2017 -- H 5228

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2017

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A N   A C T

RELATING TO HEALTH AND SAFETY -- DELEGATION OF NON-ABLATIVE

TREATMENTS

     Introduced By: Representatives Fogarty, McNamara, Bennett, Maldonado, and
Ruggiero

     Date Introduced: January 26, 2017

     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 94

DELEGATION OF NON-ABLATIVE TREATMENTS

     23-94-1. Definitions.

     As used in this chapter:

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

performing non-ablative treatment.

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

     (3) "Licensed health care professional" means a person who is allowed to perform

surgery within the scope of their licensed practice.

     (4) "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. This shall include treatments related to laser hair removal.

     (5) "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.

     23-94-2. 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 who is allowed to perform surgery within the scope of their

licensed practice.

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

delegated, the delegating licensed health care professional provides the appropriate on-site

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

     23-94-3. Delegation of non-ablative treatment.

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

licensed health care professional 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 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 is responsible for ensuring that the delegate

performing the treatment has demonstrated sufficient proficiency for each non-ablative treatment

performed.

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

health care professional shall inform the patient about the training and qualifications of who will

be performing the treatment.

     (d) A licensed health care professional may delegate the performance of a non-ablative

treatment through the use of a written protocol. 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 and the delegate and updated as necessary. The written protocol shall be provided to

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the department or to any patient, upon request.

     23-94-4. Supervision.

     A delegate may only perform a delegated non-ablative treatment under the on-site

supervision of a licensed health care professional. On-site supervision requires:

     (1) A licensed health care professional to be physically present in the facility where the

non-ablative treatment is to be performed for at least the entire duration of the treatment; and

     (2) A licensed health care professional shall be immediately available and able to respond

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

     23-94-5. Training.

     (a) A licensed health care professional 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 to ensure that the delegate is appropriately trained in

the indications and contraindications and the pre- and post-operative care involved in treatment.

     23-94-6. 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 provide guidelines for the delegation by licensed health care professionals

of non-ablative laser or energy-based treatments to a properly-qualified delegate.

     This act would take effect upon passage.

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