Chapter 360-35 LASERS
For purposes of this Chapter, the following definitions
apply:
| (1) |
"Assistant Laser
Practitioner" means a person who had been licensed by the Board to practice as
a cosmetic laser practitioner under the on-site supervision of a senior laser
practitioner but the senior laser practitioner does not have to be on-site if
the only service being performed is hair removal using lasers or pulsed light
devices. |
| (2) |
"Board" means the
Georgia Composite Medical Board. |
| (3) |
"Continuing medical education (CME)
educator" or "continuing education (CE) educator" means an individual who
teaches courses approved by the Accreditation Council for Continuing Medical
Education (ACCME). |
| (4) |
"Cosmetic
laser practitioner" means a person licensed by the Board to provide cosmetic
laser services and whose license is in good standing. |
| (5) |
"Cosmetic laser services" means
nonablative elective cosmetic light based skin care, photo rejuvenation, or
hair removal using lasers or pulsed light devices approved by the United States
Food and Drug Administration for noninvasive procedures. |
| (6) |
"Cosmetologist" means a person who is
registered to practice the occupation of cosmetologist by the State Board of
Cosmetology and Barbers pursuant to Chapter 10, Title 43 of the
O.C.G.A. |
| (7) |
"Direct supervision"
means the supervising physician (MD/DO) is physically present on the premises
and immediately available to lend medical assistance if needed. |
| (8) |
"Esthetician" means a person who is
registered to engage in the occupation of an esthetician by the State Board of
Cosmetology and Barbers pursuant to Chapter 10, Title 43 of the O.C.G.A.
|
| (9) |
"Facility" means any location,
place, area, structure, office, institution, or business or a part thereof in
which is performed or provided cosmetic laser services regardless of whether a
fee is charged for such services. |
| (10) |
"Lasers" means light-based devices that
are prescription devices, the sale of which are regulated by the U.S. Food and
Drug Administration, (FDA), that can be sold only to licensed practitioners
with prescriptive authority. It does not include devices which are not light
based such as radio frequency devices, ultrasound devices, thermal devices and
lasers not regulated by the FDA. |
| (11) |
"Medical Practitioner" means a nurse,
physician assistant or physician. |
| (12) |
"Nurse" means a person who is licensed
to practice as a registered professional nurse or who is authorized by the
Georgia Board of Nursing to engage in advanced nursing practice pursuant to
Article 1, Chapter 26, Title 43 of the O.C.G.A. |
| (13) |
"Offices" shall mean a facility offering
cosmetic laser services which serves as the principal place of practice at
which a physician regularly sees patients for the general and usual care
rendered and administered by a physician. |
| (14) |
"Physician" means one who is licensed by
the Board to practice medicine. |
| (15) |
"Physician Assistant" means a person who
is licensed by the Board as a physician assistant. |
| (16) |
"Senior Laser Practitioner" means a
physician assistant or a nurse who has been licensed to practice the occupation
of a cosmetic laser practitioner and who practices pursuant to the protocols of
a consulting physician. |
| (1) |
Applicants for
licensure as an assistant laser practitioner or senior laser practitioner must
submit an application on a form approved by the Board, submit an application
fee, and submit an affidavit that the applicant is a United States citizen, a
legal permanent resident of the United States, or that he/she is a qualified
alien or non-immigrant under the Federal Immigration and Nationality Act. If
the applicant is not a U.S. citizen, he/she must submit documentation that will
determine his/her qualified alien status. The Board participates in the
DHS-USCIS SAVE (Systematic Alien Verification for Entitlements or
"SAVE") program for the purpose of verifying citizenship and immigration status
information of non-citizens. If the applicant is a qualified alien or
non-immigrant under the Federal Immigration and Nationality Act, he/she must
provide the alien number issued by the Department of Homeland Security or other
federal immigration agency. |
| (2) |
An
applicant for licensure as an assistant laser practitioner must also show that
he/she:
| (a) |
Is 21 years old or
older; |
| (b) |
Holds a current license
as a physician assistant, licensed practical nurse, nurse, esthetician, or
master cosmetologist or has previously held a license or certificate as a
medical practitioner; and |
| (c) |
Has
received at least three laser certificates from attending laser/intense pulsed
light (IPL) courses as approved by the Board, directly taught by a licensed
