ENROLLED ORIGINAL
AN ACT
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IN THE COUNCIL OF THE DISTRICT OF COLUMBIA
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To amend the District of Columbia Health Occupations Revision Act of 1985 to revise the
governing standards of various health occupations regulated in the District, to reorganize
and update the composition and jurisdiction of various health occupation boards, and to
regulate the practices of medical radiation technology, behavior analysis, school
psychology, and general applied psychology; to amend the Department of Health
Functions Clarification Act of 2001 to remove the requirement that a dementia training
certificate be notarized, repeal certain advisory committees, and create a new Advisory
Committee on Medical Radiation Technologists; to amend section 47-2853.76e of the
District of Columbia Official Code to allow for ear piercings of minors with a sterilized
hollow needle and tattoo services for individuals aged 16 and 17 with written consent
from a parent or legal guardian; and to make other conforming and technical
amendments.
BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this
act may be cited as the “Health Occupations Revision General Amendment Act of 2024”.
TITLE I. HEALTH PROFESSIONAL LICENSURE REVISIONS.
Sec. 101. The District of Columbia Health Occupations Revision Act of 1985, effective
March 25, 1986 (D.C. Law 6-99; D.C. Official Code § 3-1201.01 et seq.), is amended as follows:
(a) The table of contents is amended as follows:
(1) Title I is amended by adding a new section designation to read as follows:
“Sec. 105. Telehealth.”.
(2) Title II is amended as follows:
(A) The designation for section 203 is amended to read as follows:
“Sec. 203. Board of Medicine; Advisory Committees on Anesthesiologist Assistants,
Polysomnography, Surgical Assistants, Trauma Technologists, Athletic Trainers, Maternal Care
Professionals, and Medical Radiation Technologists.”.
(B) The designations for sections 205 and 217 are repealed.
(C) The designation for section 208 is amended to read as follows:
“Sec. 208. Board of Pharmacy.”.
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(D) New section designations are added to read as follows:
“Sec. 223. Board of Rehabilitative Therapies.
“Sec. 224. Board of Integrative Healthcare.”.
(3) Title IV is amended by adding a new section designation to read as follows:
“Sec. 413. Immunity.”.
(4) Title V is amended as follows:
(A) New section designations are added to read as follows:
“Sec. 511a. Emeritus status.
“Sec. 514a. Negotiated settlement agreement.
“Sec. 514b. Disciplinary or adverse action against nursing education or nursing assistive
personnel training programs.
“Sec. 525. Disciplinary records.”.
(B) The designation for section 513a is repealed.
(5) Title VI is amended as follows:
(A) The designation for section 603 is repealed.
(B) The designation for Title VI is amended by striking the phrase
“PROTOCOL; COLLABORATION.” and inserting the phrase “PROTOCOL.” in its place.
(C) New section designations are added to read as follows:
“Sec. 605a. Certified registered nurse anesthetist.
“Sec. 606a. Certified nurse-midwife.
“Sec. 607a. Certified nurse practitioner.
“Sec. 607b. Certified clinical nurse specialist.
“Sec. 608a. Qualifications, certification.”.
(6) The designation for Title VII-F is repealed.
(7) A new title designation is added to read as follows:
“TITLE VII-G.
“QUALIFICATIONS FOR LICENSURE TO PRACTICE AS A BEHAVIOR ANALYST.
“Sec. 771. Eligibility requirements and education.
(8) Title VIII is amended by adding a new designation to read as follows:
“Sec. 804a. Exceptions for non-clinical practice.”.
(9) Title VIII-C section designation 853 and 854 are repealed.
(10) New title designations are added to read as follows:
“Title VIII-F.
“CATEGORIES AND QUALIFICATIONS REQUIRED FOR THE PRACTICE OF
PSYCHOLOGY.
“Sec. 881. License and registration requirements.
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“Sec. 882. Qualifications.
“Sec. 883. Limitations.
“Title VIII-G.
“CATEGORIES AND QUALIFICATIONS REQUIRED FOR THE PRACTICE OF MEDICAL
RADIATION.
“Sec. 891. Qualifications for licensure.
“Sec. 892. Limitations on practice.
“Sec. 893. Transition of licensed and registered medical radiation practitioners.”.
(11) Title IX is amended as follows:
(A) The designation for section 902 is amended to read as follows:
“Sec. 902. Dance Therapy.”
(B) The section designations for 903, 906, 908, and 912 are repealed.
(C) The designation for section 907 is amended by striking the period and
inserting the phrase “; registration or certification required.” in its place.
(D) A new section designation is added to read as follows:
“Sec. 913. Doula.”.
(12) The designation for section 1204 is amended by striking the word “therapy”
and inserting the word “therapist” in its place.
(b) Section 101 (D.C. Official Code § 3-1201.01) is amended as follows:
(1) The first paragraph (1) and paragraph (1A) are amended to read as follows:
“(1) “Board” means the Board of Dentistry, the Board of Dietetics and Nutrition,
the Board of Integrative Healthcare, the Board of Medicine, the Board of Nursing, the Board of
Optometry, the Board of Pharmacy, the Board of Podiatry, the Board of Professional Counseling,
the Board of Psychology, the Board of Rehabilitative Therapies, the Board of Respiratory Care,
the Board of Social Work, or the Board of Veterinary Medicine established by this act, as the
context requires.
