S.B. 40 Enrolled

1

COSMETIC MEDICAL PROCEDURES
2 2012 GENERAL SESSION
3 STATE OF UTAH
4 Chief Sponsor: Peter C. Knudson
5 House Sponsor: Stewart Barlow
6
7 LONG TITLE
8 General Description:
9 This bill amends the Division of Occupational and Professional Licensing 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 . prohibits the use of the term "medical" when advertising a facility that performs
20 cosmetic medical procedures under certain circumstances;
21 . exempts certain licensees from the definition of cosmetic medical procedures;
22 . establishes standards for the supervision of cosmetic medical procedures;
23 . amends the definition of the practice of medicine; and
24 . amends provisions of unprofessional conduct for physicians and other licensees
25 whose scope of practice includes cosmetic medical procedures.
26 Money Appropriated in this Bill:
27 None
28 Other Special Clauses:
29 None

30 Utah Code Sections Affected:
31 AMENDS:
32 58-1-102, as renumbered and amended by Laws of Utah 1993, Chapter 297
33 58-11a-102, as last amended by Laws of Utah 2010, Chapter 145
34 58-11a-502, as last amended by Laws of Utah 2009, Chapter 130
35 58-16a-102, as last amended by Laws of Utah 2004, Chapters 48 and 280
36 58-67-102, as last amended by Laws of Utah 2011, Chapter 214
37 58-68-102, as last amended by Laws of Utah 2011, Chapter 214
38 ENACTS:
39 58-1-505, Utah Code Annotated 1953
40 58-1-506, Utah Code Annotated 1953
41 58-1-507, Utah Code Annotated 1953
42 58-67-805, Utah Code Annotated 1953
43 58-68-805, Utah Code Annotated 1953
44
45 Be it enacted by the Legislature of the state of Utah:
46 Section 1. Section 58-1-102 is amended to read:
47 58-1-102. Definitions.
48 For purposes of this title:
49 (1) "Ablative procedure" is as defined in Section 58-67-102 .
50 (2) "Cosmetic medical procedure":
51 (a) is as defined in Section 58-67-102 ; and
52 (b) except for Chapter 67, Utah Medical Practice Act, and Chapter 68, Utah
53 Osteopathic Medical Practice Act, does not apply to the scope of practice of an individual
54 licensed under this title if the individual's scope of practice includes the authority to operate or
55 perform surgical procedures.
56 [(1)] (3) "Department" means the Department of Commerce.
57 [(2)] (4) "Director" means the director of the Division of Occupational and

58 Professional Licensing.
59 [(3)] (5) "Division" means the Division of Occupational and Professional Licensing
60 created in Section 58-1-103 .
61 [(4)] (6) "Executive director" means the executive director of the Department of
62 Commerce.
63 [(5)] (7) "Licensee" includes any holder of a license, certificate, registration, permit,
64 student card, or apprentice card authorized under this title.
65 (8) (a) (i) "Nonablative procedure" means a procedure that is expected or intended to
66 alter living tissue, but not intended or expected to excise, vaporize, disintegrate, or remove
67 living tissue.
68 (ii) Notwithstanding Subsection (8)(a)(i), nonablative procedure includes hair removal.
69 (b) "Nonablative procedure" does not include:
70 (i) a superficial procedure;
71 (ii) the application of permanent make-up; or
72 (iii) the use of photo therapy and lasers for neuromusculoskeletal treatments that are
73 performed by an individual licensed under this title who is acting within their scope of practice.
74 (9) "Superficial procedure" means a procedure that is expected or intended to
75 temporarily alter living skin tissue and may excise or remove stratum corneum but have no
76 appreciable risk of damage to any tissue below the stratum corneum.
77 [(6)] (10) "Unlawful conduct" has the meaning given in Subsection 58-1-501 (1).
78 [(7)] (11) "Unprofessional conduct" has the meaning given in Subsection 58-1-501 (2).
79 Section 2. Section 58-1-505 is enacted to read:
80 58-1-505. Cosmetic medical procedure supervisor.
81 (1) For purposes of this section and Section 58-1-506 :
82 (a) "Cosmetic medical facility" means a physician's office or a facility that has a
83 supervisor who performs the supervision required in Section 58-1-506 .
84 (b) "Supervisor" means:
85 (i) a physician with an unrestricted license under Chapter 67, Utah Medical Practice

86 Act, or Chapter 68, Utah Osteopathic Medical Practice Act, who is acting within the scope of
87 the practice of medicine, as defined in Section 58-67-102 ; and
88 (ii) an advanced practice registered nurse with an unrestricted license under Chapter
89 31b, Nurse Practice Act, who is acting within the scope of practice of advanced practice
90 registered nursing, as defined in Section 58-31b-102 .
91 (2) (a) An individual authorized by this title to perform a cosmetic medical procedure
92 shall be supervised by a supervisor when performing a medical procedure.
93 (b) Cosmetic medical procedures may only be performed in a cosmetic medical
94 facility.
95 (c) A supervisor may delegate the supervisory role only to another individual who is
96 qualified as a supervisor.
97 Section 3. Section 58-1-506 is enacted to read:
98 58-1-506. Supervision of cosmetic medical procedures.
99 (1) For purposes of this section:
100 (a) "Delegation group A" means the following who are licensed under this title, acting
101 within their respective scope of practice, and qualified under Subsections (2)(f)(i) and (iii):
102 (i) a physician assistant, if acting under the supervision of a physician and the
103 procedure is included in the delegation of services agreement as defined in Section 58-70a-102 ;
104 (ii) a registered nurse;
105 (iii) a master esthetician; and
106 (iv) an electrologist, if evaluating for or performing laser hair removal.
107 (b) "Delegation group B" means:
108 (i) a practical nurse or an esthetician who is licensed under this title, acting within their
109 respective scope of practice, and qualified under Subsections (2)(f)(i) and (iii); and
110 (ii) a medical assistant who is qualified under Subsections (2)(f)(i) and (iii).
111 (c) "Direct cosmetic medical procedure supervision" means the supervisor:
112 (i) has authorized the procedure to be done on the patient by the supervisee; and
113 (ii) is present and available for a face-to-face communication with the supervisee when

