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As Introduced
136th
General Assembly
Regular
Session
S. B. No. 226
2025-2026
Senator Gavarone
To
amend section 4731.33 and to enact section 4731.331 of the Revised
Code
regarding
the application of light-based medical devices for the purpose of
hair removal.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section
1.
That
section 4731.33 be amended and section 4731.331 of the Revised Code
be enacted to read as follows:
Sec.
4731.33.
(A)
As used in this section
and section 4731.331 of the Revised Code
:
(1)
"Laser hair removal professional" means an individual who
applies a light-based medical device to a patient for the purpose of
hair removal and who meets either of the criteria described in
division (B)(3)(b) of this section.
(2)
"Light-based
medical device" means any device that can be made to produce or
amplify electromagnetic radiation at wavelengths equal to or greater
than one hundred eighty nm but less than or equal to
1.0
X 106
one
thousand sixty-four
nm
and that is manufactured, designed, intended, or promoted for
irradiation of any part of the human body for the purpose of
affecting the structure or function of the body.
(3)
"Nurse" means a registered nurse or licensed practical
nurse, each as defined in section 4723.01 of the Revised Code. A
"nurse" does not include a registered nurse who is also an
advanced practice registered nurse, as defined in section 4723.01 of
the Revised Code.
(2)
(4)
"Physician" means
a
person
an
individual
authorized
to practice medicine and surgery, osteopathic medicine and surgery,
or podiatric medicine and surgery under this chapter.
(3)
(5)
"On-site supervision" means the supervising physician is
physically in the same location as the delegate during the use of a
light-based medical device, but does not require the physician to be
in the same room. "On-site supervision" includes the
supervising physician's presence in the same office suite as the
delegate during the use of the device.
(4)
(6)
"Off-site supervision" means the supervising physician is
continuously available for direct communication with the
cosmetic
therapist
delegate
during
the use of a light-based medical device.
(5)
(7)
"Direct physical oversight" means the supervising physician
is in the same room directly observing the delegate's use of the
light-based medical device.
(B)
A physician may delegate the application of light-based medical
devices for the purpose of hair removal only if all of the following
conditions are met:
(1)
The light-based medical device has been specifically cleared or
approved by the United States food and drug administration for the
removal of hair from the human body.
(2)
The use of the light-based medical device for the purpose of hair
removal is within the physician's normal course of practice and
expertise.
(3)
The physician has seen and evaluated the patient to determine whether
the proposed application of the specific light-based medical device
is appropriate.
(4)
The physician has seen and evaluated the patient following the
initial application of the specific light-based medical device, but
before any continuation of treatment, to determine that the patient
responded well to that initial application of the specific
light-based medical device.
(5)
The
person
to whom the delegation is made
delegate
is
one of the following:
(a)
A physician assistant licensed under Chapter 4730. of the Revised
Code with whom the physician has an effective supervision agreement;
(b)
A
person
laser
hair removal professional who is either of the following:
(i)
An individual
who
was
licensed
held
a license
as
a cosmetic therapist under Chapter 4731. of the Revised Code on April
11, 2021;
(c)
A person
(ii)
An individual
who
has completed a cosmetic therapy course of instruction for a minimum
of seven hundred fifty clock hours and received a passing score on
the certified laser hair removal professional examination
administered by the society for clinical and medical hair removal;
(d)
(c)
A
registered
nurse
or licensed practical nurse licensed under Chapter 4723. of the
Revised Code
.
(C)
For delegation to a physician assistant, the delegation must meet the
requirements of section 4730.21 of the Revised Code.
(D)(1)
(D)
For delegation to a
person
described under division (B)(5)(b) or (c) of this section
laser
hair removal professional
,
all
of
the
following
criteria must be met:
(1)
The delegating
physician
shall ensure that the
person
to whom the delegation is made
laser
hair removal professional
has
received adequate education and training to provide the level of
skill and care necessary, including all of the following:
(a)
The
person
laser
hair removal professional
has
completed eight hours of basic education that includes the following
topics:
(i)
Light-based procedure physics;
(ii)
Tissue interaction in light-based procedures;
(iii)
Light-based procedure safety, including use of proper safety
equipment;
(iv)
Clinical application of light-based procedures;
(v)
Preoperative and postoperative care of light-based procedure
patients;
(vi)
Reporting of adverse events.
