Second Substitute S.B. 40

This document includes Senate Committee Amendments incorporated into the bill on Fri, Feb 24, 2012 at 2:02 PM by khelgesen. -->

Senator Peter C. Knudson proposes the following substitute bill:

1 COSMETIC MEDICAL PROCEDURES
2 2012 GENERAL SESSION
3 STATE OF UTAH
4 Chief Sponsor: Peter C. Knudson
5 House Sponsor: ____________
6
7 LONG TITLE
8 General Description:
9 This bill amends the Utah Medical Practice Act and the Utah Osteopathic Practice Act.
10 Highlighted Provisions:
11 This bill:
12 . defines:
13 . ablative procedure;
14 . cosmetic medical facility;
15 . cosmetic medical procedure;
16 . nonablative procedure;
17 . superficial procedure; and
18 . supervisor;
19 . exempts certain licensees from the definition of cosmetic medical procedures;
20 . establishes standards for the supervision of cosmetic medical procedures;
21 . amends the definition of the practice of medicine; and
22 . amends provisions of unprofessional conduct for physicians and other licensees
23 whose scope of practice includes cosmetic medical procedures.
24 Money Appropriated in this Bill:
25 None

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- 2 - 26 Other Special Clauses:
27 None
28 Utah Code Sections Affected:
29 AMENDS:
30 58-1-102, as renumbered and amended by Laws of Utah 1993, Chapter 297
31 58-11a-102, as last amended by Laws of Utah 2010, Chapter 145
32 58-11a-502, as last amended by Laws of Utah 2009, Chapter 130
33 58-16a-102, as last amended by Laws of Utah 2004, Chapters 48 and 280
34 58-67-102, as last amended by Laws of Utah 2011, Chapter 214
35 58-68-102, as last amended by Laws of Utah 2011, Chapter 214
36 ENACTS:
37 58-1-505, Utah Code Annotated 1953
38 58-1-506, Utah Code Annotated 1953
39 58-67-805, Utah Code Annotated 1953
40 58-68-805, Utah Code Annotated 1953
41
42 Be it enacted by the Legislature of the state of Utah:
43 Section 1. Section 58-1-102 is amended to read:
44 58-1-102. Definitions.
45 For purposes of this title:
46 (1) "Ablative procedure" is as defined in Section 58-67-102 .
47 (2) "Cosmetic medical procedure":
48 (a) is as defined in Section 58-67-102 ; and
49 (b) except for Chapter 67, Utah Medical Practice Act, and Chapter 68, Utah
50 Osteopathic Medical Practice Act, does not apply to the scope of practice of an individual
51 licensed under this title if the individual's scope of practice includes the authority to operate or
52 perform surgical procedures.
53 [(1)] (3) "Department" means the Department of Commerce.
54 [(2)] (4) "Director" means the director of the Division of Occupational and
55 Professional Licensing.
56 [(3)] (5) "Division" means the Division of Occupational and Professional Licensing

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Senate Committee Amendments 2-24-2012 kh/cjd 57

created in Section 58-1-103 .
58 [(4)] (6) "Executive director" means the executive director of the Department of
59 Commerce.
60 [(5)] (7) "Licensee" includes any holder of a license, certificate, registration, permit,
61 student card, or apprentice card authorized under this title.
62 (8) (a) "Nonablative procedure" means a procedure that is expected or intended to alter
63 living tissue, but not to excise, burn, vaporize or remove below the epidermal surface of the
64 skin.
65 (b) "Nonablative procedure" does not include:
66 (i) a superficial procedure;
67 (ii) the application of permanent make-up; or
68 (iii) the use of infrared photo therapy and low level lasers for treatments that:
69 (A) are not cosmetic medical procedures; and
70 (B) are performed by a S. [ chiropractor ] chiropractic physician .S or physical therapist
70a for treatment of a condition
71 that is within their scope of practice.
72 (9) "Superficial procedure" means a procedure that is expected or intended to
73 temporarily alter living skin tissue and may excise or remove stratum corneum but have no
74 appreciable risk of damage to any tissue below the stratum corneum.
75 [(6)] (10) "Unlawful conduct" has the meaning given in Subsection 58-1-501 (1).
76 [(7)] (11) "Unprofessional conduct" has the meaning given in Subsection 58-1-501 (2).
77 Section 2. Section 58-1-505 is enacted to read:
78 58-1-505. Cosmetic medical procedure supervisor.
79 (1) For purposes of this section:
80 (a) "Cosmetic medical facility" means a physician's office or a facility that has a
81 supervisor who performs the supervision required in Section 58-1-506 .
82 (b) "Supervisor" means:
83 (i) a physician with an unrestricted license under Chapter 67, Utah Medical Practice
84 Act, or Chapter 68, Utah Osteopathic Medical Practice Act, who is acting within the scope of
85 the practice of medicine, as defined in Section 58-67-102 ; and
86 (ii) an advanced practice registered nurse with an unrestricted license under Chapter
87 31b, Nurse Practice Act, who is acting within the scope of practice of advanced practice

