Legal Status of EPT in Washington

I. Statutes/regs on health care providers’ authority to prescribe for STDs to a patient’s partner(s) w/out prior evaluation

[-] State and local health officers and their authorized representatives may issue written orders for treatment only after laboratory test results or direct observation of clinical signs or assessment of clinical data by a physician confirm the individual has, or is likely to have, a STD. Wash. Admin. Code § 246-100-203.

II. Specific judicial decisions concerning EPT (or like practices)

III. Specific administrative opinions by the Attorney General or medical or pharmacy boards concerning EPT (or like practices)

[+] The Medical Commission “recognizes that it is a common practice for health care practitioners to provide antibiotics for the partner(s) without prior examination. While not ideal in terms of diagnosis and control of Chlamydia and gonorrhea, the Medical Commission recognizes that this is often the only reasonable way to access and treat the partner(s) and impact the personal and public health risks of chlamydial and gonorrheal infections.” MD2003-04

[+] The Washington State Medical Ass’n House of Delegates passed a Resolution concerning patient-delivered partner therapy for curable STDs and recommended that “the provider should inform the patient that it would be best to have all partners exposed during the previous 60 days come into a clinic for examination, testing and treatment. However, if treatment is not otherwise assured, the patient should be provided antibiotics for their partners.”

IV. Laws that incorporate via reference guidelines as acceptable practices (including EPT)

[+] Regulations authorize local health officers to incorporate by reference: APHA’s CCD Manual, 20th edition, or other measures s/he deems necessary based on his or her professional judgment, current standards of practice and the best available medical and scientific information. Wash. Admin. Code § 246-100-036.

[+] Patients diagnosed with reportable STDs are monitored for quality of services using CDC Treatment Guidelines as the “standard of care.”

V. Prescription requirements

[+] When practitioner dispenses drugs, prescription label must bear patient’s name, although name and dosage of drug may be removed if physician determines necessary. Wash. Rev. Code § 69.41.050.

[-] A health care entity may only administer, dispense, or deliver legend drugs and controlled substances to patients who receive care within the health care entity and in compliance with rules of the board. Nothing in this subsection shall prohibit a practitioner, in carrying out his or her licensed responsibilities within a health care entity, from dispensing or delivering to a patient of the health care entity drugs for that patient’s personal use in an amount not to exceed seventy-two hours of usage. Wash. Rev. Code § 18.64.450(4)

VI. Assessment of EPT’s legal status with brief comments

EPT is permissible. Statutory laws do not require a physician-patient relationship that would otherwise preclude EPT. The opinions of the Medical Commission and Medical Ass’n House of Delegates clearly favor the use of EPT, which is further supported by local health officers’ authority to incorporate standards of practice (e.g., CDC STD Treatment Guidelines) that may allow EPT for the treatment of particular diseases.