114 and where a cosmetic medical procedure is performed.
115 (d) "General cosmetic medical procedure supervision" means the supervisor:
116 (i) has authorized the procedure to be done on the patient by the supervisee;
117 (ii) is available in a timely and appropriate manner in person to evaluate and initiate
118 care for a patient with a suspected adverse reaction or complication; and
119 (iii) is located within 60 minutes or 60 miles of the cosmetic medical facility.
120 (e) "Indirect cosmetic medical procedure supervision" means the supervisor:
121 (i) has authorized the procedure to be done on the patient by the supervisee;
122 (ii) has given written instructions to the person being supervised;
123 (iii) is present within the cosmetic medical facility in which the person being
124 supervised is providing services; and
125 (iv) is available to:
126 (A) provide immediate face-to-face communication with the person being supervised;
127 and
128 (B) evaluate the patient, as necessary.
129 (f) "Hair removal review" means:
130 (i) conducting an in-person, face-to-face interview of a patient based on the responses
131 provided by the patient to a detailed medical history assessment that was prepared by the
132 supervisor;
133 (ii) evaluating for contraindications and conditions that are part of the treatment plan;
134 and
135 (iii) if the patient history or patient presentation deviates in any way from the treatment
136 plan, referring the patient to the supervisor and receiving clearance from the supervisor before
137 starting the treatment.
138 (2) A supervisor supervising a nonablative cosmetic medical procedure for hair
139 removal shall:
140 (a) have an unrestricted license to practice medicine or advanced practice registered
141 nursing in the state;

142 (b) develop the medical treatment plan for the procedure;
143 (c) conduct a hair removal review, or delegate the hair removal review to a member of
144 delegation group A, of the patient prior to initiating treatment or a series of treatments;
145 (d) personally perform the nonablative cosmetic medical procedure for hair removal, or
146 authorize and delegate the procedure to a member of delegation group A or B;
147 (e) during the nonablative cosmetic medical procedure for hair removal provide general
148 cosmetic medical procedure supervision to individuals in delegation group A performing the
149 procedure, except physician assistants, who shall be supervised as provided in Chapter 70a,
150 Physician Assistant Act, and indirect cosmetic medical procedure supervision to individuals in
151 delegation group B performing the procedure; and
152 (f) verify that a person to whom the supervisor delegates an evaluation under
153 Subsection (2)(c) or delegates a procedure under Subsection (2)(d) or (3)(b)(ii):
154 (i) has received appropriate training regarding the medical procedures developed under
155 Subsection (2)(b);
156 (ii) has an unrestricted license under this title or is performing under the license of the
157 supervising physician and surgeon; and
158 (iii) has maintained competence to perform the nonablative cosmetic medical
159 procedure through documented education and experience of at least 80 hours, as further
160 defined by rule, regarding:
161 (A) the appropriate standard of care for performing nonablative cosmetic medical
162 procedures;
163 (B) physiology of the skin;
164 (C) skin typing and analysis;
165 (D) skin conditions, disorders, and diseases;
166 (E) pre and post procedure care;
167 (F) infection control;
168 (G) laser and light physics training;
169 (H) laser technologies and applications;

170 (I) safety and maintenance of lasers;
171 (J) cosmetic medical procedures an individual is permitted to perform under this title;
172 (K) recognition and appropriate management of complications from a procedure; and
173 (L) cardio-pulmonary resuscitation (CPR).
174 (3) For a nonablative cosmetic medical procedure other than hair removal under
175 Subsection (2):
176 (a) (i) except as provided in Subsection (3)(a)(ii) and (iii), a physician who has an
177 unrestricted license to practice medicine shall:
178 (A) develop a treatment plan for the nonablative cosmetic medical procedure; and
179 (B) conduct an in-person face-to-face evaluation of the patient prior to the initiation of
180 a treatment protocol or series of treatments;
181 (ii) a nurse practitioner who has an unrestricted license for advanced practice registered
182 nursing may perform the evaluation and develop the treatment plan under Subsection (3)(a)(i)
183 for nonablative medical procedures other than tattoo removal; or
184 (iii) a physician assistant acting under the supervision of a physician, with the
185 procedure included in the delegation of service agreement as defined in Section 58-70a-102 ,
186 may perform the evaluation under Subsection (3)(a)(i)(B) for nonablative medical procedures
187 other than tattoo removal; and
188 (b) the supervisor supervising the procedure shall:
189 (i) have an unrestricted license to practice medicine or advanced practice registered
190 nursing;
191 (ii) personally perform the nonablative cosmetic medical procedure or:
192 (A) authorize and provide general cosmetic medical procedure supervision for the
193 nonablative cosmetic medical procedure that is performed by a registered nurse or a master
194 esthetician;
195 (B) authorize and provide supervision as provided in Chapter 70a, Physician Assistant
196 Act, for the nonablative cosmetic medical procedure that is performed by a physician assistant,
197 if the procedure is included in the delegation of services agreement; or

198 (C) authorize and provide direct cosmetic medical procedure supervision for the
199 nonablative cosmetic medical procedure that is performed by an esthetician; and
200 (iii) verify that a person to whom the supervisor delegates a procedure under
201 Subsection (3)(b):
202 (A) has received appropriate training regarding the medical procedures to be
203 performed;
204 (B) has an unrestricted license and is acting within their scope of practice under this
205 title; and
206 (C) is qualified under Subsection (2)(f)(iii).
207 (4) A supervisor performing or supervising a cosmetic medical procedure under
208 Subsection (2) or (3) shall ensure that:
209 (a) the supervisor's name is prominently posted at the cosmetic medical facility
210 identifying the supervisor;
211 (b) a copy of the supervisor's license is displayed on the wall of the cosmetic medical
212 facility;
213 (c) the patient receives written information with the name and licensing information of
214 the supervisor who is supervising the nonablative cosmetic medical procedure and the person
215 who is performing the nonablative cosmetic medical procedure;
216 (d) the patient is provided with a telephone number that is answered within 24 hours
217 for follow-up communication; and
218 (e) the cosmetic medical facility's contract with a master esthetician who performs a
219 nonablative cosmetic medical procedure at the facility is kept on the premises of the facility.
220 (5) Failure to comply with the provisions of this section is unprofessional conduct.
221 (6) A chiropractic physician licensed under Chapter 73, Chiropractic Physician Practice
222 Act is not subject to the supervision requirements in this section for a nonablative cosmetic
223 medical procedure for hair removal if the chiropractic physician is acting within the scope of
224 practice of a chiropractic physician and with training specific to nonablative hair removal.
225 Section 4. Section 58-1-507 is enacted to read:

