BILL REQ. #:  H-3300.1 

Read first time 04/18/09.   Referred to Committee on Health Care & Wellness.

     AN ACT Relating to creating the Washington state board of naturopathy; amending RCW 18.36A.020, 18.36A.060, 18.36A.080, 18.36A.090, 18.36A.100, 18.36A.110, 18.36A.120, and 18.130.040; adding new sections to chapter 18.36A RCW; and repealing RCW 18.36A.070.

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

NEW SECTION.  Sec. 1   A new section is added to chapter 18.36A RCW to read as follows:
     (1) There is hereby created the board of naturopathy consisting of seven members appointed by the governor to four-year terms. The governor shall consider naturopathic members who are recommended for appointment by the appropriate professional associations in the state. Five members of the board shall be persons licensed under this chapter and two shall be members of the public. No member may serve more than two consecutive full terms. Members hold office until their successors are appointed. The governor may appoint the initial members of the board to staggered terms from one to four years. Thereafter, all members shall be appointed to full four-year terms.
     (2) The public members of the board may not (a) be a member of any other health care licensing board or commission, (b) have a fiduciary obligation to a facility rendering services regulated under this chapter, or (c) have a material or financial interest in the rendering of services regulated under this chapter.
     (3) The board shall elect officers each year. Meetings of the board are open to the public, except that the board may hold executive sessions to the extent permitted by chapter 42.30 RCW. The department shall provide secretarial, clerical, and other assistance as required by the board.
     (4) Each member of the board shall be compensated in accordance with RCW 43.03.265. Members shall be reimbursed for travel expenses incurred in the actual performance of their duties, as provided in RCW 43.03.050 and 43.03.060.
     (5) A majority of the board members appointed and serving constitutes a quorum for the transaction of board business. The affirmative vote of a majority of a quorum of the board is required to carry a motion or resolution, to adopt a rule, or to pass a measure.
     (6) The board may appoint members to panels of at least three members. A quorum for transaction of any business by a panel is a minimum of three members. A majority vote of a quorum of the panel is required to transact business delegated to it by the board.
     (7) The board may adopt such rules as are consistent with this chapter, as may be deemed necessary and proper to carry out the purposes of this chapter.
     (8) The governor may remove a member of the board for neglect of duty, misconduct, or malfeasance or misfeasance in office, or upon written request of two-thirds of the physicians licensed under this chapter and in active practice in the state. Whenever the governor is satisfied that a member of the board has been guilty of neglect of duty, misconduct, or malfeasance or misfeasance in office, he or she shall file with the secretary of state a statement of the cause for and the order of removal from office, and the secretary shall forthwith send a certified copy of the order of removal and statement of causes by certified mail to the last known post office address of the member. If a vacancy occurs on the board, the governor shall appoint a replacement to fill the remainder of the unexpired term.

NEW SECTION.  Sec. 2   A new section is added to chapter 18.36A RCW to read as follows:
     (1) In addition to any other authority provided by law, the board shall:
     (a) Determine the minimum education and experience requirements for licensure in conformance with RCW 18.36A.090, including but not limited to approval of educational programs;
     (b) Prepare and administer, or approve the preparation and administration of, examinations for licensure;
     (c) Establish by rule the procedures for an appeal of examination failure;
     (d) Determine whether alternative methods of training are equivalent to formal education, and establish forms, procedures, and criteria for evaluation of an applicant's equivalent alternative training to determine the applicant's eligibility to take the examination; and
     (e) Adopt rules implementing a continuing competency program.
     (2) The uniform disciplinary act, chapter 18.130 RCW, governs unlicensed practice, the issuance and denial of licenses, and the discipline of licensees under this chapter. The board shall be the disciplining authority under this chapter.