“(1A) “Boards of Allied Health” means the Board of Dentistry, the Board of
Dietetics and Nutrition, the Board of Massage Therapy, the Board of Optometry, the Board of
Podiatry, the Board of Rehabilitative Therapies, and the Board of Respiratory Care.”.
(2) The second paragraph (1) is designated as paragraph (1C).
(3) Paragraphs (1E), (1F), (1G), and (1H) are designated as paragraphs (10A),
(10B), (10C), and (10D).
(4) Paragraphs (1E), (10A), (10B), (10C), and (3) are repealed.
(5) Paragraph (1B) is amended by striking the phrase “means the Board of
Marriage and Family Therapy,” and inserting the word “means” in its place.
(6) Paragraph (10D) is amended by striking the word “midwife” and inserting the
phrase “health professional providing maternal services” in its place.
(7) Paragraph (6C) is amended to read as follows:
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“(6C) “Doula” means an individual certified by the Board of Medicine to provide
culturally competent and continuous physical, emotional, and informational support to a birthing
parent during pregnancy, labor, birth, and postpartum.”.
(8) A new paragraph (6C-i) is added to read as follows:
“(6C-i) “Electronic form” means a record created, generated, sent, communicated,
received, or stored by electronic means.”.
(9) Paragraph (15) is amended to read as follows:
“(15) “Suspension” means termination of the right to practice a health profession
for a specified period of time or until such time that the specified conditions in an order are
satisfied.”.
(10) A new paragraph (15A) is added to read as follows:
“(15A) “Telehealth” means the use of synchronous or asynchronous
telecommunication technology to provide access to health assessment, diagnosis, intervention,
consultation, supervision, and information where the health professional and the patient, client,
or supervisee are located at different physical locations.”.
(11) Paragraph (16) is amended by striking the period and inserting the phrase
“and is licensed to practice veterinary medicine in the District.” in its place.
(c) Section 102 (D.C. Official Code § 3-1201.02) is amended as follows:
(1) Paragraph (2) is amended to read as follows:
“(2) “Practice of advanced practice registered nursing” means the independent
performance of advanced-level nursing actions, with or without compensation, by a licensed
registered nurse with advanced education, knowledge, skills, and scope of practice who has been
certified to perform such actions by a national certifying body acceptable to the Board of
Nursing in the appropriate advanced practice registered nursing role and in at least one
population focus. Advanced practice registered nursing shall include the categories of certified
registered nurse anesthetist, certified nurse-midwife, certified nurse-practitioner, and clinical
nurse specialist. The practice of advanced practice registered nursing includes:
“(A) Advanced assessment;
“(B) Medical diagnosis;
“(C) Prescribing;
“(D) Selecting, administering, and dispensing therapeutic measures;
“(E) Treating alterations of the health status; and
“(F) Carrying out other functions identified in Title VI and in accordance
with procedures required by this act.”.
(2) Paragraph (2A-ii)(C)(iii) is repealed.
(3) Paragraph (2B)(A) is amended to read as follows:
“(2B)(A) “Practice of audiology” means the planning, directing, supervising, and
conducting of habilitative or rehabilitative counseling programs for individuals or groups of
individuals who have, or are suspected of having, disorders of hearing or balance; any service in
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audiology, including prevention, identification, evaluation, consultation, habilitation or
rehabilitation, academic instruction, clinical instruction, and research; participating in hearing
conservation, hearing aid and assistive listening device evaluation, selection, preparation,
dispensing, and orientation; fabricating ear molds; cerumen management; interoperative
neurophysiologic monitoring; providing auditory training and speech reading; administering tests
of vestibular function or tinnitus; or speech and language screening limited to a pass-or-fail
determination for the purpose of identification of individuals with disorders of communication
and associated referral for management of communication and balance disorders, or cognitive,
dexterity, depression, or vision screening, and associated referral for management of related
disorders. The practice of audiology does not include the practice of medicine or osteopathic
medicine, or the performance of a task in the normal practice of medicine or osteopathic
medicine by a person to whom the task is delegated by a licensed physician.”.
(4) The existing paragraph (2C-i) is redesignated as paragraph (2C-ii).
(5) A new paragraph (2C-i) is added to read as follows:
“(2C-i) “Practice of behavior analysis” means the design, implementation, and
evaluation of environmental modifications to produce socially significant improvement in human
behavior, including the use of direct observation, measurement, and functional analysis of the
relationship between environment and behavior.”.