226 58-1-507. Cosmetic medical procedure -- Truth in advertising.
227 Beginning July 1, 2013, a facility that performs a cosmetic medical procedure as
228 defined in Section 58-67-102 may not advertise or hold itself out to the public as a "medical
229 spa", "medical facility", or "medical clinic" unless the facility has an individual on the premises
230 while a cosmetic medical procedure is performed who is licensed under:
231 (1) Chapter 31b, Nurse Practices Act, as an advanced practice registered nurse,
232 practicing as a nurse practitioner;
233 (2) Chapter 67, Utah Medical Practice Act; or
234 (3) Chapter 68, Utah Osteopathic Medical Practice Act.
235 Section 5. Section 58-11a-102 is amended to read:
236 58-11a-102. Definitions.
237 As used in this chapter:
238 (1) "Approved barber or cosmetologist/barber apprenticeship" means an apprenticeship
239 that meets the requirements of Subsection 58-11a-306 (1) for barbers or Subsection
240 58-11a-306 (2) for cosmetologist/barbers and the requirements established by rule by the
241 division in collaboration with the board in accordance with Title 63G, Chapter 3, Utah
242 Administrative Rulemaking Act.
243 (2) "Approved esthetician apprenticeship" means an apprenticeship that meets the
244 requirements of Subsection 58-11a-306 (3) and the requirements established by rule by the
245 division in collaboration with the board in accordance with Title 63G, Chapter 3, Utah
246 Administrative Rulemaking Act.
247 (3) "Approved master esthetician apprenticeship" means an apprenticeship that meets
248 the requirements of Subsection 58-11a-306 (4) and the requirements established by rule by the
249 division in collaboration with the board in accordance with Title 63G, Chapter 3, Utah
250 Administrative Rulemaking Act.
251 (4) "Approved nail technician apprenticeship" means an apprenticeship that meets the
252 requirements of Subsection 58-11a-306 (5) and the requirements established by rule by the
253 division in collaboration with the board in accordance with Title 63G, Chapter 3, Utah

254 Administrative Rulemaking Act.
255 (5) "Barber" means a person who is licensed under this chapter to engage in the
256 practice of barbering.
257 (6) "Barber instructor" means a barber who is licensed under this chapter to teach
258 barbering at a licensed barber school or in an apprenticeship program as defined in Section
259 58-11a-306 .
260 (7) "Board" means the Barber, Cosmetology/Barbering, Esthetics, Electrology, and
261 Nail Technology Licensing Board created in Section 58-11a-201 .
262 (8) "Cosmetic laser procedure" includes a nonablative procedure as defined in Section
263 58-67-102 .
264 (9) "Cosmetic supervisor" means a supervisor as defined in Section 58-1-505 .
265 [(8)] (10) "Cosmetologist/barber" means a person who is licensed under this chapter to
266 engage in the practice of cosmetology/barbering.
267 [(9)] (11) "Cosmetologist/barber instructor" means a cosmetologist/barber who is
268 licensed under this chapter to teach cosmetology/barbering at a licensed cosmetology/barber
269 school, licensed barber school, licensed nail technology school, or in an apprenticeship
270 program as defined in Subsection 58-11a-306 (2).
271 [(10)] (12) "Direct supervision" means that the supervisor of an apprentice or the
272 instructor of a student is immediately available for consultation, advice, instruction, and
273 evaluation.
274 [(11)] (13) "Electrologist" means a person who is licensed under this chapter to engage
275 in the practice of electrology.
276 [(12)] (14) "Electrologist instructor" means an electrologist who is licensed under this
277 chapter to teach electrology at a licensed electrology school.
278 [(13)] (15) "Esthetician" means a person who is licensed under this chapter to engage
279 in the practice of esthetics.
280 [(14)] (16) "Esthetician instructor" means a master esthetician who is licensed under
281 this chapter to teach the practice of esthetics and the practice of master-level esthetics at a

282 licensed esthetics school, a licensed cosmetology/barber school, or in an apprenticeship
283 program as defined in Subsection 58-11a-306 (3).
284 [(15)] (17) "Fund" means the Barber, Cosmetologist/Barber, Esthetician, Electrologist,
285 and Nail Technician Education and Enforcement Fund created in Section 58-11a-103 .
286 [(16)] (18) "Licensed barber or cosmetology/barber school" means a barber or
287 cosmetology/barber school licensed under this chapter.
288 [(17)] (19) "Licensed electrology school" means an electrology school licensed under
289 this chapter.
290 [(18)] (20) "Licensed esthetics school" means an esthetics school licensed under this
291 chapter.
292 [(19)] (21) "Licensed nail technology school" means a nail technology school licensed
293 under this chapter.
294 [(20)] (22) "Master esthetician" means an individual who is licensed under this chapter
295 to engage in the practice of master-level esthetics.
296 [(21)] (23) "Nail technician" means an individual who is licensed under this chapter to
297 engage in the practice of nail technology.
298 [(22)] (24) "Nail technician instructor" means a nail technician licensed under this
299 chapter to teach the practice of nail technology in a licensed nail technology school, a licensed
300 cosmetology/barber school, or in an apprenticeship program as defined in Subsection
301 58-11a-306 (5).
302 [(23)] (25) "Practice of barbering" means:
303 (a) cutting, clipping, or trimming the hair of the head of any person by the use of
304 scissors, shears, clippers, or other appliances;
305 (b) draping, shampooing, scalp treatments, basic wet styling, and blow drying; and
306 (c) removing hair from the face or neck of a person by the use of shaving equipment.
307 [(24)] (26) "Practice of barbering instruction" means instructing barbering in a licensed
308 barber school, licensed cosmetology/barber school, or in an apprenticeship program as defined
309 in Subsection 58-11a-306 (1).

