three or more basic science tests. A candidate must retake the entire clinical science component if he or she failed to achieve a passing score in four or more clinical science tests. A candidate must retake any test(s) for which the candidate failed to achieve a passing score.
(3) A candidate who failed to achieve a passing score in three or more basic science tests and/or four or more clinical science tests must achieve a passing score on those tests within the next two administrations of the examination. A candidate who does not achieve a passing score within those next two administrations of the exam will be required to retake the entire component.
(4) A candidate must achieve passing scores on all tests in the entire exam within a twenty-seven month period; otherwise the candidate's exam results are null and void and the candidate must retake the entire exam. Provided: WAC 246-836-030(2) shall apply to a candidate who took the basic science component of the exam after two years in training.
(5) A candidate is required to pay a reexamination fee to retake the exam or any portion thereof.
(6) A candidate who took the basic science component of the exam after two years of training must submit an application for reexamination, along with reexamination fees, to take the clinical science component and the state law test at a later exam administration.
[Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-050, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-050, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060. 88-14-009 (Order PM 742), § 308-34-140, filed 6/24/88.]
(2) In emergency situations, such as personal or family
illness, the ((department)) board may in its discretion, for
good cause shown, waive all or part of the continuing
education requirement for a particular one year period for an
individual licensee. The ((department)) board may require
such verification of the emergency as is necessary to prove
its existence.
[Statutory Authority: RCW 43.70.280. 98-05-060, § 246-836-080, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-080, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-080, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060. 88-14-009 (Order PM 742), § 308-34-180, filed 6/24/88.]
(a) Satisfactory completion of a basic naturopathic medical program in a naturopathic school or college officially approved by the country where the school is located.
(i) The naturopathic education program at the time of graduation shall be equivalent to or exceed the minimum required standards for Washington state approved colleges of naturopathic medicine.
(ii) Any deficiencies in the naturopathic medical program shall be satisfactorily completed in a Washington state approved college of naturopathic medicine.
(b) Applicants licensed under the laws of a country outside of the United States or its territories shall be required to take the current licensing examinations noted in WAC 246-836-030: Provided, That those persons meeting the requirements of WAC 246-836-110, (Licensing by endorsement), are exempt from this requirement.
(c) All other requirements of chapter 18.36A RCW and this chapter must be met, including the requirement that the applicant be of good moral character; not have engaged in unprofessional conduct; and not be unable to practice with reasonable skill and safety as a result of a physical or mental impairment.
(2) Applicants for examination shall:
(a) File with the ((department)) board a completed
notarized license application with the required fee at least
sixty days prior to examination.
(b) Request the college of naturopathic medicine to
submit an official transcript directly to the ((department))
board.
(c) Request the licensing agency in the country of
original license to submit evidence of licensure to the
((department)) board.
(d) If the applicant's original documents (education and
licensing) are on file in another state, the applicant may
request that the other state send to the ((department)) board
notarized copies in lieu of the originals.
[Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-100, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-100, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060(1). 89-02-051 (Order PM 815), § 308-34-310, filed 1/3/89.]
(1) The candidate has graduated from and holds a degree/diploma from a college of naturopathic medicine approved by the state or jurisdiction where the school is located and which prepares candidates for licensure as a naturopathic physician: Provided, That such program at the time of the candidate's graduation is equivalent to or exceeds the minimum naturopathic medical educational standards required for Washington state approved schools;
(2) The candidate holds a current valid license in good
standing to practice as a naturopathic physician in another
state or jurisdiction. Official written verification of such
licensure status must be received by the ((department)) board
from the other state or jurisdiction;
(3) The candidate has completed and filed with the
((department)) board a notarized application for licensure by
endorsement, a true and correct copy of the current valid
license, and the required application fee;
(4) The candidate has successfully passed a naturopathic
physician licensure examination in another state or
jurisdiction. Written official verification of successful
completion of the licensure examination and of licensure in
good standing must be requested of the state or jurisdiction
by the candidate and must be received by the ((department))
board directly from the state or jurisdiction;
(5) The candidate must meet all other requirements of chapter 18.36A RCW and this chapter, including the requirement that the applicant be of good moral character; not have engaged in unprofessional conduct; and not be unable to practice with reasonable skill and safety as a result of a physical or mental impairment; and
(6) The state or jurisdiction in which the candidate is currently licensed grants similar privilege of licensure without examination to candidates who are licensed in Washington as naturopathic physicians.
[Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-110, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-110, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060(1). 89-02-051 (Order PM 815), § 308-34-320, filed 1/3/89.]
(2) The minimum educational requirement for licensure to
practice naturopathic medicine in Washington is graduation
from a naturopathic college approved by the ((secretary))
board which teaches adequate courses in all subjects necessary
to the practice of naturopathic medicine.
(((2))) (3) These rules provide the standards and
procedures by which naturopathic colleges may obtain approval
by the ((secretary)) board in order that graduates of those
schools may be permitted to take examinations for license.
(4) The board determines the accreditation standards adopted June 2009 by the Council on Naturopathic Medical Education (CNME) to be substantially equivalent to the requirements of RCW 18.36A.100 and this chapter. Any naturopathic college holding current CNME accreditation shall be deemed to have met all requirements for approval.
[Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-130, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-130, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060(1). 89-02-051 (Order PM 815), § 308-34-410, filed 1/3/89.]
(1) In order to obtain provisional approval, a
naturopathic college must demonstrate compliance with, or
adequate planning and resources to achieve compliance with,
the standards contained in this chapter and ((chapter 18.36A))
RCW 18.36A.100.
(2) The procedures for application, examination, review and revocation of provisional approval shall be the same as those specified for full approval in this chapter.
[Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-140, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-140, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060(1). 89-02-051 (Order PM 815), § 308-34-420, filed 1/3/89.]
(a) Colleges of naturopathic medicine seeking full
approval shall apply to the ((secretary)) board on a form and
in a manner prescribed by the ((secretary)) board.
(b) Those naturopathic colleges holding current accreditation by the CNME need only reference their current CNME accreditation, which will be verified by the board; however, such colleges shall be subject to all other provisions of this chapter.
(2) The ((secretary)) board may grant full approval to
naturopathic colleges which have demonstrated compliance with
the standards contained in this chapter and ((chapter 18.36A))
RCW 18.36A.100.
(3) To be eligible for full approval a naturopathic college must have been in continuous operation for a period of at least three years.
(4) After approval by the ((secretary)) board, periodic
reports may be required. Failure to conform to or maintain
established standards may result in loss of approval. No
naturopathic college shall receive full approval for a period
longer than five years. Prior to the expiration of the period
of approval, the college must apply to the ((secretary)) board
for renewal of approval using the same criteria required under
subsection (1) of this section. The responsibility for
renewal rests solely with the naturopathic college. The
((secretary)) board shall review the application and make a
final decision of approval or disapproval in not more than one
hundred twenty days.
(5) If a naturopathic college fails to maintain the
required standards or fails to report significant
institutional changes, including changes in location, within
ninety days of the change, the ((secretary)) board may revoke
or suspend approval. The ((secretary)) board may contact a
naturopathic college at any time, either through an evaluation
committee or representative, to audit, inspect or gather
information concerning the ((operating of the school or
college)) college's compliance with the required standards.
(6) After suspension of approval of a naturopathic
college, the ((secretary)) board may reinstate approval upon
receipt of satisfactory evidence that the college meets the
standards of chapter 18.36A RCW and this chapter.
(7) After revocation of approval of a naturopathic college, a college may seek provisional approval, if otherwise qualified.
[Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-150, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-150, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060(1). 89-02-051 (Order PM 815), § 308-34-430, filed 1/3/89.]
(2) A naturopathic college may be removed from the board's list of approved colleges when they no longer hold current accreditation through the CNME. Any college failing to maintain CNME accreditation is required to apply for approval to the board in accordance with the requirements in WAC 246-836-150.
[Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-160, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-160, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060(1). 89-02-051 (Order PM 815), § 308-34-440, filed 1/3/89.]
[Statutory Authority: RCW 18.36A.060 and 34.05.220. 92-02-018 (Order 224), § 246-836-170, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-170, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060(1). 89-02-051 (Order PM 815), § 308-34-450, filed 1/3/89.]
(1) Objectives. The objectives of the ((institution))
college shall be clearly stated and address the preparation
for the naturopathic physician to provide patient care. The
implementation of the objectives should be apparent in the
administration of the ((institution)) college, individual
course objectives, and in the total program leading to
graduation.
(2) Organization.