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Senate Committee Amendments 2-24-2012 kh/cjd 88

registered nursing, as defined in Section 58-31b-102 .
89 (2) (a) An individual authorized by this title to perform a cosmetic medical procedure
90 shall be supervised by a supervisor when performing a medical procedure.
91 (b) Cosmetic medical procedures may only be performed in a cosmetic medical
92 facility.
93 (c) A supervisor may delegate the supervisory role only to another individual who is
94 qualified as a supervisor.
95 Section 3. Section 58-1-506 is enacted to read:
96 58-1-506. Supervision of cosmetic medical procedures.
97 (1) For purposes of this section:
98 (a) "Delegation group A" means the following who are licensed under this title, acting
99 within their respective scope of practice, and qualified under Subsection (2) S. [ (f) ] (i) .S :
100 (i) a physician assistant, if supervised by a physician and the procedure is included in
101 the delegation agreement;
102 (ii) a registered nurse;
103 (iii) a master esthetician; and
104 (iv) an electrologist, if evaluating for or performing laser hair removal.
105 (b) "Delegation group B" means S. :
105a (i) [ the following who are ] a practical nurse or an esthetician who is .S licensed
105b under this title, acting
106 within their respective scope of practice, and S. [ are ] .S qualified under Subsection S. [ (2)(f) ]
106a (2)(i); and .S :
107 S. [ (i) a practical nurse;
108 (ii) an esthetician; and
109 (iii) ] (ii) .S a medical assistant S. who is qualified under Subsection (2)(i) .S .
110 (c) "Direct cosmetic medical procedure supervision" means the supervisor:
111 (i) has authorized the procedure to be done on the patient by the supervisee; and
112 (ii) is present and available for a face-to-face communication with the supervisee when
113 and where a cosmetic medical procedure is performed.
114 (d) "General cosmetic medical procedure supervision" means the supervisor:
115 (i) has authorized the procedure to be done on the patient by the supervisee;
116 (ii) is available in a timely and appropriate manner in person to evaluate and initiate
117 care for a patient with a suspected adverse reaction or complication; and
118 (iii) is located within S. [ 45 ] 60 .S minutes or S. [ 45 ] 60 .S miles of the cosmetic
118a medical facility.

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- 5 - 119 (e) "Indirect cosmetic medical procedure supervision" means the supervisor:
120 (i) has authorized the procedure to be done on the patient by the supervisee;
121 (ii) has given written instructions to the person being supervised;
122 (iii) is present within the cosmetic medical facility in which the person being
123 supervised is providing services; and
124 (iv) is available to:
125 (A) provide immediate face-to-face communication with the person being supervised;
126 and
127 (B) evaluate the patient, as necessary.
128 (f) "Hair removal review" means:
129 (i) conducting an in-person, face-to-face interview of a patient based on the responses
130 provided by the patient to a detailed medical history assessment that was prepared by the
131 supervisor;
132 (ii) evaluating for contraindications and conditions that are part of the treatment plan;
133 and
134 (iii) if the patient history or patient presentation deviates in any way from the treatment
135 plan, referring the patient to the supervisor and receiving clearance from the supervisor before
136 starting the treatment.
137 (2) A supervisor supervising a nonablative cosmetic medical procedure for hair
138 removal shall:
139 (a) have an unrestricted license to practice medicine or advanced practice registered
140 nursing in the state;
141 (b) develop the medical treatment plan for the procedure;
142 (c) conduct a hair removal review, or delegate the hair removal review to a member of
143 delegation group A, of the patient prior to initiating treatment or a series of treatments;
144 (d) personally perform the nonablative cosmetic medical procedure for hair removal, or
145 authorize and delegate the procedure to a member of delegation group A or B;
146 (e) during the nonablative cosmetic medical procedure for hair removal provide general
147 cosmetic medical procedure supervision to individuals in delegation group A performing the
148 procedure and indirect cosmetic medical procedure supervision to individuals in delegation
149 group B performing the procedure; and

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- 6 - 150 (f) verify that a person to whom the supervisor delegates an evaluation under
151 Subsection (2)(c) or delegates a procedure under Subsection (2)(d):
152 (i) has received appropriate training regarding the medical procedures developed under
153 Subsection (2)(b);
154 (ii) has an unrestricted license under this title or is performing under the license of the
155 supervising physician and surgeon; and
156 (iii) if a practical nurse or medical assistant, has maintained competence to perform the
157 nonablative cosmetic medical procedure for hair removal through documented training and
158 experience of at least 80 hours, as further defined by rule, regarding:
159 (A) the appropriate standard of care for performing nonablative cosmetic medical
160 procedures for hair removal;
161 (B) physiology of the skin;
162 (C) skin typing and analysis;
163 (D) skin conditions, disorders, and diseases;
164 (E) pre and post procedure care;
165 (F) infection control;
166 (G) laser and light physics training;
167 (H) laser technologies and applications;
168 (I) safety and maintenance of lasers;
169 (J) cosmetic laser hair removal procedures;
170 (K) recognition and appropriate management of complications from a procedure; and
171 (L) cardio-pulmonary resuscitation (CPR).
172 (3) For a nonablative cosmetic medical procedure other than hair removal under
173 Subsection (2):
174 (a) a physician who has an unrestricted license to practice medicine shall:
175 (i) develop a treatment plan for the nonablative cosmetic medical procedure; and
176 (ii) conduct an in-person face-to-face evaluation of the patient prior to the initiation of
177 a treatment protocol or series of treatments;
178 (b) the supervisor supervising the procedure shall:
179 (i) have an unrestricted license to practice medicine or advanced practice registered
180 nursing;