310 [(25)] (27) "Practice of basic esthetics" means any one of the following skin care
311 procedures done on the head, face, neck, arms, hands, legs, feet, eyebrows, or eyelashes for
312 cosmetic purposes and not for the treatment of medical, physical, or mental ailments:
313 (a) cleansing, stimulating, manipulating, exercising, applying oils, antiseptics, clays, or
314 masks, manual extraction, including a comodone extractor, depilatories, waxes, tweezing, the
315 application of eyelash extensions, natural nail manicures or pedicures, or callous removal by
316 buffing or filing;
317 (b) limited chemical exfoliation as defined by rule;
318 (c) removing superfluous hair by means other than electrolysis, except that an
319 individual is not required to be licensed as an esthetician to engage in the practice of threading;
320 (d) other esthetic preparations or procedures with the use of the hands, a
321 high-frequency or galvanic electrical apparatus, or a heat lamp for cosmetic purposes and not
322 for the treatment of medical, physical, or mental ailments; or
323 (e) except as provided in Subsection (27)(e)(i), cosmetic laser procedures under
324 [direct] the direct cosmetic medical procedure supervision of a [licensed health care
325 practitioner as defined by rule,] cosmetic supervisor limited to the following:
326 (i) superfluous hair removal which shall be under indirect supervision;
327 (ii) anti-aging resurfacing enhancements;
328 (iii) photo rejuvenation; or
329 (iv) tattoo removal.
330 [(26)] (28) (a) "Practice of cosmetology/barbering" means:
331 (i) styling, arranging, dressing, curling, waving, permanent waving, cleansing,
332 singeing, bleaching, dyeing, tinting, coloring, or similarly treating the hair of the head of a
333 person;
334 (ii) cutting, clipping, or trimming the hair by the use of scissors, shears, clippers, or
335 other appliances;
336 (iii) arching eyebrows, or tinting eyebrows or eyelashes, applying eyelash extensions,
337 or any combination of these procedures;

338 (iv) removing hair from the face, neck, shoulders, arms, back, torso, feet, bikini line, or
339 legs of a person by the use of depilatories, waxing, or shaving equipment;
340 (v) cutting, curling, styling, fitting, measuring, or forming caps for wigs or hairpieces
341 or both on the human head; or
342 (vi) practicing hair weaving or hair fusing or servicing previously medically implanted
343 hair.
344 (b) The term "practice of cosmetology/barbering" includes:
345 (i) the practice of basic esthetics; and
346 (ii) the practice of nail technology.
347 (c) An individual is not required to be licensed as a cosmetologist/barber to engage in
348 the practice of threading.
349 [(27)] (29) "Practice of cosmetology/barbering instruction" means instructing
350 cosmetology/barbering as defined in Subsection [(26)] (28) in a licensed cosmetology/barber
351 school or in an apprenticeship program as defined in Subsection 58-11a-306 (2).
352 [(28)] (30) "Practice of electrology" means:
353 (a) the removal of superfluous hair from the body of a person by the use of electricity,
354 waxing, shaving, or tweezing; or
355 (b) cosmetic laser procedures under the [general] supervision of a [licensed health care
356 practitioner as defined by rule,] cosmetic supervisor limited to superfluous hair removal.
357 [(29)] (31) "Practice of electrology instruction" means instructing electrology in a
358 licensed electrology school.
359 [(30)] (32) "Practice of esthetics instruction" means instructing esthetics in a licensed
360 esthetics school, a licensed cosmetology/barber school, or instructing master-level esthetics in a
361 licensed esthetics school or in an apprenticeship program as defined in Subsections
362 58-11a-306 (2), (3), and (4).
363 [(31)] (33) (a) "Practice of master-level esthetics" means:
364 (i) any of the following when done for cosmetic purposes on the head, face, neck,
365 torso, abdomen, back, arms, hands, legs, feet, eyebrows, or eyelashes and not for the treatment

366 of medical, physical, or mental ailments:
367 (A) body wraps as defined by rule;
368 (B) hydrotherapy as defined by rule;
369 (C) chemical exfoliation as defined by rule;
370 (D) advanced pedicures as defined by rule;
371 (E) sanding, including microdermabrasion;
372 (F) advanced extraction;
373 (G) other esthetic preparations or procedures with the use of:
374 (I) the hands; or
375 (II) a mechanical or electrical apparatus which is approved for use by division rule for
376 beautifying or similar work performed on the body for cosmetic purposes and not for the
377 treatment of a medical, physical, or mental ailment; or
378 (H) cosmetic laser procedures under the [general] supervision of a [licensed health care
379 practitioner as defined by rule,] cosmetic supervisor with a physician's evaluation before the
380 procedure, as needed, unless specifically required under Section 58-1-506 , and limited to the
381 following:
382 (I) superfluous hair removal;
383 (II) anti-aging resurfacing enhancements;
384 (III) photo rejuvenation; or
385 (IV) tattoo removal with a physician's evaluation before the tattoo removal procedure;
386 and
387 (ii) lymphatic massage by manual or other means as defined by rule.
388 (b) Notwithstanding the provisions of Subsection [(31)] (33)(a), a master-level
389 esthetician may perform procedures listed in Subsection [(31)] (33)(a)(i)(H) [for noncosmetic
390 purposes] if done under the supervision of a [licensed health care practitioner] cosmetic
391 supervisor acting within the scope of the [licensed health care practitioner's] cosmetic
392 supervisor license [as defined by rule].
393 (c) The term "practice of master-level esthetics" includes the practice of esthetics, but