(a) For independent naturopathic colleges, the
institution shall be incorporated under the laws of the state
of its residence as an education corporation. Control shall
be vested in a board of directors composed of naturopathic
physicians and others. No less than one-third plus one of the
directors shall be naturopathic physicians. Under no
circumstances shall more than one-third of the directors have
administrative or instructional positions in the college. The
directors must demonstrate ((collective responsibility in))
their knowledge of((, and)) the objectives of the college
through policy decisions ((consistent with, the objectives of
the college;)), support of college programs and active
participation in college governance((;)), and selection and
oversight of the chief administrative officer.
(b) For naturopathic colleges governed by a multidiscipline university, the institution shall be incorporated under the laws of the state of its residence as an education corporation and control vested in a governing board of directors or trustees composed of qualified members with diverse professional backgrounds. At least one of the directors shall be a naturopathic physician. Under no circumstances shall more than one-third of the directors have administrative or instructional positions in the institute. The institute shall have an established means by which the college can formally, regularly, and effectively communicate to the governing body its needs for resources and provide input on relevant institutional and programmatic issues.
(3) Administration. The education and experience of
directors, administrators, supervisors, and instructors should
be sufficient to ensure that the student will receive
educational services consistent with institutional objectives.
The administration of the ((institution)) college shall be
such that the lines of authority are clearly drawn. The
((institution)) college shall present with its application a
catalog and a brief, narrative explanation of how the
administration of the ((institution)) college is, or is to be,
organized and how the administrative responsibility for each
of the following is, or is to be, managed:
(a) Faculty and staff recruitment;
(b) Personnel records management;
(c) Faculty pay scale and policies;
(d) Standards and practices relating to evaluation, improvement of instruction, promotion, retention and tenure;
(e) Admissions policies including procedures used to solicit students;
(f) Development and administration of policies governing rejection and retention of students, job placement, and student counseling and advising services;
(g) Curriculum requirements;
(h) Tuition and fee policies; and
(i) Financial management policies.
(4) Financial condition. The ((institution)) college
shall demonstrate its financial stability by submitting
certified audits once every three years and, reports, or other
appropriate evidence annually.
(5) Records. The ((institution)) college shall maintain
((an adequately)) a detailed system of records for each
student beginning with application credentials through the
entire period of attendance. The records, including
matriculation, attendance, grades, disciplinary action, and
financial accounts, shall be the permanent property of the
((institution)) college, to be safeguarded from all hazards
and not to be loaned or destroyed.
(6) Educational credentials.
(a) Upon satisfactory completion of the educational
program, the student shall receive a degree from the
((institution)) college indicating that the course of study
has been satisfactorily completed by the student.
(b) In addition, for each student who graduates or
withdraws, the ((institution)) college shall prepare,
permanently file, and make available a transcript which
specifies all courses completed. Each course entry shall
include a title, the number of credits awarded, and a grade. The transcript shall separately identify all credits awarded
by transfer or by examination.
(c) Upon request, all student records and transcripts
shall be made available to the ((secretary)) board.
(7) Catalog. The ((institution)) college shall publish a
current catalog at least every two years containing the
following information:
(a) Name, mailing address, and physical address of the school;
(b) Date of publication;
(c) Admission requirements and procedures;
(d) A statement of tuition and other fees or charges for which a student is responsible and a statement on refund policies;
(e) A school calendar designating the beginning and ending dates of each term, vacation periods, holidays, and other dates of significance to students;
(f) Objectives of the ((institution)) college;
(g) A list of trustees (directors), administrative officers and faculty members including titles and academic qualifications;
(h) A statement of policy about standards of progress required of students, including the grading system, minimum satisfactory grades, conditions for interruption for unsatisfactory progress, probation, and reentry, if any;
(i) A description of each course indicating the number of hours and course content, and its place in the total program;
(j) A description of facilities and major equipment, including library, laboratory and clinical training facilities;
(k) Statements on the nature and availability of student financial assistance, counseling, housing, and placement services, if any;
(l) A statement indicating whether the ((school)) college
is recognized by other agencies or associations for the
licensing or certification of naturopathic physicians; and
(m) Any other material facts concerning the
((institution)) college which are reasonably likely to affect
the decision of the potential student.
(8) Admission policies and procedures. The
((institution)) college shall not deny admission to a
prospective student because of ((sex)) gender, race, color,
religion, physical handicap and/or ethnic origin.