physician or certified continuing medical education or continuing education
educator. |
|
| (3) |
An
applicant for licensure as a senior laser practitioner must also show that
he/she:
| (a) |
Is 21 years old or
older; |
| (b) |
Holds a current valid
license or certificate of registration as a physician assistant or nurse or has
previously held a license or certificate of registration as a medical
practitioner; |
| (c) |
Has at least
three years of clinical or technological medical experience, or both; |
| (d) |
Has been or was licensed or nationally
board certified as a medical practitioner for at least three years; |
| (e) |
Has submitted verification of licensure
from every state in which the applicant has ever held any type of license or if
a medical practitioner, has submitted verification of national board
certification; |
| (f) |
Has received at
least two laser certificates from attending laser/intense pulsed light (IPL)
continuing medical education courses as approved by the Board, directly taught
by a licensed physician or certified continuing medical education or continuing
education educator; and |
|
| (4) |
A person currently licensed in another
state may apply for licensure in Georgia as an assistant laser practitioner or
senior laser practitioner by submitting an application, paying a fee, showing
he/she is currently licensed in another state, that state has requirements
similar to and not less stringent than Georgia, that state would accept
licensees from Georgia, and passing an examination approved by the
Board. |
| (5) |
An application shall
expire one year from the date of receipt. Any subsequent application must be
accompanied by submission of appropriate documentation and application
fee. |
| (1) |
All licenses shall expire biennially
unless renewed. |
| (2) |
Each licensee
shall notify the Board within thirty (30) days, in writing, of all changes of
address. Any mailing or notice from the Board shall be considered to be served
on the licensee when sent to the licensee's last address on file with the
Board. |
| (3) |
All active licenses must
be renewed every two years. This may be done via the internet or through mail.
A licensee may not practice after the expiration date of the license. A license
must be renewed biennially by the last day of the month in which the
applicant's birthday falls, and the licensee must establish satisfaction of
Board-approved continuing education requirements to be eligible for
renewal. |
| (4) |
Licensees have the
right to obtain a late renewal of their licenses during the three (3) month
period immediately following the expiration date. During this period, the
penalty for late renewal applies. A licensee may not practice after the
expiration date of his or her license. |
| (5) |
The Board shall administratively revoke
any license not renewed prior to the expiration of the late renewal period. In
order to obtain a license after revocation for failure to renew, an applicant
must reapply for a new license and meet the requirements in effective at the
time of the application. |
| (6) |
Notwithstanding the provisions of paragraph (4) of this rule, any service
member as defined in O.C.G.A. § 43-1-31 whose license to practice
as a cosmetic laser practitioner expired while on active duty outside the state
shall be permitted to practice in accordance with the expired license and shall
not be charged with a violation relating to such practice on an expired license
for a period of six (6) months from the date of his or her discharge from
active duty or reassignment to a location within the state. Such service member
shall be entitled to renew such expired license without penalty within six (6)
months after the date of his or her discharge from active duty or reassignment
to a location within this state. The service member must present to the Board a
copy of the official military orders or a written verification signed by the
service member's commanding officer to waive any charges. |
| (7) |
The fee for renewals and late renewals
shall be designated in the fee schedule. |
| (8) |
All applicants must provide an affidavit
and a secure and verifiable document in accordance with O.C.G.A. 50-36-1(f). If
the applicant has previously provided a secure and verifiable document and
affidavit of United States citizenship, no additional documentation of
citizenship is required for renewal. If the applicant for renewal is not a
United States citizen, he/she must submit documentation that will determine
his/her qualified alien status. The Board participates in the DHS-USCIS SAVE
(Systematic Alien Verification for Entitlements or "SAVE") program for purpose
of verifying citizenship and immigration status information of non-U.S.