394 an individual is not required to be licensed as an esthetician or master-level esthetician to
395 engage in the practice of threading.
396 [(32)] (34) "Practice of nail technology" means to trim, cut, clean, manicure, shape,
397 massage, or enhance the appearance of the hands, feet, and nails of an individual by the use of
398 hands, mechanical, or electrical preparation, antiseptic, lotions, or creams, including the
399 application and removal of sculptured or artificial nails.
400 [(33)] (35) "Practice of nail technology instruction" means instructing nail technology
401 in a licensed nail technician school, licensed cosmetology/barber school, or in an
402 apprenticeship program as defined in Subsection 58-11a-306 (5).
403 [(34)] (36) "Recognized barber school" means a barber school located in a state other
404 than Utah, whose students, upon graduation, are recognized as having completed the
405 educational requirements for licensure in that state.
406 [(35)] (37) "Recognized cosmetology/barber school" means a cosmetology/barber
407 school located in a state other than Utah, whose students, upon graduation, are recognized as
408 having completed the educational requirements for licensure in that state.
409 [(36)] (38) "Recognized electrology school" means an electrology school located in a
410 state other than Utah, whose students, upon graduation, are recognized as having completed the
411 educational requirements for licensure in that state.
412 [(37)] (39) "Recognized esthetics school" means an esthetics school located in a state
413 other than Utah, whose students, upon graduation, are recognized as having completed the
414 educational requirements for licensure in that state.
415 [(38)] (40) "Recognized nail technology school" means a nail technology school
416 located in a state other than Utah, whose students, upon graduation, are recognized as having
417 completed the educational requirements for licensure in that state.
418 [(39)] (41) "Salon" means a place, shop, or establishment in which
419 cosmetology/barbering, esthetics, electrology, or nail technology is practiced.
420 [(40)] (42) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-11a-502 .
421 [(41)] (43) "Unprofessional conduct" is as defined in Sections 58-1-501 and

422 58-11a-501 and as may be further defined by rule by the division in collaboration with the
423 board in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
424 Section 6. Section 58-11a-502 is amended to read:
425 58-11a-502. Unlawful conduct.
426 Unlawful conduct includes:
427 (1) practicing or engaging in, or attempting to practice or engage in activity for which a
428 license is required under this chapter unless:
429 (a) the person holds the appropriate license under this chapter; or
430 (b) an exemption in Section 58-1-307 or 58-11a-304 applies;
431 (2) knowingly employing any other person to engage in or practice or attempt to
432 engage in or practice any occupation or profession licensed under this chapter if the employee
433 is not licensed to do so under this chapter or exempt from licensure;
434 (3) touching, or applying an instrument or device to the following areas of a client's
435 body:
436 (a) the genitals or the anus, except in cases where the patron states to a licensee that the
437 patron requests a hair removal procedure and signs a written consent form, which must also
438 include the witnessed signature of a legal guardian if the patron is a minor, authorizing the
439 licensee to perform a hair removal procedure; or
440 (b) the breast of a female patron, except in cases in which the female patron states to a
441 licensee that the patron requests breast skin procedures and signs a written consent form, which
442 must also include the witnessed signature of a parent or legal guardian if the patron is a minor,
443 authorizing the licensee to perform breast skin procedures; [and]
444 (4) using or possessing as a nail technician a solution composed of at least 10% methyl
445 methacrylete on a client[.]; or
446 (5) performing an ablative procedure as defined in Section 58-67-102 .
447 Section 7. Section 58-16a-102 is amended to read:
448 58-16a-102. Definitions.
449 In addition to the definitions in Section 58-1-102 , as used in this chapter:

450 (1) "Board" means the Optometrist Licensing Board created in Section 58-16a-201 .
451 (2) "Contact lens" means any lens that:
452 (a) has a spherical, cylindrical, or prismatic power or curvature;
453 (b) is made pursuant to a current prescription; or
454 (c) is intended to be worn on the surface of the eye.
455 (3) (a) "Contact lens prescription" means a written or verbal order for contact lenses
456 that includes:
457 (i) the commencement date of the prescription;
458 (ii) the base curve, power, diameter, material or brand name, and expiration date;
459 (iii) for a written order, the signature of the prescribing optometrist or physician; and
460 (iv) for a verbal order, a record maintained by the recipient of:
461 (A) the name of the prescribing optometrist or physician; and
462 (B) the date when the prescription was issued or ordered.
463 (b) A prescription may include:
464 (i) a limit on the quantity of lenses that may be ordered under the prescription if
465 required for medical reasons documented in the patient's files; and
466 (ii) the expiration date of the prescription, which shall be two years from the
467 commencement date, unless documented medical reasons require otherwise.
468 (c) When a provider prescribes a private label contact lens for a patient the prescription
469 shall include:
470 (i) the name of the manufacturer;
471 (ii) the trade name of the private label brand; and
472 (iii) if applicable, the trade name of the equivalent national brand.
473 (4) "Contact lens prescription verification" means a written request from a person who
474 sells or provides contact lenses that:
475 (a) is sent to the prescribing optometrist or physician; and
476 (b) seeks the confirmation of the accuracy of a patient's prescription.
477 (5) "Eye and its adnexa" means the human eye and all structures situated within the

