2019 -- H 5251

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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:

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

amended by adding thereto the following chapter:

CHAPTER 95

DELEGATION OF NON-ABLATIVE TREATMENTS

     23-95-1. Definitions.

     As used in this chapter:

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

director performing non-ablative treatment.

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

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

electrolysis.

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

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

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

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

disable the hair follicle from producing hair.

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

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

stimulated emission of radiation.

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

electrolysis performed with laser light.

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

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

of their licensed practice.

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

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

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

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

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

electrologist.

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

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

professional or a medical director.

     23-95-2. General restrictions.

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

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

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

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

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

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

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

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

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

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

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

the chosen device.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

emergencies;

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

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

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

provided in the patient's record; and

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

patient care review and any necessary follow-up.

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

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

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

     23-95-4. Supervision.

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

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

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

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

     23-95-5. Training.

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

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

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

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

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

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

well as the treatment of complications associated with these devices.

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

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

involved in treatment.

     23-95-6. Violations and enforcement.

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

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

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

professional practices.

     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

***

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

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

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

tissue.

     This act would take effect upon passage.

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