Chapter 7A. Functions of the Department of Health.
Subchapter I. General Powers, Fees, and Funds.
§ 7–731. Exclusive agency powers.
(a) Notwithstanding the licensing powers and responsibilities given to other District of Columbia agencies and officials in subchapters I-A and I-B of Chapter 28 of Title 47 of the District of Columbia Code, the Department of Health, as established by Reorganization Plan No. 4 of 1996, effective July 17, 1996 (part A of subchapter XIV of Chapter 15 of Title 1), shall be the exclusive agency to:
(1) Regulate allied health care professionals and social service professionals;
(2) Regulate occupational and professional conduct and standards for health care and social service professionals, including investigating, licensing, and enforcing applicable laws and regulations;
(3) Regulate actions that affect the physical environment and ensure compliance with applicable federal and District laws and rules that govern the uses and practices that affect the physical environment, including air resources management, water resources management, stormwater management, soil resources management, hazardous waste, pesticides, lead poison program implementation, asbestos program management, underground storage tank regulation, aquatic and wildlife resources management, medical waste management, low-level radioactive waste control, and toxic chemical control;
(4) Regulate health care facilities and social service facilities;
(5) Regulate food service establishments, including, but not limited to, retailers and wholesalers of food and food products, grocery stores, restaurants, food vendors, dairies, patent medicine outlets, ice cream manufacturers, candy manufacturers, bottling establishments, wholesale and retail seafood dealers, delicatessens, and bakeries;
(5A) Regulate food labeling, pursuant to § 48-303;
(6) Regulate pharmacies and pharmacy personnel;
(7) Determine which drugs and other substances shall be classified as controlled substances, and identify persons and facilities that handle, manage, distribute, dispense, and conduct research with controlled substances;
(8) Regulate radiological and medical devices;
(9) Regulate the manufacture, distribution, and dispensing of controlled substances;
(10) Regulate the operation of barber shops, beauty salons, and body art establishments;
(11) Regulate swimming pools;
(12) Regulate massage and health spa establishments;
(13) Regulate animal disease control and rodent control; and
(14) Perform any other functions expressly described in Reorganization Plan No. 4 of 1996, as construed in light of all documents formally made a part of Reorganization Plan No. 4 of 1996 pursuant to § 1-315.05.
(a-1)(1) The Department of Health shall conduct a minimum of 3 inspections per year of the environmental conditions at the Central Detention Facility, Correctional Treatment Facility, and Central Cell Block. For the purposes of this subsection, the term “environmental conditions” shall include temperature control, ventilation, and sanitation.
(2) The Department of Health shall submit the report of each inspection conducted pursuant to paragraph (1) of this subsection to the Council and the Mayor within 30 days of the inspection.
(b) For the purpose of this section, the term “regulate” shall include all licensing, certification, investigation, inspection, permitting, registration, and enforcement functions, including the issuance of civil infractions, except that the Department of Consumer and Regulatory Affairs shall continue to issue licenses for businesses engaged in functions as set forth in subsection (a)(3), (a)(5), (a)(10), (a)(11), and (a)(12) of this section.
(c) The Mayor shall establish fees to implement this section. All fines and fees collected pursuant to this section shall be deposited as nonlapsing funds in the Department of Health Regulatory Enforcement Fund to the credit of the administration within the Department of Health responsible for collecting the fees to support the activities of those programs, except that fines and fees collected pursuant to Chapter 21 of Title 8 shall be deposited in the Rodent Control Fund. After September 30, 2002, fines and fees generated through rodent control activities shall be deposited in the Department of Health Regulatory Enforcement Fund.
(d) Notwithstanding any provision in this section or any other District law, the Mayor may regulate the manufacture, cultivation, distribution, dispensing, possession, and administration of medical marijuana as authorized in Chapter 16B of this title.
§ 7–731.01. Health data collection and reporting.
(a)(1) The Department of Health ("Department") shall participate in the Behavioral Risk Factor Surveillance System ("BRFSS").
(2) The Department shall annually publish a detailed report on the results of the BRFSS on its website.
(3) The Department shall include questions related to the sexual orientation, gender identity, and gender expression of respondents in its BRFSS questionnaire.
(A) The Department shall give preference to any modules or questions approved by the U.S. Centers for Disease Control and Prevention.
(B) The Department may develop its own questions related to the sexual orientation, gender identity, or gender expression of respondents to add to the BRFSS.
(4) Not Funded.
(b)(1) The Department shall annually publish a comprehensive report on the health of the District's LGBTQ community in coordination with the Office of Gay, Lesbian, Bisexual, and Transgender Affairs, pursuant to § 2-1383(b)(10).
(2) At least every 3 years, the comprehensive report shall include data collected from the BRFSS.
(3) Each report shall compare the prevalence of health-related risk behaviors, chronic health conditions, and use of preventive services among the LGBTQ population with the general population, and where possible, LGBTQ sub-populations.
(4) The Department shall post the report on its website.
(c) For the purposes of this section:
(1) "Behavioral Risk Factor Surveillance System" means the national telephone survey conducted by state health departments and coordinated by the U.S. Centers for Disease Control and Prevention to collect state data about residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services, or a similar successor survey.
(2) "LGBTQ" shall have the same meaning as provided in § 2-1381.
§ 7–732. Regulatory Enforcement Fund. [Repealed]
Repealed.
§ 7–733. Health Occupations Regulation Fund.
(a) There is established as a nonlapsing, revolving fund in the Department of Health the Health Occupations Regulation Fund (“Fund”), to be administered by the Mayor as an agency fund as defined in § 47-373(2)(I), to which all licensing fees, civil fines, and interest relating to the practice of health occupations in the District of Columbia shall be deposited and credited; except, that the Master License Fee collected by the Department of Consumer and Regulatory Affairs for the activities described in § 7-731 shall be deposited into the Master Business License Fund established by § 47-2851.13, to the credit of the Department of Consumer and Regulatory Affairs.
(b) Revenues deposited into the Fund shall not revert to the General Fund at the end of any fiscal year or at any other time, but shall be continually available to the Department of Health for the uses and purposes set forth in subsection (c) of this section, subject to authorization by Congress in an appropriations act.
(c) Subject to the applicable laws relating to the appropriation of District of Columbia funds, monies received by and deposited in the Health Occupations Regulation Fund shall be for the sole use of the boards established pursuant to Chapter 12 of Title 3, and from it shall be paid all salaries and all other expenses necessary in carrying out the duties of the boards. The Mayor shall be responsible for the deposit and expenditure of these monies.
(d) The Mayor shall submit to the Council, as a part of the annual budget, a requested appropriation for expenditures from the Health Occupations Regulation Fund. The Mayor’s budget request shall be based on an estimated projection of the expenditures necessary to perform the administrative and regulatory functions of the boards established pursuant to Chapter 12 of Title 3.
§ 7–733.01. Deposit of fees.
(a) Beginning with fiscal year 2007, the Mayor shall ensure that all fees and fines received from enforcement and regulation of the activities described in § 7-731 shall be deposited in the Regulatory Enforcement Fund as required by § 7-731(c).