citizens. If the applicant for renewal is a qualified alien or non-immigrant
under the Federal Immigration and Nationality Act, he/she must provide the
alien number issued by the Department of Homeland Security or other federal
agency. |
| (1) |
An applicant for renewal who has been
initially licensed by the Board by examination for less than two years shall
not be required to complete the continuing education hours in order to renew
the license for the first time. However, for the next renewal, the licensee
must obtain 5 hours of continuing education. |
| (2) |
Each licensee must be renewed biennially
by the last day of the month in which the applicant's birthday falls and the
licensee must establish satisfaction of at least 5 (five) contact hours of
Board-approved continuing education requirements to be eligible for
renewal. |
| (3) |
Each licensee shall be
required to answer questions on their renewal application form that establish
compliance with Board approved continuing education requirements. Licensees
will not be required to send documentation of compliance with continuing
education requirements for renewal, unless requested by the Board. |
| (4) |
False statements regarding satisfaction
of continuing education on the renewal form or any other document connected
with the practice of cosmetic laser practitioner may subject the licensee to
disciplinary action by the Board. |
| (5) |
Each licensee who must meet the
requirements of this chapter must maintain record of attendance and supporting
documents for Board approved continuing education for a period of 5 years from
the date of attendance. At a minimum, the following information must be kept:
| (c) |
hours of continuing education units
completed; and |
|
| (6) |
The
Board will audit a fixed percentage of randomly selected renewal applications
to monitor compliance with the continuing education requirements. Any licensee
so audited shall be required to furnish documentation of compliance including
name of provider, name of program, hours/continuing education units completed
and date of completion. Any licensee audited that has been found to be out of
compliance with the Board's continuing education requirements may be subject to
disciplinary action. |
| (7) |
If the
licensee has not complied with the continuing education requirement by the
expiration of the license, his/her license shall not be renewed and the license
holder shall not engage in the practice of cosmetic laser services. |
| (8) |
A licensee may late renew during the
three months following the expiration date of his or her license by presenting
satisfactory evidence to the Board of completion of the contact hours or
continuing education units of Board approved continuing education. Licenses not
renewed within 3 months following the expiration date of the license shall be
revoked for failure to renew. In order to obtain a valid license after
revocation for failure to renew, an applicant must reapply for a new license
and meet the requirements in effective at the time of the
application. |
| (9) |
Any licensee
seeking renewal of a license without having fully complied with the Board's
continuing education requirements who wishes to seek a waiver or variance of
this rule shall file with the Board:
| (a) |
A
renewal application and fee and |
| (b) |
A statement that complies with the provisions of O.C.G.A. § 50-13-9.1 setting forth the specific facts of substantial hardship which would justify a
variance or waiver, including the alternative standards which the person
seeking a waiver or variance agrees to meet and a showing that such alternative
standards will afford adequate protection for the public health, safety and
welfare; and the reason why the variance would serve the purpose of the
underlying statute. |
|
| (10) |
Courses should be in the area of cosmetic laser services, equipment safety and
operation, procedures, and relative skin modalities, directly taught by a
licensed physician or certified continuing medical education or continuing
education educator. The following courses are approved by the Board as meeting
the continuing education requirements:
| (a) |
Assistant and senior laser practitioners can obtain laser continuing education
credit for courses from the following:
| 1. |
Courses approved for Category I credit by the Accreditation Council for
Continuing Medical Education (ACCME). |
| 2. |
Courses approved for Category I Continuing
Medical Education (CME) credit by AAPA, AMA, AOA, and NCCPA. |
| 3. |
Laser courses approved by the Georgia
Board of Cosmetology. |
| 4. |
Laser
courses approved for Category I credit by Medical Association of Georgia
(MAG). |
| 5. |
Laser courses approved by
the Georgia Board of Nursing |
| 6. |
Courses sponsored by the Georgia Composite Medical Board. |
| 7. |
Courses taught by a licensed physician
specific to laser practice and safety |
|
|
| (1) |
Assistant Laser
Practitioners may practice as follows:
| (a) |
May
perform cosmetic laser services which means nonablative elective cosmetic light
based skin care, photo rejuvenation, or hair removal using lasers or pulsed
light devises approved by the United States Food and Drug Administration for
noninvasive procedures under the on-site supervision of a physician licensed by
the Board or a licensed senior laser practitioner. |
| (b) |
Shall have patients examined by a
consulting physician, or a physician assistant who is a licensed cosmetic laser
practitioner or advanced registered practice nurse who is a licensed cosmetic
laser practitioner prior to service. |
| (c) |
On-site supervision and an examination
prior to treatment as described herein are not required for the performance of
laser hair removal and pulsed light treatments. |
|
| (2) |
Senior Laser Practitioners may practice
as follows
| (a) |
May perform cosmetic laser
