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1 A BILL
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3 25-545
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5 IN THE COUNCIL OF THE DISTRICT OF COLUMBIA
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10 To amend the District of Columbia Health Occupations Revision Act of 1985 to revise the
11 governing standards of various health occupations regulated in the District, to reorganize
12 and update the composition and jurisdiction of various health occupation boards, and to
13 regulate the practices of medical radiation technology, behavior analysis, school
14 psychology, and general applied psychology; to amend the Department of Health
15 Functions Clarification Act of 2001 to remove the requirement that a dementia training
16 certificate be notarized, repeal certain advisory committees, and create a new Advisory
17 Committee on Medical Radiation Technologists; to amend section 47-2853.76e of the
18 District of Columbia Official Code to allow for ear piercings of minors with a sterilized
19 hollow needle and tattoo services for individuals aged 16 and 17 with written consent
20 from a parent or legal guardian; and to make other conforming and technical
21 amendments.
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23 BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this
24 act may be cited as the “Health Occupations Revision General Amendment Act of 2024”.
25 TITLE I. HEALTH PROFESSIONAL LICENSURE REVISIONS.
26 Sec. 101. The District of Columbia Health Occupations Revision Act of 1985, effective
27 March 25, 1986 (D.C. Law 6-99; D.C. Official Code § 3-1201.01 et seq.), is amended as follows:
28 (a) The table of contents is amended as follows:
29 (1) Title I is amended by adding a designation for a new section 105 to read as
30 follows:
31 “Sec. 105. Telehealth.”.
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32 (2) Title II is amended as follows:
33 (A) The designation for section 203 is amended to read as follows:
34 “Sec. 203. Board of Medicine; Advisory Committees on Anesthesiologist Assistants,
35 Polysomnography, Surgical Assistants, Trauma Technologists, Athletic Trainers, Maternal Care
36 Professionals, and Medical Radiation Technologists.”.
37 (B) The designation for section 208 is amended to read as follows:
38 “Sec. 208. Board of Pharmacy.”
39 (C) Repeal the designations for sections 205 and 217.
40 (D) Add designations for new sections 223 and 224 to read as follows:
41 “Sec. 223. Board of Rehabilitative Therapies.
42 “Sec. 224. Board of Integrative Healthcare.”.
43 (3) Title IV is amended by adding a designation for a new section 413 to read as
44 follows:
45 “Sec. 413. Immunity.”.
46 (4) Title V is amended as follows:
47 (A) Add designations for new sections 511a, 514a, 514b, and 525 to read
48 as follows:
49 “Sec. 511a. Emeritus status.
50 “Sec. 514a. Negotiated settlement agreement.
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51 “Sec. 514b. Disciplinary or adverse action against nursing education or nursing
52 assistive personnel training programs.
53 “Sec. 525. Disciplinary records.”.
54 (B) Repeal the designation for section 513a.
55 (5) Title VI is amended as follows:
56 (A) The designation for Title VI is amended by striking the phrase
57 “PROTOCOL; COLLABORATION.” and inserting the phrase “PROTOCOL.” in its place.
58 (B) Add designations for new sections 605a, 606a, 607a, 607b, and 608a
59 to read as follows:
60 “Sec. 605a. Certified registered nurse anesthetist.
61 “Sec. 606a. Certified nurse-midwife.
62 “Sec. 607a. Certified nurse practitioner.
63 “Sec. 607b. Certified clinical nurse specialist.
64 “Sec. 608a. Qualifications, certification.”.
65 (C) Repeal the designation for section 603.
66 (6) Repeal the designation for Title VII-F.
67 (7) Add a designation for a new Title VII-G to read as follows:
68 “TITLE VII-G.
69 “QUALIFICATIONS FOR LICENSURE TO PRACTICE AS A BEHAVIOR ANALYST
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71 “Sec. 771. Eligibility requirements and education.
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72 (8) Title VIII is amended by adding a designation for a new section 804a to read
73 as follows:
74 “Sec. 804a. Exceptions for non-clinical practice.”.
75 (9) Title VIII-C is amended by repealing the designations for sections 853 and
76 854.
77 (10) Add designations for new Titles VIII-F and VIII-G to read as follows:
78 “Title VIII-F.
79 “CATEGORIES AND QUALIFICATIONS REQUIRED FOR THE PRACTICE OF
80 PSYCHOLOGY
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82 “Sec. 881. License and registration requirements.
83 “Sec. 882. Qualifications.
84 “Sec. 883. Limitations.”.
85 “Title VIII-G.
86 “CATEGORIES AND QUALIFICATIONS REQUIRED FOR THE PRACTICE OF MEDICAL
87 RADIATION
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89 “Sec. 891. Qualifications for licensure.
90 “Sec. 892. Limitations on practice.
91 “Sec. 893. Transition of licensed and registered medical radiation practitioners.”.
92 (11) Title IX is amended as follows:
93 (A) The designation for section 902 is amended to read as follows:
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94 “Sec. 902. Dance Therapy.”
