17 May 2024
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.)
Substantial Equivalency/CR-101
Drs. Chad Aschtgen and Joanne Hillary have been working with the Board's executive director and program manager, James Chaney and Rachel Phipps, to develop language for consideration by the full Board. The subcommittee recommends opening rule-making to remove the jurisprudence examination as a requirement for licensure, to transition the jurisprudence examination from paper to electronic format, and to make the jurisprudence examination a continuing education requirement instead of a licensure requirement. At this time, a CR-101 has been filed to remove the jurisprudence examination as a licensure requirement, but the Board would need to vote to open rule-making specifically on WAC 246-836-080 to add the jurisprudence examination under continuing education requirements.
The Board was presented with a list of states that were determined to have substantially equivalent licensing requirements for naturopathic physicians and Dr. Aschtgen moved to approve this list. The motion passed unanimously. The following states are on this list: Alaska, Arizona, California, Colorado, Connecticut, Kansas, Maine, Maryland, Massachusetts, Montana, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, Utah, Vermont, and Wisconsin, as well as specific ND licensing in Idaho and Minnesota (both of which have multiple naturopath credential types).
Dr. Amira Ahdut moved to convert the jurisprudence examination from paper to electronic format, which would reduce the need for human graders and therefore should reduce or eliminate the fees associated with taking the jurisprudence exam. The motion passed unanimously.
After some discussion around possible language options, Drs. Aschtgen and Richardson proposed adding language under WAC 246-836-040 to require that the jurisprudence examination be completed within the first year of licensure. The subcommittee will draft that language and bring it back to the Board at the next meeting.
DOH Medical Test Site/Provider-Performed Microscopic Procedures Update
DOH held a public hearing on this rule-making on 4 April 2024 and the CR-103 is expected to be filed today with an effective date of 17 June 2024. This change would remove naturopathic physicians as being eligible to obtain a MTS/PPMP license.
Continuing Competency Program
The Board was asked to consider filing a CR-101 to open rule-making on WAC 246-836-080 to add the jurisprudence examination to this section as well as to address at least one petition that had been filed requesting this rule-making. Dr. Richardson proposed tabling this item until the Governor's Office appoints new Board members.
Paid Family and Medical Leave
Assistant Attorney General Luke Eaton explained that Washington State's Paid Family and Medical Leave program lists eligible providers on its website. This list formerly included naturopathic physicians but NDs were recently removed from the website. The current list is based on relevant statute, which lists DOs, MDs, ARNPs, and "any other person who is designated by secretary in rule." The Washington Administrative Code (WAC) features an extensive list of providers but excludes naturopathic physicians. Mr. Eaton and Ms. Phipps have been working with the Department to understand how to get NDs included here. Mr. Eaton suggests filing a petition with the Employment Securities Department Commissioner to open rules.
WANP Executive Director Angela Ross, ND, shared that the WANP has been aware of this issue and is working directly with leadership at Paid Family and Medical Leave and within the Employment Securities Department to get this changed.
Dr. Elias Kass expressed frustration at how often naturopathic physicians are excluded by accident or oversight and inquired as to whose ultimate responsibility it is to monitor these things. Mr. Eaton pointed to the state professional association as the primary organization that tracks and communicates about relevant rule-making activities, as well as to the legislative updates provided to Board staff directly. Dr. Aschtgen suggested regular communication between the Board and the WANP as the state professional association monitoring these kinds of things. Mr. Chaney advised that he and Ms. Phipps meet monthly with Dr. Ross to ensure open lines of communication and information-sharing between the profession and the Board. He also identified that rule-making notices come out from individual agencies and are much more challenging to monitor. Mr. Eaton shared that the struggle in monitoring rule-making across all state agencies is not unique to the naturopathic physician profession.
Intrauterine Insemination Question
Ms. Phipps shared an email requesting clarification of whether intrauterine insemination is within naturopathic physician scope of practice. Per prior Board discussion, Ms. Phipps responded that this physician would need to consult with a personal attorney, but the Board could also opt to weigh in to provide clarification. Mr. Eaton once again questioned whether reading and responding to scope questions is in the purview of the Board and reminded the Board that they had previously opted to refer to attorneys and malpractice insurers in order to reduce liability for the Board.
Statistics
There are currently 1,636 licensed naturopathic physicians in Washington.
Board of Naturopathy Recruitment
Mr. Chaney shared that DOH leadership has urged the Governor's Office to make some appointments but no action has been taken thus far. The Board will be reopening a recruitment call for the public member position that remains vacant. The Governor's Office had denied the application of a public member because they felt it would not be a good fit.
FNMRA Board Membership
Ms. Phipps advised that she had been invited to participate on the Federation of Naturopathic Medicine Regulating Authorities (FNMRA)'s Board, but that the Board of Naturopathy would have to pay $1,500 to participate. Dr. Kass expressed concerns about BON participating in FNMRA because FNMRA is one of the certifiers of continuing education. Mr. Chaney clarified that this is not a conflict of interest, but he also asserted that the benefits of belonging to FNMRA do not justify the cost of membership. Mr. Eaton affirmed that participation of the Board in FNMRA would not be a conflict of interest. Dr. Aschtgen requested inviting a representative of FNMRA to present to the Board to help the Board understand the value of participating, and staff agreed.
Telemedicine
Dr. Aschtgen asserted that the Board may want to revise the guideline on telemedicine that the Board approved in 2017. Dr. Aschtgen moved to create a subcommittee to review the telemedicine policy and this motion passed unanimously. Drs. Aschtgen, Kass, and Richardson volunteered to be on the subcommittee.
Please direct any questions about this summary to me at executive@wanp.org
~Angela Ross, ND | Executive Director, WANP