(9) Attendance. The ((institution)) college shall have a
written attendance policy ((relative to attendance)).
(10) Curriculum. The curriculum of the ((institution))
college shall be designed and presented to meet or exceed the
requirements of this chapter. Each student shall complete a
minimum of three thousand hours instruction, which shall
include no less than two hundred post-graduate hours in the
study of mechanotherapy. ((A)) Minimum ((total)) clinical
training shall be one thousand one hundred hours, of which no
less than eight hundred hours shall be training with student
actively involved in diagnosis and treatment in accordance
with RCW 18.36A.050(3). The remainder, if any, may be
preceptorships overseen by the college. The clinical training
shall be in naturopathic procedures. The following standards
are intended not as an exact description of a college's
curriculum, but rather as ((guidelines)) a guide for the
typical acceptable program. It is expected that the actual
program taught by each naturopathic college will be prepared
by the academic departments of the college to meet the needs
of their students and will exceed the outline present here. The ((secretary's)) board's policy is to preserve the autonomy
and uniqueness of each naturopathic college, and to encourage
innovative and experimental programs to enhance the quality of
education in colleges of naturopathic medicine.
| (a) | Basic science | |
| Anatomy (includes histology and embryology) | ||
| Physiology | ||
| Pathology | ||
| Biochemistry | ||
| Public health (includes public health, genetics, microbiology, immunology) | ||
| Naturopathic philosophy | ||
| Pharmacology | ||
| (b) | Clinical sciences | |
| (i) | Diagnostic courses | |
| Physical diagnosis | ||
| Clinical diagnosis | ||
| Laboratory diagnosis | ||
| Radiological diagnosis | ||
| (ii) | Therapeutic courses | |
| Matera medica (botanical medicine) | ||
| Homeopathy | ||
| Nutrition | ||
| Physical medicine | ||
| (includes mechanical and manual manipulation, hydrotherapy, and electrotherapy) | ||
| Psychological medicine | ||
| (iii) | Specialty courses | |
| Organ systems (cardiology, dermatology, endocrinology, EENT, gastroenterology) | ||
| Human development (gynecology, obstetrics, pediatrics, geriatrics) | ||
| State law and regulations as they relate to the practice of naturopathy | ||
| Medical emergencies | ||
| Office procedures | ||
| (iv) | Clinical externship/preceptorship |
(12) Faculty. Faculty members shall be qualified by
training and experience to give effective instruction in the
subject(s) taught; advanced degrees in their respective
disciplines are expected. The faculty should participate in
development and evaluation of curriculum instructional methods
and facilities; student discipline, welfare, and counseling;
establishment of administrative and educational policies;
scholarly and professional growth. Provisions shall be made
to allow and encourage faculty involvement in these
noninstructional functions, including a plan for peer
observation and evaluation among faculty. The ((institution))
college shall not discriminate on the basis of ((sex)) gender,
race, age, color, religion, physical handicap, or national or
ethnic origin in the recruitment and hiring of faculty. The
((institution)) college shall have stated policies on faculty
hiring, compensation, fringe benefits, tenure, retirement,
firing, grievance, and appeals procedures. The
((institution)) college shall submit to the ((secretary))
board for each faculty member a resume which includes the
following information.
(a) Academic rank or title;
(b) Degree(s) held, the institution(s) that conferred the degree(s), the date(s) thereof, and whether earned or honorary;
(c) Other qualifying training or experience;
(d) Name and course number of each course taught;
(e) Other noninstructional responsibilities, if any, and the proportion of the faculty member's time devoted to them; and
(f) The length of time associated with the
((institution)) college.
(13) Library. The library shall be staffed, equipped, and organized to adequately support the instruction, and research of students and faculty.
(14) Clinical training. The clinical facilities shall be adequate in size, number, and resources to provide all aspects of naturopathic diagnosis and treatment. There shall be properly equipped rooms for consultation, physical examination and therapy, and a pharmacy, a laboratory, and radiological equipment each consistent with the definition of practice in chapter 18.36A RCW as now or hereafter amended. A licensed and adequately experienced naturopathic physician must be in direct supervision of and have final decision in the diagnosis and treatment of patients by students, and must be present in the clinic at all times when the clinic is open.