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- 7 - 181 (ii) personally perform the nonablative cosmetic medical procedure or:
182 (A) authorize and provide general cosmetic medical procedure supervision for the
183 nonablative cosmetic medical procedure that is performed by:
184 (I) a physician assistant, if supervised by a physician and the procedure is included in
185 the delegation agreement;
186 (II) a registered nurse;
187 (III) a master esthetician; or
188 (B) authorize and provide direct cosmetic medical procedure supervision for the
189 nonablative cosmetic medical procedure that is performed by an esthetician; and
190 (iii) verify that a person to whom the supervisor delegates a procedure under
191 Subsection (3)(b):
192 (A) has received appropriate training regarding the medical procedures to be
193 performed; and
194 (B) has an unrestricted license and is acting within their scope of practice under this
195 title.
196 (4) A supervisor performing or supervising a cosmetic medical procedure under
197 Subsection (2) or (3) shall ensure that:
198 (a) the supervisor's name is prominently posted at the cosmetic medical facility
199 identifying the supervisor;
200 (b) a copy of the supervisor's license is displayed on the wall of the cosmetic medical
201 facility;
202 (c) the patient receives written information with the name and licensing information of
203 the supervisor who is supervising the nonablative cosmetic medical procedure and the person
204 who is performing the nonablative cosmetic medical procedure;
205 (d) the patient is provided with a telephone number that is answered within 24 hours
206 for follow-up communication;
207 (e) the cosmetic medical facility's contract with a master esthetician who performs a
208 nonablative cosmetic medical procedure at the facility is kept on the premises of the facility;
209 and
210 (f) a supervisee and supervisor, who are required to have malpractice and liability
211 insurance, have proof of insurance available for inspection at the request of a patient.

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- 8 - 212 (5) Failure to comply with the provisions of this section is unprofessional conduct.
213 Section 4. Section 58-11a-102 is amended to read:
214 58-11a-102. Definitions.
215 As used in this chapter:
216 (1) "Approved barber or cosmetologist/barber apprenticeship" means an apprenticeship
217 that meets the requirements of Subsection 58-11a-306 (1) for barbers or Subsection
218 58-11a-306 (2) for cosmetologist/barbers and the requirements established by rule by the
219 division in collaboration with the board in accordance with Title 63G, Chapter 3, Utah
220 Administrative Rulemaking Act.
221 (2) "Approved esthetician apprenticeship" means an apprenticeship that meets the
222 requirements of Subsection 58-11a-306 (3) and the requirements established by rule by the
223 division in collaboration with the board in accordance with Title 63G, Chapter 3, Utah
224 Administrative Rulemaking Act.
225 (3) "Approved master esthetician apprenticeship" means an apprenticeship that meets
226 the requirements of Subsection 58-11a-306 (4) and the requirements established by rule by the
227 division in collaboration with the board in accordance with Title 63G, Chapter 3, Utah
228 Administrative Rulemaking Act.
229 (4) "Approved nail technician apprenticeship" means an apprenticeship that meets the
230 requirements of Subsection 58-11a-306 (5) and the requirements established by rule by the
231 division in collaboration with the board in accordance with Title 63G, Chapter 3, Utah
232 Administrative Rulemaking Act.
233 (5) "Barber" means a person who is licensed under this chapter to engage in the
234 practice of barbering.
235 (6) "Barber instructor" means a barber who is licensed under this chapter to teach
236 barbering at a licensed barber school or in an apprenticeship program as defined in Section
237 58-11a-306 .
238 (7) "Board" means the Barber, Cosmetology/Barbering, Esthetics, Electrology, and
239 Nail Technology Licensing Board created in Section 58-11a-201 .
240 (8) "Cosmetic laser procedure" means only a nonablative procedure as defined in
241 Section 58-67-102 .
242 (9) "Cosmetic supervisor" means a supervisor as defined in Section 58-1-505 .

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- 9 - 243 [(8)] (10) "Cosmetologist/barber" means a person who is licensed under this chapter to
244 engage in the practice of cosmetology/barbering.
245 [(9)] (11) "Cosmetologist/barber instructor" means a cosmetologist/barber who is
246 licensed under this chapter to teach cosmetology/barbering at a licensed cosmetology/barber
247 school, licensed barber school, licensed nail technology school, or in an apprenticeship
248 program as defined in Subsection 58-11a-306 (2).
249 [(10)] (12) "Direct supervision" means that the supervisor of an apprentice or the
250 instructor of a student is immediately available for consultation, advice, instruction, and
251 evaluation.
252 [(11)] (13) "Electrologist" means a person who is licensed under this chapter to engage
253 in the practice of electrology.
254 [(12)] (14) "Electrologist instructor" means an electrologist who is licensed under this
255 chapter to teach electrology at a licensed electrology school.
256 [(13)] (15) "Esthetician" means a person who is licensed under this chapter to engage
257 in the practice of esthetics.
258 [(14)] (16) "Esthetician instructor" means a master esthetician who is licensed under
259 this chapter to teach the practice of esthetics and the practice of master-level esthetics at a
260 licensed esthetics school, a licensed cosmetology/barber school, or in an apprenticeship
261 program as defined in Subsection 58-11a-306 (3).
262 [(15)] (17) "Fund" means the Barber, Cosmetologist/Barber, Esthetician, Electrologist,
263 and Nail Technician Education and Enforcement Fund created in Section 58-11a-103 .
264 [(16)] (18) "Licensed barber or cosmetology/barber school" means a barber or
265 cosmetology/barber school licensed under this chapter.
266 [(17)] (19) "Licensed electrology school" means an electrology school licensed under
267 this chapter.
268 [(18)] (20) "Licensed esthetics school" means an esthetics school licensed under this
269 chapter.
270 [(19)] (21) "Licensed nail technology school" means a nail technology school licensed
271 under this chapter.
272 [(20)] (22) "Master esthetician" means an individual who is licensed under this chapter
273 to engage in the practice of master-level esthetics.