(b) Beginning with fiscal year 2007, the Mayor shall ensure that all licensing fees, civil fines, and interest relating to the practice of health occupations in the District shall be deposited in the Health Occupations Regulations Fund as required by § 7-732 [repealed].
§ 7–733.02. Board of Pharmacy Fund.
(a)(1) There is established, as a nonlapsing fund in the Department of Health, the Board of Pharmacy Fund (“Fund”), to be administered by the Mayor as an agency fund, as defined in § 47-373(2)(I), into which all licensing fees, civil fines, and interest earned relating to the practice of pharmaceutical detailing, and any other funds, as directed by law, shall be deposited and used for the administration of the Board of Pharmacy.
(2) For the purposes of this subsection, the term “practice of pharmaceutical detailing” shall have the same meaning as provided in § 3-1201.02(11A).
(b) All funds deposited into the Fund shall not revert to the unrestricted fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time, but shall be continually available to the Department of Health for the uses and purposes set forth in subsection (a) of this section, subject to authorization by Congress.
§ 7–734. Public Health Laboratory fees.
The Mayor is authorized to establish a schedule of fees for forms and for performing laboratory analysis of biological and environmental samples obtained from humans, animals, or various environmental media for the purpose of identifying environmental contaminants and performing epidemiological surveillance, including for cases of lead poisoning, tuberculosis, rabies, and sexually transmitted diseases. The schedule of fees may account for the provision of bulk services and may distinguish between services provided to individuals and organizations. The schedule of fees may be developed on a sliding scale based on a person’s or organization’s ability to pay for laboratory analysis, or may be waived in cases of extreme need.
§ 7–735. Public Health Laboratory Fund. [Repealed]
Repealed.
§ 7–736. Disbursements from the Laboratory Fund. [Repealed]
Repealed.
§ 7–736.01. Grant authority.
(a) For fiscal year 2010, the Director of the Department of Health shall have the authority to issue grants to qualified community organizations for the purposes of conducting health promotion, preventing disease, and providing health services; provided, that any grant in excess of $250,000 shall be awarded through a competitive process unless otherwise authorized under law.
(b) The Department of Health shall submit a quarterly report to the Council on all grants issued pursuant to the authority granted in subsection (a) of this section.
(c) For fiscal year 2014, the Director of the Department of Health shall have the authority to issue grants to:
(1) Qualified community organizations for the purpose of providing the following services:
(A) Ambulatory health services for an amount not to exceed $3,236,980;
(B) Poison control hotline and prevention education services for an amount not to exceed $350,000;
(C) Operations and primary care services for school-based health clinics for an amount not to exceed $2,250,000; and
(D) Clinical nutritional home delivery services for individuals living with cancer and other life-threatening diseases; and
(2) Organizations for the purpose of providing the following programs and services:
(A) A teen pregnancy prevention program for an amount not to exceed $400,000;
(B) Programs designed to promote healthy development in girls attending public and chartered schools in grades 9 through 12 located in areas of the city possessing the highest rates of teen pregnancy and highest enrollment in state-funded health programs in the District of Columbia, not to exceed $400,000;
(C) Farmers market incentive programs, not to exceed $200,000;
(D) Food-pantry services, not to exceed $52,000;
(E) Wildlife rehabilitation services, not to exceed $250,000;
(F) Mother-to-child (vertical) HIV transmission programs and services, not to exceed $50,000; and
(G) Nonprofit organizations dedicated to preventing any of the following chronic diseases, not to exceed $850,000:
(i) Asthma;
(ii) Cancer;
(iii) Diabetes;
(iv) Hypertension;
(v) Kidney disease; and
(vi) Obesity.
(d)(1) All grants issued pursuant to subsection (c) of this section shall be administered pursuant to the requirements set forth in part B of subchapter XII-A of Chapter 3 of Title 1 [§ 1-328.11 et seq.].
(2) The Department of Health shall submit a quarterly report to the Secretary to the Council on all grants issued pursuant to the authority granted in subsection (c) of this section and any grant in excess of $250,000 shall be awarded through a competitive process unless otherwise authorized by law.
(e)(1) Through Fiscal Year 2015, the Director of the Department of Health may issue grants totaling $ 1,550,000 to District of Columbia HIV prevention programs for a combination of HIV prevention interventions. These interventions shall include HIV screening in clinical and non-clinical settings and effective behavioral programs.
(2) Through Fiscal Year 2015, the Director of the Department of Health may issue HIV prevention grants for a combination of HIV prevention interventions that include:
(A) HIV screening;
(B) Harm reduction;
(C) Social network HIV screening;
(D) Partner services;
(E) Faith-based initiatives;
(F) Youth peer education; and
(G) Other health-education services for adolescents and older adults.
(3) For the purposes of this subsection, the term “faith-based initiative” means a program to encourage and support places of worship in delivering HIV prevention messages that promote safe-sex practices, educate people about HIV, and promote HIV screening.
(4) In Fiscal Year 2015, the Director of the Department of Health shall issue a competitive grant totaling $480,000 to a qualified community-based nonprofit corporation or organization for the creation of a comprehensive concussion care protocol for children.
(f) For Fiscal Year 2015, the Director of the Department of Health may issue grants to qualified community organizations to provide:
(1) Clinical nutritional home delivery services for individuals living with cancer and other life-threatening diseases;
(2) Ambulatory health services;
(3) Poison control hotline and prevention education services;
(4) Operations and primary care services for school-based health clinics; and
(5) A teen pregnancy prevention program.
(g)(1) All grants issued pursuant to subsections (e) and (f) of this section shall be administered pursuant to the requirements set forth in part B of subchapter XII-A of Chapter 3 of Title 1 [§ 1-328.11 et seq.].
(2) The Department of Health shall submit a quarterly report to the Secretary to the Council on all grants issued pursuant to the authority granted in subsections (e) and (f) of this section.
(h)(1) For Fiscal Year 2016, the Director of the Department of Health shall have the authority to issue grants to qualified community organizations for the purpose of providing the following services:
(A) Programs designed to promote healthy development in girls attending public and chartered schools in grades 8-12 located in areas of the city possessing the highest rates of teen pregnancy and highest enrollment in state-funded health programs in the District, not to exceed $569,000;
(B) Clinical nutritional home delivery services for individuals living with cancer and other life-threatening diseases, not to exceed $150,000; and
(C) Programs designed to support teen peer educators who work to provide sexual health information and condoms to youth, not to exceed $157,000.
(2) All grants issued pursuant to paragraph (1) of this subsection shall be administered pursuant to the requirements set forth in part B of subchapter XII-A of Chapter 3 of Title 1 [§ 1-328.11 et seq.].
(3) The Department of Health shall submit a quarterly report to the Secretary to the Council on all grants issued pursuant to the authority granted in paragraph (1) of this subsection.
