AN ACT Relating to naturopathic physicians; and adding a new chapter to Title 18 RCW.

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

NEW SECTION. Sec. 1. The legislature finds that is is necessary to regulate the practice of naturopathic physicians in order to protect the public health, safety, and welfare. It is the legislature's intent that only individuals who meet and maintain minimum standards of competence and conduct may provide service to the public.

NEW SECTION. Sec. 2. (1) No person shall practice or represent himself of herself as a naturopathic physician without first applying for and receiving a license from the director to practice naturopathy.

(2) A person represents himself or herself as a naturopathic physician when that person adopts or uses any title or any description of services which incorporates one or more of the following terms or designations: Naturopath, N.D., naturopathic physician, doctor of naturopathic medicine.

NEW SECTION. Sec. 3. Naturopathic medicine or naturopathy is the practice by naturopathic physicians of the art and science of the diagnosis, prevention, and treatment of mental and physical disorders by stimulation and/or support of the natural processes of the human body. The naturopathic physician is responsible and accountable to the consumer for the quality of naturopathic care rendered.

The practice of naturopathy includes:

(1) The prescription, administration, dispensing, and use of nutrition and food science, manual manipulation (mechanotherapy), physiotherapy, homeopathy, certain medicines of mineral, animal, and botanical origin, sanitation, minor surgery, common diagnostic procedures and suggestion in accordance with standards of competency and practice promulgated through administrative rules and regulations; and

(2) The performance of such additional acts requiring education and training which the director determines are consistent with the practice of naturopathy and authorizes through administrative rules and regulations including the practice of natural childbirth obstetrics and acupuncture.

NEW SECTION. Sec. 4. As use in this chapter, the following terms have the meaning indicated unless the context clearly requires otherwise.

(1) "Department" means the department of licensing.

(2) "Director" means the director of licensing or the director's designee.

(3) "Naturopathic physician" means an individual licensed under this chapter.

(4) "Committee" means the Washington state naturopathic practice advisory committee.

(5) "Educational program" means a program preparing persons for the practice of naturopathy.

(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 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, parenterally and topically, excluding controlled substances and legend drugs with the following exceptions: Antibiotics, vitamins, minerals, whole gland thyroid, and nondrug contraceptive devices.

(11) "Sanitation" means the formation and application of measures to promote and establish conditions favorable to health, especially public health, through measures including but not limited to insuring pure air, food, water, and environment, and the use of such preventative techniques and personal hygiene, immunization, and asepsis.

(12) "Minor office procedures" means the removal of benign superficial growths, repair and care incident thereto of superficial lacerations and abrasions, and the removal of foreign bodies located in superficial structures; and the use of antiseptics and local anesthetics in connection therewith.

(13) "Common diagnostic procedures" means the use of roentgen rays for diagnostic purposes, venipuncture to withdraw blood, commonly used diagnostic modalities consistent with naturopathic medical practice, health history taking, physical examination, and laboratory medicine which is concerned with the obtaining of samples from human tissues and their products, excluding procedures which require major surgical techniques.

(14) "Suggestion" means techniques including but not limited to counseling, biofeedback, and hypnotherapy.

(15) "Natural childbirth obstetrics" means the care and management of women during prenatal, intrapartum and postpartum stages with the delivery being nonsurgical, low risk, in the home, clinic, or other appropriate medical facility, and to include the use and prescription of ophthalmic antibiotic medications, postpartum antihemorrhagic medications, rhogam, local and topical anesthetics for episiotomy or repair of birth related injuries, and administration of such other drugs or medications as dictated by obstetrical emergency or prescribed by a practitioner licensed to prescribe such drugs.

(16) "Acupuncture" means a health care service based on a traditional oriental system of medical theory utilizing oriental diagnosis and treatment to promote health and treat organic or functional disorders by treating specific acupuncture points or meridians.

NEW SECTION. Sec. 5. Nothing in this chapter shall be construed to prohibit or restrict:

(1) The practice of a profession by individuals who are licensed, certified, or registered under other laws of this state who are performing services within their authorized scope of practice.

(2) The practice of naturopathic medicine by an individual employed by the government of the United States while the individual is engaged in the performance of duties prescribed for him or her by the laws and regulations of the United States.

(3) The practice of naturopathic medicine by students enrolled in a school approved by the director. The performance of services shall be pursuant to a course of instruction or assignments from an instructor and under the supervision of the instructor. The instructor shall be a naturopathic physician.

