jswizzle3737/ontario_laws_and_regs huggingface dataset:
Definitions
 1. In this Regulation, “controlled act” means a controlled act set out in subsection 27 (2) of the Regulated Health Professions Act, 1991; (“acte autorisé”) “drug” means a drug as defined in the Drug and Pharmacies Regulation Act. (“médicament”) Part II   Controlled Acts
PART II CONTROLLED ACTS
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General
 2. (1) A member shall not perform a controlled act under the authority of subsection 4 (1) of the Act except in accordance with this Part. (2) Where the provisions of this Part are inconsistent with a law of Canada respecting the sale, dispensing, compounding, prescribing or injection of a drug or other substance, including a drug or substance related to a targeted substance, the law of Canada shall prevail and the provisions of this Part, to the extent they are inconsistent with that law, shall not apply. (3) Where the provisions of this Part are inconsistent with the provisions of the
Narcotics Safety and Awareness Act, 2010, the provisions of that Act shall prevail and the provisions of this Part, to the extent they are inconsistent with that Act, shall not apply.
Internal examinations
 4. (1) For the purposes of paragraphs 1 and 2 of subsection 4 (1) of the Act, a member who meets all of the standards of practice of the profession in this section and section 3 of this Regulation is authorized to perform the following controlled acts: 1. Putting an instrument, hand or finger beyond the labia majora but not beyond the cervix. 2. Putting an instrument, hand or finger beyond the anal verge but not beyond the rectal-sigmoidal junction. (2) It is a standard of practice of the profession that a member may only perform a controlled act described in subsection (1) for one or more of the following purposes: 1. Examining a patient in the course of an assessment or to formulate a naturopathic diagnosis. 2. Treating the patient with naturopathic treatments or remedies. 3. Taking or collecting a specimen.
Moving the joints of the spine
 6. (1) For the purposes of paragraph 4 of subsection 4 (1) of the Act, a member who meets all of the standards of practice of the profession in this section and section 3 of this Regulation is authorized to move the thoracic, lumbar and sacral joints of the spine and the cervical joints of the spine. (2) A member may perform an act described in subsection (1) only if he or she meets all of the following standards of practice: 1. The member shall use only one or more of the following low amplitude thrust procedures when he or she manipulates a patient’s cervical joints of the spine: i. Supine lateral flexion. ii. Supine rotary. iii. C2-C7 seated rotary. 2. The member shall not perform a controlled act described in subsection (1) if, at the time that the controlled act is proposed, i. the patient has or may have one or more of the contraindications listed in subsection (3), or ii. the member is in doubt about the accuracy of the patient’s health status or health history respecting any of the contraindications listed in subsection (3). (3) The contraindications mentioned in subparagraphs 2 i and ii of subsection (2) are the following: 1. Anomalies, including dens hypoplasia, unstable os odontoideum and similar diseases, disorders or dysfunctions. 2. Acute fracture. 3. Spinal cord tumour. 4. Acute infection of the spine, including osteomyelitis, septic discitis and tuberculosis of the spine. 5. Meningeal tumour. 6. Haematomas, whether spinal or intracanalicular. 7. Malignancy of the spine. 8. Frank disc herniation with accompanying signs of progressive neurological deficit. 9. Basilar invagination of the upper cervical spine (vertebrobasilar ischemia). 10. Symptomatic Arnold-Chiari malformation of the upper cervical spine. 11. Dislocation of a vertebra. 12. Aggressive types of benign tumours, such as an aneurismal bone cyst, giant cell tumour, osteoblastoma or osteoid osteoma. 13. Internal fixation/stabilization devices. 14. Neoplastic disease of muscle or other soft tissue. 15. Positive Kernig’s or Lhermitte’s signs. 16. Congenital, generalized hypermobility. 17. Syringomyelia. 18. Hydrocephalus of unknown aetiology. 19. Diastematomyelia. 20. Cauda equina syndrome. 21. Any other disease, disorder or dysfunction that the member knows or ought to know contraindicates performance of the controlled act in the relevant circumstances of the patient.
Communicating a naturopathic diagnosis
 7. (1) For the purposes of paragraph 5 of subsection 4 (1) of the Act, a member who meets all of the standards of practice in this section may communicate a naturopathic diagnosis to a patient that identifies the cause of his or her symptoms as being a disease, disorder or dysfunction that may be identified through an assessment using one or more of the following: 1. The patient’s health history. 2. The findings of an objective patient evaluation, including a physical examination of the patient. 3. The results of any relevant tests or investigations. (2) The member shall perform the controlled act described in subsection (1) only if he or she meets all of the following standards of practice: 1. The member must have a naturopath-patient relationship with the patient. 2. The member must have the knowledge, skill and judgment to perform the controlled act safely, accurately and ethically.