(15) Physical plant, materials and equipment. The
((institution)) college shall own or enjoy the full use of
buildings and equipment adequate to accommodate the
instruction of its students, and administrative and faculty
offices. There shall be adequate facilities ((of)) for the
safekeeping of valuable records. The plant and grounds,
equipment, and facilities shall be maintained in an efficient,
sanitary, and presentable condition. All laws relating to
safety ((and)), sanitation, and other regulations concerning
public buildings shall be observed. There shall be sufficient
personnel employed to carry out proper maintenance.
(16) Cancellation and refund policy. The ((institution))
college shall maintain a fair and equitable policy regarding
refund of the unused portion of tuition fees and other charges
in the event a student fails to enter the course, or withdraws
at any time prior to completion of the course. Such a policy
shall be in keeping with generally accepted practices of
institutions of higher education.
(17) Other information. The applicant ((institution))
college shall provide any other information about the
((institution)) college and its programs as required by the
((secretary)) board.
[Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-180, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-180, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060(1). 89-02-051 (Order PM 815), § 308-34-460, filed 1/3/89.]
(2) Such inspections may be at any reasonable time during
the normal operating hours of the ((institution)) college. The report of the representative or committee and the
((institution's)) college's response shall be submitted as
part of the documentation necessary for the ((secretary's))
board's action on the ((institution's)) college's application
for approval.
(3) Expenses incurred for the site review shall be the
responsibility of the ((program)) college requesting approval.
[Statutory Authority: RCW 18.36A.060. 92-02-018 (Order 224), § 246-836-200, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-200, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.36A.060(1). 89-02-051 (Order PM 815), § 308-34-480, filed 1/3/89.]
(a) Nutrition and food science, physical modalities, minor office procedures, homeopathy, hygiene, and immunizations/vaccinations;
(b) ((Nondrug)) Contraceptive devices;
(c) Nonlegend medicines including vitamins, minerals, botanical medicines, homeopathic medicines, and hormones;
(d) Legend drugs as defined under RCW 69.41.010 with the exception of Botulinum Toxin (commonly known as, among other names, Botox, Vistabel, Dysport, or Neurobloc) and inert substances used for cosmetic purposes; and
(e) Codeine and testosterone products that are contained within Schedules III, IV, and V in chapters 69.50 RCW and 246-887 WAC.
(2) In accordance with RCW 69.41.010(13), all prescriptions must be hand-printed, typewritten, or generated electronically.
(3) Prior to being allowed to administer, prescribe, dispense, or order controlled substances, a naturopathic physician must meet the requirements in WAC 246-836-211 and have obtained the appropriate registration issued by the Federal Drug Enforcement Administration.
(4) Naturopathic physicians may not treat malignancies except in collaboration with a practitioner licensed under chapter 18.57 or 18.71 RCW.
[Statutory Authority: RCW 18.130.050(1), 18.36A.060, and 2005 c 158. 07-20-101, § 246-836-210, filed 10/2/07, effective 11/2/07. Statutory Authority: RCW 18.36A.060 [(1)](a). 92-06-020 (Order 247), § 246-836-210, filed 2/25/92, effective 3/27/92.]
(a) Provided documentation of a current Federal Drug Enforcement Administration registration from another state; or
(b) Submitted an attestation of at least four hours of instruction. Instruction must be part of a graduate level course from a school approved under chapter 18.36A, 18.71, 18.57, or 18.79 RCW. Instruction must include the following:
(i) Principles of medication selection;
(ii) Patient selection and therapeutics education;
(iii) Problem identification and assessment;
(iv) Knowledge of interactions, if any;
(v) Evaluation of outcome;
(vi) Recognition and management of complications and untoward reactions; and
(vii) Education in pain management and drug seeking behaviors.
(2) The naturopathic physician must retain training documentation at least five years from attestation date.
[Statutory Authority: RCW 18.130.050(1), 18.36A.060, and 2005 c 158. 07-20-101, § 246-836-211, filed 10/2/07, effective 11/2/07.]
(2) A report should contain the following information if known:
(a) The name, address, and telephone number of the person making the report.
(b) The name and address and telephone numbers of the naturopath being reported.
(c) The case number of any patient whose treatment is a subject of the report.
(d) A brief description or summary of the facts which gave rise to the issuance of the report, including dates of occurrences.