(i) For Fiscal Year 2017, the Director of the Department of Health shall have the authority to issue grants to qualified community organizations for the purpose of providing the following services:
(1) Programs designed to improve food access:
(A) Through mobile, vehicle-based farm stands that operate at regularly scheduled stops, provide recipes and cooking demonstrations, and distribute locally produced food to communities in underserved communities, not to exceed $50,000; and
(B) By delivering fresh produce to small retailers and corner store owners that operate in underserved communities, not to exceed $250,000;
(2) A Farmers Market Subsidy program aimed at establishing healthy dietary habits, providing incentives for farmers to locate in low-income communities, and reducing chronic illness in District residents by providing monetary assistance for the purchase of fresh fruits and vegetables to those receiving federal assistance, not to exceed $1,200,000;
(3) Programs designed to support teen peer educators who work to provide sexual health information and condoms to youth, not to exceed $150,000; and
(4) Programs designed to promote healthy development in girls attending public and chartered schools in grades 8-12 located in areas of the city possessing the highest rates of teen pregnancy and highest enrollment in state-funded health programs in the District, not to exceed $500,000.
(j) For Fiscal Year 2017, the Director of the Department of Health shall issue grants totaling $100,000 to nonprofit pediatric dental clinics to provide oral health literacy and awareness programming.
(k)(1) All grants issued pursuant to subsections (i) and (j) of this section shall be administered pursuant to the requirements set forth in part B of subchapter XII-A of Chapter 3 of Title 1.
(2) The Department of Health shall submit a quarterly report to the Secretary to the Council on all grants issued pursuant to the authority granted in subsections (i) and (j) of this section.
(l)(1) For Fiscal Year 2021, the Director of the Department of Health shall have the authority to award one or more competitive grants in an amount not to exceed $250,000 to fund an initiative to connect prenatal care for residents in Wards 7 and 8 to labor and delivery options in other parts of the District.
(2) In establishing the criteria for the award of grants pursuant to paragraph (1) of this subsection, the Department shall prioritize community-based initiatives that:
(A) Offer peer support networks;
(B) Provide co-management of the patient's treatment;
(C) Arrange for access to maternal and fetal medicine specialty services;
(D) Utilize a health information exchange; and
(E) Furnish financial assistance with transportation needs.
(m)(1) For Fiscal Year 2025, the Director of the Department of Health shall issue one or more grants totaling $300,000 to non-governmental entities to provide childcare to pregnant and birthing parents or legal guardians who are receiving urgent treatment related to pregnancy at a hospital or birthing facility in the District.
(2)(A) For childcare lasting 5 hours or less, the grantee shall provide on-site childcare.
(B) For childcare lasting for more than 5 hours, the grantee may transfer the child to a childcare facility; provided, that the Department of Health and the parents or legal guardians of the child are notified of the transfer and the identity and location of the childcare facility.
(3) For the purposes of this subsection:
(A) "On-site childcare" means childcare provided at the same hospital or birthing facility where the parent or legal guardian is receiving urgent treatment related to pregnancy.
(B) "Urgent treatment related to pregnancy" means healthcare treatment outside of standard prenatal care and labor and delivery services that is recommended by a licensed health professional to occur immediately to protect the health of the pregnant or birthing individual or the fetus.
(n)(1) By October 21, 2024, the Department of Health ("Department") shall award one or more competitive grants totaling at least $150,000 to non-governmental entities to train, compensate, and supervise at least 50 high school students to work in public and public charter high schools as sexual health educators ("student health educators").
(2) To qualify for the grant established by this subsection, an applicant shall include in its application:
(A) A list of at least 8 public or public charter school high schools, with a preference for schools located in Wards 5, 7, or 8, with whom the applicant intends to partner;
(B) The number of student health educators the applicant plans to hire, train, compensate, and supervise;
(C) The types of interventions the applicant will train student health educators to perform, including classroom presentations on pregnancy prevention, condom distribution, and referrals to sexually transmitted infection testing centers, and target numbers for each intervention type;
(D) Confirmation that the applicant is based in the District;
(E) Demonstrated experience providing programming to youth ages 14 to 21 related to sexual and reproductive health; and
(F) A commitment to provide quarterly reports to the Department that shall include:
(i) A list of public and public charter high school students working as student health educators;
(ii) A list of interventions performed by student health educators and how many students were reached by each intervention;
(iii) The total number of training hours conducted with student health educators and the topics covered, including the number of student health educators who participated in each training session;
(iv) A list of the training topics that were covered during the reporting period; and
(v) Progress made on objectives and benchmarks identified in the grant agreement.
§ 7–736.02. Communicable and Chronic Disease Prevention and Treatment Fund.
(a) There is established as a special fund the Communicable and Chronic Disease Prevention and Treatment Fund (“Fund”), to be administered by the Department of Health in accordance with subsection (c) of this section.
(b) The Fund shall consist of revenue from the following sources related to the prevention and treatment of communicable and chronic diseases by the Department of Health:
(1) Third-party payors;
(2) Sliding-fee scale collections; and
(3) Other collections.
(c) The Fund shall be used for operations necessary to provide communicable and chronic disease prevention and treatment services.
(d)(1) The money deposited into the Fund, and interest earned, shall not revert to the unrestricted fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time.
(2) Subject to authorization in an approved budget and financial plan, any funds appropriated in the Fund shall be continually available without regard to fiscal year limitation.
§ 7–736.03. Communicable disease fees.
(a) The Director of the Department of Health may establish a schedule of fees for the prevention and treatment of communicable diseases, including HIV/AIDS, hepatitis, sexually transmitted diseases, and tuberculosis to be provided to any individual who presents for prevention or treatment services, regardless of health insurance coverage or ability to pay. The Director may periodically revise the schedule of fees and may establish a sliding fee scale, based on income, for uninsured individuals. The fees, including any sliding fee scale, shall be published in the District of Columbia Register.
(b) The Director may seek reimbursement from any third-party payor for services provided relating to the prevention and treatment of communicable diseases.
§ 7–736.04. Establishment of the grocery access pilot grant program.
(a) In Fiscal Year 2025, the Department of Health shall establish a grocery access pilot grant program for the purpose of providing up to 1,000 eligible District residents with membership in a grocery delivery service at no cost for one year.
(b)(1) To be eligible to participate in the pilot program, an applicant shall:
(A) Be a resident of the District; and
(B) Be enrolled in the Supplemental Nutrition Assistance Program Education ("SNAP-Ed") program.
(2) The Department of Health shall give preference to an applicant who lives in an "eligible area" as that term is defined in § 47-3801(1D)(A).
(c) At the conclusion of the one-year pilot program, the Department of Health shall incorporate the data collected in the program in their SNAP-Ed program.
(d) The data collected pursuant to subsection (c) of this section shall be made available to the Council upon request.
§ [7–736.05]. Tobacco Use Cessation Fund.
(a) There is established as a special fund the Tobacco Use Cessation Fund ("Fund"), which shall be administered by the Department of Health in accordance with subsection (c) of this section.
(b) There shall be deposited into the Fund:
(1) Such funds as may be appropriated for that purpose; and
(2) Beginning in Fiscal Year 2025, 50% of the amounts, less attorneys' fees, received by the District in the settlement of District of Columbia v. JUUL Labs Inc., Superior Court of the District of Columbia Case No. 2019 CA 007795 B ("Settlement Funds").
(c) Money in the Fund shall be used for the following purposes:
(1) Investigators, including youth associates, to attempt vaping purchases;
(2) Social media countermarketing campaign featuring District youth;
(3) Developing and conducting a bi-annual survey on District youth use of vaping products;
(4) Educating District youth on health risks associated with vaping and tobacco use, skills to prevent use and support cessation, and shifting social norms around vaping and tobacco use; and
(5)(A) Developing a bi-annual report detailing how the Settlement Funds allocated to the Department have been spent and providing updated data from the survey required in paragraph (3) of this subsection and other relevant sources on District youth use of vaping products.