95 (B) The designation for section 907 is amended by striking the period and
96 inserting the phrase “; registration or certification required.” in its place.
97 (C) Repeal the designations for sections 903, 906, 908, and 912.
98 (D) Add a designation for a new section 913 to read as follows:
99 “Sec. 913. Doula.”.
100 (12) The designation for section 1204 is amended by striking the word “therapy”
101 and inserting the word “therapist” in its place.
102 (b) Section 101 (D.C. Official Code § 3-1201.01) is amended as follows:
103 (1) The first paragraph (1) and paragraph (1A) are amended to read as follows:
104 “(1) “Board” means the Board of Dentistry, the Board of Dietetics and Nutrition,
105 the Board of Integrative Healthcare, the Board of Medicine, the Board of Nursing, the Board of
106 Optometry, the Board of Pharmacy, the Board of Podiatry, the Board of Professional Counseling,
107 the Board of Psychology, the Board of Rehabilitative Therapies, the Board of Respiratory Care,
108 the Board of Social Work, or the Board of Veterinary Medicine established by this act, as the
109 context requires.
110 “(1A) “Boards of Allied Health” means the Board of Dentistry, the Board of
111 Dietetics and Nutrition, the Board of Massage Therapy, the Board of Optometry, the Board of
112 Podiatry, the Board of Rehabilitative Therapies, and the Board of Respiratory Care.”.
113 (2) The second paragraph (1) is designated as paragraph (1C).
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114 (3) Paragraphs (1E), (1F), (1G), and (1H) are designated as paragraphs (10A),
115 (10B), (10C), and (10D).
116 (4) Paragraphs (1E), (10A), (10B), (10C), and (3) are repealed.
117 (5) Paragraph (1B) is amended by striking the phrase “means the Board of
118 Marriage and Family Therapy,” and inserting the word “means” in its place.
119 (6) Paragraph (10D) is amended by striking the word “midwife” and inserting the
120 phrase “health professional providing maternal services” in its place.
121 (7) Paragraph (6C) is amended to read as follows:
122 “(6C) “Doula” means an individual certified by the Board of Medicine to provide
123 culturally competent and continuous physical, emotional, and informational support to a birthing
124 parent during pregnancy, labor, birth, and postpartum.”.
125 (8) A new paragraph (6C-i) is added to read as follows:
126 “(6C-i) “Electronic form” means a record created, generated, sent, communicated,
127 received, or stored by electronic means.”.
128 (9) Paragraph (15) is amended to read as follows:
129 “(15) “Suspension” means termination of the right to practice a health profession
130 for a specified period of time or until such time that the specified conditions in an order are
131 satisfied.”.
132 (10) A new paragraph (15A) is added to read as follows:
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133 “(15A) “Telehealth” means the use of synchronous or asynchronous
134 telecommunication technology to provide access to health assessment, diagnosis, intervention,
135 consultation, supervision, and information where the health professional and the patient, client,
136 or supervisee are located at different physical locations.”.
137 (11) Paragraph (16) is amended by striking the period and inserting the phrase
138 “and is licensed to practice veterinary medicine in the District.” in its place.
139 (c) Section 102 (D.C. Official Code § 3-1201.02) is amended as follows:
140 (1) The lead-in language for paragraph (2) is amended to read as follows:
141 “(2) “Practice of advanced practice registered nursing” means the independent
142 performance of advanced-level nursing actions, with or without compensation, by a licensed
143 registered nurse with advanced education, knowledge, skills, and scope of practice who has been
144 certified to perform such actions by a national certifying body acceptable to the Board of
145 Nursing in the appropriate advanced practice registered nursing role and in at least one
146 population focus. Advanced practice registered nursing shall include the categories of certified
147 registered nurse anesthetist, certified nurse-midwife, certified nurse-practitioner, and clinical
148 nurse specialist. The practice of advanced practice registered nursing includes:
149 “(A) Advanced assessment;
150 “(B) Medical diagnosis;
151 “(C) Prescribing;
152 “(D) Selecting, administering, and dispensing therapeutic measures;
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153 “(E) Treating alterations of the health status; and
154 “(F) Carrying out other functions identified in subtitle VI of this title and in
155 accordance with procedures required by this title.”.
156 (2) Paragraph (2A-ii)(C)(iii) is repealed.
157 (3) Paragraph (2B)(A) is amended to read as follows:
158 “(2B)(A) “Practice of audiology” means the planning, directing, supervising, and
159 conducting of habilitative or rehabilitative counseling programs for individuals or groups of
160 individuals who have, or are suspected of having, disorders of hearing or balance; any service in
161 audiology, including prevention, identification, evaluation, consultation, habilitation or
162 rehabilitation, academic instruction, clinical instruction, and research; participating in hearing
163 conservation, hearing aid and assistive listening device evaluation, selection, preparation,
164 dispensing, and orientation; fabricating ear molds; cerumen management; interoperative
165 neurophysiologic monitoring; providing auditory training and speech reading; administering tests
166 of vestibular function or tinnitus; or speech and language screening limited to a pass-or-fail
167 determination for the purpose of identification of individuals with disorders of communication
168 and associated referral for management of communication and balance disorders, or cognitive,
169 dexterity, depression, or vision screening, and associated referral for management of related
170 disorders. The practice of audiology does not include the practice of medicine or osteopathic
171 medicine, or the performance of a task in the normal practice of medicine or osteopathic
172 medicine by a person to whom the task is delegated by a licensed physician.”.