services including nonablative elective cosmetic light based skin care, photo
rejuvenation, or hair removal using lasers or pulsed light devises approved by
the United States Food and Drug Administration for noninvasive
procedures. |
| (b) |
May supervise
assistant laser practitioners in the performance of cosmetic laser services as
defined in the law. |
|
| (1) |
In order to qualify as a consulting physician, the physician:
| (a) |
Must be currently licensed to practice
medicine in Georgia; |
| (b) |
Must have
a principal place of business in Georgia or practice outside of Georgia but
within 50 miles from a facility with whom the physician will provide
supervision; |
| (c) |
Must be trained in
laser modalities which should include the physics, safety, and surgical
techniques involved in the use of lasers and should include the indications for
such surgical procedures, the pre- and post-operative care involved in
treatment, as well as the treatment of complications associated with laser
devices; and |
| (d) |
Must be available
for emergency consultations. |
|
| (2) |
The consulting physician shall establish
proper protocols for the cosmetic laser services provided at a facility and
shall file such protocols with the Board. |
| (1) |
Except for physician offices, all
facilities providing cosmetic laser services other than hair removal using
lasers or pulsed light devices shall meet the following standards:
| (a) |
Must have an agreement with a consulting
physician who will examine each patient prior to any cosmetic laser service
other than hair removal using lasers or pulsed light devices being performed or
who has delegated the authority to perform such examination to a physician
assistant in a job description who is a licensed cosmetic laser practitioner,
or to an advanced practice registered nurse in a protocol approved by the Board
and who is a licensed cosmetic laser practitioner; |
| (b) |
Must have a consulting physician who will
be available for emergency consultation with the cosmetic laser practitioner or
anyone employed by the facility; |
| (c) |
Must file with the Board the name,
address and credentials of the consulting physician and his/her delegates, if
applicable; |
| (d) |
Must have a senior
laser practitioner or consulting physician present at the facility or
immediately available for consultation and supervision either personally or via
telecommunications; and |
| (e) |
Must
post a sign listing the consulting physician's name, emergency contact number,
his or her board certification and specialty, and the address of his or her
principal place of practice, and indicating whether he or she is presently on
site at the facility. If the physician is not on-site, a sign must be posted
indicating who is presently acting as supervisor and that person's name,
emergency contact number, his or her degrees and qualifications, and the type
of cosmetic laser practitioner license held. |
|
| (2) |
Physician offices providing cosmetic
laser services other than hair removal using lasers or pulsed light devices
shall meet the following standards:
| (a) |
Must
have the physician examine each patient prior to any cosmetic laser service
other than hair removal using lasers or pulsed light devices being performed or
have such examination conducted by a physician assistant authorized in a job
description, or by an advanced practice registered nurse in a protocol approved
by the Board; |
| (b) |
Must have the
physician available for emergency consultation with a cosmetic laser
practitioner or anyone employed by the facility; |
| (c) |
Must file with the Board the name,
address and credentials of the physician and his/her delegates, if applicable;
and |
| (d) |
Must have a senior laser
practitioner or physician present at the facility or immediately available for
consultation and supervision either personally or via telecommunications if
cosmetic laser services are being provided by an assistant laser
practitioner. |
|
| (3) |
Failure of a facility to meet the requirements of this Chapter may subject the
owner to misdemeanor criminal charges and may subject the licensed cosmetic
laser practitioners practicing at such facility and any consulting physician
with that facility to disciplinary action by the Board. |
| (1) |
Prior to receiving cosmetic laser services for hair removal from a cosmetic
laser practitioner, a person, or if under the age of 18, his or her parent or
guardian, must consent in writing to such services and shall be informed in
writing of the general terms of the following:
| (a) |
The nature and purpose of such proposed
procedure; |
| (b) |
Any material risks
generally recognized and associated with the cosmetic laser service to be
performed which, if disclosed to a reasonably prudent person in the customer's
position, could reasonably be expected to cause such prudent person to decline
such proposed cosmetic laser services on the basis of the material risk of
injury that could result from such proposed services; |
| (c) |
The name of, degrees and qualifications
held by, and type of licenses obtained by the individual who will be performing
the cosmetic laser service; and |
| (d) |
The steps to be followed after the cosmetic laser service is performed in the
event of any complications. |
|
| (2) |
Prior to receiving cosmetic laser service
other than hair removal from a cosmetic laser practitioner, a person, or if
under the age of 18, his or her parent or guardian, must consent in writing to
such services and shall be informed in writing of the general terms of the
following:
| (a) |
The nature and purpose of such
proposed procedure; |
| (b) |
Any
material risks generally recognized and associated with the cosmetic laser
service to be performed which, if disclosed to a reasonably prudent person in
the customer's position, could reasonably be expected to cause such prudent