(B) The report required by this paragraph shall be published each year that the Department is not conducting the survey required in paragraph (3) of this subsection.
(d)(1) The money deposited into the Fund but not expended in a fiscal year shall not revert to the unassigned fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time.
(2) Subject to authorization in an approved budget and financial plan, any funds appropriated in the Fund shall be continually available without regard to fiscal year limitation.
§ 7–737. Rules.
The Mayor, pursuant to subchapter I of Chapter 5 of Title 2, shall issue rules to implement the provisions of this chapter.
Subchapter II. Inspections, Penalties, Waiver, and Employee Rights.
§ 7–741.01. Definitions.
For the purposes of this subchapter, the term:
(1) "Electronic smoking device" means any product, including one composed of a heating element, battery, or electronic circuit, that contains or delivers nicotine or any other substance intended for human consumption that can be used by a person to simulate smoking through inhalation of vapor or aerosol from the product. The term "electronic smoking device" includes any such product, regardless of whether it is manufactured, distributed, marketed, or sold as an e-cigarette, e-cigar, e-pipe, e-hookah, vape pen, or by any other product name or descriptor.
(1A) “Enclosed area” means all the space between a floor and ceiling that is enclosed on all sides by solid walls or windows or doors, exclusive of doorways, that extend from the floor to the ceiling.
(2) “Place of employment” means an enclosed area under the control of a public or private employer that employees normally frequent during the course of employment, including work areas, employee lounges, restrooms, conference rooms, classrooms, employee cafeterias, hallways, and vehicles owned by a private employer, if the vehicle is used by more than one person, and excludes a private residence, unless it is used as a child care, adult day care, or health care facility.
(3) “Public place” means an enclosed area to which the public is invited or in which the public is permitted, including banks, educational facilities, health care facilities, Laundromats, public transportation facilities, reception areas, restaurants, retail food production and marketing establishments, nightclubs, retail service establishments, retail stores, shopping malls, sports arenas, taverns, theaters, and waiting rooms, and excludes a private residence, unless it is used as a child care, adult day care, or health care facility.
(4) "Smoking" means the inhaling, exhaling, burning, or carrying of a lightedor heated cigar, cigarette, pipe, electronic smoking device, or any other tobacco or plant product intended for human consumption through inhalation, in any manner or in any form.
(5) “Tobacco bar” means a restaurant, tavern, brew pub, club, or nightclub that generates 10% or more of its total annual revenue from the on-site sale of tobacco products, excluding sales from vending machines, or the rental of on-site humidors.
§ 7–741.02. Smoking prohibitions; inspections.
The Department of Health is authorized to conduct inspections of all places of employment and public places to ensure that the activity of smoking in such places, which is hereby prohibited, is not taking place, except that:
(1) Between April 4, 2006, and January 1, 2007, the smoking prohibition set forth in this section shall not apply to a brew pub, club, nightclub, or tavern as those entities are defined in § 25-101 or the bar and bar area of a restaurant. This exception shall not apply to an indoor restaurant table of a restaurant, as defined in § 25-101.
(2) After January 1, 2007, the exception described in paragraph (1) of this section shall expire and smoking shall be prohibited in all places of employment and public places at all times.
(3) The places described in this chapter shall be required to post signs pursuant to § 7-1704 and in accordance with regulations issued pursuant to subchapter I of Chapter 17 of this title or any other District law.
§ 7–741.03. Exemptions.
(a) The following places shall be exempt from the provisions of this subchapter:
(1) A retail store that is used primarily for the sale of tobacco products and accessories in which the total annual revenue generated by the sale of non-tobacco products or accessories is no greater than 25% of the total revenue of the establishment; provided, that it does not share space with any other establishment;
(2) A tobacco bar;
(3) An outdoor area of a restaurant, tavern, club, brew pub, or nightclub;
(4) A hotel room or motel room rented to one or more guests;
(5) A medical treatment, research, or nonprofit institution where the activity of smoking is conducted for the purpose of medical research or is an integral part of a smoking cessation program; and
(6) Theatrical productions.
(b) A hotel licensed under § 25-113 shall be exempt from the provisions of this part once a year for one day for the purposes of hosting a special event which permits cigar smoking; provided, that the hotel shall:
(1) Notify the Department of Health in writing in advance of the event;
(2) Pay a fee of $2,500 to be remitted to the Regulatory Enforcement Fund as established under § 7-732 [repealed]; and
(3) Permit employees to opt out of working the special event with no penalty.
§ 7–741.04. Penalties.
An employer or person who willfully violates the requirements of this chapter by:
(1) Smoking in a prohibited area shall be subject to a fine of not less than $100 or more than $1,000; subsequent offenses shall be subject to a fine of not less than $200 or more than $1,000;
(2) Obscuring, removing, defacing, mutilating or destroying any sign posted in accordance with the provisions of this chapter shall be subject to a fine of $500; or
(3) Failing to post or maintain warning signs describing the prohibited activity and failing to notify a person observed to be smoking to stop the activity, as required by this subsection, shall be subject to a fine of $500; each day that a violation continues shall constitute a separate offense.
§ 7–741.05. Economic hardship waiver.
(a) The Mayor may grant an economic hardship waiver from the requirements of this subchapter; provided, that prior to the granting of a waiver, the applicant establishes, to the satisfaction of the Mayor, that compliance with the requirements of this subchapter has caused or will cause undue financial hardship. An economic hardship waiver shall be based on regulations issued in accordance with § 7-741.07.
(b) Notwithstanding any other provision of law, places of employment and public places where smoking is permitted pursuant to subsection (a) of this section shall:
(1) Have been in existence on or before January 1, 2007;
(2) Not permit smoking in an area that exceeds 25% of the total area, if the place of employment or public place is a restaurant as defined in § 25-101; and
(3) Be subject to conditions or restrictions as may be necessary to minimize the adverse effects of smoking and shall be consistent with the general purpose of this subchapter.
§ 7–741.06. Employee rights and protections.
(a) Places of employment and enclosed public places that permit smoking pursuant to this chapter shall not require employees to work in smoking areas provided that an employee requests to work solely in non-smoking areas.
(1) An employee who is aggrieved by a violation of this subsection shall have a private cause of action against the owner, manager, or person in charge of the place of employment or public place.
(2) An employee shall pursue and exhaust all remedies available pursuant to any collective bargaining agreement, grievance procedure, or other established means of resolving employer-employee disputes to resolve a violation of this subsection prior to commencing a civil action.
(b) An owner, manager, or other person responsible for a place of employment or public place that permits smoking under this subchapter shall not:
(1) Require an employee to work in a smoking area; provided, the employee requests to work in the non-smoking area only;
(2) Discharge or otherwise discriminate against any employee with respect to compensation or any other term, condition, or privilege of employment on the basis that the employee or applicant requested to work in a non-smoking area; or
(3) Discharge, refuse to hire, or in any manner retaliate against an employee, applicant for employment, or customer because that employee, applicant, or customer exercises any rights afforded by this chapter or reports a violation of this chapter.
