New Rhode Island Bill Sets Supervision Rules For Laser Procedures

Posted By American Med Spa Association, Tuesday, February 5, 2019

A new bill introduced in Rhode Island would create new rules for the delegation and supervision of certain laser procedures. The bill is sponsored by State Representatives Corvese, Vella-Wilkinson, Lima, O'Brien, and Azzinaro and has been initially referred to the House Committee on Health, Education, and Welfare for further consideration. You can review the text of House Bill 5251 (H5251) in full  here
H5251 adds a new section to Rhode Island’s Health and Safety Code for Non-Ablative Treatments. H5251 defines non-ablative treatments to be any laser, light, energy, or chemical procedure that isn’t expected to remove or burn tissue. Under H5251 these types of procedures can be delegated to trained individuals under the supervision of a licensed physician, physician assistant, or advance practice registered nurse. The Bill does not require that the delegated person hold any particular professional license but it does require that they receive training indications and pre- and post-operative care in the procedures. The delegating healthcare professional must have more extensive training in the procedures and be able to document their training upon request. In order to delegate these non-ablative procedures the health care professional will need to first 1) perform an assessment and determine appropriate treatment and device settings 2) insure that the delegate has the appropriate training and demonstrated proficiency 3) inform the patient verbally or in writing about the delegate’s training and qualifications 4) and have a written protocol for the procedure. The written protocol must describe the device and settings to be used, the appropriate care for common complications, the treatment plan, and quality assurance and monitoring steps. The protocol must be review annually by the delegating medical professional and be available for review upon request. If all of those steps are followed then the procedure can be delegated to the person. The supervising healthcare professional must be immediately available to respond while the treatment is being performed. It would be unprofessional conduct to delegate a non-ablative procedure without complying with the rules of H5251. 
In addition to providing guidelines for delegating these non-ablative procedures, H5251 also expands the scope of practice of electrologists. Currently, Rhode Island only licenses electrologists to provide hair removal using the traditional method of applying electrical current to the hair follicle by means of a needle. Under H5251, this would be expanded to include using any other form of energy by and instrument or devise to permanently disable a hair follicle. This would include types of laser hair removal. H5251 specifically exempts electologists from these delegation rules instead allowing them to practice in accordance with the rules their professional license.
While a relatively simple bill H5251 is indicative of at least two broader trends we have seen. One trend is the expansion of the electrologist’s scope of practice beyond the traditional needle based procedure. As laser and light based hair removal have gained in popularity some states have expanded electrology to include these procedures rather than let the license fade away. Additionally, we have seen many states expand the types of people who may perform some of the less invasive laser and light based procedures to include non-medical licensees. To accomplish this some states create a “laser technician” license while others provide well defined guidelines on training and supervision like H5251 would.    
We will be monitoring H5251 as it works its way through Rhode Island’s legislative process this year. If you would like to contact H5251’s sponsors they can be reached via their page on the Rhode Island Legislature’s  website.