Rhode Island § 23-105-2 - Medical Spas Safety Act

§ 23-105-2. Protection of patients in a medical spa.

(a) Each medical spa shall appoint a medical director who shall be:

(1) Trained in the indications for, and performance of, cosmetic medical procedures, including all medical devices or instruments that can alter or cause biological change or damage to the skin or subcutaneous tissue. Training programs provided by a manufacturer or vendor of a medical device or supplies shall not be a medical director’s, supervising physician’s, supervising PA in collaboration with a physician, or CNP’s only education in the cosmetic medical service or the operation of medical devices to be used;

(2) Responsible for implementing policies and procedures to ensure quality patient care;

(3) Responsible for the delegation and supervision of cosmetic procedures;

(4) Responsible for developing and maintaining written office protocols for each cosmetic medical procedure. Such protocols shall be kept on site at the medical spa for review and/or inspection by the department;

(5) Responsible for the oversight of all cosmetic medical procedures performed by physicians, PAs, APRNs, and RNs;

(6) Responsible for ensuring that all supervisory physicians, supervising PAs in collaboration with a physician and supervising APRNs, any physicians, PAs and APRNs performing cosmetic medical procedures, and any non-physicians and non-APRNs delegated to perform cosmetic medical procedures, are properly trained in the safe and effective performance of all cosmetic medical procedures that they perform at the medical spa; and

(7) On site or off site and able to directly observe the treatment being performed, though not necessarily in the same room (i.e., direct supervision).

(b) A physician, PA, or APRN who performs cosmetic medical procedures, or supervises such procedures delegated to and performed by a non-physician, non-PA, or non-APRN, must be trained in the indications for and performance of the cosmetic medical procedure. An APRN who performs cosmetic medical procedures, or supervises such procedures delegated to and performed by a non-physician, non-PA, or non-APRN, must be accredited by the state board of nursing.

(c) The supervising physician, supervising APRN, or supervising PA in collaboration with a physician shall:

(1) Perform an initial assessment of the patient.

(2) Prepare a written treatment plan for each patient, which plan shall include, as applicable, diagnoses, course of treatment, and specifications for any device being used.

(3) Obtain patient consent and document the patient’s consent, in the patient’s medical record.

(4) Create and maintain medical records in a manner consistent with applicable laws and regulations and accepted medical practice.

(d) Non-physicians, non-PAs, and non-APRNs may only perform cosmetic medical procedures:

(1) For which they have the requisite training; and

(2) Which have been delegated to them by a supervising physician, supervising PA in collaboration with a physician or supervising APRN.

(e) At all times in the performance of their duties relative to cosmetic procedures, all providers shall:

(1) Review and follow written protocols for each delegated cosmetic medical procedure;

(2) Verify that the supervising physician, supervising PA in collaboration with a physician or supervising APRN has assessed the patient and given written treatment instructions for each procedure performed;

(3) Review the cosmetic medical procedure with each patient;

(4) Notify the medical director, as well as the supervising physician, supervising PA in collaboration with a physician or supervising APRN, before the patient leaves or as they become aware, of any adverse events or complications, and follow up with the patient post-procedure, as appropriate;

(5) Document all relevant details of the performed cosmetic medical procedure in the patient’s medical record; and

(6) As applicable, satisfy any requirements imposed upon them by their licensing boards.

(f) Medical procedures using ablative lasers or ablative energy devices shall only be performed by physicians, physician assistants, and certified nurse practitioners.