(c) An employee who is aggrieved by a violation of this section shall be entitled to recover damages, including lost or back wages or salary. The court, in its discretion, may allow the prevailing party a reasonable attorney’s fee as part of the costs.
§ 7–741.07. Rulemaking.
The Mayor is authorized to promulgate rules necessary to implement this chapter. Any proposed regulations issued pursuant to this chapter shall be submitted to the Council for a 60-day period of review, excluding Saturdays, Sundays, legal holidays, and days of Council recess. If the Council does not approve or disapprove the proposed regulations, in whole or in part, by resolution within this 60-day review period, the proposed rules shall be deemed approved.
Subchapter III. Cottage Foods.
§ 7–742.01. Definitions.
For the purposes of this subchapter, the term:
(1) “CFBR” means the Cottage Food Business Registry within the Department of Health.
(2) “Cottage food business” means a business that:
(A) Produces or packages cottage food products in a residential kitchen;
(B) Sells the cottage food products in accordance with § 7-742.02 and regulations adopted by the Department of Health; and
(C) Repealed.
(D) Has obtained a home occupancy permit from the Department of Consumer and Regulatory Affairs pursuant to section 203 of Title 11 of the District of Columbia Municipal Regulations (11 DCMR Section 203).
(2A) "Cottage food business identification number and certificate" means the unique identifier for tracking cottage food businesses and the certificate evidencing status as a cottage food business.
(3) “Cottage food product” means a non-potentially hazardous food, as specified in regulations adopted by the Department of Health, that is sold to consumers, including through direct, retail, and online sales, within the District of Columbia in accordance with § 7-742.02 and regulations adopted by the Department of Health.
(4) “Department” means the Department of Health.
(5) "Food establishment" shall have the same meaning as provided in § 48-102(5).
§ 7–742.02. Cottage food businesses.
(a) This section shall not:
(1) Apply to a food establishment that is required to have a license under Department regulations; or
(2) Exempt a cottage food business from any applicable District or federal tax laws.
(b)(1) A cottage food business shall register with the Cottage Food Business Registry within the Department before beginning operation.
(2) The Department may perform an inspection of the cottage food business before that business may sell its cottage food products.
(3) The Department shall issue a cottage food business identification number and certificate to each registered cottage food business. Upon receipt of a cottage food business identification number and certificate, the cottage food business shall be authorized to produce, package, and sell the temperature control for safety food products on the approved food products list issued by the Department, set forth in section 103.5 of Title 25-K of the District of Columbia Municipal Regulations (25-K DCMR 103.5). The cottage food business shall not produce, package, or sell any food products that are not allowed by the Department nor use any processes and activities that are not allowed by the Department.
(4) The Department shall have the authority to enter the premises of a cottage food business registered with the CFBR to conduct a pre-operational inspection and to investigate complaints pertaining to the sale or preparation of cottage food products pursuant to subsection (d) of this section.
(c) The owner of a cottage food business may sell only cottage food products that are:
(1) Stored on the premises of the cottage food business; and
(2) Prepackaged with a label that contains the following information:
(A) The cottage food business identification number;
(B) The name of the cottage food product;
(C) The ingredients of the cottage food product in descending order of the amount of each ingredient by weight;
(D) The net weight or net volume of the cottage food product;
(E) Allergen information as specified by federal labeling requirements;
(F) If any nutritional claim is made, nutritional information as specified by federal labeling requirements; and
(G) The following statement printed in 10-point or larger type in a color that provides a clear contrast to the background of the label: “Made by a cottage food business that is not subject to the District of Columbia's food safety regulations.
(d)(1) The Department may investigate any complaint alleging that a cottage food business has violated this section.
(2) On receipt of a complaint, a representative of the Department, at a reasonable time, may enter and inspect the premises of a cottage food business to determine compliance with this section.
(3) The owner of a cottage food business may not:
(A) Refuse to grant access to a representative who requests to enter and inspect the premises of the cottage food business under paragraph (2) of this subsection; or
(B) Interfere with any inspection under paragraph (2) of this subsection.
(4) An investigation of a cottage food business conducted under this subsection may include sampling of a cottage food product to determine if the cottage food product is misbranded or adulterated.
(e) The Mayor, pursuant to subchapter I of Chapter 5 of Title 2 [§ 2-501 et seq.], may issue rules to implement the provisions of this subchapter. The proposed regulations shall be submitted to the Council for a 60-day period of review, excluding Saturdays, Sundays, legal holidays, and days of Council recess. If the Council does not approve or disapprove the proposed regulations, in whole or in part, by resolution within this 60-day review period, the proposed rules shall be deemed approved.
§ 7–742.03. Cottage food prepared or stored in a private home.
(a) Food prepared or stored in a private home shall not be used or offered for human consumption in a food establishment, except as provided in section 3806 of Title 25-A of the District of Columbia Municipal Regulations (25-A DCMR 3806) or when prepared by a cottage food business in accordance with § 7-742.02(a).
(b) A food establishment shall not include a cottage food business operating in accordance with § 7-742.02(a).
Subchapter III-A. Microenterprise Home Kitchens.
§ 7–742.11. Definitions.
For the purposes of this subchapter, the term:
(1) "Department" means the Department of Health.
(2) "Food establishment" shall have the same meaning as provided in § 48-102(5).
(3) "Microenterprise home kitchen business means a business that:
(A) Operates out of a non-commercial kitchen facility located in a private home and is operated by a resident of the home where ready-to-eat food is handled, stored, or prepared to be offered for sale;
(B) Sells ready-to-eat food products directly to consumers in accordance with § 7-742.12 and regulations adopted by the Department of Health;
(C) Has obtained a home occupancy permit from the Department of Licensing and Consumer Protection pursuant to section 203 of Title 11 of the District of Columbia Municipal Regulations (11 DCMR § 203);
(D) Does not prepare food with processes that require a Hazard Analysis and Critical Control Point (HACCP) Plan pursuant to section 4202 of Title 25-A of the District of Columbia Municipal Regulations (25-A DCMR § 4202);
(E) Does not include food manufacturing, and does not prepare alcohol-infused food products or food products containing cannabis, CBD, Kava, Kratom or any other unapproved food additive;
(F) Is not a catering business, cottage food business, bed and breakfast, residence-based group home facility, or food truck;
(G) Meets labeling requirements set forth in rules issued by the Department; and
(H) Has applied for and is otherwise eligible for a vending site permit under Chapter 1A of Title 37.
(4) "Microenterprise home kitchen permit" means a permit issued by the Department to an operator for the purpose of operating a microenterprise home kitchen business.
(5) "Operator" means an individual who resides in the private home and who manages or controls the microenterprise home kitchen business.
(6) "Ready-to-eat food" means:
(A) Fully cooked food, including, but not limited to, meat, fish, fruit, and vegetables;
(B) Raw fruit and vegetables that are washed and offered for sale whole or chopped;
(C) Any other time or temperature control food that is cooked to the temperature and time required for the specific food in accordance with regulations made by the Department; or
(D) A bakery item for which further cooking is not required for food safety.