(b)
The
person
laser
hair removal professional
has
observed fifteen procedures for each specific type of light-based
medical device procedure for hair removal that the
person
laser
hair removal professional
will
perform under the delegation.
For
purposes of this division, the procedures observed shall be performed
by a physician who uses the specific light-based medical device
procedure for hair removal in the physician's normal course of
practice and expertise.
(c)
The
person
laser
hair removal professional
shall
perform
has
performed
at
least twenty procedures under the direct physical oversight of the
physician on each specific type of light-based medical device
procedure for hair removal delegated.
For
purposes of this division, the physician overseeing the performance
of these procedures shall use this specific light-based medical
device procedure for hair removal within the physician's normal
course of practice and expertise.
(2)
For
purposes of division (D)(1)(b) of this section, the procedures
observed shall be performed by a physician who uses the specific
light-based medical device procedure for hair removal in the
physician's normal course of practice and expertise.
The
delegating physician shall see and evaluate the patient before the
use of the light-based medical device on the patient to determine
whether the proposed application of the specific light-based medical
device is appropriate.
(3)
For
purposes of division (D)(1)(c) of this section, the physician
overseeing the performance of these procedures shall use this
specific light-based medical device procedure for hair removal within
the physician's normal course of practice and expertise.
The
delegating physician shall see and evaluate the patient following the
initial application of the specific light-based medical device, but
before any continuation of treatment, to determine that the patient
responded well to that initial application of the specific
light-based medical device.
(4)
Each delegating physician and
delegate
laser
hair removal professional
shall
document and retain satisfactory completion of training required
under division (D) of this section. The education requirement in
division (D)(1)(a) of this section shall be completed only once by
the
delegate
laser
hair removal professional
regardless
of the number of types of specific light-based medical device
procedures for hair removal delegated and the number of delegating
physicians. The training requirements of divisions (D)(1)(b) and (c)
of this section shall be completed by the
delegate
laser
hair removal professional
once
for each specific type of light-based medical device procedure for
hair removal delegated regardless of the number of delegating
physicians.
(E)
The following
delegates
laser
hair removal professionals
are
exempt from the education and training requirements of division
(D)(1) of this section:
(1)
A
person
An
individual
who,
before
the
effective date of this section
September
30, 2021
,
has been applying a light-based medical device for hair removal for
at least two years through a lawful delegation by a physician;
(2)
A
person
An
individual
described
under division
(B)(5)(b)
(B)(3)(b)(i)
of this section if the
person
individual
was
authorized to use a light-based medical device under the cosmetic
therapist license
;
(3)
A person described in division (B)(5)(a) or (d) of this section
.
(F)
(F)(1)
For delegation to a
person
under division (B)(5)(b), (c), or (d) of this section
laser
hair removal professional
,
the
delegating
physician
shall provide on-site supervision at all times that the
person
to whom the delegation is made
laser
hair removal professional
is
applying the light-based medical device.
A
physician shall not supervise more than two delegates under division
(B)(5)(b), (c), or (d) of this section at the same time.
(G)(1)
(2)
Notwithstanding division
(F)
(F)(1)
of this section, a
delegating
physician may provide off-site supervision
of
a laser hair removal professional
when
the light-based medical device is applied for the purpose of hair
removal to an established patient if the
person
to whom the delegation is made is a cosmetic therapist who
laser
hair removal professional
meets
all
of
each
of
the
following criteria:
(a)
The
cosmetic
therapist
laser
hair removal professional
has
successfully completed a course in the use of light-based medical
devices for the purpose of hair removal that has been approved by the
delegating physician
;
(b)
The
and the
course
consisted of at least fifty hours of training, at least thirty hours
of which was clinical experience;
(c)
(b)
The
cosmetic
therapist
laser
hair removal professional
has
worked under the on-site supervision of the delegating physician for
a sufficient period of time that the physician is satisfied that the
cosmetic
therapist
laser
hair removal professional
is
capable of competently performing the service with off-site
supervision.
(2)
The
cosmetic
therapist
laser
hair removal professional
shall
maintain documentation of the successful completion of the required
training.
(3)
When providing supervision under division (F)(1) or (2) of this
section, a physician shall supervise not more than five laser hair
removal professionals at the same time.