Taking blood samples for performing prescribed naturopathic examinations
 8. (1) For the purposes of paragraph 6 of subsection 4 (1) of the Act, a member who meets all of the standards of practice of the profession in this section and section 3 of this Regulation is authorized to take blood samples from veins or by skin pricking for the purpose of performing one or more of the following naturopathic examinations on a patient’s blood sample: 1. BTA Bioterrain Assessment. 2. Glucose. 3. Live blood cell analysis. 4. Hemoglobin – A1C. 5. Mononuclear Heterophile Antibodies (monospot). 6. Fatty acids, free. 7. Blood Group – ABO and RhD. (2) The member shall perform the controlled act described in subsection (1) only if he or she meets all of the following standards of practice: 1. The member shall perform the controlled act only for the purpose of, i. assessing the patient’s health status, ii. communicating a naturopathic diagnosis, or iii. monitoring or evaluating the patient’s response to treatment. 2. Subject to paragraph 3, the member shall only perform the specified naturopathic examination on a patient’s blood sample using a Class III medical device that has been approved by Health Canada. 3. Where no Health Canada approved Class III medical device exists for the purpose of performing a specified naturopathic examination, but another Health Canada approved medical device exists that can be used for the purpose, the member must use such a device, in accordance with the purpose intended by the manufacturer of the device, and in accordance with the manufacturer’s instructions. 4. The member shall ensure that any instrument or device used for taking, collecting or examining a blood sample is used solely for the purpose intended by the manufacturer of the device and in compliance with the manufacturer’s specifications. 5. The member is prohibited from taking a blood sample from a patient except for the purpose of performing the controlled act mentioned in subsection (1).
PART III DELEGATION
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Definitions
 14. In this Part, “delegatee” means a person to whom a controlled act is delegated; (“délégataire”) “delegator” means a person who delegates a controlled act. (“délégant”)
Limits on delegation
 15. A member shall not, except in accordance with this Part, delegate a controlled act or perform a controlled act that was delegated to him or her.
Responsibility
 16. (1) A member who delegates a controlled act is responsible for the decision to delegate the controlled act. (2) A member who performs a controlled act that is delegated to him or her is responsible for the decision to carry out the controlled act and for its performance.
Conditions before delegating
 17. (1) A member shall ensure, before delegating any controlled act, that he or she, (a) has the authority under the Act and its regulations to perform the controlled act himself or herself; (b) has the knowledge, skill and judgment to perform the controlled act safely and ethically; (c) has a naturopath-patient relationship with the patient for whom the controlled act will be performed; (d) has considered whether delegation of the controlled act is appropriate, bearing in mind the best interests and needs of the patient; (e) after taking reasonable steps, is satisfied that sufficient safeguards and resources are available to the delegatee so that the controlled act may be performed safely and ethically; (f) has considered whether delegation of the controlled act should be subject to any conditions to ensure that it is performed safely and ethically and has made the delegation subject to conditions, if necessary; (g) has put in place a communication plan between himself or herself and the delegatee that deals with the appropriate management of any adverse events that may occur as a result of the delegation. (h) after taking reasonable steps, is satisfied that the delegatee is a person who is permitted to accept the delegation; (i) after taking reasonable steps, is satisfied that the delegatee is a health care provider who has a professional relationship with the patient, a person in the patient’s household or a person who routinely provides assistance or treatment to the patient; and (j) after taking reasonable steps, is satisfied, (i) that the delegatee has the knowledge, skill and judgment to perform the controlled act safely and ethically, where the delegatee is a member of a health profession other than the profession of naturopathy, or (ii) that the delegation is appropriate for the patient and that the delegatee has the knowledge, skill and judgment to perform the controlled act safely and ethically where the delegatee is not a member of a health profession set out in Schedule 1 to the Regulated Health Professions Act, 1991. (2) A member shall not delegate a controlled act that was delegated to him or her to perform. (3) A member who has delegated a controlled act but has reasonable grounds to believe that the delegatee no longer has the ability to perform the controlled act safely and ethically shall immediately cease to delegate the controlled act to that delegatee and shall take measures to ensure that the delegatee ceases to perform any controlled acts previously delegated by the delegator but not yet completed.
How made
 18. The delegation of a controlled act may be made orally or in writing.
Records, etc.
 19. (1) A member who delegates a controlled act shall, (a) ensure that a written record of the particulars of the delegation is available in the place where the controlled act is to be performed before it is performed; (b) ensure that a written record of the particulars of the delegation, or a copy of the record, is placed in the patient’s record at the time the delegation takes place or within a reasonable period of time afterwards; or (c) record the particulars of the delegation in the patient record either at the time the delegation takes place or within a reasonable period of time afterwards. (2) A record created under subsection (1) must include a copy of the communication plan required under clause 17 (1) (g).
Accepting delegation, etc.