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- 10 - 274 [(21)] (23) "Nail technician" means an individual who is licensed under this chapter to
275 engage in the practice of nail technology.
276 [(22)] (24) "Nail technician instructor" means a nail technician licensed under this
277 chapter to teach the practice of nail technology in a licensed nail technology school, a licensed
278 cosmetology/barber school, or in an apprenticeship program as defined in Subsection
279 58-11a-306 (5).
280 [(23)] (25) "Practice of barbering" means:
281 (a) cutting, clipping, or trimming the hair of the head of any person by the use of
282 scissors, shears, clippers, or other appliances;
283 (b) draping, shampooing, scalp treatments, basic wet styling, and blow drying; and
284 (c) removing hair from the face or neck of a person by the use of shaving equipment.
285 [(24)] (26) "Practice of barbering instruction" means instructing barbering in a licensed
286 barber school, licensed cosmetology/barber school, or in an apprenticeship program as defined
287 in Subsection 58-11a-306 (1).
288 [(25)] (27) "Practice of basic esthetics" means any one of the following skin care
289 procedures done on the head, face, neck, arms, hands, legs, feet, eyebrows, or eyelashes for
290 cosmetic purposes and not for the treatment of medical, physical, or mental ailments:
291 (a) cleansing, stimulating, manipulating, exercising, applying oils, antiseptics, clays, or
292 masks, manual extraction, including a comodone extractor, depilatories, waxes, tweezing, the
293 application of eyelash extensions, natural nail manicures or pedicures, or callous removal by
294 buffing or filing;
295 (b) limited chemical exfoliation as defined by rule;
296 (c) removing superfluous hair by means other than electrolysis, except that an
297 individual is not required to be licensed as an esthetician to engage in the practice of threading;
298 (d) other esthetic preparations or procedures with the use of the hands, a
299 high-frequency or galvanic electrical apparatus, or a heat lamp for cosmetic purposes and not
300 for the treatment of medical, physical, or mental ailments; or
301 (e) cosmetic laser procedures under [direct] the supervision of a [licensed health care
302 practitioner as defined by rule,] cosmetic supervisor limited to the following:
303 (i) superfluous hair removal;
304 (ii) anti-aging resurfacing enhancements;

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- 11 - 305 (iii) photo rejuvenation; or
306 (iv) tattoo removal.
307 [(26)] (28) (a) "Practice of cosmetology/barbering" means:
308 (i) styling, arranging, dressing, curling, waving, permanent waving, cleansing,
309 singeing, bleaching, dyeing, tinting, coloring, or similarly treating the hair of the head of a
310 person;
311 (ii) cutting, clipping, or trimming the hair by the use of scissors, shears, clippers, or
312 other appliances;
313 (iii) arching eyebrows, or tinting eyebrows or eyelashes, applying eyelash extensions,
314 or any combination of these procedures;
315 (iv) removing hair from the face, neck, shoulders, arms, back, torso, feet, bikini line,
316 or legs of a person by the use of depilatories, waxing, or shaving equipment;
317 (v) cutting, curling, styling, fitting, measuring, or forming caps for wigs or hairpieces
318 or both on the human head; or
319 (vi) practicing hair weaving or hair fusing or servicing previously medically implanted
320 hair.
321 (b) The term "practice of cosmetology/barbering" includes:
322 (i) the practice of basic esthetics; and
323 (ii) the practice of nail technology.
324 (c) An individual is not required to be licensed as a cosmetologist/barber to engage in
325 the practice of threading.
326 [(27)] (29) "Practice of cosmetology/barbering instruction" means instructing
327 cosmetology/barbering as defined in Subsection [(26)] (28) in a licensed cosmetology/barber
328 school or in an apprenticeship program as defined in Subsection 58-11a-306 (2).
329 [(28)] (30) "Practice of electrology" means:
330 (a) the removal of superfluous hair from the body of a person by the use of electricity,
331 waxing, shaving, or tweezing; or
332 (b) cosmetic laser procedures under the [general] supervision of a [licensed health care
333 practitioner as defined by rule,] cosmetic supervisor limited to superfluous hair removal.
334 [(29)] (31) "Practice of electrology instruction" means instructing electrology in a
335 licensed electrology school.

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- 12 - 336 [(30)] (32) "Practice of esthetics instruction" means instructing esthetics in a licensed
337 esthetics school, a licensed cosmetology/barber school, or instructing master-level esthetics in a
338 licensed esthetics school or in an apprenticeship program as defined in Subsections
339 58-11a-306 (2), (3), and (4).
340 [(31)] (33) (a) "Practice of master-level esthetics" means:
341 (i) any of the following when done for cosmetic purposes on the head, face, neck,
342 torso, abdomen, back, arms, hands, legs, feet, eyebrows, or eyelashes and not for the treatment
343 of medical, physical, or mental ailments:
344 (A) body wraps as defined by rule;
345 (B) hydrotherapy as defined by rule;
346 (C) chemical exfoliation as defined by rule;
347 (D) advanced pedicures as defined by rule;
348 (E) sanding, including microdermabrasion;
349 (F) advanced extraction;
350 (G) other esthetic preparations or procedures with the use of:
351 (I) the hands; or
352 (II) a mechanical or electrical apparatus which is approved for use by division rule for
353 beautifying or similar work performed on the body for cosmetic purposes and not for the
354 treatment of a medical, physical, or mental ailment; or
355 (H) cosmetic laser procedures under the [general] supervision of a [licensed health care
356 practitioner as defined by rule,] cosmetic supervisor with a physician's evaluation before the
357 procedure, as needed, unless specifically required under Section 58-1-506 , and limited to the
358 following:
359 (I) superfluous hair removal;
360 (II) anti-aging resurfacing enhancements;
361 (III) photo rejuvenation; or
362 (IV) tattoo removal with a physician's evaluation before the tattoo removal procedure;
363 and
364 (ii) lymphatic massage by manual or other means as defined by rule.
365 (b) Notwithstanding the provisions of Subsection [(31)] (33)(a), a master-level
366 esthetician may perform procedures listed in Subsection [(31)] (33)(a)(i) for noncosmetic