NEW SECTION. Sec. 6. (1) In addition to any other authority provided by law, the director shall have the following authority:

(a) To adopt rules, in accordance with chapter 34.04 RCW, necessary to implement this chapter;

(b) To set all license, examination, and renewal fees in accordance with RCW 43.24.086;

(d) To establish by rule the standards of competency and practice necessary for the safe practice of naturopathic physicians;

(e) To determine the minimum education and experience requirements for licensure in accordance with the standards of competency, including but not limited to approval of educational programs;

(f) To prepare and administer or approve the preparation and administration of examinations for licensure;

(g) To 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;

(h) To determine the minimum education and experience requirements for specialty certification to perform additional specialty procedures such as natural childbirth and acupuncture;

(i) To 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;

(j) To maintain the official department record of all applicants and licensees;

(k) To determine whether alternative methods of training are equivalent to formal education, and to establish forms, procedures, and criteria for evaluation of an applicant's alternative training to determine the applicant's eligibility to take the examination;

(l) To establish by rule the procedures for an appeal of examination failure;

(m) To 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 34.04 RCW; and

(n) To adopt rules implementing a continuing competency program.

(2) The uniform disciplinary act, chapter 18.120 RCW, governs the issuance and denial of licenses and the discipline of licensees under this chapter. The director shall be the disciplining authority under this chapter.

NEW SECTION. Sec. 7. (1) There is hereby created the state naturopathic advisory committee consisting of five members appointed by the director who shall advise the director concerning the administration of this chapter. Three members of the initial committee shall be persons who would qualify for licensing under this chapter. Their successors shall be naturopathic physicians who are licensed under this chapter. Two members of the committee shall be individuals who are unaffiliated with the profession. For the initial committee, one unaffiliated member and one naturopathic physician shall serve a four-year term, one unaffiliated member and one naturopathic physician shall serve a three-year term, and one naturopathic physician shall serve a two-year term. The term of office for committee members after the initial committee is four years. Any committee member may be removed for just cause including a finding of fact of unprofessional conduct, impaired practice, or more than three unexcused absences. The director may appoint a new member to fill any vacancy on the committee for the remainder of the unexpired term.

No committee member may serve more than two consecutive terms, whether full or partial.

(2) Committee members shall be compensated in accordance with RCW 43.03.240 and reimbursed for travel expenses in accordance with RCW 43.03.050 and 43.03.060.

(3) The committee shall have the authority to annually elect a chairperson and vice chairperson to direct the meetings of the committee. The committee shall meet at least once each year, and may hold additional meetings as called by the director or the chairperson.

NEW SECTION. Sec. 8. The director, members of the committee, or individuals acting on their behalf are immune from suit in any civil action based on any acts performed in the course of their duties.

NEW SECTION. Sec. 9. The department shall issue a license to any applicant who meets the following requirements:

(1) Successful completion of an educational program approved by the director or successful completion of alternate training which meets the criteria established by the director;

(2) Successful completion of any experience requirement established by the director;

(3) Successful completion of an examination administered or approved by the committee;

(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 director shall establish what constitutes adequate proof of meeting the above requirements.

NEW SECTION. Sec. 10. The director shall establish by rule the standards for approval of educational programs and alternate training and shall have the authority to contract with individuals or organizations having expertise in the profession and/or in education to report to the director the information necessary for the director 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 alternate training within the United States and those in foreign jurisdictions. The director may establish a fee for educational program evaluation. The fee shall be determined by the administrative costs for the educational program evaluation, including, but not limited to, costs for site evaluation.

NEW SECTION. Sec. 11. (1) The date and location of the examination shall be established by the director. Applicants who have been found to meet the education and experience requirements for licensure will be scheduled for the next examination following the filing of the application. The director 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 director shall establish by rule the requirements for a reexamination if the applicant has failed the examination.

(4) The committee may approve an examination prepared and/or administered by a private testing agency or association of licensing boards.

NEW SECTION. Sec. 12. Any person holding a valid license to practice drugless therapeutics issued by authority of the state when this chapter becomes effective shall continue to be licensed as a naturopathic physician under the provisions of this chapter.

NEW SECTION. Sec. 13. The director shall establish by rule the standards for licensure of applicants licensed in another jurisdiction.

NEW SECTION. Sec. 14. Applications for licensure must be submitted on forms provided by the department. The department may require any information and documentation needed to determine if the applicant meets the criteria for licensure as provided in this chapter and chapter 18.130 RCW. Each applicant shall pay a fee determined by the director as provided in RCW 43.24.086. The fee must be submitted with the application.

NEW SECTION. Sec. 15. The director shall establish by rule the requirements for renewal of licenses. The director shall establish a renewal and late renewal penalty fee as provided in RCW 43.24.086. Failure to renew shall invalidate the license and all privileges granted by the license. The director shall determine by rule whether or not a license shall be canceled for failure to renew and shall establish procedures and prerequisites for relicensure.

NEW SECTION. Sec. 16. Sections 1 through 15 of this act shall constitute a new chapter in Title 18 RCW.

NEW SECTION. Sec. 17. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.