 20. (1) A member shall not accept the delegation of a controlled act unless the person delegating the controlled act was, at the time of the delegation, a member of another health profession set out in Schedule 1 to the Regulated Health Professions Act, 1991 who is authorized to perform that controlled act by a health profession Act governing his or her profession. (2) A member shall not perform a controlled act that was delegated to him or her by a person to whom the controlled act was delegated. (3) A member shall only perform a controlled act delegated to him or her if, before performing the controlled act, the member ensures that he or she, (a) has the knowledge, skill and judgment to perform the controlled act safely and ethically; (b) has a naturopath-patient relationship with the patient for whom the controlled act is to be performed; (c) has considered whether performing the controlled act is appropriate, bearing in mind the best interests and needs of the patient; (d) after taking reasonable steps, is satisfied that there are sufficient safeguards and resources available to ensure that the controlled act can be performed safely and ethically; (e) has no reason to believe that the delegator is not permitted to delegate that controlled act; and (f) has ensured that any conditions have been met, if the delegation is subject to any conditions. (4) A member who performs a controlled act that was delegated to him or her shall record the particulars of the delegation in the patient’s record, unless, (a) a written record of the particulars of the delegation is available in the place where the controlled act is to be performed; (b) a written record of the particulars of the delegation, or a copy of the record, is present in the patient’s record; or (c) the particulars of the delegation have already been recorded in the patient’s record.
Contents of record
 21. Any record of the particulars of a delegation must include, (a) the date of the delegation; (b) the delegator’s name, if the controlled act was delegated to the member; (c) the delegatee’s name, if the controlled act was delegated by the member; and (d) the conditions, if any, applicable to the delegation.
Delegation of communication of diagnosis
 22. It is a standard of practice of the profession that a member shall not delegate the controlled act described in paragraph 5 of subsection 4 (1) of the Act. Part iv   inspection of premises where Certain procedures are performed
PART IV INSPECTION OF PREMISES WHERE CERTAIN PROCEDURES ARE PERFORMED
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Interpretation, etc.
 23. (1) In this Part, “designated member” means, (a) the member designated for a premises in accordance with section 30, or (b) where only one member performs or may perform a procedure in a premises, that member; (“membre désigné”) “inspector” means a person designated by the College to carry out an inspection under this Part on behalf of the College; (“inspecteur”) “premises” means any place where a member performs or may perform a procedure; (“locaux”) “procedure” means, (a) any procedure by which any two or more drugs or substances listed in Table 2 or Table 5, in any combination, are mixed, reconstituted, or by any other means made into a customized therapeutic product by a member for the purpose of administration by intravenous injection to a patient, and includes the labelling of such a customized therapeutic product, or (b) the administration of a customized therapeutic product described in clause (a) by intravenous injection to a patient by a member; (“acte”) “Type 1 occurrence” means, with respect to a premises, (a) the death of a patient at the premises after a procedure was performed, (b) the death of a patient occurring within five days after a procedure was performed at the premises, (c) any referral of a patient to emergency services within five days after a procedure was performed at the premises, (d) any procedure performed on the wrong patient at the premises, (e) the administration of an emergency drug to a patient immediately after a procedure was performed at the premises, (f) the diagnosis of a patient with shock or convulsions occurring within five days after a procedure was performed at the premises, (g) the diagnosis of a patient as being infected with a disease or any disease-causing agent after a procedure was performed at the premises, if the member forms the opinion that the patient is or may have been infected as a result of the performance of a procedure; (“situation de type 1”) “Type 2 occurrence” means, (a) any infection occurring in a patient in the premises after a procedure was performed at the premises, (b) an unscheduled treatment of a patient by a member occurring within five days after a procedure was performed at the premises, or (c) any adverse drug reaction occurring in a patient after a procedure was performed at the premises. (“situation de type 2”) O. Reg. 415/16, s. 1. (2) Anything that may be done by the College under this Part may be done by the Council or by a committee established under clause 94 (1) (i) of the Health Professions Procedural Code. O. Reg. 415/16, s. 1.
Standard of practice re procedures
 24. It is a standard of practice of the profession that a member who practises the profession in a premises where procedures are performed shall comply with the requirements of this Part with regard to the reporting of Type 1 and Type 2 occurrences. O. Reg. 415/16, s. 1.
Reporting of occurrences
 25. Every member shall report to the College, in the form and manner required by the College, (a) every Type 1 occurrence that follows the performance of a procedure in the premises by the member or another member, with the report being provided to the College no later than 24 hours after the member learns of the occurrence; and (b) the total number of Type 2 occurrences following the performance of procedures, with the report provided to the College by the designated member on an annual basis, together with, for every Type 2 occurrence that involved an infection, the type of infection. O. Reg. 415/16, s. 1.