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- 13 - 367 purposes if done under the supervision of a licensed health care practitioner acting within the
368 scope of the licensed health care practitioner's license as defined by rule.
369 (c) The term "practice of master-level esthetics" includes the practice of esthetics, but
370 an individual is not required to be licensed as an esthetician or master-level esthetician to
371 engage in the practice of threading.
372 [(32)] (34) "Practice of nail technology" means to trim, cut, clean, manicure, shape,
373 massage, or enhance the appearance of the hands, feet, and nails of an individual by the use of
374 hands, mechanical, or electrical preparation, antiseptic, lotions, or creams, including the
375 application and removal of sculptured or artificial nails.
376 [(33)] (35) "Practice of nail technology instruction" means instructing nail technology
377 in a licensed nail technician school, licensed cosmetology/barber school, or in an
378 apprenticeship program as defined in Subsection 58-11a-306 (5).
379 [(34)] (36) "Recognized barber school" means a barber school located in a state other
380 than Utah, whose students, upon graduation, are recognized as having completed the
381 educational requirements for licensure in that state.
382 [(35)] (37) "Recognized cosmetology/barber school" means a cosmetology/barber
383 school located in a state other than Utah, whose students, upon graduation, are recognized as
384 having completed the educational requirements for licensure in that state.
385 [(36)] (38) "Recognized electrology school" means an electrology school located in a
386 state other than Utah, whose students, upon graduation, are recognized as having completed the
387 educational requirements for licensure in that state.
388 [(37)] (39) "Recognized esthetics school" means an esthetics school located in a state
389 other than Utah, whose students, upon graduation, are recognized as having completed the
390 educational requirements for licensure in that state.
391 [(38)] (40) "Recognized nail technology school" means a nail technology school
392 located in a state other than Utah, whose students, upon graduation, are recognized as having
393 completed the educational requirements for licensure in that state.
394 [(39)] (41) "Salon" means a place, shop, or establishment in which
395 cosmetology/barbering, esthetics, electrology, or nail technology is practiced.
396 [(40)] (42) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-11a-502 .
397 [(41)] (43) "Unprofessional conduct" is as defined in Sections 58-1-501 and

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- 14 - 398 58-11a-501 and as may be further defined by rule by the division in collaboration with the
399 board in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
400 Section 5. Section 58-11a-502 is amended to read:
401 58-11a-502. Unlawful conduct.
402 Unlawful conduct includes:
403 (1) practicing or engaging in, or attempting to practice or engage in activity for which a
404 license is required under this chapter unless:
405 (a) the person holds the appropriate license under this chapter; or
406 (b) an exemption in Section 58-1-307 or 58-11a-304 applies;
407 (2) knowingly employing any other person to engage in or practice or attempt to
408 engage in or practice any occupation or profession licensed under this chapter if the employee
409 is not licensed to do so under this chapter or exempt from licensure;
410 (3) touching, or applying an instrument or device to the following areas of a client's
411 body:
412 (a) the genitals or the anus, except in cases where the patron states to a licensee that the
413 patron requests a hair removal procedure and signs a written consent form, which must also
414 include the witnessed signature of a legal guardian if the patron is a minor, authorizing the
415 licensee to perform a hair removal procedure; or
416 (b) the breast of a female patron, except in cases in which the female patron states to a
417 licensee that the patron requests breast skin procedures and signs a written consent form, which
418 must also include the witnessed signature of a parent or legal guardian if the patron is a minor,
419 authorizing the licensee to perform breast skin procedures; [and]
420 (4) using or possessing as a nail technician a solution composed of at least 10% methyl
421 methacrylete on a client[.]; or
422 (5) performing an ablative procedure as defined in Section 58-67-102 .
423 Section 6. Section 58-16a-102 is amended to read:
424 58-16a-102. Definitions.
425 In addition to the definitions in Section 58-1-102 , as used in this chapter:
426 (1) "Board" means the Optometrist Licensing Board created in Section 58-16a-201 .
427 (2) "Contact lens" means any lens that:
428 (a) has a spherical, cylindrical, or prismatic power or curvature;

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- 15 - 429 (b) is made pursuant to a current prescription; or
430 (c) is intended to be worn on the surface of the eye.
431 (3) (a) "Contact lens prescription" means a written or verbal order for contact lenses
432 that includes:
433 (i) the commencement date of the prescription;
434 (ii) the base curve, power, diameter, material or brand name, and expiration date;
435 (iii) for a written order, the signature of the prescribing optometrist or physician; and
436 (iv) for a verbal order, a record maintained by the recipient of:
437 (A) the name of the prescribing optometrist or physician; and
438 (B) the date when the prescription was issued or ordered.
439 (b) A prescription may include:
440 (i) a limit on the quantity of lenses that may be ordered under the prescription if
441 required for medical reasons documented in the patient's files; and
442 (ii) the expiration date of the prescription, which shall be two years from the
443 commencement date, unless documented medical reasons require otherwise.
444 (c) When a provider prescribes a private label contact lens for a patient the prescription
445 shall include:
446 (i) the name of the manufacturer;
447 (ii) the trade name of the private label brand; and
448 (iii) if applicable, the trade name of the equivalent national brand.
449 (4) "Contact lens prescription verification" means a written request from a person who
450 sells or provides contact lenses that:
451 (a) is sent to the prescribing optometrist or physician; and
452 (b) seeks the confirmation of the accuracy of a patient's prescription.
453 (5) "Eye and its adnexa" means the human eye and all structures situated within the
454 orbit, including the conjunctiva, lids, lashes, and lacrimal system.
455 (6) "Fitting of a contact lens" means:
456 (a) the using of a keratometer to measure the human eye;
457 (b) utilizing refractive data provided by a licensed optometrist or ophthalmologist; and
458 (c) trial fitting of contact lenses, which includes a period of time for evaluation for fit
459 and performance, to determine a tentative contact lens prescription for a patient if the patient:

