Ala. Admin. Code r. 540-X-11-.02 - Definitions

For the purpose of these rules, the following definitions will apply:

(1) Ablative Treatment-Ablative treatment shall include any laser device, any energy-based device, any chemical, mechanical resection devices, or any modality that is expected or intended to remove, burn, or vaporize tissue extending below the dermal-epidermal junction, as well as any modality that causes coagulation necrosis or pure ablation at or below the dermal-epidermal junction.

(2) Direct Physician Supervision - Direct physician supervision shall mean that the physician is in the physical presence of the patient being treated and is directly observing the use of the modality by a delegate.

(3) Energy Source - any therapeutic source which can affect or change living tissue, including varying levels of ability to cause trauma and/or scarring.

(4) LLBD - Lasers and Light/Energy-Based Devices - lasers/ pulsed light devices, or any energy source, chemical, or other modality that affects living tissue (when referring to the skin, anything below the stratum corneum), whether applied for surgical, therapeutic, or cosmetic purposes.

(5) Level 1 Delegate -A Level 1 Delegate is an assistant to physicians (PA) as defined in Ala. Code § 34-24-290, a certified registered nurse practitioner, or registered nurse (RN) authorized in a written job description or protocol to use a specific laser/pulsed light device or other energy source, chemical or other modality for non-ablative procedures, as designated in the written job description or protocol, and who has met the educational requirements for a Level 1 Delegate stated in these rules.

(6) Level 2 Delegate - A Level 2 Delegate is a licensed practicing nurse (LPN) or medical assistant to include aestheticians, cosmetologists, and laser technicians authorized in a written job description or protocol to use a specific laser/pulsed light device or other energy source, chemical or other modality for non-ablative procedures, as designated in the written job description or protocol, and who has met the educational requirements for a Level 2 Delegate as stated in these rules.

(7) Non-ablative Treatment - Non-ablative treatment shall include any laser/intense pulsed light treatment or other energy source, chemical or modality that, although not expected or intended to remove, burn, or vaporize tissue, is intended to cause controlled heat-induced thermal change/ injury to produce a result. This shall include treatments related to laser hair removal and other devices defined in these rules.

(8) On-Site Supervision - On-site supervision shall mean continuous supervision in which the supervising physician is physically present in the same building as the appropriate, properly trained Legal 1 or 2 Delegate who is using an LLBD. All treatments and procedures must be performed under the physician's direction and immediate personal supervision, and the physician must be immediately available at all times that the Level 1 or 2 Delegate is on duty. The physician retains full responsibility to patients and the Board for the manner and results of all services rendered.

(9) Locally Remote Supervision - Locally remote supervision shall mean the geographic physical proximity of a delegating physician to a Level 1 Delegate who is performing a non-ablative procedure who is not providing on-site supervision but who is readily available for consultation, evaluation, referral, or direct medical intervention in person or by telemedicine. A locally remote physician's geographic physical proximity from the patient's treatment site must not exceed the usual and customary response time of emergency management services for the locality. Locally remote supervision may only be provided by American Board of Medical Specialties or American Osteopathic Association board-certified physicians who have completed post-graduate training in lasers, light-based devices, chemical peels, and any other modality that may be used to perform ablative treatment.

(10) Physician - A physician licensed by the Medical Licensure Commission of the State of Alabama.

Notes

Ala. Admin. Code r. 540-X-11-.02

New Rule: Filed August 16, 2007; effective September 20, 2007. Amended by Alabama Administrative Monthly Volume XLI, Issue No. 08, May 31, 2023, eff. 7/15/2023.

Author: Alabama Board of Medical Examiners

Statutory Authority: Code of Ala. 1975, §§ 34-24-50, 34-24-51, 34-24-53.