Inspection
 26. (1) All premises where a procedure is or may be performed by a member in connection with his or her practice are subject to inspection by the College in accordance with this Part. O. Reg. 415/16, s. 1. (2) In carrying out an inspection of a premises under subsection (1), the College may also require any or all of the following: 1. Inspection, examination or tests regarding any equipment, instrument, materials or any other thing that may be used in the performance of a procedure. 2. Examination and copying of books, accounts, reports, records or similar documents that are, in the opinion of the College, relevant to the performance of a procedure in the practice of the member. 3. Inquiries or questions to be answered by the member that are relevant to the performance of a procedure. 4. Information that establishes whether a member who performs or may perform a procedure in a premises has met the standard of practice set out in section 24. 5. Direct observation of a member in his or her practice, including direct observation by an inspector of the member performing a procedure and performing a procedure on a patient. O. Reg. 415/16, s. 1.
Power of inspector
 27. An inspector may, on the production of information identifying him or her as an inspector, enter and have access to any premises where a procedure is or may be performed by a member at reasonable times and may inspect the premises and do any of the things mentioned in subsection 26 (2) on behalf of the College. O. Reg. 415/16, s. 1.
Duty of member
 28. (1) It is the duty of every member whose premises are subject to an inspection to, (a) submit to an inspection of the premises where he or she performs or may perform a procedure in accordance with this Part; (b) submit to being directly observed performing a procedure in his or her practice; (c) promptly answer a question or comply with a requirement of the inspector that is relevant to an inspection under this Part; (d) co-operate fully with the inspector who is conducting an inspection of a premises in accordance with this Part; (e) provide the inspector with a copy of any report that was given to the College in accordance with clause 25 (a); and, (f) co-operate fully with the College in accordance with this Part. O. Reg. 415/16, s. 1. (2) A member shall not perform a procedure at a premises subject to an inspection under this Part where an inspector has been denied entry or access. O. Reg. 415/16, s. 1.
Direct observation
 29. Where, as part of the inspection, an inspector directly observes the member performing a procedure on a patient, before the observation occurs, the inspector shall, (a) identify himself or herself to the patient as an inspector appointed by the College; (b) explain the purpose of the direct observation to the patient; (c) inform the patient that information obtained from the direct observation, including personally identifiable information about the patient, may be used in proceedings under this Part or any other proceeding under the Act; (d) answer any questions that the patient asks; and (e) obtain the patient’s written consent to the direct observation of the patient by the inspector. O. Reg. 415/16, s. 1.
Designated member
 30. Where two or more members perform or may perform a procedure in a premises, the members shall, (a) designate a member as the designated member for the premises, and immediately notify the College of the designated member’s identity; (b) immediately notify the College, on every occasion when a different member is designated as designated member for the premises, of the identity of the new designated member. O. Reg. 415/16, s. 1.
Requirements before using premises
 31. (1) No member shall commence using any premises for the purpose of performing a procedure unless the member has previously given notice in writing to the College in accordance with subsection (5) of the member’s intention to do so and the premises pass an inspection or pass an inspection with conditions. O. Reg. 415/16, s. 1. (2) The College shall ensure that an inspection of the premises of a member referred to in subsection (1) is performed within 180 days from the day the College receives the member’s notice. O. Reg. 415/16, s. 1. (3) A member whose practice includes the performance of a procedure in any premises on the day this section comes into force shall give notice in writing to the College in accordance with subsection (5) within 60 days from the day this section comes into force, and the member may continue to use the premises for the performance of procedures until such time as the College has inspected the premises and delivered a report in accordance with section 33. O. Reg. 415/16, s. 1. (4) The College shall ensure that an inspection of the premises of a member referred to in subsection (3) is performed within 24 months from the day this section comes into force. O. Reg. 415/16, s. 1. (5) The notice submitted by the member required in subsections (1) and (3) shall include the following information, submitted in the form and manner required by the College: 1. The full name of the member giving the notice and the full name of the owner or occupier of the premises, if he or she is not the member who is required to give notice under this section. 2. The full name of any other member who is practising or may practise in the premises with the member giving the notice. 3. The name of any health profession corporation that is practising at the premises. 4. The full name of any other regulated health professional who is practising or may practise in the premises with a member at the premises, along with the name of the College where the regulated health professional is a member. 5. The full address of the premises. 6. The date when any member first performed a procedure in the premises or the proposed date when any member or another member intends to perform a procedure at the premises. 7. A description of any procedure that is or may be performed by a member or other members at the premises and of any procedure that may be delegated by the member or other members at the premises. 8. A description of any equipment or materials to be used in the performance of a procedure. 9. Any other information the College requires that is relevant to an inspection conducted at the premises in accordance with this Part. O. Reg. 415/16, s. 1.
Timing of inspections
 32. All premises where a member performs or may perform a procedure are subject to an inspection by the College once every five years after its initial inspection or more often if, in the opinion of the College, it is necessary or advisable to do so. O. Reg. 415/16, s. 1.