(e) If court action is involved, the name of the court in which the action is filed along with the date of filing and docket number.
(f) Any further information which would aid in the evaluation of the report.
(3) Mandatory reports shall be exempt from public inspection and copying to the extent permitted under RCW 42.17.310 or to the extent that public inspection or copying of the report or any portion of the report would invade or violate a person's right to privacy as set forth in RCW 42.17.255.
(4) A person is immune from civil liability, whether
direct or derivative, for providing information to the
((department)) board pursuant to RCW 18.130.070.
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-330, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), § 308-130-330, filed 6/30/89.]
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-340, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), § 308-130-340, filed 6/30/89.]
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-350, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), § 308-130-350, filed 6/30/89.]
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-360, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), § 308-130-360, filed 6/30/89.]
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-370, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), § 308-130-370, filed 6/30/89.]
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-380, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), § 308-130-380, filed 6/30/89.]
[Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-390, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.130.070. 89-14-092 (Order PM 842), § 308-130-390, filed 6/30/89.]
(2) "Key party" means immediate family members and others who would be reasonably expected to play a significant role in the health care decisions of the patient or client and includes, but is not limited to, the spouse, domestic partner, sibling, parent, child, guardian, and person authorized to make health care decisions of the patient or client.
(3) "Legitimate health care purpose" means activities for examination, diagnosis, treatment, and personal care of patients or clients, including palliative care, as consistent with community standards of practice for the naturopathic profession. The activity must be within the scope of practice of naturopathic medicine.
(4) "Patient" or "client" means an individual who receives health care from a naturopathic physician.
[]
(a) Sexual intercourse;
(b) Touching the breasts, genitals, anus, or any sexualized body part except as consistent with accepted community standards of practice for examination, diagnosis, and treatment and within the naturopathic physician's scope of practice;
(c) Rubbing against a patient or client or key party for sexual gratification;
(d) Kissing;
(e) Hugging, touching, fondling, or caressing of a romantic or sexual nature;
(f) Examination of or touching genitals without using gloves;
(g) Not allowing a patient or client privacy to dress or undress except as may be necessary in emergencies or custodial situations;
(h) Not providing the patient or client a gown or draping except as may be necessary in emergencies;
(i) Dressing or undressing in the presence of the patient, client, or key party;
(j) Removing patient or client's clothing or gown or draping without consent, emergent medical necessity, or being in a custodial setting;
(k) Encouraging masturbation or other sex act in the presence of the naturopathic physician;
(l) Masturbation or other sex act by the naturopathic physician in the presence of the patient, client, or key party;
(m) Suggesting or discussing the possibility of a dating, sexual, or romantic relationship after the professional relationship ends;
(n) Terminating a professional relationship for the purpose of dating or pursuing a romantic or sexual relationship;
(o) Soliciting a date with a patient, client, or key party;
(p) Discussing the sexual history, preferences, or fantasies of the naturopathic physician;
(q) Any behavior, gestures, or expressions that may reasonably be interpreted as seductive or sexual;
(r) Making statements regarding the patient, client, or key party's body, appearance, sexual history, or sexual orientation other than for legitimate health care purposes;
(s) Sexually demeaning behavior including any verbal or physical contact which may reasonably be interpreted as demeaning, humiliating, embarrassing, threatening, or harming a patient, client, or key party;
(t) Photographing or filming the body or any body part or pose of a patient, client, or key party, other than for legitimate health care purposes; and
(u) Showing a patient, client, or key party sexually explicit photographs, other than for legitimate health care purposes.
(2) A naturopathic physician shall not:
(a) Offer to provide health care services in exchange for sexual favors;
(b) Use health care information to contact the patient, client, or key party for the purpose of engaging in sexual misconduct; or
(c) Use health care information or access to health care information to meet or attempt to meet the naturopathic physician's sexual needs.
(3) A naturopathic physician shall not engage, or attempt to engage, in activities listed in subsection (1) of this section with a former patient, client, or key party within two years after the provider-patient/client relationship ends.
(4) After the two-year period of time described in subsection (3) of this section, a naturopathic physician shall not engage, or attempt to engage, in the activities listed in subsection (1) of this section if:
(a) There is a significant likelihood that the patient, client, or key party will seek or require additional services from the naturopathic physician; or
(b) There is an imbalance of power, influence, opportunity, and/or special knowledge of the professional relationship.