(7) "Time or temperature control food" means food that requires time or temperature controls for safety to limit pathogenic microorganism growth or toxin formation.
§ 7–742.12. Microenterprise Home Kitchen Businesses.
(a) This section shall not:
(1) Apply to a food establishment that is required to have a license under Department regulations; or
(2) Exempt a microenterprise home kitchen business from any applicable District or federal tax laws.
(b) The Department shall develop a microenterprise home kitchen permit and develop standards and regulations relating to the requirements of this permit.
(c) A microenterprise home kitchen business shall register with the Department before beginning operation.
(d) The Department may perform a pre-operational inspection of the microenterprise home kitchen business before that business begins operation.
(e)(1) The Department may enter the premises of a microenterprise home kitchen business with a permit issued by the Department during the operating hours of the microenterprise home kitchen to conduct:
(A) Scheduled pre-operational and compliance inspections with reasonable advance notice of the inspection; or
(B) Unannounced inspections when the Department has a valid reason, which could include a consumer complaint, to suspect that a microenterprise home kitchen poses an imminent health hazard or is the source of an adulterated food or of an outbreak of illness caused by a contaminated food.
(2) The Department shall document the reason for any inspection after an initial inspection, keep a copy of the documentation on file with the microenterprise home kitchen's permit, and provide a copy of that documentation to the operator.
(f) An operator may qualify for a microenterprise home kitchen permit; provided, that:
(1) Food that is prepared at the microenterprise home kitchen is handled, stored, and prepared in compliance with Department regulations;
(2) The kitchen facility used to prepare food for the microenterprise home kitchen meets the requirements established by the Department;
(3) The operator provides written standard operating procedures to the Department that include:
(A) Proposed procedures and methods for how all food will be stored, handled, and prepared;
(B) Proposed procedures and methods of food preparation and handling;
(C) Procedures, methods, and schedules for cleaning utensils and equipment;
(D) Procedures and methods for the disposal of refuse; and
(E) A plan for maintaining time or temperature control food at the appropriate temperatures for each time or temperature control food.
(4) The operator operates only during the hours and only prepares the food items approved in the microenterprise home kitchen permit;
(5) The operator provides notification to the consumer that, while a permit has been issued by the Department, the kitchen does not meet all of the requirements of a commercial retail food establishment; and
(6) The operator successfully passes a nationally accredited Certified Food Protection Manager Course approved by the Department and obtains a District-issued Certified Food Protection Manager Certificate.
(g) An operator can apply to amend their permit by submitting a written proposal in a format determined in rules developed by the Department;
(h) The Department shall not require, as a condition of obtaining a microenterprise home kitchen permit, that an operator:
(1) Rent or lease space at a commercial kitchen outside of their home;
(2) Rent or purchase equipment, utensils, or display containers or equipment, other than what is required for safe storage, handling, and preparation of the food offered for sale;
(3) Have additional hand-washing facilities in their home, except to require that a hand washing station supplied with warm water and soap be conveniently located in food preparation, food dispensing, and warewashing areas;
(4) Have additional kitchen sinks, except to require that the kitchen sink has hot and cold water and is fully operational;
(5) Limit the individuals permitted in food preparation areas, food storage areas, and washing areas, except during food preparation;
(6) Limit the presence of animals in the home, except to require that all animals are kept outside of food preparation areas;
(7) Use specific materials for food-contact and non-food contact surfaces; provided, that the food-contact surfaces are smooth, easily cleanable, and in good repair; or
(8) Install significant equipment or make significant renovations to the home, beyond what would be required to ensure food and human safety in the food preparation areas.
(i) The Department has the authority to issue citations and summarily suspend or revoke a permit if an operator is not complying with any provisions set forth in this section.
(j) A person whose license or permit is revoked may, within 15 days after the notice of revocation by the Department, appeal the decision to the Office of Administrative Hearings.
§ 7–742.13. Rulemaking.
(a) The Mayor, pursuant to subchapter I of Chapter 5 of Title 2, shall promulgate emergency rules to implement the provisions of this subchapter no later than 45 days after July 1, 2023.
(b) The Mayor, pursuant to subchapter I of Chapter 5 of Title 2, shall promulgate final rules to implement the provisions of this subchapter no later than 120 days after July 1, 2023.
Subchapter IV. Health Occupation Advisory Committees.
§ 7–743.01. Generally.
(a) The Department of Health shall oversee the Health Occupation Advisory Committees established under this subchapter.
(b) All appointments to the Health Occupation Advisory Committees shall be made by the Director of the Department of Health.
(c) The Department of Health shall provide facilities and other administrative support for the Health Occupation Advisory Committees, as determined by the Director.
(d) The Health Occupation Advisory Committees shall review applications for licensure to practice upon request of the Board of Medicine. The Health Occupation Advisory Committees shall submit their respective recommendations to the Board of Medicine for action.
(e) For the purposes of this subchapter, the term:
(1) “Board of Medicine” means the Board of Medicine established pursuant to § 3-1202.03(a).
(2) “Health Occupation Advisory Committees” means the advisory committees established pursuant to this subchapter.
§ 7–743.02. Advisory Committee on Acupuncture. [Repealed]
Repealed.
§ 7–743.03. Advisory Committee on Anesthesiologist Assistants.
(a) There is established an Advisory Committee on Anesthesiologist Assistants to consist of 3 members as follows:
(1) The Director of the Department of Health, or his or her designee;
(2) An anesthesiologist licensed in the District with experience working with anesthesiologist assistants; and
(3) An anesthesiologist assistant licensed in the District.
(b) Of the appointees to the Advisory Committee on Anesthesiologist Assistants other than the Director, one shall serve an initial term of 2 years and one shall serve an initial term of 3 years. Subsequent appointments shall be for terms of 3 years.
(c)(1) The Advisory Committee on Anesthesiologist Assistants shall develop and submit to the Board of Medicine guidelines for licensing and regulating anesthesiologist assistants in the District. The guidelines shall set forth the actions that anesthesiologist assistants may perform under the direct supervision of a licensed anesthesiologist, who shall be responsible for the overall medical direction of the care and treatment of patients.
(2)(A) Guidelines approved by the Board of Medicine under § 3-1202.03 shall remain in effect until revised guidelines are submitted to and approved by the Board of Medicine.
(B) The Advisory Committee on Anesthesiologist Assistants shall submit revised guidelines to the Board of Medicine by June 22, 2015.
(3) The Advisory Committee on Anesthesiologist Assistants shall meet at least annually to review the guidelines and make necessary revisions for submission to the Board of Medicine.
§ 7–743.04. Advisory Committee on Naturopathic Medicine. [Repealed]
Repealed.
§ 7–743.05. Advisory Committee on Physician Assistants. [Repealed]
Repealed.
§ 7–743.06. Advisory Committee on Polysomnography.
(a) There is established an Advisory Committee on Polysomnography to consist of 3 members as follows:
(1) The Director of the Department of Health, or his or her designee; and
(2) Two polysomnographic technologists licensed in the District.
(b) Of the appointees to the Advisory Committee on Polysomnography other than the Director, one shall serve an initial term of 2 years and one shall serve an initial term of 3 years. Subsequent appointments shall be for terms of 3 years.