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- 16 - 460 (i) has not worn contact lenses before; or
461 (ii) has changed to a different type or base curve.
462 (7) "Laser surgery" means surgery in which human tissue is cut, burned, or vaporized
463 by means of laser or ionizing radiation.
464 (8) "Ophthalmic lens" means any lens used to treat the eye and that:
465 (a) has a spherical, cylindrical, or prismatic power;
466 (b) is made pursuant to an unexpired prescription; and
467 (c) is intended to be used in eyeglasses or spectacles.
468 (9) "Optometric assistant" means an unlicensed individual:
469 (a) working under the direct and immediate supervision of a licensed optometrist; and
470 (b) engaged in specific tasks assigned by the licensed optometrist in accordance with
471 the standards and ethics of the profession.
472 (10) "Optometrist" or "optometric physician" means an individual licensed under this
473 chapter.
474 (11) "Optometry" and "practice of optometry" mean any one or any combination of the
475 following practices:
476 (a) examination of the human eye and its adnexa to detect and diagnose defects or
477 abnormal conditions;
478 (b) determination or modification of the accommodative or refractive state of the
479 human eye or its range or power of vision by administration and prescription of pharmaceutical
480 agents or the use of diagnostic instruments;
481 (c) prescription, ordering, administration, or adaptation of ophthalmic lenses, contact
482 lenses, ophthalmic devices, pharmaceutical agents, laboratory tests, or ocular exercises to
483 diagnose and treat diseases, defects, or other abnormal conditions of the human eye and its
484 adnexa;
485 (d) display of any advertisement, circular, sign, or device offering to:
486 (i) examine the eyes;
487 (ii) fit glasses or contact lenses; or
488 (iii) adjust frames;
489 (e) removal of a foreign body from the eye or its adnexa, that is not deeper than the
490 anterior 1/2 of the cornea;

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- 17 - 491 (f) consultation regarding the eye and its adnexa with other appropriate health care
492 providers, including referral to other appropriate health care providers; and
493 (g) a person, not licensed as an optometrist, directing a licensee under this chapter to
494 withhold or alter the eye care services the licensee has ordered.
495 (12) "Pharmaceutical agent" means any diagnostic or therapeutic drug or combination
496 of drugs that has the property of assisting in the diagnosis, prevention, treatment, or mitigation
497 of abnormal conditions or symptoms of the eye and its adnexa.
498 (13) "Physician" has the same meaning as defined in [Subsection 58-67-102 (7)]
499 Sections 58-67-102 and 58-68-102 .
500 (14) "Prescription drug" has the same definition as in Section 58-17b-102 .
501 (15) "Unexpired" means a prescription that was issued:
502 (a) not more than two years prior to presentation of the prescription for an ophthalmic
503 lens; or
504 (b) in accordance with Subsection (3) for a contact lens.
505 Section 7. Section 58-67-102 is amended to read:
506 58-67-102. Definitions.
507 In addition to the definitions in Section 58-1-102 , as used in this chapter:
508 (1) "Ablative procedure" means a procedure that is expected to excise, burn, vaporize
509 or remove a portion or all of the epidermis, including the use of carbon dioxide lasers and
510 erbium:YAG lasers.
511 [(1)] (2) "ACGME" means the Accreditation Council for Graduate Medical Education
512 of the American Medical Association.
513 [(2)] (3) "Administrative penalty" means a monetary fine or citation imposed by the
514 division for acts or omissions determined to constitute unprofessional or unlawful conduct, in
515 accordance with a fine schedule established by the division in collaboration with the board, as a
516 result of an adjudicative proceeding conducted in accordance with Title 63G, Chapter 4,
517 Administrative Procedures Act.
518 [(3)] (4) "Board" means the Physicians Licensing Board created in Section 58-67-201 .
519 (5) "Cosmetic medical device" means tissue altering energy based devices that have the
520 potential for altering living tissue, such as American National Standards Institute designated
521 Class IIIb and Class IV lasers, intense pulsed light, radio frequency devices, and lipolytic