person to decline such proposed cosmetic laser services on the basis of the
material risk of injury that could result from such proposed
services; |
| (c) |
The name of, degrees
and qualifications held by, and type of licenses obtained by the individual who
will be performing the cosmetic laser service, by the supervisory, and by the
consulting physician; |
| (d) |
The steps
to be followed after the cosmetic laser service is performed in the event of
any complications; and |
| (e) |
The
emergency contact information for the consulting physician and the address of
his or her principal place of practice. If the cosmetic laser service is
provided at the physician's office, then this information does not need to be
included in the informed consent. |
|
| (3) |
After receiving each cosmetic laser
service other than hair removal, a person shall be informed in writing of the
steps to be followed after the cosmetic laser service is performed in the event
of any complications and the emergency contact information for the consulting
physician and the address of his or her principal place of practice. |
| (4) |
It shall be the responsibility of the
cosmetic laser practitioner to ensure that the information required by this
rule is disclosed and that the consent provided for in this Rule is
obtained. |
| (5) |
The cosmetic laser
practitioner can disclose some of this information on the procedures and risks
through the use of video tapes, audio tapes, pamphlets, booklets, or other
means of communication or through conversations with the cosmetic laser
practitioner; provided, however, that such information is also provided in
writing and attached to the consent form which the person signs. |
| (6) |
Failure to obtain informed consent shall
be grounds for disciplinary action against the license of any cosmetic laser
practitioner as provided in O.C.G.A. Section
43-34-8. |
| (1) |
A licensee shall notify the Board in
writing within 30 days after the license holder's name is legally changed. At
the time of notification, submit a certified copy of the official document
evidencing the name change. If the name change occurred during naturalization,
the application must also include the naturalization number, the name and
address of the court, the date of naturalization, and the name
change. |
| (2) |
Licensees shall notify
the Board in writing within 30 days after a change in address of record.
Failure to so notify the Board of an address change shall be deemed a violation
of this rule and may be grounds for disciplinary action pursuant to O.C.G.A.
§ 43-34-8. |
| (3) |
Licensees who utilize a post office box
as the address of record shall also provide a street address where the Board
may contact the licensee. |
| (1) |
It shall be unlawful for any person
licensed as a cosmetic laser practitioner to perform cosmetic laser services
within any area within one inch of the nearest part of the eye socket of any
consumer. |
| (2) |
It shall be unlawful
for any person licensed as a cosmetic laser practitioner to administer any
pharmaceutical agent or other substance by injection. |
The Board may impose on a cosmetic laser practitioner or
applicant any sanction authorized under subsection (b) of Code Section
43-34-8 upon a finding of any
conduct specified in subsection (a) of Code Section
43-34-8.
This Chapter shall not be construed to prohibit:
| (1) |
A licensed physician from engaging in the
practice for which he or she is licensed; |
| (2) |
A licensed physician assistant from
engaging in the practice for which he or she is licensed; |
| (3) |
A person licensed by this state as a
registered professional nurse, licensed practical nurse, or nurse practitioner
from engaging in his or her profession; |
| (4) |
A licensed esthetician from engaging in
his or her profession; |
| (5) |
A master
cosmetologist from engaging in his or her profession; |
| (6) |
Any person licensed under any other
article of this chapter from engaging in the practice for which he or she is
licensed; |
| (7) |
A person licensed in
this state under any other law from engaging in the practice for which he or
she is licensed; |
| (8) |
The practice
of providing cosmetic laser services by a person who is employed by the federal
government or any bureau, division, or agency of the federal government while
in the discharge of the employee's official duties; |
| (9) |
The practice of providing cosmetic laser
services by a student enrolled in an accredited school of nursing, schools for
physician assistants, or medical school as part of his or her training;
or |
| (10) |
Employees or authorized
representatives of a manufacturer of a laser used for cosmetic laser services
from engaging in one or more of the following: evaluating, adjusting,
measuring, designing, fabricating, assembling, fitting, servicing, training,
repairing, replacing, or delivering a laser used to provide cosmetic laser
services under the order, direction, or prescription of a physician or health
provider operating within his or her licensed scope of practice. |
| (1) |
The Board shall
appoint an advisory committee, which shall include licensed cosmetic laser
practitioners. The initial members of the advisory committee may include
persons eligible for licensing under this rule. |
| (2) |
The advisory committee shall include at
least one person licensed to practice medicine under Chapter 43-34 and
specialized in a field with expertise in the biologic behavior of the
skin. |
| (3) |
Members shall receive no
compensation for service on the committee. The committee shall have such
advisory duties and responsibilities as the Board may determine, including but
not limited to consulting with the Board on the issuance, denial, suspension,
and revocation of licenses and the promulgation of rules and regulations
concerning O.C.G.A. T. 43, Ch. 34, Art. 9. |
| (4) |
Advisory committee members must be
licensed by the Board. |