(c)(1) The Advisory Committee on Polysomnography shall develop and submit to the Board of Medicine guidelines for licensing, registration, and regulation of polysomnographic technologists, polysomnographic technicians, and polysomnographic trainees in the District. The guidelines shall set forth the education and experience requirements for registration and licensure and the actions that polysomnographic technologists, polysomnographic technicians, and polysomnographic trainees may perform.
(2)(A) Guidelines approved by the Board of Medicine under § 3-1202.03 shall remain in effect until revised guidelines are submitted to and approved by the Board of Medicine.
(B) The Advisory Committee on Polysomnography shall submit revised guidelines to the Board of Medicine by June 22, 2015.
(3) The Advisory Committee on Polysomnography shall meet at least annually to review the guidelines and make necessary revisions for submission to the Board of Medicine.
§ 7–743.07. Advisory Committee on Surgical Assistants.
(a) There is established an Advisory Committee on Surgical Assistants to consist of 5 members as follows:
(1) The Director of the Department of Health, or his or her designee;
(2) A surgeon licensed in the District with experience working with surgical assistants; and
(3) Three surgical assistants licensed in the District.
(b) Of the appointees to the Advisory Committee on Surgical Assistants other than the Director, 2 shall serve an initial term of 2 years and 2 shall serve an initial term of 3 years. Subsequent appointments shall be for terms of 3 years.
(c)(1) The Advisory Committee on Surgical Assistants shall develop and submit to the Board of Medicine guidelines for licensing and regulating surgical assistants in the District. The guidelines shall set forth the actions that surgical assistants may perform in collaboration with a licensed surgeon, who shall be responsible for the overall medical direction of the care and treatment of patients.
(2)(A) Guidelines approved by the Board of Medicine under § 3-1202.03 shall remain in effect until revised guidelines are submitted to and approved by the Board of Medicine.
(B) The Advisory Committee on Surgical Assistants shall submit revised guidelines to the Board of Medicine by June 22, 2015.
(3) The Advisory Committee on Surgical Assistants shall meet at least annually to review the guidelines and make necessary revisions for submission to the Board of Medicine.
§ 7–743.08. Advisory Committee on Athletic Trainers.
(a) There is established an Advisory Committee on Athletic Trainers to consist of 5 members as follows:
(1) The Director of the Department of Health, or his or her designee; and
(2) Four athletic trainers licensed in the District.
(b) Of the appointees to the Advisory Committee on Athletic Trainers other than the Director, 2 shall serve an initial term of 2 years and 2 shall serve an initial term of 3 years. Subsequent appointments shall be for terms of 3 years.
(c)(1) The Advisory Committee on Athletic Trainers shall develop and submit to the Board of Medicine guidelines for licensing, registration, and regulation of athletic trainers in the District. The guidelines shall set forth the education and experience requirements for registration and licensure and the actions that athletic trainers may perform.
(2)(A) Guidelines approved by the Board of Medicine under § 3-1202.03 shall remain in effect until revised guidelines are submitted to and approved by the Board of Medicine.
(B) The Advisory Committee on Athletic Trainers shall submit revised guidelines to the Board of Medicine by October 1, 2019.
(3) The Advisory Committee on Athletic Trainers shall meet at least annually to review the guidelines and make necessary revisions for submission to the Board of Medicine.
§ 7–743.09. Advisory Committee on Maternal Care Professionals.
(a)(1) There is established an Advisory Committee on Maternal Care Professionals ("Advisory Committee") to consist of 7 members as follows:
(A) The Director of the Department of Health, or designee;
(B) Two certified professional midwives, as that term is defined in § 3-1201.01(1D);
(C) One doula, as that term is defined in § 3-1201.01(6C);
(D) One licensed physician who is an obstetrician certified by the American Board of Obstetrics and Gynecology and who has professional experience working with certified professional midwives or other community-based midwives;
(E) One certified nurse-midwife or certified midwife, as those terms are defined in § 3-1201.01(1C) and (1B-i), who has worked in a non-hospital setting or who has professional experience working with certified professional midwives; and
(F) One consumer member who has experience with either midwifery or doula services.
(2) Individuals appointed in accordance with paragraph (1) of this subsection who are required to be licensed or certified shall be licensed or certified to practice their respective professions in the District.
(b) Of the appointees to the Advisory Committee, other than the Director of the Department of Health, 3 shall serve an initial term of 2 years and 3 shall serve an initial term of 3 years. Subsequent appointments shall be for terms of 3 years.
(c) The Advisory Committee shall advise the Board of Medicine on:
(1) Certifying doulas and regulating the practice of doulas in the District;
(2) Regulating the practice of certified professional midwifery in the District and developing guidelines for licensing certified professional midwives that shall:
(A) Be consistent with the standards of practice and ethical conduct established by the National Association of Certified Professional Midwives and the North American Registry of Midwives ("NARM"); provided, that these practice guidelines shall not be interpreted to set, establish, define, enumerate, or otherwise lower the applicable standard of care for a certified professional midwife or certified nurse-midwife;
(B) Define expected standards of practice and conduct;
(C) Specify a process for a certified professional midwife to obtain appropriate screening and testing for clients, including laboratory tests, urinalysis, and ultrasounds;
(D) Specify a process for a certified professional midwife to obtain and administer antihemorrhagic agents, including:
(i) Pitocin, oxytocin, misoprostol, and methergine;
(ii) Intravenous fluids, neonatal injectable vitamin K, newborn antibiotic eye prophylaxis, oxygen, intravenous antibiotics for Group B Streptococcal antibiotic prophylaxis, Rho (D) immune globulin, local anesthetic, epinephrine, and terbutaline for non-reassuring fetal heart tones and cord prolapse pending transport;
(iii) Globulin, local anesthetic, and epinephrine; and
(iv) Other pharmaceutical agents, consistent with either the scope of the practice of midwifery, or a prescription issued by a health professional for a patient-client of a midwife, that are approved by the Board of Medicine;
(E) Authorize medical device distributors and manufacturers to issue breast pumps, compression stockings and belts, and maternity belts to certified professional midwives;
(F) Require a certified professional midwife to provide each client with a signed informed consent form that describes the certified professional midwife's qualifications, education, a copy of the certified professional midwife's emergency plan, whether the certified professional midwife carries professional liability insurance, and the benefits and risks of birth in the setting of choice of the patient-client, and maintain a record of each patient-client's signed informed consent form;
(G) Require a certified professional midwife, subject to the consent of the patient-client, to report the patient-client's data to a national data registry, such as the Midwives Alliance of North America Statistical Registry or the AABC Perinatal Registry;
(H) Adopt professional continuing education requirements for certified professional midwives consistent with those required by NARM for recertification;
(I) Establish requirements for peer review consistent with those required by NARM for recertification under which information disclosed for peer review shall be protected in accordance with § 44-805; and
(J) Require the certified professional midwife to file a birth certificate for each live birth attended by a certified professional midwife, in accordance with § 7-231.08.
(d) Guidelines developed pursuant to subsection (c)(2) of this section shall not be interpreted to set, establish, define, enumerate, or otherwise lower the applicable standard of care for a licensed physician, licensed naturopathic physician, certified professional midwife, certified nurse-midwife, certified midwife, doula, or licensed basic or advanced emergency medical technician.