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173 (4) The existing paragraph (2C-i) is redesignated as paragraph (2C-ii).
174 (5) A new paragraph (2C-i) is added to read as follows:
175 “(2C-i) “Practice of behavior analysis” means the design, implementation, and
176 evaluation of environmental modifications to produce socially significant improvement in human
177 behavior, including the use of direct observation, measurement, and functional analysis of the
178 relationship between environment and behavior.”.
179 (6) Paragraph (3)(A) is amended to read as follows:
180 “(3)(A) “Practice of chiropractic” means practicing a primary care health
181 discipline through the evaluation, examination, diagnosis, counseling, and treatment or
182 management of biomechanical or physiological conditions or disorders that compromise neural
183 integrity or organ system function; the use of x-rays and advanced diagnostic imaging, physical
184 examination, and examination by instrumentation for the detection and correction of
185 subluxations and somatic dysfunctions that cause vertebral, neuromuscular, or skeletal disorder;
186 the adjustment of the spine or manipulation of bodily articulations for the restoration and
187 maintenance of health; and the referral of a patient for diagnostic imaging, tests, and clinical
188 laboratory procedures in order to determine a regimen of chiropractic care or to form a basis or
189 referral of patients to other licensed health care professionals. The practice of chiropractic does
190 not include the use of drugs or surgery but may include ancillary procedures such as dry needling
191 in accordance with the rules and requirements promulgated by the Mayor.”.
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192 (7) Paragraph (3A) is amended by striking the phrase “or cells desquamated from
193 a body surface or lesion” and inserting the phrase “cells desquamated from a body surface or
194 lesion, or cells aspirated from a lesion” in its place.
195 (8) Paragraph (4) is amended as follows:
196 (A) Subparagraph (A) is amended to read as follows:
197 “(4)(A) “Practice of dental hygiene” means the performance of any of the
198 following activities in accordance with the provisions of subparagraph (B) of this paragraph:
199 “(i) A preliminary dental examination, including charting of
200 cavities, soft tissue examination, periodontal examination, and oral cancer screening; a complete
201 prophylaxis, including the removal of any deposit, accretion, or stain from the surface of a tooth
202 or a restoration; debridement; scaling and root planing; soft tissue curettage; application of
203 topical fluoride and fluoride varnish; and the polishing of a tooth or a restoration;
204 “(ii) Applying a medicinal agent to a tooth for a prophylactic
205 purpose;
206 “(iii) Taking dental radiographs;
207 “(iv) Instructing individuals or groups of individuals in oral health
208 care;
209 “(v) Administering local anesthesia and nitrous oxide when
210 certified by the Board of Dentistry to do so;”
211 “(vi) Applying pit and fissure sealants;
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212 “(vii) Placing and removing periodontal dressings;
213 “(viii) Administering vaccinations under the direct supervision of a
214 dentist licensed under this act when certified by the Board of Dentistry to do so;
215 “(ix) Prescribing topical prescription or over-the-counter fluoride
216 preparations and topical antimicrobial oral rinses, under the general supervision of a dentist
217 licensed under this act;
218 “(x) Performing blood glucose testing;
219 “(xi) Placing or removing temporary restorations and crowns;
220 “(xii) Taking study cast impressions;
221 “(xiii) Removing sutures; and
222 “(xiv) Any other functions included in the curricula of approved
223 educational programs in dental hygiene, including dental hygiene diagnosis.”.
224 (B) Subparagraph (B) is amended as follows:
225 (i) Strike the phrase “A dental hygienist may perform” and insert
226 the phrase “Except for administering vaccinations, a dental hygienist may perform” in its place;
227 (ii) Strike the phrase “in his or her office or any public school or
228 institution rendering dental services.” and insert the phrase “in their office or mobile dental clinic
229 and in any public health setting, including a health care facility, correctional institution,
230 residential facility, public school, shelter for victims of domestic abuse or runaways, foster
231 home, nonprofit clinic, and long-term care facility rendering dental services as that term is
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232 defined in section 101(7) of the District of Columbia Long-Term Care Ombudsman Program Act
233 of 1988, effective March 16, 1989 (D.C. Law 7-218; D.C. Official Code § 7-701.01(7)).” in its
234 place.
235 (iii) Strike the phrase “subparagraph (A)(vi)” and insert the phrase
236 “subparagraph (A)(xiv)” in its place.
237 (C) Subparagraph (C) is amended to read as follows:
238