478 orbit, including the conjunctiva, lids, lashes, and lacrimal system.
479 (6) "Fitting of a contact lens" means:
480 (a) the using of a keratometer to measure the human eye;
481 (b) utilizing refractive data provided by a licensed optometrist or ophthalmologist; and
482 (c) trial fitting of contact lenses, which includes a period of time for evaluation for fit
483 and performance, to determine a tentative contact lens prescription for a patient if the patient:
484 (i) has not worn contact lenses before; or
485 (ii) has changed to a different type or base curve.
486 (7) "Laser surgery" means surgery in which human tissue is cut, burned, or vaporized
487 by means of laser or ionizing radiation.
488 (8) "Ophthalmic lens" means any lens used to treat the eye and that:
489 (a) has a spherical, cylindrical, or prismatic power;
490 (b) is made pursuant to an unexpired prescription; and
491 (c) is intended to be used in eyeglasses or spectacles.
492 (9) "Optometric assistant" means an unlicensed individual:
493 (a) working under the direct and immediate supervision of a licensed optometrist; and
494 (b) engaged in specific tasks assigned by the licensed optometrist in accordance with
495 the standards and ethics of the profession.
496 (10) "Optometrist" or "optometric physician" means an individual licensed under this
497 chapter.
498 (11) "Optometry" and "practice of optometry" mean any one or any combination of the
499 following practices:
500 (a) examination of the human eye and its adnexa to detect and diagnose defects or
501 abnormal conditions;
502 (b) determination or modification of the accommodative or refractive state of the
503 human eye or its range or power of vision by administration and prescription of pharmaceutical
504 agents or the use of diagnostic instruments;
505 (c) prescription, ordering, administration, or adaptation of ophthalmic lenses, contact

506 lenses, ophthalmic devices, pharmaceutical agents, laboratory tests, or ocular exercises to
507 diagnose and treat diseases, defects, or other abnormal conditions of the human eye and its
508 adnexa;
509 (d) display of any advertisement, circular, sign, or device offering to:
510 (i) examine the eyes;
511 (ii) fit glasses or contact lenses; or
512 (iii) adjust frames;
513 (e) removal of a foreign body from the eye or its adnexa, that is not deeper than the
514 anterior 1/2 of the cornea;
515 (f) consultation regarding the eye and its adnexa with other appropriate health care
516 providers, including referral to other appropriate health care providers; and
517 (g) a person, not licensed as an optometrist, directing a licensee under this chapter to
518 withhold or alter the eye care services the licensee has ordered.
519 (12) "Pharmaceutical agent" means any diagnostic or therapeutic drug or combination
520 of drugs that has the property of assisting in the diagnosis, prevention, treatment, or mitigation
521 of abnormal conditions or symptoms of the eye and its adnexa.
522 (13) "Physician" has the same meaning as defined in [Subsection 58-67-102 (7)]
523 Sections 58-67-102 and 58-68-102 .
524 (14) "Prescription drug" has the same definition as in Section 58-17b-102 .
525 (15) "Unexpired" means a prescription that was issued:
526 (a) not more than two years prior to presentation of the prescription for an ophthalmic
527 lens; or
528 (b) in accordance with Subsection (3) for a contact lens.
529 Section 8. Section 58-67-102 is amended to read:
530 58-67-102. Definitions.
531 In addition to the definitions in Section 58-1-102 , as used in this chapter:
532 (1) "Ablative procedure" means a procedure that is expected to excise, vaporize,
533 disintegrate, or remove living tissue, including the use of carbon dioxide lasers and

534 erbium:YAG lasers, and excluding hair removal.
535 [(1)] (2) "ACGME" means the Accreditation Council for Graduate Medical Education
536 of the American Medical Association.
537 [(2)] (3) "Administrative penalty" means a monetary fine or citation imposed by the
538 division for acts or omissions determined to constitute unprofessional or unlawful conduct, in
539 accordance with a fine schedule established by the division in collaboration with the board, as a
540 result of an adjudicative proceeding conducted in accordance with Title 63G, Chapter 4,
541 Administrative Procedures Act.
542 [(3)] (4) "Board" means the Physicians Licensing Board created in Section 58-67-201 .
543 (5) (a) "Cosmetic medical device" means tissue altering energy based devices that have
544 the potential for altering living tissue and that are used to perform ablative or nonablative
545 procedures, such as American National Standards Institute (ANSI) designated Class IIIb and
546 Class IV lasers, intense pulsed light, radio frequency devices, and lipolytic devices, and
547 excludes ANSI designated Class IIIa and lower powered devices.
548 (b) Notwithstanding Subsection (5)(a), if an ANSI designated Class IIIa and lower
549 powered device is being used to perform an ablative procedure, the device is included in the
550 definition of cosmetic medical device under Subsection (5)(a).
551 (6) "Cosmetic medical procedure":
552 (a) includes the use of cosmetic medical devices to perform ablative or nonablative
553 procedures; and
554 (b) does not include a treatment of the ocular globe such as refractive surgery.
555 [(4)] (7) "Diagnose" means:
556 (a) to examine in any manner another person, parts of a person's body, substances,
557 fluids, or materials excreted, taken, or removed from a person's body, or produced by a person's
558 body, to determine the source, nature, kind, or extent of a disease or other physical or mental
559 condition;
560 (b) to attempt to conduct an examination or determination described under Subsection
561 [(4)] (7)(a);

562 (c) to hold oneself out as making or to represent that one is making an examination or
563 determination as described in Subsection [(4)] (7)(a); or
564 (d) to make an examination or determination as described in Subsection [(4)] (7)(a)
565 upon or from information supplied directly or indirectly by another person, whether or not in
566 the presence of the person making or attempting the diagnosis or examination.
567 [(5)] (8) "LCME" means the Liaison Committee on Medical Education of the
568 American Medical Association.
569 [(6)] (9) "Medical assistant" means an unlicensed individual working under the direct
570 and immediate supervision of a licensed physician and surgeon and engaged in specific tasks
571 assigned by the licensed physician and surgeon in accordance with the standards and ethics of
572 the profession.
573 (10) (a) (i) "Nonablative procedure" means a procedure that is expected or intended to
574 alter living tissue, but is not intended or expected to excise, vaporize, disintegrate, or remove
575 living tissue.
576 (ii) Notwithstanding Subsection (10)(a)(i), nonablative procedure includes hair
577 removal.
578 (b) "Nonablative procedure" does not include:
579 (i) a superficial procedure as defined in Section 58-1-102 ;
580 (ii) the application of permanent make-up; or
581 (iii) the use of photo therapy and lasers for neuromusculoskeletal treatments that are
582 performed by an individual licensed under this title who is acting within their scope of practice.
583 [(7)] (11) "Physician" means both physicians and surgeons licensed under Section
584 58-67-301 , Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under
585 Section 58-68-301 , Utah Osteopathic Medical Practice Act.
586 [(8)] (12) (a) "Practice of medicine" means:
587 [(a)] (i) to diagnose, treat, correct, administer anesthesia, or prescribe for any human
588 disease, ailment, injury, infirmity, deformity, pain or other condition, physical or mental, real
589 or imaginary, including to perform cosmetic medical procedures, or to attempt to do so, by any