(e) Guidelines currently approved by the Board of Medicine under § 3-1202.03, shall remain in effect until revised guidelines are submitted to and approved by the Board of Medicine.
§ 7–743.10. Advisory Committee on Medical Radiation Technologists.
(a) There is established an Advisory Committee on Medical Radiation Technologists ("Committee"), which shall consist of the following 5 members:
(1) A physician licensed in the District whose practice consists mostly of the type of medicine that requires significant interaction with medical radiation technologists;
(2) Three individuals who work as medical radiation technologists; and
(3) A consumer member with no direct affiliation with medical radiation technology or a member of another health profession.
(b) To remain qualified to serve as a member of the Committee, the medical radiation technologist members who serve as initial appointees shall become licensed or registered in their profession within 180 days of the Department of Health's implementation of the licensure or registration requirements.
(c) The Committee shall develop and submit to the Board of Medicine guidelines and proposed regulations for the licensure and regulation of cardiovascular-interventional technologists, computed tomography technologists, magnetic resonance technologists, mammographers, nuclear medicine technologists, radiation therapists, radiographers, ultrasound technologists, and radiologist assistants.
Subchapter V. Dementia Services.
§ 7–744.01. Dementia Services Coordinator.
There is established within the Department of Health the position of the Dementia Services Coordinator ("Coordinator"), who shall be a full-time employee of the District. The Coordinator shall be responsible for:
(1) Organizing dementia services within the District;
(2) Implementing and updating the District of Columbia State Plan on Alzheimer's Disease;
(3) Assessing and analyzing dementia-related data collected by the District;
(4) Evaluating the District's dementia services;
(5) Identifying and supporting the development of dementia-specific trainings; and
(6) Carrying out such other duties relevant to the support of individuals with dementia as may be assigned by the Director of the Department of Health.
§ 7–744.02. Dementia training for direct care workers.
(a) For the purposes of this section, the term:
(1) "Department" means the Department of Health.
(2) "Facilities or programs" means residential facilities or home-based and community-based programs that provide supportive services, including Skilled Nursing Facilities, as defined in 42 U.S.C. § 1395i-3(a), Assisted Living Residences, as defined in § 44-102.01(4), Home Care Agencies and Hospice, as defined, respectively, in § 44-501(a)(2) and (7) [§ 44-501(a)(7) and (8)], that have residents or program participants with Alzheimer's disease or related dementia in residential settings.
(3) "Covered administrative staff member" means a senior employee at a facility or program, including an administrator as well as a managerial staff member who directly supervises covered direct service staff members.
(4) "Covered direct service staff members" refers to staff members whose work involves extensive contact with residents or program participants, including certified nursing assistants, nurse aides, personal care assistants, home health or personal care aides, licensed practical nurses, licensed vocational nurses, registered nurses, social workers, activity directors and staff, dietary staff, physician assistants, nurse practitioners, physical, speech therapists, and occupational therapy staff.
(5) "Other covered staff member" refers to a staff member who is either a full-time or part-time employee, independent consultant, or a staff member of a contractor or subcontractor who has contact on a recurring basis with, but does not provide medical services for, residents or program participants, including housekeeping staff, front desk staff, other administrative staff, and other individuals who have incidental contact.
(b)(1) Facilities or programs shall provide initial training of at least 8 hours to:
(A) All covered direct service staff members, covered administrative staff members, and other covered staff members hired on, or within 6 months after, October 1, 2021 who shall begin dementia training within 90 days of the hire date, and complete the training within 120 days of the hire date; and
(B) All covered direct service staff members, covered administrative staff members, and other covered staff members who were employed prior to October 1, 2021 and who have not received equivalent training within the prior 24 months shall complete the initial training requirements within one year following publication by the Department of Health of acceptable trainings regulations.
(2) Each facility or program shall establish procedures for ongoing staff support regarding the treatment and care of persons with dementia, which shall include on-site mentoring programs and other support mechanisms developed by the Department.
(3) For covered direct service staff members and covered administrative staff members, the curriculum used for the initial training shall cover:
(A) Alzheimer's disease, and related dementia;
(B) Person-centered care;
(C) Assessment and care planning;
(D) Activities of daily living; and
(E) Dementia-related behaviors and communication.
(4) For covered administrative staff members, the curriculum used for the initial training shall also cover:
(A) Medical management information education and support;
(B) Staffing;
(C) Supportive and therapeutic environments; and
(D) Transitions and coordination of services.
(5) For other covered staff members, training shall include, at a minimum, an overview of dementia, principles of person-centered care, and communication issues.
(6) Initial dementia training shall be considered complete only after the staff member has taken and passed an evaluation.
(c)(1) Within 120 days after October 1, 2021, the Department shall identify and designate standardized trainings, including online trainings, and trainings currently used by providers that meet the requirements of subsection (b)(3) through (5) [of this section] and shall also establish a process whereby other non-standardized training programs will be determined to meet the requirements for dementia training.
(2) To receive approval by the Department, whether online or in-person, all training modules, presentations, materials, and evaluations must reflect current standards and best practices in the care and treatment of persons with dementia.
(3) The Department may also approve independent evaluation instruments currently used by providers that meet the Department's criterion for dementia training or develop an evaluation instrument or instruments that relate to the demonstration of competency.
(d)(1) The facility shall issue a certificate to covered staff members upon completion of dementia training, which certification shall be portable between settings within the District.
(2) Provided that the covered staff member does not have a lapse of dementia-related direct service or administration employment for 24 consecutive months or more, the covered staff member shall not be required to repeat the initial dementia training.
(3) Covered staff members shall be responsible for maintaining documentation regarding completed dementia trainings and evaluations.
(e)(1) A minimum of 4 hours of continuing education in each calendar year shall be required for covered administrative staff members and covered direct service staff members.
(2) A minimum of 2 hours of continuing education in each calendar year shall be required for other covered staff members.
(3) Such continuing education shall include new information on best practices in the treatment and care of persons with dementia.
(f)(1) Persons responsible for conducting in-person dementia trainings shall have, at a minimum:
(A) Two years of work experience related to Alzheimer's disease or other related dementias in health care, gerontology, or other related field; and
(B) Completed training equivalent to the requirements provided in this section, including successful passage of any skills competency or knowledge test required by the District.
(2) Covered staff members shall not be required to bear any of the cost of training offered by the facility or program and shall receive their normal compensation when attending required trainings.
(g)(1) The Department shall exercise oversight of a facility's or program's dementia training program as part of its comprehensive regulatory responsibilities, which shall:
(A) Ensure that the facility or program provides continuing education opportunities;
(B) Ensure that the facility or program uses designated online training programs or facility-based training that meets the requirements for dementia training in the District;
(C) Include a periodic review of the training evaluation, including the use of competency measures to demonstrate knowledge gained;
(D) Involve observation and assessment of the proficiencies of direct care staff; and
(E) Ensure compliance with any other requirements not specified above.
(2) The Department may use all of its enforcement tools to ensure that facilities or programs comply with these provisions.
(h) Where the training requirements established by this section differ or overlap with other District law or regulation, the more rigorous training requirements shall apply.