(6) Paragraph (3)(A) is amended to read as follows:
“(3)(A) “Practice of chiropractic” means practicing a primary care health
discipline through the evaluation, examination, diagnosis, counseling, and treatment or
management of biomechanical or physiological conditions or disorders that compromise neural
integrity or organ system function; the use of x-rays and advanced diagnostic imaging, physical
examination, and examination by instrumentation for the detection and correction of
subluxations and somatic dysfunctions that cause vertebral, neuromuscular, or skeletal disorder;
the adjustment of the spine or manipulation of bodily articulations for the restoration and
maintenance of health; and the referral of a patient for diagnostic imaging, tests, and clinical
laboratory procedures in order to determine a regimen of chiropractic care or to form a basis or
referral of patients to other licensed health care professionals. The practice of chiropractic does
not include the use of drugs or surgery but may include ancillary procedures such as dry needling
in accordance with the rules and requirements promulgated by the Mayor.”.
(7) Paragraph (3A) is amended by striking the phrase “or cells desquamated from
a body surface or lesion” and inserting the phrase “cells desquamated from a body surface or
lesion, or cells aspirated from a lesion” in its place.
(8) Paragraph (4) is amended as follows:
(A) Subparagraph (A) is amended to read as follows:
“(4)(A) “Practice of dental hygiene” means the performance of any of the
following activities in accordance with the provisions of subparagraph (B) of this paragraph:
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“(i) A preliminary dental examination, including charting of
cavities, soft tissue examination, periodontal examination, and oral cancer screening; a complete
prophylaxis, including the removal of any deposit, accretion, or stain from the surface of a tooth
or a restoration; debridement; scaling and root planing; soft tissue curettage; application of
topical fluoride and fluoride varnish; and the polishing of a tooth or a restoration;
“(ii) Applying a medicinal agent to a tooth for a prophylactic
purpose;
“(iii) Taking dental radiographs;
“(iv) Instructing individuals or groups of individuals in oral health
care;
“(v) Administering local anesthesia and nitrous oxide when
certified by the Board of Dentistry to do so;”
“(vi) Applying pit and fissure sealants;
“(vii) Placing and removing periodontal dressings;
“(viii) Administering vaccinations under the direct supervision of a
dentist licensed under this act when certified by the Board of Dentistry to do so;
“(ix) Prescribing topical prescription or over-the-counter fluoride
preparations and topical antimicrobial oral rinses, under the general supervision of a dentist
licensed under this act;
“(x) Performing blood glucose testing;
“(xi) Placing or removing temporary restorations and crowns;
“(xii) Taking study cast impressions;
“(xiii) Removing sutures; and
“(xiv) Any other functions included in the curricula of approved
educational programs in dental hygiene, including dental hygiene diagnosis.”.
(B) Subparagraph (B) is amended as follows:
(i) Strike the phrase “A dental hygienist may perform” and insert
the phrase “Except for administering vaccinations, a dental hygienist may perform” in its place;
(ii) Strike the phrase “in his or her office or any public school or
institution rendering dental services.” and insert the phrase “in their office or mobile dental clinic
and in any public health setting, including a health care facility, correctional institution,
residential facility, public school, shelter for victims of domestic abuse or runaways, foster
home, nonprofit clinic, and long-term care facility rendering dental services as that term is
defined in section 101(7) of the District of Columbia Long-Term Care Ombudsman Program Act
of 1988, effective March 16, 1989 (D.C. Law 7-218; D.C. Official Code § 7-701.01(7)).” in its
place.
(iii) Strike the phrase “subparagraph (A)(vi)” and insert the phrase
“subparagraph (A)(xiv)” in its place.
(C) Subparagraph (C) is amended to read as follows:
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“(C) For the purposes of this paragraph, the term:
“(i) “Collaborative practice agreement” means a formal agreement
between a licensed dentist and a licensed dental hygienist agreed upon by both parties that
includes, at a minimum, the roles and responsibilities of each party, the ways in which they will
collaborate, and the specific procedures, patient types, and protocols the dental hygienist must
follow when practicing under the agreement.
“(ii) “Dental hygiene diagnosis” means the identification of an
existing oral health problem that a dental hygienist is qualified and licensed to treat within the
scope of the practice and focuses on behavioral risks and physical conditions related to oral
health.
“(iii) “General supervision” means the performance by a dental
hygienist of procedures permitted by subparagraph (A) of this paragraph based on instructions
given by a dentist licensed under this act, but not requiring the physical presence of the dentist
during the performance of these procedures. General supervision in dental clinics and public
health settings shall be pursuant to a collaborative practice agreement, meeting the requirements
set forth by the Mayor through rulemaking, with a dentist licensed under this act that designates
authorization for the services provided by the dental hygienist; provided, that the dental hygienist
has documented completion of a Board-approved course on medical emergencies within each
continuing education cycle.”.
(9) Paragraph (6) is amended as follows:
(A) Subparagraph (A) is amended to read as follows:
“(6)(A) “Practice of nutrition” means the application of the scientific principles
derived from the study of food, nutrition, biochemistry, metabolism, physiology, and behavioral
sciences for achieving and maintaining health throughout the lifespan; the provision of nutrition
care services in-person or via telehealth, including medical nutrition therapy to prevent, manage,
or treat diseases or medical conditions and promote wellness; the ordering of patient di