Washington Administrative Code › Title 246 - Health, Department of › PROFESSIONAL STANDARDS AND LICENSING › Chapter 246-836 - Naturopathic physicians › Section 246-836-300 - Affiliation relationships for colon hydrotherapy

Current through Register Vol. 24-14, July 15, 2024
(1) A naturopathic physician must establish
				an affiliation relationship with a colon hydrotherapist to allow the colon
				hydrotherapist to perform colon hydrotherapy on a patient of the naturopathic
				physician. Such affiliation relationships must be registered with the board on
				forms provided by the board and will remain in effect until rescinded by either
				practitioner.
(2) A naturopathic
				physician who has a registered affiliation relationship with a colon
				hydrotherapist and desires to terminate such relationship must provide a
				minimum of 60 days' notice to the colon hydrotherapist prior to submitting
				documentation to the board rescinding that relationship. If a colon
				hydrotherapist employee or naturo-pathic physician employee within a practice
				is terminated from employment, then any affiliation relationship with that
				terminated employee is immediately suspended and rescission is effective once
				documentation is submitted to the board.
(3) A naturopathic physician may enter into
				registered affiliation relationships with up to a maximum of 20 colon
				hydrotherapists but may petition the board for a waiver of this
				limit.
(4) Affiliation
				relationships must be fully documented, signed by both practitioners with
				copies maintained by each practitioner, and available upon request by the board
				or its designee. Such affiliation relationship documentation must include, at a
				minimum:
(a) Communication of a patient's plan
				of care to include the methods and process for shared documentation of
				treatment;
(b) Standards for
				patient referral, to include an expiration date of the referral or the total
				number of colon hydrotherapy treatments to be provided within a specified time
				frame. Unless otherwise stated, such referral shall not exceed 24 treatments
				within six months;
(c) Policy and
				procedures for transfer of patient care in the event a higher level is
				indicated;
(d) Acknowledgment that
				contraindications for a patient prohibit performing colon hydrotherapy
				including, but not limited to:
(i)
				Gastrointestinal cancer;
(ii) Acute
				or severe abdominal pain;
(iii)
				Gastrointestinal bleed within the past six weeks;
(iv) Surgery within the previous six weeks of
				the following types:
(A) Abdominal;
(B) Gastrointestinal;
(C) Colon;
(v) History of gastrointestinal hemorrhage or
				perforation;
(vi) Complicated
				abdominal hernia;
(vii) Severe
				anemia;
(viii) Acute
				diverticulitis;
(ix) Severe or
				painful hemorrhoids;
(x) Severe or
				painful fissures or fistula;
(xi)
				Acute ulcerative colitis;
(xii)
				Acute Crohn's disease;
(xiii)
				Recent myocardial infarction;
(xiv)
				Congestive heart failure;
(xv)
				Uncontrolled hypertension;
(xvi)
				Vascular or aortic aneurysm;
(xvii)
				Kidney failure or renal insufficiency;
(xviii) Acute cirrhosis; and
(xix) Pregnancy that is:
(A) First trimester;
(B) Third trimester;
(C) Complicated; or
(D) High risk; and
(e) A plan for inspection and
				maintenance of the colon hydrotherapy equipment, which must be registered FDA
				equipment and utilize disposable rectal nozzles or speculae. However, if the
				equipment utilizes reusable materials, such materials must be cleaned and
				sterilized within manufacturer's specifications. Any disposable materials shall
				not be reused or repurposed.