590 means or instrumentality, and by an individual in Utah or outside the state upon or for any
591 human within the state[, except that conduct described in this Subsection (8)(a) that is
592 performed by a person legally and in accordance with a license issued under another chapter of
593 this title does not constitute the practice of medicine];
594 [(b)] (ii) when a person not licensed as a physician directs a licensee under this chapter
595 to withhold or alter the health care services that the licensee has ordered[, but practice of
596 medicine does not include any conduct under Subsection 58-67-501 (2)];
597 [(c)] (iii) to maintain an office or place of business for the purpose of doing any of the
598 acts described in Subsection [(8)] (12)(a) whether or not for compensation; or
599 [(d)] (iv) to use, in the conduct of any occupation or profession pertaining to the
600 diagnosis or treatment of human diseases or conditions in any printed material, stationery,
601 letterhead, envelopes, signs, or advertisements, the designation "doctor," "doctor of medicine,"
602 "physician," "surgeon," "physician and surgeon," "Dr.," "M.D.," or any combination of these
603 designations in any manner which might cause a reasonable person to believe the individual
604 using the designation is a licensed physician and surgeon, and if the party using the designation
605 is not a licensed physician and surgeon, the designation must additionally contain the
606 description of the branch of the healing arts for which the person has a license, provided that an
607 individual who has received an earned degree of doctor of medicine degree but is not a licensed
608 physician and surgeon in Utah may use the designation "M.D." if it is followed by "Not
609 Licensed" or "Not Licensed in Utah" in the same size and style of lettering.
610 (b) The practice of medicine does not include:
611 (i) except for an ablative medical procedure as provided in Subsection (12)(b)(ii), the
612 conduct described in Subsection (12)(a)(i) that is performed in accordance with a license issued
613 under another chapter of this title;
614 (ii) an ablative cosmetic medical procedure if the scope of practice for the person
615 performing the ablative cosmetic medical procedure includes the authority to operate or
616 perform a surgical procedure; or
617 (iii) conduct under Subsection 58-67-501 (2).

618 [(9)] (13) "Prescription device" means an instrument, apparatus, implement, machine,
619 contrivance, implant, in vitro reagent, or other similar or related article, and any component
620 part or accessory, which is required under federal or state law to be prescribed by a practitioner
621 and dispensed by or through a person or entity licensed under this chapter or exempt from
622 licensure under this chapter.
623 [(10)] (14) "Prescription drug" means a drug that is required by federal or state law or
624 rule to be dispensed only by prescription or is restricted to administration only by practitioners.
625 [(11)] (15) "SPEX" means the Special Purpose Examination of the Federation of State
626 Medical Boards.
627 [(12)] (16) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-67-501 .
628 [(13)] (17) "Unprofessional conduct" is as defined in Sections 58-1-501 and
629 58-67-502 , and as may be further defined by division rule.
630 Section 9. Section 58-67-805 is enacted to read:
631 58-67-805. Supervision of cosmetic medical procedures.
632 (1) Except as provided in Subsection (2), a physician may not delegate the performance
633 of an ablative cosmetic medical procedure to an individual who is not licensed under this
634 chapter or Chapter 68, Utah Osteopathic Medical Practice Act.
635 (2) A physician may delegate to an advanced practice registered nurse with an
636 unrestricted license under Chapter 31b, Nurse Practice Act, the performance of an erbium full
637 ablation resurfacing procedure or a CO2 fractionated resurfacing procedure, if the physician:
638 (a) prescribes that specific procedure for the patient who is to receive the procedure;
639 (b) ensures that the advanced practice registered nurse performs the procedure under
640 the indirect supervision of the physician; and
641 (c) verifies that the advanced practice registered nurse is qualified to perform the
642 procedure by having received at least 50 hours of training specific to the procedure to be
643 performed and the laser to be used.
644 Section 10. Section 58-68-102 is amended to read:
645 58-68-102. Definitions.

646 In addition to the definitions in Section 58-1-102 , as used in this chapter:
647 (1) "Ablative procedure" means a procedure that is expected to excise, vaporize,
648 disintegrate, or remove living tissue, including the use of carbon dioxide lasers and
649 erbium:YAG lasers, and excluding hair removal.
650 [(1)] (2) "ACGME" means the Accreditation Council for Graduate Medical Education
651 of the American Medical Association.
652 [(2)] (3) "Administrative penalty" means a monetary fine imposed by the division for
653 acts or omissions determined to constitute unprofessional or unlawful conduct, as a result of an
654 adjudicative proceeding conducted in accordance with Title 63G, Chapter 4, Administrative
655 Procedures Act.
656 [(3)] (4) "AOA" means the American Osteopathic Association.
657 [(4)] (5) "Board" means the Osteopathic Physician and Surgeon's Licensing Board
658 created in Section 58-68-201 .
659 (6) (a) "Cosmetic medical device" means tissue altering energy based devices that have
660 the potential for altering living tissue and that are used to perform ablative or nonablative
661 procedures, such as American National Standards Institute (ANSI) designated Class IIIb and
662 Class IV lasers, intense pulsed light, radio frequency devices, and lipolytic devices and
663 excludes ANSI designated Class IIIa and lower powered devices.
664 (b) Notwithstanding Subsection (6)(a), if an ANSI designated Class IIIa and lower
665 powered device is being used to perform an ablative procedure, the device is included in the
666 definition of cosmetic medical device under Subsection (6)(a).
667 (7) "Cosmetic medical procedure":
668 (a) includes the use of cosmetic medical devices to perform ablative or nonablative
669 procedures; and
670 (b) does not include a treatment of the ocular globe such as refractive surgery.
671 [(5)] (8) "Diagnose" means:
672 (a) to examine in any manner another person, parts of a person's body, substances,
673 fluids, or materials excreted, taken, or removed from a person's body, or produced by a person's

