BILL REQ. #:  H-2266.1 

READ FIRST TIME 02/23/09.   

     AN ACT Relating to indirect supervision of certain health care services provided through naturopathic doctors; amending RCW 18.36A.050; adding a new section to chapter 18.36A RCW; and prescribing penalties.

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

NEW SECTION.  Sec. 1   A new section is added to chapter 18.36A RCW to read as follows:
     (1) An unlicensed practitioner may practice colon hydrotherapy under the following conditions:
     (a) A naturopath licensed under this chapter must provide indirect supervision of the unlicensed practitioner. For the purposes of this section, "indirect supervision" means the naturopath is not on the premises, but has confirmed that the unlicensed practitioner is competent to perform the colon hydrotherapy procedure and is in compliance with the requirements of this section.
     (b) The unlicensed practitioner must have a written consultation agreement with the supervising naturopath. The consultation agreement must require, at a minimum:
     (i) Monthly review of client cases and files between the unlicensed practitioner and the naturopath;
     (ii) Quarterly inspections by the naturopath of the facilities and equipment used by the unlicensed practitioner;
     (iii) A written emergency protocol in the event a client is injured or experiences an adverse reaction to the procedure; and
     (iv) A written protocol stating when a client must be referred to a licensed health care practitioner for treatment.
     (c) The colon hydrotherapy procedure must consist only of the application of filtered and temperature-controlled water into the large intestine for the purpose of removing waste. No drugs, herbs, chemicals, or other substances may be added to the water.
     (d) The unlicensed practitioner must use equipment approved by the United States food and drug administration that is maintained in original working order.
     (e) The unlicensed practitioner must maintain, in a readily retrievable manner, documentation of all training received related to the performance of colon hydrotherapy.
     (f) The unlicensed practitioner must use standard universal precautions for preventing the spread of disease at all times before, during, and after performing colon hydrotherapy.
     (g) Each client must sign a client disclosure form approved by the secretary. A copy of the client disclosure form must be provided to the client. The original client disclosure form must be maintained in a readily retrievable manner by the unlicensed practitioner.
     (2) A violation of this section by an unlicensed practitioner is a misdemeanor.
     (3) Nothing in this section may be construed to require that a health carrier defined in RCW 48.43.005 contract with a person authorized to practice colon hydrotherapy under this section.

Sec. 2   RCW 18.36A.050 and 1991 c 3 s 90 are each amended to read as follows:
     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 secretary. 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 naturopath licensed pursuant to this chapter; ((or))
     (4) The practice of oriental medicine or oriental herbology, or the rendering of other dietary or nutritional advice; or
     (5) The practice of colon hydrotherapy under section 1 of this act.