Sec. 3   RCW 18.36A.020 and 2005 c 158 s 1 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.)) "Board" means the board of naturopathy.
     (5) "Educational program" means an accredited program preparing persons for the practice of 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) "Naturopathic medicines" means vitamins; minerals; botanical medicines; homeopathic medicines; hormones; and those legend drugs and controlled substances consistent with naturopathic medical practice in accordance with rules established by the ((secretary)) board. Controlled substances are limited to codeine and testosterone products that are contained in Schedules III, IV, and V in chapter 69.50 RCW.
     (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. "Minor office procedures" also includes intramuscular, intravenous, subcutaneous, and intradermal injections of substances consistent with the practice of naturopathic medicine and in accordance with rules established by the ((secretary)) board.
     (13) "Common diagnostic procedures" means the use of venipuncture 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, laboratory medicine, and obtaining samples of human tissues, but excluding 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. 4   RCW 18.36A.060 and 1991 c 3 s 91 are each amended to read as follows:
     (((1))) In addition to any other authority provided by law, the secretary may:
     (((a) Adopt rules, in accordance with chapter 34.05 RCW, necessary to implement this chapter;
     (b))) (1) Set all license, examination, and renewal fees in accordance with RCW 43.70.250;
     (((c))) (2) Establish forms and procedures necessary to administer this chapter;
     (((d) Determine the minimum education and experience requirements for licensure in conformance with RCW 18.36A.090, including but not limited to approval of educational programs;
     (e) Prepare and administer or approve the preparation and administration of examinations for licensure;
     (f))) (3) Issue a license to any applicant who has met the education, training, and examination requirements for licensure and deny a license to applicants who do not meet the minimum qualifications for licensure; except that denial of licenses based on unprofessional conduct or impaired practice shall be governed by the uniform disciplinary act, chapter 18.130 RCW;
     (((g))) (4) Hire clerical, administrative, and investigative staff as needed to implement and administer this chapter and to hire individuals, including those licensed under this chapter, to serve as examiners or consultants as necessary to implement and administer this chapter;
     (((h))) (5) Maintain the official department record of all applicants and licensees; and
     (((i) Determine whether alternative methods of training are equivalent to formal education, and establish forms, procedures, and criteria for evaluation of an applicant's equivalent alternative training to determine the applicant's eligibility to take the examination;
     (j) Establish by rule the procedures for an appeal of examination failure;
     (k))) (6) Conduct a hearing on an appeal of a denial of a license based on the applicant's failure to meet the minimum qualifications for licensure. The hearing shall be conducted pursuant to chapter 34.05 RCW((; and
     (l) Adopt rules implementing a continuing competency program.
     (2) The uniform disciplinary act, chapter 18.130 RCW, governs unlicensed practice, the issuance and denial of licenses and the discipline of licensees under this chapter. The secretary shall be the disciplining authority under this chapter)).

Sec. 5   RCW 18.36A.080 and 1991 c 3 s 93 are each amended to read as follows:
     The secretary, members of the ((committee)) board, or individuals acting on their behalf, are immune from suit in any civil action based on any act performed in the course of their duties.

Sec. 6   RCW 18.36A.090 and 1991 c 3 s 94 are each amended to read as follows:
     The department shall issue a license to any applicant who meets the following requirements:
     (1) Successful completion of an educational program approved by the ((secretary)) board, the minimum standard of which shall be the successful completion of a doctorate degree program in naturopathy which includes a minimum of two hundred post-graduate hours in the study of mechanotherapy from an approved educational program, or successful completion of equivalent alternate training that meets the criteria established by the ((secretary)) board. The requirement for two hundred post-graduate hours in the study of mechanotherapy shall expire June 30, 1989;
     (2) Successful completion of any equivalent experience requirement established by the ((secretary)) board;
     (3) Successful completion of an examination administered or approved by the ((secretary)) board;
     (4) Good moral character; and
     (5) Not having engaged in unprofessional conduct or being unable to practice with reasonable skill and safety as a result of a physical or mental impairment.
     The ((secretary)) board shall establish what constitutes adequate proof of meeting the above requirements. Any person holding a valid license to practice drugless therapeutics under chapter 18.36 RCW upon January 1, 1988, shall be deemed licensed pursuant to this chapter.

Sec. 7   RCW 18.36A.100 and 1991 c 3 s 95 are each amended to read as follows:
     (1) The ((secretary)) board shall establish by rule the standards for approval of educational programs and alternate training and may contract with individuals or organizations having expertise in the profession and/or in education to report to the ((secretary)) board the information necessary for the ((secretary)) board to evaluate the educational programs. The standards for approval shall be based on the minimal competencies necessary for safe practice. The standards and procedures for approval shall apply equally to educational programs and equivalent alternate training within the United States and those in foreign jurisdictions. ((The secretary may establish a fee for educational program evaluation. The fee shall be determined by the))
     (2) Each educational program requesting approval shall pay all administrative costs for the educational program evaluation, including, but not limited to, costs for site evaluation.

Sec. 8   RCW 18.36A.110 and 1991 c 3 s 96 are each amended to read as follows:
     (1) The date and location of the examination shall be established by the ((secretary)) board. Applicants who have been found to meet the education and experience requirements for licensure shall be scheduled for the next examination following the filing of the application. The ((secretary)) board shall establish by rule the examination application deadline.
     (2) The examination shall contain subjects appropriate to the standards of competency and scope of practice.
     (3) The ((secretary)) board shall establish by rule the requirements for a reexamination if the applicant has failed the examination.
     (4) The ((committee)) board may ((recommend to the secretary)) approve an examination prepared or administered, or both, by a private testing agency or association of licensing boards.

Sec. 9   RCW 18.36A.120 and 1991 c 3 s 97 are each amended to read as follows:
     The ((secretary)) board shall establish by rule the standards for licensure of applicants licensed in another jurisdiction. However, the standards for reciprocity of licensure shall not be less than required for licensure in the state of Washington.