(H)
(G)(1)
For delegation to a nurse, the delegating physician shall provide
on-site supervision at all times that the nurse is applying the
light-based medical device.
(2)
Notwithstanding division (G)(1) of this section, a physician may
provide off-site supervision of a nurse applying a light-based
medical device to a patient for the purpose of hair removal if the
nurse has completed a training and education program on the use of
light-based medical devices for the purpose of hair removal that has
been approved by the delegating physician. An approved training and
education program shall satisfy both of the following criteria:
(a)
The program may be completed internally at the laser hair removal
facility or externally through a third-party provider, provided the
third-party program is overseen by a physician.
(b)
The program includes forty total hours of training, which may be a
combination of didactic training, in-person hands-on training, and
performance of laser hair removal procedures.
The
nurse shall maintain documentation of the successful completion of
the required training.
(3)
When providing supervision under division (G)(1) or (2) of this
section, the physician shall supervise not more than five nurses at
the same time.
(H)
A
delegate under this section shall immediately report to the
supervising physician any clinically significant side effect
following the application of the light-based medical device or any
failure of the treatment to progress as was expected at the time the
delegation was made. The physician shall
see
and personally
evaluate
the patient who has experienced the clinically significant side
effect or whose treatment is not progressing as expected as soon as
practicable.
(I)
No physician shall fail to comply with division
(A),
(B),
(F),
(G),
or (H) of this section. A violation of this division constitutes a
departure from, or the failure to conform to, minimal standards of
care of similar practitioners under the same or similar
circumstances, whether or not actual injury to a patient is
established, under division (B)(6) of section 4731.22 of the Revised
Code.
(J)
No physician shall delegate the application of light-based medical
devices for the purpose of hair removal to
a
person
an
individual
who
is not listed in division
(B)(5)
(B)(3)
of this section. A violation of this division constitutes violating
or attempting to violate, directly or indirectly, or assisting in or
abetting the violation of, or conspiring to violate section 4731.41
of the Revised Code for purposes of division (B)(20) of section
4731.22 of the Revised Code.
(K)
No
cosmetic
therapist to whom a delegation is made under division (B)(5)(b) or
(c) of this section
laser
hair removal professional
shall
fail to comply with division
(G)
(F)
or (H) of this section. A violation of this division constitutes the
unauthorized practice of medicine pursuant to section 4731.41 of the
Revised Code.
(L)
No nurse shall fail to comply with division (G) or (H) of this
section. A violation of this division constitutes a failure to
practice in accordance with acceptable and prevailing standards of
safe nursing care, regardless of whether actual injury to a patient
is established, for purposes of division (B)(19) of section 4723.28
of the Revised Code.
(M)
No physician assistant shall fail to comply with division (H) of this
section. A violation of this division constitutes a departure from,
or failure to conform to, minimal standards of care of similar
physician assistants under the same or similar circumstances,
regardless of whether actual injury to patient is established, for
purposes of division (B)(19) of section 4730.25 of the Revised Code.
Sec.
4731.331.
(A)
As used in this section, "standard care arrangement" has
the same meaning as in section 4723.01 of the Revised Code.
(B)
With respect to a light-based medical device applied to a patient for
the purpose of hair removal, an advanced practice registered nurse or
physician assistant may do both of the following:
(1)
Delegate to a nurse or laser hair removal professional the
application of the light-based medical device to the patient;
(2)
Supervise the nurse's or laser hair removal professional's
application of the light-based medical device to the patient.
(C)(1)
An advanced practice registered nurse may take the actions described
in division (B) of this section only if the actions are not
prohibited by the advanced practice registered nurse's standard care
arrangement.
(2)
A physician assistant may take the actions described in division (B)
of this section only if the physician assistant satisfies the
requirements of divisions (B)(3)(a) and (D) of section 4731.33 of the
Revised Code.
(3)
In delegating to and supervising a nurse or laser hair removal
professional under this section, an advanced practice registered
nurse and physician assistant shall act in the same manner and be
subject to the same conditions and requirements as a physician under
section 4731.33 of the Revised Code.
(D)
To be eligible to apply a light-based medical device under this
section, a nurse or laser hair removal professional shall satisfy the
same criteria for delegation and supervision described in section
4731.33 of the Revised Code.
Section
2.
That
existing section 4731.33 of the Revised Code is hereby repealed.