(5) When evaluating whether a naturopathic physician is prohibited from engaging, or attempting to engage, in sexual misconduct, the board will consider factors including, but not limited to:
(a) Documentation of a formal termination and the circumstances of termination of the provider-patient relationship;
(b) Transfer of care to another health care provider;
(c) Duration of the provider-patient relationship;
(d) Amount of time that has passed since the last health care services to the patient or client;
(e) Communication between the naturopathic physician and the patient or client between the last health care services rendered and commencement of the personal relationship;
(f) Extent to which the patient's or client's personal or private information was shared with the naturopathic physician;
(g) Nature of the patient or client's health condition during and since the professional relationship;
(h) The patient or client's emotional dependence and vulnerability; and
(i) Normal revisit cycle for the profession and service.
(6) Patient, client, or key party initiation or consent does not excuse or negate the naturopathic physician's responsibility.
(7) These rules do not prohibit:
(a) Providing health care services in case of emergency where the services cannot or will not be provided by another health care provider;
(b) Contact that is necessary for a legitimate health care purpose and that meets the standard of care appropriate to naturopathic medicine; or
(c) Providing health care services for a legitimate health care purpose to a person who is in a preexisting, established personal relationship with the naturopathic physician where there is no evidence of, or potential for, exploiting the patient or client.
[]
(1) A temporary practice permit may be issued to an applicant who:
(a) Holds an unrestricted, active license as a naturopathic physician in another state that has substantially equivalent licensing standards to those in Washington state;
(b) Is not subject to denial of a license or issuance of a conditional or restricted license; and
(c) Does not have a criminal record in Washington state.
(2) A temporary practice permit grants the individual the full scope of practice under this chapter.
(3) A temporary practice permit will not be renewed, reissued, or extended. A temporary practice permit expires when any one of the following occurs:
(a) The license is granted;
(b) A notice of decision on application is mailed to the applicant, unless the notice of decision on application specifically extends the duration of the temporary practice permit; or
(c) One hundred eighty days after the temporary practice permit is issued.
(4) To receive a temporary practice permit, the applicant must:
(a) Submit the necessary application, fee(s), and documentation for the license;
(b) Meet all requirements and qualifications for the license, except for the results from a fingerprint-based national background check, if required;
(c) Provide verification of having an active unrestricted license as a naturopathic physician from another state that has substantially equivalent licensing standards as Washington state; and
(d) Submit the fingerprint card and a written request for a temporary practice permit when the department notifies the applicant the national background check is required.
[]
(2) The following nonrefundable fees will be charged:
| Title of Fee | Amount |
| Application initial/retake | $100.00 |
| State examination (initial/retake) | 100.00 |
| Initial license | 100.00 |
| License renewal | 325.00 |
| Late renewal penalty | 62.50 |
| Expired license reissuance | 62.50 |
| Duplicate license | 15.00 |
| Certification of license | 15.00 |
| UW library access fee | *25.00 |
| * | The $25 access fee for the University of Washington HEAL-WA library web site, required under RCW 43.70.110, is assessed with the initial application fee and the license renewal fee. |
[Statutory Authority: RCW 43.70.110, 43.70.250, 2008 c 329. 08-15-014, § 246-836-990, filed 7/7/08, effective 7/7/08. Statutory Authority: RCW 43.70.250, [43.70.]280 and 43.70.110. 05-12-012, § 246-836-990, filed 5/20/05, effective 7/1/05. Statutory Authority: RCW 43.70.250. 03-07-095, § 246-836-990, filed 3/19/03, effective 7/1/03. Statutory Authority: RCW 43.70.280. 98-05-060, § 246-836-990, filed 2/13/98, effective 3/16/98. Statutory Authority: RCW 43.70.250. 93-14-011, § 246-836-990, filed 6/24/93, effective 7/25/93. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-836-990, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 43.70.250. 90-13-084 (Order 066), § 308-34-170, filed 6/20/90, effective 7/21/90; 90-04-094 (Order 029), § 308-34-170, filed 2/7/90, effective 3/10/90. Statutory Authority: RCW 43.24.086. 88-20-075 (Order 783), § 308-34-170, filed 10/5/88. Statutory Authority: RCW 18.36A.060. 88-14-009 (Order PM 742), § 308-34-170, filed 6/24/88.]