Sec. 10   RCW 18.130.040 and 2009 c 52 s 1 are each amended to read as follows:
     (1) This chapter applies only to the secretary and the boards and commissions having jurisdiction in relation to the professions licensed under the chapters specified in this section. This chapter does not apply to any business or profession not licensed under the chapters specified in this section.
     (2)(a) The secretary has authority under this chapter in relation to the following professions:
     (i) Dispensing opticians licensed and designated apprentices under chapter 18.34 RCW;
     (ii) ((Naturopaths licensed under chapter 18.36A RCW;
     (iii))) Midwives licensed under chapter 18.50 RCW;
     (((iv))) (iii) Ocularists licensed under chapter 18.55 RCW;
     (((v))) (iv) Massage operators and businesses licensed under chapter 18.108 RCW;
     (((vi))) (v) Dental hygienists licensed under chapter 18.29 RCW;
     (((vii))) (vi) Acupuncturists licensed under chapter 18.06 RCW;
     (((viii))) (vii) Radiologic technologists certified and X-ray technicians registered under chapter 18.84 RCW;
     (((ix))) (viii) Respiratory care practitioners licensed under chapter 18.89 RCW;
     (((x))) (ix) Hypnotherapists and agency affiliated counselors registered and advisors and counselors certified under chapter 18.19 RCW;
     (((xi))) (x) Persons licensed as mental health counselors, mental health counselor associates, marriage and family therapists, marriage and family therapist associates, social workers, social work associates--advanced, and social work associates--independent clinical under chapter 18.225 RCW;
     (((xii))) (xi) Persons registered as nursing pool operators under chapter 18.52C RCW;
     (((xiii))) (xii) Nursing assistants registered or certified under chapter 18.88A RCW;
     (((xiv))) (xiii) Health care assistants certified under chapter 18.135 RCW;
     (((xv))) (xiv) Dietitians and nutritionists certified under chapter 18.138 RCW;
     (((xvi))) (xv) Chemical dependency professionals and chemical dependency professional trainees certified under chapter 18.205 RCW;
     (((xvii))) (xvi) Sex offender treatment providers and certified affiliate sex offender treatment providers certified under chapter 18.155 RCW;
     (((xviii))) (xvii) Persons licensed and certified under chapter 18.73 RCW or RCW 18.71.205;
     (((xix))) (xviii) Denturists licensed under chapter 18.30 RCW;
     (((xx))) (xix) Orthotists and prosthetists licensed under chapter 18.200 RCW;
     (((xxi))) (xx) Surgical technologists registered under chapter 18.215 RCW;
     (((xxii))) (xxi) Recreational therapists;
     (((xxiii))) (xxii) Animal massage practitioners certified under chapter 18.240 RCW;
     (((xxiv))) (xxiii) Athletic trainers licensed under chapter 18.250 RCW; and
     (((xxv))) (xxiv) Home care aides certified under chapter 18.88B RCW.
     (b) The boards and commissions having authority under this chapter are as follows:
     (i) The podiatric medical board as established in chapter 18.22 RCW;
     (ii) The chiropractic quality assurance commission as established in chapter 18.25 RCW;
     (iii) The dental quality assurance commission as established in chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW and licenses and registrations issued under chapter 18.260 RCW;
     (iv) The board of hearing and speech as established in chapter 18.35 RCW;
     (v) The board of examiners for nursing home administrators as established in chapter 18.52 RCW;
     (vi) The optometry board as established in chapter 18.54 RCW governing licenses issued under chapter 18.53 RCW;
     (vii) The board of osteopathic medicine and surgery as established in chapter 18.57 RCW governing licenses issued under chapters 18.57 and 18.57A RCW;
     (viii) The board of pharmacy as established in chapter 18.64 RCW governing licenses issued under chapters 18.64 and 18.64A RCW;
     (ix) The medical quality assurance commission as established in chapter 18.71 RCW governing licenses and registrations issued under chapters 18.71 and 18.71A RCW;
     (x) The board of physical therapy as established in chapter 18.74 RCW;
     (xi) The board of occupational therapy practice as established in chapter 18.59 RCW;
     (xii) The nursing care quality assurance commission as established in chapter 18.79 RCW governing licenses and registrations issued under that chapter;
     (xiii) The examining board of psychology and its disciplinary committee as established in chapter 18.83 RCW; ((and))
     (xiv) The veterinary board of governors as established in chapter 18.92 RCW; and
     (xv) The board of naturopathy as established in chapter 18.36A RCW.
     (3) In addition to the authority to discipline license holders, the disciplining authority has the authority to grant or deny licenses. The disciplining authority may also grant a license subject to conditions.
     (4) All disciplining authorities shall adopt procedures to ensure substantially consistent application of this chapter, the Uniform Disciplinary Act, among the disciplining authorities listed in subsection (2) of this section.

NEW SECTION.  Sec. 11   RCW 18.36A.070 (Naturopathic advisory committee) and 1991 c 3 s 92 & 1987 c 447 s 7 are each repealed.