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- 18 - 522 devices.
523 (6) "Cosmetic medical procedure":
524 (a) includes the use of cosmetic medical devices to perform ablative or nonablative
525 procedures; and
526 (b) does not include a treatment of the ocular globe such as refractive surgery.
527 [(4)] (7) "Diagnose" means:
528 (a) to examine in any manner another person, parts of a person's body, substances,
529 fluids, or materials excreted, taken, or removed from a person's body, or produced by a person's
530 body, to determine the source, nature, kind, or extent of a disease or other physical or mental
531 condition;
532 (b) to attempt to conduct an examination or determination described under Subsection
533 [(4)] (7)(a);
534 (c) to hold oneself out as making or to represent that one is making an examination or
535 determination as described in Subsection [(4)] (7)(a); or
536 (d) to make an examination or determination as described in Subsection [(4)] (7)(a)
537 upon or from information supplied directly or indirectly by another person, whether or not in
538 the presence of the person making or attempting the diagnosis or examination.
539 [(5)] (8) "LCME" means the Liaison Committee on Medical Education of the
540 American Medical Association.
541 [(6)] (9) "Medical assistant" means an unlicensed individual working under the direct
542 and immediate supervision of a licensed physician and surgeon and engaged in specific tasks
543 assigned by the licensed physician and surgeon in accordance with the standards and ethics of
544 the profession.
545 (10) "Nonablative procedure" means a procedure that is expected or intended to alter
546 living tissue, but not excise, burn, vaporize or remove below the epidermal surface of the skin
547 and does not include a superficial procedure as defined in Section 58-1-102 , or the application
548 of permanent make-up.
549 [(7)] (11) "Physician" means both physicians and surgeons licensed under Section
550 58-67-301 , Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under
551 Section 58-68-301 , Utah Osteopathic Medical Practice Act.
552 [(8)] (12) (a) "Practice of medicine" means:

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- 19 - 553 [(a)] (i) to diagnose, treat, correct, administer anesthesia, or prescribe for any human
554 disease, ailment, injury, infirmity, deformity, pain or other condition, physical or mental, real
555 or imaginary, including to perform cosmetic medical procedures, or to attempt to do so, by any
556 means or instrumentality, and by an individual in Utah or outside the state upon or for any
557 human within the state[, except that conduct described in this Subsection (8)(a) that is
558 performed by a person legally and in accordance with a license issued under another chapter of
559 this title does not constitute the practice of medicine];
560 [(b)] (ii) when a person not licensed as a physician directs a licensee under this chapter
561 to withhold or alter the health care services that the licensee has ordered[, but practice of
562 medicine does not include any conduct under Subsection 58-67-501 (2)];
563 [(c)] (iii) to maintain an office or place of business for the purpose of doing any of the
564 acts described in Subsection [(8)] (12)(a) whether or not for compensation; or
565 [(d)] (iv) to use, in the conduct of any occupation or profession pertaining to the
566 diagnosis or treatment of human diseases or conditions in any printed material, stationery,
567 letterhead, envelopes, signs, or advertisements, the designation "doctor," "doctor of medicine,"
568 "physician," "surgeon," "physician and surgeon," "Dr.," "M.D.," or any combination of these
569 designations in any manner which might cause a reasonable person to believe the individual
570 using the designation is a licensed physician and surgeon, and if the party using the designation
571 is not a licensed physician and surgeon, the designation must additionally contain the
572 description of the branch of the healing arts for which the person has a license, provided that an
573 individual who has received an earned degree of doctor of medicine degree but is not a licensed
574 physician and surgeon in Utah may use the designation "M.D." if it is followed by "Not
575 Licensed" or "Not Licensed in Utah" in the same size and style of lettering.
576 (b) The practice of medicine does not include:
577 (i) except for an ablative medical procedure as provided in Subsection (12)(b)(ii), the
578 conduct described in Subsection (12)(a)(i) that is performed in accordance with a license issued
579 under another chapter of this title;
580 (ii) an ablative cosmetic medical procedure if the scope of practice for the person
581 performing the ablative cosmetic medical procedure includes the authority to operate or
582 perform a surgical procedure; or
583 (iii) conduct under Subsection 58-67-501 (2).

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- 20 - 584 [(9)] (13) "Prescription device" means an instrument, apparatus, implement, machine,
585 contrivance, implant, in vitro reagent, or other similar or related article, and any component
586 part or accessory, which is required under federal or state law to be prescribed by a practitioner
587 and dispensed by or through a person or entity licensed under this chapter or exempt from
588 licensure under this chapter.
589 [(10)] (14) "Prescription drug" means a drug that is required by federal or state law or
590 rule to be dispensed only by prescription or is restricted to administration only by practitioners.
591 [(11)] (15) "SPEX" means the Special Purpose Examination of the Federation of State
592 Medical Boards.
593 [(12)] (16) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-67-501 .
594 [(13)] (17) "Unprofessional conduct" is as defined in Sections 58-1-501 and
595 58-67-502 , and as may be further defined by division rule.
596 Section 8. Section 58-67-805 is enacted to read:
597 58-67-805. Supervision of cosmetic medical procedures.
598 A physician may not delegate the performance of an ablative cosmetic medical
599 procedure to an individual who is not licensed under this chapter or Chapter 68, Utah
600 Osteopathic Medical Practice Act.
601 Section 9. Section 58-68-102 is amended to read:
602 58-68-102. Definitions.
603 In addition to the definitions in Section 58-1-102 , as used in this chapter:
604 (1) "Ablative procedure" means a procedure that is expected to excise, burn, vaporize
605 or remove a portion or all of the epidermis, including the use of carbon dioxide lasers and
606 erbium:YAG lasers.
607 [(1)] (2) "ACGME" means the Accreditation Council for Graduate Medical Education
608 of the American Medical Association.
609 [(2)] (3) "Administrative penalty" means a monetary fine imposed by the division for
610 acts or omissions determined to constitute unprofessional or unlawful conduct, as a result of an
611 adjudicative proceeding conducted in accordance with Title 63G, Chapter 4, Administrative
612 Procedures Act.
613 [(3)] (4) "AOA" means the American Osteopathic Association.
614 [(4)] (5) "Board" means the Osteopathic Physician and Surgeon's Licensing Board

