2019 -- H 5251

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LC001024

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO HEALTH AND SAFETY- DELEGATION OF NON-ABLATIVE

TREATMENTS

     

     Introduced By: Representatives Corvese, Vella-Wilkinson, Lima, O'Brien, and
Azzinaro

     Date Introduced: January 31, 2019

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

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     SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby

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amended by adding thereto the following chapter:

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CHAPTER 95

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DELEGATION OF NON-ABLATIVE TREATMENTS

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     23-95-1. Definitions.

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     As used in this chapter:

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     (1) "Delegate" means a person tasked by a licensed health care professional or a medical

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director performing non-ablative treatment.

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     (2) "Department" means the Rhode Island department of health.

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     (3) "Electrologist" means a person who is licensed by the department to perform

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electrolysis.

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     (4) "Electrolysis'' means the method of removing hair from the human body by the

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application of an electrical current or any other form of energy to the hair-papilla or other source

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of hair germination by means of a needle or any other instrument or device to cause

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decomposition, coagulation, dehydration or other form of tissue destruction, to permanently

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disable the hair follicle from producing hair.

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     (5) "Laser light" means an intense, coherent, directional beam of light produced by

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stimulated emission of photons; the word laser shall mean the acronym for light amplification by

 

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stimulated emission of radiation.

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     (6) "Laser hair removal" means using laser light to perform hair removal or reduction, or

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electrolysis performed with laser light.

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     (7) "Licensed health care professional" means an advanced practical nurse practitioner or

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physician assistant licensed in Rhode Island, who is allowed to perform surgery within the scope

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of their licensed practice.

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     (8) "Medical director" means a Rhode Island licensed physician.

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     (9) "Non-ablative treatment" means any laser or intense pulsed light treatment or

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treatment by another energy source, chemical, or modality that is not expected or intended to

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remove, burn, or vaporize tissue. The term "non-ablative treatment" shall not include treatments

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related to electrolysis or laser hair removal if those treatments are performed by a licensed

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electrologist.

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     (6) "Supervision" means the overseeing of the delegated non-ablative treatment

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performed by a delegate. Supervision shall only be provided by a licensed health care

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professional or a medical director.

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     23-95-2. General restrictions.

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     (a) The use of a laser or energy-based device that is expected or intended to remove,

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burn, or vaporize the live epidermal surface of the skin is surgery and may only be performed by

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a licensed health care professional or medical director who is allowed to perform surgery within

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the scope of their licensed practice and may not be delegated.

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     (b) Non-ablative treatment may be performed by a delegate if the treatment has been

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delegated, the delegating licensed health care professional or medical director provides the

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appropriate supervision, and the delegate has met the necessary training requirements.

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     23-95-3. Delegation of non-ablative treatment.

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     (a) Prior to delegating the performance of a non-ablative treatment, the delegating

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licensed health care professional or medical director shall perform the initial assessment of the

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patient to determine which treatment is appropriate for the patient and determine the settings on

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the chosen device.

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     (b) Prior to delegating the performance of a non-ablative treatment, the delegating

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licensed health care professional or medical director shall ensure that the delegate has

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satisfactorily met the training requirements and that the treatment is within the scope of practice

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for the delegate's profession. The delegating licensed health care professional or medical director

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is responsible for ensuring that the delegate performing the treatment has demonstrated sufficient

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proficiency for each non-ablative treatment performed.

 

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     (c) Prior to the performance of a delegated non-ablative treatment, the delegating licensed

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health care professional or medical director shall inform the patient about the training and

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qualifications of who will be performing the treatment. This notice may be written or verbal.

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     (d) A licensed health care professional or medical director may delegate the performance

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of a non-ablative treatment through the use of a written protocol developed by the medical

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director. The written protocol shall provide, at a minimum:

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     (1) The identification of the devices and settings to be used;

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     (2) A description of appropriate care and follow-up for common complications, injuries,

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or adverse reactions that may result from the treatment, including a plan to manage medical

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emergencies;

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     (3) A description of the treatment plan to be followed for each non-ablative treatment

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delegated under the written protocol, including the method to be used for documenting decisions,

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communicating with the delegating licensed health care professional, and recording all treatment

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provided in the patient's record; and

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     (4) A quality assurance plan for monitoring care provided by the delegate including

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patient care review and any necessary follow-up.

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     (e) The written protocol shall be annually reviewed by the delegating licensed health care

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professional or medical director and the delegate and updated as necessary. The written protocol

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shall be provided to the department or to any patient, upon request.

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     23-95-4. Supervision.

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     A delegate may only perform a delegated non-ablative treatment under the supervision of

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a licensed health care professional or medical director. Supervision requires a licensed health care

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professional or medical director to be immediately available and able to respond promptly to any

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question or problem that may occur while the treatment is being performed.

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     23-95-5. Training.

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     (a) A licensed health care professional or medical director who delegates the performance

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of a non-ablative treatment shall be able to document to the department, upon request, the

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completion of appropriate training in the physics, safety, and surgical techniques involved in the

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use of laser and energy-based devices capable of damaging living tissues. This training should

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include an extensive understanding of cutaneous medicine and surgery, the indications and

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contraindications for such procedures, the pre- and post-operative care involved in treatment, as

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well as the treatment of complications associated with these devices.

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     (b) For each non-ablative treatment to be performed, it is the responsibility of the

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delegating licensed health care professional or medical director to ensure that the delegate is

 

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appropriately trained in the indications and contraindications and the pre- and post-operative care

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involved in treatment.

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     23-95-6. Violations and enforcement.

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     Failure to comply with any provision under this chapter or knowingly delegating a non-

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ablative treatment other than as authorized under this chapter shall constitute unprofessional

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conduct pursuant to the licensing statute under which the delegating licensed health care

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professional practices.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY- DELEGATION OF NON-ABLATIVE

TREATMENTS

***

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     This act would appropriate procedures regulating the delegation of non-ablative

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treatment, otherwise known as any laser or intense pulsed light treatment or treatment by another

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energy source, chemical, or modality that is not expected or intended to remove, burn, or vaporize

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tissue.

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     This act would take effect upon passage.

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