674 body, to determine the source, nature, kind, or extent of a disease or other physical or mental
675 condition;
676 (b) to attempt to conduct an examination or determination described under Subsection
677 [(5)] (8)(a);
678 (c) to hold oneself out as making or to represent that one is making an examination or
679 determination as described in Subsection [(5)] (8)(a); or
680 (d) to make an examination or determination as described in Subsection [(5)] (8)(a)
681 upon or from information supplied directly or indirectly by another person, whether or not in
682 the presence of the person making or attempting the diagnosis or examination.
683 [(6)] (9) "Medical assistant" means an unlicensed individual working under the direct
684 and immediate supervision of a licensed osteopathic physician and surgeon and engaged in
685 specific tasks assigned by the licensed osteopathic physician and surgeon in accordance with
686 the standards and ethics of the profession.
687 (10) (a) (i) "Nonablative procedure" means a procedure that is expected or intended to
688 alter living tissue, but is not expected or intended to excise, vaporize, disintegrate, or remove
689 living tissue.
690 (ii) Notwithstanding Subsection (10)(a)(i), nonablative procedure includes hair
691 removal.
692 (b) "Nonablative procedure" does not include:
693 (i) a superficial procedure as defined in Section 58-1-102 ;
694 (ii) the application of permanent make-up; or
695 (iii) the use of photo therapy lasers for neuromusculoskeletal treatments that are
696 preformed by an individual licensed under this title who is acting within their scope of practice.
697 [(7)] (11) "Physician" means both physicians and surgeons licensed under Section
698 58-67-301 , Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under
699 Section 58-68-301 , Utah Osteopathic Medical Practice Act.
700 [(8)] (12) (a) "Practice of osteopathic medicine" means:
701 [(a)] (i) to diagnose, treat, correct, administer anesthesia, or prescribe for any human

702 disease, ailment, injury, infirmity, deformity, pain, or other condition, physical or mental, real
703 or imaginary, or to attempt to do so, by any means or instrumentality, which in whole or in part
704 is based upon emphasis of the importance of the musculoskeletal system and manipulative
705 therapy in the maintenance and restoration of health, by an individual in Utah or outside of the
706 state upon or for any human within the state[, except that conduct described in this Subsection
707 (8)(a) that is performed by a person legally and in accordance with a license issued under
708 another chapter of this title does not constitute the practice of medicine];
709 [(b)] (ii) when a person not licensed as a physician directs a licensee under this chapter
710 to withhold or alter the health care services that the licensee has ordered[, but practice of
711 medicine does not include any conduct under Subsection 58-68-501 (2)];
712 [(c)] (iii) to maintain an office or place of business for the purpose of doing any of the
713 acts described in Subsection [(8)] (12)(a) whether or not for compensation; or
714 [(d)] (iv) to use, in the conduct of any occupation or profession pertaining to the
715 diagnosis or treatment of human diseases or conditions, in any printed material, stationery,
716 letterhead, envelopes, signs, or advertisements, the designation "doctor," "doctor of osteopathic
717 medicine," "osteopathic physician," "osteopathic surgeon," "osteopathic physician and
718 surgeon," "Dr.," "D.O.," or any combination of these designations in any manner which might
719 cause a reasonable person to believe the individual using the designation is a licensed
720 osteopathic physician, and if the party using the designation is not a licensed osteopathic
721 physician, the designation must additionally contain the description of the branch of the healing
722 arts for which the person has a license, provided that an individual who has received an earned
723 degree of doctor of osteopathic medicine but is not a licensed osteopathic physician and
724 surgeon in Utah may use the designation "D.O." if it is followed by "Not Licensed" or "Not
725 Licensed in Utah" in the same size and style of lettering.
726 (b) The practice of osteopathic medicine does not include:
727 (i) except for an ablative medical procedure as provided in Subsection (12)(b)(ii), the
728 conduct described in Subsection (12)(a)(i) that is performed in accordance with a license issued
729 under another chapter of this title;

730 (ii) an ablative cosmetic medical procedure if the scope of practice for the person
731 performing the ablative cosmetic medical procedure includes the authority to operate or
732 perform a surgical procedure; or
733 (iii) conduct under Subsection 58-68-501 (2).
734 [(9)] (13) "Prescription device" means an instrument, apparatus, implement, machine,
735 contrivance, implant, in vitro reagent, or other similar or related article, and any component
736 part or accessory, which is required under federal or state law to be prescribed by a practitioner
737 and dispensed by or through a person or entity licensed under this chapter or exempt from
738 licensure under this chapter.
739 [(10)] (14) "Prescription drug" means a drug that is required by federal or state law or
740 rule to be dispensed only by prescription or is restricted to administration only by practitioners.
741 [(11)] (15) "SPEX" means the Special Purpose Examination of the Federation of State
742 Medical Boards.
743 [(12)] (16) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-68-501 .
744 [(13)] (17) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-68-502
745 and as may be further defined by division rule.
746 Section 11. Section 58-68-805 is enacted to read:
747 58-68-805. Supervision of cosmetic medical procedures.
748 (1) Except as provided in Subsection (2), an osteopathic physician and surgeon may
749 not delegate the performance of an ablative cosmetic medical procedure to an individual who is
750 not licensed under this chapter or Chapter 67, Utah Medical Practice Act.
751 (2) A physician may delegate to an advanced practice registered nurse with an
752 unrestricted license under Chapter 31b, Nurse Practice Act, the performance of an erbium full
753 ablation resurfacing procedure or a CO2 fractionated resurfacing procedure, if the physician:
754 (a) prescribes that specific procedure for the patient who is to receive the procedure;
755 (b) ensures that the advanced practice registered nurse performs the procedure under
756 the indirect supervision of the physician; and
757 (c) verifies that the advanced practice registered nurse is qualified to perform the

758 procedure by having received at least 50 hours of training specific to the procedure to be
759 performed and the laser to be used.