11 August 2023

Below is my summary of the key discussions and decisions made at today's regular business meeting of the Board of Naturopathy, which regulates the practice of naturopathic medicine. (Please note that this summary does not reflect official meeting minutes of the Board, which is a completely separate entity from the WANP. The reflections and notes below are my own and should not be assumed to represent the Board of Naturopathy in any way.)

Non-Surgical Cosmetic Procedures Rule-Making
A primary agenda item at today's meeting was to hold the final public hearing on non-surgical cosmetic procedures rule-making in order to close out the formal rule-making process, or CR-102. This rule-making has been underway for many years. The proposed language under consideration today removes the exclusion of using botulinum toxin for cosmetic purposes - an exclusion that was put in place during initial rule-making in 2005 after naturopathic physicians gained prescriptive authority over all legend drugs (including botulinum toxin) - and adds training requirements on using botulinum toxin for cosmetic purposes.

Dr. Amira Ahdut, who has spear-headed this effort over the years, summarized the research and data that have been gathered by Board of Naturopathy members and staff as well as the written feedback that had been submitted prior to this hearing. All written comment, with the exception of one letter, was supportive of advancing this rule-making. This support was also reflected in today's public hearing, wherein all but one commenter from the public expressed support for advancing this rule language as proposed.

At the close of the public hearing, Dr. Ahdut moved to accept the language as proposed to the Board, and Dr. Chad Aschtgen seconded the motion. Drs. Ahdut, Aschtgen, Joanne Hillary, and Elias Kass all voted in favor of adopting the proposed language. Public member Brooke Fotheringham abstained. The motion passed and now a Rule-Making Order, or CR-103, will be filed. Once that is filed, there will be an effective date shared and statute will be updated.

At this time, Washington-licensed naturopathic physicians should not yet be using botulinum toxin for strictly cosmetic purposes, as the rule has been passed but it is not yet in effect. We will be in communication as soon as we are aware of an effective date. We are also beginning to explore options that would meet the training requirements adopted by the Board in order to provide safe and competent training for those in our community who are interested in adding this to your clinical offerings.

Update on Continuing Education Rule-Making Process
Board staff has learned that these rules have to be adopted - rather than implemented - by the legislative deadline of January 1, 2024. Staff had originally thought that the Board would need to hold another hearing and rule-making session on this at a special meeting in October but has now determined that the additional rule-making and public hearing can be deferred until the regularly scheduled Board meeting in November. Dr. Aschtgen, who was not able to be at the most recent special meeting and public hearing on this issue, attempted to clarify whether the urgency with which the special meeting was scheduled was necessary given this new information. While this question was not answered directly, Policy Analyst Heather Cantrell, who supports the Board with rule-making, advised that the Board will need to hold another hearing and vote to approve or change the language that was adopted at the special meeting in June in order to close out the CR-102. Therefore, at the regular November 17 meeting, the Board will hear additional public comment and will make a final vote on the proposed language regarding the continuing education rules.

Scope of Practice Policy
Attorney Luke Eaton presented two options for the Board to consider when responding to inquiries from the public about naturopathic scope of practice. The Board voted unanimously to respond to any future scope of practice inquiries with a form letter advising that the Board of Naturopathy cannot provide legal advice or interpretation and recommending consultation with personal legal counsel.

2024 Meeting Dates
The Board of Naturopathy will hold its regular business meetings on the following dates in 2024 (all Fridays): February 9, May 17, August 9, and November 8.

Public Request for Retired Active License Status
The Board once again considered a request to establish a "retired active license" status in Washington State, with less cost and fewer continuing education requirements. Mr. Eaton advised that licensing fees are not set by the Board so there would be no guarantee that the cost would be lower. He further advised that state law requires any "retired or inactive" licensees to obtain the same amount of continuing education as active licensees. This would also not be in control of the Board of Naturopathy. With this information, the Board voted unanimously (again) to NOT establish a "retired active license" status in Washington State.

Program Reports
New Executive Director for the Board of Naturopathy James Chaney announced that he has hired Rachel Phelps as the new Program Manager for this Board, effective August 16. He also reported that the Governor's office has recently hired additional staff to support recruitment and appointments on various boards and commissions. He acknowledged the frustration with this Board having a vacant public member position for over two years, despite there being interest in the position and despite the Board having completed interviews for this position in late winter/early spring.

As of this meeting, there are 1,619 licensed naturopathic physicians and 15 registered colon hydrotherapists in Washington.

Please direct any questions about this summary to me at executive@wanp.org

~Angela Ross, ND | Executive Director, WANP