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- 21 - 615 created in Section 58-68-201 .
616 (6) "Cosmetic medical device" means tissue altering energy based devices that have the
617 potential for altering living tissue, such as American National Standards Institute designated
618 Class IIIb and Class IV lasers, intense pulsed light, radio frequency devices, and lipolytic
619 devices.
620 (7) "Cosmetic medical procedure":
621 (a) includes the use of cosmetic medical devices to perform ablative or nonablative
622 procedures; and
623 (b) does not include a treatment of the ocular globe such as refractive surgery.
624 [(5)] (8) "Diagnose" means:
625 (a) to examine in any manner another person, parts of a person's body, substances,
626 fluids, or materials excreted, taken, or removed from a person's body, or produced by a person's
627 body, to determine the source, nature, kind, or extent of a disease or other physical or mental
628 condition;
629 (b) to attempt to conduct an examination or determination described under Subsection
630 [(5)] (8)(a);
631 (c) to hold oneself out as making or to represent that one is making an examination or
632 determination as described in Subsection [(5)] (8)(a); or
633 (d) to make an examination or determination as described in Subsection [(5)] (8)(a)
634 upon or from information supplied directly or indirectly by another person, whether or not in
635 the presence of the person making or attempting the diagnosis or examination.
636 [(6)] (9) "Medical assistant" means an unlicensed individual working under the direct
637 and immediate supervision of a licensed osteopathic physician and surgeon and engaged in
638 specific tasks assigned by the licensed osteopathic physician and surgeon in accordance with
639 the standards and ethics of the profession.
640 (10) "Nonablative procedure" means a procedure that is expected or intended to alter
641 living tissue, but not excise, burn, vaporize or remove the epidermal surface of the skin and
642 does not include a superficial procedure as defined in Section 58-1-102 or the application of
643 permanent make-up.
644 [(7)] (11) "Physician" means both physicians and surgeons licensed under Section
645 58-67-301 , Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under

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- 22 - 646 Section 58-68-301 , Utah Osteopathic Medical Practice Act.
647 [(8)] (12) (a) "Practice of osteopathic medicine" means:
648 [(a)] (i) to diagnose, treat, correct, administer anesthesia, or prescribe for any human
649 disease, ailment, injury, infirmity, deformity, pain, or other condition, physical or mental, real
650 or imaginary, or to attempt to do so, by any means or instrumentality, which in whole or in part
651 is based upon emphasis of the importance of the musculoskeletal system and manipulative
652 therapy in the maintenance and restoration of health, by an individual in Utah or outside of the
653 state upon or for any human within the state[, except that conduct described in this Subsection
654 (8)(a) that is performed by a person legally and in accordance with a license issued under
655 another chapter of this title does not constitute the practice of medicine];
656 [(b)] (ii) when a person not licensed as a physician directs a licensee under this chapter
657 to withhold or alter the health care services that the licensee has ordered[, but practice of
658 medicine does not include any conduct under Subsection 58-68-501 (2)];
659 [(c)] (iii) to maintain an office or place of business for the purpose of doing any of the
660 acts described in Subsection [(8)] (12)(a) whether or not for compensation; or
661 [(d)] (iv) to use, in the conduct of any occupation or profession pertaining to the
662 diagnosis or treatment of human diseases or conditions, in any printed material, stationery,
663 letterhead, envelopes, signs, or advertisements, the designation "doctor," "doctor of osteopathic
664 medicine," "osteopathic physician," "osteopathic surgeon," "osteopathic physician and
665 surgeon," "Dr.," "D.O.," or any combination of these designations in any manner which might
666 cause a reasonable person to believe the individual using the designation is a licensed
667 osteopathic physician, and if the party using the designation is not a licensed osteopathic
668 physician, the designation must additionally contain the description of the branch of the healing
669 arts for which the person has a license, provided that an individual who has received an earned
670 degree of doctor of osteopathic medicine but is not a licensed osteopathic physician and
671 surgeon in Utah may use the designation "D.O." if it is followed by "Not Licensed" or "Not
672 Licensed in Utah" in the same size and style of lettering.
673 (b) The practice of osteopathic medicine does not include:
674 (i) except for an ablative medical procedure as provided in Subsection (12)(b)(ii), the
675 conduct described in Subsection (12)(a)(i) that is performed in accordance with a license issued
676 under another chapter of this title;

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- 23 - 677 (ii) an ablative cosmetic medical procedure if the scope of practice for the person
678 performing the ablative cosmetic medical procedure includes the authority to operate or
679 perform a surgical procedure; or
680 (iii) conduct under Subsection 58-68-501 (2).
681 [(9)] (13) "Prescription device" means an instrument, apparatus, implement, machine,
682 contrivance, implant, in vitro reagent, or other similar or related article, and any component
683 part or accessory, which is required under federal or state law to be prescribed by a practitioner
684 and dispensed by or through a person or entity licensed under this chapter or exempt from
685 licensure under this chapter.
686 [(10)] (14) "Prescription drug" means a drug that is required by federal or state law or
687 rule to be dispensed only by prescription or is restricted to administration only by practitioners.
688 [(11)] (15) "SPEX" means the Special Purpose Examination of the Federation of State
689 Medical Boards.
690 [(12)] (16) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-68-501 .
691 [(13)] (17) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-68-502
692 and as may be further defined by division rule.
693 Section 10. Section 58-68-805 is enacted to read:
694 58-68-805. Supervision of cosmetic medical procedures.
695 An osteopathic physician and surgeon may not delegate the performance of an ablative
696 cosmetic medical procedure to an individual who is not licensed under this chapter or Chapter
697 67, Utah Medical Practice Act.