BILL REQ. #:  H-0745.2 

Read first time 02/12/2003.   Referred to Committee on Health Care.

     AN ACT Relating to naturopaths; amending RCW 18.36A.020 and 18.36A.040; and creating a new section.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1   RCW 18.36A.020 and 1991 c 3 s 87 are each amended to read as follows:
     Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
     (1) "Department" means the department of health.
     (2) "Secretary" means the secretary of health or the secretary's designee.
     (3) "Naturopath" means an individual licensed under this chapter.
     (4) "Committee" means the Washington state naturopathic practice advisory committee.
     (5) "Educational program" means ((a)) an accredited program preparing persons for the practice of ((naturopathy)) naturopathic medicine.
     (6) "Nutrition and food science" means the prevention and treatment of disease or other human conditions through the use of foods, water, herbs, roots, bark, or natural food elements.
     (7) "Manual manipulation" or "mechanotherapy" means manipulation of a part or the whole of the body by hand or by mechanical means.
     (8) "Physical modalities" means use of physical, chemical, ((electrical,)) and other noninvasive modalities including, but not limited to heat, cold, air, light, water in any of its forms, sound, massage, and therapeutic exercise.
     (9) "Homeopathy" means a system of medicine based on the use of infinitesimal doses of medicines capable of producing symptoms similar to those of the disease treated, as listed in the homeopathic pharmacopeia of the United States.
     (10) (("Medicines of mineral, animal, and botanical origin" means medicines derived from animal organs, tissues, and oils, minerals, and plants administered orally and topically, excluding legend drugs with the following exceptions: Vitamins, minerals, whole gland thyroid, and substances as exemplified in traditional botanical and herbal pharmacopoeia, and nondrug contraceptive devices excluding interuterine devices. The use of intermuscular injections are limited to vitamin B-12 preparations and combinations when clinical and/or laboratory evaluation has indicated vitamin B-12 deficiency. The use of controlled substances is prohibited.)) "Naturopathic medicines" means vitamins; minerals; botanical medicines; homeopathic medicines; hormones; and other substances as exemplified in standard naturopathic medical texts, journals, and pharmacopeia, including nondrug contraceptive devices. "Naturopathic medicines" include legend antibiotics as set forth in Drug Facts and Comparisons 2001 Edition (Published by Facts and Comparisons, St. Louis, MO.) and codeine and testosterone in schedules III-V of the uniform controlled substances act consistent with naturopathic medical practice in forms, doses, and for uses that are generally approved, and in accordance with rules adopted by the secretary. Naturopaths may administer intermuscular, intramuscular, intravenous, subcutaneous, and intradermal injections of substances appropriate to the practice of naturopathic medicine. However, intravenous injections may only be used to provide parenteral nutrients and saline for dehydrated patients. The secretary shall determine, by rule, which other substances are appropriate.
     (11) "Hygiene and immunization" means the use of such preventative techniques as personal hygiene, asepsis, public health, and immunizations, to the extent allowed by rule.
     (12) "Minor office procedures" means care and procedures incident thereto of superficial lacerations, lesions, and abrasions, and the removal of foreign bodies located in superficial structures, not to include the eye; and the use of antiseptics and topical or local anesthetics in connection therewith.
     (13) "Common diagnostic procedures" means the use of venipuncture ((to withdraw blood)) consistent with the practice of naturopathic medicine, commonly used diagnostic modalities consistent with naturopathic practice, health history taking, physical examination, radiography, examination of body orifices excluding endoscopy, ((and)) laboratory medicine ((which obtains)), and obtaining samples of human tissues ((products)), ((including superficial scrapings)) but excluding ((procedures which would require surgical)) incision or excision beyond that which is authorized as a minor office procedure.
     (14) "Suggestion" means techniques including but not limited to counseling, biofeedback, and hypnosis.
     (15) "Radiography" means the ordering, but not the interpretation, of radiographic diagnostic and other imaging studies and the taking and interpretation of standard radiographs.

Sec. 2   RCW 18.36A.040 and 1991 c 3 s 89 are each amended to read as follows:
     Naturopathic medicine ((or naturopathy)) is the practice by naturopaths of the art and science of the diagnosis, prevention, and treatment of disorders of the body by stimulation or support, or both, of the natural processes of the human body, and the treatment of disorder and disease, using the least interventive, most natural treatments first, resorting to more interventive prescriptive medicines only when necessary. A naturopath is responsible and accountable to the consumer for the quality of naturopathic care rendered.
     The practice of ((naturopathy)) naturopathic medicine includes manual manipulation (mechanotherapy), the prescription, administration, dispensing, and use, except for the treatment of malignancies ((or neoplastic disease)), of nutrition and food science, physical modalities, minor office procedures, homeopathy, ((certain)) naturopathic medicines ((of mineral, animal, and botanical origin)), hygiene and immunization, common diagnostic procedures, and suggestion; however, nothing in this chapter shall prohibit consultation and treatment of a patient in concert with a practitioner licensed under chapter 18.57 or 18.71 RCW. No person licensed under this chapter may employ the term "chiropractic" to describe any services provided by a naturopath under this chapter.

NEW SECTION.  Sec. 3   The naturopathic advisory committee in consultation with the Washington state board of pharmacy shall develop parameters, including education and training requirements, for the use of controlled substances authorized in this act. The parameters must be met by the naturopath prior to being authorized to prescribe controlled substances under this act.